Other Difficulties Treated

We have mentioned several times that often there is no identifiable point when a ‘difficulty’ turns into a ‘disorder’. It depends on the individual’s perception, the level of impairment in everyday functioning (and sometimes on other’s reactions and observations). However, it is always advisable to address small issues, instead of waiting for them to become overwhelming. Therein lays the strength of the CBT approach. It can teach skills and strategies that can be used within difficult situations, but most importantly also to avoid these difficulties getting more debilitating and severe. CBT skills are useful in a variety of situations and there is a skill or tool for almost every group of the population. Prevention and empowerment are key issues.

These are some other difficulties that can be treated and addressed with Cognitive Behavioural Therapy. If left untreated, these difficulties can often lead to more serious mental health disorders.

Stress reaction

stressStress is a set of reactions (thoughts, feelings, physical sensations and/or behaviours) we experience towards events we encounter with in our work or personal lives. The way we respond to certain events will determine our level of stress. Prolonged stress can cause significant physical and emotional problems for individuals. It may also be part of or lead to other mental health issues. You might have realized that there are increasing resources and hints and tips offered in the media and by various professionals. They all agree that long-term stress is unhealthy and that we need to evaluate and possibly adapt our lifestyle in various areas. Psychological support can be very valuable in helping you to learn how to recognise your stressors and the effects they have on your life. This can be extremely helpful as it can motivate you to change the situation you are in or your approach (thinking and behaviour) to a situation. A few sessions based on CBT principles can equip you with a range of skills that will be very useful to cope with the present, to avoid the mistakes of the past and to lead into a healthier future. See also previous section on anxiety.

Grief Reaction

Losing a loved one is one of the most distressing and emotional experiences people face. However, grief is not just experienced when we are faced with death. Grief is part of the reaction to any kind of loss; whether this is actual loss of people and belongings, or the loss of one’s health, or even the loss of an envisioned future after a separation. Virtually everyone deals with grief at some point. Despite the emotional difficulty, most people experiencing normal grief and bereavement endure a period of sorrow, numbness, and even guilt and anger, followed by a gradual fading of these feelings as they accept the loss and move forward. For some people, though, this normal grief reaction becomes much more complicated, painful and debilitating, or debilitating, or what is known as ‘complicated grief’. In ‘complicated grief’, painful emotions are so long lasting and severe that you have trouble accepting the death and resuming your own life.

Researchers are beginning to pay more attention to complicated grief because of the serious toll it can exact — possibly leading to depression and thoughts of suicide. Researchers have even developed a new treatment that may help people with complicated grief come to terms with their loss and reclaim a sense of joy and peace.


Bullying is a form of abuse and its effect on children and teenagers can be devastating. It is harmful and must always be discouraged. Bullying occurs when one person has power over another because of their size, difference, strength or status, and uses that power to threaten or harm the other person. The harm can be caused physically, verbally, or mentally by excluding them or spreading cruel rumours.

Examples of bullying include name calling, writing hurtful comments, making someone feel uncomfortable or scared, making threats, physically harming, leaving them out of activities, stealing or damaging property, playing tricks, harassing online, via text, phone or computer, and setting up social situations that are embarrassing. A bully usually picks on someone who is different in some way – they might have a special talent, a physical disability, speak differently, dress differently, have a different skin colour, culture, sexual orientation or their family may have more or less money than the bully’s. When teenagers bully it can be because they have been bullied themselves. Bullying can happen at home between siblings and between parents and children. Bullies often do harm to themselves too as it is something they will live with for the rest of their lives. Individuals who are being bullied live with constant stress, never knowing when the bullying will occur and trying to find ways to avoid it. They can suffer from anxiety, depression, physical illness and behavioural problems. It is not surprising that they are often reluctant to take part in school or work activities. They can even feel ashamed about being bullied, blaming themselves for what has happened and not wanting to tell anyone. Bullying is not restricted to the school environment. Increasingly employees are complaining about workplace bullying. The intervention remains the same.

Relationship Problems

Whoever we are, one thing is certain: we are all born the product of a union between a man and a woman, and we are all very much shaped by those who raised us, our parents and/or caregivers. We are the product of human relationships, and most of us spend our days within the context of relationships with other people. We need other people to be close to us in our lives, or we tend to get sick (physically and/or mentally). Who we are is very much a function of where we have come from, and who we surround ourselves with. Despite their vital importance in our lives, relationships can be very difficult to manage or even damaging. We expect our intimate partners to provide for many of our needs, but often find that differing expectations, frustration, and a need to be right create conditions for conflict and erosion of intimacy. Our children test us for weaknesses or are needy of our support and we don’t always cope. Our adult parents grow older and require care, placing an other layer of demands on our other responsibilities. A diverse set of communication and relationship skills is required if one is to successfully meet the challenges of socializing within home, work and other settings.

Primarily, we learn how to be in successful relationships by experiencing them directly; by watching our parents manage conflict successfully and stay true to their loving union. Similarly, we do our best learning on how to become a good parent while being parented ourselves. Problems experienced in our early relationships are often expressed in our own behaviour towards others (child abusers were often themselves abused). This becomes evident in close personal relationships, as well as in interactions with other people in various settings, whether at work, within interest groups or when interacting with strangers. These vital relationship skills are seldom taught in school or other institutional settings. All of this adds up to the fact that many people end up making a mess of their relationships, in part because they never learned how to do them properly. Thus, it is desirable to learn particular skills in order to become a better partner, parent, friend, employee, employer, or member of the team. These strategies become invaluable when we have to negotiate a crisis, like divorce or a demotion.

Disorders of Infancy, Childhood or Adolescence

The DSM-IV includes a section, which is dedicated to the diagnosis of mental health issues for children. Although we have training and experience in assessment and treatment of childhood issues, we would like to point out that some of these are specialised areas. CBT Psychology provides parental guidance as part of assessment and treatment of some of these areas and during the individual assessment interview we can also determine whether the particular presented difficulty of your child can be treated within the CBT context. Most often we will work closely with the family/caregivers and we will include other relevant professionals (for example school personnel or GP/ pediatrician). In any case we will be able to provide information on the particular disorders and referrals can be organised to a specialist team of professionals.

These Disorders include Pervasive Developmental Disorders (Autistic Disorder, Rett’s Disorder, Childhood Disintegration Disorder, Asperger’s Syndrome), Attention-Deficit Disruptive Disorders (Attention Deficit Hyperactivity Disorder, Opposition al Defiant Disorder, Conduct Disorder), Feeding and Eating Disorders (Pica, Rumination, Feeding), Tic Disorders (Tourette’s Syndrome, Chronic Motor or Vocal Tic Disorder, Transient Tic Disorder), Elimination Disorders (Encopresis, Enuresos), and other disorders (Reactive Attachment Disorder, Selective Mutism, Stereotypic Movement Disorder).