Clinically vulnerable children need to play, but not roulette.

The world is returning to a sense of normality with the imminent lifting of restrictions. As Boris Johnson says, ‘We need to live with Covid’.  The lifestyles and mental health of many have been compromised, not least the economy.  New freedoms are vital for optimal lives and livelihoods.

The fact is we ALL need to live as safely and as freely as possible while the virus continues to hover like a potent miasma.

A group who have suffered a vastly disproportionate amount of stress throughout the pandemic are Clinically Vulnerable Families. Their high levels of stress will rise exponentially as the morning of freedom day dawns.

The mental health needs of this group are currently in danger of being buried completely under a growing mountain of discarded masks. Their mental health needs are in threat of been overlooked negatively affecting their learning, life chances and liberties.

Amid a growing rhetoric about opening up about mental health and liberties, this must be addressed.

In our treatment clinics throughout the pandemic, many children in this group have been referred with severe anxiety. Some were refusing to go to school and others on the brink of school refusal. These children were expressing feelings of terror about bringing home the virus from school or the shops, etc. and infecting vulnerable parents or themselves.  There has been a rhetoric of real fear about losing a vulnerable but functional and loved parent to Covid. 

The fear of losing a primary caregiver and the sense of powerlessness that living with the situation brings has caused turmoil in many young minds.  Locked up with this fear, these children have in many cases internalised their deepest thoughts. Over time the bottling of these emotions has resulted in anxiety spikes, depression and in some cases self-harm and suicide attempts. 

Many of these children are also young carers shouldering a disproportionate level of responsibility in their young lives.  In most cases the very last thing they will do is burden a parent with their fears.

During the last two years, we could help providing child focussed CBT. Looking at the safeguards that were in place could and did offer some much needed comfort to them. Safeguards such as masks, free LFT’s, PCR tests and the parent’s ability to work from home helped reframe their fears.  We could work with these children to gain an accurate appraisal of risk and shift their negative thinking to a more helpful process of coping better.

With the imminent lifting of all restrictions, we have very few tools to help these children through their very real fears.  To provide false security is nothing more than gaslighting. Being told “Covid is over and let’s move on” as was the experience of one 10 year old patient in the clinic is deeply traumatic.

These vulnerable parents and children are facing an increased risk with the lifting of restrictions and no amount of CBT will alter their real and proportionate fears. The offering of a continued booster vaccine is little comfort to those who medical status has in many cases led to a poor antibody response after one, two, three or even 4 vaccines. These families fears must be heard and addressed.   We need to be able to bring down their adrenaline levels by allowing them to wear masks in school if they choose. They must have access to free LFT’s and PCR’s. Many are in receipt of Universal Credit and PIP and could not afford to pay for a necessary test. It is appropriate to press for Hepa Filters in some public places and to accommodate the clinically vulnerable in sensible work placed adaptions. 

Sensible precautions, adaptions and compassion will allow us to stem a tidal wave of potential long term mental health problems and learned helplessness in this group. It will ensure increased freedom and access to lives and livelihood for ALL. Let’s do more than talk about mental health.

Written by

Dr Chrissie Tizzard  Chartered Consultant Psychologist and Chartered Scientist

Clinical Director CTP and Lighthouse IRL. www.ctpsy.co.uk

Defuse an Anxiety Attack in less than 5 Minutes

We often play down an anxiety attack and see it as a nuisance. For many people, anxiety is far more than a nuisance – it is almost paralysing, and they long to learn how to defuse an anxiety attack. Fortunately, it can be defused in five minutes, if you know how.

A sudden emergency, a trip to the dentist or even giving a presentation can signal terror. Many of us know the feeling, but being armed with strategies like those listed below will keep the situation under control.

Learning how to manage an attack is the key. 

Knowing that you can manage an attack before it happens means you will be less likely to actually experience one. Part of the panic you feel is being convinced that you won’t be able to manage, and that the attack will go on and on, so you need to correct this belief.

•  Slow down – professional advice often focuses on slowing breathing. Sometimes though, as anxiety strikes, we quickly become too panicky to focus. If you can’t concentrate long enough to slow your breathing, sit down or find somewhere safe to pause a while.  A moment of quiet will naturally calm your breathing and allow more oxygen to circulate.

• Ground yourself – when you have paused for few seconds, it can be useful to centre yourself in the ‘here and now’.  To do this, look around the environment.  Name three things that you can see. Feel your feet on the ground or the chair supporting your back, and simply take in your surroundings.

An Anxiety attack is a trickster

What are you afraid of? What is it you fear will happen? Anxiety creeps up.  Sometimes it is hard to pin point where it has come from; for many of us it just takes over.  It is a good idea to ask yourself these simple questions. Most people say that they are unable to pinpoint the fear, but it is possible to work out the reason.  Usually, you will have a picture in your mind of your worst fear in any situation. What is it? Be honest with yourself.

• Know your fear – once you have worked out the source of the anxiety, you can beat it. Most people don’t get this far, because they believe the anxiety is swallowing them. This makes them think they are powerless – it feels like it is gobbling them up. Remember anxiety is a trickster. It is not swallowing you. Once you know your root fear in a given situation, you can logically work out that it is a thought process that has spiralled out of all proportion.  You will now be able to work out a plan to conquer the fear.
• Take out a pen or your phone and write down a plan – this will help you cope with the situation as it unfolds.  You will then have a step by step guide that you can use and also share with friends and family so they can help you too (also direct them to our blog post on panic attacks – always a useful one to bookmark!). Notice as you do this how you almost immediately begin to feel in control.

• If you start to wobble, begin again – there is no shame in doing this. It will take time for you to adapt to your new plan and follow the steps, so be kind to yourself and keep practicing.

Remember fear has two meanings:

FEAR = Fear Everything and Run

FEAR = Face Everything and Rise

Written by Louisa Gibbs, Psychotherapist and Referrals Co-ordinator at Christine Tizzard Psychology (ctpsy.co.uk), providers of 1 to 1 and group treatment for anxiety.

Long Covid: How Psychologists Can Help

 

 

Long Covid is currently a frequent and unwelcome visitor to the clinic, as we see more and more patients with symptoms of this long-term condition. Our team have now treated over 70 clients with long Covid in our UK and Irish clinics, and the numbers are sadly increasing.

It’s clear that long Covid symptoms are causing misery and disabling symptoms to people of all ages and from all walks of life; The Lancet calls it ‘a modern medical challenge of the first order’. According to the Office for National Statistics, by 4 July 2021, an estimated 945,000 people in the UK (or 1.5% of the population) had self-reported long Covid; 34,000 of these cases were in children aged 2-16 years.

While the physical symptoms are becoming obvious to physicians, the mental health effects are far less visible in wider society, and this puts a barrier in front of those experiencing the condition.

Scientists are still undecided on a precise definition of long Covid. Nevertheless, they have agreed there are several common themes that greatly trouble its victims.

Symptoms of Long Covid

A review (Shah W, Hillman T, Playford ED, et al.) identified that the most frequent symptoms of long Covid are fatigue and dyspnoea, or shortness of breath. Other less typical symptoms include cognitive and mental disorders, headache, myalgia (muscle pain), chest and joint pains, smell and taste dysfunctions, cough, hair loss, insomnia, wheezing, rhinorrhoea (runny nose), sputum, and cardiac and gastrointestinal issues. These symptoms may persist for up to six months and counting, after hospital discharge or symptom onset.

Less common symptoms of pernio (chilblains), chills, flushing, ear pain, and visual impairments associated with long COVID have also been documented (Stavem K, Ghanima W, Olsen MK, et al.). This shows the multifaceted nature of long Covid and how it involves multiple organ systems, leading to complex care needs.

The wide range of symptoms associated with this post-inflammatory condition are very frightening; many people don’t know how to cope with daily life, and understandably so. Patients with long Covid may have previously been very fit and healthy, getting involved in sports, managing a busy career, or travelling around the world, yet now they are faced with months or even years of pain, mobility issues and fatigue.

Professor Danny Altmann, from the Department of Immunology and Inflammation at Imperial College London, said on a podcast:

“In many cases, these are people who have life-changing illness. These are people who used to cycle to work who can no longer cycle, these people who now find it difficult to go up and down stairs, and people used to be full-time full-on workers, who now find it hard to turn up for a full-time job and have gone part-time.”

Long Covid causes many problems in every part of a person’s life, from having to make costly working life adjustments to painful personal relationship adjustments. Fortunately, psychologists are able to deal with all of these aspects when supporting a client with the condition.

How Psychologists Can Help Long Covid Patients

Psychological input is a powerful tool, providing targeted assistance to anyone coping with the impact of long Covid, and the chance to develop a personal treatment approach. Talking therapy with a psychologist moves people forward with hope towards wellness.

Essentially, long Covid has the potential to alter an individual’s attribution system (their way of seeing the world). This condition can be seen as a psychological trauma in many cases, especially as so little is known about long Covid, meaning that scientific approaches are evolving all the time. Psychological therapy will deal with that trauma and the thought patterns the patient experiences.

It is vital that a person is helped to make meaningful adjustments that will still give them a positive self-view, despite the temporary limitations or uncertainly that they face due to long Covid. Every client’s situation will be different, but there are always psychological approaches that can improve their wellbeing. When thinking about the condition, we can also reflect on the kind of support we already offer to clients with other long-term health diagnoses, such as autoimmune conditions.

In practical terms, psychologists have a crucial role to play in assisting and empowering clients to address all areas of their life: specifically, the physical, emotional, and cognitive responses leading to a firm action plan, which will help those with long Covid move forward despite their current restrictions.

At Christine Tizzard Psychology and our sister organisation, Lighthouse Ireland, we currently offer support to organisations, and to clients from all walks of life. Our psychologists work with adults, children, and families. We also provide training to GPs in this area. Get in touch today and see how we could help you.

References

Shah W, Hillman T, Playford ED, et al. . Managing the long term effects of covid-19: summary of NICE, SIGN, and RCGP rapid guideline. BMJ. 2021;372:n136.

Stavem K, Ghanima W, Olsen MK, et al. 1.5-6 months after COVID-19 in non-hospitalised subjects: a population-based cohort study. Thorax. 2021;76(4):405. 

 

16,000 pregnant women and new mothers without access to mental health support during the pandemic

New research from the Royal College of Psychiatrists’ Mental Health Watch has found that 16,000 women have been unable to access perinatal mental health support in England so far during the Covid-19 pandemic.

However, coronavirus was not the only cause of this gap in treatment, with the Royal College of Psychiatrists citing ‘lack of local investment in perinatal mental health services’ that has led to a ‘postcode lottery’ of varying support levels for those in need.

Mental Health Watch found that 47,000 women were expected to get support for perinatal (pregnancy or early motherhood) mental health issues from 2020-2021, but the most recent data for 2020 suggested that only 31,261 had managed to access help. Mental Health Watch analyses public NHS data to track the overall performance of mental health systems.

On average, 7% of pregnant women and new mothers in England are expected to need mental health support from local services. The overall figures for perinatal mental health issues are much higher, with as many as one in five expectant or new mothers experiencing a mental health problem, such as anxiety, pre- or post-natal depression, post-traumatic stress disorder (PTSD), or post-partum psychosis.

We can reasonably expect that the pandemic will put added complications onto any pregnancy, as social distancing measures and lockdowns have left many people feeling isolated; expectant mothers have had to attend medical appointments alone and even give birth without their partners.

Perinatal support networks have also changed, with many group meetings cancelled or moved online (which then puts anyone without reliable internet access at a disadvantage). Baby activity groups have been suspended, and play areas and nurseries have also been affected.

The Royal College of Psychiatrists has called for more funding in perinatal mental healthcare, and more investment to close the gaps in care standards across different parts of England. Last year it also drew attention to problems in Scotland, where there are only two mother and baby mental health units, and where huge swathes of the country do not have a perinatal mental health service. The NSPCC has also indicated similarly patchy provision in Wales and Northern Ireland, with the latter having the poorest perinatal mental health services in the UK and no training standard on the topic.

It is clear that more needs to be done to support pregnant women and new mothers, and not just because of the pandemic’s impact; access to services was already difficult before we faced a global health crisis. Covid-19 has increased demand for already stretched mental health services, and we cannot afford to fail people at their most vulnerable.

If you are worried about someone who is pregnant or a new parent, we can help. Our psychologists work with clients to develop a treatment plan that fits their needs and circumstances. We have a network of professionals around the UK (and in Ireland, through our sister organisation, Lighthouse Psychology) who will provide tailored local support.

Written by guest contributor Vikram Das for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk) and Lighthouse Psychology (lighthousepsychology.ie). 

Managing children's anxiety after Covid-19 lockdown

Managing children’s anxiety after Covid-19 lockdown can be hard.  After months at home, the easing of restrictions is proving tough for many.  For those with Autism Spectrum Disorder (ASD) or anxiety, the easing of restrictions can seem terrifying.

At Christine Tizzard Psychology and at Lighthouse Psychology (our sister organisation in Ireland), we are seeing a big rise in teenagers and younger children who feel very anxious. A number are refusing to go to school; some have started to self-harm; parents tell us their children’s  meltdowns have increased recently. This is naturally alarming for parents and carers.

What is this post-lockdown fear about?

Humans are sensitive: lots of us find change a bit of a challenge.  For children who have a diagnosis of ASD, ADHD or anxiety,  change is often terrifying and overwhelming.

Being overwhelmed leads kids to feel “hopeless and helpless”, and this causes the body to make more adrenaline.  When adrenaline builds steadily without it being released  children often feel very uncomfortable.  They then find ways or strategies to reduce their fears and sense of helplessness. This is where the current scary behaviours have come from.

Most children have said they did not like home learning – this may be true . Nevertheless, home learning did slowly turn into a new routine.  The takeaway is: you don’t have to like something to experience it as safe and predictable.  

Many people are in a mindset of being ‘comfortably uncomfortable’: the Covid-19 pandemic has been tough, but they are getting through it day by day and adapting to each new situation or set of rules.  Trouble only begins when we become ‘uncomfortably uncomfortable’.  Does this feel familiar?

Why are children so ‘uncomfortably uncomfortable’ at the moment?

Going back to school meant kids needed to grapple with an altered routine.  Add to this, a new routine in a school environment that no longer seemed familiar.  Children felt uncomfortable about various things; the new normal did not feel normal at all.

Lots felt odd wearing a mask, although they understood it was necessary.   Being separated from friends in class bubbles was also weird.  Kids felt alone, yet were also worried about how to relate to friends after months of contacting them only on social  media. Worries about bringing back the virus to their family was another issue frequently reported in therapy.

Roll forward to now and there are new freedoms.  You can go to the shops, get your hair cut, and so on.  For kids with ASD or anxiety, these new freedoms are experienced as more stress on an already overloaded system. Many are unable to process the new changes. These new stressors are on top of their usual challenges and worries.  Their brains are overloaded. Too many stressors at once leads to hyperstimulation, meltdowns and nightmares for parents.

How to help your child with post-lockdown Covid-19 anxiety 

1. Structure changes very gradually – too many changes and changes too quickly causes problems in behaviour. The stress that too many changes causes is often released in meltdowns or other compensatory behaviours.  Compensatory behaviours are actions that make the child feel safe or release tension; these could be symptoms of meltdowns, repetitive behaviours like handwashing or cutting. The problem is that many of these behaviours can be dangerous and only provide relief for a short while.
2. Break down ‘desired’ behaviours into several chunks – you can then focus on ‘a chunk’ at a time. Each chunk needs to be practised several times before you move to the next behaviour.

For instance, if your child will not leave the house because it feels too scary or overwhelming, try the following steps: 

Step 1  Put coat on and head to the front door.

Step 2  Put coat on and walk to the car.                                                    

Step 3  Put coat on, walk to the car, and get in the car.

Step 4  Drive to the shops, park up, return home.

Step 5 Park up, walk to the entrance of the shop, and return home.

Step 6 Briefly enter the shop at a quiet time of the day, buy an item and return to the car.

You can increase the steps or slow them down; the speed depends on your child’s response. The key thing is not to be angry, stressed or disappointed if your child is unable to move through the steps as fast as you would like them to.  The calm, tortoise-like approach always wins the day. 

This slow and steady ‘tortoise’ approach also causes less hyperarousal and adrenaline responses. Lowering stress means  fewer ‘meltdowns’, fewer incidents of ‘magical thinking’ (for example, ‘If I wash my hands 100 times, I will be okay’) and fewer incidents of self-harm.

The secret is to practice each step until it is routine and boring. For each step, allow at least four attempts.

3. Make sure there is plenty of ‘downtime’ where your child can destress and relax – for those with sensory needs. such as ASD, this is the time to make sure you have a range of items to enable this.        

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk) and Lighthouse Psychology (lighthousepsychology.ie). 

Body-Focused Repetitive Behaviour Disorders: Skin Picking, Hair Pulling and More

 

Body-Focused Repetitive Disorders might not be a familiar term to you, but you’ve probably heard of skin picking or hair pulling: the two most common examples. These behaviours come about as reactions to stress or anxiety triggers, and we’re certainly not short of potential triggers as we emerge from the pandemic.

The range of conditions known as BFRDs are compulsive and can often be spotted in childhood or teenage years, so if you know someone who is suffering in childhood or adulthood, here’s what to look out for.

Compulsive Skin Picking (CSP) or Skin Picking Disorder (SPD) is also known as excoriation, or dematillomania. Patients become fixated on existing blemishes or skin traits, such as acne, freckles, scars or moles, and pick at them. They may also identify flaws or blemishes that aren’t visible to others; therefore, we can find links to Body Dysmorphic Disorder (BDD).

Hair pulling is also known as trichotillomania, and can be shortened to trich. Patients pull hair from their bodies – mostly from the scalp, eyebrows, eyelashes, beard or moustache, but also from other parts of the body where hair grows. It can lead to bald patches, sores, and feelings of shame around the lost hair and the habit itself. Hair pulling can even become an addiction.

Reality TV star Sam Faiers has spoken out about trichotillomania, which she experiences as a compulsion to pull out her eyelashes – something that has been a part of her life for over 20 years. She has had psychological support for the condition, and talking therapy has helped her understand where it all began in childhood.

Other BFRBs include nail biting and cheek biting. They are all impulse control disorders, and can be linked to Obsessive Compulsive Disorder for the repetitive and sometimes ritualistic actions that take place. Sufferers feel comforted when they maintain these routines of skin picking and hair pulling, even though their action causes physical pain, tissue damage, scarring, and possibly infection.

These kinds of disorders usually emerge in teenage years, but children and adults can also be affected. One American study found that 38% of those with Compulsive Skin Picking also experienced Compulsive Hair Pulling.

Treatment for Body-Focused Repetitive Behaviour

Talking therapy is an important part of overall treatment for BFRBs. Talking with a qualified therapist gives a patient the chance to understand the root cause of their behaviour.

Cognitive Behavioural Therapy (CBT) is the most recommended talking therapy for skin picking, hair pulling and other BFRBs. This gives clients the chance to talk about their behaviours and understand the core beliefs and thoughts connected to them – the thinking patterns that cause them to act in a certain way. These thoughts may stretch back months or years, and could be connected to certain experiences or interactions in their past. You may also wish to consider Acceptance and Commitment Therapy (ACT).

Patients also need to find ways to stimulate their senses – particularly touch – without causing pain. Some may use similar actions to picking or pulling, but in a non-harmful setting, such as gardening (weeding, hoeing, aerating, etc., can all be therapeutic), grooming pets, flossing your teeth, or knitting.

Self-care routines can also help – getting a manicure or pedicure, practicing meditation, aromatherapy, using fidget spinners or stress squeezers to distract busy hands, and so on. Make sure you remove any tools that have helped you with your compulsion to pick or pull in the first place – for example, abrasive products, nail scissors, or tweezers.

For Liz Atkin, drawing has helped manage her repetitive skin picking. It’s a way of keeping her mind and body occupied; she uses charcoal to create dramatic sketches. She has also become known for making these sketches on the go, and giving them to strangers on the London Underground.

Compulsive skin pickers may wish to see a dermatologist to help repair their skin, but it is important to be honest about the condition to get effective help. Dermatologists need to know that the patient’s skin is affected by the skin picking, otherwise they may be looking for another cause unnecessarily.

The most important thing is to speak out and seek help for BFRDs, because they can’t be managed alone – proper intervention can make all the difference to a patient’s outlook and recovery.

Written by guest contributor Polly Allen for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk) and Lighthouse Psychology. 

Online Workshop for Mental Health Professionals: Long Covid – Clinical Tools for Mental Health Staff

Friday 16 April, 10am-12pm – email info@ctpsy.co.uk to book

As we continue to deal with the coronavirus pandemic, we learn more and more about the lingering effects of the virus on some patients. This long-term condition, known as long Covid, is similar to many chronic illnesses with inflammation in a person’s system.

The Office for National Statistics recently estimated that 1.1 million people in the UK may be living with far-reaching long-term effects of Covid-19, months after contracting it; every one of those people will be relying on a network of helpers around them. Even 13% of children aged under 11 who contracted Covid-19 have experienced long Covid symptoms.

Counsellors and psychotherapists can take this opportunity to learn about the specific support that long Covid patients will need, and the crucial role that counsellors and psychotherapists can play in patients’ recovery.

Patients with long Covid experience a range of unpleasant symptoms, including ‘brain fog’, muscle aches, chronic fatigue, and depression. People of all ages can experience long Covid. Their symptoms need to be recognised quickly by professionals, so that a therapeutic plan can be put in place as soon as possible to support recovery.

This online workshop will help you work safely and manage the expected influx of Long Covid patients as clients. You will learn how to devise effective and ethical techniques that can help these clients.

It’s not just about surviving Covid; it’s about thriving in recovery, and that can be a slow and frustrating process, especially for patients who may have previously enjoyed good health and a high level of independence. They may have had to give up or reduce work or education; change or curtail their hobbies; change their home environment to adapt to their new needs.

Whether you’re a counsellor or a psychologist, you’ll find this session useful for your ongoing development. Through live discussion and breakout room tasks, you will learn:

• What long Covid is, and its mental, physical and spiritual impacts on patients.
• The role of the therapist in long Covid treatment and recovery.
• The difference between long Covid and other chronic conditions.
• How to undertake an accurate intake assessment.
• What an effective therapeutic plan looks like for these clients.
• How to get dynamic feedback from clients with long Covid.
• How to tweak your strategies to individual needs and progress.
• When to refer onto other professionals.

As mental health professionals, we need to respond quickly and flexibly to emerging conditions such as long Covid, and the best way we can do this is by learning remotely, to avoid travel time and unnecessary contact during the pandemic.

To book your place on this interactive workshop for Friday 16 April 2021, please email info@ctpsy.co.uk.

Seven of the Best Books About Grief

Grief affects us all, whether we like it or not, and whether we feel prepared for it or not, but a huge number of us have been affected by the loss of loved ones during the Covid-19 pandemic.

Talking about grief is important, and talking therapy can play a major part in this, but there will also be times when you don’t feel like talking at all, just listening, and this is when books can really help.

Mum’s Jumper, by Jayde Perkin

This book uses simple language and bold, colourful illustrations to explain what’s it’s like to lose your mum as a child. Each moment is explored, from hospital visits to finding out the news, attending the funeral, and learning to live without a parent around for those big and small life events.

Written as a first-person story, Mum’s Jumper is easy for children to relate to. The writer talks about emotions, but also the physical sensations of grief (‘my body ached, like I’d been swimming for days’). The publishers have also created notes for teachers, to help them use the book in lessons and with individual pupils who experience the death of a relative.

It’s Not Raining, Daddy, It’s Happy, by Benjamin Brooks-Dutton

Ben Brooks-Dutton’s blog, Life as a Widower, struck a chord with readers around the world; this book is an offline chance to connect to his writing and his messages to others dealing with bereavement. Ben was walking along the street with his wife, Desreen, and their two-year-old son, Jackson, when Desreen was struck and killed by a car in a shock accident in 2012.

This book also offers an honest perspective on being the lone parent of a bereaved child, being widowed at a young age, and also on the societal pressures of men to grieve differently to women.  

Grief Works: Stories of Life, Death and Surviving, by Julia Samuel

Those of you looking for a more practical guide than a memoir will find Grief Works invaluable. Author Julia Samuel is a psychotherapist who has spent several decades helping people deal with life’s difficulties, and this book focuses on our unpreparedness for death and grief – the fear that stops us accepting or normalising the issues at hand. As she puts it, ‘grief is work, extremely hard work’.

Packed with case studies, this book is full of useful information for the bereaved and those around them, including insight on coping with unexpected death, such as that of a child, and also on confronting your own mortality. There is also an accompanying app.

The Grief Survival Guide: How to Navigate Loss and All That Comes with It, by Jeff Brazier

The book is divided into chapters covering different grief circumstances, so it’s easy to dip in and out off. Jeff brings his own experience of parenting his two children through grief (his former partner, TV personality Jade Goody, died in 2009, leaving Jeff to raise their two young sons), and seeing his mother deal with the death of both her parents.  He also draws on the many clients he has seen as a trained counsellor and life coach.

Like the other authors here, Jeff is keen for people to communicate their feelings of grief, but he is particularly interested in neuro-linguistic programming (NLP), which is a type of therapy involving language and sensory perception. It is less popular than Cognitive Behavioural Therapy (CBT), and is generally used for quick interventions.  

Chase the Rainbow, by Poorna Bell

When Poorna Bell’s husband took his own life, she was – understandably – plunged into grief. However, this was an already complicated situation, as the couple had been going through a separation at the time, as her husband struggled with spiralling drug addiction he had kept hidden for years; an addiction that began as a way to self-medicate for depression. The layering of this grief is brilliantly explored in Chase the Rainbow.

Suicide is spoken about more openly these days than ever before, but the friends and family of those who complete suicide still face immense difficulty in processing their grief, and society still treats these deaths differently; for those left behind, it can feel as though they let down the person who died, and cycles of blame and negative self-talk can run riot. If you have lost a loved one to suicide or addiction, this book will really help you come to terms with what has happened.

The Madness of Grief, by the Reverend Richard Coles

The Reverend Richard Coles is a familiar and comforting presence on our TV screens and radios. Being a vicar, he is used to helping others with their grief and their reflections on death, but this memoir is a personal story of grief and becoming a widower. His partner, the Reverend David Coles, died just before Christmas 2019, aged just 43.

Suddenly, the Reverend Richard is confronted with an avalanche of ‘sadmin’ – the paperwork and procedures that are left to surviving close relatives when someone dies. The cause of the Reverend David Coles’ death isn’t revealed until some way into the book, so we won’t share details here, but you don’t need to have lost a loved one in the same way to appreciate The Madness of Grief. Rather than looking back years later, the book covers the period between the death and the funeral, when feelings are most raw.

The Adult Orphan Club: How I Learned to Grieve the Loss of My Parents, by Flora Baker

Losing both parents during your own childhood is undeniably traumatic, but what happens when you lose them in adulthood? Why don’t we talk about the pain of becoming an adult orphan? Flora Baker, who became an orphan aged 29, explores this complex and often overlooked topic.  

Flora looks at the immediate fallout after death, the practical tasks and legal issues you should know about, support networks, the potential of therapy, and much more. The Adult Orphan Club also has useful advice on how to communicate with someone whose parents have both died, and how to cope with this double bereavement in the long-term.

If you have any book recommendations that should be added to our list, please let us know via Twitter.

Of course, if you are grieving and would like to explore talking therapy with a professional psychologist, we are here to help. We have a range of therapy options which can be tailored to your needs, and we treat children as well as adults; family therapy is also available.

Written by guest contributor Polly Allen for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk). 

 

Online Workshop for Therapists: Working with PTSD in Post-Covid Patients

Friday 9 April, 10am-12pm – email info@ctpsy.co.uk to book

We’re excited to bring you another online interactive workshop for therapists, as part of our response to Covid-19 and the emerging needs of patients and the professionals around them.

Studies on patients recovering from Covid-19 have found a high incidence rate of Post-Traumatic Stress Disorder (PTSD). In fact, one recent study in February 2021 (Gemelli University Hospital in Rome, studying 381 patients, reported in JAMA Psychiatry) found that the rate of PTSD among post-Covid patients was as high as 30%, with many cases of patients having been ventilated during their treatment. In contrast, the normal rate of PTSD in patients subjected to trauma is 1-1.5%.

We should therefore make sure that therapists working with post-Covid patients have the specific skills and safety awareness to either assess their clients or refer on to other professionals. There are several risks to consider if patients aren’t treated properly, including prolonged suffering, worsened PTSD, and even possible claims of negligence brought against the therapist.

Our practical online workshop empowers and informs therapists, showing how to support and treat or refer this emerging client group. In just two hours, you will learn:

• How to accurately diagnose PTSD caused by Covid-19.
• When to treat your client and when to refer them on to another therapist or professional.
• How to construct a referral letter.
• Basic ‘holding tools’ to support the client when they need a referral. This will include a discussion about Eye Movement Desensitisation and Reprocessing (EMDR) and trauma-focused CBT.

Without timely and proper intervention to support clients, we know that PTSD can persist for years. Post-Covid patients will also need to manage their physical recovery at the same time. When we give them the treatment and tools to process and tackle PTSD, we also help their overall recovery from a life-changing virus.

The workshop will be led by Dr. Chrissie Tizzard, who has over 25 years’ experience as a clinical psychologist working with trauma-affected clients. She is also the founder of Christine Tizzard Psychology.

Book your place now by emailing info@ctpsy.co.uk.

Online Workshop for Health Professionals: Reducing PTSD in Frontline Staff During COVID-19

Friday 19 March, 10am-12pm – email info@ctpsy.co.uk to book

Are you a psychologist, therapist or line manager working with staff who are dealing with Covid patients? If so, you have probably noticed symptoms connected to trauma exposure.

This live and interactive taster workshop, led by an expert in civilian trauma, will help you identify potential symptoms of stress disorders, so you can work effectively in your own professional capacity and also refer on to other services where appropriate.

When we are repeatedly exposed to trauma, this can lead to the development of Acute Stress Disorder, or Post Traumatic Stress Disorder (PTSD). Some people won’t go on to develop a clinical condition, if they have adequate peer support or professional supervision to tackle the symptoms, but all are at risk.

Not all individuals working in this area will continue on to develop a clinical condition. For some individuals working in this field the availability of adequate peer and/or professional supervision is sufficient to diffuse the unpleasant symptoms.

What you will learn

In this workshop, we will explore:

• The definition of trauma experienced by civilians.
• Trauma scenarios and relevant factors.
• Separating normal responses to trauma from possible ‘red flags’ that suggest someone is at risk of developing a clinical condition, such as a stress disorder.
• Techniques, based on published research, that can be used with distressed clients before clinical symptoms develop.

About the expert

Our workshop leader is Dr. Chrissie Tizzard, who has over 25 years’ experience working with trauma in civilians, and has given lectures around the world on this topic. Her PhD was also focused on trauma, entitled Vicarious Traumatisation in the Helping Professions. She is also the founder of Christine Tizzard Psychology.

To book your place, please email info@ctpsy.co.uk.