This article is a case study about a young client struggling with anxiety. It discusses how he and his therapist found a way to communicate with one another through the use of drawing therapy.

Jake and his overwhelming anxiety

Jake was too young to be one of my clients, unfortunately he was also too old to fit into the paediatric mental health team and the teenage support group for anxiety was overwhelmed.

 Jake had a bad experience and didn’t trust therapists

Jakes mother  described a boy who every morning thought he would get up and go to school and by 9:05 had failed.  He was then stressed all day about having to go to school the next day and couldn’t concentrate on his schoolwork at home, even if his granny sat and helped him

The start of CBT therapy

Jake`s mother and I agreed not to tell the services that I was working with him in case it stopped him from obtaining more appropriate input.  We also agreed she would sit in on the sessions as a silent observer.

Jake didn’t say much either apart from telling me how he’d been let down by other therapists who had promised a phased return to school with him in control – but this hadn`t happened. I told Jake that I didn’t really care whether he went to school or not, all I cared about was helping him get through the time period until he felt ready to do so.

I did the standard CBT things using Zoom at Jakes pace, he was very anxious before our sessions and quite often came into therapy feeling upset, and sometimes he cancelled, hiding in his bedroom.

How drawing therapy became part of his CBT

Once I discovered Jake could draw things changed.  Using the shared whiteboard he could depict his feelings and could use the subsequent image to explain what he meant.

Several of these drawings changed things greatly for both of us, the first picture showed how he felt about anxiety and the treatment of it.  He drew a very cross looking person with steam coming from his ears.  After we discussed it  I asked him whether he wanted to continue working with me.  There are no words to describe the rewarding feeling I had as I watched smiley faces prop up on my computer screen as he drew, miles away, in his own sitting room.

CBT Drawings to express and understand anxiety

Today Jake and I talked about anxiety, or rather I talked and he drew. I thought I knew what it felt like to be anxious, I’d been anxious before exams, been a bit stressed if I didn’t know the outcome of a dilemma, and I’m scared of the dark. Anxiety is huge, scary, unstable and destructive. Jake drew his “ monster” on the shared whiteboard.

The first thing I noticed was the Boris hairstyle – my interpretation, Jake just wanted to make it look stupid. It wasn’t very big either but had a foot in the door. The front door which was open because the anxiety had come with a reasonable-sounding request. Once Jake allowed the anxiety in it talked and talked to him and even when he tried to make it leave by another door it never stopped telling him something was wrong. In the end, Jake simply stopped opening the door.

He wasn’t frightened though, his anxiety was stupid, annoying and persistent, but never scary, destructive or unstable.

I guess anxiety is just a word, but a picture is a thousand words.

AUTHOR: Emily Cobb

Cognitive Behavioural Therapy

If you are looking for therapists who offer Cognitive Behavioural Therapy for a range of mental health issues you can read more about it on this page. We offer therapy at Act Counselling and CBT Services and are happy to speak with you today should you wish to find out more and book in with one of our therapists. Get in touch with us today via our online contact form or call us on 0141 554 0838.

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There was a room full of people, looking as scared as me, I was nervous about what I was about to feel, do, say and see. 

As the weeks turned into months, the friendships and bonds grew, we learned about each other, and the things we’d each been through. 

We get into our groups, and each module Gillian would change us round, who knew that we’d learn so much, and the personal growth that would be found. 

Then in March the virus hit, we had to stop the club, but just for a little bit. The structure changed and we were now on zoom, we were worlds  away from our safe cosy room. 

 A world pandemic wouldn’t stop our club,  for nearly every week we all turned up. Even With all the different walks of life, facing sickness, uncertainty, heartache and strife. 

We supported each other on a Tuesday, through the week and in the chat, Gary’s Jokes made us all laugh when we felt flat. 

Now it’s the last week and we

See each other through the screen. How much I wish I could hug you, and show how much to me, you really mean. 

Some weeks have been a challenge, even to get out of bed, but I’m so glad I did, just to feel the love that was so openly spread. 

Now it’s time to say goodbye as we each go out into the world, to show off our knowledge, courage and  new self that this course has unfurled. 

I wish you all so much love and luck, it’s been so amazing being your friend. This club has been my saving grace with my heart now on the mend. 

Thank you for all you’ve done for me, you’ll never really know,  how much the power of our club, has changed me and helped me grow. 

– By Ruth Whyte

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Frank didn’t do feelings. He was a man at all times. Anger doesn’t count as a feeling, Frank did anger. Frank knew why he did anger – it was necessary to protect himself and his family. He did sometimes regret what he did in anger. I’m not sure why Frank came to therapy, I know why he said he came to therapy – to deal with his need to check things all the time.

Not a talker

Frank didn’t do talking much either, at least not about feelings. He was a large man, pleasant and smiling, easily laughing, Successful in his occupation. After some time Frank did do the talking, even about feelings. He felt things that he had buried since childhood. He didn’t so much as “sit with the discomfort“ but seem to shrink into himself like a little boy.

Frank was fearless

Frank was fearless, he could stand up to anybody. He knew what was right, he knew what was wrong. He knew who had to be stopped and he knew who had to be protected and he knew it was his job to do that. He didn’t know why sometimes he went too far. Frank was not a bully, he was not a violent man so he began to avoid situations where he might need to defend somebody. Frank has a lovely family and didn’t need to go out socially. He was able to check whether he was likely to get himself into trouble before he went for a walk, he didn’t need to go for a walk very often anyway. His wife was pretty good at making sure he was never anywhere where there was conflict. He was a minefield made as safe as possible. There was always the possibility of something unpredictable so Frank had to be on high alert all the time.          

The well-trodden path

Frank didn’t do talking about emotions, he did do pictures and he did do analogies. Frank described his behavioural experiments as walking through a field that was overgrown. There was a path in it that was well-trodden but lead to thistles. He had to stop himself going down that way and tread out another path. This was quite difficult the first time, but Frank noticed that the more times he did it the easier it became until he had two well-trodden paths, then three and four.

Frank didn’t do feelings, but he did face the buried monster. He realised that he was burying it. He drew a picture. The picture had a man digging a hole and putting the soil in a pile in front of him to keep the monster away. Frank commented that “I’m so busy digging to pile up a wall in front of me that I don’t notice the great big hole I’ve dug out  behind me that I’m about to fall into”   

Making friends with the monster

Frank stopped building his wall, he tolerated with the feelings of fear and trepidation that engendered .Instead of running away from the monster he stayed and watched his approach. He saw that the big dog running towards him with his teeth showing wasn’t growling, just panting in the heat. He drew the dog and as he looked at it he laughed saying, “ that doesn’t look like a dog, that looks like a teddy bear!“         

Frank walks alongside his monster, it isn’t a very nice monster but it is nowhere near as bad as he had originally thought. Frank keeps an eye on the monster so that it doesn’t get out of hand again .

Frank is brave

I enjoyed working with Frank, he was brave and worked hard to understand what was happening underneath the layers of rules and walls.He was Open, honest and generous with his self reflection. The confusion, desolation and horror of the core belief was almost palpable. The courage he showed when he stopped building the wall to keep the monster away and waiting until it appeared to face it  was difficult to believe.

I have often used his analogy of the path in the field, The monster becoming a teddy bear and the concept of making a wall to keep the monster out but creating a big hole and falling into it as a result of this.

Frank’s ideas have helped other clients understand.  Frank’s ideas have helped me understand.

Frank doesn’t think he does feelings, Frank doesn’t think he can talk, especially not about feelings. I think Frank is wrong, in vulgar parlance I think Frank “nailed it”.  

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One of my favourite things about counselling is the serendipity of working through a problem or difficulty with someone only to discover there is a big lesson in there for me – a lesson that teases me out of hypocrisy and forces me to practice what I preach.

One such lesson followed on from an input from Andy on the “responsibility pie”. I was working with a client at the time who was extremely resilient but had taken on more responsibility than she could manage, her wellbeing depending on her ability to make sure everyone in her life was okay.

Rules for living and core beliefs

We talked through what she could take responsibility for in her current situation. We explored how much control she really does have in any situation and the impact of other people (and their free will and choices), of the situation and of the choices that we make (some of which are unconscious). We objectively thought about her choices and how they were impacted by her conditioning (her rules for living and core beliefs) and considered that she did not always make her choices consciously and never with bad intentions. In this way she found relief from guilt and shame and from her own expectations of herself.

The love of pie

She really identified with the responsibility pie, as an analogy and we took it to the n^th degree. We discussed how much she loves pie, how much she keeps for herself – not sharing with others. This sense of being “greedy” flipped her situation on its head, it became juxtaposed with her rescuer / helper sensibilities and helped generate a discussion about empowering others by withholding our need to take responsibility.

This lesson, given to me by Andy and my speaker is helping me to share pie – to empower others and to empower myself – keeping any need for validation safely out of my practice. A client’s difficulty became a positive learning experience for the client and an opportunity for me to engage in true reflective practice, providing us both with a catalyst for growth.

Share that pie

So basically – don’t eat all the pies, sharing pie is good for everyone, but eating all the pie is okay as long as we learn from it. This is permission for us to feel less guilty and create space to be what we are inspired to do.

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Age, occupation, interests, culture, and religion. We use all of these or none of these to connect to another. As curious, social beings we instinctively gravitate towards making contact, finding love in many forms, and searching for meaning.

Death is certain

Despite this, we are born alone, and we must die alone, the only thing certain in life is death. Depending on your perspective contemplating this can be debilitating or liberating. Dr Irvin Yalom recognises through his work with cancer patients that being so acutely aware of the end drives people to live in the now. Within this there is a challenge, to embrace this mindset before there is illness, diagnosis, or prognosis. Keep the end in mind to drive you to do more, to think more, to feel more. Keep the end in mind to focus on your own life process, to let go of the expectations you have of yourself and of others. There is almost nothing you can do about the thoughts, feelings, and actions of others but you can control you and now is the time.

You are you, and I am I

Daughter, sister, friend, colleague, wife. As we go through our own life process, making contact, finding love, searching for meaning, there are but 23 words first uttered by Fritz Perls to remember, You are you, and I am I, and if by chance we find each other, it’s beautiful. If not, it can’t be helped.

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There was a little empath named Sharon, who had witnessed many troubled times as a young girl, teenager, and young woman. She realised at an early age that she had special powers: a desire and the skills to help other people feel better.

Her dream was to reach the top of the Magic Mountain where she would achieve her Diploma in Counselling Skills. From here, she would be able to see far and wide across the land, and she felt she could reach out to help others as a qualified Counsellor. But first, she must climb to the first level of the Magic Mountain by successfully completing the COSCA Certificate in Counselling Skills. The little empath set off on her first quest.

The COSCA cave

She found a reputable course provider with excellent reviews and travelled far, into deepest darkest east end Glasgow. There, she was met by her two empath Godmothers, Alison and Claire. They were both very wise in the ways of counselling and they were to be her guides. Through the glass doors, and into the COSCA cave, she met a lovely group of other empaths. She was soon to realise that they too, had the same special powers to help other people. Very soon, the little empath felt right at home.

Lots of learning

For the next ten weeks there was a lot of learning to be done. The little empath thought she had always been a good listener, but, working more intensely with her supportive triad she realised there was much, much more to it. Always the one to give advice, she saw that she must quietly listen with a range of attending and responding skills. She must not ‘fix’ things and instead, must truly be there with her speaker. After all, the answers lie within. It was just her job to help the speaker reveal them. She loved using the Guided Fantasy and has used this back in her own kingdom with the young people she teaches. They were then able to uncover some feelings they had not known were there, and were also able to put a name to an emotion that they were unable to talk about in traditional one to one discussion.

The wise Godmothers

Soon, the wise Godmothers bestowed another gift. In order to reach level one of the quest, the little empath must truly know in her heart the core principles of counselling: Acceptance, Genuineness and Empathy. Luckily her magic powers allowed her to feel empathy for others readily. Sometimes this was a bit too much and she knows she has to protect herself in order to not feel drained and be of more use to her speakers.

Remember to relax

Genuineness was interesting to learn about as the little empath thought she came across as open and interested. However, her study of her recorded video clip revealed a stern face and closed body language. Her supportive triad said she just looked professional and was maybe a little nervous in front of the camera, and that she didn’t look stern to them at all. The little empath was relieved to hear this as she really wanted to look as genuine as she felt inside. She made a decision to remember to relax her body and face and to never cross her legs or lace her fingers again.

Acceptance

Acceptance was the real stumbling block as her deeper judgements of others were revealed. The Godmothers gave out tiny pieces of folded paper, but they held monumental discussion points. Emotive names were inside and this made the little empath shudder. Could she honestly put her triggers to one side and help the horrible trolls or the wicked witches of the world? After all, they have feelings too and someone has to help them. A lot of self-reflection is needed to answer this, and suddenly for the first time, the Diploma at the top of the Magic Mountain seemed out of reach. Would she ever get to the top to achieve something she was once so certain of?

Disaster struck

Then, one day, disaster struck! The land was cursed with a virus and all the empaths and the Godmothers were banished to self-isolation and social distancing. What was to become of them? Luckily, the Godmothers found a way to sprinkle magic Zoom dust on all the laptops and the empaths rejoiced as they were reunited by way of digital media. Hurrah!

The little empath misses the energy of her tribe in person, but is thankful for the mystical power of technology to help her continue in her quest.

How things changed…

In the beginning of Module 2 of the Certificate in Counselling Skills, the little empath and her tribe had settled into a ‘stay at home’ routine. She could not believe how quickly the sands of time had passed in the last ten weeks, and she settled down to review how that had been for her.

Having spent fifteen long weeks staying safe at home, the little empath also conducted all of her full time work as a teacher online. In addition to the COSCA course she also committed to another online distance learning course. The amount of screen time was proving to be a challenge for her and left her feeling a little overwhelmed at having to be such an integral part of the digital world. Sometimes she feared that the prophecies were coming true and that human and machine would indeed merge as one. She made a promise to herself to allow more study time for the next module and try new ways of learning to help overcome the intensity she felt around being online so much.

Positive energy…

Her new triad provided a calm and positive energy from the beginning. She loved watching the confidence of her triad grow with each skills practice as she herself even started to feel more relaxed watching her recordings. After consulting the ‘feelings wheel’, she could now identify with a feeling of optimism rather than being critical of herself. Progress already?

The cycle of change…

The middle of Module 2 was proving to be more in-depth in terms of content and discussion. Complex topics around sexuality, feelings, the grief cycle, change, values and ethics sparked lots of interesting discussion for the tribe. The cycle of change and the change curve were insightful tools for the little empath to consider. It helped her see some reasons why she had not been able to make the changes she wanted in her life, and she was eager to try this out for herself, and also within a counselling approach. The little empath likes to think about change from all possible angles and this can sometimes leave her feeling exhausted about all the ‘what if’s. She found the motivation grid very useful for this and has used it to make a decision about looking for another job in a different school. This gave her clarity and more confidence in her decision and she was thankful to her godmothers for bestowing these gifts.

A wave of emotions…

Sexuality was a topic that opened up a wave of emotions for the little empath. She realised that a wicked witch had tried to poison her mind with untruths in the past around what it meant to be a sexual being. By challenging her thoughts, she uncovered deep-rooted feelings that she had forgotten about. While saddened by this at first, she now sees it as a positive as she has been able to look back at her changed attitudes more deeply and this will hopefully help her to be more genuine and empathetic in a counselling approach.

Time to reflect…

The ending of Module 2 was mixed emotions for the little empath as she was invited to consider how to say goodbye to her triad. Following what felt like a more intense part of the course the triad had time to discuss how they felt and what progress they had made. Through this safe space the little empath realised that while she felt on one hand that the module went by so quickly, she also discovered that she had soaked up so much information that it was likely to be slow burner for her as she allowed herself to revisit the theory and reflect on how it has affected her personally as well as in a counselling approach.

Looking forward to a two-week break to recharge, the little empath knows that another beginning is just around the corner in the form of Module 3 and she is eager to explore the content with her tribe and another new triad.

The End

By Sharon Kirman

Cognitive Behavioural Therapy

If you are looking for therapists who offer Cognitive Behavioural Therapy for a range of mental health issues you can read more about it on this page. We offer therapy at Act Counselling and CBT Services and are happy to speak with you today should you wish to find out more and book in with one of our therapists. Get in touch with us today via our online contact form or call us on 0141 554 0838.

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There is so much noise.  It is deafening.  Communication is in overload.  We have a global catastrophe here and now.

I invite you to stop, pause for a moment and consider your life, your presence in humanity and your capabilities just now and as we go forward. You may not be unwell, you may not know somebody in hospital, you may not know someone who is ill.  You may feel this will not impact on you or you will get through it because you are young or you have a healthy lifestyle or you are not taking this seriously for a variety of other reasons.  You may be infected, you may fall ill, and you could die.  At the same time conversely, those in higher risk categories due to cancer treatments/therapeutic drugs or older age may come through it.  We do not know who will survive and who will not, and this is the reality which we each must face.

Come together, respect each other

I am invested in the outcome for me, my family, my relatives, my friends, my neighbours, for you, for your family, your relatives, your friends and the future of our human race.  This is so much bigger than just you and me.  This is about us coming together now, respecting each other and offering our strengths whatever they are for the greater good.  I believe that you  have  something to offer from a smile to a kind word shared,  to your time, skills, knowledge and personal resources with a willingness to learn,  giving freely for no other reason than the wish to contribute of yourself and help make a difference to the outcome today tomorrow and when it finally ends whatever that will look like.   I believe in your capacity to put aside your own fears and issues and focus on the strengths you have in going forward to enable healing and compassion, sharing and supporting each other.   Already, this is happening, it is alive and growing.   We are connecting, recognizing it is down to each of us and that each of us can make a difference.

Be kind to yourself

For those of you who are struggling for personal reasons or reasons out with your control, be kind to yourself and reach out for help enabling a friend or a professional to share your pain and help you accept yourself for who you are just now.   Today, may not be your time to shine, but your time will come and then it will be your turn to share your strength and acceptance for another.  I cannot within these words, reach out to everyone and I know there are those who feel the situation is out of their control and this may be.   Take what control you can back into your being and space no matter how small that is.   Do what you need to do without causing harm.  Consider your strengths and put them to good use.  Identify the tasks that you need to address and deal with them one by one.  Call out your unmet needs and share and they will be met.  Trust in humankind.

Reflect, reassess

From operating as an individual to operating as a community, and we can stop and reassess what we are doing.  What has got us to a place with too few ventilators, not enough PPE, too few drugs, people not self-isolating/social distancing, funerals with no one to attend them, frontline staff at risk of dying.  This is for analysis and but not just now.  In seeing the problems, we can identify solutions which are realistic and achievable.  We need big thinking and a joined-up approach locally, nationally and globally.  We need to sustain an effort for this acute phase and going forward into a more chronic ongoing stage.  

I ask you to Identify your strengths and play to them. 

• Those who can coordinate, coordinate
• Those who can innovate, innovate
• Those who can dream, dream
• Those who can labour, labour but do it now.

Start today, this is not an unscheduled holiday for some and a crisis for the few who are fearfully fulfilling their professional role whilst inwardly fearing for their lives and the lives of their families.  What can you do for you, your loved ones, your neighbours, for your country men and women, for humanity?  This is not a dress rehearsal. 

What you can do

Consider your mortality.  Look at death in the eye and hold onto life.  Let us thrive in a new way, living together compassionately and kindly.  

Our shared vision and positive coordinated action can make a positive difference for humankind. It is not too late.

Now is the time.   Look after your neighbour and friends as you would like your own family members to be looked after.  Who are our neighbours and friends?  They are all of humankind.

I am a mother of 5 young people, a wife, a daughter, a sister, an aunt, a cousin, a friend, a neighbour, a citizen of the world.  I am also a nurse and a trainee counsellor.

By Siobhan Campbell – year 1 diploma student

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The ACT Counselling Services team are currently travelling around Scotland delivering a 1 day training event on John Bowlby’s Attachment Theory and Lifelong Relationships. We are also very fortunate to have an extremely talented Neuroscientist contributing to some of the inputs. Most of our knowledge in relation to Attachment Theory comes directly from John Bowlby’s Son – Richard Bowlby, who members of the ACT team were fortunate to be taught by. These events have been enormously well received and requests to deliver these events have been flooding in.

When writing and delivering the events, as well as in subsequent discussions we never cease to be amazed that the first 2-3 years of one’s life will shape how one thinks, feels and behaves in relationships with others throughout the life cycle. The very brief introduction to Attachment Theory offered below does not even begin to do the theory justice, so if it peaks your interest then, by all means get in touch and we will be happy to advise you of times and places where future deliveries of the 1-day event will take place.

What is Attachment Theory

Basically it is an evolutionary and instinctual necessity for Human Beings to endeavour to form Secure Attachment Styles with significant caregivers. This is a basic aid to human survival. The human brain in 2016 is exactly the same as it was in archaic times (over 50,000 years ago). Our brains (when we are infants) do not realise that it is 2016 and most people in the western world live in comfortable and safe environments. Our brains respond as if we still live in the wild, amongst the animals and if an infant is not close to a larger, older and protective caregiver then one might be eaten for want of a better word.

Forming a secure attachment

As such, infants engage in what is called ‘Attachment Behaviour’ in an attempt to keep the primary caregiver close by and to form a ‘Secure Attachment.’ Babies are born ready and know exactly what to do in order to form a secure attachment and as a result, feel safe. How the primary caregivers respond will actually determine whether a secure or insecure attachment style is formed.

What attachment behaviour involves

Attachment Behaviour involves the child crying when separated from the primary caregiver. This is the child’s insurance policy as it is a very difficult (almost impossible) cry to ignore. Attachment behaviour also involves remaining close to the primary caregiver and quickly returning to their clutch when feeling threatened. When the child is confident that it’s needs are being met then a secure base is established from which the child can begin to explore the world, safe in the knowledge that the consistent and loving primary caregivers will be present and available on return.

Do you want to know more?

If you want to find more about attachment theory, a lot more about yourself and more importantly how to improve the quality of life of yourself or others then simply get in touch using one of the various methods available on this site. You can call ACT counselling and CBT services in Glasgow on 0141 554 0838 or email us here.

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The ACT Counselling Services team have had 2 insightful weeks delivering inputs 6 and 7 of the ‘Practising Schema Focused Therapy’ course. The themes have all been about perpetuation and ‘Repetition Compulsion’ (Freud, S), or ‘Schema Chemistry’ (Young, J). We think it is absolutely incredible that we, as human beings continue, albeit unconsciously, continue to play out very specific childhood experiences over and over again. This perpetuation causes us significant problems and distress, but we keep on doing it. The hardest part to come to terms with is that is actually our attempts to cope that continue to cause the problems. This often leads people to approach ACT for relationship advice.

What went wrong…?

We pick our parents as partners. If you don’t believe this, then you are most likely in denial. No parents are perfect and we unconsciously choose partners who we hope will provide us with the opportunity of correcting what went wrong. As a result of parental deficiencies we, at some point, experienced anger, sadness or despair as a result of our unmet needs. Children, however, cannot tolerate these feelings and instead cling to hope. We perceive that the problem actually lies with ourselves and continue, throughout our lives to seek the corrective experience.

Want to find out more or get some relationship advice, get in touch to discuss signing up for the next course, beginning 04/05/16. See more information here in our Services section.

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In the 10+ years that I have known my wife she has always been involved in helping people in some way, both in her professional life as well as her personal one. Throughout this time she has always had a fascination with what “makes people tick” and a real skill for developing relationships with people and getting them to see things from a different point of view. My wife has now been a qualified CBT therapist for several years and currently delivers the CBT diploma course with ACT counselling. I think this course really allowed her to develop those skills as well as giving her more of the theoretical understanding of what she was already thinking and doing with people.

How it affected me

The course had a big impact on me as well. My wife would come in from the course buzzing with excitement, telling me about what they had been doing that day and discussing whatever topic had been delivered by Andy and the team. She would talk about things like “core beliefs”, which are the messages we get from those around us growing up (generally our parents) and how this can influence our thoughts and behaviour throughout life. This made me consider my own experiences as a child as well as those of the children I work with as a social worker.

CBT in social work

Another way the course impacted on me was with the idea that as a therapist you are not giving them answers so much as guiding them to find their own solutions. As a social worker, this can be more of a challenge with some of the families I work with as we often have to be very directive and clear with people what we expect to happen. However, we will often use CBT principles to ensure families are motivated to work towards these shared goals. It has also been very useful in considering how I support my team of staff in supervision, both formally and informally in finding their own solutions to issues both within and outwith the workplace.

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