Have you tried to stop using substances or alcohol before but not been successful? Have you ever said, “I’m never doing that again”, but been unable to keep promises made to yourself or others?

• Can you stop for short periods but keep returning to old ways?
• Are you confused about why you find it so difficult to give up drink or drugs and keep going back to them despite the negative consequences they cause in your life?
• Do you hide the reality of your use from those closest to you?
• Have relationships with family members, friends or loved ones become strained as result of your behaviour and relationship to drink and/or drugs?
• Do you turn to drugs and/or alcohol often to cope with your emotions, life’s challenges, or difficult memories of the past?
• Have you recently relapsed or continue to relapse and don’t understand why?
• Perhaps you are concerned about a family member or friends’ relationship to substances or alcohol, but have no idea what to do to help them?

If any of this sounds familiar, then seeing a specialist addictions counsellor can help. Addictions counselling with Bristol Counselling and Psychotherapy focuses on supporting you to come to understand either your own or another’s relationship with drugs or alcohol.

It may be that you have known about a problem for some time. You might have been told to get help. Or not know what to do about a loved one. Or a doctor has advised you to stop for health reasons, but you cannot.

Whatever your reasons for coming to counselling, we will guide you through the process of acceptance and understanding necessary to make effective and lasting change. We will explore root causes that influence the desire to use in the first place. As well as work towards forming effective coping strategies to support desired goals for recovery.

What Causes Addiction?

No one thing causes addiction, rather it is a complicated mix of factors that combine to cause a person to turn to drink or drugs in the first place.

In fact, there is evidence that the following can all contribute to a person becoming addicted:

• Relationships
• Environment
• Social groups
• Personal trauma
• Genetics
• Personal circumstance
• Physical factors

However, there is one specific factor that leads to addiction. There is not a specific trauma or experience that someone will go through that will automatically cause addiction. Addiction develops over time through a complex series of events and factors, and will tend to move through four stages: use, misuse, abuse, and dependency.

The first thing is to understand Addiction is complex and it is not anyone’s fault. What causes addiction for one person will be subtly different from what causes it for someone else. Consequences and issues can turn up at any time, and there is nothing wrong with seeking help about your experience with drink or drugs.

What Addiction Counselling Will Look Like

You and your counsellor will discuss the right direction therapy should take for you. You will discuss your goals, whether it is to stop entirely, or to learn to have a more manageable relationship with drink or drugs. Dependent on your goals you will then set about agreeing the kind of therapy approach that is best suited to you.

Cognitive Therapy

Cognitive Therapy is a talking and action therapy that supports a person to identify and manage their problems by changing the way they think and behave. It is an action-oriented, psychosocial therapy that identifies and addresses faulty thinking patterns influencing negative emotions and behaviours. It is widely recognised as an effective therapy for problematic alcohol and drug use.

Motivational Interviewing

Motivational interviewing is a directive, client-centred counselling style for eliciting behaviour change by helping explore and resolve both reasons to change, and reasons to stay the same. Through this process, a person can identify what motivates them to drink or use drugs, while helping them to recognise what is necessary to change. Motivational Interviewing is focused, and goal directed. Every goal is chosen by you as you move through the process of learning to nurture motivation and belief in yourself to change.

Relapse Prevention Therapy

Relapse Prevention Therapy is a structured approach that helps you work through a combination of experiences that are involved with substance and alcohol abuse. Such as, cravings management, triggers, high risk situations and more. In doing so you will be supported to build effective coping strategies that foster a belief in oneself to maintain the desired level of recovery. It focuses on scenarios which may lead to relapse, as well as supporting people in direct aftermath of alcohol and drug relapse. Relapse prevention is primarily focused on building confidence in your ability to manage temptation and maintain recovery.

Psychoeducation

Psychoeducation is a therapeutic intervention that teaches information which supports a better understanding of psychological, behavioural, and social problems associated with problematic drink and drug use.

Addictions we work with

• Alcohol
• Illicit drugs
• Prescription or over the counter medications
• Gambling

Co-dependency is a learned behavior that can be passed down from one generation to another. It is an emotional and behavioral condition that affects an individual’s ability to have a healthy, mutually satisfying relationship. It is also known as “relationship addiction” because people with codependency often form or maintain relationships that are one-sided, emotionally destructive and/or abusive. The disorder was first identified about ten years ago as the result of years of studying interpersonal relationships in families of alcoholics. Co-dependent behavior is learned by watching and imitating other family members who display this type of behavior.

Who Does Co-Dependency Affect?

Co-dependency often affects a spouse, a parent, sibling, friend, or co-worker of a person afflicted with alcohol or drug dependence. Originally, co-dependent was a term used to describe partners in chemical dependency, persons living with, or in a relationship with an addicted person. Similar patterns have been seen in people in relationships with chronically or mentally ill individuals. Today, however, the term has broadened to describe any co-dependent person from any dysfunctional family.

What Is A Dysfunctional Family And How Does It Lead To Co-Dependency?

A dysfunctional family is one in which members suffer from fear, anger, pain, or shame that is ignored or denied. Underlying problems may include any of the following:

• An addiction by a family member to drugs, alcohol, relationships, work, food, sex, or gambling.
• The existence of physical, emotional, or sexual abuse.
• The presence of a family member suffering from a chronic mental or physical illness.

Dysfunctional families do not acknowledge that problems exist. They don’t talk about them or confront them. As a result, family members learn to repress emotions and disregard their own needs. They become “survivors.” They develop behaviors that help them deny, ignore, or avoid difficult emotions. They detach themselves. They don’t talk. They don’t touch. They don’t confront. They don’t feel. They don’t trust. The identity and emotional development of the members of a dysfunctional family are often inhibited.

Attention and energy focus on the family member who is ill or addicted. The co-dependent person typically sacrifices his or her needs to take care of a person who is sick. When co-dependents place other people’s health, welfare and safety before their own, they can lose contact with their own needs, desires, and sense of self.

How Do Co-Dependent People Behave?

Co-dependents have low self-esteem and look for anything outside of themselves to make them feel better. They find it hard to “be themselves.” Some try to feel better through alcohol, drugs or nicotine - and become addicted. Others may develop compulsive behaviors like workaholism, gambling, or indiscriminate sexual activity.

They have good intentions. They try to take care of a person who is experiencing difficulty, but the caretaking becomes compulsive and defeating. Co-dependents often take on a martyr’s role and become “benefactors” to an individual in need. A wife may cover for her alcoholic husband; a mother may make excuses for a truant child; or a father may “pull some strings” to keep his child from suffering the consequences of delinquent behavior.

The problem is that these repeated rescue attempts allow the needy individual to continue on a destructive course and to become even more dependent on the unhealthy caretaking of the “benefactor.” As this reliance increases, the co-dependent develops a sense of reward and satisfaction from “being needed.” When the caretaking becomes compulsive, the co-dependent feels choiceless and helpless in the relationship, but is unable to break away from the cycle of behavior that causes it. Co-dependents view themselves as victims and are attracted to that same weakness in the love and friendship relationships.

Characteristics Of Co-Dependent People Are:

• An exaggerated sense of responsibility for the actions of others
• A tendency to confuse love and pity, with the tendency to “love” people they can pity and rescue
• A tendency to do more than their share, all of the time
• A tendency to become hurt when people don’t recognise their efforts
• An unhealthy dependence on relationships. The co-dependent will do anything to hold on to a relationship; to avoid the feeling of abandonment
• An extreme need for approval and recognition
• A sense of guilt when asserting themselves
• A compelling need to control others
• Lack of trust in self and/or others
• Fear of being abandoned or alone
• Difficulty identifying feelings
• Rigidity/difficulty adjusting to change
• Problems with intimacy/boundaries
• Chronic anger
• Lying/dishonesty
• Poor communications
• Difficulty making decisions

Questionnaire To Identify Signs Of Co-Dependency

This condition appears to run in different degrees, whereby the intensity of symptoms are on a spectrum of severity, as opposed to an all or nothing scale. Please note that only a qualified professional can make a diagnosis of co-dependency; not everyone experiencing these symptoms suffers from co-dependency.

1. Do you keep quiet to avoid arguments?
2. Are you always worried about others’ opinions of you?
3. Have you ever lived with someone with an alcohol or drug problem?
4. Have you ever lived with someone who hits or belittles you?
5. Are the opinions of others more important than your own?
6. Do you have difficulty adjusting to changes at work or home?
7. Do you feel rejected when significant others spend time with friends?
8. Do you doubt your ability to be who you want to be?
9. Are you uncomfortable expressing your true feelings to others?
10. Have you ever felt inadequate?
11. Do you feel like a “bad person” when you make a mistake?
12. Do you have difficulty taking compliments or gifts?
13. Do you feel humiliation when your child or spouse makes a mistake?
14. Do you think people in your life would go downhill without your constant efforts?
15. Do you frequently wish someone could help you get things done?
16. Do you have difficulty talking to people in authority, such as the police or your boss?
17. Are you confused about who you are or where you are going with your life?
18. Do you have trouble saying “no” when asked for help?
19. Do you have trouble asking for help?
20. Do you have so many things going at once that you can’t do justice to any of them?

If you identify with several of these symptoms; are dissatisfied with yourself or your relationships; you should consider seeking professional help.

Am I a sex and love addict?

If we were asked to think of an addiction, we would probably think of substance addictions such as alcohol or drugs. When specifying behavioural addictions, we may consider gambling or shopping but what do we know of love and sex addiction? Is it just an excuse for promiscuity or should we in fact regard it with the same gravity as other addictions?

Sex and love addiction is not measured or diagnosed in quantity but instead by the negative impact and consequences associated with the behaviour, on yourself and others. It is characterised by obsessive feelings and behaviours which the sufferer feels compelled to repeat regardless of the consequences. These behaviours and thoughts get progressively worse, ultimately resulting in the breakdown of personal relationships. This repetitive pattern with negative consequences can happen both as a result of excessive acting out (sexual bulimia) or the opposite, sexual anorexia.

Love addiction behaviours

• Clinging to an idealised relationship, despite a different reality
• Returning time and again to an abusive and damaging relationship
• Placing responsibility for emotional wellbeing on others
• Craving attention from many different relationships and seeking new sources of attention

The addictive behaviour fixes a problem

In an addict, we know that there is some kind of developmental immaturity which gets 'fixed' by their addiction (whether behavioural or substance). It is believed that these symptoms are borne out of adapting to survive emotionally within their family system. Co-dependent childhood experiences such as enmeshment on one extreme, or abandonment or neglect on the other, are major contributory factors.

You may be in a dark place right now but I will do my best to take you to a lighter and much brighter place.

Most of my clients come to me at a moment of crisis or trauma in their lives. The coping strategies you may have used for years have often broken down and then maybe something too big to manage alone has come along. So you are coming to me for therapy, treatment or just help. The good news is that when we have finished you will look back on the crisis that brought you to me as a blessing in disguise. Once you have had anxiety treatment from a professional therapist, like me, you will understand the causes of your anxiety and we will have given you a set of tools and helped you to develop the resilience to cope with whatever life throws at you.

There is no quick fix for anxiety and it will take work from both of us. Overcoming an anxiety disorder takes time and commitment. Therapy involves facing your fears rather than avoiding them. The important thing is to stick with it and commit to the treatment. If you start feeling discouraged with the pace of recovery, remember that therapy for anxiety is very effective in the long run. You’ll reap the benefits if you see it through.

You can also support your own anxiety therapy by making positive choices. Everything from your activity level to your social life affects anxiety. Set the stage for success by making a conscious decision to promote relaxation, vitality, and a positive mental outlook in your everyday life. This may sound like an impossible thing right now but believe me, we will get there together

• Maybe you are going through a tough time in your life, a crisis, a change, the end of a relationship, an illness, the sickness or death of a loved one?
• Maybe you are dealing with past trauma or old painful feelings?
• Maybe we are simply imagining things that aren’t really true, inventing things that aren’t really there?
• Perhaps your life has become a burden, and you just can’t seem to feel happy like you used to?
• You may feel too stressed to keep up with daily duties and responsibilities?
• You might feel like you want to run, to crawl into the corner, to escape to safety, to find solid ground again?

Yes, sometimes anxiety comes, unwanted and unexpected, instantly bringing a pounding heart, a racing mind, a feeling of sickness, a feeling of the ground falling out from under us.

When anxiety comes, in its all power, it can feel like “Something bad is going to happen!”. Our thoughts may tell us that we are about to die, or pass out, or have a heart attack or stroke.

Counselling/psychotherapy to treat anxiety

When we feel anxiety we naturally enlarge or exaggerate our problems, we think very negatively, imagine the worst possible scenarios and worrying about the future non-stop. We understand that this is very unhelpful, but we just can’t switch it off. It’s human nature. In talking therapies such as counselling, we work towards breaking down your problems into smaller, more manageable parts. I teach my clients techniques for decreasing a sense of agitation and worries.

OCD can affect men, women and children. Some people start having symptoms early, often around puberty, but it usually starts during early adulthood.

OCD can be distressing and significantly interfere with your life, but treatment can help you keep it under control.

Symptoms of obsessive compulsive disorder (OCD)

If you have OCD, you'll usually experience frequent obsessive thoughts and compulsive behaviours.

An obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters your mind, causing feelings of anxiety, disgust or unease.

A compulsion is a repetitive behaviour or mental act that you feel you need to do to temporarily relieve the unpleasant feelings brought on by the obsessive thought. For example, someone with an obsessive fear of being burgled may feel they need to check all the windows and doors are locked several times before they can leave their house.

Women can sometimes have OCD during pregnancy or after their baby is born. Obsessions may include worrying about harming the baby or not sterilising feeding bottles properly. Compulsions could be things such as repeatedly checking the baby is breathing.

Getting help for obsessive compulsive disorder (OCD)

People with OCD are often reluctant to seek help because they feel ashamed or embarrassed.

OCD is a health condition like any other, so there's nothing to feel ashamed or embarrassed about. Having OCD does not mean you're "mad" and it's not your fault you have it.

There are many and varied reasons which lead people to seek relationship counselling. These may include issues such as communication, bereavement, fertility, trust, intimacy, family issues – including parenting, step-families and extended families – infidelity, work, financial worries and separation or divorce. As an experienced counsellor I have worked with individuals and couples from diverse backgrounds and I welcome same-sex and heterosexual couples.

Are you struggling to discuss important issues with your partner without an argument or do you disagree on how to parent your children? Are you finding it difficult to be intimate together or is work stress impacting upon your relationship? Have you recently separated from your partner and would like to explore what went wrong or do you have difficulty in developing and sustaining intimate relationships?

I aim to provide a safe, supportive, non-judgemental and confidential environment in which we can work together on the issues that are important to you, meeting your unique, individual needs.

I can offer short or longer-term counselling. In short term counselling we can focus on the more immediate issues you are experiencing in your day-to-day life whereas longer term work might allow a wider perspective on how your past experiences may be affecting your current difficulties. Length of counselling varies but six sessions is a helpful minimum.

Self-esteem is the way we think and feel about our self, and confidence is the way we feel and operate in the world. These are essentials for happiness and peace of mind. Thinking of our self as not being as good as others in some way, is what is behind low self-esteem or lack of confidence. If we don’t compare ourselves to others in this way, there is no problem. Often, the thoughts about how others may judge us are what are behind these painful and debilitating feelings. In turn, those thoughts are often our own judgements of ourselves which we are ascribing to others. So if I think to myself that I’m not good enough in one way or another and may then extend that thought to think that other people think I’m not good enough, I will start to believe that. Thinking and believing that we’re not good enough is exactly what drains confidence and self-esteem.

Counselling for low self-esteem and lack of confidence

We would work together using CBT as well as behavioural and thought pattern changing techniques within a counselling setting to identify and get rid of old messages about not being good enough and build up confidence and self-esteem levels.

Here are some tools and suggestions:

Talk to someone. Talk to a friend or to the Samaritans. If it has been going on for a while or seems particularly distressing or is impacting on your life, consider seeking therapy.

If you find yourself eating until you feel uncomfortably full or sick, you may be struggling with binge eating. You may find yourself facing difficult emotions and unable to break out of a continuous cycle, you can find out more about what binge eating disorder may feel like and the vicious cycle of binging and self-loathing that you may feel trapped in.

I can also help you to work out more about how food addiction and compulsive eating can contribute to binge eating, and psychological and nutritional support can help you break out of binge eating patterns and help you reach wellness.

What is binge eating disorder like?

Binge eating behaviour can make you feel intense feelings of shame and self-loathing for the way you eat. You may experience secretly bingeing on vast amounts of food, even when you are not hungry, to the point of feeling uncomfortably full.

A difficult day at work, a bust-up with a loved one or just a feeling that your life is dull and boring can all be triggers that cause you to binge eat. At some point you have learnt that eating certain treat foods gives you an instant surge of pleasure and a release from the difficult, painful and uncertain stress or emotions that you feel. However, this is quickly followed by feelings of guilt and shame, and being disgusted by your binge eating behaviour.

Often people who binge eat struggle with their weight. You may follow a binge eating episode with restrictive dieting for several days to make up for it. This may create intense cravings for sugar and a physiological drive to eat, setting you up for another binge episode. With your physiology and emotions in chaos, it is easy to feel trapped in what feels like a constant binge eating cycle.

Stress can keep us on our toes and be a force for good in our lives. However too much stress and feeling overwhelmed with what we are dealing with, can damage our health and our enjoyment of life. Counselling for stress can help you to recognise the root causes and help you to learn stress management techniques.

What is stress?

Stress is a physical reaction caused by hormones in our bodies. Often when we experience a demand or requirement on ourselves, our brains produce adrenaline and cortisol and this helps to manage the pressure we are facing at that time. It is a physical response that causes us to go into a ‘fight or flight’ mode and this boost of physical adrenaline gives us a surge of energy and we focus on the task at hand.

As a result, it is important to realise that stress is not wholly a bad thing. This physical stress reaction has the effect of making us focused, alert, able to cope and motivated.

However, stress can become a negative force when the physical response does not go away, and we remain with the feeling of stress continuously, even when the situation does not warrant it.

How must stress is too much?

It can be hard to know when the stress levels in your life have tipped over into ‘too much stress’. It is often the case that it creeps up on you, in part because you have become used to the level of stress in your life and do not realise the impact it is having on you.

It is also very much the case that we are all different. As a result, what can be too much stress for one person, will be a very manageable amount for another and vice versa. This will be down to a multitude of factors including the level of an individual’s connection with, and ability to deal with, their emotions, their support network and their understanding of stress and how to cope with it. All these and other factors will affect how an individual reacts to stress.

Am I stressed? Am I overwhelmed?

Here are some common signs and symptoms of that indicate that you have reached your stress saturation point:

Cognitive Symptoms of stress:

• Unable to concentrate
• Memory problems
• Racing / anxious / worrying thoughts
• Only seeing the negative in most things

Physical Symptoms of stress:

• Needing the toilet frequently / diarrhea
• Aches and pains
• Feeling nauseous / cramps and pain in your stomach
• Chest pain /palpitations
• Dizziness
• Breathlessness
• Headaches

Emotional Symptoms of stress:

• Moodiness / irritability
• Feeling depressed or unhappy
• Feeling angry / having angry outbursts
• Feeling overwhelmed
• Feeling isolated and alone

These symptoms will, understandably, have an impact on your behavior and you may:

• Experience insomnia
• Notice the impact of your symptoms on your friends and family
• Withdraw from others
• Eat too much, too little or rely on highly caffeinated and sugary food and drink to cope with tiredness
• Use alcohol / drugs / cigarettes as an attempt to relax

Stress and the Impact on Physical Health

When we are in a state of stress either frequently or constantly, it will begin to have an impact on our physical wellbeing. The stress reaction is normal, but only when it comes and goes and helps us to cope, in the short term, with a demanding situation.

However, when we cross over from being ‘occasionally’ in a ‘stress reaction state’, to this being most or all of the time, it takes its toll on the body.

Some of the impacts on physical health are:

• Heart Disease
• Skin Conditions such as eczema
• Digestive problems
• Sleep Problems
• Weight Issues
• Thinking and memory problems
• Reproductive issues

What are the causes of stress?

The things that cause stress are known as ‘stressors’. These are situations or events that put demands on you and can be positive as well as negative. For example, . . . getting married, promotion at work or buying a property can all feel very positive things but they can also be ‘stressors’. Negative examples are financial worries, relationship difficulties or health concerns.

These are known as ‘external stressors’.

There are also ‘internal stressors’, which are things you worry and become anxious about in your mind, rather than because of an external situation. For example imagined scenarios or negative approaches to things.

Finally, there are levels of things in life that some find stressful and others will not.

It might be that, on a regular basis, you manage high levels of stress that you enjoy and thrive on. However something occurs that may seemingly be of no consequence to someone else, but feels intensely stressful to you despite your ability to manage stress normally. In the same way, another individual can find many things stressful that you find inconsequential, or that you actively enjoy.

There are a variety of external and internal factors that cause stress and each person’s unique and individual makeup will be a key component to what causes and does not cause them stress.

How does working with a counsellor for stress help?

Counselling can be a way to gain perspective on your stress. Within a few sessions it is likely that you will begin to understand what areas in your life are causing you overwhelm and the ways in which you can being to change and manage the stressful areas of your life.

Counselling for stress means you are dealing with the problem, beginning to manage it and understand it rather than simply feeling overwhelmed, anxious or worried about what is occurring without doing anything about it.

Counselling is also a safe and confidential space where you can speak openly and freely about what it is that is causing stress in your life and how you feel about those people, experiences or situations at present.