Shame, self-loathing and low self-esteem: assessment and treatment on 13th July 2021

Shame based disorders are unique conditions characterised by symptoms from both the depressive and the anxiety spectrum; the treatment therefore requires a creative and comprehensive approach that undermines all these mixed and complex symptoms.

We view internal shame and self-loathing as the very foundation for low self-esteem which in itself poses a challenge and demands  a more holistic understanding of what it actually is…  is it a poor and very rigid evaluation of the self ? Is recent neuroaffective research corect in asserting that the amygdala highjacks the system in a social crisis ? Or is it also an overhelming sense of vulnerability around significant others.. perhaps all these factors play a crucial role. All covert and surface level difficulties will be explored during the workshop.

NA-CBT alongside the most recent CBT technology bring such an important contribution to the overall understanding and the treatment of shame and low self-esteem (LSE). CBT treatment protocols distinguish Depression from LSE and the “NeuroAffective” approach as well as the “Oxford model” (which we will be exploring in some depth during the workshop) are by far the best equipped treatment programmes for such conditions. One of the principle questions we shall try to answer right away is perhaps the most obvious: what are main maintenance mechanisms we need to understand and focus on during treatment ?

In any case.. How does low self-esteem affect us?

In a snapshot, one of the problems with thinking that we are not good enough is that we start to behave as if it’s true. Low self-esteem often changes an individual’s behaviours by forcing acts that confirm the person isn’t able to do anything and is not managing tasks very well. When one experiences internal shame, low esteem and low confidence (all inter-connecting domains) one would hide him-herself away from social situations, he/she might stop trying new activities or might even avoid challenging situations. In the short term, avoiding challenging situations makes you feel a lot safer. In the longer term, this avoidance can actually backfire because it reinforces your underlying self-doubt and fear of fitting in. It teaches you an unhelpful life rule that the only way to cope is by avoiding things. It may be important to mention that this is not necessarily ‘social anxiety’, which makes such conditions so difficult to diagnose or fit into a strict DSM (or ICD) type criteria.

Living with shame and LSE can harm your mental health because it leads to various other problems such as deeper states of depression, addiction or eating disorders.. over time, one tends to develop many unhelpful habits, such as over-eating, smoking, or drinking too much, as a way of coping.

The Oxford model for LSE and NeuroAffective-CBT

More links about NeroAffective-CBT are provided on this site; however in regards to the empirical approach developed at Oxford, Melanie Fennell and her colleagues from Oxford University (one of them being Mark Williams founder of Mindfulness Based Cognitive Therapy), have long established themselves as leaders in the field of CBT for low confidence and low self-esteem. The team have developed effective treatment programmes described as the “Oxford model” which will be discussed in some depth during the workshop alongside the NA-CBT approach.

The workshop therefore provides a solid practical and theoretical introduction to the neuroaffective and underlying mechanisms that maintain such complex conditions and offers detailed interventions that  disrupt the maintaining vicious cycles.


Panic Disorder: assessment, diagnosis and treatment via Zoom on 15th June 2021

Panic Disorder is an intensely distressing condition. If you haven’t experienced it for yourself you’ll have a hard time understanding just how frightening it can be. Panic attacks may occur a few times in a lifetime or many times a week. In my experience learning to assess for, and then treat, “panic attacks” is an absolutely critical skill for anyone working with anxiety and stress.

Panic Disorder is typically characterised by symptoms such as blurred vision, racing heart, inability to “catch your breath”, dizziness, a feeling of being unable to control oneself… this is rather different from the everyday use of the word “panic”, and generates a very real sense of danger.

The focus on avoiding danger and being safe can grow to a sense that one must not venture far from thw comfort zone and so there is often an association with agoraphobia. This can persist even after successful treatment of the panic disorder itself.

Prior to the cognitive-behavioural model that was developed, panic disorder was considered very difficult to treat. However it is one area of mental health where there has been great advancement and treatments have gone from “zero to hero” – with the latest treatment model enabling therapists to treat panic with a good degree of success. Notably treating panic disorder without agoraphobia is associated with very good outcome rates and is deemed one of the most successful treatments that has been developed.

However, people who have panic attacks but don’t have an anxiety disorder are at risk of developing mental health problems further down the line. Effective early intervention can therefore be very helpful and is surprisingly effective.

Panic attacks and panic disorder are surprisingly common. The 12 month prevalence for panic attacks is about 2.7% and the life time prevalence about 22%. Moreover in social phobia panic attacks or full blown panic disorder is present in 33% of cases or more.

What this course will do for you
The training covers a wide range of CBT topics from introductory through to advanced. The combination of lecture, case studies (video/audio analysis) and role play significantly develops skills and knowledge of CBT techniques and provides an effective and cost efficient investment in your professional development.

This training will provide a CPD Certificate (6 hours) signed by a senior BABCP accredited psychotherapist and lecturer as well as the principle of the college.