If you live with ADHD, you probably already know that anxiety often comes along for the ride. The two aren’t the same thing, but they feed off each other in ways that can make daily life exhausting. The good news is that this combination is well understood by therapists, and there’s a trusted local option right here in Newcastle upon Tyne: Sian Barnard at Peaceful Minds, based in Gosforth.

Why ADHD and Anxiety Often Go Hand in Hand

ADHD affects how the brain manages attention, time, and impulse control. Anxiety, on the other hand, is about how the brain responds to perceived threat or uncertainty. On their own, they’re distinct experiences. But for many people with ADHD, anxiety develops as a kind of by-product:

• Masking and overcompensating. Years of trying to “keep up” with neurotypical expectations, remembering deadlines, sitting still in meetings, not interrupting, can leave the nervous system in a near-constant state of alert.
• Fear of forgetting or messing up. When your working memory is unreliable, everyday tasks can feel like a minefield, which naturally breeds worry.
• Rejection sensitivity. Many people with ADHD describe an intense fear of criticism or disapproval, which can shade into social anxiety over time.
• Sleep and routine disruption. ADHD often disrupts sleep and structure, and both of those are protective against anxiety when they’re stable.

Because the two conditions overlap so much, therapy that only addresses one side of the picture often falls short. That’s why finding a therapist who understands both ADHD and anxiety, rather than treating them as separate boxes to tick, tends to make the biggest difference.

What Kind of Therapy Actually Helps with ADHD-Related Anxiety?

A few approaches show up again and again in ADHD-informed anxiety treatment:

• CBT (Cognitive Behavioural Therapy), sometimes adapted specifically for ADHD, helps identify the thought patterns and avoidance behaviours that keep anxiety on a loop.
• Cognitive Behavioural Hypnotherapy (CBH), which pairs CBT with hypnotherapy techniques, can help calm the physical, in-the-moment symptoms of anxiety, racing thoughts, tension, poor sleep, while working on the underlying patterns.
• ACT (Acceptance and Commitment Therapy) focuses less on eliminating anxious thoughts and more on building a different relationship with them, while still moving toward what matters to you.
• EMDR, if anxiety is tangled up with past experiences of shame or trauma (which is common for people diagnosed later in life).

Meet Sian Barnard at Peaceful Minds, Gosforth

For anyone searching for ADHD anxiety therapy in Newcastle upon Tyne, Sian Barnard of Peaceful Minds is a well-established local option worth knowing about.

Sian is a psychotherapist and clinical hypnotherapist with an MSc in Cognitive Behaviour Therapy and Rational Emotive Behaviour Therapy from Goldsmiths, University of London, and over a decade of practice experience, including time working in central London before relocating to the North East. At Peaceful Minds, she combines CBT with hypnotherapy (CBH) to help clients work through anxiety, panic, low self-esteem, and the racing, overwhelmed feeling that so often accompanies ADHD.

Peaceful Minds Practice Details

• Practitioner: Sian Barnard, MSc CBT/REBT, Clinical Hypnotherapist
• Location: The Grainger Suite, Dobson House, Regent Centre, Gosforth, Newcastle upon Tyne, NE3 3PF
• Sessions: Face-to-face in Gosforth, plus online via Zoom or WhatsApp Video for flexibility
• Contact: 01670 631877 / 07737 491728
• Email: sian@peacefulminds.org.uk
• Website: https://peacefulminds.org.uk
• Getting Started: A free initial consultation is available so you can ask questions and decide whether the approach feels right before committing.

If racing thoughts, overwhelm, or constant low-level worry are making everyday life with ADHD harder than it needs to be, a conversation with Sian is a low-pressure way to explore whether CBT and hypnotherapy could help.

Other Ways to Get Support in Newcastle

NHS Talking Therapies (Free, Self-Referral)

Newcastle’s NHS Talking Therapies service, run in partnership with Vita Health Group, offers free CBT-based support for anxiety and low mood to adults registered with a Newcastle GP. You don’t need a GP referral and can self-refer directly online or by phone. It’s an excellent option if cost is a barrier, although waiting lists and session limits mean it may not always explore the ADHD side of things in depth.

Other Private ADHD-Informed Therapists

Directories such as Psychology Today and the Counselling Directory allow you to filter therapists by ADHD and location. Private counselling in Newcastle typically ranges from around £30 per session up to £100+ for clinical psychologists.

Lower-Cost Community Support

Local organisations such as Anxious Minds also provide affordable counselling for anxiety and can be a useful stepping stone if private therapy isn’t currently possible.

A Few Things Worth Asking

• How do you approach anxiety when it’s linked with ADHD?
• What does a typical course of therapy look like?
• Can you provide reminders or flexibility around appointments?
• Do you offer online sessions?

Frequently Asked Questions

Does CBT work for anxiety linked to ADHD?

Yes. CBT is one of the most evidence-based treatments for anxiety, and many therapists, including Sian Barnard, tailor it specifically for people living with ADHD.

What’s the difference between CBT and hypnotherapy?

CBT helps change unhelpful thinking patterns, while hypnotherapy focuses on calming the nervous system’s physical response. Combining both aims to address anxiety from two complementary directions.

Is there a free way to try therapy?

Yes. Peaceful Minds offers a free initial consultation, and NHS Talking Therapies also accepts free self-referrals.

Where is Peaceful Minds located?

The practice is based at the Grainger Suite, Dobson House, Regent Centre, Gosforth, Newcastle upon Tyne, with online appointments also available.

The Takeaway

Anxiety alongside ADHD isn’t a personal failing—it’s often a very understandable response to years of navigating a world that isn’t designed for how your brain works. If you’re in or around Newcastle upon Tyne, speaking with Sian Barnard at Peaceful Minds could be the first step towards feeling calmer and more in control.

Ready to talk? Call 01670 631877 or 07737 491728, email sian@peacefulminds.org.uk, or visit https://peacefulminds.org.uk to book your free 15-minute consultation.

This article is for general information only and should not be used as a substitute for professional medical advice. If anxiety is significantly affecting your daily life, please seek guidance from your GP or a qualified mental health professional.

If you are looking for therapy in Newcastle the information below might help.

I am still doing some face-to-face as well as Zoom and Skype sessions

Types of Therapy

Therapy covers a vast array of treatments. The psychological based therapies for mental health problems can be confusing to even those in the profession.

The lines are now blurred, however, traditionally :

Counsellors and counselling was shorter term for things like bereavement and short term issues. Again things are changing but counsellors didn’t always have as extensive training as psychotherapists. Sessions tend not to have structure and are based on what the individual brings to the session.

Psychotherapists, traditionally are trained up to Masters level and specialize in a particular type of psychotherapy:

• Cognitive Behaviour Therapy
• Psychodynamic
• Systemic/Family

There are many many more. Psychology Today www.psychologytoday.com is a great resource for finding information about therapy.

Clinical Psychologists cover an array of psycho-therapeutic techniques but may specialize, they are educated up to doctorate level.

Cognitive Behaviour Therapy or CBT

You might consider therapy for long term mental health issues like anxiety and depression which I would say CBT is one of the most efficient, hence its ubiquity within the NHS. CBT identifies the thoughts that cause distress and gives the client specific tools to change those thoughts and helps identify the behaviours. It is therefore great for behaviour related problems like worrying, overthinking, procrastination, ruminating, addictions, OCD. As a therapist I am also trained in Rational Emotive Behaviour therapy that identifies deep rigid beliefs that lead to all your painful emotions. Anger, guilt shame jealousy and hurt. It also supports unconditional acceptance, which is about responsibility not blame.

Psychodynamic Therapy

Is more “global” as opposed to CBT that is problem specific and is about rewiring the persons life narrative. It places emphasis on the significance of childhood experiences. Psycho-dynamic looks at the patterns of emotions and thoughts and how they interact, placing a lot of emphasis on the internal dynamics of these. It also aims to helps the client rewire their internal narratives to give them a positive sense of self.

Family Therapy

Systemic /Family is an approach helping people understand the dynamics of their family relationships to communicate better by reducing the distress of dysfunctional systems. It can be used for instance when a child or teenager is anorexic or violent. Or even and adult child living away from home but still distressed by the family dynamics. It can also be useful if one of the parents is struggling.

Hypnotherapy

There are other alternative therapies such as hypnotherapy which isn’t as regulated as the traditional therapies. I’m a member of the British Society of Clinical Hypnosis, having trained at the London College of Clinical Hypnosis, there is also the GHR. Hypnotherapy borrows from many traditional psychotherapies and tailors sessions to the individual needs. It is nothing like you see on films and TV. Hypnotists that do it for entertainment are just that, showman. It works in therapy because when you are deeply relaxed you can take in information quicker and it is accepted easier. You cant make anyone do anything against their will and just about everyone I meet who can relax and fall asleep can be hypnotized.

What To Expect From my Therapy ?

Depending on the issue I can see clients for two sessions for something like quit smoking or teeth grinding, the average tends to be around the six sessions for phobias, social anxiety, worry or confidence, milder anxiety. When a client comes in with a cluster of issues like panic, depression, disorder PTSD, OCD therapy can take longer. Comfort eating, eating disorders I can see them longer term but the sessions are spread out. It various quite a lot. I work with a big variety of symptoms and problems, there isnt much I haven’t dealt with these days.

Sessions tend to be face to face in my office in Regents Centre, Gosforth, Newcastle-Upon-Tyne.

Hypnosis can work over the internet if the client can guarantee no interruption. Alternatively, we do half an hour hypnosis work and I can record an MP3 separately.

Sessions are completely confidential and I would only break confidence if I thought my client was a suicide risk or going to harm someone else.

 What to Expect from Your first sessions?

You would normally come to Dobson House and tell reception you are here or during COVID times people text and I come and greet them at the main doors. Masks are expected to be worn where 2m is not possible so I ask on stairwells and corridors. My office is large enough for there to be 2m distance and well ventilated. However, this is always subject to the government advice and rule changes. There is also 3 cafes near by for you friend or family members to grab a coffee. Cosentinos just next to Dobson House main entrance, there is Marks & Spencer’s and Asda just 200yrds away.

The first session is about setting a goal for the outcome of therapy and discussing how it will work. There’s no point in just rambling aimlessly through session after session and not knowing what is being resolved and what is not. I gain an understanding of the issue or issues and then feed back my understanding so we all know what we are focusing on. This sometimes can be the first time a client has seen their issues in an organized format. More times than not, it is the first step in healing and things don’t look as bleak as they first thought.. Also it is the first step on the path towards a solution. Whether I’m doing hypnotherapy or CBT or a combination we don’t always have time for hypnosis.

How do I Book a session?

The easiest way to book a session is to call me on 07737491728. My hours vary but generally I work Monday to Friday till 8.00 pm at night and can see clients for emergencies on a weekend.

Its important to feel comfortable when booking a session so a telephone conversation or video call is offered to answer any questions you may have.

]]> https://peacefulminds.org.uk/i-need-a-therapist-in-newcastle-how-do-i-go-about-it-what-do-i-need-to-know/feed/ 0 https://peacefulminds.org.uk/lock-down-anxiety/ https://peacefulminds.org.uk/lock-down-anxiety/#comments Tue, 10 Nov 2020 09:11:47 +0000 https://peacefulminds.org.uk/?p=6928 Lock Down Anxiety

Anxiety is an emotion that tells us we are under threat or in danger. Its part of our survival system and it is meant to be uncomfortable to spur us into action for self-preservation. (That’s why one of our biggest behaviours we demonstrate when we feel anxious is avoidance or to run)

In the past we would have been more scared of predators and our enemies. Today our anxieties are usually about our predictions, thoughts, fear of being judged and anticipation about possible futures. We really don’t like uncertainty and that makes us catastrophize which is a way of focusing on the worst possible outcome believing it to be the most likely outcome when it’s not. The churning of these awful outcomes along with the phrases that begin with “what if …”  is called worry. Or I call it whatifery.

How many ways can we feel anxious at the moment, here are some common ones?

• Existing anxieties (financial, OCD, social, health, phobias) are experienced with more intensity
• Worrying about your future job and the effect a depressed economy could have on your earning potential
• Anxiety about losing touch with people, they may not be your friends anymore
• Anxiety about catching the virus or a loved one catching it
• Anxiety about your civil liberties being taken away
• You may feel you can’t live with the people you are locked down with
• You may now just feel you’ve been in the house too long and that outside is generally scary or that interacting with people is too overwhelming
• Worried about what happens after lock down

Whichever one you are experiencing there are some general principles you can follow.

1. Put things into perspective. Exaggerating possible, but not likely, outcomes does not prevent them from happening, it doesn’t stop or solve anything. How likely is the virus to kill you? If we go back to March the government had us so scared, we were frightened to set foot outside the door. It depends on your age and underlying health conditions. If you are a healthy child, teenager, young adult it’s not likely to affect you anymore than flu or you may even have mild to no symptoms. The older you get the more chance (but not a guarantee) that you may have it more severely. 50- and 60-year olds can also experience no symptoms. Its worth noting that the average age of death from COVID-19 is 82 years of age. The life expectancy in the UK is 81.

If you are in an at-risk group and take all the precautions necessary if you have to go out. Therefore, by using masks, visors, distancing, taking vitamin D and keeping as much of a fit mind and body as possible you are reducing your risks significantly.  Don’t mix often with those that mix a lot. Even then if you get it is not a guaranteed death sentence, though you might be very poorly.

2. If you ask yourself questions that have no answer but that trigger your internal survival alarm like “what if we are locked down forever and the economy crashes and there is anarchy?”. Or “what if I lose my job?” then you will continually feel anxious as there is no answer to something that might not happen in the future from the present point in time such a now. Whatifery whatifery what a load of piffery – this is a silly but useful saying to alert you to your over thinking

3. Don’t try to control things out of your control. Ask yourself “what can I do something about and what can’t I? The economy, government, people who don’t adhere to rules. Remember no matter how loud you shout at the telly they won’t hear you.

4. Do the things that bring you happiness. It may be limited but identify them and engage in them. A soak in the bath, a movie, a walk , face-ime or call friends. Remember when you’re feeling low, talking and thinking about someone else is a good way of putting things in perspective and shifting the focus outwards. Anxiety is all about looking in.

5. Don’t watch the news! On TV or online. They present you with a doom and gloom world that you can’t do anything about. The headlines are designed to grab your attention by stimulating your fear and emotional centre. They are rarely absolute truths in and of themselves.

6. What you fear is diminished by facing it. You can do it all at once or in bite size chunks. This can be relevant for leaving the house, shopping or going back to work. This is because the amygdala, the organ in your brain responsible for anxiety and fear, can only learn not to be fearful of something by re-experiencing it and seeing that you didn’t come to harm. It learns. It changes its programming through emotion and experience. For example, that old story about getting back on the horse immediately after a fall. The fall may trigger a trauma, (an unresolved terror that repeats itself in a time-loop like it was happening in the present moment). You can’t tell the person to get over it as the loop doesn’t understand English. By getting back up on the horse ( which will be terrifying) the amygdala learns again that riding is more or less safe. To definitely cancel out any trauma by going out on the horse every day after the fall would make sure a new loop was written over any possible trauma ones.

7. If you need support seek it! Whether it’s with friends, family or a professional. Being alone in an anxious head without any help to get out of it can be hellish. Don’t let toxic thoughts be your only companion.

8. Be aware of your bodily sensations that occur during anxiety so you aren’t afraid of them. There will be a set of feelings that occur here are some common ones. Having these in an intense flash is known as a panic attack also known as full fight-or-flight.

1. Heart racing/chest pain
2. Shortness of breath and struggle to get breath
3. Shoulder, neck and limb pain
4. Nausea, acid re-flux, heart burn, diarrhea, constipation
5. Sweating, shaking
6. Brain fog/not feeling real or spaced out
7. Insomnia
8. Racing thoughts

9. Health anxiety can develop when the above symptoms are be mistaken for something life threatening due to the symptom being accompanied by the anxious/terror feeling. The brain puts two and two together and gets five. A lot of people end up in A&E believing they are having a heart attack. Or have repeated trips to the doctor believing they may have cancer. Checking the internet to self-diagnose is the absolutely worst thing to do for increasing anxiety

10. Mindful meditation in particular is pretty good for accepting and dealing with anxiety. When you fight a thought or try and control one you just feed them more energy and they get stronger. Mindful meditation accepts they are there and then gently ignores them. They lose their potency and you can begin to feel calm. Similarly, if you fight anxiety you also fuel it.

11. Hypnosis is a great technique for putting the body into rest-and-digest, the opposite to fight-or-flight. Hypnosis helps the body to repair damaged cells, the immune system is boosted, digestion and absorption of nutrients is optimized. This is what happens when we re asleep too. The heart rate slows down as does breathing and blood pressure. We are truly relaxed.

There is, of course, a lot more to anxiety than this. For specific help contact me directly. Each person will have individual anxieties or combinations of anxieties. The above tips might help you stop exacerbating them.

Watch out for my next article on what happens when low mood sets in.

The main point to grasp here is that there is a difference between concern and caution versus panic and anxiety!

Anxiety and panic make you feel like the threat is bigger than it is ….and it is just round the corner…. and it will kill you. This will affect your mental health, sleep, diet, your behaviours’ and mood.

When you are cautious and concerned about a threat you keep things in perspective while being safe and careful. You recognize that if you are in a vulnerable group the risk of more serious harm goes up, however for the vast majority of the population no symptoms, mild symptoms or a few days in bed at worst is a small possibility. This thinking DOES NOT make you complacent or take unnecessary risks. It allows you to carry on your daily business without that terrible fear. It will propel you to follow government guidelines in ALL cases but not isolate, overthink or make yourself ill.

COVID is clearly a nasty virus, as a 50 year old woman with no health problems I do not wish to contract it. However if I do it wont be the end of the world and I will tolerate any discomfort it may bring. I have a 99.999999999% chance of surviving it. I also do not want to pass it on so I will carry on with my life being concerned and cautious. I suggest we all do.

There is a difference between concern and caution versus anxiety and panic. This is my point.

I define self-confidence as not having a fear of negative judgement from significant others. I can personally say I don’t fear what other people think in most situations, however, I would probably have a reasonable level concern if I knew was going embarrass myself. It’s the fear or anxiety element that leads to avoidance behaviours, such as not going to social functions, being unable to speak in 1-2-1’s, small groups or in public. It can also be around fear of failing in front of people. If it amounts to an absolute need to be the best (or one of the best) and it’s therefore not worth even trying if that is not guaranteed then we are most likely looking at perfectionism.

The significant others aspect can be peers, colleagues, bosses, or strangers. It is anyone who you don’t want negatively appraising you. Self -confidence comes on a sliding scale from the psychopaths and narcissists on one side to the socially phobic on the other. It is possible that we all move up and down the scale at various times in our lives.

There’s a difference between not caring what others think (psychopath) and having healthy disregard. I term healthy disregard for what others think as doing and saying what you want as long as you balance  your needs with those of others after you have weigh up the effects on them, an ultimately your relationships. For example,I wouldn’t go into the city centre naked, even if I loved my body and desperately needed to show it off. I would realise that I may offend the majority of people,plus my arrest would affect my family and probably my livelihood. However, if you feel self-conscious enough about messing up a joke in front of a group of friends so don’t bother to tell it then you probably self-conscious. If you have an intense fear of making a fool of yourself or being judged on your appearance than you probably have social anxiety. Especially if you avoid a lot of social situations because of this reason.

People may also fear suddenly being thrown into the spot light or offending someone, but it all boils down to a poor self-worth; not feeling good enough. The reasons for poor self-worth are a huge subject .

The good news is that the intense and even mild anxiety is avoidable. It is the inner-dialogues and beliefs that we hold that causes anxiety. If we tell ourselves that we must never be judged in a way we would hate by those we deem to have  significant opinions and that it would be unbearable; and  that we will be rejected or laughed at; and that it would confirm that we a defective in some way,  then that will clead to anxiety as we anticipate the onslaught of shame.

This is in essence a scary, exaggerated interpretation of the truth. The truth, i.e. reality, is more along the lines of; our friends like us for who we are and are genuinely fond of us, and people we don’t really know aren’t really invested in whether they like us or not. So that if we really do make a fool of ourselves or look strange, they aren’t really going to attach much importance to it ( we assume they do. We are not high on their priority list).  To rigidly demand that you must never make a fool of yourself puts yourself under immense pressure to perform perfectly every move. Telling yourself that it wold be so unbearable and excruciating suggesting you would fail to cope and get through it adds to the anticipated horror as does the suggestion that there will be future knock on situations and effects like social rejection ad ridicule. It all stems from and then leads back to a very poor sense of self worth.

If you don’t think very much of yourself compared to others you will make assumptions like this. It can become a self-fulfilling prophecy because when we are nervous we become tongue-tied and can shake due to our brains being in a state called ” fight or flight”. This then reinforces our beliefs and endorses our fears. We then want to avoid situations which increases anxiety. Only when you face a fear can it be diminished. It can be done slowly and in a managed way. That is how I work with my clients.

I also get them to change the way they think and talk to themselves. To  a way that is based on reality and is in perspective – rational- not based on assumptions and faulty predictions. Changing your thoughts and adopting behaviours that allow you to face what ever it is that you are anxious about will increase confidence. It takes work, there isn’t a magic wand.

Consciously controlling the breath in order to increase physical, mental and emotional wellbeing has been around for thousands of years. Records confirming this appear in many ancient cultures around the world, beginning in ancient Mesopotamia to the practice of Indian Yogis, Hawaiian kahunas, Buddhist monks, Martial Artists and Christian Monks. They believed that breathing had an important role in tapping into a universal energy to aid balance, healing and wellbeing.

Science tells us that there are hundreds of thousands of messages going from the brain to the body, and from the body to the brain at any one time via chemical, hormonal and electrical means. Messages from the respiratory system have a rapid and powerful effect on the brain. This has to be the case because if you stop breathing, or the airway is blocked, the brain has about three minutes to work out how to breathe again. The ancients knew that if you could send a message to the brain to calm down in a language it understood, it would work better than just saying to one’s self “clam down”.

More recently, about one hundred years ago, autogenic training was developed by Heinrich Schultz and involves an element of controlled breathing with relaxation. All forms of meditation involve either attention paid to the breath or the slowing down of the breath.

Today there is a raft of therapists and doctors promoting breathing techniques for not only relaxation but as tools for managing anxiety and anxiety-based disorders from OCD, panic disorder, insomnia to PTSD.

THE SCIENCE, HOW DOES IT WORK?

In a nutshell – The rate at which we breath has an effect on the rate at which our heart beats, this is an indication that a number of other processes have also kicked in that keep us in balance. These systems include immune response, healing, digestion and absorption. In fact, most people are aware that we can tell how much the body is in a relaxed state by measuring our pulse. So, breathe work is about using your breathing in a conscious manner to keep your body in balance, also called homeostasis. However, in time and with practice, breathe work that keeps you calm can become second nature. This is because you begin to breathe at the optimum rate for your body to be in the best possible state of wellbeing. When the body goes into a relaxed state it then feeds back to the brain that all is well and the brain begins to calm down.

The majority of our bodily functions are controlled out of our awareness one major system is called the autonomic nervous system.  Here comes a slightly more detailed description of the above. It is composed off two parts; one part reacts to threat or danger and gets the body ready to run or defend itself (Flight or Flight) and the other part brings this highly aroused state back under control and helps us calm down and relax (Rest and Digest). The sympathetic nervous system is the medical name for “fight or flight” and the parasympathetic sympathetic nervous system is the medical name for “rest and digest”. You cannot have one without the other. They work opposite each other in order to keep us in balance or homeostasis.
When we detect danger or feel threatened there is an immediate response by the sympathetic nervous system; messages flood from the brain to body to “get ready”. The chemicals noradrenalin, adrenalin and cortisol are released to affect changes in the body. The body needs energy to fight or run; this comes from using oxygen from the air we breathe to burn the stored energy in the form of glucose or fat we have in our muscles. Therefore, we need the lungs to work very quickly and take in as much oxygen as possible and it does this in short shallow rapid breaths. The heart then has to speed up to push the newly oxygenated blood as fast as possible to the necessary muscles. Sweating is triggered sometimes to cool this heat producing energetic process down. This process takes up a lot of energy so it also shuts down or reduces other energetic processes not immediately important; processes like digestion, sex, healing and fighting disease. During the “burning” of energy within the cells releases free radicals that damage cells and cause inflammation.

The body cannot stay in this heightened state of arousal for long as it puts physical stress on the body so the counter system, parasympathetic or rest and digest, kicks in when the danger is over. It restores the body to balance, kick starting digestion, healing, immune responses.
But what happens if the parasympathetic nervous system fails?

Well, you will not be surprised to hear that’s where stress, anxiety disorders and worry can come from. They make sure the parasympathetic nervous system can’t do its job. In more serious situations like Post Traumatic Stress Disorder the sympathetic nervous system doesn’t turn off and a condition of hyperarousal occurs. This is where the brain and body are in a continuous loop of telling each other that they are still in danger.

Breath work can help. It’s about giving the parasympathetic nervous system a hand.

Other therapies for like CBT are used to manage the cognitive and behavioural roots of anxiety disorders; to stop telling the body it’s in danger. Breath work can work in tandem to manage the symptoms and the effect they have on keeping the person in an aroused stated

How can we help the parasympathetic Nervous System ?

We learn specific breathing techniques; feel the benefits; practice them regularly; feel the long term benefits and then, as it becomes part of lives, we forget how we used to be.

In this part I, I will introduce simple techniques that can be combined:

• Belly Breathing ( diaphragmatic breathing)
• Resonant Breathing
• Pursed Lips Breathing
• Restrictive Breathing ( Seashell breathing)
• Breath Moving

Part 2 will look at :

• HA ! breathing
• Breath Counting
• Vibrational breathing using “OM”

Belly Breathing

What’s the point ? How does it Work ?

Well, I must admit that until I understood the science and then felt the positive effect I was reluctant to put any real effort in diaphragmatic breathing. The other way of breathing is called chest breathing and can make the body feel tense and nervous as it is how we breath when we are feeling under threat.

The diaphragm is a dome-shaped muscle, which separates our chest and abdomen. When we breathe in the diaphragm tightens, flattens and moves down, sucking air into the lungs. As the diaphragm moves down, it pushes the abdominal contents down, which forces the abdominal wall out. When we breathe out the diaphragm relaxes, air passes out of the lungs and the abdominal wall flattens. This type of breathing has two important effects on the body:

• It is in itself relaxing compared to the ‘emergency mode’ breathing of the upper chest, which is an integral part of ‘fight or flight’ response to a stressful situation (see the Stress management leaflet for more information).
• It is typical of the regenerating processes such as when you are asleep, digesting food or the body is at peace. You can see it in the way babies and children breathe.

Abdominal (diaphragmatic) breathing is the most efficient and relaxed way of getting enough air into your lungs. Breathing too quickly, too deeply or irregularly can result in unpleasant symptoms such as dizziness, faintness, headache, visual disturbance, tingling, chest pain, palpitations, sighing, yawning and excessive sniffing. It can commonly become a trigger for anxiety

How to Do It

Find a quiet room where you will be undisturbed for about 10–15 minutes.

1. Lie down on the bed or floor with a pillow under your knees. Undo tight clothing and remove your shoes. Spend a few moments settling yourself down.
2. Close your eyes, spread your feet 12–18 inches apart, and check that your head, neck and spine are in a straight line.
3. Focus your attention on your breathing. Do not try to change your breathing for the moment. Become aware of how fast or slow you are breathing, whether you are breathing with your chest or diaphragm. Notice whether there are any gaps or pauses between your inhalation or exhalation.
4. Now, put one hand on your upper chest, and one hand on your abdomen just below your rib cage. Relax the shoulders and hands. As you breathe in, allow the abdomen to rise, and as you breathe out, allow the abdomen to flatten. There should be little or no movement in the chest. 6
5. Allow yourself a little time to get into a regular rhythm. It may help to imagine that as you are breathing in, you draw half a circle with your breath around your body, and as you breathe out, you complete the other half of the circle. Allow your breath to become smooth, easy and regular.
6. Now, slow down your breathing out, then be conscious of a comfortable pause before allowing your breaths in to follow smoothly and easily. If any distractions, thoughts or worries come into your mind, allow them to come, then allow them to go, and bring your attention back to your breathing.
7. When you are ready to end this exercise, take a few deeper breaths in. Bring some feeling back into your fingers and toes. Open your eyes slowly, and turn over onto one side before gently sitting up.

Part 2 to follow

In the past we would have been more scared of predators and our enemies. Today our anxieties are usually about our predictions, thoughts, fear of being judged and anticipation about possible futures. We really don’t like uncertainty and that makes us catastrophize which is a way of focusing on the worst possible outcome believing it to be the most likely outcome when it’s not. The churning of these awful outcomes along with the phrases that begin with “what if …”  is called worry. Or I call it whatifery.

How many ways can we feel anxious at the moment, here are some common ones?

• Existing anxieties (financial, OCD, social, health, phobias) are experienced with more intensity
• Worrying about your future job and the effect a depressed economy could have on your earning potential
• Anxiety about losing touch with people, they may not be your friends anymore
• Anxiety about catching the virus or a loved one catching it
• Anxiety about your civil liberties being taken away
• You may feel you can’t live with the people you are locked down with
• You may now just feel you’ve been in the house too long and that outside is generally scary or that interacting with people is too overwhelming
• Worried about what happens after lockdown

Whichever one you are experiencing there are some general principles you can follow.

1. Put things into perspective. Exaggerating possible, but not likely, outcomes does not prevent them from happening, it doesn’t stop or solve anything. How likely is the virus to kill you? If we go back to March the government had us so scared, we were frightened to set foot outside the door. It depends on your age and underlying health conditions. If you are a healthy child, teenager, young adult it’s not likely to affect you anymore than flu or you may even have mild to no symptoms. The older you get the more chance (but not a guarantee) that you may have it more severely. 50- and 60-year olds can also experience no symptoms. Its worth noting that the average age of death from COVID-19 is 82 years of age. The life expectancy in the UK is 81.

If you are in an at-risk group and take all the precautions necessary if you have to go out. Therefore, by using masks, visors, distancing, taking vitamin D and keeping as much of a fit mind and body as possible you are reducing your risks significantly.  Don’t mix often with those that mix a lot. Even then if you get it is not a guaranteed death sentence, though you might be very poorly.

2. If you ask yourself questions that have no answer but that trigger your internal survival alarm like “what if we are locked down forever and the economy crashes and there is anarchy?”. Or “what if I lose my job?” then you will continually feel anxious as there is no answer to something that might not happen in the future from the present point in time such a now. Whatifery whatifery what a load of piffery – this is a silly but useful saying to alert you to your over thinking

3. Don’t try to control things out of your control. Ask yourself “what can I do something about and what can’t I? The economy, government, people who don’t adhere to rules. Remember no matter how loud you shout at the telly they won’t hear you.

4. Do the things that bring you happiness. It may be limited but identify them and engage in them. A soak in the bath, a movie, a walk , face-time or call friends. Remember when you’re feeling low talking and thinking about someone else is a good way of putting things in perspective as well as shifting your focus outwards away from thoughts about you.

5. Don’t watch the news! On TV or online. They present you with a doom and gloom world that you can’t do anything about. The headlines are designed to grab your attention by stimulating your fear and emotional centre. They are rarely absolute truths in and of themselves.

6. What you fear is diminished by facing it. You can do it all at once or in bite size chunks. This can be relevant for leaving the house, shopping or going back to work. This is because the amygdala, the organ in your brain responsible for anxiety and fear, can only learn not to be fearful of something by re-experiencing it and seeing that you didn’t come to harm. It learns. It changes its programming through emotion and experience. For example, that old story about getting back on the horse immediately after a fall. The fall may trigger a trauma, (an unresolved terror that repeats itself in a time-loop like it was happening in the present moment). You can’t tell the person to get over it as the loop doesn’t understand English. By getting back up on the horse ( which will be terrifying) the amygdala learns again that riding is more or less safe. To definitely cancel out any trauma by going out on the horse every day after the fall would make sure a new loop was written over any possible trauma ones.

7. If you need support seek it! Whether it’s with friends, family or a professional. Being alone in an anxious head without any help to get out of it can be hellish. Don’t let toxic thoughts be your only companion.

8. Be aware of your bodily sensations that occur during anxiety so you aren’t afraid of them. There will be a set of feelings that occur here are some common ones. Having these in an intense flash is known as a panic attack also known as full fight-or-flight.

1. Heart racing/chest pain
2. Shortness of breath and struggle to get breath
3. Shoulder, neck and limb pain
4. Nausea, acid re-flux, heart burn, diarrhea, constipation
5. Sweating, shaking
6. Brain fog/not feeling real or spaced out
7. Insomnia
8. Racing thoughts

9. Health anxiety can develop when the above symptoms are be mistaken for something life threatening due to the symptom being accompanied by the anxious/terror feeling. The brain puts two and two together and gets five. A lot of people end up in A&E believing they are having a heart attack. Or have repeated trips to the doctor believing they may have cancer. Checking the internet to self-diagnose is the absolutely worst thing to do for increasing anxiety

10. Mindful meditation in particular is pretty good for accepting and dealing with anxiety. When you fight a thought or try and control one you just feed them more energy and they get stronger. Mindful meditation accepts they are there and then gently ignores them. They lose their potency and you can begin to feel calm. Similarly, if you fight anxiety you also fuel it.

11. Hypnosis is a great technique for putting the body into rest-and-digest, the opposite to fight-or-flight. Hypnosis helps the body to repair damaged cells, the immune system is boosted, digestion and absorption of nutrients is optimized. This is what happens when we re asleep too. The heart rate slows down as does breathing and blood pressure. We are truly relaxed.

There is, of course, a lot more to anxiety than this. For specific help contact me directly. Each person will have individual anxieties or combinations of anxieties. The above tips might help you stop exacerbating them.

Watch out for my next article on what happens when low mood sets in.

Messages in the brain are carried by electrical signals along nerves called neurons, when the neuron ends the electricity stops and the message is then carried forward by chemicals. Chemicals carrying the message are called neurotransmitters. Neurotransmitters are very sensitive to other chemicals, whether it be drugs, alcohol or hormones such as cortisol, high doses of cortisol such as times of stress has been shown to impair and distort memory.

Trauma has an enormous effect on the entire mechanism. The hot system takes over and overrides the logical cool system. The Amygdala sets in motion the “fight or flight” response. You begin living in the moment, full attention on immediate survival. You have to be the strongest and fittest possible. This means increased blood flow to carry oxygen to the muscles, increased heart rate. We have to be lighter and not expend energy on digestion so we might want to shed loads, food can come out quickly up or down ! We need fast muscle reactions so we shake in readiness. A huge amount of chemicals flood the brain.

One response is dissociation, where the brain separates its self from the experience of the trauma, like putting it in a box. This gives an ‘other worldly dreamlike feeling’ so things aren’t experienced in real time. This is a way of protecting the mind from the horror of the event, because it can anticipate the possible physical damage. People with PTSD can appear to be in their own worlds, and in a way they are, they can remove themselves from reality. The entire memory can be sealed off permanently and the event can be buried so deep there is amnesia. People with PTSD can tend to slip into their own worlds and dissociate as being in reality can be to painful.

Even when the memory is sealed off and buried it can still affect the person’s emotions and behaviours and they may not be able to explain their reaction. This is because the brain works by association. If knives, blood, a persons name, loud bangs or anything that has been associated with the traumatic memory before it was buried they can trigger a fear response.

If the trauma is repetitive, extreme or prolonged the brain doesn’t have time to cool down and can become physically altered. The amygdala can be come stuck in its activity not allowing the hippocampus to introduce rational thought. The amygdala can no longer recover and recompose. It remains on high alert stimulating all the stress hormones which further have damaging effects on the brain chemistry and the neurons themselves. This is when trauma can turn into post traumatic stress. Reliving the feelings of “fight or flight” long after the event. You can’t just expect someone to “snap out of it” .

They have essentially been brain damaged.

Severe cases psychotic episodes can be induced which include visual and auditory hallucinations and even imagined  feelings oftouch.While I haven’t seen this in my years of of working with bullied individuals I would rule nothing out when it comes to the mind.

When an individual is screamed at in the workplace, the shock can take the amygdala on overdrive; then if the person feels isolated and receives no support they will feel vulnerable; need to be on high alert will be maintained. If they need the job desperately, or believe they do, they will panic about the future and catastrophize.  Imagine if the abuse is constant these experiences will get worse as they are compounded by feelings of worthlessness. Each experience is keeping the hot system in overdrive.

Prescription drugs can be a great help in controlling the fight or flight response, but how do we rewire the brain and restore physiological health ?

Every one is different. Some people are physiologically more resistant to stress, others think differently and dont trigger the “fight or flight”  response.  This is where CBT ( cognitive behaviour therapy) and hypnosis  can play a big part. And this is where I help individuals during and after bullying episodes.

Sian Barnard

Psychotherapist and Clinical Hypnotherapist

Look out for part 3

What I hear you cry? Especially if you have known someone in the military or who has had a horrendous accident and has PTSD.

The brain, as I see it, is an infinitely complex organic entity that is connected to a mammalian body carrying residual survivalist feedback mechanisms. Ehh?

In other words the instincts we needed back when we were apes to flee a predator when threatened are still working perfectly and are with us today. Unfortunately, the threats these days are more of a psychological and emotional nature. So not only would we run if a bomb went off we also feel panicked when we feel humiliated or anticipate shame. Circumstance may mean we may have to stay in that humiliating or threatening position and endure the torment.

This is stress. The effects on the physical body of stress is widely known. The effect on the mind has not been so widely reported. High levels of cortisol a “fight or flight” hormone has been shown to have a profound effect on learning and memory. It also has been shown that mental illness such as depression can stem from prolonged stress.

PTSD is now recognized as a real illness. You can get PTSD after living through or seeing a dangerous event, such as war, a hurricane, or gruesome accident. You feel under threat and fearful long after the danger is over. It is now suspected that anything that is traumatic where you feel out of control can have residual terror symptoms. The following are the more common causes:
Being a victim of or seeing violence
The death or serious illness of a loved one
War or combat
Car accidents and plane crashes
Hurricanes, tornadoes, and fires
Violent crimes, like a robbery or shooting
And now I am asking if bullying can be a cause?
Some of the symptoms include:
Agoraphobia
Panic attacks
Bad dreams
Flashbacks, or feeling like the scary event is happening again
Scary thoughts you can’t control
Staying away from places and things that remind you of what happened
Feeling worried, guilty, or sad
Feeling alone
Trouble sleeping
Feeling on edge
Angry outbursts
Thoughts of hurting yourself or others.
Children who have PTSD may show other types of problems. These can include:
Behaving like they did when they were younger
Being unable to talk
Complaining of stomach problems or headaches a lot
Refusing to go places or play with friends.

PTSD starts at different times for different people. Signs of PTSD may start soon after a frightening event and then continue. Other people develop new or more severe signs months or even years later.
What’s going on in the mind to cause PTSD and how can bullying play a part ?
A good way to view the brain is see it as having two systems. One system is cognitive, complex and the thinker; we can call this the cool system. The other is our emotional-fear system ; the hot system. The hippo campus is cool. It s job is to record in a non judgmental unemotional way events as we experience them, taking in space and time of events. The amygdala is hot, quick, inflexible, run entirely on emotions, its fragmented in its interpretations, it creates our experience of fear. It is strongly linked with instinct and very difficult to have under conscious control.

We store hot and cool memories. A hot memory recalls the emotion that was coded with the event and will bring back low level emotional content, with very little detail . If we think of cool memory we will remember the data or facts of the event, it will be a recollection in episodic form. It can be relived without thinking its happening again in the present moment.

What happens if the signalling within the brain all goes wrong and the hot and cooled systems malfunction ? What happens in the brain during excruciating stress aka trauma?

PART 2 ON ITS WAY

Sian Barnard

We all recognize a bully because most of us remember them from school. What we don’t expect is to have to deal with them as adults. In fact a lot of people don’t recognise they are being bullied. Signs of bullying:

• become depressed and down

• not getting to sleep or waking in the middle of the night

• hating the thought of going into work

• being snappy with family

• lack of confidence in social situations as well as work.

• putting the bully’s behaviour down to a clash of personality with themselves and taking most of the blame.

Bullying can also be very obvious and involve aggressive attitudes and rudeness, however, it can also be more subtle. For example, excluding and ignoring people in conversations or passing them in a corridor or street. A person’s contribution to the workplace can be ignored, petty or unjustified criticisms can be made by the bully. Overloading people with work is an other form of bullying. This has significant affect on a persons self-esteem as they can think that this is evidence that they are not good at their job.

Why do they do it?

Bullying is a symptom of low self worth. A deep feeling of being not good enough can manifest as over compensating behaviours. Which is why a person’s strengths in the workplace can make the bully feel threatened, and that triggers their behaviour. If the bully feels the other person is more popular, better looking, more competent or earning more than this is a trigger for revengeful behaviour.

can make working life miserable. You lose all faith in yourself, you can feel ill and depressed, and find it hard to motivate yourself to work.

What can I do?

Don’t think you are making a fuss out of nothing or that you are to blame. This is the most common reaction. If in doubt talk to an objective friend then find an ally at work. Don’t be ashamed to tell people what’s going on. Bullying is serious it can effect you long after the bully has gone, and you need to let people know what’s happening so that they can help you. A lot of the time when you share your experiences you may discover that it’s happening to other people too or the person in the role before you.

Speak to someone about how you might deal with the problem informally. This person could be a representative, such as a trade union official, HR or your supervisor or manager.

Stay rational even though you can feel ill and hopeless; the criticisms or personal remarks are not connected to your abilities. They are a direct reflection of what the bully thinks of themselves deep down, the bully’s own weaknesses. The bully needs to feel superior and control you as it staves away self-loathing. Stay calm, and don’t be tempted to explain your behaviour. Ask them to explain theirs.

There is a chance that the bullying may not be deliberate. If possible, talk to the bully as they may not realise how their behaviour has affected you.

If it is very subtle making it difficult to recite petty instances tell them it’s a collection of minor instances adding up into a big negative attitude. You don’t need to get into an argument about who said what and did whatever. If you say this is how I feel, they can’t say “ no you don’t” . Tell them how it’s affecting your life. If you feel like you’re getting drawn in to a row., tell them that all you want to do is to make them aware of the effect they are having, and leave that with them.

If there are definite instances describe what’s been happening and why you object to it. Stay calm and be polite. If you don’t want to talk to them yourself, ask someone else to do it for you.

This is known as a contemporaneous record. It will be very useful if you decide to take action at a later stage. Try to talk calmly to the person who’s bullying you and tell them that you find their behaviour unacceptable. Often, bullies retreat from people who stand up to them. If necessary, have an ally with you when you do this.

Making a formal complaint is the next step if you can’t solve the problem informally. To do this, you must follow your employer’s grievance procedure. Be confident that your reaction is enough proof for you to do something about the situation. One thing is certain. It wont just stop.

It may take a little while to regain confidence after it has stopped or even if it has only reduced. Anxiety and low mood can be managed and even eliminated with help. This is where going to your GP or engaging in CBT will help speed things up.

Sian Barnard

CBT psychotherapist