Tag Archives: psychotherapy

Therapist with client

How can counselling help physical health problems?

Sick female on sofa with paramedics and concerned friend

There are countless people suffering everyday with symptoms that are medically unexplained. They may have a label/diagnosis but insufficient explanation as to what is actually going on to fully manage it. These are often managed with medication such as painkillers or anti-inflammatories, or patients simply have to try and put up with them having received a half-hearted explanation from their primary care physician. Examples include non-cardiac chest pain, tension-type headaches, globus-syndrome, chronic fatigue syndrome, non-epileptic seizures, candidiasis hypersensitivity, chronic pain syndromes, irritable bowel syndrome.

When a patient goes to their primary care physician for a physical symptom they should, of course by investigated to see if the symptom is caused by a physical health problem. For example, if you have difficulty swallowing, the physician will first take a full history, then your throat will be examined and further tests/scans etc will be done to discover any pathophysiology . Differential diagnoses could be gastro-oesophageal reflux disease (GORD), stroke, multiple sclerosis and various cancers. But if all of these are ruled out by the time the various tests are finished the most important thing is not to dismiss the patient’s symptom! How many of us with chronic symptoms have had various tests come back as “all clear” and thought—so what next?! I’m still suffering…how do I manage my symptom(s)?!

Female on floor with blanket blowing her nose

Research has shown that 52% of adult referrals to rheumatology, cardiology, gastroenterology, neurology and gynaecology have no known pathology linked to that speciality and are therefore discharged from that speciality without a management plan. This happened to me when I was referred to rheumatology—I received a half-hearted diagnosis of fibromyalgia, was told there might be a leaflet in the waiting room I could pick up on my way out and that was that. No treatment options, no plan, no hope.

It can be very difficult to see how a very physical symptoms can have any psychological component but the mind is an incredibly powerful organ. It controls everything that happens in your body. Day-in-day-out, unconsciously, your mind controls digestion, metabolism, your heart rate and respiration. You don’t consciously think “breath-in…breath-out…” but your body just does it. However, you can choose to slow down or speed up your breathing, take a deep breath or hold your breath if you want to. It’s also been shown that being aware of your heart beat can be effective during times of anxiety when you need to calm yourself down, you can consciously slow it down.

If you want to manage physical symptoms, a helpful exercise can be to think about where you feel emotions. For example, most people feel, at least a little workplace stress—where do you feel this? Do your shoulders feel tense? Does your chest feel heavy? Do you feel a knot in your abdomen? Noticing how your emotions impact your body is an important start on the road to getting your mind and body re-connected.

Another helpful processes is to think about when you first started noticing your physical symptoms. For example, did you experience a bereavement, a period of work stress, bullying, car accident or other trauma? Once identified, considering how you managed this event is key—do you think you’ve fully processed it? Don’t compare yourself to others, everyone deals with life’s events differently. Do you think there’s a pattern to how you deal with things? Are you a stiff-upper-lip type? Or do you busy yourself with helping others? Perhaps some things feel too painful to process? Noticing these patterns and considering what impact this could be having is important. If we don’t process stressful events, the stress needs to go somewhere; the tissues in your body will hold onto it until your consciously choose to release it.

Male on side of bed with head in hand

Not processing events fully can lead to shame and guilt. Holding onto these feelings becomes a negative cycle that can impact every area of life.

You may feel that your physical symptoms come and go randomly with no connection to anything and despite trying to find triggers. The body is amazing at holding onto stress and releasing it at a later date. For other people the body provides an early warning signal that your under stress. Counselling can help you become more aware of your emotions and how you process them. It can also help you becomes more in tune with your body, which, in turn, will improve your physical health.

If you’re not yet convinced that the brain-body connection is important, take a look at this study (Suzanne C. Segerstrom, Ph.D., et al.), it shows that law students who were confident had more and better functioning immune cells than worried students. This systemic review and meta-analysis (Alan Rozanski, MD, et al.) also showed that optimism was associated with lower risk of cardiovascular events.

During these difficult times, people are struggling with all sorts of unusual experiences and are dealing with untold pressures, don’t downplay how hard you’re finding it! It’s been shown that talking is one of the most important things we can do, whether this is to a trusted friend or to a professional counsellor, making the first step will be the hardest but it will benefit every aspect of your life.

female video call

How to find the right counsellor for you

I’m currently training to be a counselling. As someone who’s also experienced “lying on the therapists couch” I thought I’d put some thoughts together for people who might be looking for a counsellor or therapist in these difficult times.

If you were looking for a doctor, you would make sure they were registered with the General Medical Council. Therefore you should make sure that your therapist/counsellor is a member of an organisation such as: BACP, UKCP or NCS* (or equivalent in other countries). The counselling/therapy profession isn’t currently fully regulated (that means anyone can call themselves a counsellor and isn’t breaking the law)…but by making sure that they’re a member of an organisation such as these, you’ll be getting a professional who:

  • Has achieved a substantial level of training (at least diploma level having undertaken 100 hours supervised placement hours etc)
  • Frequently undertakes continuous professional development
  • Adheres to a specific code of ethics (which can be found on each website)

You may wish to use a directory such as Counselling Directory to search for a verified, accredited counsellor/therapist. We have been incredibly fortunate that counselling has become more accessible recently, it’s now available online or on the phone, although there may be pros and cons, see this recent blog. There are specific platforms where this is all that’s offered so that it’s available across the world (e.g. Better Help and My Online Therapy). However, location may be a priority, should you wish to return to face-to-face counselling at some point. When browsing profiles a few red flags to beware of:

  • A counsellor who claims they deal with too many areas—some very experienced counsellors may have expertise in a number of areas but watch out for inexperienced counsellor’s who’re just trying to look more attractive.
  • Offering too many therapies—integrative is a type of therapy that is a specific way of blending therapies but being a specialist in more than about 4-5 therapeutic interventions means the therapist may not know the therapies in any depth. Also beware of the opposite—very specialist therapies claiming to cure-all are spinning you false hope!

Before you go to meet you counsellor/therapist, try to be clear with yourself what you want. For example, they don’t/shouldn’t diagnose or offer advice, the sorts of things you might achieve involve understanding yourself and why you repeat unhelpful patterns better and developing more helpful ways of coping with life’s ups and downs. It’s not up to them to decide what you need. During the introductory session, it’s important to find out if what you want and what they offer align.

Once you meet a therapist, you may think that feeling a sense of connection is the most important thing; while you’re not wrong there are some other important points to consider:

  • Do you trust them to keep the boundaries? These are the framework on which everything else hangs—they help you maintain trust and they’re where the work begins! For example, if the sessions always run over time, do you trust them to maintain confidentiality?
  • Will you be able to form a working alliance with this person? This is the relationship that exists between the counsellor and client that means they are able to work together in a judgment free zone towards shared goals. Do you understand how they work and will this help you?
  • Will this person challenge you? If you feel too comfortable with this person, if they’re too similar to you, it can be difficult to push yourself outside your comfort zone and make the changes that are needed.
  • Have you been able to ask all the questions you have? Do you know how much it’s going to cost? Are you signing up for a specific number of session or is it open ended? How will you be reviewing you progress?

Obviously you don’t want things to go wrong but if at any point you’re uncomfortable or wonder if they’ve behaved unethically, have they told you what to do? (Speak to them initially, then contact their membership body.)

Counselling/therapy can be hard but fantastically rewarding.

A life unexamined is not worth living—Socrates
  • *BACP = British Association for Counsellors and Psychotherapists
  • UKCP = UK Council for Psychotherapy
  • NCS = National Counselling Society

My journey through therapy

Over the past few weeks I've been publishing blogs about different types of therapy. I've been very fortunately that the NHS offered me such fantastic opportunities, each therapy helped me understand something new and helped me grow and develop. Every therapy has its pros and cons. If you want therapy on the NHS, depending on the set up in your area, you will need to be referred, either by you GP or via a psychiatrist.

Follow the links to find out more:

Let me know your experiences.