Have you tried therapy?

We all agree mental health is important, right? That we should talk about our feelings, check in on friends and listen without judgement. But have you ever tried to reach out for help, like real help? Its complex, overwhelming and can be notoriously difficult to access. According to the mental health foundation Approximately 68% of women and 57% of men with mental health problems are parents. The most common mental health problems experienced during pregnancy and after birth are anxiety, depression and post-traumatic stress disorder (PTSD). Being a parent is extremely emotionally taxing. Trying to juggle the needs of your children on top of the stress of work and the financial implications that childcare and general family life impose on us, while existing on the same amount of sleep you could reasonably expect to receive if you were all prisoner of war. It’s easy to see why our brains can become overwhelmed. So I spoke to a Merseyside based Clinical Psychologist about why we experience anxiety and the different types of therapy available. Essentially we develop anxiety when our brain becomes hyper vigilant to threat, she explains. “Our brains are amazing organs, and have evolved to keep us safe, to seek out and protect us from danger. All day long, in terms of neurobiological process going on, your brain is picking up a threat in terms of all the things that you’re worrying about. Each of those worries is a potential threat to your physical, emotional or family well-being, but with anxiety, our brains don't understand when the threat has passed, or that we have the cognitive skills to manage that threat.” So our primitive brain is looking for a Saber-toothed Tiger to protect us from? but nowadays, the Saber-toothed Tiger has become our council tax bill, up coming parents evening and the constant catastrophic news stories that we’re absorbing. “Yes, so when we’re thinking about the types of therapy a person may access, the way that our brains evolved is important to consider. The neuroscience is more complicated than this, but in very accessible terms, the first part of our brain to evolve is the part nearest our brain stem. We can think of this as our alarm system. It has literally evolved to keep us safe. Its where we experience our most basic emotions and where we experience those very important but very simple threat responses flight, fight or freeze.” She goes on to explain that as our brains became more sophisticated and we moved out of environments where that kind of physical threat wasn’t around quite as much, the temporal lobes of our brains started to evolve and much later on the pre-frontal cortex, which allows us to become much more sophisticated civilised humans. “Our pre-frontal cortex is where what we call our executive functioning takes place; Complex decisions making, planning, and relating to other people. However, when our 'alarm system' is constantly activated, it's much harder to access this frontal lobe.” “The other really important factor to consider in determining what therapy might be appropriate for us, and how we experience the world more generally, is how our very earliest relationships with our caregivers developed. This is what we call our attachment style. How we internalise our relationships with our caregivers, based on whether we subconsciously, and all this is all at a very subconscious level, expect our early caregivers to meet our universal and basic needs for safety, connection, security, love, containment and appropriate boundaries, or not. It’s not about having a perfect parenting experience, not at all, more about it being consistent, contained and reliable.” She goes on to explain how these very early experiences determine the relational blueprint that we then innately use to navigate the world. “Our relationship with ourselves, our relationship with other people, our relationship with our world around us. The reason that that is important is because our early attachment can be adversely impacted on by experiencing trauma in your young life. Equally, when someone has experienced healthier attachments, it sets a very stable and resilient foundation if you experience trauma in your later life. As we said before, no-one has a perfect parenting experience, and the majority of us will have experienced some difficult experiences at some point, but equally hopefully have some of our needs met.” When we’re looking at the type of therapy that somebody might access, all of these things are really important to consider. “We have to think very carefully about the approaches we use. So whilst traditionally we had less choice in respect to therapy, more recently we may talk to you about either using a top-down or bottom-up approach, as our understanding of the impact of adversity and trauma on the brain has developed.” “Top-Down Therapies, are basically the cognitive based therapies use that very front part of our brain. CBT for example, has an evidence base for many difficulties, and it is the type of therapy you're most likely to be offered through your GP for low mood and anxiety. But its used as a bit of a panacea in mental health services, particularly in Britain, without always thoroughly assessing whether its going to be accessible and helpful for someone. CBT involves challenging your thoughts to impact on your feelings. Now if you’re somebody who’s experienced trauma, that can impact how you see the word around you. How you view people and within that what your individual attachment system and brain does in response to threat. Essentially, individuals who have experienced high levels of trauma may find it difficult to establish a sense of safety great enough to allow their frontal lobes to be activated for any length of time, and that alarm system quieten. So while CBT is very helpful and can be used alone for many people, others may require us to incorporate other types of therapy first, or in replacement, that help soothe the brain and body, and later tackle trauma head on. EMDR (eye movement desensitisation and reprocessing therapy) is completely trauma focused because it takes unprocessed memories e.g. an explosion, car crash, or more continued trauma like an abusive relationship, and works to re-process them. So instead of the individual re-living the memory as if it is still happening, in the form of flashbacks, strong emotions and nightmares, the therapy works to allow the memory to be stored within our adaptive information network, and the individual's brain understands this event is in the past. In turn, this allows the 'alarm system' to understand the threat has passed. It’s usually most productive to work on a mixture of the trauma focused therapy and some of the relational therapy together. Because while you’re suffering with anxiety due to you brain picking up a threat in relation to the present, none of us are entirely un-impacted by our early life experiences. So somewhere inside your brain, those two things will link together and provide some insight into your current worries.” So how can we access therapy? First and foremost, contact your GP. Our GP is usually our first step into the referral pathways of mental health services, and certainly for our local Improving Access to Psychological Therapies Service (IAPT)., which offers therapies for low mood and anxiety. There are also a variety of locally commissioned Secondary Care mental health services for longer-term difficulties, those who might experience psychosis, difficulties with eating, and for significant trauma. REferrals can be made to these services via the GP and each team will have their own assessment process But it you feel like you need help before it becomes your turn on the waiting list, there are lots of other options for you to explore. Check if you have a health care plan provided by your employer. For example, corporate Medicash policy holders can access 8 free face to face therapy sessions. Equally, there are a number of locally based Clinical Psychologists, Counsellors, Psychotherapists and therapists within every locality offering independent and private therapy. You can simply do a Google search, or there are search services such as Counselling Directory, which can help guide you. There are lots of different titles and types of therapy and it can be a little confusing. Any potential therapist should be willing and able to explain what they do, and offer a consultation or assessment to think about whether they are the right kind of therapist for you. wwww.themindmap.co.uk acknowledge that shame, stigma and waiting lists often clock the path to wellness and are on a mission to normalise mental health while offering counselling, training and advice. Via their simple to use website you can browse therapists and book an appointment for the price of a haircut.