Coping with uncertainty in difficult times.
16/03/2020 18:47 Filed in: Anxiety | Mindfulness
Right now there’s a tremendous amount of uncertainty in the world, as the impact of the spread of the Corona virus is felt in so many different aspects of our lives: The word I keep hearing is ‘surreal’, and this sums up the strange mixture of normality and difference, along with the lack of certainty that comes with such a rapidly changing situation.
Naturally enough, this makes things even harder for people who tend towards anxiety, and perhaps feel a strong need for certainty and control in their lives. So I’d like to share a simple process that can help to take the edge off those moments of rising anxiety. The word ‘APPLE’ can serve as a reminder for the steps in the process, but if you always find it hard to remember what each letter stands for, just make a note of the steps and practice it until it becomes automatic. Spend just as long as you need to on each step, it might be seconds or a few minutes on any of them, but there’s no need to rush.
Acknowledge: This involves noticing when anxiety and uncertainty arise, and simply acknowledging it’s here – like a guest arriving at your front door. It may help to simply acknowledge it in the voice of your mind: ‘Ah, hello uncertainty’, letting the voice tone be as friendly as possible. ‘Come in, have a seat’.
Pause: What normally happens next is an automatic reaction, a reflex action that may involve seeking to control or avoid the feeling or situation. Instead we pause, rather than react. Take a deep breath… Feel your body release a little tension as you slowly breath out. Take as many deep breaths as you wish, then let your breathing settle into a slow, comfortable rhythm. By not reacting automatically, you’ve taken control of the way you’re responding.
Pull Back: Tell yourself that this is simply a feeling that has arrived, it may stay awhile, and it will pass too. Recognise the thoughts in your mind are just some words or images, and they’re coming from that feeling; in a sense, they belong to that ‘guest’ that’s come to visit, so there’s no need to own them yourself. You may like to use the idea of a radio playing, and all those thoughts are simply the radio program – and right now the radio just got tuned to ‘Radio Worry’. The thoughts can be there, you don’t need to be the thoughts.
Let Go: Standing back a little from the thoughts and feelings, observing them rather than being them, makes it possible to let them go, in their own time. I like the image of standing on a station platform, the trains are your thoughts and feelings, and you can watch them come and go. From time to time, you find you’ve boarded a train and been taken for a ride… This step is like getting off the train, and letting it go. You might prefer the image of clouds in the sky, with your mind the blue sky behind the clouds, and the thoughts as clouds that float by.
Explore: Be present, and explore what else is here in this moment. Notice your breath. Notice your body, and feel how you can control it: Push your feet into the floor a little, have a stretch, let the tips of your thumbs gently pass over your finger tips and feel the rich pattern of sensations as they do. These difficult thoughts and feelings are here, but there’s a body around them, a body you can control. Notice what is around you, and name five things you can see, four things you can feel, three things you can hear. Actively choose where your attention rests, rather than simply letting it get pulled around by thoughts that are playing on ‘Radio Worry’. Let your attention come to rest wherever you need it to be, such as the task you’re trying to get done, or the activity you had been enjoying…
Naturally enough, this makes things even harder for people who tend towards anxiety, and perhaps feel a strong need for certainty and control in their lives. So I’d like to share a simple process that can help to take the edge off those moments of rising anxiety. The word ‘APPLE’ can serve as a reminder for the steps in the process, but if you always find it hard to remember what each letter stands for, just make a note of the steps and practice it until it becomes automatic. Spend just as long as you need to on each step, it might be seconds or a few minutes on any of them, but there’s no need to rush.
Acknowledge: This involves noticing when anxiety and uncertainty arise, and simply acknowledging it’s here – like a guest arriving at your front door. It may help to simply acknowledge it in the voice of your mind: ‘Ah, hello uncertainty’, letting the voice tone be as friendly as possible. ‘Come in, have a seat’.
Pause: What normally happens next is an automatic reaction, a reflex action that may involve seeking to control or avoid the feeling or situation. Instead we pause, rather than react. Take a deep breath… Feel your body release a little tension as you slowly breath out. Take as many deep breaths as you wish, then let your breathing settle into a slow, comfortable rhythm. By not reacting automatically, you’ve taken control of the way you’re responding.
Pull Back: Tell yourself that this is simply a feeling that has arrived, it may stay awhile, and it will pass too. Recognise the thoughts in your mind are just some words or images, and they’re coming from that feeling; in a sense, they belong to that ‘guest’ that’s come to visit, so there’s no need to own them yourself. You may like to use the idea of a radio playing, and all those thoughts are simply the radio program – and right now the radio just got tuned to ‘Radio Worry’. The thoughts can be there, you don’t need to be the thoughts.
Let Go: Standing back a little from the thoughts and feelings, observing them rather than being them, makes it possible to let them go, in their own time. I like the image of standing on a station platform, the trains are your thoughts and feelings, and you can watch them come and go. From time to time, you find you’ve boarded a train and been taken for a ride… This step is like getting off the train, and letting it go. You might prefer the image of clouds in the sky, with your mind the blue sky behind the clouds, and the thoughts as clouds that float by.
Explore: Be present, and explore what else is here in this moment. Notice your breath. Notice your body, and feel how you can control it: Push your feet into the floor a little, have a stretch, let the tips of your thumbs gently pass over your finger tips and feel the rich pattern of sensations as they do. These difficult thoughts and feelings are here, but there’s a body around them, a body you can control. Notice what is around you, and name five things you can see, four things you can feel, three things you can hear. Actively choose where your attention rests, rather than simply letting it get pulled around by thoughts that are playing on ‘Radio Worry’. Let your attention come to rest wherever you need it to be, such as the task you’re trying to get done, or the activity you had been enjoying…
Anxiety UK therapy outcomes for 2016
01/02/2017 12:06 Filed in: Psychotherapy | Hypnotherapy
Anxiety UK have published figures for therapy outcomes in 2016, measured using the IAPT method for calculating recovery, reliable improvement and reliable recovery.
Out of 221 planned completions, 67% of clients recovered, 87% reliably improved and 67% reliably recovered.
This compares very favourably to the national IAPT outcomes for 2015/16 which were 46.3% recovered, 62.2% reliably improved and 44% reliable recovery.
Just to be clear, these figures relate to all forms of therapy provided through Anxiety UK's approved therapist schemes, working with CBT or hypnotherapy. I think they show the quality of the service and support that Anxiety UK are able to offer their members through the scheme.
For any one who is curious, the IAPT method for calculating recovery, reliable improvement and reliable recovery is as follows:
A referral is classed as ‘recovered’ if the client has finished a course of treatment and moved from caseness* to not being at caseness by the end of the referral.
A referral is deemed to have shown reliable improvement if it shows a decrease in one or both assessment scores that surpass the measurement error, (for GAD7 assessment this is 4, for PHQ9 it is 6).
Reliable improvement and recovery can be combined to create an overall measure of reliable recovery where both a change from caseness to not caseness during the course of the referral and which show reliable improvement.
*Caseness is the term used to describe a referral that scores highly enough on measures of depression and anxiety to be classed as a clinical case.
More information on the use of IAPT services can be found in this report.
Out of 221 planned completions, 67% of clients recovered, 87% reliably improved and 67% reliably recovered.
This compares very favourably to the national IAPT outcomes for 2015/16 which were 46.3% recovered, 62.2% reliably improved and 44% reliable recovery.
Just to be clear, these figures relate to all forms of therapy provided through Anxiety UK's approved therapist schemes, working with CBT or hypnotherapy. I think they show the quality of the service and support that Anxiety UK are able to offer their members through the scheme.
For any one who is curious, the IAPT method for calculating recovery, reliable improvement and reliable recovery is as follows:
A referral is classed as ‘recovered’ if the client has finished a course of treatment and moved from caseness* to not being at caseness by the end of the referral.
A referral is deemed to have shown reliable improvement if it shows a decrease in one or both assessment scores that surpass the measurement error, (for GAD7 assessment this is 4, for PHQ9 it is 6).
Reliable improvement and recovery can be combined to create an overall measure of reliable recovery where both a change from caseness to not caseness during the course of the referral and which show reliable improvement.
*Caseness is the term used to describe a referral that scores highly enough on measures of depression and anxiety to be classed as a clinical case.
More information on the use of IAPT services can be found in this report.
Supporting Anxiety UK
Anxiety UK
I am now an Anxiety UK Approved Therapist, providing therapeutic support to the charity’s members and partner beneficiaries in my work as a hypnotherapist. I am subject to Anxiety UK’s regular monitoring of my professional qualifications, supervision, continual professional development, insurance and professional body membership in addition to complying with the ethical framework and professional standards set down by my registered governing body, the National Society of Hypnosis, Psychotherapy and Mindfulness.
Full details of the Anxiety UK Approved Therapist scheme can be found here: www.anxietyuk.org.uk/getinvolved/therapists-at-anxiety-uk.
Details about becoming a member of Anxiety UK to be able to access therapy via the charity can be found here www.anxietyuk.org.uk/membership.
Anyone who becomes a member of Anxiety UK can gain a number of benefits, one if which is access to reduced-rate therapy services. These must initially be booked through Anxiety UK (see the membership link above).
Alternatively, non-members can access therapy through the charity’s FAST referral service, the details are here: www.anxietyuk.org.uk/our-services/fast
Of course, my services are still available to be booked directly.
I am now an Anxiety UK Approved Therapist, providing therapeutic support to the charity’s members and partner beneficiaries in my work as a hypnotherapist. I am subject to Anxiety UK’s regular monitoring of my professional qualifications, supervision, continual professional development, insurance and professional body membership in addition to complying with the ethical framework and professional standards set down by my registered governing body, the National Society of Hypnosis, Psychotherapy and Mindfulness.
Full details of the Anxiety UK Approved Therapist scheme can be found here: www.anxietyuk.org.uk/getinvolved/therapists-at-anxiety-uk.
Details about becoming a member of Anxiety UK to be able to access therapy via the charity can be found here www.anxietyuk.org.uk/membership.
Anyone who becomes a member of Anxiety UK can gain a number of benefits, one if which is access to reduced-rate therapy services. These must initially be booked through Anxiety UK (see the membership link above).
Alternatively, non-members can access therapy through the charity’s FAST referral service, the details are here: www.anxietyuk.org.uk/our-services/fast
Of course, my services are still available to be booked directly.