S01E08 Transcript: Dr. Julie Smith on Therapy

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intro

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Gemma Styles: Hello, I'm Gemma and welcome to Good Influence. This is the podcast where each week you and I meet a guest who will help us pay attention to something we should know about as well as answer some of your questions. This week we're talking about therapy; people's attitudes towards seeking help, education on how our minds work and how to start talking about mental health. Joining me this week is Dr. Julie Smith. Julie is a clinical psychologist who shares bite sized mental health and motivational videos online @drjuliesmith on TikTok, Instagram and YouTube. Her online audience has grown astronomically through 2020 as, particularly young people, have related to her videos and put her advice into practice. You might have come across her online sharing advice such as this:

[inserted audio from TikTok video]

Imagine you're at a train station and there are two trains you can choose from. One looks really old and uncomfortable. It looks unsafe, and you're not even sure it can get you there. But the other one looks flash, it looks luxury, it seems safe and comfortable. And they'll even serve you drinks. So of course, you sit down in that one and wait to leave. As you sit there waiting, you notice the old train coming and going several times and all these other people seem to be just getting on with their journey. But your train is stuck in place going nowhere. You begin to realise that to get to where you want to go, you're going to have to step off this comfortable train and take a risk with the old looking one. But now you're comfortable. So it's so much harder. So if you're struggling to make that move in life, try shifting your focus from how you want to feel now to where you want to be in the future and keep reminding yourself of two things. One, why you want to get there so badly in the first place. And two, that the discomfort along the way will be temporary.

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Gemma Styles: Okay, I’ll just shift myself sorry. I'm a fidgeter and it’s… not ideal.

Dr. Julie Smith: Me too. The fidget podcast. [both laugh]

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DISCUSSION

Gemma Styles: So before we dive in, and I start asking you too many further questions. Could you tell us a little bit about what your background is?

Dr. Julie Smith: Yes. So I'm a clinical psychologist, and historically worked in the NHS and then run a little private practice. But now I am offering sort of educational content really on social media around you know, Instagram, TikTok and YouTube, that sort of thing.

Gemma Styles: Am I right in thinking that something that's changed for you quite recently, maybe over the course of this year, really, that you've made that shift online?

Dr. Julie Smith: Yes, I really started last year, this time last year, actually. I'd been running a sort of small private practice. And a lot of the people who were coming along, I noticed didn't really need that sort of long term therapy, a lot of people would, um, a significant part of therapy is education, in which we teach people about their emotions and how their mind works, and how they can influence their mood and that sort of thing. And I found that a lot of people, once they had that education, they were ready to go. And they, they would do great. And a lot of them were saying, you know, I wish I'd been taught this in school and, and it was really kind of changing their lives. So I became quite passionate about making that information more available. And I think I was probably ranting on to my husband about it a bit too much. And he suggested I, you know, fix it and put something out there on YouTube or something. So we started to make a couple of posts and videos. And in the meantime, discovered TikTok, so started to do some really kind of small bite sized videos, because you're obviously restricted to 60 seconds. So really kind of, um, you know, condensing everything down into really small, simple messages. And, yeah, that was this time last year. So we're now on I think it's, you know, two, just over 2 million followers on on TikTok. So there's been a real, you know, in 2020, there's been a real shift towards, you know, people looking for that sort of information.

Gemma Styles: Yeah, I was gonna say that is kind of quite fortuitous timing of you moving all of this kind of stuff online. What with, the way this year is going a combination of you know, not being able to go and see people and… people have struggled this year a lot.

Dr. Julie Smith: Yeah, absolutely. I think there's something about you know, during lockdown, obviously, lots of people were switching on social media to connect with other people, but it's quite another step to then hit follow on an account that is exclusively about mental health, and psychology. So I think there's a real sort hunger for that information out there. And people were genuinely, you know, feeling uncertain, and, and dealing with lots of stress. You know, there's huge things that people have been having to deal with the last year. So I think it's a real sign that people are looking out for that sort of information at the moment.

Gemma Styles: Yeah, for sure. I feel like it is something that in the past few years, I mean, the conversation around mental health is partly shifting, I want to say but also just happening more often? I feel like people's attitudes to, to therapy and psychology are a bit more positive than maybe they would have been a couple years ago. Have you found that even before the pandemic, that people, did you sort of find an uptick in people looking for therapy beforehand?

Dr. Julie Smith: Yeah, I think it probably surprised me, when I left the NHS and started working private, in a private practice. I thought it would be, you know, really, really difficult to find people who needed or wanted that sort of approach. But actually, it really wasn't, you know, and, and lots of people were seeking that help. I think there's lots of shortfall in the NHS in terms of, you know, people falling through the cracks or not having enough of a service so maybe, you know, maybe in primary care where they're allowed to have maybe six sessions, it's not quite enough for someone, but they don't meet the criteria to go into the next mental health team. And so, and so they, those people tend to then come to private practice and say, I, you know, it wasn't enough. I need some more therapy. And, yeah, so absolutely. I think there was a, there has been a shift of the last several years probably of people just talking about this stuff more, you know, I think, that's something I've discovered as well being on social media is how many people are out there really bravely sharing their recovery stories, saying, Yes, my life looks a success. But I've also been through this really difficult time, and this is how I came through it. And that's really inspiring other people to then share their own stories about, you know, I'm struggling, or I did struggle, and this is how I got through it.

Gemma Styles: I think this is one of the things I kind of noticed at the moment, there are so many more people talking about mental health online, myself included, to be honest. And I think it's a funny narrative sometimes of how people take that. So you have found, I would say on TikTok, it’s majority, a younger leaning audience, I would say if, if you think that's right? I feel like people like to say a lot these days, you know, young people, they're all snowflakes. And they all think there's something wrong with them, and they all need therapy. Do you think actually mental health conditions are more common now? Or is it that young people just have better emotional literacy and know how to talk about what they're feeling?

Dr. Julie Smith: I think it’s a mix of both, I think life is changing life is very different, how it was, you know, 50 years ago, and, and there are added stresses and strains to that. And, but at the same time, people are feeling more able to talk about it. And so, you know, and there are more services there, too, who are picking up on things and, and diagnosing and more treatments available. So I think it's a combination of all of those things. And, you know, the old sort of snowflake comments is actually I would see it as the opposite when someone is brave enough to say, Look, I'm a human being, and I have struggled in the way that human beings do. And this is how I've got through it in order to help somebody else. I think that's the opposite of snowflake, I think it's really brave and courageous, to sort of make yourself vulnerable, in order to, you know, potentially help other people. I think that's a brilliant thing to do.

Gemma Styles: I couldn't agree more, I think it's, it's so important that people do talk about it. And I mean, even among my friends, kind of I know, there's just- I didn't know whether it was just because I'm getting a bit older. And we're all kind of realising that there's things that we need to work on. But there's more of my friends than ever, I would say, will, kind of like, just drop into a conversation or like, Oh, so my therapist, and you don't, you don't realise how many people are actually, actually using these services or actually, in need or getting a benefit from it. So I, I still think that, you know, the conversations need to be had so when people realise it is quite, quite an acceptable thing to do.

Dr. Julie Smith: Absolutely. And when someone does that, when they just drop into conversation, that they have had therapy or are going to therapy, and I just I think that's the way forward you know, it I kind of dream of a day when you could easily say, I've got an appointment my therapist just as easily as you say, I've got a GP appointment or I've got an appointment with my personal trainer, you know, these things that you do for your health and wellbeing, in my opinion, they should all be on a par with each other, you know, it shouldn't have any more stigma attached to be trying to enhance your mental health as it is to enhance your physical health.

Gemma Styles: For sure. Um- I recently shared on my Instagram stories, one of your posts, which was about anxiety, and it was what people see versus what's actually happening.

Dr. Julie Smith: Right.

Gemma Styles: I feel like I've been in pretty good grips with my anxiety for a while I kind of understand mostly how it affects me, but I still found it really helpful to kind of be reminded why some of my behavioural traits kind of make sense. And I had like a few people who I know kind of message me about it and say, that's so interesting. That makes so much sense for me. And I think it's quite reassuring, when you find that online content that just lets you understand a bit more of what's happening in your own brain. Do you think that's part of the mental health conversation that we need more kind of not telling people, you know, you're having this behaviour, there's something wrong with you, but just making people better able to understand their own behaviour?

Dr. Julie Smith: Oh, absolutely. Because I think awareness is such a huge part of change. And that's, you know, if I'm working with someone in therapy, for example, building that self awareness is probably that first big chunk of therapy, you know, so getting people understanding that when a certain feeling or a certain behaviour comes up, what's actually happening, what that means, because when you're in it, it's really, really hard to sort of see the wood for the trees. And when you're able to kind of see patterns or notice that that behaviour might mean that, or is associated with a certain emotion, then it gives you a kind of bird's eye view, it's like kind of seeing the map, rather than being in the woods. So um, and I think that gives you such opportunity to then change. Probably first in hindsight, you know, at the end of the day, you think I did that again today. But actually, over time, the more awareness you build, you're more able to then make different choices in the moment when you're stuck. So absolutely, those sorts of conversations are a really great move forward I think.

Gemma Styles: I feel like when I talk about mental health online, and when I've mentioned therapy before, because I've been to therapy, but one of the things people tend to ask is kind of how did you find your therapist? Or how do you go about it? How do you find the right one? Which I was really quite lucky in that respect, because I didn't have to find her. Only because the GP who I was seeing about it, within that practice, they had a psychotherapist who works there. So I just went to the therapist who was within that practice, didn't have to seek her out. And by you know, happy chance, got on really well with her, she was a good fit for me and X Y Z. But how- if you're kind of starting from scratch, and even if you haven't necessarily got a referral? How would you say you go about kind of finding the right therapist or finding a therapist for you?

Dr. Julie Smith: Sure, I think- I get lots of these questions from people around the world. And because mental health systems are different around the world, I can only really answer in terms of the UK and how we know it to be in England, but I would always say that's a first, you know, a good first port call is is to go to your GP and see who they are aware of in the local area, because they may, whether, you know, if you want to, for example, seek out a private therapist, and they may be aware of people in the area. But if you want to go through the NHS, then the GP is your first point of contact, and they will refer you on to NHS services, if that's necessary. But if you're looking for someone on a on a private basis, then yeah, start with the GP, but also, you know, get online and and look at people's profiles. And, you know, people advertise on all sorts of platforms, like the Counselling Directory or Psychology Today, those sorts of places. But really, you know, I think it's really important to have those first conversations. When I was running my, my practice, I would always, you know, allow people to have that sort of first telephone call for free, where you could chat for half an hour and just see if, if that felt, okay, and if you wanted to come along to that first appointment. So if you can get to, you know, give people a call, and just feel that out, have a conversation, you know, and see, if you, you feel able to have conversation with that person, that's probably a good sign to begin with. But also if you if you start therapy with someone, and then a session or two in you think, Oh, this really isn't working, this isn't for me, I don't click with this person or feel able to share with them, then you can stop at any point, you know, you're not sort of signed in and and can't leave. So I think it can be a bit of trial and error as to finding that person you can have a good relationship with because no matter what method that person is using in terms of the different therapies that are available, the, the strongest predictor of benefit is whether you connect with that person, and you can have a good quality therapeutic relationship. So yeah, just allow yourself to get to know someone and if you feel you can talk to them, then then that's ideal.

Gemma Styles: So when you say about the kind of different types of therapy, I don't know if this is just too big a question to ask but, are you able to give us a kind of overview of maybe some of the more common types of therapy or you know, common ways that people work?

Dr. Julie Smith: Sure. So I think you can, you can go to something like counselling, which might be a really good place to sort of offload each week and talk and get that reflected back and sort of that can really, really help to just get clarity on things. If you want specific goal based therapy, so if there's a specific change that you want to make, or a very specific problem, um, CBT (cognitive behavioural therapy) is a sort of umbrella term that's used a lot, and incorporates quite a few different approaches. But there's lots of evidence behind it, so it's widely available. It works for lots of different things, it often depends on the specific problem. But I think often when you go to, when you go to a therapist, for example, a psychologist is trained in lots of different therapies. So I'm biased because I'm a psychologist, but I think if you go to a psychologist, then they're able to make that judgement about which approach would be most helpful for you. And they can sort of tailor that and take bits from different therapies to, to piece together for the individual, which is really helpful. But yeah, there are lots of different approaches that- I really love a cognitive analytic therapy, which is that sort of CAT therapy for short, no cats involved, but it's really about kind of relationships. And I just, I've seen lots of people experience real positive change with that particular therapy, about how those early relationships can influence your adult relationships and how you behave in those relationships, the sorts of roles you take on. And so that's, that's a really nice therapy too. But in general, you know, different aspects of CBT are really evidence based. So for people struggling with things like anxiety, or low mood, um, it's a good first first therapy to try.

Gemma Styles: Yeah, I think it's definitely something that I've come across. So I think the first time someone sent me for CBT was I think, when I was at uni, and I'd gone to my GP, and they sent me to like a group CBT sort of session, which I think was mostly about anxiety, if I'm remembering rightly, but I really didn't like it at all. And I don't know if that was, you know, if it was the specific session, or if it was the fact that it was in a group maybe didn't suit me very well? But I just remember thinking like, for years, even before, because that was when I was at uni. So when I was maybe 19. And then I didn't go and have therapy, then until I was how long ago was that? Maybe 26, 27? But I remember thinking for, for years after I had that kind of group session that I was like, No, I don't like CBT. CBT is not for me. It just doesn't work for me. And then I don't think that's necessarily the case, because I think there were definitely some CBT elements of then the therapy that I had. So do you think it is more? I mean, you were saying it’s more about the person than about the particular style, right?

Dr. Julie Smith: Yeah. And and also, I guess you can I think that- this is a trouble, isn't it? With groups, some people really benefit from groups, because they get that sense of, Oh, I thought I was alone in this. And actually, all these other people seem to be struggling with something similar. So some people get that sense of, oh, we're all in this together and they make connections and then they feel that benefit of, of the group specifically. And other people don't, other people are in that place where they need an individualised, less, you know, groups are often more educational, aren't they? And you just taking your information rather than exploring your individual story. So sometimes you what you need is that individual one to one look at your personal stuff. And sometimes you need to take on board some skills and so groups are often better for those sorts of skills stuff, I think, and individual's better for for the more individualised stuff. So sometimes it's about group but also, I think you can have- I've had people who have had a sort of bad experience with maybe a CBT group or a manualised CBT, where they're on the phone to someone and that person is working through a worksheet with them or something. And it's just so far away from a sort of good quality sitting in a room and really talking out about your stuff. So yes, I think sometimes people can get a sense of, this approach isn't for me, and maybe they've had a kind of bad experience with that approach in a less than ideal situation maybe. So it can be a whole combination of things. There's a lot to get right. But when when it's right and and people get exactly what they need at the right time. It can be, you know, life changing.

Dr. Julie Smith: Yeah, for sure. When we're talking about these different kind of approaches. What would you say is the kind of technique that you're using or the way that you teach in the content that you deliver online?

Dr. Julie Smith: So I think it's probably really important to, to put out there, the stuff I put online is not therapy, so I don't think you can substitute for that, you know, one to one, talking with an individual, about your own personal life and formulating that and understanding that, but the parts of therapy that are more educational, so that sort of more generalised stuff about, okay, here's a technique you can use to calm anxiety here’s a breathing technique. This is what meditation is about. This is how your thoughts influence your emotions, those sorts of things that are general sort of psychoeducation. That's the stuff that I put online really, the stuff that can be applied to all of us, to help us understand ourselves better. And so they come from, sort of variety of approaches, really, lots of is, is CBT, or ACT therapy, which is Acceptance and Commitment Therapy, which is another sort of branch of, of CBT. And obviously, you know, the CAT therapy is more about relationships, which is difficult to teach on a more general level because it's so individual.

Gemma Styles: Yeah.

Dr. Julie Smith: But yeah, so it's really, it's really this sort of educational portion of something that may or may not be included in someone's therapy, rather than it being sort of a therapy as such.

Gemma Styles: Yeah. Would you say is a good thing to do? So if you're somebody who is thinking, I think I would benefit from therapy, but you're struggling to access it, either because you can't afford it, or the waiting lists are long, or at the moment you know, you want to go and sit in a room with somebody, but you're in a lockdown area, and you're not allowed to? Do you think seeking out these kind of resources on the education side is, is going to be beneficial?

Dr. Julie Smith: Absolutely, I think it's, if someone is interested in learning about their mind, whether they're struggling or not, then this stuff can really add to that. And if it builds the awareness around a few things, then then it can help. And I think the the feedback that I get sort of speaks for itself in some ways that, you know, lots of people come back to me and and say, or, you know, this particular video, or that, you know, bunch of videos have really changed my life because I'm, I'm using it, and I'm putting it into practice with my family. And this is, you know, the change that it's made. So, and really, the feedback has gone beyond what I ever thought it would be. So it's, it's absolutely doing something for people, they're using it to good effect. It's not always going to be enough for people, sometimes people just need to go to therapy. But I think the reality is, most people out there won't ever have access to therapy across the world anyway. And while certain therapies are available on the NHS, I think you have to probably be in the right place at the right time with the right problem to access it. Because it's so limited. You know, there are so few psychologists in the NHS, compared to what I think there should be anyway. So you know, yeah, I think it's, it's getting something- it's not ideal, you know, in an ideal world, we could all have someone we could go to and work through problems. But it's, it's it's my little kind of addition to the world if you like to put it out there and make it available.

Gemma Styles: Yeah, absolutely, I mean, that's, that's kind of what you were saying about why you started doing this in the first place. Right? Because you know so many people are going to struggle to access this kind of service.

Dr. Julie Smith: Yeah, absolutely.

Gemma Styles: Which is frustrating, right? Because it, it would be beneficial. I mean, I think, I'm one of those people, and everyone does this when they've been to therapy, you come out of therapy and go, Oh, everyone needs to go to therapy, everyone can benefit from this. But again, if it's, if it's not something you're able to access, then I think resources like yours are incredibly, incredibly useful.

Dr. Julie Smith: Yeah. And I think it's sort of, if it can help in a small way, I think I get a lot of feedback from people saying, Thank you, it's your, you know, particular video has encouraged me to seek help, and now I'm in therapy and finding it useful. So thank you. And if and if it's if that's all it's done, then fantastic, job done. You know, if it steers people in, in the right direction to start sort of managing their mental health in whatever way is most appropriate for them, then, I'm happy with that.

Gemma Styles: So you mentioned just before about, you know, people taking these ideas and sort of implementing them with family, which kind of leads me on to a video of yours that I saw recently was called What Not to Say: the Depressed Edition, which I enjoyed, and I really like the idea of it because I think part of what we really need in the mental health conversation and support that people need is not necessarily always for the individual, but sometimes more kind of helping people out who are in their life with how to communicate with someone who is struggling with something. I think it's, it's quite a common question that I've seen around of, you know, how do you help that person in your life? Who is the one who is struggling. So when we talk about therapy, I think you kind of think about, you know, it's the one person and their therapist who they're seeing. But it's hard to know how other people in their life do kind of get involved, like the onus is really on the individual. Is there any advice that you could give for kind of friends or family members on how you support someone who's either in therapy? Or who is struggling, but doesn't want to go?

Dr. Julie Smith: Absolutely. Well, I think the first thing I would say, to people who are caring for someone who's struggling with their mental health is, is don't be afraid to seek your own help. Because it's a big deal caring for someone who is really struggling, it takes a lot. And it, it can take its toll on people. So you know, I've known lots of people over the years who've been in therapy, because they are the primary carer for someone who is really struggling with their mental health. And, you know, if you, if you can look after yourself, then you're going to be in a better place to look after that person and support them in the best way. In terms of the things like, you know, what to say? I think it's, a lot of people don't say anything, because they are so worried about saying the wrong thing.

Gemma Styles: Yeah.

Dr. Julie Smith: And so they kind of freeze, and they don't know what to say. And then there's, that can create sort of disconnection between the two people, because they don't know how to communicate with each other. But I think in some ways, you know, take the pressure off, you don't have to say anything hugely profound or wise, that's going to solve this whole problem and enlighten them to the you know, the way forward, you just have to let them know that you care. That, that you have their best interest, and you want to support them in the way that is most helpful for them. And encourage them to then communicate with you, you know, ask them, How, how can I support you, I really care for you, and I really want to support you. I'm not sure how to do that, this is new to me. What can I do that's helpful? You know? Do we just sit together in silence? And, you know, watch a movie? Or is that you know, would you like to go out for a walk with me? And, you know, allow that person to take the lead and let you know, what they need and what they find most helpful. And what they don't find helpful. Take away that pressure to fix it all. Because you can't.

Gemma Styles: Yeah, definitely, yeah. You know, it's going to be really difficult for anyone who doesn't have a background in any of this to suddenly, you know, if someone comes to you and says, I'm really struggling, then yeah, you're never going to know, like, how to fix it straight away. But I don't think fixing it straight away is really what people are looking for most of the time.

Dr. Julie Smith: Yeah, absolutely. I think most people just want to be heard, and feel cared for and feel understood. And so just sort of being alongside someone while they're experiencing it, and not feeling that pressure to, to make it all better now. I think when we, when we see someone in distress, it causes us distress. And so the tendency is then to, to try and make it all go away in the moment. So saying something to change the subject, or, you know, at least it's not as bad as such and such down the road, or those sorts of comments that, really, um, you know, and I totally understand that because it's that person, probably feeling upset at seeing someone upset. And so just trying to kind of, you know, pat on the back and make it all better in the moment. And actually, sometimes you just need to sit with someone in that feeling. And it will, it will pass it will come back down again. Just the process of showing someone kindness will help that emotion to come back down.

Gemma Styles: Yeah. Is there any kind of advice you would give to someone who- I'm kind of thinking here, especially because of how your educational content has kind of resonated with younger people, particularly… Have you got any advice on how people sort of have that conversation, if you are the one who's struggling and you don't know how to talk to someone about it, whether you know, there's a friend you want to talk to or if you are younger, there's maybe more chance you still live at home with your parents. So if you're not sure how to broach that conversation, is there any way that you would suggest to start to kind of bolster your own safety in being that vulnerable?

Dr. Julie Smith: In terms of sort of looking after yourself if you're about to have a conversation with someone?

Gemma Styles: Yeah, I think looking after yourself, but also just how to start that conversation because I think that's something I didn't, I didn't know how to say to my mum. Mum, I'm really, really sad for a long time. Like, I just didn't know how to start that because you almost feel bad. Well, I almost felt bad telling my mum how awful I felt.

Dr. Julie Smith: Yeah, yeah, absolutely. It's a big deal, isn't it? And I think sometimes people think that, when they have that conversation, it has to be very formal. And they have to sit down and unravel everything and all the details. And and I don't think it really has to be that way, I think you can, you can do it in any way that feels doable for you, you know, if you need to reach out, but you've just cannot face anyone and say it out loud, then send a letter, send a text, send an email and say, as little or as much as you feel able to and let them know that you're struggling and how they might be able to support or whether you can then have a conversation after that. And, you know, reaching out is the most important thing, how you do it is down to the individual. Is whatever you feel capable of doing.

Gemma Styles: Yeah.

Dr. Julie Smith: In terms of starting those conversations, I think sometimes conversations can be easier for people when when they're not sort of sat face to face, as well, sort of over a table or something, you know, go out for a walk with someone. Sometimes that can just feel so much easier to start talking about something because you haven't got someone sort of eyeballing you and yeah, and then just to start with something very simple, you know, a simple summary that, you know, I've been struggling recently. And yeah, and then that person can then sort of begin to ask you questions, for example.

Gemma Styles: Yeah, I think kind of starting those conversations quite gently, could kind of be a good idea as well, in terms of, you know, if you start a conversation saying, I'm really struggling at the moment, and kind of don't offer too much more, I think being able to judge what you get back from that person is probably going to be quite helpful as well, in terms of, you know, if they're instantly like, Oh, are you okay? Like, what's what's going on? What, what can I do to help you? Then that's probably a good person who's going to be able to, you know, maybe take on board this conversation and sort of help you figure it out a little bit. Whereas if somebody is just not really open to the conversation, maybe you know to choose somebody else?

Dr. Julie Smith: Absolutely, it's all a sort of process of, of testing the water isn’t it, and sort of seeing whether you can trust someone with it, because you don't have to share your story with everyone. And, and I think people have to earn it almost with, with that trusting relationship. So you can test it out a little bit and, and tell them a little bit about something, and, and see what their reaction is. And if it's something that you would then feel supported by, then you can tell them some more. And absolutely, I think, you know, do it bit by bit and judge as you go, um, about whether you want to continue and tell them more. But, you know, finding someone, if there's no one in your life, then that you feel you can trust, it's really important to reach out to a professional and, you know, go to your GP, or find a counsellor, or someone privately if that's the situation that you can access, so that you just have someone to go to. You know, with the professionals, their job is not to judge, is not to shut you down. So if there's no one in your life that you trust, I think, you know, definitely go and seek out a professional.

Gemma Styles: Yeah, I think that's probably a good moment to mention as well when we say there, you know, if there isn't somebody in your life, and you don't feel like you can get to you know, your doctor for whatever reason. There are also- there's more and more services now where you can call someone or text someone like the text service that we have here in the UK now called Shout, the crisis text line where you know, if you're in a bad spot, I think it's 85258 the number and I think I just like to mention it to be honest, because I really hate to think of people who are you know, in that situation, and they think, I feel really terrible, but I don't have anyone to talk to and I actually can't get to a doctor right now. There are still options.

Dr. Julie Smith: Yeah, absolutely. And, but you know, people like Shout and the Samaritans, they, they are well trained, and they're there to listen. And the process of talking is helpful in itself, it helps you to begin to unravel some of the things that when it's all stuck in your head feels really confusing. And it's hard to, you know, see through it all. But when when you start to talk, it is a process of beginning to understand what's going on. And not instant, but it but it just talking is helpful in itself even without, you know, a structured therapy. So talking and if and if, if talking feels too much at the moment, then also writing things down can be really helpful. That sort of expressive writing where you just get out onto a page, and then it can really help to sort of process whatever emotion is there and begin to sort of make sense of things.

Gemma Styles: Yeah, I think that's completely right. I think, even in my experience, [laughs] trying to remember now where I'd first started trying to talk to anyone about anything about how I was feeling, as soon as I would start talking, I was just in floods of tears and couldn't talk at all. And I kind of thought at the time, like, well, how am I ever going to sort this out if I just can't even talk about it. But once you start talking about it, it does get easier to carry on talking about it. I think that's the main thing. So even if it feels really hard at the beginning, it's worth doing.

Dr. Julie Smith: Did you do it into the small chunks? Like you were saying, where you just sort of put something out there, short summary, and then come with details later?

Gemma Styles: Yeah, I think so. I felt like when it was kind of, you know, private conversations, I'm trying to think- it would be, I feel like at the beginning, it would be somebody would kind of ask me what was wrong. And I would just cry, and not really be able to tell them anything, and then have to go back later and kind of say, actually, this is how I've been feeling a little bit. I think it's a bit of a, was a bit of a sort of floodgate of emotions. And then you have to revisit it at a time when you feel a bit calmer.

Dr. Julie Smith: Yeah. And I think that's it isn't it, once you, if something has been sort of held in for a long time, then there's going to be an initial sort of rush of emotion isn't that and once that's allowed out, then it becomes so much easier to sort of breathe through it and start talking. And often people experience that actually, when they first go to therapy, it's not unusual for people to spend that first hour or two, in floods of tears, just because it feels like a safe space. And so it all rushes out. And then and, and people sort of apologising their way through it. And, and but it's normal, you know, that if you've been holding something in for a long time, it needs to come out, and then you can begin to process everything else. So also, you know, if people feel like, gosh, if I start talking, it's all just gonna unravel, and I'm not going to be able to stop crying, then, that's okay. That's really normal. And any therapist who is in any way experienced will just be absolutely used to that, and it's part of the job.

q&a

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Gemma Styles: Every week, I'll be asking my guest some of your questions. And the first one comes in from Tiff. She says,

I'll fixate on something, for example, that a certain person doesn't like me, and it snowballs to the point that then I fear seeing that person and there must be something wrong with me if they don't like me. How can you stop repetitive thoughts like that?

Dr. Julie Smith: When it's with with thoughts that you don't want to have. The the idea of trying not to have them can sometimes become the problem. So, so the more you try not to think about something. So if we said now, it's that sort of classic experiment of just try not to think about a pink elephant right now just think of anything except a pink elephant. Yeah, and you're thinking about it. So we don't do negative. So the minute you try it, that's why most diets don't work. Because people say, I'm not going to go in the fridge and eat that chocolate, I'm not going to do it, I'm not going to do it. And so you're thinking about it all day. And so, you know, trying not to have a thought is, is almost impossible, but it's really about allowing those thoughts to come, and then listening to them and doing something with it. So responding to it differently. And that's where therapy can really help with that sort of thing is, is allowing you to understand why you might be worried about something like that, what you know, what's going on for you, that causes you to worry so much about that, and then addressing the problems in different ways. So, you know, because the thought will perhaps be just one, one symptom or sign that something's not quite, you know, as it should be there, that, that she's, you know, maybe feeling kind of worried about friendships or something else. And I guess, you know, I can't sort of comment on individuals without, you know, first doing a full assessment and understanding that context-

Gemma Styles: Of course, yeah.

Dr. Julie Smith: But in general, you know, trying not to have a thought is futile. And then we end up becoming almost obsessed with that thought or it becomes intrusive, because it just keeps coming. Whereas changing our relationship with it, allowing it to come and then looking at it in more detail. And, and doing something different with it is the way forward.

Gemma Styles: Okay, thank you. Next question is from Andy, who says:

I'm really struggling with having so many unanswered questions at the moment. How can I stop myself feeling so out of control of everything around me?

Dr. Julie Smith: Yeah, I think this is a big one for for lots of people, isn't it in 2020, there is just so much uncertainty, the life that we perhaps felt we had some level of control over or some level of predictability. That all that seems to have just gone out the window and so people are dealing with such uncertainty about the future and livelihoods and, you know, finances and all of those sorts of things are all suddenly really uncertain. And I think being able to sit with that is is a real skill. But it's okay to not feel okay through that as well. The, the answer isn't just to have control of everything. Because we can't control the things we can't control. You know, it's nice to focus on the things that you can control in that. So, you know, looking after yourself as much as possible, when you're living in an uncertainty, it causes you stress, it switches on that threat response. So all of those basics become all the more important. So making sure you're really looking after yourself, getting good sleep, having a good routine, a good diet, so eating the right things at roughly the right times each day. And, so, and having exercise. So moving your body and doing what your body was built to do, all of those things are sort of foundations to positive mental health. So if you can be going back to those basics every day, and adding in one thing that helps, then all of that is going to help you to deal with the sort of complicated context of of life and that uncertainty. And it can make a huge difference. I think they, they are basics, so people underestimate how powerful they can be. But those four things will often be one of the first things that I will talk to people about in therapy is, is Where are you at with those, you know, are you sleeping? Or when do you exercise? And, you know, what is that diet like? Are you kind of on caffeine all day, and then can’t sleep at night, all those sorts of things can can really have a huge difference. So yeah, take it back to basics when life is is really difficult as it is at moment for lots of people.

Gemma Styles: Next question is from Louise, and she asks,

Sometimes I'm on my phone when I can't sleep, and I scroll, I scroll and I scroll before I realise an hour or so has passed. Is this an addiction?

Dr. Julie Smith: It certainly can be, you know, social media platforms are built, they're not built for your wellbeing they're built to hold your attention for as long as possible. And they have refined that process down to a tee. So it certainly can be and you you almost get into a sort of zone don't you where you're scrolling and you're not really aware that you're scrolling, you're just, just doing it. And time can pass and so, um, having your phone as far away from your bed as possible, is a good thing for sleep. And, and sleep is just I just cannot stress enough how important it is for good mental health, you've only got to have one bad night and it affects the next day. But if you're, if you're doing that on a regular basis, and you're not getting enough sleep on a regular basis, you know, sleep deprivation is used as a form of torture for a reason. [both laugh]

Gemma Styles: Right.

Dr. Julie Smith: It's really not good for our emotional health, our psychological health. So, you know, if you if you feel that you can get yourself an alarm that's not your phone, and leave your phone downstairs on silent, so that you can get that really precious time to rest.

Gemma Styles: Okay, that’s a good one. And then last question from Claire, more about therapists than therapy. [laughs] She asks,

How do therapists deal with their own shit while being a therapist? How do they keep things separate? Do you have to be a certain level of stable to be a therapist in the first place?

Dr. Julie Smith: Well, yeah, a lot of therapists have their own therapy and, and we all have to have our own what we call clinical supervision. So you know, you meet up with another therapist or psychologist who's doing same sort of work as you and you share ideas and and work on, you know, how to, you know what to do next with someone, or new research that's coming out and trainings you've been on, that sort of thing. So that ensures that you're you're doing your job really well but also can help you identify if you're struggling something yourself, because things come up, you know, therapy is like nothing else and, and, and things can get triggered and emotions can come up and and so during our clinical training, we're all taught that you need to look after yourself along the way and, and you can't you can't substitute that you have to prioritise your own health as much as as everybody else's. So it's really important and yes, it lots of therapists will have their own therapy, as well.

recommendations

Gemma Styles: Remember, if you want to get in touch with us or have any questions for future episodes, email me at goodinfluencepod@gmail.com. Before you go, I've got three things I ask of every guest and that's if listeners want to find out more about what we've been talking about… Could you give us something to read, something to listen to and something to watch, please? What's something that we could watch?

Dr. Julie Smith: So something to watch, I guess if someone is interested in learning a bit more about, you know, mental health and that sort of thing. My videos are probably a great place to start.

Gemma Styles: Absolutely!

Dr. Julie Smith: So, but also things like TED talks are a great place to start the you know that, where there are lots of great researchers out there. And TED Talks give them a good platform to begin to talk about some of their research, and there's lots on mental health. So that would be a good place to start as well. And from there, if you really click with an idea, you can then you know, often these people have books that you can kind of go and buy and things like that. So, yeah, either, either my videos or things like TED talks are great.

Gemma Styles: Perfect. And speaking of books, is there something you'd recommend us to read?

Dr. Julie Smith: Yeah, absolutely. And it's not? I don't think there are, you know, I'm not going to sort of recommend any therapy specific books, because I think it depends on your problem and the thing you want to look out and the approach you want to take on, things like that. But there's a book called Mindset by a lady called Carol Dweck. And I've done a few videos on on growth mindset and fixed mindset. And I think if you are even considering the idea of therapy, something that really helps is being able to open up to the potential for change. So if you kind of tell yourself that this is just how I am, I've struggled with this my whole life, so it's just unchangeable, it's unfixable, then you're unlikely to even go to therapy, let alone sort of find the benefit. And so you're more likely to seek therapy and benefit from it, if you are able to, to see that potential for change. And that book, Mindset, is all about, you know, the the potential to to improve at something, or change things and it's the sort of the, the neuroplasticity if you like so each each time you have a new experience your brain changes to accommodate that. And and, and so there is potential for improvement on everything with enough effort and practice and learning. And Carol Dweck really sends that home with just brilliant research. So it's a really good place to start to sort of get you boosted and ready to think about positive change.

Gemma Styles: Okay, that sounds like a really good one. And then finally, a recommendation for something to listen to please.

Dr. Julie Smith: Um, listening- I love to listen to the Rich Roll podcast, he's um, he's an ultra athlete, so he's not a therapist or anything. But he talks a lot about wellness and there's lots of, he interviews some great people, it's quite thought provoking and inspiring and, and it's all about you know, sort of looking inwards and reflecting on different parts of life and how we can improve them and make them better. So that's a that's a nice place to start, I think.

outro

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Gemma Styles: Thank you for listening to Good Influence. And thank you, Julie, for joining me. If you've enjoyed the episode, please take a minute to subscribe to the podcast on Global Player or wherever you're listening. And if you're feeling generous, rate and review us too. It's really appreciated and helps other people find the podcast. See you next week.