Anxiety can present in many different forms. Common anxiety disorders are Generalised Anxiety disorders, Panic disorder, Post traumatic stress disorder, Hypochondriasis and Obsessive Compulsive disorder (OCD). Whilst these present in different ways, and may have different underlying basis; they all share the common features of hightened anxiety and a sense of losing control over thoughts and feelings which in turn lead to some maladaptive behaviours that are being implemented as a way of trying to reduce distress by the client. For many, these behaviours result in short term alleviation of symptoms (for example washing hands for a person with OCD might help reduce anxiety short term) but in the long term the behaviours prove meaningless as they prolong distress, increase a sense of losing control and also reinforce the use of unhelpful coping responses.

In Metacognitive therapy and ACT (acceptance and commitment therapy) (Annika’s favoured styles of working ) unlike in traditional CBT, the focus of treatment for anxiety disorders is not on the content of thoughts. Metacognitive therapy focuses on the underlying processes that lead to anxiety disorder for example persistent worrying and rumination, threat monitoring (being on the 'lookout' for threat)

and maladaptive coping responses such as avoidance behaviours and other unhelpful attempts to handle thoughts and feelings. As such it offers a range of targeted techniques that can speed up recovery. Metacognitive therapy has generated a very strong evidence base in the treatment of the majority of common mental health conditions and addictions. This can many times feel comforting for the client as it prevents over-identification with specific themes of thoughts, and allow the psychological knowledge acquired during sessions to be generalised to any area of life where stress arises.

Acceptance and Commitment Therapy (ACT) is a unique empirically based psychological approach that uses acceptance and mindfulness strategies, together with commitment and behavior change strategies, to increase psychological flexibility. ACT offers a flexible, dynamic and collaborative way of engaging clients through the use of metaphor and various exercises that enables a greater understanding of the mind. ACT has demonstrated a solid evidence base in the treatment of anxiety disorders as well as a range of other psychological problems.

Stress can arise from a wide range of reasons. Common factors are:

• too much work, too little time

• feeling torn between work and home life

• poor work/life balance

• poor self-care

• losses

• relationship difficulties

Stress presents differently for different people but most of us can probably acknowledge that the feelings associated with high levels of stress are very uncomfortable. Feeling snappy, irritable, anxious,on edge or having problems sleeping are all common warning signs that stress is accumulating and not being managed. Sadly, far too many people await a ‘crash’ before looking for help or resort to unhelpful coping mechanisms that only act to increase long-term stress. During high levels of stress, it becomes difficult to have a conscious choice over behaviours- as we become more reliant on our ‘auto-pilot’. The inability to recognise stress can often cause more significant mental health difficulties further down the line.

On occasions people who are struggling with high levels of stress will find themselves using a lot of energy trying to ‘catch up’; but usually are so unable to focus and concentrate that even minor decisions and small tasks feel major. This can lead to negative cycles of emotion and behaviours that can be surprisingly easy to break once the client can get some help in learning to recognise where they are going wrong. People who are living in a state of chronic stress will recognise that they feel unable to enjoy themselves, fail to feel relaxed and instead of leading a life of choice and value- many individuals end up leading a life just based ‘shoulds’ ‘musts’ and obligations.

Dealing with stress with help of a therapist usually means addressing some of the underlying triggers, learning to better manage time, appropriate ways of prioritising time in accordance with one’s value system and passions, addressing boundaries to work and often addressing building up or repairing areas of life that have taken a hit due to the stress.

You will learn more adaptive ways of thinking, how to cope and act around triggers for anxiety and of course also how to manage the triggers themselves whether such triggers are work related or personal.