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Specialities

If you wish to gain further information about any of these areas of speciality please contact Dr Jennifer Rathjen.

 

Depression

Depression is characterized by low mood, negativity and can also involve subjective feelings of heaviness, slowness and lack of motivation to engage in activities. Sleeping and eating patterns may be disrupted. Social withdrawal and sometimes a quickness to become irritable or easily hurt, can accompany an episode. Along with feelings of hopelessness and pessimism, thoughts of suicide may occur.

 

Depression effects mental health and wellbeing, relationships, work and physical health. A great deal of research has gone into developing effective treatments and therapies for depression, both psychological and medical. For some people psychological therapies by themselves are effective in resolving their depression.

 

Depression is a complex condition which requires an informed, eclectic treatment approach tailored to a client's particular clinical needs to help give an individual the knowledge, skills and strategies to regain energy, confidence, optimism and strength. Psychological therapy for depression will teach skills and techniques to rebuild areas of an individual's life that may have suffered as a result of depression, such as relationships, social life, leisure, family and career. Psychological therapy has also been proven to help prevent relapse of depression. The earlier help is sought for depression the better.

 

Bipolar Disorder

For some people who experience depression there are mood swings where an individual experiences a cycle of acute highs (mania) and lows (depression) in mood and often times with normal periods in between. If there is a depressed phase, the person may appear to be suffering from depression. If a manic phase is present, the individual may engage in behaviour that is highly unusual for them. Propelled by manic energy and/or delusional ideas, they may make rash business or personal decisions or engage in wild episodes of shopping, gambling, drinking or sexual behaviour.

 

Research supports both medical and psychological therapies for bipolar disorder. Psychological strategies focus on acute treatment and also continuation treatment to assist in maintaining a symptom free state by preventing relapse.

 

Post Natal Depression

Post-natal depression refers to the depression that develops after having a baby.

The birth of a baby can trigger a mix of powerful emotions such as excitement and joy along with fear and anxiety. But these emotions can also be a result of something less expected by the mother at that time - depression.

 

The symptoms are similar to those of general depression with the woman becoming emotionally withdrawn and overwhelmed with feelings of despair, guilt and worthlessness. Eating and sleeping patterns may alter markedly and the mother may lose interest in everything including the baby and be unable to concentrate or carry out daily tasks. The earlier help is sought for post natal depression the better.

 

Generalized Anxiety or Worry

Most people feel anxious at some point; it is an entirely normal response to something stressful. There are times when a little anxiety actual motivates us to do well. However, at other times anxiety can become more persistent and impact on everyday life. Generalized anxiety disorder is characterized by generalized fears, daily tension and extreme worry over everything and nothing in particular. Individuals with generalised anxiety disorder often anticipate the worst and they exhaust themselves while waiting for it to happen. The physical signs include: rapidly beating heart, pressure or tightness in the chest, shortness of breath, shakiness, light headedness and stomach discomfort.

 

Generalized anxiety disorder is very treatable using a variety of evidenced based psychological techniques that help to reduce worry to more manageable and normal levels.

 

Panic Attacks

Panic attacks are intense anxiety reactions within a comparatively short space of time, usually for minutes although occasionally a panic attack can last for an hour or more. Panic attacks include such features as pounding heart, rapid breathing and shortness of breath or difficulty breathing, heavy perspiration, weakness or dizziness. Sufferers often believe that they are having a heart attack and their first presentation may be to an emergency department of a hospital. There is also often a sense of terror or loss of control and sufferers frequently believe that they are going crazy or are going to die. Fearing when the next attack will occur causes persistent worrying and intense anxiety between attacks.

 

Individuals sometimes begin to avoid situations that lead to panic attacks. In some cases this can lead to agoraphobia, an avoidance of open spaces or crowds.

 

There are a variety of evidenced based psychological treatments that are very useful in helping people control and manage their panic attacks and prevent further episodes.

 

Phobias

A phobia is a persistent, excessive and disruptive fear. Most commonly this is a particular object or situation that the person tries to avoid. Some examples of phobias include: fear of heights, flying, receiving injections, seeing blood, vomiting, spiders, snakes, bridges or tunnels, escalators, lifts, or other enclosed spaces.

 

As time goes on, a specific phobia may be strengthened by a person's avoidance behaviour itself. So, even though a phobia can start simply, the longer it goes on untreated, the more potentially complicated it can become.

 

Evidenced based therapies can help with specific phobias so that the person is able to face the situations they fear with increasingly less distress and anxiety.

 

Social Anxiety

Almost everyone feels nervous now and then in social situations, such as when giving a speech or at job interviews. For most people this anxiety passes fairly quickly and causes little disruption or distress. But when social anxiety is persistent, intense and distressing and causes people to avoid particular social activities, it is classified as a phobia.

People with social phobia tend to feel fearful meeting new people or when they might be observed or evaluated. They are often concerned that they will embarrass or humiliate themselves, or that others will think badly of them. They may fear a wide range of social interactions, or just specific situations, such as public speaking.

 

Social avoidance can interfere with career progress, making friends, enjoying work, having intimate relationships and getting to know people. Evidence-based treatments can help sufferers to reduce their anxiety and to ultimately take part in the activities they fear.

 

Obsessive Compulsive Disorder (OCD)

OCD occurs on a spectrum from mild to severe and moderate to severe expressions are quite disabling if left untreated. Even mild forms are irritating to the person and interfere with peace of mind and comfort. In addition to the embarrassment or shame a person may feel as a result, symptoms of OCD can impose significant limitations on a person's range of activities or productivity, at work, school, or even in the home. For these reasons, quality of life is negatively impacted.

Each person with OCD experiences their own combination of symptoms. Obsessions may occur in combination with compulsions, or without. Obsessions are unwanted, or intrusive thoughts that are distressing and extremely difficult to suppress or eliminate. They often consist of themes, such as the fear of having made a mistake, of having hurt or contaminated someone, of having touched something that is contaminated and other thoughts that make an individual feel anxious. These thoughts are recognized as unrealistic or irrational and perhaps even bizarre, yet they persist as the person dwells on them.

One form of reassurance may come in the form of compulsions. Compulsions are unwanted, repetitive behaviours or rituals that are performed in order to reduce anxiety. They are disruptive to the flow of an individual's life, and can be quite time consuming. Although the person typically recognizes these behaviours, such as checking, washing, or hoarding, as being excessive, he or she feels compelled to engage in them. Resisting or overcoming these behaviours is extremely difficult. The behaviours are intended to prevent something bad from happening (illness, danger, etc.), but they are out of proportion, unnecessary, or essentially meaningless. Evidenced based therapies can be utilized to help individuals significantly reduce the symptoms of OCD and help achieve enduring relief.

 

Pain Management

Psychological factors are associated with difficulties in the management of pain and evidence for the effectiveness of psychological strategies is now well established. Psychological strategies can have a significant effect in the experience of pain and help individuals who experience pain live a valued life.

 

Childhood Abuse

Survivors of childhood abuse (sexual, psychological or neglect) can face many difficulties including increased rates of depression and anxiety, increased rates of alcohol & other drug use, difficulty managing strong emotions and relationship difficulties.

 

Evidenced based treatment strategies can help manage these difficulties and assist adults who have experienced abuse in childhood lead fulfilling lives.

 

Personality Disorders

People suffering from personality disorders tend to misread other people, situations and even themselves. They may be especially reactive, volatile or impulsive. They often respond in disproportionate or socially inappropriate ways.

 

All personality disorders are rooted in a sense of chronic insecurity and emotional pain that confuses, drains, and demoralizes a young person. Psychological symptoms and interpersonal adjustment problems result. People who are at a loss, overwhelmed or desperate will latch on to any behaviour or pattern which seems at the time to promise some relief from emotional pain, or provides a sense of connection or stability. These include maladaptive interpersonal coping styles characterized by aggressive, controlling, dependent, avoidant, passive, detached, explosive, self gratifying or exploitative behaviours. These can become entrenched if they are not outgrown.

Evidence-based treatments can help individuals with personality disorders develop coping strategies to help foster emotional and interpersonal stability.

 

Grief and Bereavement

Everyone's experience of grief and loss is unique and we all experience it in different ways including anger,   shock, numbness, relief, confusion, sadness, guilt, sleeplessness and loss of   appetite. Often it is experienced as an emotional roller-coaster.

 

Some individuals may want to ask   for professional help, especially when the loss of a loved one has triggered   unresolved feelings, if a person has had many experiences of bereavement, if   they feel suicidal or if they just want to talk to someone.

 

Psychological therapy can help   manage grief and help individuals find a suitable place for the lost person   to allow life to continue with adaptation and change, not forgetting or   wiping out the memory.

 

Stress Management

Stress is the pressure under which   individuals are placed by daily life. It can be positive and spur a person   into action to meet a deadline; but too much stress can put a person's health   at risk and leave them unable to function.

 

Common causes of stress include   problems at work, or in relationships, renovation or relocation, retrenchment   or unemployment, a traumatic event, illness or disability, workplace   bullying, change and unrealistic expectations.

 

When stress and the reaction to it   are dominating a person's life and there is no chance to switch off, it is   time to seek help. Inability to sleep, increased alcohol intake and anger   outbursts are all early symptoms which can alienate the stressed person from   those around them and add to the problem.

 

There are a variety of evidenced   based methods that can be used to help combat stress.

 

Deliberate Self-Harm

Deliberate self-harm is a term used   when an individual injures or harms themselves on purpose. Common examples   include hitting, cutting or burning oneself, pulling hair or picking skin.   Self-harm is often used as a coping strategy when an individual experiences   overwhelming distress and can be seen as an attempt to regulate intense affect. Self-injury can be an attempt to feel more in control, to punish oneself, to release tension or to feel something if the individual feels numb   and disconnected.

 

Deliberate self-harm may be   reflective of significant emotional difficulties that require attention and   treatment. Evidenced based therapies can help address underlying issues and   focus on developing more helpful coping skills to manage emotional distress.

 

Anger Management

Anger is a normal and healthy emotion. We all experience anger at various times during the course of our lives.

 

Sometimes we feel justified in our   anger and indeed we may be. Anger that is appropriate (that is, realistic   given the situation and to the degree it is felt) is normal and serves as a   call to action (to mobilize or to guide assertive behaviour). However, anger   that is inappropriate (out of proportion, extreme or explosive) is likely to   be a problem.

 

Angry outbursts, chronic hostility,   or episodes of rage may be a reaction to past or ongoing fundamental   frustration, trauma, abuse, or victimization. Dysfunctional anger can be a   feature of a particular psychological condition, cognitive style, value   system, or family dynamic.

Therapy can teach individuals how   to control anger by assertively expressing wishes and angry feelings and also   learn how to reduce physiological symptoms and change angry thinking   patterns.

 

Self Esteem

Most people experience low self   esteem at some point in their life (e.g. if they lose their job or a   relationship breaks up) but they can also experience high self esteem at   other points in their life (e.g. if they are promoted, successfully complete   a challenge or fall in love). However, those who can't bounce back after   their self esteem has been bruised and constantly feel negatively about  themselves, may be suffering from chronic low self-esteem.

 

Therapy can help individuals   suffering from low self-esteem to develop a more positive sense of self and help them live a more fulfilling life.

 

Assertive Communication

Assertiveness is the ability to say what one thinks and feels in a simple direct way that does not attack, manipulate, or hurt other people's feelings. The ability to differentiate   between appropriately direct and tactful statements or requests and less desirable   forms of communication (aggressive, passive, and passive-aggressive) is a   skill that can be developed and enhanced with awareness and practice.

 

Learning to be assertive helps individuals to be more confident and enables them to obtain more of what they   want. It helps minimize anxiety, frustration and resentment in relationships   with parents, family, co-workers, and friends.

 

Weight Loss Management

Many individuals managing obesity find that they get caught in an endless cycle of diets, fads, clubs and ultimate disappointment? Most people over-eat or eat the wrong foods to   either comfort themselves, reward themselves, punish themselves or protect   themselves - or a combination of these. Often people will eat to feel better,   then the resulting guilt and lack of weight loss causes them to feel bad and   therefore eat more.

 

For many people the eating may be a   symptom of something else. It may be poor self-esteem, lack of love, or a   traumatic experience that is now forgotten. Often the eating holds down   uncomfortable emotions that have been buried and repressed.

 

Evidenced based strategies that   address underlying issues and incorporate flexible eating plans can help achieve   weight loss to improve health and well being.

 

Workplace Difficulties

The Workplace is a complex environment and sometimes stress and anxiety can arise. Strategies to manage stress, social anxiety, interpersonal issues, performance anxiety and other workplace concerns can help to improve overall quality of life.

 

Post Traumatic Stress Disoder

Common reactions to trauma may include feelings of shock or disbelief, intense fear, or feelings of helplessness,depression or loss of interest in activities you used to enjoy. These reactions are normal and tend to resolve in their own with time and emotional support from freinds and family. However, when these reactions intenisify and persist beyond a month after the trauma and become disruptive to your life then you may be experiencing Post Traumatic Stress Disorder (PTSD). PTSD is a debilitating condition. Treatment typically consists of education on the nature of the trauma and PTSD reactions, emotionally processing the trama experience, identifying and challenging unrealistic thoughts and beliefs that you may hold about the tramatic event, and gradually facing situations that you have avoided since the trauma.

 

Life Coaching

Life coaching helps clarify purpose and direction, to help individuals   make better use of their strengths and develop resilience to increase   effectiveness and build their self esteem. Life coaching helps individuals to   set goals and build the necessary skills for personal and professional success   and emotional well being.