Services & Therapy
Katherina Doherty – Registered Psychologist
Below are the common areas of focus. If you need to discuss other issues or would like clarification, please contact us (See Contact Page).
Anxiety is a natural response to a stressful situation. Our stress response acts as our bodies “alarm” and is important for survival helping us respond quickly to threats in new or challenging situations. Anxious feelings usually pass once the stressful situation has passed. For people with anxiety disorders, however, anxious thoughts, feelings, or physical symptoms are severe and interrupt daily life, often without any particular cause. Similar to the fire alarm that goes off at inappropriate times, our bodies alarm may not be in line with the level of threat or risk being experienced. We can learn to face challenging situations more effectively by developing skills for more intentional responding rather than automatic “fight/flight/freeze” responses. Anxiety can be treated effectively with psychological therapy, particularly cognitive behaviour therapy and mindfulness.
Everyone feels sad, moody or ‘down’ from time to time. Depression is when we experience flat or low mood or a sense of ‘emptiness’ over a prolonged period of time, lasting weeks, months or years. Symptoms can include loss interest in things, changes in appetite, sleep and concentration, feeling tired or lacking energy and feelings of worthlessness or guilt, which impact on our daily life and relationships.
Depression can be experienced as being overwhelmed by life’s challenges and not having the skills to cope. People’s style of dealing with life’s stressors, coping skills, problem-solving abilities, thinking patterns and social skills to build positive relationships are common issues in the treatment of depression. We can develop these skills to help manage mood. Depression is highly responsive to psychological therapy. Effective psychological treatments for depression are cognitive behaviour therapy and interpersonal therapy.
We all face life challenges and can generally cope well when stress lasts for a short period of time. When stress is unrelenting, and in the absence of adequate supports, the effects can impact negatively on our physical and mental health. Stress is often described as feeling overloaded, wound-up, tense and worried and occurs when we face a situation we feel we can’t cope with. Stress can also occur in the absence of adequate stimulus when people experience boredom.
Not all stress is bad. Our bodies stress response helps motivate us to perform well and complete tasks when dealing with challenging situations. Our bodies respond to stress by activating the nervous system and releasing hormones such as adrenalin and cortisol which increase heart rate, blood pressure and muscle tension to help us react quickly to stressful situations. Chronic stress such as ongoing financial, health, relationship or work-based issues, social isolation or abuse can lead to physical and mental health problems such as sleep difficulties, weakened immune system, worry, irritability, difficulty concentrating and feeling overwhelmed. Stress can be managed with relaxation approaches, mindfulness-based stress reduction and cognitive behavioural stress management.
Posttraumatic stress disorder (PTSD) refers to symptoms that can emerge following the experience of a traumatic event that involves exposure to actual or threatened death, serious injury, or sexual violence. Symptoms commonly include a sense of reliving the traumatic event, avoidance of reminders of the traumatic event, feeling numb, having negative thoughts and mood and feeling agitated or wound up. PTSD can increase risk of developing other mental health problems, such as depression and anxiety, or problems with alcohol or drug use. Trauma-focused Cognitive Behaviour Therapy helps people confront memories and reminders of trauma, change the way they think and feel about traumatic experiences and find more helpful ways of coping, through exposure therapy and cognitive therapy techniques.
Exposure to early childhood trauma such as physical or sexual abuse or emotional neglect can have significant long-term effects on healthy development. These experiences lead to toxic stress, leaving the body’s stress response permanently on alert and the feelings of being overwhelmed or “flooded”. Children can learn to disconnect from emotional experiences which can cause difficulties in adult attachment relationships. Trauma-focused therapy helps people build safety in the therapeutic relationship and awareness of automatic patterns of responding which can impact on interpersonal relationships.
Sometimes people can experience problems with their alcohol use. Problems can include:
- difficulty meeting responsibilities at home, work or school
- trying unsuccessfully to cut down or quit
- drinking more than intended despite wanting to stop
- recurring problems with health, safety, relationships, finances or the law
- needing alcohol to cope with everyday life
- organising events around drinking
- drinking more to have the same effect
- feeling sick or moody without alcohol, but feeling normal when they use again
- drinking as a way to maintain friendships or relationships.
Psychological treatments can help people who experience problems with alcohol. Motivational interviewing can help explore readiness to change drinking behaviour and brief interventions provide information about safe drinking and harm minimisation. Cognitive behaviour therapy (CBT) helps change unhelpful thoughts and behaviours that can contribute to alcohol use and build skills to manage alcohol cravings.
Sleep is essential for wellbeing and ongoing sleep problems can affect physical health, mental health and quality of life. Sleep difficulties can involve problems falling asleep at bedtime, problems staying asleep during the night with frequent awakenings, or, early morning awakenings without being able to go back to sleep. Cognitive behaviour therapy for insomnia (CBTi) is an effective psychological therapy for the treatment of insomnia. Treatment involves psycho-education on sleep, sleep monitoring, sleep hygiene, relaxation skills, stimulus control and cognitive restructuring.
Frequent conflict or arguments, emotional distance, loss of trust or sense of betrayal are common relationship problems. While arguments and disagreements are a normal part of dealing with differences, unresolved conflict causes emotional distance. Therapy can identify negative patterns in relationship and help couples to connect rather than disconnect. Couples can learn to de-escalate negative cycles of interaction and ‘turn towards’ each other to discuss their needs and fears. Trust can be rebuilt by helping couples acknowledge hurt and betrayal, be responsive to each other’s needs and strengthen their emotional bond. All relationships go through different phases and relationship counselling can help build strong foundations at the early stages, deal with the transition into parenthood or with fertility issues, cope with loss or illness and manage the later stages of relationship. Couples therapy is based on the principles of the Gottman Method and Emotion Focused Therapy.
Grief is the natural reaction to loss. Grief can be experienced in response to the death of a loved one, separation or divorce or other significant loss-related events. People cope with grief in a variety of ways with individual differences in the intensity and duration of the grieving process. Some people may find it helpful to talk openly about their loss and others may want time alone. Personality, cultural factors and the nature of the loss can influence grief reactions. Typically, grief is associated with intense emotions such as shock and disbelief, sadness, anger, guilt and remorse, anxiety, loneliness, helplessness, and a sense of yearning. Most people can manage their grief by maintaining self-care and, with the support of others, adjust to their loss in time. When grief is complicated or prolonged, professional support can be helpful in adjusting to loss.
Self-esteem refers to how we view and think about ourselves and the value we place on ourselves as a person. When our self-esteem is low we have a negative overall opinion of ourselves, judge ourselves negatively and place a negative value on ourselves as a person. People with low self-esteem hold negative basic beliefs about themselves and engage in frequent self-criticism while ignoring positive qualities. These beliefs are sometimes formed in childhood or can be influenced by negative life experiences and relationships. Negative beliefs about self may be related to having unrelenting high standards or perfectionist tendencies. When our self-worth is overly influenced by achievement or body image we can experience low self-esteem. Messages in the media or social media often suggest self-worth is linked to the way we look and can significantly influence how young people in particular judge themselves. Low self-esteem can lead to depressed mood, relationship difficulties and can impact on performance and achievement. Self-esteem can be improved by understanding how negative beliefs were formed and challenging thinking styles and behaviours. By developing awareness of the emotional impact of negative self-talk we can learn self compassionate and improve our self-esteem.
Recent research shows that diet matters to depression. Better quality diets reduce depression risk, while unhealthy dietary patterns (higher in processed foods) are associated with increased depression and often anxiety. Researchers now believe that depression is a whole-body disorder, with dysfunction of the immune system (chronic, low-grade systemic inflammation) as a very important risk factor. If we do not consume enough nutrient-dense foods such as fruits, vegetables, wholegrains, fish etc., this can lead to insufficiencies in nutrients, antioxidants and fibre, and this has a detrimental impact on our immune system. A diet high in saturated fats and refined sugars has a negative impact on brain proteins the stress response system, which is also important in both depression and anxiety.
Mental health also impacts on dietary behaviours. Stress and uncomfortable emotions prompt us to consume “comfort foods” such as sweet and fatty foods, which can be addictive. Short-term benefit is offset by the long-term damage done by these foods. Interventions focused on improving diet and exercise are likely to help to prevent and treat depression and other mental disorders. (Adapted from the Food and Mood Centre, Deakin University)
Parents play a central role in children’s social and emotional development and mental health. From the time of birth, children need stable and responsive attachments with caring adults. The most important influence on early brain development are “serve and return” interactions, as children naturally reach out for interaction through babbling, facial expressions, gesturing and words to which the adult responds. The earliest years of life are a particularly sensitive time for brain development and secure attachment to a primary caregiver. If an adult’s responses to a child are unreliable, inappropriate or simply absent, the damage to the developing architecture of the brain can have lifelong impacts on learning, behaviour, physical, mental and emotional health. Adolescence is also a vital “window of opportunity” for building core life skills but is also a period of vulnerability for the development of mental health problems.
Nurturing and enriching early life experiences provide the foundation for healthy brain development and increase the probability of positive outcomes in adulthood. Parental mental health problems can impact on parenting, the parent-child relationship and the mental health outcomes for children. Through professional support, parents can develop self-regulation and parenting skills to help them maintain responsive relationships with their children to support their social and emotional development and mental health.
Work stressors can include factors such as interpersonal difficulties, workload, deadlines, safety issues, long hours, physical environment and structural/organisational issues. People may experience a lack of motivation, autonomy, recognition or financial reward in their job roles and may face uncertainty due to job insecurity, organisational changes or economic conditions. Individuals can experience conflict, lack of support or training or harassment, discrimination and bullying. Work stress can be unrelenting and some factors are beyond the control of the individual to change. Fly-in fly-out (FIFO) workers and their families face additional stresses which can impact on mental health and relationships. Often work stress can spill over into home life, impacting on other relationships, sleep and self-care. Professional support can help people gain perspective on problems, resolve conflict, improve time management and organisational skills and reduce the impacts of work stress through self-care and lifestyle management.