Let's Talk About CBT

In this episode, Helen is joined by Colin Blowers, James Jackson, and Hashir Aazh for a thoughtful conversation about tinnitus and how cognitive behavioural therapy can help. The panel draws on professional expertise and lived experience to explore what tinnitus is, why it can become distressing, and the importance of getting it checked. The conversation focuses on how CBT can support people to change their relationship with tinnitus, reduce distress, break unhelpful cycles of attention and anxiety, and live a full and meaningful life even when tinnitus is present. Key themes include acceptance, habituation, flare-ups, and why learning to manage reactions to tinnitus, rather than trying to eliminate it, can make a real difference. This episode will be helpful for anyone experiencing tinnitus, supporting someone who is, or interested in how CBT can help people live well with long-term conditions. Resources & Support: Helpful website: NHS information about tinnitus: https://www.nhs.uk/conditions/tinnitus/ More information about tinnitus can be found at Tinnitus UK World Tinnitus Congress- https://wtc2027.co.uk/ Books: Living Well with Tinnitus: A self-help guide using cognitive behavioural therapy- Hashir Aazh and Brian C.J. Moore Find more information about CBT- www.babcp.com Find our sister podcasts and all our other episodes in our podcast hub here: https://babcp.com/Podcasts Have feedback? Email us at [email protected] Follow us on Instagram & Bluesky: @BABCPpodcasts Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was produced by Steph Curnow

In this episode, Helen is joined by Jackie and Professor Roz Shafran to explore loneliness through both lived experience and clinical psychology perspectives. Jackie shares her personal journey with anxiety, bereavement, and loneliness, describing how these experiences affected her mental health and led her to seek CBT support. She reflects on what helped, what was challenging, and how strategies such as goal setting and connection building continue to support her today. Roz Shafran, Emeritus Professor of Translational Psychology at UCL, offers a clear and compassionate overview of how loneliness is understood in research and clinical practice. The conversation explores the difference between loneliness and social isolation, how loneliness can affect people at different stages of life, and what effective interventions can look like. The discussion covers stigma around loneliness, access to support and why loneliness deserves to be taken seriously. Jackie and Roz also share practical advice for anyone who recognises themselves in the discussion and is considering reaching out for help. Resources & Support: If you or someone you know needs urgent help, reach out to Samaritans at 116 123 (UK) or visit samaritans.org We have more information on how you can find help and support on our Mental health support services page here: https://babcp.com/what-is-cbt/mental-health-support-services-information/https://babcp.com/what-is-cbt/mental-health-support-services-information/ The loneliness umbrella study mentioned by Roz is: Solmi, M., Veronese, N., Galvano, D., Favaro, A., Ostinelli, E.G., Noventa, V., Favaretto, E., Tudor, F., Finessi, M., Shin, J.I., Smith, L., Koyanagi, A., Cester, A., Bolzetta, F., Cotroneo, A., Maggi, S., Demurtas, J., De Leo, D. and Trabucchi, M. (2020). Factors Associated With Loneliness: An Umbrella Review Of Observational Studies. Journal of Affective Disorders, [online] 271, pp.131–138. doi:https://doi.org/10.1016/j.jad.2020.03.075. Find more information about CBT- www.babcp.com Find our sister podcasts and all our other episodes in our podcast hub here: https://babcp.com/Podcasts Have feedback? Email us at [email protected] Follow us on Instagram & Bluesky: @BABCPpodcasts Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was produced by Steph Curnow

In this episode, Helen Macdonald talks with CBT therapist Sally Tribe about the impact of menopause and how Cognitive Behavioural Therapy can help. Sally shares her own experience of perimenopause, describes the wide range of symptoms people can experience, and explains how CBT can support those affected. The discussion covers the biological, psychological, and social aspects of menopause, the importance of awareness in workplaces and healthcare, and what reasonable adjustments and compassionate understanding can look like. They also talk about the latest guidance from NICE, how to access CBT through the NHS or private routes, and why no two menopause experiences are the same. Useful Information The British Association for Behavioural and Cognitive Psychotherapies (BABCP) is the lead organization for CBT in the UK. Find a NHS Talking Therapies service here Read the article by Sally on the menopause here Get in Touch If you have any questions or suggestions for future episodes, please email the Let's Talk About CBT team at [email protected]. You can also follow us on Instagram and BlueSky at @BABCPPodcasts. Remember to rate, review, and subscribe to the podcast wherever you get your podcasts. You can also listen to our sister podcasts: Let's Talk About CBT - Practice Matters and Let's Talk About CBT - Research Matters. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was edited by Steph Curnow

It's World Mental Health Day 2025, and this year's theme is 'access to services - mental health in catastrophes and emergencies'. The theme highlights the importance of people being able to protect their mental health in times of global instability. In this special episode of Lets' Talk about CBT, Helen Macdonald speaks with Kerry Young, a consultant clinical psychologist specialising in PTSD, particularly among asylum seekers and refugees. They discuss the impact of trauma on mental health, the challenges faced by asylum seekers in accessing mental health services, and the importance of community support. The conversation also touches on the role of interpreters in therapy, barriers to accessing services, and positive developments in mental health support for asylum seekers. Useful Information The British Association for Behavioural and Cognitive Psychotherapies (BABCP) is the lead organization for CBT in the UK. For those interested in supporting or learning more, Kerry suggests looking up: Freedom from Torture, the Helen Bamber Foundation, Breaking Barriers, Host Nation and The Refugee Council More information from the European Association for Behavioural and Cognitive Therapies can be found here Find translated health information from Doctors of the World here and translated mental health information from the Royal College of Psychiatrists here Links to services by region: Find a NHS Talking Therapies service here Wales: https://sanctuary.gov.wales/refugeesandasylumseekers/healthandwellbeing# https://www.mentalhealth.org.uk/our-work/programmes/refugee-programmes/refugee-and-asylum-seekers-wales Scotland: https://scottishrefugeecouncil.org.uk/health/#Mentalhealthsupport Northern Ireland: https://www.mentalhealth.org.uk/our-work/research/journey-wellbeing-refugees-transport-and-mental-health-northern-ireland Ireland: https://www.hse.ie/eng/about/who/primarycare/socialinclusion/intercultural-health/mental-health-supports/ Get in Touch If you have any questions or suggestions for future episodes, please email the Let's Talk About CBT team at [email protected]. You can also follow us on Instagram and BlueSky at @BABCPPodcasts. Remember to rate, review, and subscribe to the podcast wherever you get your podcasts. You can also listen to our sister podcasts: Let's Talk About CBT - Practice Matters and Let's Talk About CBT - Research Matters. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF

Ever heard of low Intensity CBT and wondered what it was all about? Or what it would be like to receive it? In this episode of Let's Talk about CBT, Helen talks to Laura Stevenson-Young, a cognitive behavioural therapist and Director of Low Intensity CBT Clinical Training at Newcastle University and Emily who shares her lived experience of low intensity cognitive behavioural therapy. Together, they explore what low intensity CBT is, what it's like to receive it, and how it can empower people to take control of their mental health. Emily talks candidly about the challenges that led her to seek help, including grief, anxiety, fertility concerns and low self-esteem. She describes the impact of low intensity CBT on her life, and the practical tools she still uses today. Laura explains how this type of therapy works, who it's for, and why it can be so effective. Resources & Support Find an NHS Talking Therapies service: https://www.nhs.uk/nhs-services/mental-health-services/find-nhs-talking-therapies-for-anxiety-and-depression/ More about CBT and BABCP: https://www.babcp.com Find our sister podcasts and all our other episodes in our podcast hub here: https://babcp.com/Podcasts Have feedback? Email us at [email protected] Follow us on Instagram & Bluesky: @BABCPpodcasts Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was produced by Steph Curnow Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't. I'm Helen Macdonald, your host. I'm the Senior Clinical Advisor for the British Association for Behavioural and Cognitive Psychotherapies. Hello and welcome. Today, I've got Emily and Laura with me and we're going to be talking about low intensity CBT, what that is and what it's like to be on the receiving end. But first, I'm going to ask you both to introduce yourselves. Emily? Emily: Hi, yeah, thank you for having me. I'm Emily, I live in Yorkshire with my fiancé. And in November 2022, I reached out to my local mental health service for a number of reasons, which I'm sure we'll cover in this podcast. I began with a four-week introduction to CBT program, which was in a group setting online. That was in December. And then by January, I began my CBT therapy and yeah, it was one of the best things I've done. Helen: Thanks, Emily. And Laura. Laura: Hi, Helen. Thanks for having us and Emily. So, I'm Laura Stevenson-Young. I'm a cognitive behavioral therapist and Director of Low Intensity CBT Clinical Training at Newcastle University. So this means that I train practitioners to deliver low intensity CBT interventions for many different types of mental health problems, namely depression and low mood, generalized anxiety disorder, panic, OCD and some other problems that can really affect the quality of people's lives such as stress or sleep difficulties and long-term health conditions. So I trained as a low intensity CBT therapist, mostly known as a Psychological Wellbeing Practitioner or PWP for short, well over a decade ago. And I then went on to further CBT training and became a clinical trainer in low intensity CBT. So this is probably really going to come out today, but I'm a real advocate for low intensity CBT, the practitioners who deliver it. I'm so passionate about the work that they do and how they empower people to manage their own mental health within NHS Talking Therapies. Helen: Thanks Laura. So Emily, you said there were a number of things that led to you reaching out to the local mental health services. And I wonder if you're willing to tell us a bit more about what was going on? Emily: Yeah, of course. Yeah. I mean, kind of looking back, I should have done it a lot earlier than I did. It was kind of a lot of things building up over probably a couple of years. My mood definitely was low after losing my granddad and then with different job roles, kind of things to do with that, it was an ongoing thing. And then in 2022, that's when I'd gained a lot of weight, I was losing a lot of confidence, and I was letting a lot of stress at work get on top of me, which then had an impact on my relationship. And then obviously we were just coming out of lockdown as well. So I think that had a massive impact on my mental health. It was definitely, there was a lot of low mood and also anxiety around all I wanted to do was see friends and family, but the thought of doing that was actually making me incredibly anxious and busy places were making me anxious, new surroundings were causing kind of panic attacks. We'd gone on a trip and we were getting on a plane kind of in 2022 and I had a full panic attack getting on the plane. And there was nothing within my brain that was pinpointing what exactly it was. But I think...overriding the kind of that sadness and th

In this episode, Helen Macdonald speaks with Chris Frederick- advocate, suicide survivor, founder of Project Soul Stride, and self-described "Mental Health Jedi." Chris shares his deeply personal journey, from childhood trauma and racial adversity to becoming a mental health advocate and what helped his recovery- and the things that didn't. Resources & Support: If you or someone you know needs urgent help, reach out to Samaritans at 116 123 (UK) or visit samaritans.org Brent Recovery College- https://www.cnwl.nhs.uk/services/recovery-and-wellbeing-college The Listening Place- https://listeningplace.org.uk/ James' Place- https://www.jamesplace.org.uk/ Find more information about CBT- www.babcp.com Find our sister podcasts and all our other episodes in our podcast hub here: https://babcp.com/Podcasts Have feedback? Email us at [email protected] Follow us on Instagram & Bluesky: @BABCPpodcasts Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was produced by Steph Curnow Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't. I'm Helen Macdonald, your host. I'm the Senior Clinical Advisor for the British Association for Behavioural and Cognitive Psychotherapies. Today I'm speaking with Chris Frederick. I'm absolutely delighted to have him here with me in the studio. He's going to share about his personal history and some difficult experiences that he had in his earlier life. How he ended up looking for help with his mental health and some of the things that helped as well as some of the things that were less helpful and how he's then started using his lived experience to help inform professionals, services and members of the general public about what helps and what helps people to access the kind of support that they need. He's also going to tell us how he ended up being known as the mental health Jedi. Chris, would you just like to introduce yourself and tell us a bit about who you are? Chris: So my full name is Chris Frederick. Born and bred in London, currently living in northwest London. I guess I like to introduce myself. Firstly, is I'm a suicide attempt survivor. I think it's important to get that out there. I'm an advocate and founder of Project Soul Stride, which we'll touch on a little bit later. And, also I'm a mad Star Wars fan. Helen: Oh, fantastic. And you've just mentioned a couple of things, really important things about your background and who you are. Is there anything else that you'd be happy to tell people listening today about your background and challenges or barriers that you've experienced? Chris: I mean I guess if I backtrack to the story that, that brought me to that point, very quickly in the barriers, because they might be things that listeners would identify with. I'm a twin, I'm 55. Growing up for us in the early seventies was a tough time. We lived as a small family of four in a flat in a council estate in Wembley and due to the pressures that my father and my mother who were very young, they were only 19 and 18, and they'd not long been in the UK from the Caribbean. So they themselves were carrying their own baggage, their own trauma, their own legacy and that transferred, I guess, onto us as young children. My father was a very strict, sort of military type figure. A beautiful looking man- if you put a picture of Muhammad Ali at his prime and my father at his prime, they could almost be twins, brothers, because that's how you know, he was tall, statuesque, beautiful green eyes, but on the downside, he had a heavy hand. And you know what I mean by that Helen, he had a heavy hand. He was quite, he was an intimidating character. And that manifested itself in negative behaviour in the house, physical abuse of various descriptions. And we grew up watching and witnessing and being victim of that as we grew up, and this is all within a black community. And then we moved at the age of 11, we upped sticks and moved to Chislehurst, which was a suburb of Kent. So imagine now we've moved from an all sort of majority ethnic community to now an ethnic minority community where we were the only black family on the street. Elms Street Avenue number 60, remember it well. Went to Kenmore Manor, and I remember for the first three years we were two of only five non-white pupils in the entire school. So without going into too much detail, you could also now begin to identify with the certain trends, the recurring themes, the racism of course, the pressures from my family. My parents eventually split up and divorced. My relationship with my twin eventually split. And so we ended up the complete, the family was completely fractured and still is today. And you bundle all that up. I started to experience mental ill health probably at the a

In this latest episode of Let's Talk About CBT, host Helen Macdonald is joined by two international guests- Tafi Mazikana and Sherrie Steyn who share their journey from CBT service user and therapist to CBT innovators. Tafi, originally from Zimbabwe, opens up about his experiences with anxiety while working in a high-pressured job in finance and how a digital CBT intervention through IAPT (now known as NHS Talking Therapies) changed his life. He talks candidly about the cultural stigma around mental health, what it was like to try therapy for the first time, and his realisation that CBT is about learning practical, empowering skills. We also hear from Sherrie, a clinical and community psychologist from South Africa and co-founder of the Vimbo Health app along with Tafi. She reflects on her friendship with Tafi, the surprising conversations that sparked their collaboration, and the importance of culturally adapted therapy. Together, they describe how Vimbo Health was developed to meet the unique challenges and needs of people in South Africa, particularly in terms of language, cultural metaphors, accessibility, and affordability. They explore how therapy can be made more relevant and relatable, from replacing metaphors like "three-legged stools" with potjie pots to tackling barriers like mobile data costs and mental health stigma. Whether you're a therapist or someone curious about accessing help in a different way, this conversation shines a light on how CBT can be tailored, inclusive, and transformative. Resources & Links: Learn more about Vimbo Health: https://www.vimbohealth.com/ Information on CBT and how to find a therapist If you or someone you know needs urgent help, reach out to Samaritans at 116 123 (UK) or visit samaritans.org Find our sister podcasts and all our other episodes in our podcast hub here: https://babcp.com/Podcasts Have feedback? Email us at [email protected] Follow us on Instagram & Bluesky: @BABCPpodcasts Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was produced by Steph Curnow Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't. I'm Helen Macdonald, your host. I'm the Senior Clinical Advisor for the British Association for Behavioural and Cognitive Psychotherapies. I'm absolutely delighted today to have some international guests for you. And in a moment, I'm going to ask, Tafi and Sherrie to introduce themselves. We're going to be talking with them about the experience of having CBT and then some really exciting developments that have happened since. But first, let's start with some introductions. Tafi, would you like to tell people who you are? Tafi: Yes, definitely. Thank you, Helen, really a pleasure to be with you today on this podcast. So I'm Tafi Mazikana and I'm Co-founder and CEO of Vimbo Health, a metal health app that's operating mostly out of South Africa. My background as I've shared, is not as a practitioner. My background is as a patient, of CBT who became very curious, perhaps too curious. So I was living in the UK working in banking and finance, and I was just very lucky to come across the services of IAPT which allowed me to self-refer in this area of mental health. I never knew that one could actually reach out and do something, so that was game changing in itself. But I was offered to have a digital CBT intervention, which was very transformative for me but obviously just left question marks as someone born and raised in Africa to say, well, who's thinking about the African context? Because, as I'll share later, there are things and ways of thinking and speaking that are different and I was just curious about who is going to think about that. And so became more and more involved, in this area of CBT, and in particular digital CBT. Helen: Thank you so much, Tafi. There's lots that we're going to talk about there. Before we start that though, Sherrie, can I ask you to introduce yourself please? Sherrie: Hi Helen. Thank you for having me. My name is Sherrie Steyn and I am from South Africa. I'm actually very fortunate to be from the East coast, so the sunny side, and my background is in clinical and community psychology. I tend towards the behavioural types of psychology. So I've done some ABA or as we call it VBA now and of course a special interest in CBT. So having done that clinical and community psychology, I then went on to do one of the allied CBT training courses through UCL. So I was very fortunate, to have done that. And that's a little bit about my background and, yes, I'm also the co-founder and CSO of Vimbo, I like to say I'm the science, because it sounds cool and yeah, just very happy to be here and share some of our experiences with you today. Helen: Thank you so much. So if I

In this episode of Let's Talk About CBT, Helen Macdonald speaks with Phil Cooper, mental health nurse and co-founder of the charity State of Mind Sport, and Ian Knott, former professional rugby league player and State of Mind presenter. Phil shares how State of Mind was born out of tragedy and developed into an award-winning mental fitness programme, now reaching thousands of athletes across the UK and beyond. Ian talks candidly about his experience of severe injury, depression, and suicidal thoughts after retiring from sport, and how CBT helped him to rebuild his life. We hear how sports settings are being used to break down stigma, encourage conversations, and promote mental health support—particularly among men—and how brief interactions and powerful personal stories can save lives. Resources & Links: State of Mind Sport website Information on CBT and how to find a therapist If you or someone you know needs urgent help, reach out to Samaritans at 116 123 (UK) or visit samaritans.org Find our sister podcasts and all our other episodes in our podcast hub here: https://babcp.com/Podcasts Have feedback? Email us at [email protected] Follow us on Instagram & Bluesky: @BABCPpodcasts Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was produced by Steph Curnow Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't. I'm Helen MacDonald, your host. I'm the senior Clinical Advisor for the British Association for Behavioural and Cognitive Psychotherapies Today what we've got for you is an episode about mental health, mental fitness and sports, and I've got Phil and Ian here to talk to me today. Phil, will you just introduce yourself? Phil: My name's Phil Cooper. I'm a mental health nurse by background. I used to work as a nurse consultant in mental health and drug and alcohol misuse. I love sport. And, for some strange reason or quirk of random chaos, I became to be one of the co-founders of State of Mind Sport charity that focuses on mental fitness. Helen: Thank you, Phil. Ian, please, will you introduce yourself? Ian: My name's Ian Knott. I'm a former rugby league professional and I currently am a presenter for State of Mind. I talk about my story, my lived experience of having to retire through a serious injury and then developing mental illness. So I talk about that. Helen: Thanks very much, Ian, and I'm sure our listeners will want to hear more about that later in this episode. Firstly though, can I ask Phil to tell us a bit more? Phil, will you tell us about State of Mind and how it came to be and what it does? Phil: Sure State of Mind Sport began unfortunately on the back of a tragedy within the sport of rugby league, where a Great Britain Rugby League international called Terry Newton, unfortunately took his own life in September, 2010. Sent great shock waves, I think, through the whole sport for such a high profile player. At the time there was relatively little support or mental health support for players at that time. I suppose as a mental health nurse who loves rugby league and sport, I read a league paper on a Monday morning, somebody wrote an article saying how the NHS and the sport should get together to try and prevent suicide. Also, somebody also wrote a letter, again a mental health professional, called Malcolm Rae and Ernie Benbow had written the article and I saw this and thinking, wow, this is Monday morning, I shall write these two individuals- checked with my chief exec, of course, because obviously you have to be doing all these things- and then invited them to a meeting we were going to have in good old health style a conference, that soon changed when we invited a couple of players such as Ian, and they suggested, why didn't we ask the governing body for a round of fixtures to promote mental health at that time or mental fitness. I then found myself in the strange position being ferried to Hull Kingston Rovers Ground to be presented before all the chief execs of all the top divisions with clubs to say, this is a really good idea. It's free. So the sport love that bit and, we'll deliver a session to your players before the season and then a round of fixtures themed around that. So we had a State of Mind round in 2011 and player bought into it. There was very little support, as I said, and they began to talk about it on social media. They wore t-shirts in the warmup before the round of fixtures, but crucially, they knew what it was about, and they were all bought in. Things have grown massively since that time, which has been great for us. And also promoting mental fitness in rugby league, one of the toughest sports on the planet. Helen: Thank you Phil. So can you tell us a little bit more about what you really mean by mental

In this special episode celebrating World CBT Day 2025, we explore this year's theme: CBT: A Solid Return on Investment. Host Helen Macdonald, Senior Clinical Advisor at BABCP, is joined by a range of voices reflecting on the impact, value, and future of CBT. We hear from: Dr. Adrian Whittington, National Clinical Lead for Psychological Professions at NHS England, about the rollout and outcomes of NHS Talking Therapies. Dr. Stirling Moorey, BABCP President, on the historical development of CBT and its increasing relevance and recognition over the decades. Nic, a former CBT client, who shares how therapy helped him manage anxiety linked to a long-term health condition. Dr. Saiqa Naz, past president of BABCP, who discusses her personal journey into CBT and her commitment to inclusion, diversity, and working with underrepresented communities This episode offers a rich blend of lived experience, clinical insight, and future vision, showing how CBT continues to be a wise investment for individuals, services, and society as a whole. Further information and links: Visit BABCP to learn more about CBT Find support via NHS Talking Therapies Discover more about World CBT Day Find our sister podcasts and all our other episodes in our podcast hub here: https://babcp.com/Podcasts Have feedback? Email us at [email protected] Follow us on Instagram & Bluesky: @BABCPpodcasts Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This podcast was produced by Steph Curnow Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't. I'm Helen Macdonald, your host. I'm the Senior Clinical Advisor for the British Association for Behavioural and Cognitive Psychotherapies. Welcome to this special episode of Let's Talk about CBT celebrating World CBT Day. World. CBT Day takes place every year on the 7th of April, and this year's theme is CBT: A Solid Return on Investment. In this episode, we're exploring just what that means- I will be speaking with Adrian Whittington, who's the National Clinical Lead for Psychological Professions at NHS England and with Stirling Moorey, who's our current BABCP President about how CBT has developed over time and the importance of continued investment in it. We'll also hear a personal story from Nic, who is a former client of Stirling's, who shares how CBT helped him manage anxiety and improve his quality of life. Finally, I sit down with Saiqa Naz who is past president of BABCP to talk about her journey into CBT from starting out in the Improving Access to Psychological Therapies services, to completing a clinical psychology doctorate, and how she embodies the idea of CBT being a real return on investment. We hope you enjoy this episode and the range of voices reflecting on the impact and value of CBT. Let's get started! Here's my conversation with Adrian and Stirling…. Adrian, would you introduce yourself please? Adrian: Yes. Hi. I am Adrian Whittington. I'm National Clinical Lead for Psychological Professions at NHS England, which means within England I'm the professional lead for psychologists, psychological therapists, and psychological practitioners. Helen: Thank you, Stirling, please introduce yourself. Stirling: Hi, I'm Stirling Moorey. I am currently the president of the BABCP and I'm a retired psychiatrist and really have been around in the CBT world since 1979. So, Adrian is speaking about CBT today and in the UK particularly and I'll just give a bit of a view of what it's been like to be in the CBT world for this length of time. Helen: Thank you very much. And so Stirling, if we come to you first, that's a long career- you must have seen a lot of developments over the years. Tell us a bit about what you've seen and how things have developed. Stirling: Indeed, I mean, so right at the very beginning when I was a medical student, cognitive therapy was just being invented. And so we had BT, Behaviour Therapy, but not the CBT that we have today. And so it was quite sort of revolutionary. The behaviour therapists look down their nose a little bit at it, the psychoanalytic therapists very much looked down their nose, and I remember at one point talking to a psychoanalyst who told me that being a CBT therapist was a bit like playing a tin whistle compared to being a concert violinist. I think things have changed since then. So, over the years, what's happened is that really from the work of pioneers like Isaac Marks in behaviour therapy, Aaron Beck in cognitive therapy, for the first time psychotherapists started to actually address what evidence do we have that this works? And using randomised control trials. And this has been really powerful. It was revolutionary at the time because people thought you couldn't manualise therapy but Beck and others mana

In this episode of Let's Talk About CBT, Helen Macdonald speaks with James from the charity Gambling with Lives about the serious impact of gambling addiction, its links to mental health, and the role of CBT in recovery. What We Cover in This Episode: 🔹 How gambling has changed – From a backstreet niche to an industry making billions through addictive products. 🔹 Gambling addiction and mental health – How gambling harms go beyond financial loss and can lead to depression, anxiety, and even suicide. 🔹 The neuroscience of gambling – How gambling rewires the brain, making it difficult to stop. 🔹 Recognising the warning signs – What to look for in yourself or a loved one. 🔹 The role of CBT in recovery – How cognitive behavioural therapy is a key treatment approach in NHS gambling addiction services. 🔹 Breaking the stigma – Why gambling addiction is not just about personal responsibility and we need to talk about how it can harm people and the amount of gambling advertising that is out there. 🔹 Getting help – Resources for those affected, including training for healthcare professionals. Resources & Links: Find out more about Gambling with Lives: gamblingwithlives.org Visit Chapter One for training and resources: chapter-one.org NHS gambling support services: NHS gambling support If you or someone you know needs urgent help, reach out to Samaritans at 116 123 (UK) or visit samaritans.org Find our sister podcasts and all our other episodes in our podcast hub here: https://babcp.com/Podcasts Have feedback? Email us at [email protected] Follow us on Instagram & Bluesky: @BABCPpodcasts Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was edited by Steph Curnow Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't. I'm Helen Macdonald, your host. I'm the Senior Clinical Advisor for the British Association for Behavioural and Cognitive Psychotherapies Welcome to today's episode. I'm really pleased to have James with me today. He's from an organisation called Gambling with Lives, and I will ask him first to introduce himself. Hello, James. James: Hi Helen, thank you for having me on. I'm James. I live in Stockport, originally from Norfolk, hence I haven't got a Northern accent, but I'm here today representing the charity Gambling with Lives. The charity was set up by bereaved families who'd lost loved ones to gambling related suicide and I now oversee our prevention work, which includes education, training, information, and resources. And a lot of that stems from my own lived experience of a 12-year gambling addiction, which started as a young person, and which I'm sure we'll touch on today. Helen: Thank you, James. And so I'm very aware that a charity that's been very much grounded in the experiences of bereaved families, there's going to be some difficult things to talk about here. And just to say for our listeners, there will be links to where to find help and support on the show page and as well as anything that we talk about during today's episode. So can I ask you just to tell us a little bit more about gambling? What is it? You know, how people might get themselves into trouble with it, maybe? James: Yeah, it's a big question. And the first answer that comes to my head is that gambling is not what it was. I think a lot of people have a perception of what gambling is, and that's a weekly bet at the horses or going to the bingo on a Thursday night, or the football pools. Gambling has absolutely transformed over the last 10, 20, 30 years. And it all really started from a point in 2005 when the Gambling Act was created by the Labour government at the time, which changed gambling from being this thing that was, you know, quite hidden, quite behind closed doors, wasn't promoted, was quite hard to go and do, wasn't that easy or available or accessible, and that Gambling Act changed that completely and allowed for relentless advertising, sponsorship, marketing, and allowed for bookmakers in the high street to have really addictive electronic machines in their premises. And they were things like the fixed odds betting terminals, which were roulette machines, which at the time were called the crack cocaine of gambling because they were that addictive. And that was not what gambling was. I remember when I was a child, in our town, I'm from a quite a sleepy, small town in Norfolk. And the bookies in our town used to be this like really dingy, horrible place to be honest behind in a back alley that I used to walk past it and think I'm never going in there, that is a place not for me. It's for old men, smoke coming out the doors, did not have any interest in that. But then when I was 16, which was a couple of years after this Gambling Act, it changed int

In this episode, Helen talks with Lizzie, a beauty content creator and disability advocate, and Bex, a CBT therapist, about Lizzie's journey navigating living with long term health conditions, trauma and the transformative impact of Cognitive Behavioural Therapy (CBT). Lizzie shares her experiences living with Crohn's disease, POTS (Postural Orthostatic Tachycardia Syndrome), and hypermobility spectrum disorder, alongside the emotional challenges of managing these conditions. She discusses her initial scepticism about therapy and how CBT helped her address anxiety, PTSD, and prioritising her own well-being. Bex offers insights into the therapeutic process, addressing common misconceptions about CBT, and highlights the importance of building trust and tailoring therapy to individual needs. Together, they discuss the interaction between physical and mental health and strategies for balancing driven lifestyles with well-being. Useful links: Explore Lizzie's content on Instagram and TikTok (@slaywithsparkle). Listen to our sister podcasts: Let's Talk About CBT - Practice Matters and Let's Talk About CBT - Research Matters: https://babcp.com/Podcasts Find us on Instagram: https://www.instagram.com/babcppodcasts/ Learn more about CBT www.babcp.com Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was edited by Steph Curnow Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't. I'm Helen Macdonald, your host. I'm the Senior Clinical Advisor for the British Association for Behavioural and Cognitive Psychotherapies What we've got for you today is a conversation with Lizzie and Bex. Lizzie's going to talk about her experiences of having CBT and living with a number of conditions that she'll tell us more about in the episode. We're going to talk to Bex, who is a CBT therapist, and she's going to talk with us about working with Lizzie as well. Welcome to you both. Lizzie, would you like to introduce yourself? Lizzie: Hello! Thank you so much for having me. So as Helen's just said, my name is Lizzie. I am also a beauty content creator known as @slaywithsparkle on Instagram and TikTok and a little bit of YouTube and I'm also a speaker that talks about disability awareness. And I try and raise awareness about the health conditions I've got and general sort of disability awareness and activism about that. Helen: Thank you Lizzie, and welcome. Thank you for coming to talk to us today. And Bex, would you like to tell our listeners about you? Bex: Hi. Yes, I'm Bex. I'm a CBT therapist and worked with Lizzie a little time ago, when I worked in a physical health service for IAPT at the time. And I currently work more with trauma in Sheffield both in the NHS and privately. Helen Thank you, Bex. And maybe I should just say, when you said IAPT, we're now talking about NHS Talking Therapies. Bex: That's right. Yes. Thank you for providing the update. Helen: So Lizzie, can I ask you a bit about what was happening for you? What was going on that meant you ended up having CBT? Lizzie: So for me, I really had quite a negative opinion about any sort of talking therapy and had very much been brought up with the idea that if you have some sort of mental health problem, you should be able to solve it yourself. And if you just think positively and carry on, then everything should be fine. Because of my health conditions, so I will just mention just briefly so people are aware what my health conditions are just for context. So I have, Crohn's disease, which I was diagnosed with when I was 21 and then later about 9- 10 years later, I was diagnosed with hypermobile spectrum disorder and also POTS, which is a condition that affects my blood pressure and heart rate. And when I had a first flare of Crohn's disease. I'd obviously had it a long time without realising, but when I first flared with Crohn's disease, I really struggled with the concept of having a physical health condition that I couldn't push through. So with my Crohn's, I ended up ignoring a lot of the doctor's advice because I had this idea that I should be able to cure myself. I really pushed myself to look at alternative therapies. And then, because of that, I ended up ignoring what the doctor said and becoming a lot more ill. Unfortunately, because of a combination of the Crohn's having been misdiagnosed for a long time as IBS, and then because of all of those sorts of ideas about that I should be able to cure myself, my Crohn's did get so bad that I ended up having to go to hospital and have emergency surgery on my bowel. Years later, so about two or three years later, I started having real panic attacks, which I'd never had before. I was anxious all the time and I couldn't sleep. I would sometimes wake up in the m

In this episode of Let's Talk About CBT, Helen Macdonald speaks with Pete Moore, author and creator of The Pain Toolkit, about his journey of living with long-term pain. Pete shares his experiences of how he was able to move from being overwhelmed by pain to learning CBT techniques and strategies which helped him learn to manage it effectively, regain control, and even help others do the same. Useful links: The Pain Toolkit website Live well with pain website Listen to our sister podcasts: Let's Talk About CBT - Practice Matters and Let's Talk About CBT - Research Matters: https://babcp.com/Podcasts Find us on Instagram: https://www.instagram.com/babcppodcasts/ Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was edited by Steph Curnow Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't. I'm Helen Macdonald, your host. I'm the Senior Clinical Advisor for the British Association for Behavioural and Cognitive Psychotherapies Today, I'm speaking with Pete Moore, who'll be sharing with us his journey living with long term pain. Many years ago, Pete took part in an inpatient pain management program, which among other things uses cognitive and behavioural techniques to learn how to manage long term symptoms of pain. Pete will tell us about his journey and where he is today in not only managing his own pain and staying active, but also how he helps other people to learn key ways of living successfully with long term pain. Pete, would you like to introduce yourself to our listeners? Pete: Yes, well, hi everyone. My name's Pete Moore and I'm the author and originator of the Pain Toolkit. I just want to say, Helen, thanks very much for inviting me along to do this podcast and I'm really looking forward to having a chat with you. Helen: That's great. Thank you very much, Pete. I think a good place to start would be if I ask you just to tell me a bit about how you ended up living with long term pain. Pete: Yeah, it's, such a familiar story actually that of mine. Back then in the early nineties, I had back pain and such and I used to sort of manage it by taking over the counter medication, et cetera, or just having a rest. But I didn't really do a lot to help myself. I didn't really know what to do with it. I just, you know, it's like most people just get on with life. But I think it was about 92, back then I was a painter and decorator, and I was painting a house over in Windsor Castle. Anyway, I went home that night and the next day I couldn't get out of bed. I found out later on that I'd prolapsed some discs in my back, I think, two in the lower, and one in the middle. And I was pretty scared, really frightened, et cetera. And I found it difficult even going to the GP, really. And anyway, long story short, I was given medication and anti inflammatories but little was I to know that back then there was, you know, managing back pain or managing pain itself was like being put in something called the medical model. And I wasn't really given any guidance around what I could do for myself. It was just, "take these pills. If they haven't worked, come back and see me". So I wasn't quite on Christmas card terms with the GP, but, you know, I was around there every month or so. Anyway, I had to stop working et cetera. And for me, movement was more pain. So I stopped moving. I was sent to the physiotherapist, but back then I don't think that they was quite well up to speed with managing pain or back pain and I was given exercises to do and which say do 10 of these, 10 of these, 15 of those and, and as you know yourself, when you've got subacute pain, as I did, then, I've got up to five or six repetitions and the pain went up so much I thought this can't be right. So, to me, I learned that, back then the exercise equalled more pain. So I just stopped moving. Helen: So I'm hearing you got lots of back pain. You did what most people would do, which is go and see your GP and you got prescribed medicines. And you said, medical models. So it's very much, you go and see somebody and they're going to prescribe some treatment and you expect to get better. But what you're telling me is that the medicines, the physiotherapy actually ended up probably not helping very much. And actually you were still struggling with the pain. And you also said that you were really scared as well. Pete: I guess I couldn't see any future for myself really and I was getting depressed and I just, I had no plan, you know, that was it and at the time I was only I think in my mid-forties, something like that back then. And I thought what's my future? I couldn't see any future for myself, and I went through a pretty, pretty sticky time really, you know. People that used to call and say how you doi

In this episode of Let's Talk About CBT, host Helen Macdonald speaks with Sarah, Sally, and Leanne about Sarah's experience of having Cognitive Behavioural Therapy (CBT) after giving birth. They explore how CBT helped Sarah regain control during a challenging postnatal period, addressing struggles such as insomnia, anxiety, and adjusting to new motherhood. Sarah shares her journey of balancing therapy with the therapeutic benefits of movement and time spent in nature. CBT therapists Sally and Leanne discuss the powerful combination of therapy, physical activity, and connecting with nature for improving mental health. Useful links: NHS Choices- Insomnia-https://www.nhs.uk/conditions/insomnia/ NHS Guidance on feeling depressed after childbirth: https://www.nhs.uk/conditions/baby/support-and-services/feeling-depressed-after-childbirth/ MIND information on how nature can help mental health: https://www.mind.org.uk/information-support/tips-for-everyday-living/nature-and-mental-health/how-nature-benefits-mental-health/ For more on CBT the BABCP website is www.babcp.com Accredited therapists can be found at www.cbtregisteruk.com Listen to more episodes from Let's Talk About CBT here. Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF This episode was produced and edited by Steph Curnow Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't. I'm Helen MacDonald, your host. I'm the senior clinical advisor for the British Association for Behavioural and Cognitive Psychotherapies Today I'm very pleased to have Sarah, Sally and Leanne here to talk with me about having CBT, in Sarah's case, when you've recently had a baby and also the value of getting more active and getting outside into nature and how that can help when you're also having CBT. Sarah, would you like to introduce yourself, please? Sarah: Hi, I'm Sarah. I'm, 37 from Sheffield and like I said, just recently had a baby, and she's absolutely wonderful. She is a happy, loud little bundle of joy. I ended up having CBT though, because the experience of having the baby wasn't what I thought it was going to be, I think is the reason. And I, just went a little bit mad, so I got some help. Yeah, I'm normally a very happy, positive, active person. Lots of friends, very sociable, always like to be doing things, always like to be in control and have a plan. I like to know what I'm doing and what everyone else is doing. And all that changed a little bit and I didn't really know what to do about it. So yeah, got some therapy. Helen: Thank you Sarah. So, we'll talk with you a bit more about what that was like. And first, Sally, would you like to just briefly say who you are? Sally: Yeah, so I'm, my name's Sally. I am a Cognitive Behavioural Therapist, working both in the NHS and in, in private practice at the moment. Helen: Thank you. And Leanne, Leanne: Hi, I'm Leanne. and I'm a cognitive behavioural therapist as well. And I also work in the NHS and in private practice with Sally. Helen: Thank you all very much. What we're going to do is ask Sarah to tell us a bit more about, when you use the term mad, perhaps I could ask you to say a little bit more about what was happening for you that made you look for some therapy. Sarah: Wel the short answer to that is I developed insomnia about 12 weeks postnatally, didn't sleep for five days. Baby was sleeping better than most, you know, so it was equally frustrating because there was no real reason I didn't think that I should be awake. And sleep obviously is very important when you've had a baby. As I said, I like to be in control, like to prepare, like to know what's going on. So I did hypnobirthing, I prepared, I planned, I packed the biggest suitcase for this birth of this baby that I was really excited for and I thought I'd prepared mentally for every eventuality- what kind of birth, what would happen afterwards, but all very physical because they're the sorts of things that I could understand and imagine. And basically I ended up having an emergency C section, which in the moment I was fine with and I didn't think I was bothered by it, but the level of pain afterwards, that then again affected my level of control over looking after the baby. And the level of debilitation it created that I wasn't expecting- this is the key thing, I wasn't expecting it. That meant that I wasn't able to be me, really. I wasn't able to not least look after a baby, but get myself dressed, get myself showered, walk to the shop, drive a car, play netball, walk my dog. And I wasn't able to do any of that. I didn't appreciate that I was struggling with that, with accepting that. And because it went on for so long, and of course with this comes the baby blues that everyone talks about, but that's mea

We're back! Let's Talk about CBT has been on hiatus for a little while but now it is back with a brand-new host Helen Macdonald, the Senior Clinical Advisor for the BABCP. Each episode Helen will be talking to experts in the different fields of CBT and also to those who have experienced CBT, what it was like for them and how it helped. This episode Helen is talking to one of the BABCP's Experts by Experience, Paul Edwards. Paul experienced PTSD after working for many years in the police. He talks to Helen about the first time he went for CBT and what you can expect when you first see a CBT therapist. The conversation covers various topics, including anxiety, depression, phobias, living with a long-term health condition, and the role of measures and outcomes in therapy. In this conversation, Helen MacDonald and Paul discuss the importance of seeking help for mental health struggles and the role of CBT in managing anxiety and other conditions. They also talk about the importance of finding an accredited and registered therapy and how you can find one. If you liked this episode and want to hear more, please do subscribe wherever you get your podcasts. You can follow us at @BABCPpodcasts on X or email us at [email protected]. Useful links: For more on CBT the BABCP website is www.babcp.com Accredited therapists can be found at www.cbtregisteruk.com Credits: Music is Autmn Coffee by Bosnow from Uppbeat Music from #Uppbeat (free for Creators!): https://uppbeat.io/t/bosnow/autumn-coffee License code: 3F32NRBYH67P5MIF Transcript: Helen: Hello, and welcome to Let's Talk About CBT, the podcast where we talk about cognitive and behavioural psychotherapies, what they are, what they can do, and what they can't. I'm Helen Macdonald, your host. I'm the senior clinical advisor for the British Association for Behavioural and Cognitive Psychotherapies. I'm really delighted today to be joined by Paul Edwards, who is going to talk to us about his experience of CBT. And Paul, I would like to start by asking you to introduce yourself and tell us a bit about you. Paul: Helen, thank you. I guess the first thing it probably is important to tell the listeners is how we met and why I'm talking to you now. So, we originally met about four years ago when you were at the other side of a desk at a university doing an assessment on accreditation of a CBT course, and I was sitting there as somebody who uses his own lived experience, to talk to the students, about what it's like from this side of the fence or this side of the desk or this side of the couch, I suppose, And then from that I was asked if I'd like to apply for a role that was being advertised by the BABCP, as advising as a lived experience person. And I guess my background is, is a little bit that I actually was diagnosed with PTSD back in 2009 now, as a result of work that I undertook as a police officer and unfortunately, still suffered until 2016 when I had to retire and had to reach out. to another, another psychologist because I'd already had dealings with psychologists, but, they were no longer available to me. And I actually found what was called at the time, the IAPT service, which was the Improving Access to Psychological Therapies. And after about 18 months treatment, I said, can I give something back and can I volunteer? And my life just changed. So, we met. Yeah, four years ago, probably now. Helen: thank you so much, Paul. And we're really grateful to you for sharing those experiences. And you said about having PTSD, Post Traumatic Stress Disorder, and how it ultimately led to you having to retire. And then you found someone who could help. Would you like to just tell us a bit about what someone might not know about being on the receiving end of CBT? Paul: I feel that actual CBT is like a physiotherapy for the brain. And it's about if you go to the doctors and they diagnose you with a calf strain, they'll send you to the physio and they'll give you a series of exercises to do in between your sessions with your physio to hopefully make your calf better. And CBT is very much, for me, like that, in as much that you have your sessions with your therapist, but it's your hard work in between those sessions to utilize the tools and exercises that you've been given, to make you better. And then when you go back to your next session, you discuss that and you see, over time that you're honing those tools to actually sometimes realising that you're not using those tools at all, but you are, you're using them on a daily basis, but they become so ingrained in changing the way you think positively and also taking out the negativity about how you can improve. And, and yeah, it works sometimes, and it doesn't work sometimes and it's bloody hard work and it is shattering, but it works for me. Helen: Thank you, Paul. And I think it's really important when you say it's hard work, the way you described it there sounds like the therapist was like the coach telling you how to or workin

The British Association for Behavioural and Cognitive Psychotherapies, the lead organisation for cognitive behavioural therapy (CBT) in the UK and Ireland, is 50 years old this year. In this episode Dr Lucy Maddox explores how CBT has changed over the last 50 years. Lucy speaks to founding members Isaac Marks, Howard Lomas and Ivy Blackburn, previous President David Clark, outgoing President Andrew Beck and incoming President Saiqa Naz about changes through the years and possible future directions for CBT. Podcast episode produced by Dr Lucy Maddox for BABCP Transcript Dr Lucy Maddox: Hello, my name is Dr Lucy Maddox and this is Let's Talk about CBT, the podcast brought to you by the British Association for Behavioural and Cognitive Psychotherapies or BABCP. This episode is a bit unusual, it's the 50th anniversary of the British Association for Behavioural and Cognitive Psychotherapies this year. And I thought this would be a nice opportunity to explore some of the history of cognitive behavioural therapy, especially the last 50 years. Some of the roots of CBT can actually be traced way back. Epictetus, an ancient Greek Stoic philosopher wrote that man is disturbed not by things, but by the views he takes of them. This is pretty close to one of the main ideas of cognitive behavioural therapy, that it's the meaning that we give to events, rather than the events themselves which is important. But actually, cognitive behavioural therapy started off without the C. To find out more, I made a few phone calls. Isaac Marks: Hello, Isaac Marks here. Dr Lucy Maddox: Isaac Marks was one of the founding members of BABCP and a key figure in the development of behavioural therapy in Britain. I asked him if he could remember what CBT was like 50 years ago. Isaac Marks: Originally it was just BT and a few years later the cognitive was added. At the time, the main psychotherapy was dynamic psychotherapy, sort of Freudian and Jungian. But just a handful of us in Groote Schuur Hospital psychiatric department, that's in Cape Town, developed an interest in brief psychotherapy. And I was advised if I was really interested in it and I was thinking of taking it up as a sub profession, that I should come to the Maudsley in London. Dr Lucy Maddox: Isaac and his wife moved to London from South Africa and Isaac studied psychiatry at the Maudsley Hospital in Camberwell. What was it about CBT that had interested you so much? Isaac Marks: Because it was a brief psychotherapy, much briefer than the analytic psychodynamic psychotherapy. We were short of therapists and there wasn't that much money to pay for extended therapy, just a few sessions. Six or eight sessions something like that could achieve all what one needed to. They had quite a lot of article studies. Dr Lucy Maddox: And I guess that's still true today, that those are some of the real standout features of it, aren't they? That it is a briefer intervention than some other longer-term therapies and that it's got a really high quality evidence base. Isaac Marks: I think that's probably true, yes. Howard Lomas: There was a group that met at the Middlesex Hospital every month. And that was set up by the likes of Vic Meyer, Isaac Marks, Derek Jayhugh. Dr Lucy Maddox: That's Howard Lomas, another founding member of BABCP remembering how the organisation got set up 50 years ago from lots of different interest groups coming together. Howard Lomas: These various groups that got together and said, "Why don't we have a national organisation?" So that was formed back in 1972. Dr Lucy Maddox: Howard's professional background was different to Isaac's psychiatry training, but he found behaviour therapy just as useful. Howard Lomas: I'd originally trained well in social work, but I was a childcare officer with Lancashire County Council. Dr Lucy Maddox: And how were you using CBT or behaviour therapy in your practice? Howard Lomas: Well, as a general approach to everything, thinking of everything in terms of learning theory. How do we learn to do what we do and maintain it with children? Things like non-attendance at school and other problems, behavioural problems with children and then later problems with adults. But I suppose when I moved to Bury in 1973, I was very much involved in resettlement of people with learning disability from the huge hospitals that we had up here in the north. We'd three hospitals within sight of each other, each with more than 2,000 patients. Dr Lucy Maddox: Wow. Howard Lomas: They're all closed now long since, but yeah, the start of that whole closure programme of trying to get people out into the community. You learn normal behaviour by being in a normal environment, which people in institutions clearly aren't and weren't. So it's trying to create that ordinary valued environment for people. And simply doing that would teach them ordinary behaviours, valued behaviours. It was evidence-based, it was also very effective. It looked at behaviour for what it was rathe

In this bonus episode of Let's Talk About CBT, hear Dr Lucy Maddox interview Dr Tom Ward and Angie about SlowMo: digitally supported face-to-face CBT for paranoia combined with a mobile app for use in daily life. Podcast episode produced by Dr Lucy Maddox for BABCP Transcript Dr Lucy Maddox: Hello and welcome to Let's Talk about CBT, the podcast from the British Association for Behavioural and Cognitive Psychotherapies, BABCP. This podcast is all about CBT, what it is, what it's not, and how it can be useful. In this episode, I'll be finding out about an exciting new blended therapy, SlowMo, for people who are experiencing paranoia. This digitally supported therapy has been developed over 10 years with a team of people including designers from the Royal College of Art in London, a team of people who have experienced paranoia. And a team of clinical researchers, including Professor Philippa Garety, Dr Amy Hardy and Dr Tom Ward. The design of this intervention really prioritised the experience of people using the therapy in what's called a design led approach. To understand more I video called Tom Ward, research clinical psychologist based in Kings College London, and I had a phone call with Angie, who's experienced using the therapy. Here's Angie's story. Angie: I mean, I've had psychosis for many years. About 20 years ago I was really poorly, I was in and out of hospital. Going back about 20 years ago they kept giving me different diagnoses and I expect everybody else had the same thing. Anyway, then I met a psychiatrist and I was with him for over 20 years until he retired. And he really helped me a lot, I was actually diagnosed with schizophrenia. Part of me was really scared and another part of me was sort of relieved that I knew that I was dealing with. I get voices, sometimes I see or feel things that aren't really there. But part of my diagnosis is I also get very depressed. And when I get very depressed, that's when the voices are at their worst because I haven't got the strength to sort of fight them off, if you like. If I'm having a good day, then I can use the skills I've learnt in the past to not listen to the voices and to have a reasonably good day. If I'm having a bad day and it's a duvet day, then that's when I really suffer with the voices. Unless you can actually accept that you have this issue, and you actually accept that you need the help, it doesn't matter what they do to help you, you're just not going to take it on board. Dr Lucy Maddox: Angie wanted some help, specifically with paranoid thoughts she was experiencing about people looking at her or laughing at her. She found out about the SlowMo trial and applied to be a part of it. And ended up being one of the very first people to try the therapy. Tom led on the delivery of therapy in the trial. Dr Tom Ward: I've worked and have worked for the last couple of years trying to develop and test digital interventions for people experiencing psychosis. So I've been involved in developing interventions that help people who are experiencing distressing voices. And been involved in work in a therapy called avatar therapy and more recently I've been working with colleagues to develop an intervention designed to help people who are experiencing fear of harm from others, which we would sometimes refer to as paranoia. Dr Lucy Maddox: In case listeners wonder what avatar therapy is could you just briefly say what that is? Dr Tom Ward: So in avatar therapy, digital technology is used with the person to create a representation of the distressing voice that they hear. So we work with the person to create an avatar which has an image which matches the image the person has of their distressing voice. And which comes to sound like the voice that they hear. And we use this avatar direct in dialogue. Very much with the rationale that many people who are experiencing distressing voices have relationships with their voice where they feel disempowered and lacking power and control. And we try to use the work with avatars and the dialogue with avatars to provide an opportunity for the person to reclaim power and control. And so we're very much working directly with the experience in quite a potentially powerful way for people. Dr Lucy Maddox: Could you tell me about the current project you're working on, so SlowMo? Dr Tom Ward: Yeah, so the first thing to say is that SlowMo stands for slow down for a moment. And so, it's a therapy which is a targeted therapy for people who are experiencing paranoia. And it's based in the idea that's been popularised by Daniel Kahneman and other people that human thinking can be sort of thought about in terms of two different types of thinking. There's fast thinking where we approach situations and we go with our first impression. We go with our intuition and gut feeling and we don't take time to think it through. And slow thinking is more around taking a step back from situations and weighing things up and considering differe

Children don't come with a manual, and parenting can be hard. What is evidence-based parenting training and how can it help? Dr Lucy Maddox interviews Sue Howson and Jane, about their experiences of delivering and receiving this intervention for parents of primary school aged children. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP Sue and Jane both recommended this book: The Incredible Years (R): Trouble Shooting Guide for Parents of Children Aged 3-8 Years By Carolyn Webster-Stratton (Author) Sue also recommended this book: Helping the Noncompliant Child Family-Based Treatment for Oppositional Behaviour Robert J. McMahon, Rex L.Forehand 2nd Edition Paperback (01 Sep 2005) ISBN 978-1593852412 Websites http://www.incredibleyears.com/ https://theministryofparenting.com/ https://www.nurturingmindsconsultancy.co.uk/ For more on CBT the BABCP website is www.babcp.com Accredited therapists can be found at www.cbtregisteruk.com Courses The courses where Sue works are available here, and there are similar courses around the country: https://www.reading.ac.uk/charliewaller/cwi-iapt.aspx Photo by Markus Spiske on Unsplash This episode was edited by Eliza Lomas Transcript Lucy: Hello and welcome to Let's Talk About CBT, the podcast from the British Association for Behavioural and Cognitive Psychotherapies, BABCP. This podcast is all about CBT, what it is, what it's not and how it can be useful. This episode is the last in the current series so we'll be having a break for a bit, apart from a cheeky bonus episode, which is planned for a few months' time so look out for that. Today, I'm finding out about evidence-based parenting training. This is a type of intervention for the parents of primary school aged children. It draws on similar principles to cognitive behavioural therapy about links between thoughts, feelings, behaviours and bodily sensations and ideas from social learning theory. It also draws some ideas from child development such as attachment theory and parenting styles. To understand more about all of this, I met with Sue Howson, parenting practitioner who works in child mental health services and Jane, a parent who has experienced the training herself. Jane: My name is Jane and I've got a little boy called Jack who is seven and he's in Year 3. Lucy: And you've experienced evidence-based parenting training, is that right? Jane: Yeah, I have. It's something called the Incredible Years. And there was a really nice lady called Sue and my school put us in touch to form a group to kind of help me manage Jack a little bit more at home. Lucy: So, your journey into it was that the school let you know about it? Jane: Yeah. Basically, I was having a few issues with Jack at home and I think it was kind of impacting on school as well. So, I was working with the special needs coordinator and she, obviously, had me, Jack and my family in mind as someone who might benefit from working a little bit with Sue. I was a bit nervous at first, you know, like professionals coming in, getting involved. But she was really nice and it was really beneficial. Lucy: Is it okay to ask what sort of difficulties you were having at home, sort of what was going on? Jane: Yeah, I can tell you now because it's all changed, it's much better. Lucy: Oh good, that's great to hear. Jane: I mean, Jack's a lovely boy. He's my eldest and he's really nice and just a bit of a joy – he is now. But I think one of the main things that I was struggling with, with him, was kind of difficulties with falling asleep. In the evenings, he would always want me to fall asleep either next to him or in his bed and that was kind of impacting on our evening, mine and my husband's quite a lot. And it was taking up a lot of time and I think evenings are quite hard because you're so tired and you just want to go to bed. So, that was one of the issues. And the no sleep was impacting on all aspects of our family life, really. I would just be really tired all the time and quite short, and end up shouting at Jack when I just wanted him to go to sleep and he wouldn't. And shouting wasn't ideal and doesn't help but I'd just get frustrated, really and I think quite a lot of us were quite unhappy. Lucy: That sounds super hard. Jane: Yeah. I mean, he is seven but he'd kind of throw a massive wobbly if he didn't get what he wanted, like, I don't know, like an extra biscuit or chocolate finger or something from the cupboard, he would just kind of lose it. And that was really hard to deal with, particularly when you're tired. I know you shouldn't but you always kind of end up giving in a little bit, don't you, because you just want the easy life. And you know that you shouldn't but… Sue: It's really hard when you're being shouted at or when you're exhausted like that. Jane: And I'd also feel like the path of least resistance, like sometimes it just easier to give in, even though I knew that I shouldn't. So, I guess those are the main issues, really,

In this episode Dr Lucy Maddox speaks to Sharon and Dr Anne Garland, about CBT for depression. Hear how Sharon describes it, and how both group and individual therapy helped. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP Books Overcoming Depression by Paul Gilbert Podcast Episodes CBT for Perfectionism Compassion Focussed Therapy Websites www.babcp.com www.cbtregisteruk.com Image by Kevin Mueller on Unsplash Transcript Lucy: Hello and welcome to Let's Talk About CBT, the podcast from the British Association for Behavioural and Cognitive Psychotherapies, BABCP. This podcast is all about CBT, what it is, what it's not and how it can be useful. In this episode we're thinking about CBT for depression. I spoke with Dr Anne Garland who spent 25 years working with people who experience depression and Sharon, who has experienced it herself. Both Anne and Sharon come from a nursing background. Anne now works at the Oxford Cognitive Therapy Centre as a consultant psychotherapist, but she used to work in Nottingham, which is where Sharon had CBT for depression. Here's Sharon. How would you describe what depression is like? Sharon: When I was going to school, when I was a little girl, an infant, we would have to go over the fields because I lived in the country, and go down. I could hear the bell of the junior school but couldn't find it because of the fog. I walked round and round, I was five, walked round and round and round in those fields trying to get to the bell where I knew I would be safe and being terrified on my own. And that's how it feels actually. Darkness, cold, very frightening. Lucy: I asked Anne how depression gets diagnosed and she described a range of symptoms. Anne: In its acute phase it's characterised by what would be considered a range of symptoms. So, tiredness, lethargy, lack of motivation, poor concentration, difficulty remembering. Some of the most debilitating symptoms are often disturbed sleep and absence of any sense of enjoyment or pleasure in life and that can be very distressing to people. People can be really plagued with suicidal thoughts and feelings of hopelessness that life is pointless. I think one of the most devastating things about depression as an illness is it robs people of their ability to do everyday things. So for example, getting up, getting dressed, getting washed, deciding what you want to wear can all be really impaired by the symptoms of depression. I try and help people to understand that the symptoms are real, they're not imagined. Often people will tell me that they imagine these things or that they aren't real and that it's all in their mind. Their symptoms are real, they exist in the body and do exert a really detrimental effect on just your ability to do what most of us take for granted on a day-to-day basis. Lucy: And so it's a lot more than sadness isn't it? Anne: Absolutely. It can be very profound feelings of sadness but often that's amplified by feelings of extreme guilt, of shame, anger and anxiety is another common feature of depression. Also, when people are very profoundly depressed they can actually just feel numb and feel nothing and that in itself can be very distressing because things that might normally move you to feel a real sense of connection. Say for example your children or your grandchildren, you may have no feelings whatsoever, and that in itself can be very alarming to people. Lucy: The way that depression and its treatment are thought about can vary depending on who you speak to. Just like with other sorts of mental health problems. More biological viewpoints prioritise thinking about brain changes that can occur with depression while more social perspectives prioritise thinking about the context that people are part of. Anne: As CBT tends to take a more pragmatic view of thinking about a connection between events in our environment, our reactions to those in terms of biology, thoughts, feelings and behaviour and how all of those things interact and that's a very pragmatic way of thinking about things really. And I guess traditionally in CBT there's the idea of making what is referred to as a psycho biosocial intervention. What that essentially means is that you can use medication plus psychological therapies – particularly CBT in this instance – and interventions that may influence your environment. If you do those things altogether then you're more likely to get a better outcome, which is really what our service in Nottingham is predicated on that idea. That if you think about all of those aspects in a practical, pragmatic way, then that may maximise your chances of seeing an improvement in depression. And I think one of the challenges in depression, if you look at the research literature, is once you've had one episode of depression, you have a 25% chance of another. Once you've had two, a 50% chance. And once you've had three, a 95% chance of another episode. So the concept of recurrence becomes reall

Anxiety is one of the most common mental health problems, but there's a good evidence-base for CBT as a helpful intervention. In this podcast, Dr Lucy Maddox speaks with Dr Blake Stobie and Claire Read, about what CBT for anxiety is like, and how anxious thoughts can be like the circle line. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP Websites BABCP https://www.babcp.com Accredited register of CBT therapists https://www.cbtregisteruk.com Anxiety UK https://www.anxietyuk.org.uk NICE guidelines on anxiety https://www.nice.org.uk/guidance/qs53 Apps Claire recommended the Thought Diary Pro app as being helpful to use in conjunction with therapy to complete thought records. https://www.good-thinking.uk/resources/thought-diary-pro/ Books Claire recommended this workbook on Overcoming Low Self Esteem by Melanie Fennell https://www.amazon.co.uk/Overcoming-Low-Self-Esteem-Self-help-Course/dp/1845292375/ref=sr_1_2?dchild=1&keywords=self+esteem+workbook+melanie+fennell&qid=1605884391&s=books&sr=1-2 And this book by Helen Kennerley on Overcoming Anxiety is part of the same series https://www.amazon.co.uk/Overcoming-Anxiety-Books-Prescription-Title/dp/1849018782/ref=sr_1_1?dchild=1&keywords=overcoming+anxiety&qid=1605884437&s=books&sr=1-1 Credits Image used is by Robert Tudor from Unsplash Podcast episode produced and edited by Lucy Maddox for BABCP Transcript Lucy: Hello and welcome to Let's Talk About CBT, the podcast from the British Association for Behavioural and Cognitive Psychotherapies, BABCP. This podcast is all about CBT, what it is, what it's not and how it can be useful. In this episode we're thinking about CBT for depression. I spoke with Dr Anne Garland who spent 25 years working with people who experience depression and Sharon, who has experienced it herself. Both Anne and Sharon come from a nursing background. Anne now works at the Oxford Cognitive Therapy Centre as a consultant psychotherapist, but she used to work in Nottingham, which is where Sharon had CBT for depression. Here's Sharon. How would you describe what depression is like? Sharon: When I was going to school, when I was a little girl, an infant, we would have to go over the fields because I lived in the country, and go down. I could hear the bell of the junior school but couldn't find it because of the fog. I walked round and round, I was five, walked round and round and round in those fields trying to get to the bell where I knew I would be safe and being terrified on my own. And that's how it feels actually. Darkness, cold, very frightening. Lucy: I asked Anne how depression gets diagnosed and she described a range of symptoms. Anne: In its acute phase it's characterised by what would be considered a range of symptoms. So, tiredness, lethargy, lack of motivation, poor concentration, difficulty remembering. Some of the most debilitating symptoms are often disturbed sleep and absence of any sense of enjoyment or pleasure in life and that can be very distressing to people. People can be really plagued with suicidal thoughts and feelings of hopelessness that life is pointless. I think one of the most devastating things about depression as an illness is it robs people of their ability to do everyday things. So for example, getting up, getting dressed, getting washed, deciding what you want to wear can all be really impaired by the symptoms of depression. I try and help people to understand that the symptoms are real, they're not imagined. Often people will tell me that they imagine these things or that they aren't real and that it's all in their mind. Their symptoms are real, they exist in the body and do exert a really detrimental effect on just your ability to do what most of us take for granted on a day-to-day basis. Lucy: And so it's a lot more than sadness isn't it? Anne: Absolutely. It can be very profound feelings of sadness but often that's amplified by feelings of extreme guilt, of shame, anger and anxiety is another common feature of depression. Also, when people are very profoundly depressed they can actually just feel numb and feel nothing and that in itself can be very distressing because things that might normally move you to feel a real sense of connection. Say for example your children or your grandchildren, you may have no feelings whatsoever, and that in itself can be very alarming to people. Lucy: The way that depression and its treatment are thought about can vary depending on who you speak to. Just like with other sorts of mental health problems. More biological viewpoints prioritise thinking about brain changes that can occur with depression while more social perspectives prioritise thinking about the context that people are part of. Anne: As CBT tends to take a more pragmatic view of thinking about a connection between events in our environment, our reactions to those in terms of biology, thoughts, feelings and behaviour and how all of those things interact and that's a very pragmatic w

We tend to think about therapy as something that is helpful for individuals, but what about when you want to address problems which affect you and a partner or spouse? In this episode, Dr Lucy Maddox speaks to Dan Kolubinski about cognitive behavioural couples therapy, and hears from Liz and Richard about what the experience was like for them. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP Dan recommended the book Fighting For Your Marriage by Markman, Stanley & Blumberg https://www.amazon.co.uk/Fighting-Your-Marriage-Best-seller-Preventing-dp-0470485914/dp/0470485914/ref=dp_ob_title_bk Some journal articles on couples therapy are available free online here: https://www.cambridge.org/core/journals/the-cognitive-behaviour-therapist/information/let-s-talk-about-cbt-podcast The podcast survey is here and takes 5 minutes: https://www.surveymonkey.co.uk/r/podcastLTACBT The BABCP website is at www.babcp.com And the CBT Register of accredited CBT therapists is at https://www.cbtregisteruk.com Photo by Nick Fewings on Unsplash Transcript Lucy: Hello, and welcome to Let's Talk About CBT. It's great to have you listening. When we think about therapy, we often think of one-to-one conversations between one person and their therapist. But what about when the problems that we're going for help with are related to how we're getting on with a partner or a spouse? Cognitive behavioural couples therapy helps with these sorts of difficulties. To understand more about it I spoke to a married couple, Richard and Liz, and Dan Kolubinski, their therapist. Richard and Liz did this therapy privately, but couples therapy is also available on the NHS to help with some specific difficulties. We hear more about that from Dan later on. For now though let's hear what Richard and Liz thought of their couples therapy in this interview which I recorded with them remotely. Richard: My name's Richard. I'm 37 years old and I've been married to Liz for just over seven years now. I'm a postie at the moment, and kind of lived in Essex most of my life. Liz: It's like a dating programme. Richard: It is, isn't it? Yeah, a little bit. (laughs) Liz: So I'm Liz and I make cakes for a living, and write about mental health. So that's us. Lucy: That's great. So thanks so much for agreeing to speak with me about your experience of couples therapy, and specifically cognitive behavioural couples therapy. Would you mind telling me how you came across it and what made you think you might want to try it? Liz: Yeah. So I think it's something that we've spoken about in the past. And we've both had therapy separately, and I think we've both had various different types of therapy. So Richard has had CBT before, I think we've both done psycho-dynamic counselling. So when we decided we were going to do it, we realised that for us it was more beneficial to almost do a crash course, as it were, together. So to do a whole weekend, rather than a little bit once a week. And that was how we discovered Dan, and were able to book in with him. Richard: Yeah, I think we both understand the value or had both experienced and understood the value of therapy individually. So it was kind of an easy step for us then to decide there could be a lot of value in doing this together. Lucy: That makes total sense. So you already had a bit of an understanding of what it might be like, or what it's like on an individual level? Liz: Yeah, definitely. And actually very early on in our marriage we had some couples counselling, which I don't think was actually as successful, and it was after that that we had separate counselling. And I think it was after we were both able to get ourselves into better positions, as it were, that that's when we were able to come back together and experience some therapy together. Lucy: That's really interesting. Do you think that helped you access the conversations together in a different way? Richard: Yes, I think it did. I think we both had an experience of therapy, of CBT and of other therapies, and the structure they would take or how they engaged you and enabled you to talk safely, and the prompts that might be used. When we did it together, it did make the conversations a bit freer, a bit more open. And I think we both felt it was a safe environment, which when we first had it I don't think we did feel. And that made a big difference I think. Liz: Yeah. And I think as with any relationship, until you've got a level of happiness with yourself, it's very difficult to have a relationship with somebody else that involves vulnerability or trust. And I don't think we had that the first time we tried having counselling together. I think we were almost so reliant on our relationship to form who we were, that the first time around we put too much pressure on ourselves, on the relationship, and also on the counselling, and we expected some magic wand. Whereas now we've realised it actually does take a bit of work. Richard: Yeah. Liz: B

What is digital CBT? How does therapy work over the internet? Can it ever be as good as face-to-face? Dr Lucy Maddox hears from Dr Graham Thew and Fiona McLauchlan-Hyde about an internet-based CBT programme for PTSD. Fiona shares her experience of how this therapist-supported programme helped her through traumatic grief, and also has some helpful advice for people trying to comfort those who are bereaved. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP BABCP website is at www.babcp.com CBT Register of accredited CBT therapists is at https://www.cbtregisteruk.com BPS Top tips for psychological sessions delivered by video call for adult patients https://www.bps.org.uk/sites/www.bps.org.uk/files/Policy/Policy%20-%20Files/Top%20tips%20for%20psychological%20sessions%20by%20video%20%28adult%20patients%29.pdf Resource from OCD-UK on getting the most out of online CBT https://www.babcp.com/files/Therapists/Oxford-OCD-Making-the-Most-Out-of-Remote-Therapy-for-Patients-by-OCDUK.pdf Graham's recent paper in the Cognitive Behavioural Therapist can be found on the podcast journal article page https://www.cambridge.org/core/journals/the-cognitive-behaviour-therapist/information/let-s-talk-about-cbt-podcast Information from Cruse about traumatic grief https://www.cruse.org.uk/get-help/traumatic-bereavement/traumatic-loss The Good Grief Trust https://www.thegoodgrieftrust.org Image is by Cassie Boca on Unsplash Transcript Lucy: Before we get started, I want to remind you about the survey which I released at the beginning of August. I really would like to know more about who is listening to these podcasts and what you would like. The link to the survey is in the show notes and it takes about five minutes to complete. If you have time to fill it in I would be really grateful. Hello, and welcome to Let's Talk About CBT, with me, Dr Lucy Maddox. This podcast is all about CBT, what it is, what it's not, and how it can be useful. Today I am exploring digital CBT. I speak to a therapist who has been researching internet based CBT programmes that are supported by a therapist, and I speak to someone who has experienced this first hand. The particular programme that we talk about is for PTSD, which we've heard about before in a previous episode. In this case PTSD was related to an experience of traumatic grief. Fiona: I think I started last September and I finished just before lockdown, actually. Lucy: Gosh, so in a way good timing. Fiona: Yeah, it was great timing to finish just before lockdown. It put me in a good place I think, to be able to deal with what was going on, rather than if it had been six months earlier it would have been a very different experience I think. Lucy: It took Fiona, who is based in Oxfordshire, a long time to find this type of therapy. Fiona: It all started six and a half years ago, when my husband died of cancer. Lucy: I'm so sorry. Fiona: He was diagnosed in the June, and he died in the December, and it was really horrific. He was 49, I was 42 at the time. And so it was heartbreaking and I couldn't cope. I couldn't cope afterwards. We had a little girl, she was seven when he died. And my world was turned upside down. And I got help at first. But then, as with all things, life goes on around you and everyone thinks you're fine. And I was still putting my lipstick on, so therefore everyone thought I was okay. And I felt I was getting worse and worse, and no one would believe me. And it wasn't until I threw all of my toys out of the pram; after having therapy through my local GP – so this was last year, last summer – sitting in my car afterwards for about an hour just sobbing, because no one believed me that I was feeling as bad as I was. And I asked to be put in touch with TalkingSpace. And they put me forward for a trial with Oxfordshire Mental Health, and it changed my life. It absolutely changed my life. Because I was drowning and no one believed me, it was awful. Lucy: It sounds like such a dark time. Fiona: It was a really dark time. And everyone just kept saying come on, you know, it's been so many years. And I was functioning, but I think it was last year… So I suffered from panic attacks; I suffered from panic attacks from before my husband died, and they got worse. They'd gone away for years and then they came back when he was diagnosed. And last summer, around this time last year, I had such a severe panic attack, I was driving my daughter and she had to call an ambulance. And that was when I decided that come what may I needed help. But it was still quite some time after that. I still had to go through about six weeks of people going, "Come on, you're fine. Take a pill." And I didn't want to take a pill. So yeah, I was lucky, eventually. Lucy: It sounds like you had to be really tenacious to get access to the therapy? Fiona: It was a real, real battle. And as much as I really liked my GP, and my GP was the person who was there when my husband was dying. So he knew

Let's Talk About CBT Survey Have you got 5 minutes to complete a quick survey about your experience of listening? It would really help us to know who is listening and what you would like from the podcast. Thank you! https://www.surveymonkey.co.uk/r/podcastLTACBT Podcast episode produced by Dr Lucy Maddox for BABCP Photo by Emily Morter on Unsplash

What does existing research tell us about the possible impact of the pandemic on children and young people's mental health? Dr Lucy Maddox speaks with Dr Maria Loades about Maria and colleagues' recent rapid review of the literature on isolation and mental health, and what CBT principles suggest can be helpful to head off problems, in particular with loneliness during the pandemic. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP Maria recommended lots of helpful resources on loneliness and social isolation which we've listed here: Books Together: Loneliness, Health And What Happens when we find Connection – Vivek Murthy https://www.amazon.co.uk/Together-Loneliness-Health-Happens-Connection/dp/1788162773 Overcoming social anxiety and shyness https://www.amazon.co.uk/Overcoming-Social-Anxiety-Shyness-Gillian/dp/1849010005 Overcoming your children's social anxiety and shyness https://www.amazon.co.uk/dp/1845290879/ref=cm_sw_em_r_mt_dp_U_6p13EbZ0ER2XD Websites Mind - https://www.mind.org.uk/information-support/tips-for-everyday-living/loneliness/about-loneliness/ How to cope with loneliness during coronavirus – https://www.verywellmind.com/how-to-cope-with-loneliness-during-coronavirus-4799661 TEDx talk by Will Wright 'Loneliness is literally killing us' - https://www.youtube.com/watch?v=ruh6rN5UrME&feature=youtu.be Loneliness and isolation in teenagers – a parent's guide https://www.bupa.co.uk/newsroom/ourviews/2019/05/teenager-loneliness As always if you want more information on BABCP check out www.babcp.com If you want to find a CBT accredited therapist check the register of BABCP accredited therapists https://www.cbtregisteruk.com/ Articles The rapid review we talked about is here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267797/ Podcast That podcast episode with Shirley Reynolds on teenagers doing more of what matters to them is here: https://letstalkaboutcbt.libsyn.com/helping-teenagers-do-more-of-what-matters-to-them Transcript Lucy: Hi and welcome to Let's Talk About CBT with me, Dr Lucy Maddox. In this episode brought to you by the British Association for Behavioural and Cognitive Psychotherapies, we think about the possible effects of quarantine on children and young people's mental health. I'll let my guest for today introduce herself. Maria: My name is Dr Maria Loades and I'm a clinical psychologist and I work at the University of Bath as a lecturer on the doctorate and clinical psychology programme. Lucy: Maria and her colleagues have been especially interested in the effects of the pandemic on children and young people. She co-authored a rapid review of evidence to try to understand what this effect is likely to be. Maria: What we wanted to do was to look at two things. One is the studies that have been done that have looked at social isolation in a pandemic context in children and young people and how that's impacted on their mental health. Secondly, we were also interested in thinking, okay, if these measures mean that young people experience this increase in loneliness, what do we know about how loneliness might be related to mental health for children and young people. Lucy: So obviously there's not loads of pandemics to study, but you're trying to work out from what's been done before, how does loneliness impact on mental health problems for children and young people? You turned the review around really quickly didn't you, because normally it takes months to do something like this. Maria: Yes, we really felt like it was particularly important to pull this together as quickly as we could to inform policy and practice going forward. Lucy: And what did you find? Maria: As we expected, there isn't much known about the impact of pandemics specifically. There was just one study that looked at mental health in children and young people in a pandemic context and it did find that there was significantly increased rates of mental health problems for those who had experienced disease containment measures like quarantine or social isolation. And the study focused on trauma symptoms and they found really much higher rates of trauma symptoms amongst those young people who had experienced those disease containment measures. But that is only one study. More broadly though, there were over 60 studies that looked at loneliness and mental health. And we found that there is good evidence that loneliness increases the chances of developing mental health problems, both anxiety and depression, up to nine years later. So there's not only a loneliness and depression and anxiety linked when we measured them at the same point in time, but there's good evidence that being lonely now will mean an increase in risk of mental health problems at a later date. Lucy: Maria thought one study was particularly interesting. It looked at duration of loneliness compared to intensity of loneliness. Maria: Now what we mean by that is how long the loneliness is going on for, as compared to how strong

How does doing more of what matters help teenagers with low mood and depression? And what can we all learn from this, particularly at the moment? Prof Shirley Reynolds speaks to Dr Lucy Maddox. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP If you want to know more the following resources might be helpful. Books Shirley has written two books about depression in teenagers, one for teens and one for parents: For parents: Teenage Depression: CBT Guide for Parents https://www.amazon.co.uk/Teenage-Depression-CBT-Guide-Parents/dp/147211454X For adolescents: Am I Depressed and What Can I Do About It? https://www.amazon.co.uk/Am-Depressed-What-Can-About/dp/1472114531/ref=pd_lpo_14_t_0/260-4076808-4951665?_encoding=UTF8&pd_rd_i=1472114531&pd_rd_r=bd1ea151-b4d3-40bc-99bc-583aa3824613&pd_rd_w=xtKq9&pd_rd_wg=CFBxI&pf_rd_p=7b8e3b03-1439-4489-abd4-4a138cf4eca6&pf_rd_r=MFANFKSAD9RE92R6XS65&psc=1&refRID=MFANFKSAD9RE92R6XS65 Websites BABCP website www.babcp.com Register of BABCP accredited therapists https://www.cbtregisteruk.com/ These resources about child and adolescent mental health might also be useful Young Minds https://youngminds.org.uk/ MindEd https://www.minded.org.uk/ Association for Child and Adolescent Mental Health https://www.acamh.org/ Other resources Shirley is running a course with Future Learn from 1st week in June about adolescent depression – aimed to help parents and professionals understand and help young people who struggle with low mood: https://www.mooc-list.com/course/understanding-depression-and-low-mood-young-people-futurelearn Have you seen the BABCP animation about what CBT is? Only 1 minute long and available here: https://www.youtube.com/watch?v=ZRijYOJp5e0 Photo by Daria Tumanova on Unsplash Podcast episode produced by Dr Lucy Maddox for BABCP Transcript Lucy: Hi and welcome to Let's Talk About CBT with me, Dr Lucy Maddox. This podcast is all about CBT, what it is, what it's not and how it can be useful. Today I'm speaking to Professor Shirley Reynolds from the University of Reading about how doing more of what matters can help teenagers boost their mood, and how this might be particularly helpful for all of us to remember at the current time. Shirley: The thing I'm really mostly interested in is understanding more about adolescent depression in order to help us really develop better treatments and better ways of preventing young people from developing depression. So that we can really try and divert them away from a path that can lead into a lifetime of problems with low mood. Lucy: Fantastic. And at this time in particular when we're all shutting doors a bit because of the pandemic and teenagers are shutting doors as well, what can your research tell us that might be helpful at this time in particular do you think? Shirley: I think there are some general points and some more specific points. I think the general point is that one of the things we know, not just from our own research but from many people's research is that when you're a teenager, most teenagers are going to be incredibly attached to and reliant on having relationships with their friends, their peers. The family becomes a bit less important, it's not unimportant, but the importance of it becomes a little bit less and that's replaced by a really, really strong focus on needing to be part of a social group. Being accepted by other people, contributing to things with your friends, being part of something bigger than yourself. And so what that tells us then is that a period like now when young people simply cannot have those relationships in the normal ways, that this is a potential point of really massive stress for them and distress for them. And we need to try and support them; to maintain any relationships they already have, in whatever way is possible. And what most parents are currently struggling with, but I think getting a handle on, is that currently that is going to be on a computer. It's not just young people, we all need these things. This is a lifelong thing for most people, but it's a particular importance at that critical development period when we're teenagers. Lucy: So making sure that we're supporting the young people in our lives to maintain contact with their friends in whatever way is possible. Shirley: In whatever way is possible, absolutely. And accepting and understanding that it's frustrating and difficult and anxiety provoking and that that's true for everybody, parents, children, and everybody else. There's a degree to which we have to kind of let our normal expectations just be shifted around a bit and learn to live with that and be okay with that. Lucy: Actually, just you talking about teenagers in particular made me think about that tension that can happen sometimes between teenagers really wanting to be independent and maybe family really wanting to comfort teenagers during this time. And sometimes that can be a really tricky balance to walk, can't it, if you're a pa

We're all living through uncertain times at the moment. What does research from CBT tell us about what tends to help people tolerate uncertainty? Dr Lucy Maddox interviews Professor Mark Freeston about what might help. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP For more on BABCP our website is www.babcp.com For Mark's research survey follow this link: https://www.ncl.ac.uk/who-we-are/coronavirus/research/uncertainty/ A preprint of Mark's research paper on coronavirus and uncertainty is available here: https://www.researchgate.net/publication/340653312_Towards_a_model_of_uncertainty_distress_in_the_context_of_Coronavirus_Covid-19 If you feel like you're struggling here are some resources: https://www.nhs.uk/oneyou/every-mind-matters/ https://www.samaritans.org/ https://www.nhs.uk/conditions/stress-anxiety-depression/mental-health-helplines/ https://www.nhs.uk/using-the-nhs/nhs-services/mental-health-services/how-to-access-mental-health-services/ The register of BABCP accredited CBT therapists is here: https://www.cbtregisteruk.com/ Photo by Katie Mourn on Unsplash Episode edited and produced by Lucy Maddox Music by Gabriel Stebbing Transcript Lucy: Hi and welcome to Let's Talk About CBT with me, Dr Lucy Maddox. This podcast is brought to you by the British Association for Behavioural and Cognitive Psychotherapies, BABCP. It's all about CBT, what it is, what it's not and how it can be useful. Today in another post-pandemic special episode I'm speaking remotely to Professor Mark Freeston from Newcastle University. Mark's research is about how intolerance of uncertainty relates to anxiety and he spoke to me about how findings from this research can be relevant at this current, very uncertain time. Mark was clear that feelings of anxiety and distress in response to the current pandemic are totally normal. Mark: Anxiety problems that we see in mental health services have an element that is recognised to be excessive about them. But what we're looking at at the moment, which is anxiety and distress in response to the coronavirus pandemic doesn't necessarily have this excessive element about it. So it's not a disorder, it's just a lot of very anxious and distressed people. Lucy: How is your research particularly relevant at the moment? Mark: Since the early 90s, we've been looking at a thing called 'intolerance of uncertainty'. This is particularly timely given the high level of uncertainty that's going on. Some people find not knowing, the unknownness of things as particularly difficult to manage. Lucy: It's quite an existential problem almost, isn't it? It's quite a human problem that we all might have at different moments. Mark: The evolutionary theory, so some very clever evolutionary psychologists and they say that everyone is probably born to be intolerant of uncertainty, but to greater or lesser degrees we become more able to tolerate uncertainty. So it's not like a personality trait that is sort of stuck at the same level all your life. When different things happen your ability to tolerate the unknownness of things is likely to change, not necessarily on a day-to-day basis, but you may have periods of greater tolerance or intolerance of uncertainty. Lucy: Is it that intolerance of uncertainty which leads us to feel very anxious? Mark: Eventually, yes. The way we've been looking at it in our current research and we've been working on this for over a year, because we've been thinking about before the pandemic came along, we'd been thinking about caregivers of people with dementia or people living with chronic and fluctuating illnesses. And so we were thinking about a lot of different types of contexts where there's both scary things happening and a lot of uncertainty going on at the same time. If you are intolerant of uncertainty and there is real uncertainty around, you are going to probably perceive the situation as being more uncertain than it is. So you start off not liking uncertainty, then when things are uncertain, not only do you not like it, but you see the situation as even more uncertain. And you probably also look at the things that might happen, particularly the bad things that might happen as more likely. It's that combination we think, that makes people anxious. Lucy: And then at the moment, do the same things apply, might some of us feel more anxious in response to what's going on with the pandemic than others? Mark: Yes, and obviously people who have got more at stake, so people who are at greater risk, also about financial things. It's at multiple levels that there's lots of uncertainty going on and some people find this more difficult than others. Lucy: Mark told me about some research which suggests that over the last 30 years we've all been finding uncertainty harder to tolerate. Mark: What we found is that intolerance of uncertainty scores have been going up since the 1990s. Lucy: Oh really? Mark: Yeah, so essentially year on year. One of my colleagues

Note: This episode was recorded before government guidance on restricting travel due to coronavirus. We all experience ups and downs in mood, but what happens when the highs are so high and the lows are so low that it really interferes with your life? In this episode we hear from Cate Catmore and Professor Steven Jones about CBT for bipolar disorder. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP For more resources check out these links below. Books Coping with bipolar disorder by Steve Jones, Peter Haywood and Dominic Lam https://www.amazon.co.uk/Coping-Bipolar-Disorder-CBT-Informed-Depression-ebook/dp/B07ZWQ877T/ref=sr_1_1?dchild=1&keywords=coping+with+bipolar+disorder&qid=1585237730&s=digital-text&sr=1-1 Overcoming Mood Swings by Jan Scott https://www.amazon.co.uk/dp/B003GUBILQ/ref=dp-kindle-redirect?_encoding=UTF8&btkr=1 Online resources NICE guidelines on bipolar are summarised here https://www.nice.org.uk/guidance/cg185 Cate spoke about mindfulness. You can hear more about mindfulness-based cognitive therapies here https://letstalkaboutcbt.libsyn.com/lets-talk-about-cbt-mindfulness-based-therapies This BPS report is called Understanding Bipolar Disorder https://shop.bps.org.uk/understanding-bipolar-disorder.html Recovery toolkit for friends and relatives of someone with bipolar disorder based on research at Lancaster University https://reacttoolkit.uk/ Guardian article on CBT for bipolar disorder by Lucy from a few years ago https://www.theguardian.com/science/sifting-the-evidence/2016/feb/08/nice-critique-a-call-for-more-research-not-an-excuse-for-less-treatment-psychotherapy-cbt If you'd like to read more academic journal articles this range of papers about bipolar disorder has been made free until 30th April 2020 from the BABCP journals https://www.cambridge.org/core/journals/behavioural-and-cognitive-psychotherapy/bipolar-articles-from-bcp-and-tcbt The photo is by Claire Satera on Unsplash This episode was produced by Lucy Maddox. Transcript Lucy: Hello and welcome to let's talk about CBT, with me, Dr Lucy Maddox. This podcast brought to you by the British Association for Behavioural and Cognitive Psychotherapies or BABCP is all about CBT. What it is, what it's not and how it can be useful. As an aside, if you listen regularly to this podcast and like it, please do consider rating and reviewing it, it helps other people to find it. And if you have ideas for other episodes that you'd like to listen to, just let me know at [email protected]. Right then, I thought I'd start this episode with a quote from Kaye Redfield Jamison, who's a clinical psychologist and writer. She writes, "When you're high it's tremendous, the ideas and feelings are fast and frequent like shooting stars, and you follow them until you find better and brighter ones. But somewhere, this changes. The fast ideas are far too fast and there are far too many. You are irritable, angry, frightened, uncontrollable and enmeshed totally in the blackest caves of the mind." That was about Kaye's experience of bipolar disorder which is the diagnosis that this episode concentrates on. For this podcast, I went to Lancaster and met Cate, who's experienced the highs and lows of bipolar disorder and what CBT can do to help. And Steve, whose research team works on a CBT-based intervention for bipolar disorder. Cate: I'm Cate Catmore, I'm 64, and I live with my husband, got two children, two sons and two granddaughters. I did CBT a while ago and then I had a course of recovery-based CBT recently. Steve: Hi, I'm Steve Jones, I'm co-director of the Spectrum Centre for mental health research at Lancaster University. The focus of our work is on trying to learn more about the psychological and social factors underpinning bipolar disorder and related conditions. And to use that information and learning to develop new interventions that are developed with the service user in mind. We've been in existence for about 11 or 12 years, and we've always had people with lived experience of bipolar disorder as colleagues as well as collaborators. Lucy: Cate had her recovery-based CBT as part of a research study at Lancaster University, delivered by one of Steve's colleagues. It's not the first time Cate had CBT for bipolar disorder, but she felt she was more able to access it this time round. Cate: In the very first place I had CBT when I was hospitalised about 10 years ago. I hadn't kept up with it, and I'd just let it slide, really. And then, I heard about recovery-based CBT through a bipolar support group at Lancaster University. Lucy: I asked Cate about her experience of having bipolar disorder. Cate: I didn't have too many manic episodes, but I have to say that was how it was diagnosed, and I must admit I did enjoy the manic phase. Lucy: What did it feel like? Cate: It felt free and exciting and I wanted to do everything that I could, and I felt that everything that I did I was doing very well. The main thing that I remembe

This is an understandably stressful time and it's normal to feel worried. What can we learn from CBT for health anxiety that might help us with feelings of anxiety during the pandemic? In this short bonus episode, Dr Lucy Maddox interviews Dr Jo Daniels from Bath University, about things we know are likely to help. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP Read an article by Dr Jo Daniels on how to stop anxiety about coronavirus spiralling out of control here: https://theconversation.com/coronavirus-how-to-stop-the-anxiety-spiralling-out-of-control-133166 Another article about panic here: https://thepsychologist.bps.org.uk/truth-about-panic And this about how it's normal to feel worried: https://www.ft.com/content/d6c65a50-6395-11ea-abcc-910c5b38d9ed BBC piece on protecting your mental health at this time: https://www.bbc.co.uk/news/health-51873799 BABCP: www.babcp.com Photo by Kelly Sikkema on Unsplash Transcript Lucy: Hi, I'm Dr Lucy Maddox and this is Let's Talk About CBT. This is a podcast brought to you by the British Association for Behavioral and Cognitive Psychotherapies. This is a bit of an unusual episode. I've come to Bath University to interview Dr Jo Daniels who has experience in researching health anxiety in relation to medical conditions. There's obviously a great deal of worry around at the moment, understandably, in relation to coronavirus. I've come to ask Jo about how we can look after our psychological wellbeing as well as our physical health. The information that Jo talks about is based on cognitive behavioural therapy principles for anxiety. Obviously there's no evidence base for this in relation to coronavirus in particular, but really health anxiety in relation to any physical illness has some very similar features, so we hope that this advice can be helpful. Jo: My name is Jo Daniels and I'm a senior lecturer in clinical psychology and also a clinical psychologist working in health. Lucy: Could you say a bit about the work that you've done that's relevant to our reactions to the coronavirus pandemic? Jo: The research that I've done so far is focused on health anxiety and distress in medical conditions. I do some work in the emergency department and think about why people keep coming back in and it's usually to do with anxiety rather than pain. I've also worked in health anxiety in complex conditions such as Addison's disease, chronic fatigue syndrome, also stroke, looking at how important anxiety is in both emotion and physical experience. Lucy: Fab. I mean it's really understandable that people are feeling worried at this time because there's loads of stuff around about Covid-19 and about what we should be doing about it. What advice would you have about how we can avoid spiralling out into panic about what's happening? Jo: I think the first thing to say, which feels quite important, is it's very, very normal to have a fear response, to feel anxious because this is a threat really and that's the way that our brains are interpreting it, as a threat. Important to just accept that we're all a little bit worried at the moment and we're really in it together. In terms of the things that we can do help ourselves, it's a digital age, so a lot of people are accessing various sources of media and information at the moment. Thinking about where the notifications are essential, thinking about the sources of information that we access, where some of the new stories are designed to be alarmist. Keeping perspective is really, really important and we can do that in a number of ways. So keeping in touch, especially if we're moving into having to be at home, we need to be in touch with people to keep perspective and also to keep ourselves happy. Also trying to stay calm. It's really important that we go about our normal daily business as much as we can. Things are going to change over the next few months, but normality is really important. So ensuring that we do the same things that we normally do and don't adapt too much because sometimes when we do that, we start to do things that are actually counterproductive. Lucy: So like a balance between following the advice that's out there, the sensible advice on reputable websites, but doing as much as we can to keep our routine and keep in touch digitally with people that we care about? Jo: Exactly. It's really important to be vigilant, but not hyper vigilant. If you look for trouble, that's what you'll find. Lucy: What does hyper vigilance mean, just in case people don't know that? Jo: That's when we're really paying extra attention to things. You see that a lot in health anxiety and at the moment I think a lot of us may be doing that, looking for signs of coronavirus. The interesting thing is, is that actually if we become quite anxious; we will product physical symptoms in our body that may mimic it. So things like chest pain, you can get a bit of chest pain or dizziness, nausea, feeling a bit hot, all of those ph

Imagine being asked to give up the most effective strategy you have for coping with stressful situations... this is often what it can feel like to people trying to give up self-harm. In this episode, Dr Lucy Maddox talks to Jane, who first used self-harm when she was 14, and Dr Lucy Taylor, who works with young people to try to overcome self-harm. This episode contains discussion about self-harm and reference to suicide. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP Books Cutting Down by Lucy Taylor, Mima Simic, & Ulrike Schmidt https://www.amazon.co.uk/Cutting-Down-workbook-treating-self-harm/dp/0415624533 Websites www.cbtregister.uk for a list of BABCP accredited therapists https://youngminds.org.uk/ for resources for parents and children about self harm https://www.minded.org.uk/ for resources on child and adolescent mental health and development www.babcp.com for more CBT resources You can also listen to our podcast on Dialectical Behavioural Therapy, or DBT, for more on a different approach to self harming. Transcript Lucy: Hi, and welcome to let's talk about CBT, with me, Dr Lucy Maddox. This podcast, brought to you by the British Association for Behavioural and Cognitive Psychotherapies or BABCP, is all about CBT. What it is, what it's not, and how it can be useful. Today, we're focusing on CBT for self-harm. We obviously talk a lot about self-harm and we also mention suicide, so please look after yourselves and if you know that's something that's especially hard for you to listen to, then maybe just skip this one. Jane: I think self-harm is something that is a way to control your feelings. It was a way for me to feel something and know why I was feeling it, and know that I was doing it, and know that I could understand it. Lucy: That was Jane, who we're going to hear more from in a bit. For this episode, I also went to speak to Dr Lucy Taylor, a clinical psychologist, who has worked for 20 years in the NHS, mostly with children and young people. And who now works in private practice in Surrey. Lucy T: My main interests are self-harm and cognitive behavioural therapy and how to engage young people that might be struggling a little bit to come to therapy. Lucy: Could you say a little bit about what self-harm is? Lucy T: Yeah, I think generally, the way we think about self-harm is on a dimension, and when we look at the literature and we look at the studies on self-harm, we talk about causing deliberate harm to your body. And that might be through cutting yourself or burning yourself or taking an overdose. But when we're talking about the dimension, it might mean also maybe drinking a little bit too much alcohol or not eating nutritionally rich food or restricting your diet. So, it can mean lots of different things, but when we're talking about it within the clinic, it's a deliberate act of hurting yourself. And sometimes that can mean you want to die, and often that isn't because you want to die, but it is a way of coping. Lucy: So, it sounds like a bit of a spectrum of experience, actually. Lucy T: Yes. And I think when people come to the clinic, it's starting to cause problems. So, it might be that we all occasionally do things that actually aren't great for us, but it doesn't necessarily cause a problem in our everyday lives. When it's becoming more it's affecting functioning or it's starting to affect relationships, or work or jobs or school, or when people are concerned about others, that's usually when they come to the clinic. Lucy: For Jane, self-harm was first around for her when she was a teenager. But she didn't actually get help until her early 20s. Jane: My name is Jane, I self-harmed from the age of 14. People spoke about it openly. Lucy: Like in your class, you mean? Jane: Just in general, but it was still very looked down upon. I remember being in school, and I had these colourful bits of material over my arms, because I had cut myself. And because they weren't uniform, the teacher made me stand up in front of the class and take them off. Lucy: That's so grim. Jane: Yeah, (laughs) I don't think she knew, I don't think that's intent. But that's another thing, had it been talked about the way it is now, that would have probably been the first thing that came to her head, maybe it's that. It doesn't mean that it is, maybe I'm just being defiant and want to wear my rainbow armbands, but I don't think she was aware. But then, even then, there was no conversation with a counsellor, they told my mum, that was it, but my mum already knew. Lucy: It's disappointing, though, isn't it? I don't know, it makes me feel sad to think of you as a young girl, not getting help at that point. Jane: Yeah, but it was just something that I think a lot of kids of did, and a lot of people that I knew did it for different reasons, in different ways. Lucy: I spoke to Lucy Taylor about the prevalence of self-harm in young people. Lucy T: I think recent statistics suggest that at lea

Striving for achievement has got to be a good thing, right? But what if it starts to get in the way of our happiness? What if the standards we hold ourselves to are unattainable or unrealistic? What if we feel like we'll never measure up? In this episode, Sam and Professor Roz Shafran speak to Dr Lucy Maddox about CBT for clinical perfectionism - what it is, what it's not, and how it can be useful. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP For more information here are some resources. Books This is Roz's book on Overcoming Perfectionism https://www.amazon.co.uk/Overcoming-Perfectionism-scientifically-behavioural-techniques/dp/1845297423 Or for a shorter booklet this is also written by Roz and published by the Oxford Cognitive Therapy Centre https://www.octc.co.uk/product/booklets/changing-perfectionism-2 Other Reading This is a short article on clinical perfectionism by Roz and colleagues https://nopanic.org.uk/perfectionism/ For some free ACT resources from Dr Russ Harris check out his website (Sam talked about ACT) https://thehappinesstrap.com/free-resources/ The bullseye worksheet in these resources is the 4 quadrant image that Sam talks about: https://thehappinesstrap.com/upimages/The_Complete_Happiness_Trap_Worksheets.pdf The clinical perfectionism questionnaire is on p39 of this article - it is 12 items long and gives you an idea of the sorts of problems that clinical perfectionism can exacerbate. If you are worried speak to your GP: https://www.researchgate.net/publication/259530421_The_Clinical_Perfectionism_Questionnaire_Further_evidence_for_two_factors_capturing_perfectionistic_strivings_and_concerns Some worksheets are available here on clinical perfectionism https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Perfectionism Podcasts Check out other podcast episodes on ACT https://letstalkaboutcbt.libsyn.com/lets-talk-about-cbt-act-episode And compassion focused therapy http://letstalkaboutcbt.libsyn.com/lets-talk-about-cbt-compassion-focussed-therapy-episode-0 Websites For BABCP accredited therapists visit www.cbtregister.co.uk For BABCP visit www.babcp.com Transcript Lucy: Hi, and welcome to let's talk about CBT with me, Dr Lucy Maddox. This podcast is from the British Association for Cognitive and Behavioural Psychotherapies or BABCP. It's all about CBT, what it is, what it's not and how it can be useful. In this episode, we'll be finding out about clinical perfectionism, it's a bit of an unusual episode, because clinical perfectionism is not a typical diagnosis. It's a problem which can go alongside many different diagnoses, for example, depression or anxiety. To understand more, I met with clinical perfectionism expert, Professor Roz Shafran, and Sam, who's experienced CBT for perfectionism. Sam currently studies for a master's in psychology in London. Before this, he worked for a couple of years, and before that studied English at Oxford. Through all of it, he experienced perfectionism-based anxiety, this is where it started. Sam: So, I think I've always been interested in academics and I know a lot of people aren't. But it meant that at school I enjoyed working hard, but I think the praise I got as a child for doing well became quite addictive. And so, the more I did well, the more I wanted to continue to do well. And then, pressure mounts, and I think I wasn't aware of that as a child. But suddenly, it wasn't just about doing the best I could in class, but doing the best that could possibly be done, getting full marks. And that's unreasonable, and I think an unhelpful aim. And then, I also felt there was an uglier side of that, which was more comparative, doing better than people around me because I think I found the education system very relative. And it was about being judged against others as well. And I think while that in itself is stressful, I think what was perhaps most difficult was the way it then grew and eclipsed other aspects of life, resting or doing hobbies, or socialising. Even at a young age was tinged with guilt, or it was in the shadow of the work I could be doing. Lucy: So, hard to stop? Sam: Yeah, I think so. Lucy: How would you describe perfectionism? What does it mean to you? Sam: So, for me, it's only recently that I've viewed it as a potentially bad thing. I think generally it meant to me doing my best at things and striving to feel devoted to things. And I think certain aspects of that feel quite rewarding and energising to feel motivated is good. And I think a lack of that can feel unsettling or depressive. But recently, especially through therapy, I've started to relate to the more harmful sides of my perfectionism. And the way it relates to my anxiety, and so I feel it's not just about having high standards, but unreasonably high standards and inflexibly high standards. So, it's not just about trying hard, but needing to try my hardest and needing to do my best. Or a conception of my best that is sometimes beyon

How can a talking therapy help with a problem that feels as physical as chronic fatigue syndrome? Ben Adams talks to Dr Lucy Maddox about overcoming his initial scepticism about CBT and why he's glad he did. Professor Trudie Chalder explains the ideas that cognitive behavioural therapy for chronic fatigue syndrome is based on. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP More information is in the the links and books below. Websites For more about BABCP check out: www.babcp.com To find an accredited therapist: http://cbtregisteruk.com NHS Webpage about treatments for CFS: https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/treatment/ Books Overcoming Chronic Fatigue Syndrome by Mary Burgess and Trudie Chalder Note At the time of recording all information was accurate. NICE guidelines are currently being reviewed and due for release in 2021 Transcript Lucy: Hi, and welcome to Let's Talk About CBT, the podcast from the British Association for Behavioural and Cognitive Psychotherapies, or BABCP. This podcast is all about CBT, what it is, what it's not and how it can useful. In this episode we're going to find out about CBT for chronic fatigue syndrome, also known as myalgic encephalomyelitis or ME. Throughout the podcast you might hear 'chronic fatigue' sometimes used instead of the full name. But it's chronic fatigue syndrome or ME that we're talking about. I went to a specialist clinic at the Maudsley Hospital in London to meet Ben who's experienced chronic fatigue and its treatment. I was there on the hottest day of the year so the tube was pretty horrific. Ben: I'm Ben Adams and I was diagnosed with chronic fatigue syndrome back in, gosh, 2015 I think it was now. To give a little bit of a history I was healthy, broadly healthy, in as much as anybody is, until about sort of 2012. Then I became… I had a period of depression, there was difficulties in my personal life and relationships and all sorts of family things. And I think my body sort of chose to break down in some way or stop me a little bit. And I started feeling very tired, really unwell, my brain wasn't clear. I thought originally it was the depression, but actually I think that morphed into the chronic fatigue. I think one sort of caused the other. And they can go hand in hand quite a lot. It took me about a year or so – or a bit longer – to actually get the diagnosis of chronic fatigue as opposed to trying to treat depression which wasn't really doing it. Because I wasn't actually that depressed (laughs). My mood was actually fairly good. I was just concerned about why I felt so weak and so feeble all the time. And, yeah, it had a lot of impacts on me. I missed a lot of work during that time. I was working full-time beforehand, had rarely had any sickness over the last sort of 20 years of work. The odd day off here and there but I had… I mean over about four years or so, I had about 18 months off totally in sections. And when I was at work I was on phased returns and doing short hours and not doing a great deal to be honest. So I had a really long period of sort of getting worse and worse, trying to get back to work, making myself worse. And I actually felt that each time I've tried to get back to work after a long period of sort of being unwell and being off sick, it would be hard and after a while it would be… it would feel like I was making myself worse. Like the activity, the mental and physical activity of going to work, each time there'd be a sort of a breakdown afterwards and I'm thinking, "God I'm getting worse and worse, that my baseline is getting lower each time of what I can do." And so it was getting to the point where I was almost housebound when I was at my worst. I think, yeah, I'd had about nine months off sick in my longest sort of period off sick at once. And it felt like it was getting up to the end really. I'd tried all sorts of things beforehand. I'd had a very short period of CBT at the start of my illness, but that was also a bit sort of to do with depression as well. So maybe it wasn't targeted as well. And so that didn't work brilliantly and so during those four years I was trying all sorts of remedies that you read on the internet. Vitamins, testosterone, I don't know, everything I could try. And nothing helped. And then eventually I got into the Maudsley Hospital. Lucy: We'll hear more from Ben and his experience of therapy. At the clinic I also met Trudie Chalder, Professor of CBT at King's College London, and Director of the Persistent Physical Symptoms Research and Treatment service. I asked Trudie, who's treated lots of people with chronic fatigue, what it means to have the condition. Trudie: Chronic fatigue syndrome is defined by, obviously, its symptoms. So the primary symptom has to be fatigue, but it's also associated with lots of other physical symptoms such as pain, painful muscles, so myalgia, sleep difficulties, concentration and memory problems to name but a few. It

How do you talk about something in therapy when all you want to do is avoid thinking about it? And why might it help to be able to tackle it? Nick Gilbert talks to Dr Lucy Maddox about how he sought help for post traumatic stress disorder (PTSD) and his therapist, Dr Jen Wild, explains the theory behind the treatment, and dispels some myths about what it's like. This show includes reference to suicide. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP Some more sources of information are listed below. Websites For more about BABCP check out: www.babcp.com To find an accredited therapist: http://cbtregisteruk.com NHS Website about treatments for PTSD are described here: https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/treatment/ Support for veterans can be found here: https://www.combatstress.org.uk/ Books Overcoming Traumatic Stress by Claudia Herbert Trauma is Really Strange by Steve Haines Jen has a book coming out soon too - watch this space for details. Transcript Transcript Lucy: Hi, and welcome to Let's Talk About CBT with me, Dr Lucy Maddox. The podcast all about CBT, what it is, what it's not and how it can useful. In this episode we'll find out about post-traumatic stress disorder, known as PTSD. I went to Oxford to record this episode and apologies in advance for the drilling, there were some building works going on outside where we were recording. We did try recording in the bathroom but it didn't really work. I met Nick Gilbert who was diagnosed with PTSD in 1990, six years after the event that triggered it. This is his story. Nick: I'd reached a point where I was sat in my car and had no idea what I was going to do next. I was actually considering ways of ending my life. So I'm sat in the car considering these things and I phoned my GP who was aware that I'd got issues – got some problems. He put me though to or put me in front of Talking Heads I think it's called. And they phoned me and said would I be prepared to take part in a study. And, quite frankly, I was so desperate at the time, if they've have suggested witchcraft I'd have probably gone along with it. Lucy: Nick started having CBT in 2012. Nick: And then I met Dr Jennifer Wild and I don't think it's too much to say that that lady changed my life. Jen: The people I work with are suffering from post-traumatic stress disorder and the treatment I'm giving is trauma-focused cognitive behavioural therapy. Lucy: Jen Wild is a consultant clinical psychologist at the Oxford Centre for Anxiety Disorders and Trauma. Jen: Post-traumatic stress disorder, or PTSD as it's commonly known, is a severe stress reaction that can develop after natural disasters like a tsunami, a physical assault, sexual assault, car accidents, really unpleasant events where people flooded with unwanted memories and can't get them out of their head. It's very debilitating, it's very terrifying, it takes up their concentration. They feel very hyperalert. Lucy: What does hyperalert mean? Jen: Hyperalert is feeling very on edge, very aware of your surroundings. And I think what happens with PTSD is people's focus of attention shifts. So instead of being very absorbed in their environment or with their work or their family, for example, suddenly people are very focused on something bad could happen, "I could lose my life at any moment. Something might happen to my kids." So the shift of attention is from being absorbed in the environment to something terrible could happen. And when people are focused on danger they notice danger. Lucy: It sounds just like it's very scary all of the time. Jen: It's very scary, it's very unsettling. There are four clusters of symptoms with PTSD. So the first cluster called the reexperiencing symptoms, and that really means people are reexperiencing the trauma in the form of unwanted memories or nightmares or physical reactions in response to trauma reminders. The second cluster of symptoms are the avoidance symptoms. So understandably when we've been through something horrendous, we want to push it out of our mind, avoid reminders, avoid people who remind us of the situation, avoid TV programmes that might remind us of the horrible trauma. So the second cluster of symptoms are the avoidance symptoms. The third cluster of symptoms are what's called, in our language, negative alterations in cognition and mood. That basically means people feel and think more negatively. So they might have thoughts like, "I'm permanently changed for the worse," or "This trauma happened and it's 100% my fault." So they may be excessively blaming themselves. And then the fourth cluster of symptoms are what we call the hyperarousal symptoms. So that's the sleep problems, the concentration problems, that feeling of being on edge, hyperalert to danger. And that they're usually caused, these hyperarousal symptoms, by the trauma memory, so the memory of the trauma keeps people feeling like danger is just around the corner. Lucy

What are 'intrusive thoughts' (we all have them) and what has CBT for OCD got to do with a polar bear? People sometimes talk about being "a little bit OCD", but the reality of obsessive compulsive disorder is much more difficult than a tendency to line your pens up or be super tidy. Ashley Fulwood talks to Dr Lucy Maddox about his journey towards recovery from OCD with the help of CBT, and Professor Paul Salkovkis explains how CBT works. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP Want to know more? Websites For more about BABCP check out: babcp.com To find an accredited therapist: http://cbtregisteruk.com Ashley's charity, OCD-UK is here, and there is a lot of useful information on their website: https://www.ocduk.org/ And another OCD charity, OCD Action, is here: https://www.ocdaction.org.uk/ Books Break Free From OCD by Fiona Challacombe, Victoria Bream Oldfield and Paul Salkovskis Overcoming OCD by David Veale and Rob Wilson Transcript Lucy: Hi and welcome to Let's Talk About CBT with me, Dr Lucy Maddox. This podcast is all about cognitive behavioral therapy, what it is, what it's not and how it can be useful. Today we concentrate on cognitive behavioral therapy for obsessive compulsive disorder, or OCD. Before we meet this week's interviewees I'd like you to try really, really hard not to think of a polar bear. Do not imagine a polar bear. What did you notice? Did you see a polar bear in your mind's eye? We'll come back to that later. For one of this episodes interviews I took a train up to Belper, near Derby to meet with someone who has had personal experience of OCD. Ashley: My name is Ashley Fulwood and I work for the charity, OCD UK. OCD UK is a charity founded by me and a colleague in 2004. We're completely service user led. So everybody involved in our charity at the moment has been affected by obsessive compulsive disorder, either directly, sufferers like myself, or through a loved one. But it's been good because through my work the charity is how I've actually made progress with my OCD and I'm now certainly on my recovery journey. Lucy: Life for Ashley now is really different from how it was at the height of his OCD. Ashley: I thought I was managing my OCD and it's only years later when I started working with the charity that I realised, actually I wasn't managing my OCD. I was able to go to work and hold a full-time job, so that's why I thought I was managing it, compared to other people. But looking back, it tainted every aspect of my life, so it became a very regimented day. I would get up, go to work, avoid eating or drinking during the day. Obviously as a guy we can urinate without having to touch the toilet, so I could just about do that. As my workday ended at 6pm, my colleagues who I'd got on brilliantly with, they would all go off to pubs and restaurants and clubs and they would always invite me but I would make excuses because I knew that I'd have to go home and go through my rituals. So I'd head off home, I'd probably grab a takeaway or something to eat on the way home so that I was ready to use the toilet when I got in. I would use the toilet. By the time I'd finished doing my shower rituals it would be 9:00/10:00 at night, which is more or less time for bed and repeat-repeat-repeat. Lucy: Ashley is not the only person I spoke to for this podcast. I also spent an afternoon in Oxford speaking to the current president of BABCP board and international expert in cognitive behavioural therapy for OCD. Paul: I'm Paul Salkovkis, I'm the director of the Oxford Centre for Psychological Health, which includes various bits, but particularly the Oxford Centre for Cognitive Therapy and the Clinical Psychology Training Course. Lucy: I asked Paul to explain what OCD is. Paul: OCD is much misunderstood. What it is, is people experiencing really unpleasant intrusive thoughts, things which pop into their head, but also images, impulses or doubts which upset them. And those are the things we call 'obsessions.' They're things which pop in the head which are unacceptable and then compulsions that are actually related in the sense that they're things that people do to try to prevent bad things from happening. For example, to wash their hands that feel contaminated or say a prayer if they've had some sort of very unacceptable thought. Try to wipe thoughts out and so on. And those are compulsions. Together they both occur actually in everybody. So everybody experiences occasional upsetting thoughts and do things that perhaps are driven by those kinds of thoughts. The disorder bit is when it interferes with their life and stops you doing things that you want to do. So it's not just the obsessions and compulsions, but it's the interference with life, taking time, distress to the point of torture sometimes. And at its most extreme. This is a life destroying problem. Lucy: Could you say a little bit more about what sort of intrusive thoughts people might experience? Paul: Cla

Maggie's flat was so full that the council threatened to clear it out themselves. CBT helped her understand the reasons behind her hoarding disorder and start to let go of some of her possessions. Maggie and Dr Victoria Bream speak to Dr Lucy Maddox. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP Want to know more? Some useful resources are included here. Websites For more about BABCP check out: babcp.com To find an accredited therapist: http://cbtregisteruk.com Hoarding UK's website has resources including support group listings: https://hoardinguk.org/ Centre for Anxiety Disorders and Trauma website: https://www.kcl.ac.uk/ioppn/depts/psychology/research/researchgroupings/cadat Books Overcoming Hoarding by by Satwant Singh (Author), Margaret Hooper (Author), Colin Jones (Author) https://www.amazon.co.uk/Overcoming-Hoarding-Self-Help-Behavioural-Techniques/dp/1472120051 Transcript Lucy: Hello, and welcome to Let's Talk about CBT, the podcast from the British Association for Behavioural and Cognitive Psychotherapies, BABCP. This podcast is all about CBT. What it is, what it's not and how it can be useful. In this episode, we're going to find out about hoarding disorder. I speak to someone who has experienced hoarding and the treatment for it and a clinical psychologist who specialises in CBT for hoarding disorder. Maggie: My name's Maggie and I've been fortunate to have received therapy in a group and individual therapy. So, I would like to be able to share some of my experience that I hope will be of help to people. Lucy: Could you say a little bit about how things were for you before therapy? Maggie: Hoarding is how I coped with life because it kept people out and it kept me in, where I didn't have to deal with the outside world. Being alone has always been my comfort zone. Lucy: So, it kind of kept you from having... Maggie: Kept things at bay. I saw the outside world and people as the 'other'. The enemy. That's what I've had to deal with. There was a lot of pressure from the borough where I live with the fire risk that hoarding causes. Lucy: So, you were quite unsure about it to start with? Maggie: I wasn't happy because I was being challenged and I felt threatened. I had a way of life that suited me. Lucy: Is it okay to ask what your house was like? Maggie: It's a council flat that I've had for 18 years, now. It just built up and up. I just didn't try and stop it. I have always seen books as my best friend. I always felt books would be the solution to my problems. When I retired 13 years ago, I was able to indulge in a lifestyle that I'd always wanted, where I'd just ride around on buses and read what books I want. Go deep into things and study what my hobbies are. Lucy: It sounds quite nice, actually. Maggie: Well, it is. It's a selfish life. But family life didn't mean happiness to me and relationships didn't spell happiness. My comfort zone was living life vicariously. Learning about life and people through biographies, books, magazines, rather than going straight in to the physical reality. Which suited me. Lucy: I'm sure a lot of people can recognise that. There's something very nice about that, isn't there? But it sounds like it was really getting in the way. Maggie: Well, it doesn't give you deep, ultimate satisfaction. You're always on guard, in a way. When I first started individual therapy, it seemed very threatening. But it isn't threatening, now. It's almost like I can feel creative more instead of not moving beyond that defensive position. Lucy: We'll hear more about Maggie and her reasons for hoarding later. But first, here's Dr Victoria Bream, clinical psychologist at the Centre for Anxiety Disorders and Trauma and the Maudsley hospital. Victoria: Hoarding is characterised by a large volume of possessions in the home. Things can sometimes be somewhat organised but generally are in disarray. It can be a mixture of items, often paper, books. Also, food, clothes, bric-a-brac. Things inherited from other people. All these items are of such a volume that someone's home is difficult for them to use in the way for which the home was designed. So, the bathroom... The bath may be full of clothes. In the kitchen, there might be books all over the worktops. We'd characterise it as hoarding disorder when someone's life is actually impaired and they're experiencing a certain amount of distress from this. I think everybody has the capacity to form a strong attachment to any item. People with hoarding difficulties, for various reasons – some of which we understand and some of which I think we don't – form that level of attachment to a greater number of objects. Lucy: Has it made you think about your relationship with possessions differently, doing this work? Victoria: Oh, constantly. I think that might be one of the things that draws me to it. I really get it, with understanding how possessions can mean so much. My home is far from immaculate and I hang on to all sorts of

Hearing voices is much more common than used to be thought, but what if they're cruel voices that seem to try to stop you from living your life? Chris Shoulder talks to Dr Lucy Maddox about how he uses CBT techniques to manage his experience of voices and Dr Emmanuelle Peters explains the theory behind the treatment. Show Notes and Transcript Here are some resources if you'd like to find out more information. Podcast episode produced by Dr Lucy Maddox for BABCP Websites If you'd like to know more about BABCP check out the website: http://babcp.com If you want to find an accredited therapist look here: http://www.cbtregisteruk.com/ Chris has also written about his experience of CBT on the BABCP website: https://www.babcp.com/Public/Personal-Accounts/Chris-S.aspx Hearing Voices Network is an organisation providing a network for people who hear voices. https://www.hearing-voices.org/tag/voice-collective/ PICuP Clinic where Emmanuelle and Chris work is here: https://www.national.slam.nhs.uk/services/adult-services/picup/ NICE guidelines for service users/relatives are here: www.nice.org.uk UK based organisation the Paranoia Network is here: www.asylumonline.net/paranoianetwork.htm Mad Pride campaigns against misunderstanding and discrimination experienced by people who are seen as 'mad' or mentally ill www.madpride.org.uk This website offers an alternative perspective, practical advice and email support to people who are interested in exploring the idea of spiritual crisis. There are some local groups, for example in London. www.SpiritualCrisisNetwork.org.uk, Books and articles Overcoming Paranoid and Suspicious Thoughts. Research suggests that 20–30 per cent of people in the UK frequently have paranoid thoughts. This is a practical self-help guide. https://www.amazon.co.uk/Overcoming-Paranoid-Suspicious-Thoughts-Books/dp/1845292197 Overcoming distressing voices, Mark Hayward, Clara Strauss, and David Kingdon, 2012, London: Constable and Robinson. A self-help guide based on a cognitive behavioural approach. https://www.amazon.co.uk/Overcoming-Distressing-Voices-Books/dp/1780330847 For an article about CBT for psychosis by Lucy click here: https://www.theguardian.com/science/sifting-the-evidence/2014/may/20/cbt-psychosis-cognitive-behavioural-therapy-voices Other media A History of Delusions - radio 4 series by Dr Dan Freeman https://www.bbc.co.uk/programmes/m0001d95/episodes/player Voice hearer and psychologist Eleanor Longden talks about her experiences in this TED talk. https://www.ted.com/talks/eleanor_longden_the_voices_in_my_head Credits Editing consultation from Eliza Lomas Music by Gabe Stebbing Image by Justin Lynham via Flikr Creative Commons Produced by Lucy Maddox for BABCP Transcript Lucy: Hello, and welcome to Let's Talk About CBT, the podcast from the British Association for Behavioural and Cognitive Psychotherapies, BABCP. This podcast is all about CBT, what it is, what it's not, and how it can useful. In this episode we're going to find out about CBT for psychosis. I went to a specialist clinic in London called the PICuP Clinic which stands for Psychological Interventions Clinic for Outpatients with Psychosis. I spoke to Chris who works there and who's experienced psychosis himself and the treatment for it. Chris: I am Chris Shoulder and I manage the peer support network. I get together with people as well and we sort of kind of try to see what we can do for people who are waiting for the therapy, and with people who've had their therapy and get them together. A bit of mentoring kind of thing really. But it's also that they can speak to somebody who actually knows that the therapy's about and they've been through the whole process. And they can allay any fears that anybody might have. Lucy: Oh that sounds great. So it's perfect to be speaking to you because this podcast is trying to sort of help explain to people what CBT for different sorts of problems is like. Some people might not know what psychosis is actually, and it's quite a kind of technical word. Would you give your definition of it? Chris: Well, psychosis I think is like the umbrella term for lots of different things. You may be experiencing kind of things that are not considered the norm, whatever I guess what the norm is. You might feel like you're being watched or as one person I worked with thinks they're being "surveilled" as she puts it. Or you might be hearing voices. You just don't feel right. You feel kind of maybe that you're being victimised or there's people talking about you or people can read your mind. I mean there's so many kind of anomalous things that make up what psychosis is. And then apart from that you might feel really anxious. You feel depressed. You feel confused as well with it. And it's quite a baffling thing to experience and to kind of describe because there's a myriad of things that go with psychosis. Yeah. Lucy: For people who aren't sure what a dissociative episode sort of means or kind of feels like, w

Most of us have some worries about how we look, but what if those worries get so bad they stop you being able to go out? Body Dysmorphic Disorder (BDD) is a serious problem but it can be overcome, as Gareth explains. Gareth and Prof David Veale talk to Dr Lucy Maddox. This show includes mention of suicide. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP For more information have a look at... Websites The website of the BABCP is at babcp.com. To find an accredited CBT therapist go to http://www.cbtregisteruk.com. The website of the BDD Foundation is at: https://bddfoundation.org/ You can find questionnaires, information, videos of people with BDD speaking about their experience and resources about where to seek help. This Australian website has self-help booklets on BDD: https://www.cci.health.wa.gov.au/ Books A really good book by David is this one: Overcoming Body Image Problems by David Veale and Rob Wilson. Gareth recommends looking through when you're not too anxious, and persevering even if it doesn't reduce your anxiety straight away as it will help you hit the ground running with therapy. Credits Editing consultation: Eliza Lomas Music: Gabe Stebbing Picture: Vince Fleming from Unsplash Transcript Lucy: Hi, and welcome to Let's Talk About CBT, the podcast made by the British Association for Behavioural and Cognitive Psychotherapies, BABCP. This podcast is all about CBT, what it is, what it's not and how it can be useful. In this episode we explore CBT for body dysmorphic disorder, or BDD. BDD involves being really preoccupied with perceived defects in your appearance. Most of us will experience dissatisfaction about some aspect of how we look, but body dysmorphic disorder is much more severe. It's really distressing and it really gets in the way of people's lives. I went to hear first-hand about what it's like to experience BDD. Gareth: Yes, my name is Gareth, I'm an ex-sufferer of BDD and I've had CBT for BDD in the past. When I had BDD I really believed that I was very ugly, that I had very deformed features and that other people would notice these and treat me differently because of them. I used to worry about my nose, that it was too big and that it was just sort of unattractive. That my face was too thin, this may sound funny, but that my head was too small for my body, proportionately. I guess there were some other concerns that my eyes bulged out of my head and things like that and that I was just too skinny overall. But I think the main things were nose and jaw. Lucy: Did it sort of creep up on you or did it happen quite suddenly? Gareth: No, I think it definitely crept up on me. It was interesting, in therapy, looking back and thinking where it started from; I had some very clear memories from earlier in life. When I was eight years old and then a little bit later, but then it crept in during my teenage years and it was only when I got to 17 or so that it really sort of mushroomed and the anxiety just became very disabling. I think because it becomes all encompassing, it starts to affect all areas of your life and a part of the condition is you develop a lot of behaviours in response to the preoccupation, I guess. So for me, I would often research surgical procedures online for hours on end or take photographs or videos of myself and analyse them for long periods of time. Or look in mirrors for long periods of time analysing my perceived defects and thinking about how I could change them or improve them. But also, avoiding a lot of things because of my concerns about the way I looked. I guess the two things operated in tandem. As the behaviours around mirror checking and things started to increase, then the avoidance did as well and I became more and more withdrawn from the world. It was really a very distressing and unpleasant period of time. Some of these activities, once you get hooked into it, once you look in the mirror and get the emotional reaction to how you look and start to check, or once you start to take photographs and get involved in that procedure, hours can just disappear and your mood just goes down and down as time goes on. So yeah, very time consuming. Lucy: Did it get in the way of you making friends and going out to social things? Gareth: For me I had a good group of friends up until age 19 or 20, but then it really did start to interfere with that and stopped me from seeing them and those relationships broke down, which made me feel more isolated and have more time to think about my appearance and sort of made the whole problem worse. But ultimately the anxiety was so bad that I couldn't work for, I think seven years, which was probably a quarter of my life at that time. So it was a very long period of time. Lucy: It's really hard for me to imagine you being so worried about that actually because I'm come to meet you now and you're clearly professional and going about your business. It's hard to fit those two together. So things seem to ha

Ever wondered how CBT fits with ideas about health and wellbeing from more spiritual perspectives? A BABCP outreach event held in a local Glasgow mosque in Summer 2018 explored just this. Saiqa Naz, Chair of the BABCP's Equality and Culture SIG, Shayhk Abdul Aziz Ahmed and Dr Aman Durrani all speak to Dr Lucy Maddox. Show Notes and Transcript: Podcast episode produced by Dr Lucy Maddox for BABCP If you want to know more, check out these resources... Articles Andrew Beck has written an article in the Sept 2016 edition of CBT Today, on page 14, available here: http://www.babcp.com/files/CBT-Today/cbt-today-september-2016.pdf on Helping To Deal With Racism As A Therapist. Saiqa Naz has written an article on p15 of this issue of CBT Today, available here: http://www.babcp.com/files/CBT-Today/cbt-today-february-2017.pdf on Working as a BME CBT Therapist. Books Badri, M. (2013). Abu Zayd al-Balkhi's sustenance of the soul: The cognitive behavior therapy of a ninth century physician. International Institute of Islamic Thought (IIIT). Beck, A. (2016). Transcultural cognitive behaviour therapy for anxiety and depression: A practical guide. Routledge. Videos To watch the outreach event in full, you can access three videos here: 1) Coping with Stress and Anxiety 1/3: A spiritual and cultural perspective, Shaykh Abdul Aziz Ahmed https://www.youtube.com/watch?v=7i4I8AgIO30&list=PLDRvEQKwDiOGDndWynElDmzqUFo8Pa_vI&index=7&t=0s 2) Coping with Stress and Anxiety 2/3: A psychological perspective, Saiqa Naz https://www.youtube.com/watch?v=5FSWDWSJzXk&list=PLDRvEQKwDiOGDndWynElDmzqUFo8Pa_vI&index=9&t=0s 3) Coping with Stress and Anxiety 3/3: Q&A https://www.youtube.com/watch?v=NQpAiktShBc&list=PLDRvEQKwDiOGDndWynElDmzqUFo8Pa_vI&index=5 Website British Association for Behavioural and Cognitive Psychotherapies https://www.babcp.com/ Transcript Lucy: Hello, and welcome to this bonus episode of Let's Talk About CBT with Dr Lucy Maddox. In this episode, I'm going to introduce you to three people who put on a special outreach event in Glasgow back in July. This free event was open to the general public but aimed to reach out specifically to the Islamic community in Glasgow where the BABCP conference was being held. Data shows that Black, Asian and minority ethnic communities are under served by primary mental health services and are less likely than other groups to be referred for talking therapies like CBT. Research findings from Mind in conjunction with the Time to Talk coalition in 2017 highlighted a lack of culturally sensitive and tailored services to meet the diverse needs of many local populations. In addition, some significant cultural barriers can be present within communities which can prevent people seeking help or speaking up. The event was held in an Islamic community space and it involved talks about mental health from different perspectives, from a CBT therapist, a psychiatrist and an Islamic scholar. Dr Aman Durrani, psychiatrist, introduced the event and Saiqa Naz, CBT therapist, and Shayhk Abdul Aziz Ahmed, Islamic scholar, spoke. I spoke to Saiqa before the event. As well as being a CBT therapist, Saiqa is chair of the Equality and Culture Special Interest Group of the BABCP. I asked her to tell me more about why minority communities are not seeking mental health support. Saiqa: We've been hearing about this for many years, that people from BME communities aren't accessing support, so we're just trying to hopefully challenge the stigma by educating them about what mental health is and what kind of support is available to them, and hopefully that will encourage them to seek help. The whole idea, I guess, is to show people that psychology is at one with the faith and that might encourage people to seek help in the future. They say, don't they, that if you love your job it's not work, it's a passion, it's a hobby, and that's how I see it. I love connecting with people. I love meeting people. I love being out and about in the community getting to know people, and that's who I learn from. So, there's the learning I've taken from the community and trying to bring it back into the profession. I'm really passionate about it because for me, CBT, I think everyone should be able to access it. You don't have to be unwell to access it. I know services are set up in that way, but some of the tools that we use, and we teach people are really practical. I think that's why I'm passionate, because you don't have to be unwell to seek help. Lucy: So, it's something that anyone can benefit from? Saiqa: Yeah, definitely, and that's what I love about CBT. I always like to use the analogy of people being plumbers and just having extra tools in your toolkit to use when you need it. Lucy: Saiqa wanted to encourage therapists to seek out her workshops and talk to the special interest groups about any problems that they're having, and if you're going to therapy, feedback to your therapist any cultural issues you think are important. I spoke

How does mindfulness fit with CBT? And is it all about sitting about on a yoga mat? (spoiler - it's not). This episode delves into Mindfulness Based Therapies, including Mindfulness Based Cognitive Therapy (MBCT) and Mindfulness Based Stress Reduction (MBSR). Prof. Willem Kuyken and Chris Henry speak to Dr Lucy Maddox. Show Notes and Transcript: Podcast episode produced by Dr Lucy Maddox for BABCP If you're interested in finding out more... Books This is book that Willem mentions in the podcast and it comes with a CD of meditations: Williams, M., & Penman, D. (2011). Mindfulness: a practical guide to finding peace in a frantic world. Hachette UK. These books are also good: Teasdale, J. D., Williams, J. M. G., & Segal, Z. V. (2014). The mindful way workbook: An 8-week program to free yourself from depression and emotional distress. Guilford Publications. Segal, Z. V., Williams, M., & Teasdale, J. D. (2018). Mindfulness-based cognitive therapy for depression. Guilford Publications. Websites Headspace has lots of animations about mindfulness and an app you can download to your phone (they do a free trial so you can see if you like it). https://www.headspace.com/ This organisation are bringing mindfulness to schools with several specially devised programs: https://mindfulnessinschools.org/ Here is the organisation that Willem works at: http://oxfordmindfulness.org/ And in particular this page has lots of resources you can access for free: http://oxfordmindfulness.org/for-you/ British Association for Behavioural and Cognitive Psychotherapies website is here: https://www.babcp.com/ Transcript Willem: Mindfulness is a human capacity that we all have in any moment of our life. So, in that sense, anybody can do it anywhere and anytime. There's no particular person or particular way of doing mindfulness. It's a way of meeting our minds, meeting our experience, meeting our world in a different way. Chris: If I'm anxious, at my wit's end, worried about things, then the one thing that I'm absolutely not is balanced or on an even keel, as it were. And the amazing thing is that that kind of pressure of stress and feeling there's no way out or no light at the end of the tunnel, in a worst scenario... Whenever I have practised mindfulness meditation, if I've been feeling a bit troubled or a bit down or, on occasion, very, very worried about something, invariably I always feel better afterwards. Lucy: This is Let's Talk about CBT and I'm Dr Lucy Maddox. This series of podcasts, brought to you by the BABCP, explores cognitive behavioural therapy or CBT. What it is, what it's not and how it can be useful. Today, we're thinking about mindfulness-based therapies. These are some of the wider family of CBTs or cognitive behavioural therapies. I'll be talking to Willem Kuyken and Chris Henry about mindfulness-based stress reduction and mindfulness-based cognitive therapy. I met Willem in Oxford and asked how he would describe mindfulness. Willem: There's a short answer to that, which is that mindfulness is a capacity that we all have to bring a certain kind of awareness to our experience. An awareness that has curiosity, interest and care. A longer answer is that mindfulness is something that has three different elements to it. It's the 'what?' Our attention and our awareness. The 'how?' That is cultivating a certain mode of mind, if you like. A certain way of thinking. Of meeting our experience, meeting our world, with curiosity, kindness, care, equanimity and patience. We're not just reacting to the world, we're actually meeting the world in a very particular way. Meeting our experience in a very particular way. Then I think the third part of it is the 'why?' Why are we doing this? It's not just for fun or just for no good reason. In the case of mindfulness-based cognitive therapy for depression, it's to help people with a very long history of depression begin to see the patterns of thinking, the patterns of behaviour and the patterns of reacting that's lead to depression in the past. And learn new ways of responding. So, there's a what? How? And why? to mindfulness. Lucy: Could you say a little bit about what got you into mindfulness-based therapies? Willem: Yeah. When I was a young, clinical academic in my 20s, I became interested in mindfulness as something for myself. In those days, it wasn't really in the mainstream. It certainly wasn't in the mainstream of academia. I found it personally very helpful in all aspects of my life. It was then, in the late 1990s, I went to a conference called East Meets West. There were a range of people talking about how mindfulness could be applied in health. They were just beginning to think about mindfulness for depression. It was a wonderful opportunity for something that had been personally important to me for, at that point, more than 10 years, and was also a professional interest. Lucy: Who is mindfulness particularly useful for? Willem: Okay. I'm going to answer that question as a scien

How do we develop patterns of thinking and behaving from our earlier experiences? What is Schema Focussed Therapy and how does it fit in the wider family of CBTs? Dr Gill Heath and Mary speak to Dr Lucy Maddox. Show Notes and Transcript: Podcast episode produced by Dr Lucy Maddox for BABCP If you're interested in finding out more... Websites BABCP has a Schema Therapy Special Interest Group which you can find out about here: https://www.babcp.com/Membership/SIG/Schema-Therapy.aspx The Schema Therapy Society has more information about the therapy and therapists, and some more resources: https://schematherapysociety.org Books The book we talk about in the episode is the first one: Young, J. E., & Klosko, J. S. (1994). Reinventing Your Life: The Breakthough Program to End Negative Behavior... and Feel Great Again. Penguin. Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner's guide. Guilford Press. Rafaeli, E., Bernstein, D. P., & Young, J. (2010). Schema therapy: Distinctive features. Routledge. Transcript Lucy: This is Let's Talk About CBT, and I'm Dr Lucy Maddox. This series of podcasts, brought to you by the BABCP, explores cognitive behavioural therapy, or CBT, what it is, what it's not, and how it can be useful. We've been thinking about the wider family of CBTs, and today we're going to be thinking about schema-focused therapy. For this episode, like the others in the series, I spoke to somebody who has experienced schema therapy for themselves, as well as someone who is used to delivering schema therapy. I went to London to speak with Mary and Dr Gill Heath. Mary has been having schema therapy for a while, and she took the time to explain to me what it has been like for her and how she sees it. Mary: My understanding of schema therapy is it's like separating out the different ways that you think about things and so like looking at the different parts of yourself and the different ways of approaching things. So, like the part that is just furiously angry at things, or the part that's just really, really, really sad and doesn't really understand why. It's separating those out and going, "Okay, when I'm feeling that, what is that?" so like, "What do I want when I'm feeling that? What are those? What's underneath those feelings? What am I trying to get to?" Lucy: I also spoke to Mary's therapist, Gill Heath, clinical psychologist and co-director of Schema Therapy Associates. She told me some of the things that she likes about using this approach. Gill: It's really flexible. In my experience, it seems to work with quite a broad range of issues because you can really understand the person's individual patterns. The techniques, the things like the imagery, and the chair work, and being real with a person, they work with all sorts of different patterns. I feel like, pretty much whatever someone brings in, I can understand it in schema terms, and that's helpful. I've found that clients really like it, too. They seem to make changes a bit more quickly and at a deeper level for me than when I was practising using other approaches. Lucy: Now, if you've ever studied child psychology, you might recognise the word 'schema' from the work of a researcher called Jean Piaget. Piaget thought we all develop schemas, or frameworks, about how the world works, and that we either assimilate new ideas into these frameworks or we change the framework to make sense of new information. In schema therapy, the therapist is working with you to identify what your schemas are and to spot ones that might not be helpful. One of the things that I find interesting about schema therapy is that it brings together approaches which are often seen as quite different. Gill explained some of the different influences on the therapy, and the theory behind it. Gill: Schema therapy is what we call an 'integrative therapy'. That means it has taken the strongest elements of more well-established psychotherapy, such as CBT and psychodynamic therapy. It has, kind of, pulled them together into a coherent whole, so it has pulled out some of the strengths that CBT has in really focusing in on thinking patterns. That's very much testimony to its CBT roots. It's borrowed from other sides, such as I don't know if any of your listeners will have come across an approach called 'gestalt therapy'. That therapy talks about different parts of yourself. Psychodynamic theory has some very useful ideas about how relationships work and how attachments work. So, schema therapy has brought together those different principles and different techniques from different areas, but within a unified… It does have its own unified theory for how problems develop and how to change them. It's really designed for longer-standing problems, and its primary goal is to help you get your needs met by healing your schemas rather than just reducing your symptoms. Lucy: What's a schema? Gill: A schema is like a lens that colours how we see the world and how w

What is Acceptance & Commitment Therapy and what's it like to have it? How can we live a life in line with our most important values? Dr Joe Oliver, Gary Bridgeman, Dr Graciela Rovner and Dr Eric Morris talk to Dr Lucy Maddox. Show Notes and Transcript: Podcast episode produced by Dr Lucy Maddox for BABCP If you're interested in finding out more about the British Association for Behavioural and Cognitive Psychotherapies, or about Acceptance and Commitment Therapy here are some resources: Websites babcp.com is the British Association for Behavioural and Cognitive Psychotherapies website and it links to the CBT register of accredited CBT therapists in the UK (or go straight to cbtregisteruk.com). BABCP also has an ACT special interest group which members can join. https://www.actmindfully.com.au/free-stuff/ is a resource page on Russ Harris' website. Russ Harris has also written books on ACT (see below). https://contextualconsulting.co.uk/resources houses some of the resources that Joe Oliver refers to in the podcast including some youtube video links. https://contextualscience.org/clinical_resources houses some ACT resources for clinicians and has more information about trainings. https://www.babcp.com/Therapists/Compassion-Fatigue.aspx has some extra resources if you're a therapist feeling in need of support. Books Oliver, J., Hill, J. & Morris, E. (2015) ACTivate Your Life: Using acceptance and mindfulness to build a life that is rich, fulfilling and fun. Robinson. Harris, R. (2011). The happiness trap. ReadHowYouWant. com. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford Press. Hayes, S. C. (2005). Get out of your mind and into your life: The new acceptance and commitment therapy. New Harbinger Publications. Jackson Brown, F. & Gillard, D. (2016) Acceptance and Commitment Therapy for Dummies. Wiley. Papers Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour research and therapy, 44(1), 1-25. There are also several podcasts about ACT - if you search for acceptance and commitment therapy podcast you will come up with a few different ones. Transcript Lucy: This is Let's Talk About CBT and I'm Dr Lucy Maddox. This series of podcasts, brought to you by the BABCP, explores cognitive behavioural therapy or CBT. What it is, what it's not, and how it can useful. Today we're thinking about acceptance and commitment therapy or ACT. This is one of the wider family of CBTs. For this episode, like the others in this series, I tried to find people who've experienced having acceptance and commitment therapy for themselves as well as people who are used to delivering ACT. We've got that but unusually in this episode lots of the people who volunteered to speak about what it's like to have ACT are also ACT therapists. I don't think this is a coincidence. There's something about this approach where experiencing using the concepts in your own life is an important part of being a therapist. I started off by meeting with Dr Joe Oliver, clinical psychologist, co-director for UCL CBT for psychosis postgraduate diploma and director of Contextual Consulting which is an ACT based consultancy. I started off by asking him what is ACT? Joe: The acronym starts to unpack a little bit of what it is. So that the key piece about acceptance and then sitting right alongside commitment when things get really big and feel overwhelming. Very instinctual perhaps to try and want to push those experiences away or not have them. So the acceptance part is helping us to make room and space for, breathe into and allow those experiences. Crucially so that we can do the commitment bit, which is to take action, to do things as we might choose to based on things that are important to us, things that matter to us. Lucy: So like if you're feeling really sad, for example, would ACT say that there's something about trying to accept that you're feeling sad? Is that the sort of experience that you're talking about? Joe: Yeah, exactly, yeah. It's kind of it's a tricky word, right, like particularly feelings like sadness or maybe anxiety that if most of us were being honest with ourselves we wouldn't say we necessarily warm to. Lucy: No, rather not have it. Yeah. Joe: Rather not have them. Yeah, exactly. But at the same time there's a piece of this model talks about making room and space for the parts of those experiences that are natural, the human part of experience. Which is to say when things, of course, in life don't go as we want them to or important relationships end or people move away from us. Those feelings that arrive, including things like sadness, how, as much as perhaps we might want to push them away, there's a recognition of the normalness, the naturalness of those experiences. Lucy: And so is there something about, does ACT think that it's actually more helpf

Couldn't we all be a little kinder to ourselves? Find out how self-compassion can influence us and hear about how compassion focussed therapy helped Chris with depression. Prof. Paul Gilbert and Chris Winson talk to Dr Lucy Maddox. Show Notes and Transcript: Podcast episode produced by Dr Lucy Maddox for BABCP If you're interested in finding out more about the British Association for Behavioural and Cognitive Psychotherapies, or about Compassion Focussed Therapy here are some resources... Websites babcp.com is the British Association for Behavioural and Cognitive Psychotherapies website and it links to the CBT register of accredited CBT therapists in the UK (or go straight to cbtregisteruk.com). BABCP also has a Compassion special interest groups which members can join. https://compassionatemind.co.uk/ is the website of the Compassionate Mind Foundation. https://underwaterbreathes.wordpress.com/ is Chris Winson's blog. On Twitter, the hashtag #365daysofcompassion was created by Chris and connects you to other people using principles from CFT to help with everyday life. Books Gilbert, P. (2010). Compassion focused therapy: Distinctive features. Routledge. Welford, M. (2016). Compassion focused therapy for dummies. John Wiley & Sons. Irons, C., & Beaumont, E. (2017). The Compassionate Mind Workbook: A step-by-step guide to developing your compassionate self. Robinson. Welford, M. (2012). The Compassionate Mind Approach to Building Self-confidence Using Compassion Focused Therapy. Constable & Robinson. Papers Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53(1), 6-41. Gilbert, P. (2015). Affiliative and prosocial motives and emotions in mental health. Dialogues in clinical neuroscience, 17(4), 381. Transcript Lucy: This is Let's Talk About CBT and I'm Dr Lucy Maddox. This episode is all about a type of talking therapy called compassion-focused therapy. It sometimes gets called CFT. This is one of the family of cognitive behavioural therapies or CBTs. For today's podcast I went to Derby to speak to Professor Paul Gilbert and Chris Winson. Paul: Yes, so hello. I'm Paul Gilbert, clinical psychologist. Retired from the health service but still work as a professor at the local university and also the University of Queensland where we're doing research on compassion-focused therapy. Chris: My name's Chris Winson and I've gone through a CBT form of therapy called compassion-focused therapy, CFT. And that was to help with depression. Lucy: I asked both Paul and Chris how they described CFT. Paul: So compassion really is about the way in which we turn towards suffering and try to alleviate suffering where we can and prevent it. Learning to have the courage to face the pain that we need to face with the wisdom to know what to do to actually help ourselves and prevent it. Chris: CFT is all about really kind of engaging with a lot of the thoughts that we all have and that depression particularly kind of amplifies. And kind of not shying away from those emotions but engaging with them with a kindness and an encouragement to perhaps work with it rather than reacting perhaps as you would do intuitively. And in my instance with something like depression, compassion-focused therapy really does help towards those self-critical, self-judgemental, perfectionist kind of thoughts that depression really kind of takes and turns the volume up on to maximum. Lucy: Paul was the first person to develop CFT. Paul: During the 70s and 80s we were all pursuing cognitive therapy, and quite well too I think. So we were working with very complex and severe people with depression. And they could be quite good at developing alternative thoughts to some of the more difficult beliefs and attitudes to self-help. But they would often say, "Yes, I can see the logic in these alternatives, like I think I'm a failure but in reality I can see I've achieved this, that and the other. I can't really feel any different." So one day, and I'd like to tell you it was because it was wisdom and because I was so clever, but unfortunately it wasn't. It was simply accidental. I asked this lady, "Well, how do you hear these alternative thoughts in your mind? Speak them out." "Well, what do you mean?" I said, "Speak them out as you actually hear them." And she said, "Okay. Okay, so you're depressed, so you've got a husband who loves you and he stands by you, hasn't he? You've got children who love you. For God's sake, look at the evidence!" So I said, "Oh my goodness. Is that actually how you hear them?" And she said, "Yeah." So I thought, "Ooh." So I said, "Well, what would happen, imagine that you had the same alternative thoughts that you could see that in reality your husband did care about you and you had children who loved you and were doing very well at school and so on. You'd been a good mother to them. And this was with a voice that was very kind and compassionate to you because it realised all

How do we live with impossible dilemmas? How can someone stop self harming when it's the only way they know of coping? What is DBT and how did it help Louise? Dr Michaela Swales and Louise Brinton-Clark talk to Dr Lucy Maddox. This episode includes reference to self-harm. Podcast episode produced by Dr Lucy Maddox for BABCP Show Notes and Transcript If you're interested in finding out more about the British Association for Behavioural and Cognitive Psychotherapies, or about Dialectical Behaviour Therapy here are some resources... Websites babcp.com is the British Association for Behavioural and Cognitive Psychotherapies website and it links to the CBT register of accredited CBT therapists in the UK (or go straight to cbtregisteruk.com). BABCP also has a DBT special interest groups which members can join. https://www.sfdbt.org/ is the Society for DBT website which has a list of accredited DBT therapists in the UK https://www.behavioraltech.org/ has research articles and a good video on "What is DBT?" Books Heard, H. L., & Swales, M. A. (2016). Dialectical behaviour therapy: distinctive features. Routledge. Koerner, K. (2012). Doing dialectical behavior therapy: A practical guide. Guilford Press. Linehan, M. (2014). DBT Skills Training Manual. Guilford Publications. Linehan, M. M. (2014). DBT Skills Training Handouts and Worksheets. Guilford Publications. Swales, M. A. (Ed.). (2017). The Oxford Handbook of Dialectical Behaviour Therapy. Oxford University Press. Transcript Louise: It is a life-saving treatment for some people. I don't believe I would have graduated or got married or even, it sounds really daft, even have passed my driving test. Lucy: This is Let's Talk About CBT and I'm Dr Lucy Maddox. This episode is all about a type of talking therapy called dialectical behaviour therapy or DBT. This is one of the family of cognitive behavioural therapies or CBT which was talked about in episode one. We talk a bit about self-harm today, so please take care of yourself, if you know that's a tricky subject for you. To get away from the acronyms and try to understand what DBT is actually like I went to Bangor, in Wales, to meet with Dr Michaela Swales and Louise Brinton-Clark. Louise: My name's Louise Brinton-Clark, I have been a member of a DBT group, dialectical behaviour therapy group, both as a service user and as a graduate facilitator. Michaela: My name's Michaela Swales, I'm a clinical psychologist, I'm also the director of the British Isles DBT training team. So, as well as having delivered DBT for probably the best part of 20 years in my clinical practice, I've also spent the last 15 years or so training others to deliver DBT. Lucy: Dialectical behaviour therapy is a bit of a mouthful, I asked Michaela to explain what it means. Michaela: So, within the treatment, we do a lot to help people change things and we do a lot to help people accept things. And in a way, those two things acceptance and change, at least on the face of it, look like they're totally in contradiction. They're what's termed in a particular branch of philosophy – not that you need to know philosophy to do this treatment – a dialectic. They're two things that are in almost polar opposites to each other, but there's value in both of them. And so constantly in the treatment we're always looking for both change-based ways to solve problems and acceptance-based ways to live your life. And being dialectical means looking at both of those things, and sometimes you have to do a mix of those things to really get things to work. It is a behavioural treatment, so it focuses a lot on changing behaviours, both those things that other people can see that we do, but also those things that we experience internally. And as we know from lots of areas of life, changing our behaviour is hard, it takes a lot of hard work. And I think many of the people who come for this treatment have a lot of things in their life that they are really struggling with, multiple things. And so it is a tough treatment. Lucy: I also asked Louise to explain DBT. Louise: My understanding of what dialectical behaviour therapy is it's working with opposites but bringing them together. It's that thinking in extremes, isn't it? It's called black and white thinking. Lucy: Which I guess we all get into sometimes. Louise: We do get into. And that grey area, my god, the grey area is the size of the universe, really. It's immeasurable. And I know what I typically used to do, and I guess I still do sometimes, is thinking in those extremes, that stereotypical, "I hate you, don't leave me." It's two total opposites of the same thing. Lucy: So, like push-pull kind of… Two opposites, how do we reconcile them? Louise: Or hurting yourself to stop the pain. Lucy: DBT is a treatment that's often used to treat severe self-harm and huge ups and downs in mood. It's a pretty comprehensive treatment package as both Michaela and Louise told me about. What does it look like when people are referred fo

What is cognitive behavioural therapy? What's it like to have it? How can it be useful? Is it just 'positive thinking'? (spoiler - it's not). Prof David Clark, Prof Sarah Corrie, Jo and Frank talk to Dr Lucy Maddox. A mix of interviews, myth-busting and CBT jargon explained, this accessible podcast is brought to you by the British Association of Behavioural and Cognitive Psychotherapies. www.babcp.com Podcast episode produced by Dr Lucy Maddox for BABCP Transcript Lucy: Hello, and welcome to Let's Talk About CBT, a new podcast exploring cognitive behavioural therapy; what it is, what it's not, and how it can be useful. My name is Dr Lucy Maddox, and I'm a consultant clinical psychologist. I use cognitive behavioural therapy, or CBT, a lot in my work, alongside other therapeutic approaches. I also work as senior clinical advisor for the BABCP, which stands for the British Association for Behavioural and Cognitive Psychotherapies. I thought that a podcast might be a great way of explaining CBT to people who are curious to know more about it. I'm getting lots of experts in the field to come and help me do that. In this episode I'll be interviewing Prof David Clark about what CBT is, I'll be speaking to Jo and Frank, two people who have experienced what it's like to have CBT first hand, and I'll be busting some CBT myths with Prof Sarah Corrie. I'll also be picking a bit of CBT jargon to explain. First, let's hear what David Clark has to say about what CBT is. David Clark is a professor of experimental psychology at Oxford University, and national clinical advisor to the Department of Health. I caught up with him at the annual conference of BABCP in Manchester, back in July. I started by asking him to explain just what is CBT? David: So CBT is a psychological therapy which is designed to help people who are troubled by excessively severe or persistent negative emotions. Emotions are part of everyday life; things happen to us which make us feel happy, make us feel sad. That's an intrinsic feature of just being a human being. But for some of us we get into phases in our lives where we get excessively down or excessively anxious, in a way which persists. And CBT is based on a very old idea about what might be happening in that situation. It really goes back to the Greeks. And there was a Greek philosopher, Epictetus who said we are not disturbed by the things that happen to us on their own, but rather the way we think about them. And so the central idea of CBT is that when we have excessive negative emotions, it's partly to do with distorted patterns of thinking. We see the world as much more dangerous than it really is, we view ourselves in a much more negative way than is realistic. So the first thing in CBT is to help people spot their excessively negative and unhelpful thoughts. But it's called CBT because the second thing is behaviour – the first is cognitions, the second is behaviour – and that's because once we start thinking in a negative way, that changes the way we behave, and that can often keep the problem going. If, for example, you are someone with one of the most common anxiety problems, social anxiety, you would really like to make new friends and things. But when you go to a party and you feel a bit self-conscious, you think maybe people don't like me, you'll leave the room immediately; you'll avoid. And then of course you don't get a chance to meet other people. And so the way in which your thoughts change your behaviour keeps the whole problem going. And so your therapist will work with you to try and identify your negative thoughts, and also the way in which it changes your behaviour. Nowadays it has got quite elaborate, so there isn't really one thing that you would say is CBT. Really CBT is a lot of different therapies, all of which have a focus on the way you think, the way the thinking changes your behaviour. And also two other things: the way it changes what you remember – and in some conditions, like post-traumatic stress, that's very important – and also what you pay attention to. In life there are lots of things going on, and we can choose to attend to some things more than others. And when we're distressed, we tend to focus on the things which fit with our negative view. What we do in CBT is try and work out, for the particular problem that you're coming to therapy for, how does your thinking affect your attention, your memory and your behaviour. When we find unhelpful patterns, then you work with your therapist to change those patterns of thinking and behaviour. It's very practical. You don't just sit and chat; quite often you'll leave the office with your therapist and test things out. Lucy: So more of a doing therapy, really? David: It's a doing and thinking therapy. So what are the doings you could do? Well, if you get sudden attacks of anxiety, what we call panic attacks, which are quite common for some people, they might think in a panic attack, when they notice their heart racin