low self-esteem

Body Dysmorphia

Body Dysmorphia

Most of us feel unhappy or insecure about the way we look at some point in our life, however these feelings usually come and go. While body dysmorphia is an increasingly common condition (around 1% of the population) it is very different because it affects the individual the majority of the time and leads them to have a permanently distorted view of their appearance, to the extent they are convinced that the way they look is abnormal or ugly, even when it isn't. They will spend a great deal of time looking in the mirror critically, or avoiding mirrors completely, and often leads to a strong desire to have cosmetic surgery.

Fuelling these feelings is the constant thought they are unattractive, which is hugely distressing, and depressing, for the person. Even when friends, partners and family members try to convince the person that they look great, the negative thoughts remain overwhelming. In an effort to combat these negative feelings the person tends to obsess over the way they look, spending hours trying to cover up or hide the perceived flaw, which is why more serious manifestations of Body Dysmorphia are categorised as an obsessive-compulsive disorder, and for this reason CBT is often recommended as the treatment of choice. Sometimes deeper issues with their roots in the past can be the cause of the problem, hence longer-term therapies might be more appropriate.

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social anxiety

Social Anxiety Disorder – Social Phobia

While many of us can feel nervous or uncomfortable in a social situation, for those with Social Anxiety Disorder (also known as social phobia) these feelings are quite overwhelming and disabling. The person might end up avoiding all social contact with others simply because these ‘normal’ social situations make them feel extremely uncomfortable or embarrassed. In extreme instances the whole of the person’s life, not just the social, can gradually start to fall apart.

Triggers might be:


  • Talking to strangers
  • Speaking in public
  • Going on a date
  • Making eye contact
  • Entering rooms
  • Using public spaces or facilities
  • Going to parties
  • Eating in front of other people
  • Going to school or work
  • Starting conversations

For some giving a speech is relatively easy while going to a party can be a nightmare. Alternatively, the person can easily manage a one-on-one conversation yet feel unable to step into a crowded classroom. What this highlights is that there are a variety of underlying reasons for dreading certain social situations. For example, the person might suffer from an overwhelming fear of being judged, being embarrassed or humiliated, offending someone accidentally, or suddenly becoming the centre of attention.

While targeted treatments such as CBT are shown to be highly effective other therapies which help build the person’s sense of self-esteem and confidence can also be extremely beneficial. Research has shown that a wide range of factors can be of relevance to explaining the condition, which depends largely on the individual.

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Self Harm

Self Harm

For many when faced with distressing or stressful life experiences they tend to neglect themselves, perhaps smoking or drinking too much, driving too fast, spending excessively, engaging in unsafe sex, all as ways of numbing or avoiding difficult feelings. For others however the depth and intensity of their pain is such that these ways aren’t enough and they feel direct injury to themselves is the only way to cope.

Self harm can cover a multitude of behaviours. Most common is scratching or cutting the skin, usually the arms or legs, but other parts of the body too. Some burn or scald themselves, pick at their skin, pull their hair out, violently hit themselves against things. These forms of behaviour, which clearly cause pain or harm to the body, can be ways of coping with deep emotional pain, a way of taking control, managing something overwhelming. These acts can be a means of putting an internal pain on the ‘outside’, a tangible way of showing your suffering to the world, a cry for help; not attention for the sake of it but a desperate attempt to show others that something is seriously wrong. For some it can be a way of restoring a feeling of reality, a way of making yourself feel real or ‘connected’ top your body. For others it may serve the purpose of punishing the self, relieving feelings of shame or guilt. These feelings are sometimes linked to abuse, whether emotional, physical or sexual. More broadly these behaviours are often indicators of an underlying depression, low self esteem or poor physical self image.

Self harming behaviour is not necessarily an indicator of severe mental illness but instead a way of trying to cope with pain, and the only way possible. Just because a person self injures this does not make them a danger to others. Their hurt and anger is primarily directed against themselves. Also it is not generally a sign of suicidal intent; these actions aren’t about ending one’s life just a way of coping with it.

Some self help advice

You might begin to make sense of your behaviour by considering:

  • When it began
  • What was happening in your life back then
  • How did self harming help you survive these experiences, both in the past and in the present
  • How do you feel before and after you have self harmed. Maybe keep a diary of thoughts and feelings as they occur around harming behaviours. Are they indicative of buried needs, feelings, thoughts, memories?
  • What does your behaviour represent to you? What is it a response to?

Having identified these you can work towards other ways of responding to your internal distress that is less damaging in the longer term. Along with seeking professional help with the underlying issues, the following suggestions can begin to initiate small steps towards alternative, more productive, self-help behaviours:

  • Cutting less deeply, less often
  • Taking better care of your injuries
  • To get a similar physical sensation, flick elastic bands on your wrist, hold ice cubes in your hand until they melt
  • Tearing up bits of paper and making a collage
  • Avoid drinking too much when self harming
  • Taking better care of your injuries
  • Writing down the feelings instead
  • Drawing or painting your feelings
  • Talking with a friend when the feelings take grip

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anger management in worcester

Anger Management

Anger is a normal and natural reaction to feeling threatened, violated or receiving unjust treatment. In itself it is neither good nor bad; but it can be frightening. It can go from feelings of mild irritation to seeing a red mist in front of your eyes and feeling an uncontrollable rage. Anger is an emotion that many people suppress, this can be as harmful as experiencing uncontrolled rage. Suppressed anger can have many physical and emotional symptoms such as poor digestion, high blood pressure, depression and addictions.

Angry feelings can lead to destructive and violent behaviour and so we tend to be frightened of it in others and in ourselves. The way we are brought up plays an important part in how we express our anger. We may come from a family where we were not able to show feelings of anger, or one where we may have witnessed destructive and violent outburst, which cause us to fear anger.

Ways to manage your anger

Learn ways to be more assertive. Being assertive means you are clearer in your communications and are more likely to have your needs understood and met

Examine your past patterns of behaviour and history around anger. See if you can begin to rectify any of the unhealthy ways of expressing anger you may have adopted

Acknowledge old angers from the past, especially from your childhood. Perhaps you could begin to change your attitude to what has happened to you

If anger causes you to want to lash out, then learn to walk away from situations and explain that you are too angry to talk at the moment


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counselling for depression worcestershire


Depression is a medical term used to describe the condition of a person whose mood is lowered, perhaps to feeling constantly unhappy, or even to such an extent that they may be at the point of feeling suicidal.


What causes depression?

Life events such as bereavement, abuse suffered early on in life or the loss of a job or relationship can cause depression. In some cases a feeling of lowered mood escalates into depression for no apparent reason. There are also physical reasons for why some people experience depression.


Warning signs

  • Your mood is always low; you may feel unable to enjoy anythin.
  • Everything may seem harder to do, and it is difficult to concentrate
  • You may not feel like getting out of bed in the morning. You may feel tired all of the time as if you have no energy
  • Sleeping and eating patterns may become disrupted
  • When things are really bad you may become preoccupied with thoughts of suicide

Ways to manage depression

  • Recognise that there are no instant solutions to problems in life, especially depression
  • Acknowledge that you are experiencing problems and share this with a supportive trustworthy friend or member of you family
  • Seek help via your GP or contact an experienced counsellor or therapist

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