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

There’s an old joke that middle age is climbing the ladder of success, only to realise it’s leaning against the wrong wall. To many outwardly successful people, that might sound familiar. Many of us reach a point — often in midlife or following a major transition — where something just isn’t working anymore. And even though we can’t always name what’s wrong, we feel it. Because we shouldn't feel this way, right? RIGHT? We’ve worked hard.Taken responsibility. Built lives that

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

When moral injury arises from systemic constraints — when people feel unable to act on what they believe is right — it doesn’t just cause distress. It can create a kind of paralysis. A deep sense that nothing will change until everything changes. This is understandable. The roots of moral distress are often structural, cultural, and deeply embedded — beyond the reach of any one person. Many professionals reach a point where they feel exhausted, disillusioned, or emotional

Introduction: The Hidden Wounds of Moral Injury Moral injury is not a disorder. It does not stem from a broken brain, a chemical imbalance, or a lack of resilience. Instead, it is a wound—deep, relational, and ethical. This injury occurs when someone experiences or participates in events that clash with their core moral beliefs. Often, it results from betrayal by a leader, institution, or system during critical moments. This issue is prevalent yet mostly unspoken among vetera

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

A veteran once said to me: “I spent six months being trained to join. I got two days to leave.” It stuck with me. We put enormous effort into preparing people to enter the Armed Forces — physically, mentally, culturally. The identity of ‘serviceperson’ is forged through structure, repetition, and meaning. But when it comes time to leave, at it's best the resettlement process helps people find a good job and a stable start to come out to, but too many get a debrief, a few form

“I knew how to be a soldier. I don’t know how to be… this.”​ This sentiment echoes the experiences of many veterans as they navigate the shift from military service to civilian life because transition isn't just about changing jobs; it's about redefining identity, purpose, and belonging. ​ Research highlights several challenges faced by veterans:​ Identity Reconstruction: Veterans often grapple with redefining their sense of self after leaving the structured environment of th

Understanding Veteran Transition For many military veterans, the shift to civilian life is not simply a logistical change but a profound psychological transition. This process—referred to as transition in the U.K. and reintegration in the U.S.—involves adapting to new roles in society, relationships, and employment. Some veterans navigate this transition smoothly, but for others, difficulties arise when their military identity and civilian roles appear incompatible. Liles (20

Process-Based Therapy (PBT) represents a significant shift in psychological treatment, moving away from rigid diagnostic categories and symptom-focused interventions toward a more individualized, dynamic, and flexible approach. At its core, PBT emphasizes understanding the underlying psychological processes that contribute to a person’s distress and well-being. A key aspect of PBT is its use in clinical case formulation, which allows therapists to develop tailored treatment p

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

Today I came across the line “Do it well or don’t do it at all”, a piece of advice I’ve come across many times in my life but to which I’ve never really given much thought until now. On the face of it appears to be good advice, seemingly extolling the virtues of hard work and effort over a perhaps half-hearted or lackadaisical attitude. Who could argue with that? Except the phrase doesn’t really have anything to do with hard work and effort but has everything to do with suc

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

Asking what your client wants from your work together might seem obvious but it isn't always as clear is it may first seem. In reality, it's common for clients in a mental health or psychological assessment to be focused on the things they don't want. For e.g., many will point to the symptoms they want to be rid of, such as anxiety, grief, sadness, low mood, intrusive thoughts or memories, or want to 'work through the trauma' (usually with the hope that doing so will make th

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

I was fortunate to be interviewed by journalist, author, and British Army veteran, Joe Glenton on all things Military Mental Health, Trauma, and Moral Injury, as part of ForcesWatch's Warrior Nation series on War and Memory. You can listen to the full interview below...

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