A man sits on his couch thinking about action. There is a particular kind of frustration that comes from understanding yourself very well and still being stuck. You know why you do what you do. You can trace the patterns back to where they came from. You understand the mechanisms maintaining them. You may have spent months or years in therapy, or reading, or reflecting, developing a clear and accurate account of what is going on. And yet the thing you want to change has not c

We all carry a story about who we are. Not a conscious narrative we have deliberately composed, but a working account of ourselves that operates mostly in the background: the kind of person we are, what we are capable of, what we would and would not do, what we deserve and do not deserve. Most of the time we do not experience this as a story. We experience it as simply knowing ourselves. It feels like accurate self-knowledge rather than a constructed account, and that is prec

Social anxiety is one of the most common and also most limiting of the anxiety difficulties. It can also one of the most misunderstood, both by the people who experience it and sometimes by the treatments offered for it. Many people with social anxiety know, at some level, that their fears are out of proportion. They know that the presentation probably went fine, that most people are probably not scrutinising them as closely as it feels, that the conversation they are still r

Obsessive-compulsive disorder is one of the most misunderstood conditions in mental health — often by the people who experience it, and by those around them. It is also very treatable, when approached with the right methods. This post explains what OCD actually is, what evidence-based treatment involves, and how both CBT and ACT can be used to address it. What OCD actually is OCD is characterised by two things: obsessions and compulsions. Obsessions are intrusive, unwanted th

There's a particular kind of stuck that's worth talking about, because it's common, it's frustrating, and it's rarely discussed honestly. It's the experience of understanding your difficulties clearly, perhaps better than most people understand their own, and still not being able to change them. You know where the anxiety comes from. You can trace the patterns back to their origins. You understand how your childhood experiences shaped the way you relate to others, to yours

Understanding Emotional Flatness Emotional flatness isn’t always a sign of disorder. Sometimes, it’s a functional adaptation. In roles that require high responsibility, emotional control is essential. Distress isn't acceptable in these situations. After all, colleagues and clients rely on you to keep going. These high-pressure environments can evoke painful feelings that are hard to manage. Consequently, many people learn to suppress their emotions, maintain composure, and fo

Exposure therapy has long been a cornerstone in the treatment of anxiety-related conditions. Traditionally, its effectiveness has been understood through the lens of habituation —the idea that with repeated exposure to a feared stimulus, anxiety will gradually decrease. While this model has proven clinically useful, recent developments in the science of learning suggest a need to revisit and expand our understanding. In particular, Inhibitory Learning Theory (ILT)  offers an

Introduction: Why Identity and Role Get Confused In high-stakes, high-responsibility professions — the military, healthcare, therapy, education, policing (and many more) — identity often becomes fused with the role. It’s not just what we do. It becomes who we are. But when that role is shaken, lost, or betrayed by the system it exists within, the consequences go deeper than stress or exhaustion. They strike at the core of identity, and often bring shame, moral injury, and dis

Therapists often talk about “holding space.”I know — it can sound a bit vague or, frankly, a little pretentious. But at its heart, it’s simple: holding space means showing up with non-judgmental, compassionate curiosity  toward someone else’s experience — whatever that experience may be. It’s not about fixing. It’s not about advice.It ’s about making room  for what’s real. Why does that matter? Because we live in a culture that teaches us to fight, fix, or flee from uncomfort

In the ever-evolving field of psychotherapy, Process-Based Therapy (PBT) is gaining traction as a dynamic, individualized approach to mental health treatment. Unlike traditional therapy models that focus on diagnostic categories or fixed treatment protocols, PBT emphasizes psychological processes—how individuals think, feel, and behave in response to their environment. This flexibility allows therapists to tailor interventions to each person’s unique needs, enhancing the effe

In this short video, I offer a brief overview of the ACT Matrix, a simple, but powerful, tool for helping individuals identify their personal values, the difficult thoughts and feelings that unduly influence their actions in ways that do not work for them, and to commit towards action that genuinely aligns with what matters most to them. Christian K Hughes is a Psychotherapist, Clinical Supervisor, and Clinical Trainer, specialising in CBT & Acceptance and Commitment Therapy

It's fair to say that a majority of clients come to therapy in hope that we will be able to control their emotions more effectively. This is an understandable goal, given the distress they are often experiencing, but, in ACT, we take the perspective that habitual attempts to control emotions very frequently result in increased suffering. Therefore, we try to move away from attempts to directly control our emotions and towards alternative ways of responding when difficult em

The head/heart gap is an experience that many clients in therapy will recognise. They understand the concept being discussed, but it is not translating into making them feel any different, or into any meaningful change in their lives. As practitioners, we can probably relate to this too, as we know, from our own experience, that there is a big difference between understanding something is helpful, and actually making use of it. The reason for this is that, even when we are

Experiential avoidance is an important concept within Acceptance and Commitment Therapy (ACT). It is the idea that, as humans, it is natural, and normal, for us to try and escape experiences which are uncomfortable or painful. That has survival value when it comes to many things in life; for example, it makes sense to avoid the physical pain of touching a hot surface because that will protect us from harm. But, equally, avoiding pain and discomfort in another context, such

Functional Contextualism sits at the heart of Acceptance and Commitment Therapy (ACT) as an essential element in understanding individuals difficulties and helping practitioners collaboratively design effective interventions with their clients. Despite this, F.C. is not always well understood which may be explained, in part, because it contrasts significantly with the way psychological problems are traditional conceptualised in western medicine. For decades, the dominant app

As mindfulness has become increasingly well known among the general public, and in the world of therapy and mental health care, it has also begun to gain something of bad reputation. Increasingly, there are accusations of 'McMindfulness' made about the way mindfulness is used and these have begun to taint the reputations all clinical mindfulness interventions. Much of the criticism is that mindfulness has been divorced from both its historical and cultural roots and, stripped