Dr. Sugarman has worked with clients presenting with a range of different difficulties. Some of the more common presenting problems that people seek psychological support for are listed below, with details of how they can affect peoples' lives and how therapy may be of help.
Your problem may not fall under the categories listed, or it may be that you are not sure how to describe what is bothering you at the moment. Please get in touch to discuss your difficulties further and see whether psychological therapy may help you to live the life you want to live.
Dr. Sugarman is able to offer psychological therapy remotely via Zoom if you are not able to attend in person or would prefer not to. She asks that you attend an initial assessment session in person, then subsequent sessions can be held remotely.
Phobias are common, and do not always require treatment. However, if you are experiencing disproportionate anxiety in relation to a particular situation or trigger, and it is getting in the way of your life, addressing this through treatment could help you to face things that you have been avoiding and reduce any associated impact on your quality of life. Psychological therapy has been proven to be extremely effective in the treatment of specific phobias.
Obsessions and compulsions (OCD)
OCD is a chronic disorder in which people have distressing intrusive thoughts, to which they respond with compulsive actions. These may be mental/covert (e.g. going over and over a situation or question in your mind) or overt (checking the door is locked or the cooker is turned off repeatedly). OCD can present in a variety of different ways, from fears about contamination and cleanliness to repeated, intrusive thoughts about harming or hurting others. OCD can be extremely debilitating, and can lead to significantly reduced mood and quality of life. Psychological therapy can help people experiencing symptoms of OCD to better understand the causes and maintenance factors. Dr. Sugarman can support you to understand the OCD and learn techniques to gradually free you up from compulsions and the associated anxiety and distress.
Social anxiety in is relatively common, and generally occurs as a consequence of fears of being judged by other people. It is natural to experience anxiety in certain social situations, particularly when we feel as though we are on display (e.g. public speaking) or when the stakes are perceived to be high (e.g. meeting new people or being evaluated in a work environment). However, social anxiety becomes a serious problem when worries about your performance or other peoples' judgements leads you to avoid social situations entirely or tolerate them under extreme distress. Psychological treatment can assist you to understand the mechanisms of the anxiety and develop more useful ways of coping so that you can approach social situations or new challenges at work with enjoyment, without worries getting in the way.
Low Self Esteem
Self esteem is how you judge your own worth. For many people, a negative self image poses a huge barrier to getting where they would like to be in work, social situations and romantic relationships. People may constantly worry about their competence at work, or about the likelihood of rejection from friends or partners.
It is natural for changes in health to provoke some anxiety, and everyone will experience this from time to time. However, for some people, worries about health take over their lives so that it is difficult to focus on anything else or enjoy anything. Although the physical symptoms people are experiencing are real and extremely distressing, unhelpful ways of coping can exacerbate and maintain the associated anxiety. Cognitive Behavioural Therapy can help people to identify how the health anxiety started, and understand how it has been maintained by processes that are intended to reduce distress. Dr. Sugarman has worked with many clients to reduce anxiety about their health, supporting them to learn the tools to manage ups and downs around physical health as they happen.
Relationships are complex, and require understanding and commitment from both partners to continue to function in the face of life stresses. People may experience significant changes in mood as a result of ongoing conflicts or due to the end of a relationship. Many people also experience distress due to diffculties in finding an appropriate partner.
Adjustment Difficulties (e.g. to changes in life circumstances or the diagnosis of a long-term health condition)
As we go through life, our minds try to navigate any changes to our environments, interpersonal relationships, work and health as best as they can. Significant life changes can make it difficult to use the coping mechanisms that have always worked to keep us well, and as a result, we may experience increased worry or a change in your mood. Therapy can help clients to identify how they can maintain their wellbeing in new or challenging situations, identifying areas of strength and resilience and drawing upon these to best cope with changes.
Anxiety is an evolved response to threat, and all of us experience anxiety from time to time. When worries become overwhelming, people may find that it is taking up much of their time. People may find themselves worrying disproportionately about things that they cannot control, or even worrying about worrying. Psychological treatment can help people experiencing significant levels of worry to learn techniques to understand and manage worry better so that it does not have such a big impact on their life.
Depression or Low Mood
Fluctuations in mood are a normal response to life events, and there are some situations in which we might expect more prolonged bouts of low mood. Low mood becomes more concerning if it is chronic (e.g. lasts longer than two weeks, or keeps coming back) and affects our motivation and ability to derive pleasure from things we used to enjoy. This can lead people to withdraw from social activities and neglect their self-care. If left untreated, clinical depression can seriously affect someone's social and occupational functioning. It can lead to deterioration in their physical health and, in some situations, can cause people to feel suicidal.
Panic attacks are sudden, intense episodes of anxiety that lead to physical symptoms such as heart palpitations, chest pains, dizziness and breathlessness. Panic may present in a number of different ways, and it can be difficult for medical professionals to initially identify panic as the cause of physical symptoms. Panic may or may not be accompanied by agoraphobia (fear of being in places that are crowded or difficult to escape from)
Everyone has different thresholds and triggers for anger, and when anger is kept under control, it does not interfere with peoples' lives and relationships too much. However, some people describe noticing that they have more of a short fuse than they used to, and working on this can help them to reduce conflicts and enable them to manage situations more calmly and effectively.
Body Dysmorphic Disorder
People with Body Dysmorphic Disorder (BDD) believe that one or more parts of their body is significantly flawed, and they become very preoccupied with thoughts and worries about this. They may engage in a number of behaviours to try to change their body, or they may avoid or try to manipulate situations where the perceived flaw may be visible or noticeable to other people. Examples include being preoccupied with the appearance of one's hair, weight or the appearance of particular body parts. BDD often occurs in conjunction with other disorders such as social anxiety and depression.