A very important component of stress is the physical tension we carry around. In fact people who experience high levels of stress and anxiety can be so physically tense much of the time that it becomes their normal physical state. This exercise has two parts. The first part involves tensing each muscle group so that you become aware of holding physical tension. The second part is a progressive relaxation of each of these muscle groups so that you have the experience of purposefully letting go of tension and being in a more comfortable, restful state. Instructions: Find a quiet, comfortable place. A reclining chair is ideal as you want to be relaxed but remain awake. Make sure your clothes are comfortable and take off your shoes. Take five nice slow, calm breaths from your stomach. Now you need to consider your muscles in groups; focusing on tensing the muscles in a certain area (for example the hand) before then going on to release this tension. So turn your mind’s attention to your left hand. Slowly and gently tense up the muscles in your hand until your hand is as tight and tense and gripped as you can manage. Hold this tension for five seconds before releasing. Fully release this tension at the same time as breathing out. Spend about fifteen seconds really noticing how relaxing the muscles in your hands feels different from tensing them. Noticing this difference is the most important part of the exercise. After fifteen seconds move on to the next muscle group and repeat the steps of tensing and then relaxing that muscle group. Muscle groups to focus on: Foot, lower leg and entire leg; then other foot etc Hand, entire arm including shoulders; then other hand etc Buttocks (squeeze) Stomach (squeeze) Chest (take deep breath) Neck and shoulders (tense up to ears) Mouth (open mouth wide and clench) Eyes (clench shut) Forehead (raise eyebrows) How to make the most of this exercise For the first week do this exercise twice a day. Set aside ten to fifteen minutes in a quiet place. Practicing a lot in the first week will mean that you learn this skill more thoroughly and can then quickly notice when you are holding tension and relax yourself. It is best if this exercise is done when you are feeling calm and rested but it can also be used to reduce tension. You might find it easier to listen to recorded instructions. There are many audio versions of progressive muscle relaxation exercises available on the internet.

Please click the images below to see the individual blogs to help in overcoming physical symptoms of anxiety Relaxed Breathing When we are anxious we breathe more shallowly and do not breathe out a full breathe. Square or Box Breathing Breathing is a fundamental element of our anxiety/calming system in the body Body scan A body scan is a relaxation technique that can help us to control anxiety or unhelpful emotions. Progressive Muscle Relaxation A very important component of stress is the physical tension we carry around. Exercise and Stress The evidence on the link between exercise and improved mood, concentration, health and well being is strong, clear and consistent.

The Difficulties of Being a Parent A child arriving into the world is a wondrous thing. But often times we are not prepared for how life changes. A lack of sleep, a lack of time, a lack of enough support can make us feel depressed and anxious and stressed beyond anything we thought possible. Our struggles to get pregnant, our struggles with pregnancy and traumatic births can all add significantly to how we feel. I will outline some of the more common issues below. Children are not born with an understanding of how to sleep through the night. This is something that needs to be taught. As a psychologist, my children should have been perfect from the moment they were born. I had read the books and knew what the literature said...but I found myself walking my son around my coffee table, in a sling, with a dummy in his mouth with the vacuum cleaner on for white noise, for hours and hours every week. Then, when he was finally old enough to sleep in a cot on his own, I patted his back for at least an hour each night. If he noticed my move away from him before he slept, I had to start again. It was exhausting. The anxiety of wanting him to be okay - he was slightly premature and did not thrive as a baby, was unbelievable. And, the books might tell us that we are creating problems we will have to unpick later on unless we get them sleeping in a bed, on their own in the dark, but I wonder if those that wrote the books have ever been sleep deprived. Sleep deprivation means we will do anything to go back to sleep, so we end up sleeping in a chair with white noise and of course we know it is not ideal but at least it is sleep. Evolution increases anxiety when we have children. It makes us more hypervigilant to danger and has helped our species survive. So on top of sleep deprivation, we feel anxious. And we go from having time to ourselves to no time at all. If we are lucky, we have some support but heightened anxiety and exhaustion do not bode well for relationships, so often times couples argue. As children grow into toddlers , they need to learn how to keep safe, about right and wrong and don't understand the importance of eating their greens when cake tastes so nice. They don't know how to control their emotions and can be fine one moment and screaming with anger the next. When we are the parent of a tantruming child, we might assume everyone is looking to us as the problem - why cant we control our child? Why are we such a bad parent? We might begin to see all of the well behaved children around us and assume that the problem is in fact with us. However, the majority of parents can identify with what is being said here and a child that tantrums is in a space where they feel allowed to tantrum and there is a lot to be said for that. When children are old enough to go to nursery or school, morning routines can be exhausting and end up in a shouting mess before piling children in to the car for the school run. It might be that your particular difficulty is that your children will not get dressed alone, remember to do things, such as eat breakfast or brush their teeth, without being told numerous times. It may be that they become easily distracted and you find them with the paints out just as you need to leave to make it to school on time.  The evening routine can be just as hard. After-school clubs, playdates, homework, snacks, dinner, bath, bed time and then arranging everything for the following day. The tasks are never ending. To have to deal with a child who wants to do none of this makes the situation a lot harder. It may be that your younger children don't seem to understand the meaning of 'no' and are constantly testing you. They may not want to share and hate their siblings. You may be sick of repeatedly asking your child to do something and ashamed when your child has a full-blown tantrum at the school gates. With older children negotiating social media, screen time, homework and sleep can be a daily battle.  And the toddler eventually grows into a teenager . The teenage period is a time of intense emotions and the transition from being a child to being an adult is rarely a smooth one. Many of the behaviours of teenagers baffle and exasperate parents. It may be that your teenage child wants to be an adult and do the things adults do without any interference from Mum or Dad. It is difficult to find the balance between allowing them to make mistakes and learn and keeping them safe.  Parenting can be the best of times and the worst of times. All parents struggle and all parents make mistakes. My top tips for parenting are as follows: Love your children unconditionally. Give yourself a huge pat on the back because being a parent is not easy. Rather than criticising yourself for mistakes, try to think about what you have done well. If you behaved in ways that you were not proud of, think about how you would like to behave in the future and put a plan in place to behave in the way you want to. Forgive yourself if you get it wrong - we all get it wrong and to admit to that and discuss this with our children can help them to understand that it is okay to not be perfect. Saying 'sorry' helps your children make mistakes too. Try to set clear boundaries and stick to them. Praise your children when ever they do anything well and especially when this involves a behaviour that makes your life easier. Try to understand how your own experience of growing up might be impacting on your parenting style. If you feel your parents did not care enough, do you over compensate by giving up your life to be a caring parent? Did one or other of your parents make you feel like you were not good enough? Do you feel like your children think the same? Children can say some awful things to their parents. A confident parent will brush this off as normal. A parent lacking in confidence, may find the words of their child crushing and believe they are the truth. If you experienced a trauma in your life are you hypervigilant to that happening for your children and stifle their growth because of your fears? Remember that the way a child will succeed is if they feel good about themselves, so, returning to number 1 - love your children unconditionally. They may not be perfect and they may not get it right but that is a normal part of being human and if they can feel your love they will be happy and find their way, eventually. If you are thinking about therapy, then make sure you find someone who has the expertise to help you. Ideally, this would be a psychologist or therapist who has worked in a CAMHS service in the NHS. At Dr Stuart Psychologists have highly trained CAMHS psychologists as part of the team. Please do be in touch if you would like to understand how we can help to navigate this most difficult time of life. ​ ​

Phobias - What are they and when do they become a problem?   Phobias are grouped into different categories - Complex Phobias and Simple Phobias. Complex phobias, such as agoraphobia and social phobia, will be discussed in other blogs. Simple Phobias are outlined below and what we will be focusing on today.   What is a Phobia?    A marked fear or anxiety about a specific object or situation. When presented with that object or situation, it will provoke an overwhelming and a debilitating sense of fear or anxiety. How we might think about this is that you might have an intense fear of chairing a meeting, attending an interview, taking an exam. The anxiety you feel might be severe and intense but with a phobia, either you would run a mile or be unable to function in the situation. The anxiety or fear about the object or situation is out of proportion to the actual danger posed.   To be diagnosed with a Specific Phobia (like a diagnosis for depression or a diagnosis of obsessive-compulsive disorder), your fear must also be present for at least 6 months and, here is the important bit, it must cause significant distress or impairment in social, occupational or other important areas of functioning. So basically, if you can live day to day with your phobia and it only causes significant distress on the occasion you meet with it, it would not be viewed as that problematic by health professionals.   But I bet it feels problematic to you.   It is interesting to me that most people can live their whole lives with a phobia and are very clever at surreptitiously avoiding the thing they fear. People have said they are rational human beings but when faced with their phobic object or situation, without the option to run, they can turn into a screaming, unhinged reck - not my words. Not the kind of impression most of us want to give to the world.     Symptoms of a phobia.   When faced with the thing we fear, the brain triggers the fight and flight response and an uncontrollable reaction in the body occurs. The brain releases the stress hormones - cortisol and adrenaline. These flood the body making people feel a wave of anxiety and intense hypervigilance.   You might notice your breath begins to be shallow as your body takes in more oxygen. Your heart might pump fast - taking this oxygen to your muscles. Muscles can feel tense or tight as they prepare for danger. You might feel nausea or butterflies in your tummy, as energy is diverted from breaking down food to preparing the body for battle. You might start to sweat or feel shaky. Another common symptom is to feel lightheaded or dizzy.   Development and course...or Nature/Nurture. We are born with two innate fears - a fear of falling and a fear of loud noises. These would have served us well in hunter-gather time. But there is some suggestion that we also have an innate fear of spiders and snakes.   Most phobias, however, develop through learned responses, in other works, in relation to a traumatic event. It might be that you remember the time you were stuck in a lift or your neighbour’s evil cat did not let you pass it on the stairs or the turbulence in the plane sent your parents into a spin. Or it might be that you cannot remember. Most phobias develop before the age of 10 and because we find a way to live with them (or avoid them) most phobias remain throughout a person’s life. It is also a known fact that if our parent has a fear of an animal, they will pass on that fear to us.     Types of phobias There are a wide variety of objects or situations that someone could develop a phobia about. In fact there are over 100. Some might make more sense, such as a fear of flying or dogs. But what about a fear of air or a fear of numbers? Specific phobias are divided into 4 main categories. I have included some of the more common phobias below. Fear of problems in the natural environment Astraphobia - a fear of thunderstorms and lightening Acrophobia - fear of heights Dendrophobia - a fear of trees Fears of animals Arachnophobia - fear of spiders Ailurophobia - fear of cats Cynopphbia - a fear of dogs Fear of Medical Treatments or Issues Dentophobia - fear of dentists and dental treatment Hemophobia - fear of blood Trypanophobia - a fear of needles or injections Fears related to specific situations. Claustrophobia - fear of closed in spaces, such as lifts. Glassophobia - fear of heights Aerophobia - fear of flying.   When does a phobia become a problem? Most people choose to live with a phobia and take great care to avoid the thing they fear. Most individuals do not seek professional help until a situation or event in life presents itself and the phobia can no longer be avoided. Some examples of this might be: We are offered our dream job - but the office is on the 50th floor of a building. Our child is getting married, but the wedding is taking place the other side of the world. The office for our current job moves and either we take 3 hours to get there by public transport or 1 hour by car, but this involves driving on a motorway. We have booked our dream trip but realise that we will arrive in the rainy season and thunder and lightning strikes will be a daily occurrence. Treating Phobias One of the problems with living with a phobia is that by trying to constantly avoid the thing you fear you are telling your brain there is actually a problem. So, every time you cross the street to avoid the dog, your brain will believe it was a lucky miss because that dog was definitely going to bite you. Every time you avoid going on a train, your brain is convinced that you had avoided a certain disaster. Every time you avoid a hospital appointment your brain will be convinced the doctor was going to carry out a procedure that would lead to certain death. The point here is that unless you actually face the thing you fear your brain can never find out whether the thing you fear is actually a problem . This is the important bit... we have to show our brains that the thing that it is frightened of is actually benign. How do we do that? The obvious answer is to face our fears. But when we approach the object or situation of our phobia our brains tells us: RUN!!!!! YOU WILL DIE IF YOU DO NOT RUN!!!!!! So overcoming a phobia is not easy...but it can be done.     Step 1: Understanding Anxiety It is important to understand anxiety and why your body responds in the way it does when faced with your fear.   Step 2: Practice Anxiety Reducing Techniques. It is important to practice this outside of the feared situation. When we are in a situation where our brain is telling us we are going to die, stopping to try to remember how to breath properly does not work.   Step 3: Develop an exposure program that involves a graded hierarchy or a 'fear ladder'. This involves coming up with several steps starting with things we have mild anxiety towards and moving towards things we have intense anxiety for.   An example of exposure therapy for fear of spiders: 1.     Look at a picture of a small spider. 2.     Look at a dead spider in a jar. 3.     Look at a picture of a larger spider. 4.     Watch a video of a small spider. 5.     Watch a small alive spider in a jar. 6.     Be in a room with a small spider. 7.     Be in a room with a larger spider. 8.     Be in a room with a number of spiders. 9.     Hold a small spider in our hands. 10.  Hold a large spider in our hands.   An example of exposure therapy for a fear of heights: 1.     Stand on a low stool. 2.     Go up 5 rungs on a ladder. 3.     Go up one flight of stairs and look over the banister from a distance 4.     Go up 10 rungs on a ladder 5.     Go up one flight of stairs and look over the banister close by. 6.     Go up two flights of stairs and look over. 7.     Go up five flights of stairs and look over. 8.     Go up 10 flights of stairs and look out a window. 9.     Go up 20 flights of stairs and look out of a window. 10.  Go up 20 flights of stairs and look out from a balcony.   An example of exposure therapy for a fear of needles 1.     Think about having an injection 2.     Listen to someone talking about having an injection 3.     Look at photos of needles 4.     Look at photos of someone having an injection 5.     Watch a video of someone handling a needle 6.     Watch a video of someone having an injection 7.     Hold a needle in your hand 8.     Watch someone having an injection in the same room as you 9.     Place or hold a needle close to the site of injection 10.  Have an injection in your arm   Step 4: Prior to carrying out the first point on your fear ladder, carry out relaxation techniques to calm the body.   Step 5: Begin working through the hierarchy.     Top tips : Ask friends and family to celebrate your journey with you.  This can help with motivation. There will be items on the fear ladder that feel quite easy. Enjoy the feeling of achievement and watch your brain dismissing how hard it actually was to do it. Often, we will get to a point in a ladder where we feel stuck and cannot do the thing. Break this item down again as perhaps there are more steps involved. Plan a celebration at the end - maybe buying your child the dog they always wanted or throw a party on the top floor of a high building. Or maybe just have a cup of tea and bask in the wonderful feeling that you have overcome your fear, and it will never plague you again.