‘Many of my clients talk about how they had wanted to be in therapy long before making their first appointment. All sorts of things got in the way. Hoping things would magically get better, shame of admitting the need for help, fear of what would be unearthed, concern about what others would think, imagining that it would take for ever, to name a few. Mic Wright speaks about his journey in therapy and how thankful he is for having started it.

I’m in therapy. I have been since January this year. I will be forever.

What booze and pills were to some of my friends in recovery, bleakness and despair is to me. I got therapy just as many of them go to addiction meetings. For a time I was addicted to the depression, understanding entirely the notion that Kurt Cobain sang about on In Utero: “I miss the comfort in being sad.” But ‘sad’ isn’t the true extent of depression. It’s not the sadness that can kill you but the blankness, the nothingness, the inability to feel. Today, better to some extent thanks to therapy, I’m still a little surprised by happiness. That giddy feeling in my stomach is unfamiliar. The fizz and bubble of glee feels foreign somehow.

I won’t tell you what I talk about with my therapist or even what she’s called. The beautiful quality of therapy is that it is a private relationship, a two-way thing. On a Wednesday morning at 09.30, I’m in that room with the therapist and what takes place is shared only between us.

I can see why some people fool themselves into thinking their therapist is their friend. It is an intimate connection. The plastic is stripped from the wires; pure electricity can spark. With a therapist that works well for you – and it really comes down to personalities – you feel able to tell them anything and everything.

Some of you reading this column will be instinctively disgusted by the over-sharing. I know you’ll ask why I’ve chosen to talk about my therapy and to admit that I struggled with depression. Well, I’m not ashamed. Therapy isn’t just the preserve of celebrity drunks and drug addicts. Sometimes you have to admit that your own brain is conspiring against you, that your own emotions are not always yours to control. Going to a therapist to make sure my mind is in good shape feels the same to me as taking responsibility for my physical health. Without therapy, without a weekly mental M. O. T, I fear I’d slip back into black dog’s dark kennel again.

I’ll be straight with you – just as I’ve been straight with my therapist. I was very unwell for 8 months last year. I lost the ability to do simple things. The white page was a tundra of doubt for me, one I was afraid to make a mark on. Forms became endlessly complex; I put them off for months. All I wanted to do was sleep. I wanted to hibernate from humanity and wake up again one day when my worries had evaporated.

The logic of depression is brutal and circular. You feel terrible but are convinced you deserve to feel terrible because you are such a worthless person. To break that cycle I needed to go beyond the kind advice of friends and family.

Before I tried therapy I was convinced that it was something that worked only for neurotic New Yorkers in Woody Allen films and the kind of navel-gazing hippies that make me want to throw myself into the ocean. The truth is that therapy works but it only works when you’re ready to let it and you find the right person to speak to. Medication can certainly save some people but all it did for me was provoke vomiting and stomach cramps. Therapy has freed me from the gloom that threatened to envelop me. I don’t imagine that I will never feel that despair again, but now I have someone who can help me fight it, who can pull me out of it with the stern, certainty of professional kindness.

I am thankful for it and it would be cheap at three times the price.’

I have worked with many women with many different psychosexual issues and found this article interesting :-

Relationships can break down due to painful sex

Angela Lyons still very much loved her husband of 44 years – but there was one thing missing in their relationship: a sex life.

When her husband finally turned to her after years of this and lamented: ‘I want my wife back,’ Angela knew the time had come to seek help.

‘That was the moment I knew I couldn’t avoid the problem any longer,’ recalls Angela, 66, a retired administrator and mother of two.

Angela suffers from dyspareunia – pain during sex. She had the condition for six years from the age of 57, before finally plucking up the courage to seek help.

It’s a surprisingly common problem. One study published in the journal Menopause in 2008, based on the results of an anonymous questionnaire, reported that 40 per cent of women suffer from it.

Another study, published, in the Scandinavian Journal of Public Health, found it affected around 10 per cent of women. Determining the true number who experience pain during sex is difficult, as many are simply too embarrassed to seek help.

‘The crucial thing to remember here is that there is lots that can be done to pinpoint what is causing the problem,’ says Dr Sarah Jarvis, a London-based GP. ‘But women need to start off by going to see their GP, and that can be hard to do if you are feeling embarrassed about the whole issue.’

She says she has seen relationships break down due to painful sex – yet often the cause can be easily identified.

‘I can take swabs, check for infections or inflammation, investigate if their contraceptive coil has slipped out of place, or do ultrasounds and ultimately refer on to the appropriate specialist if I think it necessary.’

There can be a variety of causes. ‘Illness or infection, physical or psychological, or a combination of several factors can trigger it,’ says Kate Lough, pelvic-floor physiotherapist at the Western Infirmary in Glasgow.

One of the most common causes is menopausal changes. Falling levels of the female hormone oestrogen, which normally keeps tissues moist and healthy, can cause vaginal dryness.

‘Also, post-menopause, the vagina is not as elastic and expandable as it was,’ adds Kate Lough. This is because the drop in oestrogen affects collagen, the protein that helps keep tissues healthy. The physical problems can be compounded by the effect that falling hormones have on sex drive, mood and energy.

Falling levels of the female hormone oestrogen, which normally keeps tissues moist and healthy, can cause vaginal dryness.

Physiotherapist Janetta Webb’s tips for managing dyspareunia :-

The physical discomfort can often be helped with hormone replacement therapy (HRT), oestrogen cream or pessary. The advantage of the cream or pessary is that it works exactly where it’s needed, increasing blood flow, improving lubrication and boosting tissues, and has less risk of side-effects.

Gel or cream can be used twice a week and is left in overnight. Another option is a vaginal moisturiser. These are better than KY Jelly, explains Dr Heather Currie, a consultant gynaecologist and managing director of the website Menopausematters.co.uk.

This is because KY Jelly is a short-acting product designed for medical use, while vaginal moisturisers last longer and are better suited, she says, for sexual activity.

Yet while all these treatments could make a difference, Ms Lough says many older women feel almost ashamed of their issues.

‘Some women feel embarrassed about being sexually active into their 70s and don’t ask for help if there’s a problem,’ she explains.

Some women feel embarrassed about being sexually active into their 70s and don’t ask for help if there’s a problem

This was the case for Angela Lyons. But after finally plucking up the courage to go to her doctor, she was prescribed pessaries and oestrogen http://onhealthy.net/product/xanax/ cream, which have led to a great improvement. She was amazed there could be ‘such a simple solution’.

There are many other causes of painful sex, however. Some women may experience problems as a result of scar tissue from a tear in the perineum made in childbirth from an episiotomy (where an incision is made in the perineum to help deliver a baby).

An estimated 90 per cent of women experience a tear during their first delivery. Sometimes any discomfort or pain may not become apparent until years later, for instance when the woman goes through the menopause and hormonal changes start to affect the tissues in the area.

Problems with scar tissue can usually be sorted out by a small procedure – known as Fenton’s procedure – where the scar tissue is removed. This can be done as a day case, often under local anaesthetic, and the woman recovers very quickly, explains Pat O’Brien, a consultant gynaecologist at University College London Hospitals and a spokesperson for the Royal College of Obstetricians and Gynaecologists.

Another cause of pain during sex is endometriosis, when womb-like tissue grows in the ovaries, fallopian tubes or cervix. Patches of endometriosis can vary in size from a pinhead to large clumps.

Women with this condition may feel pain deep inside, which may last a few hours after sex. The pain, which is in the lower tummy and pelvic area, can be constant, not just around the time of intercourse, and may be particularly intense on the days just before and during a period.

Fibroids – growths of muscle and tissue in the womb – can also cause problems. While fibroids themselves are not painful, they can make the womb quite ‘bulky’, which in turn can lead to discomfort during intercourse.

Constipation or a bout of irritable bowel syndrome (IBS) can also have an effect.

More everyday triggers include general irritation or allergy caused by soaps and shampoo.

Mr O’Brien advises against using intimate feminine hygiene products. ‘The vagina needs a certain amount of good bacteria to be able to do its job properly. There is no need to buy special products – a sensible personal hygiene routine is all that is needed.’ For June Edwards, 57, a retired administrator from Glasgow, the solution was not straightforward. She was diagnosed with lichen sclerosus, a skin disorder that causes small, itchy or sore white spots on the genitals.

Over time, these spots can become larger and come together to create large, white plaques. They can make sex feel painful

Most common in women over 50, its cause is unknown, although it is not contagious. One in 1,000 women is affected, but it’s believed milder cases go untreated as women don’t seek help or believe it to be thrush.

But unlike thrush, lichen sclerosus doesn’t cause discharge, and over-the-counter medication for thrush won’t help it.

June suffered with lichen sclerosis for eight years from the age of 49, during which time it got worse. She waited seven years until she went to her GP. There, she was referred on to a gynaecologist, who prescribed steroid cream to reduce inflammation.

She was also referred to Kate Lough for help tackling the pain.

Some causes may be more psychological than physical – vaginismus, a condition where muscles at the vaginal entrance shut tightly, can make sex painful or impossible.

Kate Lough says: ‘The reasons for this condition can be physical or psychological – there may be a background history of abuse, or trauma from childbirth.

‘A vicious cycle may be set up, with pain leading to nervousness about intercourse, which in turn leads to further tension and pain.’

Dr Jarvis urges anyone who experiences pain with sex to seek help, as in almost every case ‘things can be done to improve the situation’.

Article by By Josie Golden for the Daily Mail.

In the April edition of Good Therapy there is an interesting article on the 20 Cognitive Distortions and how they affect your life. It reads :-

Our circumstances don’t define us. Regardless of what happens in life, we always have the power to choose our attitude. So what’s the difference between someone who remains hopeful despite experiencing great suffering and the person who stubs his or her toe and remains angry the rest of the day? The answer lies in the person’s thinking patterns.

Psychologists use the term “cognitive distortions” to describe irrational, inflated thoughts or beliefs that distort a person’s perception of reality, usually in a negative way. Cognitive distortions are common but can be hard to recognize if you don’t know what to look for. Many occur as automatic thoughts. They are so habitual that the thinker often doesn’t realize he or she has the power to change them. Many grow to believe that’s just the way things are.

Cognitive distortions can take a serious toll on one’s mental health, leading to increased stress, depression, and anxiety. If left unchecked, these automatic thought patterns can become entrenched and may negatively influence the rational, logical way you make decisions.

 

1. Black-and-White Thinking

A person with this dichotomous thinking pattern typically sees things in terms of either/or. Something is either good or bad, right or wrong, all or nothing. Black-and-white thinking fails to acknowledge that there are almost always several shades of gray that exist between black and white. By seeing only two possible sides or outcomes to something, a person ignores the middle—and possibly more reasonable—ground.

 

2. Personalization

When engaging in this type of thinking, an individual tends to take things personally. He or she may attribute things that other people do as the result of his or her own actions or behaviors. This type of thinking also causes a person to blame himself or herself for external circumstances outside the person’s control.

3. ‘Should’ Statements

Thoughts that include “should,” “ought,” or “must” are almost always related to a cognitive distortion. For example: “I should have arrived to the meeting earlier,” or, “I must lose weight to be more attractive.” This type of thinking may induce feelings of guilt or shame. “Should” statements also are common when referring to others in our lives. These thoughts may go something like, “He should have called me earlier,” or, “She ought to thank me for all the help I’ve given her.” Such thoughts can lead a person to feel frustration, anger, and bitterness when others fail to meet unrealistic expectations. No matter how hard we wish to sometimes, we cannot control the behavior of another, so thinking about what others should do serves no healthy purpose.

 

4. Catastrophizing

This occurs when a person sees any unpleasant occurrence as the worst possible outcome. A person who is catastrophizing might fail an exam and immediately think he or she has likely failed the entire course. A person may not have even taken the exam yet and already believe he or she will fail—assuming the worst, or preemptively catastrophizing.

 

5. Magnifying

With this type of cognitive distortion, things are exaggerated or blown out of proportion, though not quite to the extent of catastrophizing. It is the real-life version of the old saying, “Making a mountain out of a molehill.”

 

6. Minimizing

The same person who experiences the magnifying distortion may minimize positive events. These distortions sometimes occur in conjunction with each other. A person who distorts reality by minimizing may think something like, “Yes, I got a raise, but it wasn’t very big and I’m still not very good at my job.”

 

7. Mindreading

This type of thinker may assume the role of psychic and may think he or she knows what someone else thinks or feels. The person may think he or she knows what another person thinks despite no external confirmation that his or her assumption is true.

 

8. Fortune Telling

A fortune-telling-type thinker tends to predict the future, and usually foresees a negative outcome. Such a thinker arbitrarily predicts that things will turn out poorly. Before a concert or movie, you might hear him or her say, “I just know that all the tickets will be sold out when we get there.”

 

9. Overgeneralization

When overgeneralizing, a person may come to a conclusion based on one or two single events, despite the fact reality is too complex to make such generalizations. If a friend misses a lunch date, this doesn’t mean he or she will always fail to keep commitments. Overgeneralizing statements often include the words “always,” “never,” “every,” or “all.”

 

10. Discounting the Positive

This extreme form of all-or-nothing thinking occurs when a person discounts positive information about a performance, event, or experience and sees only negative aspects. A person engaging in this type of distortion might disregard any compliments or positive reinforcement he or she receives.

This cognitive distortion, similar to discounting the positive, occurs when a person filters out information, negative or positive. For example, a person may look at his or her feedback on an assignment in school or at work and exclude positive notes to focus on one critical comment.

 

12. Labeling

This distortion, a more severe type of overgeneralization, occurs when a person labels someone or something based on one experience or event. Instead of believing that he or she made a mistake, people engaging in this type of thinking might automatically label themselves as failures.

 

13. Blaming

This is the opposite of personalization. Instead of seeing everything as your fault, all blame is put on someone or something else.

 

14. Emotional Reasoning

Mistaking one’s feelings for reality is emotional reasoning. If this type of thinker feels scared, there must be real danger. If this type of thinker feels stupid, then to him or her this must be true. This type of thinking can be severe and may manifest as obsessive compulsion. For example, a person may feel dirty even though he or she has showered twice within the past hour.

 

15. Always Being ‘Right’

This thinking pattern causes a person to internalize his or her opinions as facts and fails to consider the feelings of the other person in a debate or discussion. This cognitive distortion can make it difficult to form and sustain healthy relationships.

 

16. Self-Serving Bias

A person experiencing self-serving bias may attribute all positive events to his or her personal character while seeing any negative events as outside of his or her control. This pattern of thinking may cause a person to refuse to admit mistakes or flaws and to live in a distorted reality where he or she can do no wrong.

 

17. ‘Heaven’s Reward’ Fallacy

In this pattern of thinking, a person may expect divine rewards for his or her sacrifices. People experiencing this distortion tend to put their interests and feelings aside in hopes that they will be rewarded for their selflessness later, but they may become bitter and angry if the reward is never presented.

 

18. Fallacy of Change

This distortion assumes that other people must change their behavior in order for us to be happy. This way of thinking is usually considered selfish because it insists, for example, that other people change their schedule to accommodate yours or that your partner shouldn’t wear his or her favorite t-shirt because you don’t like it.

 

19. Fallacy of Fairness

This fallacy assumes that things have to be measured based on fairness and equality, when in reality things often don’t always work that way. An example of the trap this type of thinking sets is when it justifies infidelity if a person’s partner has cheated.

 

20. Control Fallacy

Someone who sees things as internally controlled may put himself or herself at fault for events that are truly out of the person’s control, such as another person’s happiness or behavior. A person who sees things as externally controlled might blame his or her boss for poor work performance.

 

If these cognitive distortions look familiar to you we can work together to change your thought patterns into empowering affirmations.

 

 

References:

1  Beck, Aaron T. (1976). Cognitive therapies and emotional disorders. New York: New American Library.

2  Beck, Aaron T. (1972). Depression; Causes and Treatment. Philadelphia: University of Pennsylvania Press.

3  Tagg, John (1996). Cognitive Distortions. Retrieved from http://daphne.palomar.edu/jtagg/cds.htm#cogdis

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