Therapy Digest 07

It’s that time of week again and here’s my latest therapy digest of media that caught my eye relating to my work or topics that have shown up with my clients.

Dieting is the wrong focus for overweight kids and teens.

For parents who have teenagers struggling with their weight, a recent study in Cleveland, USA showed that encouraging them to diet sent the wrong message and could have long-lasting adverse effects on their relationship with food.

Researchers followed more than five-hundred teens in the US who had been told to diet. After checking back in with them some fifteen years later, the researchers found that the diet group they studied were now more likely to be overweight and have problems with their body image than a control group who were not told to diet.

Experts from many countries now agree that focussing on dieting at a young age can create a dysfunctional relationship with food that can influence a person’s eating behaviours for decades.

Seeing dieting as a negative influence is due in part to the fact that most diets are calorie restrictive and the compulsion to eat and even overeat can feel overwhelming when one is experiencing enforced hunger and lead to yo-yo dieting.

A pattern of behaviour develops for many yo-yo dieters of commitment to the latest fad diet-plan only to give up and regain the weight they lost plus usually more too. This pattern of weight loss and weight loss can hurt self-esteem as people feel like failures when in fact it was the diet that failed them.

So, how does acknowledging that focussing on diets with young people can be counter-productive sit with a recent campaign initiated in some UK schools that intend to send a letter home to parents to alert them that their child is overweight? The idea behind the letters is in response to a record number of under-11s who are already too heavy and who are potentially contributing to a national health crisis.

The ‘fat-shaming’ letters have sparked a debate as to whether sending these notifications to parents are cruel or a necessary evil to prompt parents to act. The discussion also poses the question that if your child is overweight as a parent do you already know this and are in denial or just not sure what to do for the best?

It is not clear from advance information whether the letters advise parents on how to tackle their child’s obesity and whether putting a child on a diet is recommended or not.

Apparently what the letter doesn’t address is the causal link between childhood obesity and food poverty when lower-income families struggle to provide nutritious and satisfying food on a tight budget. The ability to provide nourishing meals if further hampered when the adults in the household are not skilled at home cooking or do not have access to adequate cooking facilities.

A more promising approach that came from the US study of teens reported that instead of focusing on what not to eat it is better to focus on the health and nutrition that comes with eating well. To achieve this will mean teaching children about how to buy, prepare and eat real food versus the drawbacks of eating junk food.

Influencing young people with sound information about proper nutrition is harder to achieve as many of the world’s largest ‘frankenfood’, and soda manufacturers regularly contribute to the funding and the creation of misleading or biased resources for schools and colleges.

The report also recommended teaching young people mindful eating so that kids learn to slow down their eating and focus on their meal times by turning off devices so that consumption doesn’t happen in a zoned out way while occupied doing something else.

“It’s so important to give teens these skills at this juncture in their life, and I talk to parents about tools, not rules. So moving away from food rules but helping them change their habits around the way they eat,” said Susan Albers, at the Cleveland Clinic.

Experts also recommend helping your teenager learn to manage stress by relaxing, reading or going for a walk, as opposed to turning to food. That will help steer them away from comfort-eating and swallowing down their emotions with food which leads to emotional eating.

If you or a member of your family is struggling with weight loss or weight management food may have become a way to manage painful emotions including anxiety and anger. If this sounds familiar, you can book an obligation free call on this page.

Women quit sex after cancer.

I was saddened but not surprised to read a recent headline in the Daily Mirror newspaper quoted the results of a survey from the UK’s Breast Cancer Care charity.

They asked nearly 1,000 women of whom almost 95% said cancer treatment had stopped them from having sex. This figure included a high percentage of women who had been diagnosed three or more years previously indicating that women struggle with this problem for a long time.

Of the total of women surveyed 94% reported that side effects of their life-saving treatment such as surgery, chemotherapy, radiotherapy or hormone therapies had stopped them having sex and they blamed the adverse impact on their libido, uncomfortable vaginal dryness and reduced self-esteem.

More than two-thirds said they were not warned about the possible detrimental impact of their treatment on their sex life and the majority reported they did not receive adequate support from health professionals.

Samia al Qadhi, Chief Executive of Breast Cancer Care, said, ‘These figures paint a troubling picture of the reality for countless women whose relationships and sex lives are sidelined – sometimes permanently.’ She continued, ‘Everyday we hear from women with dramatic scars, hair loss and intimate physical changes. The treatment for breast cancer can be utterly traumatic and side effects can continue for years.’

When I read the article in the newspaper, it hit home to me that for every traumatised woman there must be quite often a traumatised partner too also sidelined and cut adrift by a system not geared up to resolve the emotional fallout of these treatments and the inevitable physical changes that survival has demanded.

Clearly, cancer survivors, in particular, are exposed to PTSD (Post Traumatic Stress Disorder) from both the diagnosis and the rigours of the treatment.

It feels cruel indeed to submit women to all of what cancer treatment entails to continue living and yet not be given every possible support to thrive fully.

I work with a lot of clients living with chronic disease and have worked over the years with many women survivors of breast cancer too.

The work often needs to begin by exploring how their image of who they are has so fundamentally changed and that naturally brings with it grief and sadness for the person they were before their illness.

There are similar feelings of loss acknowledged by most of my clients who are living with the fall-out from chronic disease. The loss of one’s former self is felt very strongly and deserves to be acknowledged and mourned.
There is no expectation of clients having to accommodate a blanket acceptance of everything that has happened to them on the premise of ‘I can’t dwell on this because I’m lucky to be alive’. The work gives a voice to all of their emotions from anger and sadness to fear, and the work can only be transformational if those emotions are acknowledged as valid.

When working therapeutically with life-changing issues such as these, it is wonderful to be able to work directly with the sub-conscious mind. Working in this way cuts through all of the subtle and not so subtle pressure to be brave or stoic or whatever else is going on so that powerful changing can be made at a profound level.

It is important not to underestimate the enduring trauma of partners, parents and other family members too. Their need for therapy to resolve the residual fears they are holding on to and their own sadness can get lost in the relief of their loved one’s recovery. However, it is vital to work so that everyone is able to unite once more in their new landscape.

Survivors of cancer need to find a way to fully come home to themselves and that journey is just as vital for their complete recovery than the chemo or whatever else they had. Therapy can bring them back to who they are, even as charged as they may be. It can also give them the choice and hopefully the desire to reconnect with the sexual part of themselves and renew their emotional relationships. The aim is never just to survive but to fully thrive again.

If you have recovered from cancer or know someone who has who continues to struggle to reconnect with who they are then you can book an obligation free call with me here on this page. If you thought survival was your goal but now you’re ready to thrive then its time to reach out.

Are drug users in your workplace?

It is no surprise that a recent report by a US federal government agency acknowledged that some 69 per cent of illicit drug users in the United States is in employment.

As a London based therapist often the clients who come to see me for help with their addiction problems are high-earning, high achieving, high functioning alcoholics or Class A drug dependents although of course, they would never describe themselves in this way.

The metropolitan professionals I see are mainly, although not exclusively men and they often normalise their recreational drug and drink consumption either in secret or in the carefully chosen company of friends or work colleagues who pretty much share their habits.

What they come to see me for as a therapist it is to cure them of their unexplained panic attacks; alarming bouts of paranoia or to relieve their symptoms of anxiety.

Alternatively, they may come to see me about how insomnia is ruining their life. Or perhaps how their violent outbursts of rage with their partner leave them feeling shaken. They are often overwhelmed by the emotional fallout from their extreme mood-swings ruining their relationship and yet at a loss to know where all their anger came from.

It only takes a few open questions to find out about their usual levels of drinking and drug use.

It is often initially described to me as occasional; recreational; just weekends. Then after a few more questions, it becomes apparent that it’s almost every, if not every weekend and that the weekend often begins on a Thursday night and can run through to a Tuesday.

In therapy, clients although initially resistant, begin to acknowledge the elephant in the room and see the correlation between their addictive behaviour and its impact on their mental well-being as well as the detrimental effect it is having on their private life.
However, it is not just out of hours behaviour that can be compromised by their drug use. It impacts on how they are at work too and if you are an employer and you have reason to suspect that drug use is affecting an employee’s performance and/or relations with co-workers, here’s some guidance on what to do

1. Don’t ignore the signs.
Obviously, if an employee has dilated pupils, slurred speech, or an unsteady walk, or if he or she smells of alcohol, you have every reason to suspect that person is having a problem. But you should also be on the alert for more frequent absences, especially with suspicious excuses, deteriorating relationships with co-workers, inattentiveness, taking longer to complete tasks or alternating between completing tasks quickly or slowly, evading responsibility for errors, and decreased attention to grooming or hygiene.

2. Make sure you know the law.
If you believe an employee may be suffering from a drug or alcohol problem that is affecting his or her work, don’t wait for it go away. Plan to sit down in private with the employee to address the problem. Before your meeting, make sure to review your legal rights and obligations to your employee.

3. Don’t assume that you know what’s truly going on–or that your employee will tell you.
Years ago, in what seems like another life now, I led a sales team. They were all younger than me and exuberant and high energy most of the time. They worked hard and as well as working together they often partied together at the weekends. I began to notice a pattern of behaviour with them collectively. Monday’s would be a slow day with a hung-over quietness amongst the team. There would be fewer calls made to sales prospects and plenty of staring vacantly into space and cigarette breaks. Regular Monday morning’s hang-over city is probably pretty common when you employ lots of young single extroverts enjoying their life in the capital and they needed lost of rallying and prompting to get through their work.

Nothing compared to the mayhem of Tuesday’s though. The team members were often agitated and argumentative with each other and worse with me. They could even be short with prospective customers on the telephone or inept at following up ‘warm calls’ that could lead to sales. Some members of the sale’s team were particularly difficult and unreasonable – but only on a Tuesday!

I couldn’t work out why this was happening and did some research to find that use of Class-A drugs such as cocaine and ecstasy cause this Tuesday mood change as people’s bodies go through the effects of a physical withdrawal from their weekend drug use.
I had to work to resolve this by focussing purely on the performance results of the team. Eventually, I promoted the worst offender to head up the team and made his pay bonuses dependent on the results the team achieved collectively. This proved to be the only way for a culture change to take place and with the insider knowledge he had of his team members he was able to make them behave more responsibly, motivated as he was by his own pay-cheque.

4. Steer the employee toward professional help.
Whatever you do, don’t try to counsel the employee yourself, or organise an in-office intervention. Your employee needs help from a trained professional, not a boss or friend, however well-meaning. If your company has an employee assistance program, you should point the employee in that direction. If not, come to the meeting prepared with brochures and phone numbers for local organisations that can provide help along with information about services your company’s insurance will cover, if any.

5. Don’t cover for the employee.
If an employee is failing to complete assigned work due to a suspected substance abuse problem, you may be tempted to lend a helping hand by finishing up some tasks yourself or re-assigning work to someone else. While you need to make sure that the work gets done, make sure to document any instances where you or someone else has to complete tasks that were the employee’s responsibility. Don’t try to save the employee from embarrassment by making excuses when he or she misses a meeting or deadline.

Your employee’s sub-standard performance should have consequences, so a record of these incidents will be a valuable tool to either compel the employee to face up to the problem or provide cause for discipline or termination if that becomes necessary. But more to the point, if you care about your employee, know that you aren’t helping him or her by providing cover — you’re enabling the substance abuse to continue. In the long run, that will only make things worse, for yourself, your employee’s co-workers, and your company.
(Some points of this guidance were first published by

If you recognise that your own drug or alcohol use is getting out of control or already has impacted on your relationships and work then reach out now and make an obligation free call via the link on the page.