Trueform Therapy

Tag: mental health

  • Are Your Values Really Yours?

    If you’ve ever been asked to name your values, you’ve probably seen a list like this: integrity, freedom, compassion, growth, connection, adventure. You’re invited to pick your top five, and then live by them.

    It’s a reasonable exercise. But in the therapy room, I’ve noticed it often misses the harder question. Most people can pick five words from a list without much trouble. What’s much harder is knowing which of those words are really theirs, and which they picked up somewhere along the way, from family, culture or the people they needed to belong to.

    That difference turns out to matter a great deal.

    The Values We Inherit

    We don’t arrive at our values from nowhere. Many of them come from what we learned growing up: what earned approval, what was expected of us, what was simply “how things are done”. Some of those values fit us well. Others we carry around like hand-me-down clothes that never quite fitted.

    You can often tell the difference by the feeling attached to them. A value that’s genuinely yours tends to feel like something you care about. An inherited one often feels more like a rule: something you should do, and feel guilty or anxious about when you don’t.

    Psychologists working with self-determination theory, a well-established framework for understanding motivation, make a similar distinction. They describe some motivation as “introjected”: driven by guilt, pressure or the need for approval, as if someone else’s voice had moved into your head. Other motivation is “identified” or intrinsic: you do it because you value it, or because you genuinely enjoy it.

    Why It Matters Which Is Which

    In an influential 1999 study, the psychologists Kennon Sheldon and Andrew Elliot looked at what happens when people pursue goals for these different reasons. They found that people who pursued goals because they genuinely valued them put in more sustained effort and were more likely to achieve them. And reaching those goals made them happier.

    But the more striking finding was what happened with goals driven by guilt or pressure. People could achieve them, and still feel no better. Same goal, same effort, but a different reason behind it, and a very different result.

    I see this often. Someone builds the career they were “supposed” to want, earns the promotion, buys the house, and then wonders why it all feels so hollow. It isn’t that they’ve failed. It’s that they’ve succeeded at something that was never quite theirs.

    This is also why I think the question “what are my values?” connects so closely with belonging. When our sense of being accepted depends on agreeing with the people around us, it can be very hard to notice where their values end and ours begin. I’ve written more about that in How Belonging Shapes Our Thoughts.

    Values Are Directions, Not Destinations

    There’s another distinction that I find helpful, and it comes from acceptance and commitment therapy, often known as ACT.

    In ACT, values are understood as directions rather than destinations. A goal is something you can tick off: get a new job, run a 10k, call your sister more often. A value is more like a compass bearing: being a caring friend, living creatively, being honest. You never “complete” a value. You just choose, again and again, whether to move towards it.

    This helps because it takes some of the pressure off. You don’t have to overhaul your life to live by your values. You can move a little in their direction today, in a single conversation or a single choice, and that counts.

    Where It Hurts

    One of the founders of ACT, Steven Hayes, has made a point I come back to often: our pain and our values are closely linked. We tend to hurt most about the things we care about most.

    So if you’re not sure what you value, it can help to look at what hurts. What do you feel guilty about, or envious of, or sad to have lost? Loneliness can point to a value of connection. Frustration at work can point to a value of fairness, or creativity, or doing something that matters. Grief, in particular, is often love with nowhere to go.

    This can also explain why living by your values isn’t always comfortable. Caring about something means it can hurt you. And choosing one value sometimes means letting go of something else that also mattered. Choosing time with your family may mean letting go of a certain kind of career. Choosing honesty may mean disappointing someone. There’s often a small grief in these choices, and it’s worth allowing room for it, rather than pretending every values-led decision should feel good.

    Questions Worth Sitting With

    Rather than a checklist, here are a few questions you might carry with you this week.

    When you think about something you value, does it feel like a choice or a rule? If it feels like a rule, whose voice does it sound like?

    If no one would ever know or approve, would you still choose it?

    When have you felt most like yourself? What were you doing, and who were you with?

    What hurts at the moment, and what does that hurt say about what you care about?

    And when you look at how you spend your days, what values would someone guess you hold? How close is that to the values you’d name?

    There are no right answers. And it’s normal for your answers to change over time. Values shift as we grow, as our circumstances change, and as we let go of some of the expectations we were carrying.

    When It’s Hard to Know What You Want

    For some people, these questions are genuinely difficult. If you’ve spent years fitting in, keeping the peace, or adapting to what others needed, you may have had little chance to notice what you actually want. That isn’t a failing. It’s often what happens when keeping others happy has felt more important, or safer, than listening to yourself.

    Therapy can be a place to slow down and untangle this: to notice which values feel like yours, which ones you might be ready to put down, and what it might look like to live a little closer to what matters to you.

    At Trueform Therapy, I offer one-to-one sessions in person in Cardiff and online across the UK and EU. If any of this resonates, you’re welcome to get in touch for an initial conversation.

    If You Want to Explore These Ideas Further

    For a practical introduction to values as directions rather than destinations, Russ Harris’s The Happiness Trap is a clear and accessible guide to acceptance and commitment therapy, with plenty of exercises.

    If you’re interested in the psychology of motivation, Edward Deci’s Why We Do What We Do explains self-determination theory in a readable, personal way.

    And for a deeper, more philosophical exploration of how we choose what matters in a limited life, Oliver Burkeman’s Four Thousand Weeks (2021) is thoughtful, honest and surprisingly comforting.

    And if you’d like to look at the research directly:

    An introduction to values in acceptance and commitment therapy: Psychology Tools

    Sheldon and Elliot’s self-concordance model: summary

  • When Something Feels Off With Your Therapist

    Maybe it’s a small thing. Your therapist said something that didn’t sit right, and you nodded along. Maybe it’s bigger: weeks of sessions that feel like they’re going nowhere, or a sense that you’re not being understood. You notice it on the way home. You think about mentioning it next time. And then, next time, you don’t.

    Many people never say it. They keep going for a while, feeling a little worse about it each week, and then they stop booking sessions. Sometimes they conclude that therapy just doesn’t work for them.

    I want to suggest something different. That uneasy feeling is worth taking seriously. And saying it out loud, to your therapist, might be one of the most useful things you ever do in therapy.

    The Things People Don’t Say

    If you’ve ever held something back from a therapist, you’re far from alone. In research by Barry Farber, Matt Blanchard and Melanie Love, 93 percent of people surveyed said they had lied to a therapist at least once. Most often, it was out of embarrassment. But some of it was something else: wanting the therapist’s approval, or not wanting to cause problems. In other words, the same people-pleasing that brings many people to therapy in the first place can follow them into the therapy room.

    It doesn’t help that therapists aren’t as good at noticing when something’s wrong as you might hope. In one well-known study, therapists were asked to predict which of their clients would get worse. Out of 550 clients, they predicted three, even though they’d been told that around 8 percent of clients in their clinic usually did.

    So if you’re waiting for your therapist to notice that something isn’t working, you might be waiting a long time. That’s not because they don’t care. It’s because what goes on inside you isn’t always visible from the other chair.

    Why Saying It Can Help

    Here’s what I find most interesting about this.

    Researchers who study the therapy relationship, particularly Jeremy Safran, Christopher Muran and Catherine Eubanks, have looked at what they call “ruptures”: moments when the connection between client and therapist strains or breaks down, through a misunderstanding, a disagreement, or a sense of not being heard. You might expect ruptures to be bad for therapy. But their research suggests that when a rupture is noticed and worked through together, therapy tends to go better, not worse. The evidence is still fairly small, but it points in an encouraging direction.

    I see why in my own work. For many people, telling their therapist “that didn’t feel right” or “I’m not sure this is helping” is the first time they’ve ever said something like that to someone who matters to them, and had it heard rather than punished. If you grew up learning to keep the peace, to avoid disappointing people, or to hide your needs, then saying it in the therapy room isn’t a detour from therapy. It’s therapy, happening in real time.

    A good therapist will welcome it. They may feel a flicker of discomfort, as anyone would, but they’ll be curious rather than defensive. And how they respond will tell you a lot about whether this is the right person for you.

    Comfort Isn’t the Whole Story

    It’s natural to look for a therapist you feel comfortable with, and that matters. But “comfortable” can be a little misleading.

    Good therapy isn’t always comfortable. Sometimes it touches on things you’ve spent years avoiding, and that’s going to feel uneasy, at least for a while. Feeling uncomfortable isn’t necessarily a sign of a bad fit. Sometimes it’s a sign that you’re getting somewhere.

    The difference is in how the discomfort feels. Uncomfortable but safe is one thing: you’re finding something hard, but you feel respected, heard and free to slow down. Feeling judged, dismissed, pushed too fast or not taken seriously is something else. That’s worth paying attention to.

    A few questions can help you tell the difference. Do I feel listened to? Do we agree, roughly, on what we’re working on? Does the way we work suit me, or am I fitting myself around their approach? Could I tell them if something wasn’t working? If the answer to the last question is no, that in itself is worth exploring, with them if you can.

    What Experience Does and Doesn’t Tell You

    It’s easy to assume that the more years a therapist has been practising, the better they’ll be. The research is more surprising.

    In a 2016 study, Simon Goldberg and colleagues followed 170 therapists working with more than 6,500 clients over as many as 18 years. On average, the therapists’ outcomes didn’t improve with experience. If anything, they declined very slightly.

    That doesn’t mean experience counts for nothing, or that new therapists are better. Some therapists do keep improving, and specific training matters a great deal for some difficulties, such as trauma or eating disorders. But it does mean that years in practice on their own aren’t a reliable guide. It’s more useful to ask how a therapist keeps learning, how they check whether therapy is helping, and whether they’ve trained in what you’re looking for help with.

    Checking the Basics

    There are a few practical things worth checking before you start.

    In the UK, “counsellor” and “psychotherapist” are not legally protected titles. In theory, anyone can use them. The best safeguard is to check that your therapist is registered with a professional body that holds an accredited register approved by the Professional Standards Authority, such as the BACP, UKCP or National Counselling and Psychotherapy Society. You can search each organisation’s register online. Registration means they’ve met training standards, follow an ethical framework, have regular supervision, and that there’s somewhere to turn if something goes wrong.

    It’s also reasonable to expect a clear agreement at the start: how often you’ll meet, what it costs, the cancellation policy, and how confidentiality works, including its limits.

    And then there are the everyday practicalities: whether session times fit around your life, whether the cost is sustainable, and whether the location, or online sessions, work for you. These matter more than they might seem. Therapy that’s hard to get to is hard to keep up.

    One thing worth knowing: most therapists in private practice aren’t able to offer support between sessions in a crisis. If you need urgent help, you can contact your GP, call NHS 111 (in Wales, 111 and press 2 for mental health support), or call Samaritans any time on 116 123.

    If It Still Isn’t Right

    Sometimes, even after talking about it, the fit just isn’t there. That’s OK. It’s not a failure, on your part or theirs. People are different, and so are therapists.

    If you decide to end, it can help to have a final session to close things properly, rather than just stopping. Many therapists are also happy to suggest colleagues who might suit you better. And when you start again with someone new, you’ll know more about what you need, which is useful in itself.

    A Relationship Worth Getting Right

    The relationship with your therapist is one of the strongest predictors of whether therapy helps. That makes it worth paying attention to, and worth speaking up for.

    At Trueform Therapy, I offer one-to-one sessions in person in Cardiff and online across the UK and EU. I’m a registered member of the BACP, and I’ll regularly check with you how the work feels and whether it’s helping. If something isn’t working, I want to know. If you’d like to see whether we’d be a good fit, you’re welcome to get in touch for an initial conversation.

    If You Want to Explore These Ideas Further

    If you’re curious about what goes unsaid in therapy, Barry Farber, Matt Blanchard and Melanie Love’s Secrets and Lies in Psychotherapy explores why clients hold things back, and what helps. It’s written for professionals, but it’s readable.

    For a sense of what a good therapy relationship looks like from the therapist’s side, Irvin Yalom’s The Gift of Therapy (2002) is short, warm and full of practical wisdom.

    And if you’d like to look at the research directly:

    How to check a therapist is registered in the UK: Therapy Route

    Why people lie to their therapists: TIME

    Do therapists improve with experience? (Goldberg and colleagues, 2016): Society of Clinical Psychology summary

    Alliance ruptures and repair in therapy (Safran, Muran and Eubanks-Carter): summary (PDF)

  • Why Trying to Calm Down Can Keep You Anxious

    Anxiety is not a personal failing, a mindset problem, or a sign that you “can’t relax”. It’s your body’s threat system doing its job. Sometimes the visit is brief and useful. Sometimes anxiety arrives, puts its feet up on the coffee table, and refuses to leave.

    Most advice about anxiety is about getting rid of it: breathe, relax, think positive, calm down. Some of that advice genuinely helps. But there’s something about anxiety that much of this advice misses, and I think it explains why so many people try everything and still feel stuck.

    Sometimes, the harder we try to make anxiety go away, the longer it stays.

    What Anxiety Is Trying to Do

    Anxiety prepares you for danger. It makes you more alert, tenses your muscles, speeds up your heart and your thinking. That’s very helpful if you’re stepping out in front of an oncoming car. It’s much less helpful when you’re lying awake at 2am replaying a conversation from 2017.

    It shows up in the body as much as the mind: restlessness, tight shoulders or jaw, a churning stomach, a racing heart, shallow breathing. It shows up as irritability, as trouble concentrating, and as a kind of tiredness that surprises people. Anxiety is exhausting.

    For some people, it settles into more persistent patterns, such as generalised anxiety, panic attacks, social anxiety or phobias. These have different names and look different from the outside, but they share a common thread: a threat system that has become very good at spotting danger, and much less good at standing down.

    The Trouble With Getting Rid of It

    Here’s the part that often surprises people.

    When anxiety rises, it’s natural to do something to make it stop. We leave the situation. We avoid the next one. We check, reassure ourselves, distract, or reach for a technique to calm down. In the moment, it works. The anxiety drops, and we feel relief.

    But that relief teaches the threat system something. It learns: that was dangerous, and we only got through it because we escaped. Next time, the alarm goes off a little sooner.

    Psychologists call these strategies “safety behaviours”, and there’s good evidence that they play a part in keeping anxiety going. Even helpful tools, like breathing exercises, can work this way if we use them as an emergency exit: something we must do to get rid of the feeling, rather than a way of steadying ourselves while we stay.

    I want to be careful here, because the picture isn’t simple. A 2016 review by Shannon Blakey and Jonathan Abramowitz found that the evidence on safety behaviours during therapy is mixed. Used thoughtfully, some may help people approach things they would otherwise avoid altogether. So it isn’t that coping tools are bad. It’s that how and why we use them matters.

    The question to ask isn’t just “does this calm me down?” It’s “does this help me stay with my life, or help me escape from it?”

    Tools That Help, and How to Use Them

    With that in mind, there are things that genuinely help. Think of them less as ways to make anxiety vanish, and more as ways to bring your nervous system back within reach, so you can carry on.

    Start with the body. An anxious body struggles to listen to logic, so this is often the place to begin.

    Movement is one of the best-supported things you can do. You don’t need a fitness overhaul. Walking counts. Stretching counts. A large body of research has found that physical activity reduces anxiety, often noticeably.

    Sleep matters more than most people realise. A 2019 study by Matthew Walker’s team at the University of California, Berkeley found that a single sleepless night raised anxiety levels by up to 30 percent in healthy adults. It was a small study, but it fits with what many people notice. So aim for consistency rather than perfection, and be kind to yourself after a bad night. A poor night’s sleep is data, not a judgement. It tells you something about your capacity the next day.

    Regular meals help too. Long gaps without eating can bring on shakiness, a racing heart and irritability, which feel a lot like anxiety and can make it worse.

    Slow your breathing, especially the out-breath. Try breathing in for a count of four and out for six. If counting annoys you, just make each breath out a little longer than the breath in. That’s enough. In a 2023 study at Stanford, people who spent five minutes a day on “cyclic sighing”, a breathing pattern that emphasises long, slow out-breaths, saw greater improvements in mood than people who practised mindfulness meditation. The study was small and mostly involved young, healthy students, so it’s an encouraging sign rather than the final word.

    Tense, then release. Clench a group of muscles for a few seconds, then let go. Work your way around the body. This is less about forcing yourself to relax, and more about reminding your body what not tense feels like.

    Be curious about your thoughts, not convinced by them. Anxiety is excellent at presenting opinions as facts. Instead of “this will go badly”, try “I’m having the thought that this will go badly”. That small step back creates a little distance. You can also ask yourself gently: what’s the evidence? What else might happen? You’re not arguing with your brain. You’re just widening the view.

    Shrink the task. Anxiety loves vague, enormous goals. Break things into small, even boring, steps. Progress beats motivation every time.

    Moving Towards, Not Away

    Perhaps the most powerful thing you can do with anxiety is the least comfortable: gradually moving towards the things it tells you to avoid.

    This is the idea behind exposure, one of the best-researched approaches to anxiety. You approach what frightens you in small, manageable steps, and allow the anxiety to be there without trying to escape it. Over time, the threat system learns something new: I felt anxious, I stayed, and I was OK. That learning is what helps anxiety soften, not the absence of the feeling.

    Other approaches arrive at a similar place from different directions. Acceptance-based therapies encourage making room for anxiety rather than fighting it. And the existential psychologist Rollo May argued that some anxiety is simply part of living a full life: a sign that we’re facing something that matters to us, or stepping into the unknown.

    None of this means forcing yourself into overwhelming situations. It means small steps, at a pace that feels challenging but bearable, ideally with support.

    You Don’t Have to Do It Alone

    Anxiety tends to isolate us, and connection interrupts that.

    Talking to someone you trust can help, even if they don’t offer solutions. Being heard often takes some of the intensity out of anxiety on its own. Peer support groups can help too: there’s something steadying about hearing “me too”.

    Therapy isn’t a last resort, either. Cognitive behavioural therapy has particularly strong evidence for anxiety, and other approaches can help as well, especially when anxiety is tangled up with older patterns, with loss, or with questions about how you want to live. At Trueform Therapy, I offer one-to-one sessions in person in Cardiff and online across the UK and EU, and we can draw on whichever approaches suit you best.

    When It’s Worth Seeing Your GP

    If your anxiety is new, has changed suddenly, or comes with strong physical symptoms such as chest pain, palpitations or breathlessness, it’s worth seeing your GP. Some physical conditions, such as thyroid problems, as well as some medications and lots of caffeine, can cause symptoms that feel like anxiety. It’s always worth ruling those out.

    One Slower Breath

    Anxiety doesn’t disappear because you tried hard enough to make it go. It tends to soften when your nervous system learns, again and again, that it’s safe enough, supported enough, and not alone. Progress is often uneven. That’s normal.

    If anxiety is running the show, getting help isn’t weakness or failure. It’s a sensible response to a system under strain.

    And if today all you managed was reading this and taking one slower breath, that still counts.

    If You Want to Explore These Ideas Further

    If you’re interested in anxiety as part of being human rather than only a problem to fix, Rollo May’s The Meaning of Anxiety (1950) is a classic. It’s philosophical, but deeply humane.

    For a practical introduction to making room for anxiety rather than fighting it, Russ Harris’s The Happiness Trap is a clear, accessible guide to acceptance and commitment therapy.

    If you’d like a structured self-help approach, Helen Kennerley’s Overcoming Anxiety is a well-regarded CBT-based guide from the UK’s Overcoming series.

    And if you’d like to look at the research directly:

    Blakey and Abramowitz’s review of safety behaviours in anxiety (2016): RTI International

    How one sleepless night affects anxiety: ZME Science summary

    The Stanford study on breathing practices and mood: Simply Psychology summary