What We Can Help With

Here at Dynamic Psychotherapy, we help with a wide range of issues and conditions, using a range of therapeutic modalities including ISTDP

The list below includes just some of the most common issues we help clients with – please get in contact with us for more specific information. We have a team of experienced therapists ready to help you achieve transformational change

Read on for an overview of some of the most common conditions and issues we help our clients with.

Anxiety

“Worry often gives a small thing a big shadow”
Swedish proverb

Anxiety is one of the most common presentations of psychological suffering. In Australia, approximately 25% of people will experience distressing levels of anxiety at some stage in their lives. It is also one of the conditions that we know the most about, and are most effective at treating, meaning that most people do not have to continue to suffer from anxiety if they access effective treatment.

Anxiety can be understood as a risk response; the body is signalling that the individual is experiencing some kind of a threat. While aspects of this threat response, for example being constantly wired or hypervigilant or physically ready for action or a freeze response, might be helpful is there is an imminent danger to life, when the response is activated in the context of everyday relationships, and becomes habitual, anxiety often becomes debilitating and distressing, and impedes rather than helps the individual. Persistent anxiety can trigger depression and other mental health conditions.

Some common symptoms of an anxiety-related condition include

restlessness
a racing heart
rapid breathing
breathlessness
hyperventilation
panic attacks
a sense of impending doom
insomnia
nervousness and unease
sweaty hands and feet
tingling or numbness
chronic muscle tension
tension headaches
migraines
gut problems such as nausea, IBS, and diarrhoea
poor concentration and attention
dizziness

There are several types of anxiety disorders that are all characterised by symptoms of anxiety but with each having its own unique set of characteristics.

Some of the different types of anxiety are

Agoraphobia
Generalised Anxiety Disorder
Obsessive Compulsive Disorder
Panic Disorder
Phobias
Selective Mutism
Social Anxiety Disorder

It is helpful to seek assistance with anxiety conditions as soon as possible to get a quicker recovery. If you are worried about your anxiety symptoms, the first step is to talk to your GP about a Mental Health Care Plan and referral for a practitioner that can help you. The Mental Health Care Plan will allow you to access a Medicare rebate for psychological help.

Depression

“There is hope, even when your brain tells you there isn’t.”
John Green

Depression is intense ongoing negative mood that can be characterised by a loss of interest in previously enjoyable activities, a loss of enjoyment in any aspect of life, and a lack of hope for anything different. Approximately 15% of Australian will experience at least one depressive episode in their lifetime.While most people experience flat mood or ‘being a bit down’ from time to time, depression is more intense and is a serious psychological condition that can range from mild, to moderate, to severe. It can severely negatively impact on all aspects of functioning.

The complete lack of hope for any positive change, or for a life that is significantly different, can lead to suicidality. An important aspect of being depressed can be to hold on to the fact that the hopelessness is a symptom of the depression and that, as the depression lifts, a worthwhile existence and hope for not only a positive future, but for effective ways of dealing with depressive episodes, becomes apparent.
The most common symptoms of depression are:

flat mood
hopelessness
frustration
loss of interest in previously enjoyable activities
weight gain or loss unrelated to the person’s diet
headaches, pain and other somatic symptoms
excessive sleep or insomnia
tiredness and fatigue
thoughts of self worthlessness
self-critical thoughts
concentration difficulties
suicidal thoughts and impulses
thoughts that nothing is ever going to change or improve

These symptoms may be mild or moderate, or may be severe and persistent.If you know that you have depression, or suspect that you may be depressed, it is important to seek help as soon as possible, letting those close to you know of your condition and consulting your GP. Therapy can be a vital part of treatment for depression including not only treating the current condition, but focusing on relapse prevention.

If you are suicidal or experiencing yourself at risk of self harm, you can call Lifeline on 13 11 14 for immediate assistance and while making plans for effective treatment for your depression.

Somatisation, Functional Neurological Disorder (FND) and Conversion

Physical symptoms for which a physical cause cannot be found are sometimes due to a psychological condition known as Somatisation. The physical symptoms are real, not imagined, but as the physical symptoms are triggered by emotions, psychotherapy can be an effective treatment. Somatisation can cause significant emotional distress and/or impaired physical functioning. Approximately 3-5% of Australians seeking help from their GP or an allied health professional will have somatisation.

When a trauma triggers emotions that trigger anxiety, the emotion may be avoided to avoid the anxiety it produces. For example, if anger is triggered interpersonally, and that anger triggers anxiety, rather than experiencing the anxiety-provoking feeling, it can be avoided by being channelled back into the person. Just as anger can be channelled back into critical thoughts that ‘attack’ the individual, anger can be channelled back into an attack in the form of pain or other symptoms.

When the Somatisation affects physical functioning under voluntary motor or sensory control, the condition is called Functional Neurological Disorder (FND) sometimes known as Conversion Disorder

FND often impacts upon body mobility and senses, with symptoms such as an inability to use limbs with weakness, paralysis, or numbness, abnormal movements, difficulties with swallowing, vision, hearing or speech, or seizures. Symptoms can vary in severity. As with somatisation, the symptoms are not and cannot be intentionally produced or controlled.

Sometimes the emotion may be ‘converted’ into a symptom that also reduces the individual’s capacity to act on the emotion. If a person experiencing anxiety-provoking anger, the body might lose a capacity that also ensures that the person cannot act on the urge that goes with the anger.

For example, a woman presented for therapy with a condition known as adhesive capsulitis, better known as ‘frozen shoulders’. She had a severe lack of mobility in her shoulder joints that caused pain and marked inconvenience in daily activities. Medical specialists could not find a cause for her condition. It was suggested that she try psychotherapy. Onset coincided with an interpersonal incident that evoked a mix of feelings including intense anger towards someone she also cared about.

Rather than being able to face the anger, and act on it in an adaptive way, experiencing this anger triggered anxiety and her anger had been channelled back into her body in a way that not only punished her but rendered her incapable of acting on her anger in any way that might be harmful. Her anger went through a conversion process that was meant to be protective but based on the false premise that facing her anger would result in someone getting hurt.

Another woman suffered debilitating knee pain and instability. Once she could face anger towards her husband, including noticing a wish (that she had no intention of acting on) to kick him, her knee pain disappeared.

Psychotherapy helped this woman to face that she felt intense anger including an urge to physically lash out and ‘shut up’ the person who had verbally hurt her. Once she could face the extent of her anger without the anxiety taking over and it being channelled back into her, not only did her frozen shoulders instantly disappear, but she was able to act on her anger in a healthy adaptive way, to seek a conversation about what had taken place in the relationship.

With Somatisation and FND it is very important to exclude possible physical causes for the symptoms. For example, Guillain-Barre Syndrome can cause muscle weakness and pain. Lupus can trigger fatigue and joint pain. Myasthenia Gravis, Hashimoto’s Thyroiditis, Multiple Sclerosis, Parkinson’s are all examples of some of the physical conditions that may not be immediately diagnosed without careful investigation.

Trauma/PTSD

Trauma, a word from Greek meaning ‘wound’, results from direct exposure to intensely distressing events involving death, serious injury, or sexual violation, such as sexual and other physical attacks, war, terrorist attacks, severe neglect, road and other accidents, and natural disasters.

Post traumatic Stress Disorder (PTSD) has been described as an internal war that continues long after the distressing event or events. The severity of the symptoms of PTSD does not necessarily depend on the severity of the traumatic event. Untreated, it can trigger additional distressing psychological conditions including other anxiety disorders and depression.

The distressing traumatic event is often relieved through flashbacks, intrusive thoughts, and nightmares.
Other common symptoms of PTSD are:

hypervigilance
anxiety including panic attacks
avoidance
mood swings
irritation
anger including explosive outbursts
sadness
depression
critical thoughts
guilt

Not everyone who is exposed to a highly traumatic event will develop PTSD. We understand that there are risk factors that make someone more vulnerable to developing PTSD, included previous exposures to other traumatic events.
It is very important to seek help for PTSD. We have learned a lot in recent years about the effective treatment of PTSD. One of the hardest first steps in overcoming PTSD is acknowledging suffering and seeking help and this can be particularly true if you are someone who is used to pushing through and appearing to ‘cope’ . Your GP can guide you to a therapist who is experienced in treating PTSD.

Grief and Loss

“Grief changes shape, but it never ends.”
Keanu Reeves

When we lose one whom we love, the anguish and pain can seem unbearable. It can be difficult to continue functioning, emotionally and physically, in life. This initial reaction will often ease with time and with sharing our experience with those close to us. However, if the initial reaction is severe, or over the weeks following the loss there is no or little easing of the symptoms, and the pain remains unbearable, therapy can be important to work through the feelings that result in ‘complicated’ grief.

Signs and symptoms of complicated grief may include:

intense sorrow, pain and rumination over the loss of your loved one
excessive avoidance of reminders
excessive focus on thoughts, memories, and objects related to your loved one
problems accepting the death
numbness or detachment
withdrawal and isolation
insomnia
intense anger
thoughts that life holds no meaning or purpose
inability to enjoy life and depression
alcohol abuse or other substance abuse
a wish to have died along with your loved one/suicidality

At times, people with complicated grief may consider suicide. If you’re thinking about suicide, talk to someone you trust. If you think you may act on suicidal feelings, call Lifeline on 13 11 14

A severe loss reaction can be triggered by the loss of personal function, for example due to a chronic or permanent injury, the loss of a job, of other losses that result in the loss of a way of life. Again, with self-care and sharing with those close to you, the immediate severe emotional impact often lessens in the initial weeks, but if you continue to suffer emotionally, therapy can help you adjust to the new reality and process the emotions that have been triggered.
It is important to not leave yourself alone in grief and loss and to let your GP know, or seek help from a therapist, if your suffering is intense and/or is not lessening with time.

Eating Disorders

“What mental health needs is more sunlight, more candor, and more unashamed conversation.”
Glenn Close

There are a wide range of eating-related conditions with the most common eating disorders being:

Anorexia nervosa
Bulimia nervosa
Binge eating disorder
Avoidant restrictive food intake disorder

People can suffer from eating disorders at any age with onset often being during adolescence and early adulthood and in the context of emotional stress. Increasingly we are finding children developing eating disorders. The problems relating to eating can start in various ways but often there is food obsession and food restriction in the early stages of the condition developing, in addition to worry about body shape and general look. Eating disorders can lead to severe health conditions and even death if left untreated.

Eating disorders are often accompanied by binge eating and/or restricted eating, purging behaviours such as vomiting and/or using laxatives, and excessive exercise. They are often comorbid with other psychological conditions such as anxiety, depression, obsessive-compulsive disorder (OCD), and substance misuse.

Obsessive Compulsive Disorder (OCD)

Obsessive compulsive disorder (OCD) is characterised by obsessive thoughts and rumination, and compulsive behaviours. There is often an irrational sense of needing to engage with particular thoughts, or act on particular urges, to avoid some kind of specific or non-specific threat.

The urges may become repetitive rituals such as counting to a number, or repeating certain words or phrases, or tapping, or performing a tasks over and over such as turning a light switch on and off, checking that a door or window is locked, prolonged handwashing, or putting clothes on in a certain order and needing to repeat the sequence until there is a sense of having ‘got it right’.

Many people have small short rituals that do not excessively negatively impact on their functioning, but OCD refers to thoughts or behaviours that interfere with quality of life.

Anger Management

Anger is a normal healthy emotion that is triggered when we experience a threat, whether that be a threat to life or a threat such as someone crossing a boundary, treating us or somebody else badly, or causing physical or emotional hurt. Anger is designed to enable us to address the threat.

Not everyone has a healthy relationship with their anger. If rather than acting on anger in a way that involves calm assertiveness and seeking a conversation, we lash out verbally and/or physically, anger becomes problematic for us and our relationships. Alternatively, if our anger ‘implodes’ on to us in verbal self attack, depression, or physical pain and suffering, it is also problematic.

Psychological therapy can help people face and feel their anger without excessive anxiety so that they can use it to be protective and to deepen (rather than hurt) relationships

Panic Attacks

Panic attacks are specific episodes of intense anxiety that include marked physical and cognitive symptoms of anxiety. Rapid heartbeat, rapid breathing, and a sense of extreme terror or impending catastrophe are usually markers of a panic attack. They are extremely distressing and there is often no, or very little, warning of onset. A frequent reason for presentation at hospital emergency departments is a panic attack being mistaken for a heart attack.

Nocturnal panic refers to waking from sleep in a state of panic.

Sometimes a person may experience an isolated episode of panic but others will experience recurrent panic attacks on a daily or weekly basis and meet the criteria for panic disorder.

Following a panic attack, there is often marked concern that another panic attack will occur.

Insomnia

Insomnia is the term used to describe regular difficulty in falling asleep, and/or staying asleep, and/or waking early and being unable to return to sleep, and to a degree that results in a reduction in day time functioning.

Insomnia due to emotional causes is usually related to anxiety and may also involve excessive rumination. Chronic insomnia may be involved in the onset of other emotional issues, and may trigger physical health conditions.

If good sleep hygiene is used, that is, going to be at a reasonable and regular time, reducing exposure to screens in the period before sleep, limiting stimulants during the day and particularly in the evening, ensuring that the room is dark and the temperature is optimal for sleep, and sleep is still an issue, psychological intervention can help to find and deal with the emotional triggers for the insomnia.

Stress

Stress is a term used to to refer to the triggers for anxiety. It usually indicates physical and emotional symptoms of anxiety relating to a specific incident or situation, or relating to a series of incidents or situations, which accumulate and take an individual over their capacity to cope physically and emotionally. Stress is often accompanied by a sensation of marked pressure.

Short exposures to stress can be helpful. When a deadline induces stress, the anxiety that ensues can help mobilise the individual to focus and work hard in order to meet the deadline and make positive gains. However, if the stress is too high, and/or prolonged, it can result in marked anxiety, other emotional distress, and even physical health conditions or aggravate existing health conditions

Learning to deal with stress differently will reduce emotional suffering.

Learning to deal with stress differently can lead a person to have increased capacity to work and achieve but without a significant emotional cost and without the risk of stress becoming chronic.