If you are suffering from study pressure, exam stress, or general stress or anxiety….

Cognitive-behaviour (behavior) therapy, or CBT has been to be extremely effective. It is called an evidence-based treatment approach as large, well-controlled studies have proved its effectiveness – both here and overseas.

How does it work?

We all have a stream of thoughts going through our minds every moment of our waking lives. We are continuously having an internal dialogue with ourselves (some of us have this conversation out loud sometimes which can cause other people to look at us funny!).

These thoughts that we have are not necessarily reflecting the truth about things – they are merely our own "take" on life, and can be right, wrong, accurate or inaccurate.

Unfortunately, though, we tend to regard our thoughts as true, and as our thought affect our emotions, we can start to feel very bad – based only on our unreliable thoughts!

For example: if you always anticipate that awful things could happen in the future – your thoughts are often starting with "what  if"…you will undoubtedly feel anxious a great deal of the time!

People usually only dwell on the negative possibilities – like failing (if you are a student) or getting caught in a lift (if you are claustrophobic). Not many people have anxiety about winning the lottery!

CBT helps individuals recognise and alter unhelpful and innacurate thinking patterns so that they can begin to live happier and more mindful lives, free from debilitating anxiety and depression.

If you would like to experience CBT, please contact us!

It appears that we can blame it on evolution!

Why is it so difficult to stop our minds drifting to unpleasant and anxiety-provoking topics? Often this happens in the middle of the night, especially to insomniacs who often find that their thoughts prevent them from getting back to sleep.

Well, evolutionary psychologists put it down to the way in which our brains are wired, says Ronald Siegel in his article entitled “West meets East” in the September/October edition of Psychotherapy Networker (in which he discussed the link between psychotherapy and Eastern spiritual practices, such as mindfulness).

The arguement goes that the human beings of today have survived through natural selection only because, through thousands of years, they are the ones who were constantly on the lookout for danger and needed to be extremely adept at anticipating possible risks and life-threatening situations. So anxiety and fear kept you alive whilst happiness and complacency got you killed.

So, although the world has changed a great deal since the days of our cavemen ancestors, our physiology and the wiring of our brains have remained more or less the same, causing us to react to (usually) benign life events, such as traffic snarl-ups and work pressure, asif they were of the magnitude of a tiger hiding in the shadows, waiting to pounce.

So if we are wired for anxiety and stress, what can be done about it?

First it is necessary to develop an awareness of the problem. Then with the help of cognitive-behavioural techniques (CBT), relaxation training and mindfulness techniques it is possible to gain control of one’s thoughts and to calm down the mind. It is important to take on board that one’s thoughts are merely a product of one’s mind and are not necessarily accurate. It is quite possible to substitute more balanced thoughts for thoughts that lead to anxiety, stress and depression. This will help to calm the mind, paving the way for a more measured, focused and appreciative approach to life, including one’s relationships.

And this can only lead to an inhanced feeling of happiness and contentment!

Yesterday I conducted a stress management workshop for a group of Grade 11 and 12 learners. They were saying that they are feeling a great deal of stress and pressure at this stage because of their work-load and the thought of the upcoming exams.

I wish I could talk to all other learners and students out there about the importance of keeping their thoughts focused and not to dwell on the possibility that they might not do well! I use the analogy of the trapeze artist on the high-wire. If he/she allows him/herself to think that they might fall, this will probably happen (it becomes a self-fulfilling prophecy).

It is therefore crucial for students to monitor their thinking and alter their thoughts if they notice themselves becoming negative.  A pattern of “what-if ” thinking, for example “What if I can’t answer the questions in the paper and I fail” should therefore be banished and replaced by thoughts such as “I will do the best I can”. These ideas come from Cognitive Behaviour Therapy (CBT). “What-if”"thinking, if not controlled, can lead to runaway feelings of anxiety and stress.

I also spoke to the students about the importance of practicing relaxation and mindfulness exercises to help with focus and to calm the mind. It is also essential to pay attention to one’s body and health at times of pressure and stress – to eat well, exercise and to get sufficient sleep.

By keeping your stress levels in a zone that is optimal for you by doing the above, you will be well prepared, physically and psychologically, for the road ahead. All you will need to add to this recipe for success is a great deal of focused study!

Please contact me if you have any questions about the above or any other aspect of stress management.

Don’t allow your stress to run away with you in the build up to the examinations!

If you are a student I am sure that you are thinking a great deal about the forthcoming examinations! As a your future rests on getting good results the thought of the exams will be causing you some degree of stress!

Of course we all cope with stress in different ways and with varying degrees of success. Some of us have trouble sleeping whilst others suffer from anxiety, feelings of panic or physical ailments such as headaches and back pain.

If stress levels are too high or stress becomes chronic, it can seriously affect memory. Brain science has determined exactly why that is and how it works. However, all we need to know about this is that hormones and neurotransmitters that are released during the stress response (also called the “fight or flight” response) can block memory formation and retrieval. This is responsible for the common situation of “going blank” during an exam.

It is therefore imperative that students and learners take on board the essential knowledge and skills to enable them to gain control of their stress. These include cognitive behavioural therapy (CBT), relaxation training, visualisation and mindfulness training.

I will be presenting a workshop entitled “Preparing yourself for the Exams” in Claremont, Cape Town, On Saturday morning the 17th September. The workshop is open to Grade 11s and 12s and to students.

For more information about the workshop, please contact us.

Best wishes with your exam preparation!

When you know if your heart of hearts that your intimate relationship has become a major source of stress and unhappiness in your life , why don’t you break it off?

All your friends and family are giving you a consistent message that you would be better off without your current partner, why do you steadfastly resist their advice?

In my Cape Town psychology practice I often get clients who find themselves stuck in this position – they often feel desperate – they love their partner but he/she drives them crazy. They have often been in a destructive relationship for a long time and are feeling at the end of their tether.

Why won’t they admit that their relationship is doing them psychological harm, end it and move on with their lives?

The reasons people stay in toxic relationships are often complex and driven by largely unconscious factors such as:

1. The comfort of the familiar

In many cases there is the feeling that the bad relationship is comfortable in a sense, because it is known and predictable.

2. Needing to be needed

Clients often reveal a fear that their current relationship may be their last – that they will not find anyone else if they break off  their current relationship. There is a fear of being alone forever.

3. Trying to avoid “bad” feelings

Ending a relationship usually precipitates a sense of loss and mourning, with associated feelings of sadness (and even misery), anxiety, panic, and sometimes may trigger depression. Avoidance is a natural and normal tendency in the circumstances. However, we all need to face such feelings if we want to transform our lives for the better.

3. Poor self-esteem

Some individuals believe that they are not deserving of a caring, supportive relationship and of a happy, fulfilled life. There are, of course, always a number of unique, complex reasons for such an outlook. Often the underpinnings are to be found in the person’s early life experiences.

4. Not being able to say “no” or get their needs met

Clients caught up in toxic relationships often report that they feel unable to insist that their own needs get acknowledged – they often nag their partner to change but to no avail. They are in many cases locked into a co-dependent, enabling dynamic with their parnter where they feel helpless to change things for the better.

5. Believing one’s partner must/will change

Often I will hear “If only my partner were to realise the error of his/her ways and change for the better, our relationship would be good”.

This is a normal, but unfortunately, misguided belief!

It is crucial to accept that we can only change ourselves, if we become more strategic and positive in our interactions with our partners, our relationships have a chance to transform. However, if the other person in the relationship is not motivated to similarly change for the better, you may be doing yourself a big favour if you decide that enough is enough and to move on with your life!

How can parents help their teenage children to cope better in the build up to the end of year exams?

In my psychology practice I am seeing a number of teenagers at the moment who are starting to feel the pressure of looming end of year exams. One of my clients, who is in Grade 12, routinely stays up till 2.30 in the morning so that she can feel adequately prepared for the next day of school! Her parents are at their wits’ end because they feel their efforts to help their daughter have fallen on deaf ears.

Relationships between parents and their teenagers can come under serious strain during exam preparation time, especially for those with kids in Grade 11 and 12.  Schools and teachers tend to place a great deal of pressure and high expectations of their learners to do well, and in teenagers who are already internally driven to do well, the stress can become overwhelming and debilitating.

How can parents be of help to their children during this time?

1. Don’t get triggered by your teenager’s behaviour and attitude.

Teenagers are at a developmental stage where their brains are not yet fully developed and they are subject to hormonal surges and changes. They are thus often irrational, selfish, and idealistic – add to this the considerable stress of the upcoming exams and you have an extremely volatile personality to deal with! Try to be understanding and empathic, even though this may be extremely difficult! (You will probably need to find ways of dealing positively with your own stress levels – perhaps through exercise, talking to friends, yoga or meditation – and maybe all of these!).

2. Use your child as a consultant – listen to what your child has to say in terms of how you can be of help.

You may feel you are trying your best to help your teenager, but perhaps they may have their own ideas of how you can be of help. If you are tending to nag them about certain things, like getting to bed on time, your child may be perceiving this as adding to his/her stress. Your child may, in fact, come up with novel ways in which you can be a significant support.

3. Think strategically!

If your efforts in the past have not been met with a positive response by your teen, try something new. Advertising companies are very aware that if their campaigns don’t bear fruit, they will need to find another angle. As parents, we are also in the business of persuasion – and parenting to teenagers is definitely an example of a tough sell!

4.  Listen to yourself speak.

We need to be constantly aware of how we say things and the vocabulary we use as emtionally loaded words are easily able to trigger our unconscious.  Words and phrases such as “must”, “should”, “have-to”, “always” and “never” can cause instant feelings of  anxiety, stress, and panic in ourselves and also in the person we are speaking to (see more about this in Cognitive Behavioural Therapy, CBT).

As our unconcious minds do not process negatives, for example “don’t panic”, it is better to state ideas as a positive such as “remain calm” and suggest that your teenager “take things one step at a time”.

In future posts, I will return to this discussion.

Please contact me with any comments or queries.

If you are currently pregnant (or that your partner is pregnant), or you have just become a parent for the first time, it is an exciting and challenging time!

Newby moms and dads have a great deal to adjust to, so it is important to start the process as soon as you get the news!

So what can you do to make this journey as happy and smooth as possible and  how can you help your partner prepare for this new, exciting stage in your relationship?

1. Communicate, communicate! From the first

moment you find out that you are pregnant, begin to talk to your partner about the implications and ramifications for yourselves as individuals and also as a couple.  Becoming a parent and co-parenting with your spouse or partner presents many and varied challenges – to talk about and explore these beforehand will stand you in good stead for when the baby arrives.

2.  Operate as a team and be there for each other. Ask your partner what he/she needs from you at the various stages of the pregnancy and after the birth. A strong, mutually supportive relationship at this stage will ensure that when the baby arrives, an immediate family bond is established, which becomes a strong foundation for the future.

3. Look out for signs of emotional distress in your partner. Pre- and post-partum depression and anxiety is quite common and mostly goes unrecognised. Although emotion fluctuations are normal in pregnancy and post-delivery because of strong hormonal fluctuations,  if you notice that your partner seems depressed and/or anxious for

days on end, if she has trouble sleeping and stops doing her usually daily activities, it is important that you encourage her to go for counselling.

4. Make sure you are prepared for the delivery (both practically and psychologically).

Whether you opt for a natural birth or for a caesarian section, be aware that things don’t always go according to plan, so it is important not to get too invested in one option as circumstances may dictate a different scenario entirely.

5. Get support from outside.

The first weeks as new parents will be a roller-coaster ride! Make sure you have adequate family and/or friends around for support, as well as nursing/breastfeeding/medical backup.

If you have any questions, please do not hesitate to contact me.

Why thirty six hours of freedom can lead to a lifetime of sexual insecurity!

A recent ad on the radio for a variant of the “little blue pill” suggests that as soon as a man experiences the first hint of erectile problems he should not worry about identifying a cause (or causes) but should immediately go to his doctor for a prescription.

I believe this is shortsighted and extremely dangerous psychologically! (I am not saying that this type of medication has it’s place – what I am suggesting is that it is important that a full medical and psychological assessment be undertaken first).

An erection failure is invariably a highly stressful and anxiety-provoking event, often causing an immense sense of insecurity and self-doubt. Unless this is addressed through counselling or psychotherapy, the anxiety and doubt will remain, making it extremely difficult for the individual to take the chance to “fly solo” again, without the “help” of medication.

What impact will this have on one’s self-esteem and confidence!?

I therefore strongly suggest that anyone who is experiencing sexual problems first get themselves checked out, both medically and psychologically, and then, whether or not medication is considered, that a course

of counselling or psychotherapy be taken – not necessarily on a full stomach!

Doing well in your exams is not only a function of working hard – many bright and dedicated students bet owerwhelmed by anxiety and stress during exams, causing them to  “hit a blank”  at the critical moment.

How good are you at managing your stress?

It goes without saying that, in the 21st Century, the majority of psychologists and psychotherapists believe that individuals are all capable of making positive changes to their lives, no matter how old they (or we) may be, that change is possible right up to the moment that we take our last breath.

(This was not always the case. Freud, for example, believed that human development was complete after adolescence).

The great news is that increasingly detailed knowledge of the structure and workings of the brain from the exciting and rapidly developing field of neuroscience seem to back up this view. Neuroscientists speak

about “neuroplasticity” of the brain, meaning that our brains are

“a work in progress”, no matter what how old we are and that we are capable of  by doing and thinking in different ways, people are able to change old, counterproductive patterns of behaviour and ways of relating to partners, children and the world in general.

How can this be achieved?

First, old, dysfunctional patterns need to be interrupted and changed. This invariably happens in all forms of successful psychotherapy.

Second, the person needs to be trained to focus their attention in a conscious, purposeful way

Third,  a psychotherapist will help the client identify and then start to practise, new , more positive and healthy habits and patterns of behaviour, forming new neural networks in the brain. (see Pat Ogden, Sensorimotor Psychotherapy, Susan Aposhyan:Body-Mind Psychotherapy).

I see it as most encouraging that the new findings coming fromthe field of  neuroscience  provide scientific support to our work as psychologists and psychotherapists, and that psychologists utilising many different approaches, from Positive Psychology to Cognitive-Behavioural Therapy (CBT), all have the above, central elements in common!

Reference: Psychotherapy Networker, March/April 2011