--------- EPISODE KEYWORDS ---------

Therapy, Stress Management, Sleep Troubles, Bereavement, Social Anxiety, Cognitive Behavioural Therapy, Therapeutic Relationship, Personal Growth, Mental Well-being, Mindfulness, Re-framing, Grief, Loss, Self-esteem, Positive Thinking, Coping Strategies, Graded Exposure, Breathing Techniques, Community Support, Mental Health Resources

--------- EPISODE SUMMARY ---------

Kate was initially sceptical about therapy, but life's pressures had become overwhelming, leading her to take her husband’s advice and seek professional help. Through Bupa, she connected with Dr. Joy Wong, and together they navigated the complexities of stress, sleep troubles, bereavement, and social anxiety. Their shared journey highlights the profound impact of a strong therapeutic relationship, emphasizing trust and understanding as pivotal elements for personal growth and healing.

Join us as Dr. Joy shares the transformative effects of cognitive behavioural therapy (CBT), a cornerstone in Kate's progress. Discover practical techniques Kate employed, from mastering breathing exercises to re-framing her emotional responses, which are instrumental in overcoming life's hurdles. These strategies not only improved Kate’s social interactions but also bolstered her self-esteem, providing a real-life testament to CBT's effectiveness in fostering mental well-being.

Shifting focus from stress to positivity, we discuss how Kate found joy and rejuvenation in simple pleasures, like beach visits and mindful practices. We explore re-framing grief, highlighting how changing perspectives can facilitate emotional healing and maintain meaningful connections with loved ones. Whether it’s overcoming social anxiety or improving sleep, the episode offers a variety of techniques and resources for listeners, emphasizing the importance of seeking professional support for mental health challenges. Tune in to learn how the power of the mind can enhance overall well-being and transform life’s challenges into opportunities for growth.

--------- EPISODE CHAPTERS ---------

(0:00:16) - Therapeutic Relationship and Success Stories

Kate's journey through therapy for stress, sleep, bereavement, and social anxiety with Dr. Joy, emphasizing the importance of trust and understanding.

(0:09:20) - Therapeutic Techniques and Breakthroughs

CBT techniques helped Kate manage stress, reframe emotions, and improve social interactions, as demonstrated by Joy from Lifespan Psychology.

(0:20:28) - Power of Mind in Wellness

Nature's power in managing stress, using CBT techniques, and coping with bereavement across cultures.

(0:24:15) - Transformation Through Reframing Grief and Loss

Re-framing can transform our mindset and help cope with grief by focusing on positive memories and finding closure.

(0:31:24) - Overcoming Social Anxiety and Improving Sleep

Overcoming social anxiety and boosting self-esteem through techniques like discussing strengths, graded exposure, and managing physical symptoms.

(0:45:20) - Resources and Community Support

Our podcast is not a substitute for professional help. Seek therapy and support, use available resources, and continue meaningful conversations.

--------- EPISODE TRANSCRIPT ---------

0:00:16 - Esther

Hi, my name is Dr Esther Cole. I'm the founder and director of a multi-award winning international team, Lifespan Psychology - the Diverse Practice. I'm a consultant, clinical psychologist, life coach and therapy business coach and the first black clinical psychologist to receive the BPS Early Career Award. I run individual and group coaching sessions for therapy bosses aspiring to build their team. Boss stands for 'Business Owner Support Squad'.

Welcome to the Breaking Through Therapy Podcast! This is the only podcast that supports you to come on the show with your therapist, at least one year later, to talk about the breakthroughs that you've made along your journey and its impact on your life ever since. So this is the mental wellness podcast for people interested in having talking therapy, professionals who deliver talking therapy and everyone in between. Hello everybody, today I'm joined by the lovely Kate and Dr Joy Wong. We're going to be talking about some really helpful strategies from Kate's experience of stress at work, difficulties with sleep, bereavement and social anxiety. It's pretty amazing, really what you've overcome in the time that you work with them, Dr Joy. I think I'm just going to start by saying it would be really helpful to get some techniques for our listeners if you're able to share what your experience was and those techniques from both perspectives, from the therapist and the client's perspective. Yeah, if you could just start by telling me when did you meet Dr Joy, Kate, and what brought you to therapy in the beginning?

0:02:04 - Kate

So you have to start from the beginning. I had been getting more and more stressed, I think, at work. I think it had built up over several years. I was running a whole department and had too much work, nobody to help me at all, I didn't even have a manager at that point, so it was just me with an awful lot of work. And then I think I got used to just working all hours, given I didn't ever really switch off, and it just gradually over time got worse. And then the company brought in a new financial director who was then my manager as well. We had a whole new department. So I had three colleagues also that I'd say some going by myself to suddenly having a complete change. We moved offices as well. So it was all so much change in such a short amount of time.

And then within that period my father also died. Everything just suddenly built up to a point where I just wasn't coping and I was not sleeping. I was very, very tearful most of the time. Anything would start me crying. I was snapping, particularly like my husband. You know the people I love the most. Probably he could even say good morning the wrong way and I'd have a go at him.

I was just in a really bad place so that, as I said, built up over quite a long time, and it was actually my husband, who had had therapy in the past, that said to me I really think you should go and see somebody. And I was, having never, ever had any therapy, I was very, very skeptical and didn't really want to go, but I just thought, ok, well, it's going to be worth a try because I was just in such a bad place. Because I was just in such a bad place, so I contacted BUPA, who gave me a list of therapists I could see. I read all of their sort of bios and I selected, you know, a few for the short list. I then arranged meetings to just have a sort of initial chat, and that was obviously one of them was Joy, and immediately we just seemed to really hit it off. I think, being female, being probably a bit younger than me but my sort of age, I think there was a really good connection. That was how I sort of came to see.

0:04:43 - Esther

Joy, and I think that makes a world of sense. I mean, why would you think you need to have therapy? Because the situation that you were surviving, the enormous, like the overwhelming demands that you had at work. It just makes logical sense. Well, it's not me, there's nothing wrong with me, it's my work environment and my father's just passed away... Incredibly, incredibly difficult time. And so, Joy, what do you remember from that 350-minute consultation?

0:05:09 - Joy

I think we connected quite quickly because we were kind of like similar age, I would say. And then I appear as also a working mom. So I think, most importantly, Kate felt that she was being hurt right away. I seemed to understand what she was going through, I mean in terms of the age, and she has a son similar age as my older daughter. So you know, talk about a little bit about university and her son would be going away, leaving home that sort of fear I myself have too. So we kind of just clicked right away.

0:05:47 - Esther

So the research suggests that having things in common with your therapist is a really important factor. Do you think that's what was going on here in terms of your therapeutic relationship? How would you describe your therapeutic relationship?

0:05:59 - Kate

I think we just formed a really strong bond. I totally trusted Joy from the beginning and I really found her easy to talk to, which for me I'm not great with people I don't know. I think that was one of the things Joy and I actually worked on, because I always say in social situations I find it really difficult. But I think just because Joy she let me talk and didn't interrupt and I really felt like she was listening and totally understood.

0:06:30 - Esther

And how would you describe the therapeutic relationship? Because you know this is new for people. People listening who really are sceptical really would never talk to a therapist, someone they've never met before, particularly someone with social anxiety. So it's amazing that you've overcome that enough, Kate, to be on our show raising money for charity. That means the world to us, really. But yeah, what do you make of that, Joy?

0:06:52 - Joy

I think, as a therapist, our job, I think our initial job is to get close, to make the client, just you know, feel comfortable and trust us, and that's our initial job. So if we fail on that one, then of course the client will go okay. Thank you for the free chat and I will get in touch with you. So that's what happens most of the time too. So you know, some of the times, you know, I think, like Kate and I, we just kind of felt that connection right away. I think the similarities really, you know, matter a lot and all those skills.

0:07:31 - Esther

You know lots of people are very naturally good listeners, aren't they? A lot of people naturally feel very at ease and you feel you can trust them. But, Dr Joy, you've got an enormous amount of skills as well. I know that from working with you professionally: you've got an enormous range of skills. I know that you taught Kate a range of strategies over a period of time. So what year was this and how many sessions did you have?

0:07:56 - Joy

Last year, I would say about 14 months ago, actually Kate only had 10 sessions, amazingly, really, she really was an ideal client. We would put that way because she was really a fast learner. She is a fast learner and then she managed to habituate the skills I mean habituate. We'll talk a little bit about that habituation. So she managed to habituate the way she should sing, the way she should react, the way she should react, in a very short period of time. So she literally kind of, you know, learned to live CBT way, so that CBT as part of her life.

Quite quickly she showed me, you know, how it worked for her and it's just, you know, so amazing, you know, only for 10 sessions. So that's why we always say CBT can be really brief therapy. So it really has proven. I mean, in our case, in Kate's case, it really worked quite well. I mean well, of course, of course it takes two, to, it's just, you know, the client. Like I always say, I would really like to work with clients who are eager to change, to make a change, you know, for the better, and they really want to get, you know, healthier and just, you know they are willing to make the effort to make the change, and I really love to work with ideal clients like Kate.

0:09:20 - Esther

Okay, let's take a pause there.

Come and have a free 15-minute consultation with one of our incredible multi-award-winning practitioners at Lifespan Psychology, the Diverse Practice. We're a multicultural team of doctor-trained psychologists, psychotherapists and counsellors offering assessment, evidence-based talking therapy coaching, training and consultations based talking therapy coaching, training and consultations. We now also offer ADHD assessments in person and online. We work with a range of corporate, commercial and holistic companies and accept private medical insurance, referrals from the NHS, social care and rehabilitation companies. We also offer a range of fees for self-funding clients. Contact us at info@lifespanpsychology.co.uk or www.lifespan-psychology.com and follow us on our various social media channels, in the show notes. Our clients at Lifespan Psychology are our true award winners. We're here because of you. We're an award-winning team because of you, and we're inspired to be the best that we here because of you.

You know, we don't just read these books and we're studying psychology. We want to bring the work to life and it's incredible to hear you say that Kate was able to kind of absorb like CBT strategies.

How do we change our thinking? How do we change our behaviour? How does this become habitualized or how does this become a habit? And so it'd be really great for the listeners if you could walk us through what that looks like. Because obviously we're trained on the techniques but then we have to encourage you or kind of inspire you or motivate you to use them and actually see the benefit in your life. And you know this is based on research evidence but not everyone fits, you know, the research study or not everything works for everyone. We want to mention kind of three main breakthroughs in therapy that you had. What would you say the three main breakthroughs were? And then I suppose we'll walk around in those a bit more and look at how the CBT comes to life.

0:11:22 - Kate

For me. Initially I think I was given breathing exercises by Joy, which I found really really helpful just to slow everything down, to really be conscious of my breathing situation, where normally I would have probably snapped at people or whatever. That I just took myself slightly away and literally did some breathing exercises and just calmed myself down and I still use that now. I mean, whenever I feel particularly stressed I just go back to it. It has the most amazing effect. It really takes you away from the situation, gives you time to just calm down. I think that was a really fantastic tip and it's really helped me.

Another thing that was a big breakthrough was when my father actually died. Just before he died he told me some secrets that he'd been sort of keeping hold of and at the time I was really angry and upset and a bit confused about everything. But joy really helped me to totally turn the way I thought about it. I think it was called re-flaming it but basically to actually realize that my father obviously loved me so much that he felt that he could tell me those before he died and actually by listening and not judging or not saying anything, I had helped him to die in peace. So that again really helped me and made me feel really positive about the whole thing, rather than feeling angry and all of these other emotions.

A third, which was more social situations, I think, which, as I said, I'd always found really, really awkward and always thought why do people want to talk to me? I've got nothing to say, really doubting myself, all of that and simple things like making eye contact and Dr Joyce said you said A talk to yourself before you go and maybe think what have I done that I'm particularly bad of and have things that I would actually be able to talk about. But also, when I meet people, if I feel uncomfortable looking them in the eye she's suggested I just look slightly to the side of their face so people still think you're looking at them and that honestly changed so much. I'm much more confident now and I don't have the anxiety before they go to things because I have got lots to say. That's interesting.

0:14:04 - Esther

Well, absolutely, and you know this is like living breathing CBT experiment right here, because we are all extremely interested in what you've got to say. The experiments they do in CBT are kind of behavioral experiments, basically, where you test out your beliefs but you've got nothing, to say nothing, of value, that you're not of interest. Well, clearly that's not true, and I'm sure I'll be able to tell you the stats on how many people actually listen to this podcast as well. So to prove that to you, that it's of enormous value to us and obviously yourself when we met before you mentioned having a speech impediment from childhood as well for you to be able to come on the show and actually speak to us very clearly and, you know, really engagingly. We can't thank you enough, really, and I think those breakthroughs are going to be really helpful. So, Joy, could you talk us through the breathing exercises that you did?

0:14:54 - Joy

Yeah, I basically do box breathing. That's four, four, four breathing. So we can do a little bit of demonstration right now with cake help. So we usually do just. You know I count four.

One, two, three, four. That's the time when the client takes a breath in through the nose and then the second, one, two, three, four. You hold your breath, and then... one, two, three, four... breathe out through your mouth. So we just repeat. So let's do two more times. Ready... go: one, two, three, four. One, two, three, four and breathe out... one, two, three, four, one more. One, two, three, four. One, two, three, four... and one, two, three, four. So you could do it like I used to tell Kate to do it. Like, you know, three times a day, 10 cycles each time or, if you like, any time when you feel stuck, any time you feel you need to reset, then you just do it. Nobody's going to notice what you do, you just. You know you don't have to close your eyes, you can just sit there and you just do 10 side curls and nobody's going to notice. I think it's an easy skill to do.

0:16:13 - Esther

I actually did close my eyes. I feel really calm, slightly dizzy in a good way, like... you know, that sort of magical, creepy feeling that you get when you're really relaxed. I think what was really powerful for me was the holding of the breath for four. Normally we're taught, aren't we, to breathe in and breathe out, or just like a long breath, but it's the in for four, hold for four and then release for four, and doing it through the nose and then releasing through the mouth. I think that is a really nice cycle.

0:16:40 - Kate

Thank you so much for sharing that it has the most amazing calming effect.

0:16:48 - Esther

Great, so anybody listening listening if they could email me back on info@breakingthroughtherapy.com and let me know if you found that just as relaxing as we did.

0:16:53 - Speaker 1

Thank you both of you for that um, speaking of relax, why don't we do a little bit more? That's what Kate used to like is the imagery bit. So are you all ready? We can do a little demonstration for like one, two minutes. Shall we all do it now?

0:17:10 - Esther

That sounds great to me! That's what I need to be doing on a podcast. You know, brand new thing, never done it before so, everybody, we could just close our eyes.

0:17:22 - Joy

And I will take you through. We start with a little bit of mindfulness. Just breathe easy and place both hands onto your belly. So this time, just one breath in and out. So breathe in through your nose and out through your mouth. Focus on each breath and your belly movement. We'll do one more time. Keep your eyes closed and I want you to imagine yourself lying on your favourite beach. Keep breathing. I want you to imagine this nice huge glass of pina colada in front of you with a big chunk of pineapple hanging. Take a sip, a big sip. Now you swallow, move your tongue in your mouth and feel the pineapple, coconut bits in your mouth, coconut bits in your mouth, feeling refreshed, still enjoying the aftertaste. Let's continue with the breathing. And you still feel your belly movement: in and out, in, out. Now I'm going to count to five. One, two, three, four, five. Time to come back. Open slowly. How did that feel?

0:19:31 - Kate

I loved it. There's something about the imagery of imagining that pina colada and using your tongue that just totally takes your mind off anything else. I was on that beach.

0:19:48 - Joy

You go there five times a day, don't you? So that was a bit of mindfulness. You know the use of the tongue and also focusing on your breath and your belly movement, so that was a bit of mindfulness.

0:20:02 - Esther

That was wonderful and I don't know how you knew that pina colada was my favourite cocktail!

0:20:10 - Joy

A lot of people's favourites are mine, too, so I use that right away, from day one. So I hope everybody felt differently about... imagery, or some people like to call that a kind of hypnosis, but it was was really just to have a real taste of it. So, yeah, I really believe, you know, if you don't want to get stuck in your brain, you don't want to feel stuck about life, just take a moment to just, you know, think about something, and do something. You know, we've got an example here. Look at Kate. She's managed to do so well and that's what she's been doing every day. Like she takes herself five, ten times to that beach a day and she feels great. But you know, I would still like to say, you know, in Kate's case, she really has a wonderful supportive husband, she has a lovely son and a great job and a beautiful home and she goes on holiday, you know four times a year... [I wish! Two times!] the kind of life that most people dream of.

So I used to tell her why would you want to spend time to feel stuck with this job? Why would you want to spend time to think about that business is not even your business. Why wouldn't you want to spend more time to think about your next holiday destination? And you know, I think these are things really quite powerful in terms of you know, now she managed to kind of move her focus away from that job satisfaction she once wanted so badly. But then, you know, we used to say this you know, oh, it's just a job to pay your bills, just a job that you know you want to kill your time. But then really, in terms of life, you wanted to spend more time to think about you know how to enjoy your life, indeed.

0:22:01 - Kate

And actually I think by doing that it actually makes you better at your job as well, because you're not so stressed. And I'm much better at work than I was.

0:22:14 - Joy

So you don't snap at people now.

0:22:18 - Esther

That's what's incredible about the mind. This is why I always wanted to be a psychologist, from a very young age, probably around the age of 14. Because... isn't it incredible that we can call to memory an experience... Now, unfortunately, there can be dark experiences or like dramatic experience that we can also call to memory. But to imagine that we're on a beach gives our mind and our bodies enough of a sensation just to temporarily be a bit of a kind of anaesthetic or... I don't know what you want to say. But it gives us those endorphins or gives us that release of positivity, calms our nervous system, and it's just about thinking about something, ultimately just about imagining that drink in your mouth.

And I think that is the power of the mind. And actually... many people, if you were to ask them to bite into a lemon, their salivary glands would start working, so you'd start getting a lot of juice in your mouth, even though there's no real lemon. So this is the power of the mind, isn't it? And what we tell ourselves is so important. You know, the tough inner critic. You know the voices that you might have been having, Kate, to tell you to continue working harder and harder, or that you weren't good enough, you know. And with CBT we can change those thoughts, can't we in the pattern of thinking? You know: I do deserve a holiday, I do deserve a break, I do deserve a manager, I do deserve more support, I don't deserve to be treated like this and really starting to put our boundaries in place. So I think that's what the breathing exercises and the mindfulness does. It gives us that space and distance from the kind of turmoil that might be going on in our minds, and then we can get a bit more control of our lives.

I think it's really great that those techniques were so effective. Is it okay if we move on to bereavement a bit now? I know we're covering quite a few subjects, but I think this will really appeal to many, many people. And how we deal with bereavement, it's so different, isn't it, from person to person, culture to culture, religion, community. But what you said you found helpful was this idea of re-framing. Could you both tell us a bit more about that, what re-framing is?

0:24:30 - Joy

Why don't we just, you know, do another example again? So I would tell you. Well, the old Kate would say "Oh no, there's another rainy day, my roses will all be dead." So yeah, what would the new Kate say now?

0:24:43 - Kate

I would say it's raining, it's going to make them grow really well. There's always a good side.

0:24:51 - Joy

It's the opposite now. So don't you feel that the power of that re-framing? It's like you just give a new meaning to what has happened, so you could really still, you know, get stuck with the old way you used to feel, but then it's not going to help you, it's not going to do any good in your life. So why do you continue to think so negatively? But some people do, I mean until they find a new meaning to it. But then again, some people are not so eager to make a change, some people are so used to the way they think. That's why I always say you can get better quickly if you have that mindset to want to get well. But some people... I can't say lazy, but they're so used to the way they used to think. It's just, you know, that's the difference. But then Kate appeared to be really desperate. I really want to get better, I want to get well, I want to live a normal life. So she was really desperate to get better.

0:25:54 - Kate

Well, I wasn't enjoying life. I wasn't happy. I really wanted to be happy.

0:25:59 - Esther

It's thinking the situation is still the same: it's still raining on the roses, but it's what you will take from that - that maybe they're getting watered today. They're not be drowned out and in terms of losing your dad, re-framing, rather than feeling angry, what kind of thoughts did you tell yourself about the situation when the secrets were told to you?

0:26:18 - Joy

I think well, at the time I was, as I said, upset, angry... It left me with not the nicest memories, I suppose, of my father. I was all full of anger, but actually, as Joy said: to actually think, well, he must have really loved me to have told me those things before he did die and to trust me, to tell me. He was able then to die with a clear sort of [conscience]. He'd got it off his brain and actually I helped him do that. So, yeah, it was very powerful. It really has worked.

0:26:51 - Speaker 2

And you know, that goes for communication in the broader sense, doesn't it that somebody's intention and how we receive it might be a mismatch there and his intention may not have been to cause any anger or upset in you. [I'm sure it wasn't, yes.] Yeah, but it's how we receive it, isn't it? It's how we then interpret it. So you know, that was the kind of philosopher's statement was, when we think about CBT it's you know, men are disturbed not by things, but the view they take of them. We could put that in the show notes. It's really hard with communication. It's a minefield because it's what we hear, how we receive that, how we interpret that, how that makes us feel, what we then do.

But it sounds like you were able to be really strong and be really present for him, really listen and then bring that to therapy. That is the power of therapy, isn't it, that we find ourselves in a space that is safe for us, we can be unburdened. So it's almost like if we can just wait until the next session, if we can hold in our response, take it to therapy, process it, think about it, learn something from it, see ourselves and the other person in our life in a slightly different way. We can feel completely different, can't we? About the same situation. That's so powerful. Is there anything else for our listeners that you might want to say about coping with grief and loss?

0:28:12 - Joy

I think it's a little bit of closure, that you feel comfortable to put a closure because some people just don't want that closure, because they don't want to feel living without that person, so they don't want that closure. But then somehow that closure helps a bit. So you know, like Kate, so she managed to change the way she thought about the whole thing and then she started feeling better about her relationship with her late father. She learned to put that closure, but then in a good way, not a bad way. I believe she was still thinking... anytime she thinks about those things that she would still say well, dad, I helped you, didn't I? So I think she would still talk to her dad in her way. So you know, a closure is not a bad thing. It's not totally a bad thing, it's not a negative thing. It can be a positive thing

0:29:03 - Kate

Yeah, it made me be able to remember all the lovely times and the things we did, the chats we had, you know. Really, rather than focusing, as I was, just on the negative, it totally changed and I was able to then have lovely memories, which is what you want.

0:29:29 - Esther

Again, really powerful what our mind does. So if we have an angry filter or an upset filter, we will interpret and remember memories in an angry and upset way and we will filter out positives. Really a lot of mind kind of tricks here. So it's controlling our minds by taking the positives from the relationship and putting that positive filter on the memories that you have and having that as a storyline and that as the narrative that there are so many positives, and then continuing that relationship. You know if you feel comfortable in ways that you remember him or maybe talking to him even though he's not physically present, keeping that communication or his memory alive in different ways. Well, thank you so much for that.

Ok, that's food for thought. Let's take a break here.

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So the next phase of the techniques that you learned were around the social situations, which, again, I think people find really, really helpful. I've worked with lots of people who experience social anxiety and really struggle in social situations, and often it's linked to quite low self-esteem, which I always try and work with them to bolster their self-esteem, and I wondered what your journey was. I can hear some really interesting strategies that you took with you to social situations, but can you both elaborate a bit more on that for our listeners?

0:31:54 - Joy

Kate used to think that it's always awkward to be in a social situation. Always awkward. And she would always pray: don't come to me, don't talk to me, I don't want to say anything. So she was always like that.

0:32:12 - Kate

Absolutely.

0:32:14 - Joy

And if anyone would come to her and start saying things, then you would start to shake and really not want to respond, or... just awkward. But then, you know, I discussed with Kate and I said why don't you talk about the things that you're good at, about the way that you know you are more competent, and not talk about the things you don't know? So then you won't feel so awkward. So she started doing it. Also, I taught her to look at people's forehead instead of the eyes. So it started right away. And then I remember that following session she told me oh, she went to a party. And then the following session, it was really great and people really talked to me and they respected me, and I was telling them the story about the company. So she was so confident to tell people about the stories and they really kept asking her and that really made her feel you know: well, I can really talk; I can really not feel that awkwardness. Once she started, she just kept doing it. So you enjoy going to party now, don't you? [Yes!]

0:33:25 - Esther

And I think that's the thing. We can get stuck with a view of ourselves, can't we? I hope it didn't happen to you, but you know I was bullied as a child and many stages of my life I still thought I was seen in the way that I was seen when I was bullied, but actually I realized, no, there's a new version of me; that doesn't apply. Those rules don't apply here.

0:33:47 - Kate

As you said earlier... because I have a speech impediment. I think there was a lot of that and, yes, people bullied me when I was young and I think I had always lacked that 'r'. Well, as I said, I just never thought that people actually wanted to talk to me because I didn't have anything interesting to say. So, yeah, again, Joy just helped me to think that actually, no, I am worth talking to. I'm the longest-serving employee with the company and actually I've got a lot that I can talk about, but not just work-wise, but yeah.

0:34:22 - Esther

Brilliant, and so you had other strategies. Like in the beginning, would you write scripts? I can't remember what your advice was, something about writing things down or having themes that you might talk about in the room?

0:34:31 - Kate

I would certainly think about what I could talk about. I didn't write them down, but I'd have a sort of like a list in my head of things that I knew I was good at, rather than sort of meeting people and then just going totally like silent, as I used to literally shake, and if my husband was with me at any of them I'd just say "Don't leave my side." And he'd say, "But I need to go and get and drink," and I was like "Nope, you can't leave me," whereas now I'm fine.

0:35:03 -Esther

That's really helpful actually, because in the CBT model - cognitive behavioural therapy - we talk about safety behaviours, and so one of those would have been your husband not wanting to leave your side. So what we try and do in the therapy is break down those safety behaviours bit by bit. So it might be he's allowed to leave you for 30 seconds to get a drink in the beginning. Then he has to leave you for five whole minutes, then he has to not be with you until you know... it's called graded exposure sounds like you were able to let go of some safety behaviours that you had. So really really build that confidence, because that's what that does. Letting go of the safety behaviours helps you build the confidence you need.

But also what's really difficult with a lot of anxiety conditions is that we do present with physical symptoms like shaking. So it could be palpitations, it could be dizziness. These are all the fight or flight responses kicking into gear to, you know, make you leave the situation or hide! Fight, flight, freeze, hopefully not fight. Maybe not fight in this situation, but it's all the adrenaline, it's all the stress hormones at work to get you to work in that situation and things like breathing techniques really help and the visualizations and meditations really help with the physical side of anxiety, don't they?

Okay, that's food for thought. Let's have a pause here.

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So, moving on to that, that sounds really helpful, what you're able to do there in overcoming social anxiety. The last section I want to talk about sleep, because I think you did some really good work on sleep, didn't you?

0:37:14 - Joy

Kate was unable to go to sleep because she'd got all the work stuff in her head. So for start she was unable to sleep. Once she got to sleep, then if she woke up in the middle of the night she wasn't able to go back to sleep because she started thinking about the work again. Kate, do you remember what you tried to do to make yourself to go to sleep easier?

0:37:37 - Kate

I would do some of the mindfulness, but actually the whole approach to make things much calmer. No screens, just have a much gentler wind-down to going to sleep and listen to some nice music, if I needed to. And well, actually one of the things as well is when I leave my work at five. I used to literally physically shut the door, now and it's gone. I don't think about it now at all, whereas before, as you said, it was in my brain the whole night.

0:38:13 - Joy

So I told you to say goodbye to your computer, and your office. When you slam that door, "Goodbye, I have nothing to do with you now, till tomorrow morning." So the goodbye is just, like a thing that you actually she has to tell herself that you know she wants to say goodbye to the work like a closure thing for the day. So then she moves on to do her things at home, so cooking, gardening, whatever, cats. So then Kate is now able to really say goodbye to the work when the time is up, and then no more bothering her in the evening, not thinking about it at all when she wakes up. So Kate, I think in our last session you were telling me you no longer wake up in the middle of the night. So is it easy to go to sleep now?

0:39:00 - Kate

Yes, definitely. I quite often still do some breathing when I first go to bed just to really relax me, listen to some music or something, not have my phone... [Yeah, important!]

0:39:31 - Esther

Sensory overload, notifications, not having those boundaries, not be able to stop thinking about it, kind of takes over, and then it hijacks your sleep as well. So you're telling your nervous system that you're safe by putting all those boundaries in place, and you know, separating work from home life and looking after yourself and enjoying things in the evening. So it really is about programming ourselves, isn't it, to not be in that state of hyper alert.

0:39:44 - Kate

I think in the past, even when I was asleep, but I was dreaming, I was actually doing spreadsheets in my sleep. So you know, it was really in there!

0:40:02 - Joy

But now I think the gist really is you learn to detach yourself from that, because it's really not worth it. This is what I used to say: you're only paid to do eight hours a day. Why should you work more than that? That works, doesn't it? So, yeah, I think there are lots of different ways to tell yourself. When you want to put a stop on it, you can do it. But just, you know you've got to be creative, to think, to be flexible, to tell yourself: I have to stop this. So, Kate, again, she did it really successfully. And I think what she used to say in the last few sessions she would say and I think what she used to say in the last few sessions. She would say, "Oh, I'm sleeping like a baby now." [Oh, yes!]

0:40:45 - Esther

I don't know why they say that. For any other working mums out there: our babies don't sleep! Amazing. It's been great talking to you. Dr Joy, one quick question, actually... I really believe in the power of cross-cultural therapy. I don't think it's talked about enough. You know, when you talked about wanting your therapist to be similar, there is a similarity bias in the industry and that people tend to seek out people who are like them, and so, on the whole, it's more white, female, middle class people that may seek therapy and maybe feel comfortable in therapy, and we really want it to be accessible to everyone. And so, do you have any comments about what it was like working cross-culturally? Maybe you could tell the listeners where you're both from so they know... Just the power of actually working cross-culturally.

0:41:36 - Joy

I am from Hong Kong. I was trained in the UK and USA and in Hong Kong, but then I worked here for quite some time. Kate?

0:41:43 - Kate

I'm from England, born and bred here, but yes, for me it didn't present any issues or anything. In fact, it didn't really come into my thinking. Obviously, I knew you were from Hong Kong, but it didn't make a difference to me. I would say to people just have a very open mind and if you have a connection with the person, go for it.

0:42:10 - Esther

Kate, what would you say to someone who's sceptical about therapy, and particularly therapy with someone who maybe was from a different background?

0:42:13 - Kate

I would say that you definitely definitely need to approach therapy with a very open mind. Just go in, listen almost well not not homework, but I did practice between sessions any of the techniques and, certainly for me, very quickly I felt a big difference. So it made me keen to actually carry on. And I think you need to just throw yourself 100% into it and you will definitely benefit.

0:42:44 - Esther

Amazing. Thank you so much. Dr Joy, did you have any comments on that? Cross-cultural benefits, cross-cultural therapy...

0:42:47 - Joy

Well, actually I don't really look at the differences, you know, in terms of, like you know, between me and clients or like what I said from the beginning. I tend to look at similarities instead of the differences. But then I really enjoy working with people from different cultures because I learn so many things that there's so much to learn about different cultures. And of course, I really don't think of where that person's from, but I would rather think, you know, maybe if I learned something more about that culture, it would make us, you know, connect more. Maybe I can understand more.

And, of course, don't say the wrong things, you know. I think it's interesting, but then I still feel that I would always look to the similarities, like the age, like the same gender, you know what this person may be going through. Then what do I have you know this person may be going through, then what do I have to connect with? So I think you know cross-cultural differences really, you know, don't bother me that much if I can say that way, but then I would rather look for the similarities instead. But then still, you know, there are so many cultures, so many things to learn, so it would be nice. I mean, each time I work with somebody from a place that I've never heard of that I end up, you know, learning something new, every time. So, yeah, it's really interesting job. That's why I love this job very much.

0:44:11 - Esther

And what I heard as well was that, Kate, your husband recommended going to therapy, and men are also a group who don't go to therapy as much, and it's hard to convince them of the benefits. And isn't that wonderful that it was your husband's suggestion in the first place? So thank you.

Dr Joy works in our team. She's an amazing member of our team. She currently works online. You can find her at www.lifespanpsychology.co.uk or www.lifespan-psychology.com and make an inquiry, and she offers free 15-minute consultations to see if you'd like to work together and if you're a good fit, as her and Kate were. It's been a real... joy! Thank you for being our first guest on this show and for supporting me as well. It's a really new and exciting project where there's no other podcast out there with a client and therapist together, and this is a new journey for me, and so thank you for being part of the beginning of that journey. It hasn't always been easy, but it's just been amazing doing it with you both.

This podcast is not a replacement for professional psychological or psychiatric help. You can book an appointment with our team on info@lifespanpsychology.co.uk, but we do not provide a crisis service. If you've been affected by any of the content and need to speak to somebody urgently, please contact your GP to make a referral for talking therapies. You can contact NHS 111 out of hours or the Samaritans on 116 123. Childline also offer a free, confidential helpline for children young people in distress and offer support from counsellors online. Call 0800 1111 or go to www.childline.org.uk. If you're worried about someone's safety, please call 999 and bring them to the Accidents and Emergency Service. You can contact the charity CALM, Campaign Against Living Miserably or NSPCC for Children. These resources are in the show notes. Thank you for being part of the Breaking Through Therapy community. I would also like to thank the composer of this theme tune. It's called Bliss, by Luke Bergs. Let's dive into more conversations that change the courses of people's lives in upcoming episodes.

Transcribed by https://podium.page