CBT in the City Newsletter 35 - 2013

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FORMALLY CALLED CBT MONTHLY

Check out our new services in you local area November 2013 Message from Susie page 1 Pit Stop exercise

page 3 What

is ACT?4 A day in the life of a therapist Page 5 Fabulous Mindfulness weekenders 7 Hoarding a problem that is misery 8

Established

2006

The journey started in January 2006 in 10 Harley Street when Matt Broadway-Horner was working full time at the Priory hospital in north London. Initially he started part time in his clinic working two evenings weekly for the first year and then gradually growing until now working full time in 4 locations, 3 in London and 1 in St Albans. This has been a dream come true for Matt to work using CBT to help people deal with their problems before it becomes chronic and they are forced to take time off work due to illness.

Indeed the driving force behind the formation of the clinic comes from personal experience of Matt watching a relative struggle with mental illness with no alternatives proposed by the NHS until the conditioned worsened needing the enforcement of the Mental Health Act (1983)

Clinic services Our priority is work with you in finding the right therapist and that is convenient to you.

There are 2 main ways to contact us Call on 020 7467 1508 Contact@cbtinthecity.com

What is CBT?

Message From Susie @ CBT in the City The clinic has some fantastic programs like The Staying Stopped group for problem drinkers which run 3 times weekly for 6 weeks - a popular group which has been operational since 2006.

Mindfulness weekends are very successful both in London and ST Albans, do treat a loved one and pay for a taster session of mindfulness with a mindfulness practitioner. It could not be easier just go online www.cbtinthecity.com or click on link http://www.cbtinthecity.com/ shop/index.php? _a=viewCat&catId=2

discuss issues in a confidential group. The group is for men only and is once a week for 8 weeks.

We also operate a IVF clinic for those who are currently in an IVF treatment but require psychological therapies in the form of a support, help and guided discovery to finding your own resolve and resilience. Also new to CBT in the City is a group for surrogates and for parents in waiting which offers support and of course all these groups options are available on an individual option. So as you can see we do offer a wide range of services for your convenience so that you feel better about the life choices you make Call Matt or Susie on 02074671508 for more info

Cognitive Behaviour Therapy is a tradition that focuses on the way people think and act in order to help them overcome their emotional and behavioural problems. The effectiveness of CBT has been extensively researched more than any other Therapy and has shown that people stay well longer. This positive result is due in part to the educational aspects of CBT which can be applied to help an individual to become their own CBT Therapist

Which one?

Within therapy services we offer different approaches with in the CBT tradition, like REBT, Behavioural Activation, ACT, Mindfulness, CT, Imagery and Rescripting therapy, and Functional Analytic Psychotherapy. All have evidence of working and can significantly improve your life

Social media Do you know any man who suffers from Peyroines Condition? and is struggling to come to terms with this long term condition then we could be the answer. The clinical director has created a group for men to

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Pit Stop Exercise When your mood gets the better of you and destroys relationships then lets see if this skill will be useful to you. It is one of many skills and here is the first one. Ask yourself out of 100% of all the situations where your unhelpful anger got the better of you, How many would you regret the action or words said?

Hindsight is golden and this is where the 4 step can help and use this to your benefit. The 4 step will help you make the choice between unhelpful anger and turn towards helpful anger. Helpful anger I will use the word annoyance as this a helpful situation for voicing displeasure if it is necessary.

1. Walk away- This not to be used as a form of punishment to the other person. But instead say “Can we talk about this later as I need to make a call?” You can use any reason, cooking, needing the toilet etc but the aim here is to make an adult attempt to talk about this in 1 hr or later on in the day and so you are arranging now to make time for a discussion later.

2. Get calm-Take the dog for a walk or if no dog then take yourself out. Have a shower or draw water for a bath and use your sense of touch, sight, smell and sound to listen to the water, look at the steam and smell the soap.

3. Rethink- Ask yourself these 2 questions a) Am I fostering a relationship with the other person? b) Do I have more than one option here? If the answer to both questions is yes then you go to 4th step if not then go back to 2nd step and spend more time in getting calm. If you are able to consider more than one option then it may suggest you are tapping into helpful emotions like helpful anger or disappointment.

4. Go back with a response-Do you still need to say or act in the way you wanted to right now? Maybe now you don’t need to say the unhelpful angry words or actions as it is a waste of your time and energy? If so then act inline with your new evidence and walk according to your new behaviours and tendencies. Or maybe you still need to talk about problem but now have thought about a more helpful way to convey your displeasure.

It is the hope of the author to encourage you to tap into cool thoughts and thinking styles that will help you reach your value directions and will aid flexibility ultimately achieving goals. The 4 step is to be used at your point of return and this will be discussed in another article, as it is no use if you have lost your temper already. As with any skill it needs to be practiced as many times as you think of it. Try using it as often as you can and remember its

The CBT in the City Task force here to help YOU!

For more information please contact us

02074671508

What is ACT? an approach within the CBT tradition

By Matt Broadway-Horner ACT (Acceptance and Commitment Therapy) has acquired its name from the central message of accepting experiences which are outside of your personal control and beyond your means to enable any actions that may improve or better a situation or lifestyle. When using Acceptance and Commitment Therapy (ACT) people can develop for themselves a better more meaningful living, while maintaining the ability to handle the stress and pains which everyone will experience at some time in there existence. Using Mindfulness based therapies your mind can taught the personal and physiological skills to deal with dark or difficult thought and feelings, making them less important and thus reducing the impact they have on your general living. ACT can help people see clearly in there mind and encourage what they truly believe are the important factors in life for a stable well being. Acceptance and Commitment Therapy can inspire and motive your mind, clearing your thoughts from negative to positive thinking methods which will cleanse, inspire and motivate ones self, understanding and the disciplines required to move forward to a healthy mental progression and personal self change. Mindfulness based ACT (Acceptance and

Commitment Therapy) is different from the more traditional CBT (Cognitive Behavioural Therapy) as instead to challenging difficult, painful and distressing thoughts by challenging the problems. ACT employs a range of techniques which enables an individual to accept the thoughts and employ methods of Mindfulness, metaphors and language to reduce the concern and repetitive negative thought patterns. The basics of Acceptance and Commitment Therapy (ACT) and Mindfulness based Cognitive Behavioural Therapy (CBT) treatments have been developed to train the mind in ways of observing your life experience at this present moment without judgement or fear.

Mindfulness based ACT helps us protect, defuse and distance ones thoughts, reactions and sensations.

ACT is, at its core the psychological and mental suffering which is most usually caused by cognitive entanglement, avoidance of an experience and the psychological stubbornness which may lead to a failure to take control and develop the required behavioural changes in accordance with core values Core Principles of ACT: Creating a natural fusion with your thoughts Evaluation of each experience Avoidance of your experience Developing a reason giving towards your behaviour Core Principles a healthy alternative is to Acceptance and Commitment Therapy: Accept your personal reactions and be present Building a path for change Confidence to take action for self improvement ACT may be used in the treatment of many problems including addictions, anxiety, chronic pain, diabetes management, psychosis, stress, smoking and problems workplace

Core Principles of ACT: 1. Creating a natural fusion with your thoughts 2.Evaluation of each experience 3.Avoidance of your experience 4. Developing a reason giving towards your behaviour

Core Principles a healthy alternative is to Acceptance and Commitment Therapy: 1. Accept your personal reactions and be present 2.Building a path for change 3. Confidence to take action for self improvement

For more info please contact Matt or Susie 02074671508

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Hoarding helpline: 0800 and ask for expert

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Matt Broadway-Horner To book an appointment then speak with Matt Our group therapy is called The Hoarders group which can be a option that can be combined with 121 therapy and home treatment. tel: 02074671508 or email: contact@cbtinthecity.com.

What to do with hoarding?

Above all be patient and don’t mimic or be hostile to your loved one as this will not change their situation but instead make it worse Be a cheer leader Encourage and congratulate the small steps Be a co-therapist Check in with your relative or friend to find out what they need to do for homework. Homework should be a central part to therapy. The hoarder will tell you if they feel supported and part of a collaborative relationship CBT is one of the effective therapies CBT, art therapy and other imaginal therapies are just as effective as each other. CBT has many educational aspects and this is what helps people to understand and take the led in therapy Therapy It can be like a dance, 3 steps forward and 2 steps back BUT remember the 1 step gained and keep positive

For more info please contact Matt or Susie 02074671508

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A Day in the Life of A Therapist

by Matt Broadway-Horner Off to Sri Lanka on my yearly travels to enjoy time with my family and also to volunteer my time as a visiting lecturer to Colombo University. This is to teach to the 3rd cohort of students enrolled in Sri Lanka’s first ever Clinical Psychology course training to become part of the strong body of helping professionals in the country. I am working on behalf of the UK and Sri Lankan trauma charity which was set up in 1996 helping the country to cope better after tsunami and 30 years of civil war which has left the country in a poor state in every sense of the word. I met the course coordinator who shared with me the work that she has undertaken and what she wants to do next. She strikes me as a courageous woman as she shares with me her dreams and also her concerns about the governments plan to have a 24 hour drinking red zone in Colombo which will just “cover up the ills of our society”. She does not wants western problems of booze and partying to engulf her beloved country and I share her concerns and wonder why the government wants to take this move Does the government want to help the country to boogie getting pissed like many do with joy abandon to celebrate life? or do they want to anasthatise the people in helping them to forget the problems and atrocities of civil war?

Her students were a joy to teach and they managed to tolerate my western methods of teaching and endure some role play in order to learn skills of Functional Analytic Psychotherapy. They had many questions for supervision which seemed appropriate to the level of study and learning but others where not, which seemed to be specific to placement configurations. The students were given cases too problematic for even the most experienced of us, which does not aid the knowledge or confidence of the students. The students seemed relieved to know that I would struggle with some of their cases but unfortunately the course has yet to evolve into a stronger position as its still in its infancy. The students are eager for knowledge and want to become better and improve in their skills and I look forward to the day they will graduate to become qualified and be my colleagues. Another part of my work for the charity was to deliver a workshop on OCD calling it, What is anxiety and how does it manifest into an obsessional problem? with the participants being patients or relatives form the local area or so I thought but upon arrival I could see many workers from other charities as well as local Sri Lanka doctors and therapists. I quickly made up my mind to change the presentation from basic to intermediate level so as to cater for the many different needs in the room. The needs I assessed as multi level and so had an open floor for discussion using some role play to answer their questions. My main focus is OCD and the many different types that do not receive air time because of the shame attached to them like paedophile OCD, rape OCD, gay OCD, Incest OCD which the attendees found interesting and wanted to know more. All funds raised went to the renewal centre which is the outreach base in Colombo. I enjoyed helping very much and I wish them all the best and look forward to helping next year. For donations please go to www.cbtinthecity.com and make a payment using your card and drop us a email telling us about your donation so that I can make a record.

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2014 in

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Matt Broadway-Horner

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Book now for your treatment or buy a gift for a friend.

Please click on link http:// www.cbtinthecity.com/shop/ index.php? _a=viewCat&catId=2 and make payment for the full amount of ÂŁ195

Mindfulness weekend

Start 930am coffee & Tea 10 til 12 Mindfulness 12 til 1 Lunch (town centre 2 mins away) 1 til 330pm Mindfulness 330 til 4 tea & Coffee 4 til 5 MIndfulness

Start 930am coffee & Tea 10 til 12 Mindfulness 12 til 1 Lunch (town centre 2 mins away) 1 til 330pm Mindfulness 330 til 4 tea & Coffee 4 til 5 MIndfulness

Start 930am coffee & Tea 10 til 12 Mindfulness 12 til 1 Lunch (town centre 2 mins away) 1 til 330pm Mindfulness 330 til 4 tea & Coffee 4 til 5 MIndfulness

Intellectual Fascismby Albert Ellis Why had you better not rate your self or your essence? Albert Ellis provides a few more reasons: 1. Rating your self or your you-ness is an overgeneralization and is virtually impossible to do accurately. You are (consist of) literally millions of acts, deeds, and traits during your lifetime. Even if you were fully aware of all these performances and characteristics (which you never will be) and were able to give each of them a rating (say, from zero to one hundred) how would you rate each one?; for what purpose?; and under what conditions? Even if you could accurately rate all your millions of acts, how could you get a mean or global rating of the 'you' who performs them? Not very easily!

2. Just as your deeds and characteristics constantly change (today you play tennis or chess or the stock market very well and tomorrow quite badly), so does your self-change. Even if you could, at any one second, somehow give your totality a legitimate rating, this rating would keep changing constantly as you did new things and had more experiences. Only after your death could you give your self a final and stable rating.

3. What is the purpose of rating your self or achieving ego aggrandizement or self-esteem? Obviously, to make you feel better than other people: to grandiosely deify yourself, to be holier than thou, and to rise to heaven in a golden chariot. Nice work, if you can do it! But since self- esteem seems to be highly correlated with what Bandura (1977) calls self-efficacy, you can only have stable ego-strength when (a) you do well, (b) know you will continue to do well, and (c) have a guarantee that you will always equal or best others in important performances in the present and future. Well, unless you are truly perfect, lots of luck on those aspirations!

4. Although rating your performances and comparing them to those of others has real value because it will help you improve your efficacy and presumably increase your happiness rating your self and insisting that you must be a good and adequate person will (unless you, again, are perfect!) almost inevitably result in your being anxious when you may do any important thing badly, depressed when you do behave poorly, hostile when others out-perform you, and self- pitying when conditions interfere with your doing as well as you think you should. In addition to these neurotic and debilitating feelings, you will almost certainly suffer from serious behavioral problems, such as procrastination, withdrawal, shyness, phobias, obsessions, inertia, and inefficiency (Bard, 1980; Ellis, 1962, 1971, 1973; Ellis and Becker, 1982; Ellis and Harper, 1975; Ellis and Knaus, 1977; Grieger and Grieger, 1982; Miller, 1983; Walen, diGiuseppe and Wessler, 1980; Wessler and Wessler, 1980).

For these reasons, as well as others that I have outlined elsewhere (Ellis, 1962, 1971, 1973, 1976, 1988), rating or measuring your self or your ego will tend to make you anxious, miserable, and ineffective. By all means rate your acts and try (undesperately!) to do well. For you may be happier, healthier, richer, or more achievement- confident (confident that you can achieve) if you perform adequately. But you will not be, nor had you better define yourself as, a better person.

If you insist on rating your self or your personhood at all which REBT advises you not to do, you had better conceive of yourself as being valuable or worthwhile just because you are human, because you are alive, because you exist. Preferably, don't rate your self or your being at all and then you won't get into any philosophic or scientific difficulties. But if you do use inaccurate, overgeneralized self-ratings, such as 'I am a good person,' 'I am worthwhile,' or 'I like myself,' say 'I am good because I exist and not because I do something special.' Then you will not be rating yourself in a rigid, bigoted, authoritarian, that is, fascistic manner.

Compulsive hoarding

by Matt Broadway-Horner Compulsive hoarding is a mental disorder that affects up to one person in every two hundred in the UK. It is classed by some as a type of OCD (Obsessive Compulsive Disorder) although there is a new school of thought that believes that it differs from general types of OCD, and that it should be treated as an illness in its own right. But what exactly is compulsive hoarding, and why can it be so damaging? Compulsive hoarding is not just a whimsical notion to collect certain items. It is far more serious, and in its most chronic manifestations it gets totally out of control and ruins lives; not only the lives of the individuals cursed with compulsive hoarding syndrome, but also the lives of those who may be unfortunate enough to cohabit with them, and even the safety of their neighbours. A compulsive hoarder is not simply someone who is lazy, or negligent. Chronic hoarders are suffering from a neuropsychiatric illness that will not go away unless professional help is sought. The consequences of hoarding are horrific and can be literally fatal. One of the most infamous cases of hoarding was the American Collyer brothers. Way back in 1947, their bodies were discovered in their crumbling New York City mansion, where they had lived surrounded by an amazing 100 tons of clutter, some of which subsequently fell on top of them crushing them to death.

Only last year a woman was smothered to death when a huge pile of clothing fell on her. There have been many instances of fires being caused by inflammable clutter which has in turn caused the deaths of several hoarders who were tragically unable to escape in time because doorways and passages in their homes were totally obscured by piles and piles of clutter.

Compulsive hoarding can strike anyone of any age, gender, or background. It is treatable, but it can be quite difficult in some cases to get a hoarder to acknowledge that their clutter presents any form of problem. The other problem is that professional help, via cognitive behavioural therapy, but not every therapist knows how to treat the problem and so it is important to find a specialist CBTer. In terms of the type of clutter that hoarders amass, it can be

anything and everything. The items may have some value, but in many cases the items are no more than junk, often being broken beyond repair and therefore useless. But a typical hoarder will perceive that the object may one day come in useful.

Most people for example will throw their old newspapers away into their recycling bin, but by comparison, a hoarder will hold on to those old papers believing them to be a source of potentially useful, and maybe even life changing information. When newspapers are thought of in this way by a hoarder, it becomes possible to understand that to discard them may seem an act of sheer recklessness, and would be seen by them as being both wasteful and foolish. The mere thought of discarding them will cause the hoarder much grief and soul searching.

Of course any kind of organisation quickly becomes impossible. In the beginning it may be possible to loosely categorise things and stow them logically, but with continual compulsive hoarding, the sheer volume of growing clutter becomes unmanageable, and it is gets put anywhere where space permits. One of the symptoms of a compulsive hoarder is one of procrastination. They can be reluctant, and in some cases unable to reach decisions. One reason for not putting things away is the desire to be able to see them at all times so they do not become forgotten. In other instances, what starts out by harmlessly leaving a few items of clothing on top of a chest of drawers instead of inside them, can in time become a veritable mountain of clothing causing danger from smothering (as mentioned above), and of course representing a potential fire hazard. There is also a danger of infection. Old clothes left lying around for months will get damp and collect mildew. This can irritate those who suffer from allergies and conditions

such as asthma. Old empty food containers and even food leftovers will attract rodents, and their droppings and urine are a constant source of potentially serious infection. The mountains of clutter left lying around can also interfere with the proper function of things in the house.

Fireplaces become unusable, and winters can be very cold and uncomfortable in hoarder’s houses, and even toilets and bathrooms become overrun with clutter. Cluttered houses are dangerous places for children, and also for the elderly who will have extreme difficulty trying to navigate themselves around and through the chaos. But it is not only the hoarders themselves who are in danger, their clutter also represents a fire hazard to neighbour’s houses, and also to any members of the emergency services who are called to the house to deal with fires or other emergencies.

There is also a financial consideration.

To de-clutter a chronic hoarder’s house is quite an expensive operation, and if the hoarder cannot finance it him/ herself, then the local council has to step into the breach and use taxpayer’s money. Of course there is no guarantee that the house won’t revert back to becoming a rubbish tip again. The good news however is that CBT treatments (as mentioned in an earlier paragraph), have shown successful results. It is not normally possible to truly rid a hoarder of his/her compulsion altogether, but a structured CBT program can help a hoarder to manage their condition. They are taught to recognise and analyse their compulsions in a way that makes it possible to resist them, perhaps not 100%, but to really put a limit on adding to their clutter, whilst at the same time making it possible for the hoarder to be able to consider gradually discarding and reducing the size of their hoard.

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Services available from Matt BroadwayHorner

Author

Workshops

Supervision

Personal development

Building links

Therapy

Coaching

Module leader

Consultant

Contract development and security

Teaching

Project management

Masters level marking

Medico legal reports

Who is Matt?

Matt is the visiting lecturer & module leader for the module complex mental health problems in the PgDip / MSc CBT program at University of Hertfordshire. Currently Matt is the project leader for the department of health project bid merging Long Term Conditions like Diabetes, Multiple Sclerosis, heart problems etc with IAPT services delivering CBT packages to patients and restructuring it to incorporate health psychology. Another project Matt is involved in is the CBT in Schools which has been running for 3 years and is proving successful in reducing many problems within schools and also empowering teachers to be best they have ever been!

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Matt used to work on a research study as a Consultant on delivering Cognitive Behaviour Therapy to people with Learning Disabilities within Camden and Islington populations. He is also currently a consultant lead on the CBT in

the City Schools Project with the primary objective of delivering CBT to Students in London Schools. The research is supported by Camden and Islington NHS Mental Health Trust, Mental Health Research Network and The National Institute for Health Research Matt also used to work as a Consultant Psychotherapist for the Priory Hospital in North London, working with clients both in group and individual therapy using Cognitive Behaviour Therapy. He also supervises other Therapists, multi-disciplinary team members and trainees. He previously worked as a specialist in the NHS at St George's Mental Health Trust in the Addictions department and acute Adult Psychiatry. He is available for Individual CBT and/or Group CBT Therapy for cash payers and for those wanting to use their private medical insurance

10 HARLEY STREET LONDON W1G 9PF

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