CBTMONTHLY September 3rd 2011
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Testimonial by Ruby on her journey with Depression
Trauma-how canHoarding-more imagery help? than just clutter
What can you do first with intrusive 1 CBT in the City Ltd Registered company in UK:6709268. CBT in the City is a registered Trademark copyright 2010 and all work produced and published is the property of CBT in the City Ltd. Any reproduction is prohibited
CBTMONTHLY September 3rd 2011
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Contents Meet the teamPage 3
Hoarding? What is it and how can it be treatedFactcorner Page 5
pitstophow to assess for NATs/intrusive thoughts Page 7
testimonialRuby Page 10
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CBTMONTHLY September 3rd 2011
Team members Multi professional group !
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Matt Broadway-Horner is the Clinical Director of CBT in the City Clinics. He consults on research projects in both the NHS and private sectors. He currently holds a teaching post at University of Hertfordshire as Module leader for complex mental health disorders Post grad Dip/Masters program. He has had many years experience of running groups as well as 121 therapy using Cognitive Behaviour Therapy for anxiety disorders, Depression and Trauma
Sophie Mayes worked as an occupational therapist for 12 Dr Tamsin Kewley Consultant Psychiatrist works within years in the field of mental health. She has worked in a number of specialities such as drug addictions, personality disorders, the NHS and private sector in delivering high quality medical forensic services and community mental health teams. She assessments, case load management and medication reviews. specialised in Cognitive Behaviour Therapy BSc and Post Grad She has worked in behavioural units and psychotherapeutic Dip CBT and is employed by the South London and Maudsley communities in treating eating disorders, anxiety, depression trust as a high intensity cognitive behaviour therapist. This and addictions. To book your consultation with Dr Tamsin involves working in as a therapist across Lambeth doing group Kewley please use our contact form and individual CBT specialising in depression and anxiety disorders. Part of this work involves working at the Centre for ! Anxiety Disorders at the Maudsley hospital and specialising in treating post traumatic stress disorder. She also has other !"#$%&'()"*+$%")(&+&$'&,'"(-./ interests in obsessive compulsive disorder and social phobia and has extensive experience in running groups %011(2324(564(7829(:;<(=;<>(?@:;<=0A?;@
For more information, book an appointment or enrol in a CBT Programs you will need to contact us, register online or telephone 0207 467 1508 !
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Hayley Matthews is a trained Cognitive Behaviour Therapist accredited with the BABCP and registered with the Health Professions Council as an Occupational Therapist. She currently works for an Improving Access to Psychological Therapies service in delivering Cognitive Behaviour Therapy to people with anxiety disorders and depression on an individual and group basis. Hayley also supervises other therapists and multi-disciplinary team members. Hayley is available for individual CBT and/or Group CBT Therapy for cash payers and for those wanting to use their private medical insurance.
CBT in the City Ltd Registered company in UK:6709268. CBT in the City is a registered Trademark copyright 2010 and all work produced and published is the property of CBT in the City Ltd. Any reproduction is prohibited
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CBTMONTHLY September 3rd 2011
hoarding compulsive and ruins lives By Fact corner
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.
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 The consequences of hoarding are horrific and can be (as mentioned above), and of course representing a potential literally fatal. One of the most infamous cases of hoarding was fire hazard. the American Collyer brothers. Way back in 1947, their bodies There is also a danger of infection. Old clothes left lying were discovered in their crumbling New York City mansion, around for months will get damp and collect mildew. This can where they had lived surrounded by an amazing 100 tons of irritate those who suffer from allergies and conditions such as clutter, some of which subsequently fell on top of them asthma. Old empty food containers and even food leftovers will crushing them to death. Only last year a woman was smothered attract rodents, and their droppings and urine are a constant to death when a huge pile of clothing fell on her. There have source of potentially serious infection. been many instances of fires being caused by inflammable The mountains of clutter left lying around can also clutter which has in turn caused the deaths of several hoarders interfere with the proper function of things in the house. who were tragically unable to escape in time because doorways Fireplaces become unusable, and winters can be very cold and and passages in their homes were totally obscured by piles and uncomfortable in hoarder’s houses, and even toilets and piles of clutter. bathrooms become overrun with clutter. Cluttered houses are Video of clearing a cluttered property in Edinburgh. dangerous places for children, and also for the elderly who will If you need a cluttered property clearing click here have extreme difficulty trying to navigate themselves around Compulsive hoarding can strike anyone of any age, gender, and through the chaos. or background. It is treatable, but it can be quite difficult in But it is not only the hoarders themselves who are in some cases to get a hoarder to acknowledge that their clutter danger, their clutter also represents a fire hazard to neighbour’s presents any form of problem. The other problem is that houses, and also to any members of the emergency services professional help, via cognitive behavioural therapy, but not who are called to the house to deal with fires or other every therapist knows how to treat the problem and so it is emergencies. important to find a specialist CBTer. There is also a financial consideration. To de-clutter a In terms of the type of clutter that hoarders amass, it can chronic hoarder’s house is quite an expensive operation, and if be anything and everything. The items may have some value, the hoarder cannot finance it him/herself, then the local but in many cases the items are no more than junk, often being council has to step into the breach and use taxpayer’s money. broken beyond repair and therefore useless. But a typical Of course there is no guarantee that the house won’t revert hoarder will perceive that the object may one day come in back to becoming a rubbish tip again. ! useful. Most people for example will throw their old newspapers away into their recycling bin, but by comparison, a hoarder will !"#$%&''#())*+,&-)()*./."'.0'( hold on to those old papers believing them to be a source of potentially useful, and maybe even life changing information. 12*3224*5677*898:*;<:*=>8? 2@*AB6C7*52DE65EF53ECDEGA5CEHI52B When newspapers are thought of in this way by a hoarder, it
5 CBT in the City Ltd Registered company in UK:6709268. CBT in the City is a registered Trademark copyright 2010 and all work produced and published is the property of CBT in the City Ltd. Any reproduction is prohibited
CBTMONTHLY September 3rd 2011
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.
Fact corner
hoarding continued By Fact corner
The good news however is that CBT treatments (as treatment. tel: 02074671508 / 02075588894 or email: mentioned in an earlier paragraph), have shown successful contact@cbtinthecity.com. 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. For help with ! Hoarding then please contact the office today on 0207 467 1508 and ask to speak with Matt Broadway-Horner. !"#$%&'()"*+$%")(&+&$'&,'"(-./ To book an appointment then speak with Nuala Asad %011(2324(564(7829(:;<(=;<>(?@:;<=0A?;@ Our group therapy is called The Hoarders group which can be a option that can be combined with 121 therapy and home
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CBTMONTHLY September 3rd 2011
my journey with worry the shrinking of life
“Through a number of reallife experiments together with the therapist I started to re-educate my mind. The practical element was paramount as it showed me the lack of real substance of most of those beliefs that were responsible for causing states of anxiety”
By Francesco
When I first considered doing CBT I was going through a very tough time characterised by excessive worrying and states of extreme anxiety. This was severely impacting on the quality of my life to the point that even simple, ordinary tasks felt like a big burden which in turn led to inaction. When I started the CBT it was important for my motivation to set clear and specific objectives and attach a timeline to them. Through a number of real-life experiments together with the therapist I started to re-educate my mind. The practical element was paramount as it showed me the lack of real substance of most of those beliefs that were responsible for causing states of anxiety. I soon realised that it was mainly down to me what I wanted to achieve and got rid of the erroneous conviction that the success of the therapy mainly depended on the therapist. A combination of raising-awareness discussions and real-life experiments gradually softened my mind and my approach to problems. Progressively I was taking ownership of my life whiles at the same time excessive worrying and anxiety were fading in the background. By the time I finished my 14/15 sessions over a period of 4 months I felt much better, however the full benefit of the therapy only emerged further down
Francesco
the line when I realised that I had gained a new, more flexible approach to my life on a permanent basis and not simply a quick win on the wave of the therapy." For more information on treatment for worry/Generalised Anxiety Disorder call now on 020 74671508 or email contact@cbtinthecity.com
pit stop exercise By Matt Broadway-Horner
CBT skills lesson in pack of 6 lessons for more information contact
Once you have assessed your Automatic Negative Thoughts (ANT’s) then you need to reduce conviction in them. Rate you conviction level of how much you really believe it out of 100% this being the highest level of convictionDispute you ANT’s or core beliefs by using empirical, logical and practical disputing questions. For this exercise see how many practical disputes you can discover. Let me start you now with the following: How does thinking this way help me? What are the advantages of thinking this
way? What are the disadvantages of thinking this way? Now rate you conviction level again and hopefully there will be a reduction. Continue to do this until the level is as low as 30%. Now you need to find an Alternative Realistic Thought (ART’s) or helpful core belief and ask yourself practical questions to develop conviction it. So in the beginning conviction is 0% but then after the exercise then rate again your conviction level. Repeat until conviction level has been built upto 70%. For CBT skills lesson pack then contact the office on 020 74671508
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London Clinics are situated in Harley Street, Angel/Islington and Southgate. Outside London Clinics are in St Albans, Essex and Norwich
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CBT in the City Ltd Registered company in UK:6709268. CBT in the City is a registered Trademark copyright 2010 and all work produced and published is the property of CBT in the City Ltd. Any reproduction is prohibited
CBTMONTHLY September 3rd 2011
is characterized by excessive, uncontrollable and often irrational worry about everyday things that is disproportionate to the actual source of worry. This excessive worry often interferes with daily functioning,
Matt Broadway-Horner
Worry problem demoralisation By Matt Broadway-Horner
Generalized anxiety disorder (GAD) is an anxiety disorder For more information on therapy for Worry call 020 7467 that is characterized by excessive, uncontrollable and often 1508 and find out individual therapy. Our group therapy is irrational worry about everyday things that is disproportionate called The Worry group which can be a option that can be to the actual source of worry. This excessive worry often combined with 121 therapy interferes with daily functioning, as individuals suffering GAD typically anticipate disaster, and are overly concerned about everyday matters such as health issues, money, death, family problems, friend problems, relationship problems or work difficulties. Individuals often exhibit a variety of physical symptoms, including fatigue, fidgeting, headaches, nausea, numbness in hands and feet, muscle tension, muscle aches, difficulty swallowing, bouts of difficulty breathing, difficulty concentrating, trembling, twitching, irritability, agitation, sweating, restlessness, insomnia, hot flashes, and rashes and inability to fully control the anxiety. (ICD-10, a bible for diagnosis for Professional health practitioners). These symptoms must be consistent and on-going, persisting at least six months, for a formal diagnosis of GAD to be introduced.[Approximately 6.8 million American adults experience GAD,) and 2% of adult Europeans, in any given year, experience GAD.
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CBT in the City Ltd Registered company in UK:6709268. CBT in the City is a registered Trademark copyright 2010 and all work produced and published is the property of CBT in the City Ltd. Any reproduction is prohibited
CBTMONTHLY September 3rd 2011
cognitive behaviour therapy made a difference the human condition By Ruby
I was in a pretty bad way, isolating and withdrawing from friends and family. The more irritable I was the more I would withdraw as I could not recognise myself and I felt myself slipping away. Work colleagues would view me as being independent and everything being ok. Friends viewed me as strong and not needing help so when I isolated they did not think differently about it. I had Depression and through therapy I have learned that I portrait a strong image of myself to others so not to think or feel that I am a failure. The more I protected myself from being a failure the less rewarding life became. Its a catch 22 and so my life shrank. I learned that my perceptions on failure were not kicked up to reality and when addressed that my failure was not indeed a failure and this helped me to expand my life and take back what the Depression has taken. Also I can see the benefit of accepting certain things as a failure as they were things out of my control but it did not mean I was a failure but life cannot guarantee fairness all the time. This testimony is to encourage others to seek help and not suffer in silence as I had done for 2 years because I was afraid of what others would think.
For more information on Imagery Rescripting and Reprocessing Therapy then contact the office 020 7467 1508 or email matt@cbtinthecity.com Remember we are here to help
If you need help then book an appointment today
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CBTMONTHLY September 3rd 2011
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