• Persistent low mood

• Self-critical thoughts

• Changes in sleep & appetite

• Loss of pleasure, reduced libido

• Anger, irritability

• Chronic feelings of shame and/or guilt

• Ruminative, circular thinking

• Suicidal ideation

Unmet developmental needs for a stable and secure attachment or an attuned connection may be communicated through episodes of recurrent depression. This might be characterised by persistent low mood, hopelessness, reduced motivational drive and disruption to regular biological rhythms; manifesting in changes to sleep such as insomnia or excessive daytime sleepiness, problems concentrating, a loss of interest in usual activities, and a reduced interest in sex.

Depression can also be felt through feelings of irritability, agitation and restlessness, and a reduced ability to derive pleasure from relationships or life.

Typically, there is a dominant guilt and shame-inducing inner critic in depression, so many individuals experiencing depression are also highly self-critical and troubled by feelings of chronic shame. In more severe cases, suicidal thinking may also become a risk, as can psychosis.

CBT is an effective treatment in depression; however, where CBT has already been tried without success, or depression is more chronic or recurrent in nature, Schema Therapy and/or EMDR are often needed to work with the deeper emotional experiences underlying this distressing condition.

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• Easily triggered by others

• Distrusting, holding grudges

• Intimacy fears

• Abandonment anxiety

• Ghosting

• Unhealthy boundaries, Co-dependency

• Swinging between idealising and denigrating others

• Interpersonal hostility and/or aggression

• Personality disorder

Earlier attachment interruptions or a more recent traumatic ending, loss or separation may interfere with relationships through abandonment anxiety, fear and distrust of others, and in other cases, unhealthy boundaries and co-dependency. Interpersonal difficulties may be limited to intimate relationships only or reflect more pervasive difficulties in relating within both intimate and platonic relationships.

Where attachment interruptions are marked and repeated, and problems in regulating mood and identity become more chronic and pervasive, personality disorder may be diagnosed. 

Schema Therapy is very effective in working with the developmental origins of adult relationship problems.

Schema Therapy is also helpful for anyone wishing to resolve abandonment anxiety, intimacy fears, unhealthy boundaries, trust issues, and any other pattern of relating that interferes with the quality and stability of relationships.

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• Feeling anxious and nervous

• Panic attacks

• Physical symptoms (heart palpitations, sweaty hands, breathlessness)

• Intrusive, ruminative thoughts

• Catastrophising thoughts (fearing the worst)

• Avoidant behaviours, phobias

• Obsessions & Compulsions

Everyone feels anxious at times. Indeed a certain amount of anxiety is to be expected in a fully lived life. There are situations however where anxiety may become more problematic and impact negatively on life choices, interfering with everyday functioning.

For some, anxiety restricts their ability to socialise and mix with others, while others have no difficulty mixing with their friends and family, but are flooded with anxiety if they are asked to speak in public. Others develop specific fears or phobias, such as a fear of flying, a fear of spiders, or claustrophobia.

Anxiety is identified by the nature of one’s anxious fearful thoughts but also physiological symptoms, which may include heart palpitations or breathlessness. Some individuals develop compulsive behaviours such as hand washing or checking behaviours in an attempt to cope with anxious and obsessive thinking. Obsessive Compulsive Disorder may be diagnosed where these difficulties become extremely self-limiting, interfering with relationships and overall well-being.

If you present for therapy with symptoms of anxiety, it is likely that I will offer you Schema-focussed CBT. If however CBT has already been tried with limited effect, or there is an identifiable trauma memory underpinning your anxiety symptoms, EMDR may be most effective.

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• Feeling fearful and unsafe

• Heightened startle response

• Flashbacks

• Nightmares

• Repetitive & distressing images or sensations

• Dissociation

• Physical sensations (pain, sweating, trembling)

• Somatisation (a physical expression of an unspoken story)

A recent traumatic event in adulthood or an earlier attachment trauma may resolve and heal naturally through adjustment and time. However, sometimes memories of a past event persist and remain locked in the emotional limbic system of the brain, expressed in trauma symptoms such as flashbacks, nightmares, and a heightened startle response. In some cases, symptoms reach the threshold for Post Traumatic Stress Disorder (PTSD).

Where an individual has dissociated significantly during a traumatic experience, physical health needs such as chronic pain and other physical health manifestations may also emerge. This process of somatisation is, in some cases, an attempt by the body to express an unspoken story.

If an individual has experienced repeated attachment trauma during their development, where basic needs for safety, a secure attachment, and an attuned connection are not met, Complex Post Traumatic Stress Disorder (C-PTSD) may develop.

Eye Movement Desensitisation & Reprocessing (EMDR) is the recommended treatment for PTSD.
For C-PTSD, I recommend a combination of Schema Therapy and EMDR.

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• Irritability, anger, rage

• Interpersonal difficulties

• Difficulties regulating mood

• Physical symptoms (Hot, clenching muscles, tension)

• Impulsive & Destructive behaviour

Anger is a natural instinctive response to an injustice or a threat. A healthy level of anger may be helpful in alerting us to unacceptable or toxic behaviour in others particularly if our boundaries are being unfairly crossed. For some, however, anger has become more chronic and is eroding health and relationships. Anger and irritability may be a sign of depression, or may be related to another issue such as alcoholism, bipolar disorder or grief.

Anger may emerge as a way of coping with vulnerable feelings by finding fault in the circumstances of one’s life and in those around oneself. Either way, anger issues are invariably accompanied by relationship problems, as problematic levels of anger interrupt the stability of relationships and functions to push others away. Being able to identify and work through the vulnerable feelings that sit beneath anger is a significant focus for treatment. Venting the anger may be needed in some circumstances, whilst for others, progress is achieved by setting limits around angry modes.

Schema Therapy, particularly schema mode work, is very effective in working with anger - be it the anger of a child mode, the anger of an overcompensatory coping mode, or the anger of an avoidant angry-protector mode.

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• Sudden & severe variations in mood, activity and energy levels

• Elevated energy & elevated mood phase:

  • increased confidence, unusual talkativeness

  • increased goals/ideas

  • racing thoughts

  • impulsive/risky behaviour

• Lowered energy & lowered mood phase:

  • depressed, apathetic

  • Unstable self-esteem

  • slowing of drive, fatigue

  • reduced motivation, retreating from others, opting out of goals and commitments.

Unmet developmental needs for stability, be it through interruptions in early attachment experiences, or inconsistencies in nurturance, acceptance and limits, may manifest in adulthood through difficulties in regulating mood and emotional reactivity. Mood instability can range from everyday variations that fall close to healthy limits, to more severe and potentially dangerous fluctuations in mood, with diagnosable manic and depressive episodes. Where there are additional life stressors in adulthood or biological risk factors, these mood regulatory difficulties may reach the threshold for Bipolar Affective Disorder.

Both Schema Therapy & EMDR are used effectively in treating characterological variations in mood and reactivity.

Where cylcothymic oscillations in mood are becoming more frequent or bipolar disorder is diagnosed, psychological treatment is often best delivered in combination with psychiatric treatment to stabilise mood and manage risk. Under these circumstances, I will, with your consent, make a psychiatric referral to ensure integrated care.

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• Pushing others away, avoiding intimacy

• Self-sacrificing, rescuing, people pleasing

• Deceitfulness, infidelity

• Perfectionism, hyper-criticalness, over-control

• Comfort eating, Netflix binges

• Avoidance, procrastination

• Alcohol, drug misuse or dependence

• Compulsive sex, porn, gambling, gaming, smartphone use

Self-sabotage can be thought of as repeated unhealthy patterns in thinking and behaving which act to inhibit psychological health, connections and growth, and keep one from achieving personal goals. Self-sabotaging behaviours include procrastination, perfectionism and hyper-control. Addictive behaviours and impulses can also be conceptualised in this way, including alcohol misuse, comfort eating and excessive gaming. These behaviours have usually developed initially as attempts to cope with unmet core needs for connection, or as an attempt to escape upsetting feelings. But ultimately these behaviours (also described as schema coping modes) perpetuate the very feelings they were initially developed to avoid, i.e. increasing feelings of shame or disconnection from others.

Schema Therapy is an extremely effective model for working with self-defeating patterns of thinking and behaviour. Strengthening healthier adult coping resources is a goal, as is resolving the unmet needs which sit beneath the inner-saboteur.

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• Stress, Burnout

• Perfectionism & Over-control

• Fear of failure/Fear of Success

• Procrastination

• Imposter syndrome

• Issues with trust & collaborating

• Narcissistic self-reliance

• Unfulfilled personal relationships

Many of the worlds most inventive, creative and entrepreneurial minds are also some of the most troubled. It’s not uncommon for successful professionals and founders to enter therapy in crisis at the height of their success, having neglected to attend to their mental health and relationship needs whilst pursuing their business and career goals. This is sometimes about time and priorities as some individuals only feel able to invest time in their psychological health when business pressures have eased. But for others, the success itself is a trigger. The emotional needs that sit deep beneath a tenacious and driven vision can emerge unexpectedly.

I offer tailored therapy and coaching services for founders and creatives. These services are also recommended for anyone embarking on a new business or professional pursuit to ensure that mental health needs are not neglected as they rush energetically and enthusiastically into a new project. Individuals who want to leave an unfulfilling job, but don’t have the confidence, or fear the risks involved in leaving the stability of their long-term role, will also benefit from these services.

Learn more about creative & entrepreneurial mental health services