Common disorders and CBT treatment

Anxiety Disorders

Anxiety disorders are very much talked about such as panic disorder as well as generalized anxiety disorder. Other types of anxiety disorders are OCD (Obsessive Compulsive Disorder), social phobia, and other more specific phobias. Post-traumatic stress disorder is not formally known as an anxiety disorder.

CBT is especially effective for the treatment of panic disorder and panic attacks. 6-12 sessions are usually sufficient in the treatment of panic attacks.

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Obsessive Compulsive Disorder (OCD)

The core features of obsessive compulsive disorder (OCD) are:

Intrusive thoughts or images and an avoidance of objects or situations which trigger the obsessions:

  • Compulsive behaviours such as overt or covert or mental rituals carried out in an attempt to neutralize intrusive thoughts and images.
  • Themes of obsessions are contamination, physical violence to self or others, death, accidental harm, unacceptable behaviour, unacceptable sexual acts, blasphemous thoughts, orderliness or nonsensical phrases, words etc.

Cognitive Behavioural Psychotherapy is the treatment of choice with regards to OCD and has been advanced since the 1950s. CBT offers evidence based solutions. A course of 16 sessions is usually required to help you overcome OCD.

You will be seen individually, but I can involve relatives or friends if you believe that this may be helpful. It is not uncommon for relatives to experience a certain amount of distress especially if they do not know how to help. In some cases a supportive relative can act as Co-Therapist.

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Social Phobia

Social Phobia is characterized by excessive shyness and persistent fear of social or performance situation during which the individual believes to be negatively evaluated by others. Social situations are often avoided or endured and the sufferer often resorts to the use of safety behaviours in an attempt to cope.

People with social phobia tend to have specific negative beliefs about the self in social situations. These beliefs can be activated in anticipation of the social event causing anticipatory worry or anxiety. During the social event the person with social phobia tends to switch their attention to self, focusing on how they come across to others and this leads to an increase in anxiety and self-consciousness or shyness often accompanied by physical symptoms. This can interfere with or contaminate the social situation, causing embarrassing situations.

People with social phobia often have one set of rules for themselves and another set of rules for others. They tend to be very strict about how they should come across or perceived by others and are often much more accepting of others. They can be prone to perfectionism and typical thinking distortions such as mind reading or jumping to conclusions.

Social phobia usually requires a course of 12-24 treatment sessions.

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Depression

Depression is a condition that not just affects mood (depression) but also appetite, sleep, memory, concentration and motivation. It can cause the sufferer to feel more irritable than usual and people often complain of a change or loss in libido. We find that there are degrees of how depressed people feel and this can range from mild to moderate to severe feelings of depression. This can lead to strong feelings of hopelessness when it can be difficult to problem-solve or to find a way out.

CBT can offer hope and it is an evidence based treatment of choice. Medication can offer a short-term solution but depression is likely to return following a course of medication. CBT offers lasting results and enables the sufferer to become 'their own therapist' more able to deal with future episodes having learned strategies to deal with occasional set-backs. As relapse prevention is an integral part of CBT, it can offer more lasting and long-term benefits more able to deal with occasional setbacks.

The number of sessions required will depend on the severity of the depression.

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Body Dysmorphic Disorder (BDD)

BDD is a preoccupation and strongly held belief and worry with some aspect or perceived defect of your physical appearance. The feeling of upset and worry can lead to excessive checking, comparing, scrutinizing and camouflaging behaviours that take up a lot of your time and may stop you going around or being around other people. Confidence and mood often deteriorates and the sufferer can start to feel really unattractive, unworthy, angry and depressed.

Although many people feel dissatisfied with their appearance from time-to-time, people with BDD can not be reassured by the opinion of others and their thoughts about their appearance or perceived defect tends to dominate and distress them most of the time.

CBT is an effective and evidence based treatment for BDD.

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Low Self Esteem

A person with low self-esteem holds a very strong belief about the type of person they are. Typical statements of a person with low self-esteem are:

  • I am not good enough
  • I am unlovable
  • I am stupid

These beliefs are not just occasional or transient negative thoughts that we all might experience from time-to-time but they keep on reoccurring in specific situations. The person with low self-esteem tends to make negative predictions about what could go wrong and becomes involved in anticipatory worry. This heightens anxiety. In order to compensate or stop bad things from happening they may take unhelpful precautions. These actions are taken with the intention to cope, but unfortunately can reinforce and at times confirm the negative belief the person holds.

CBT suggests that these negative beliefs are not facts and that they are maintained by unhelpful behaviours. In order to overcome low self-esteem the sufferer is encouraged to test out these beliefs and develop a new set of helpful behaviours.

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NHS
N.I.C.E
The Hackwood Partnership
Natural Therapies Clinic
BABCP