Blog Post

Extract from The Anxiety Management Manual

The Anxiety Management Manual represents a synthesis and consolidation of the clinical work I have carried out with people since 1974. My career began as an occupational therapist in Johannesburg, South Africa where I worked in hospitals with diverse medical conditions. I discovered that patients recovered well when they understood why we were giving them particular tasks and the benefits they would reap from engaging in the process.Another key to successful treatment was assigning activities that were practical and relevant to their lives.

As occupational therapists, we were responsible for motivating patients, getting them moving and helping them function in everyday life. At that time, when psychodynamic and humanistic psychology was revered, the work we were doing was undervalued and seen as merely ‘keeping the patients busy’.

Owing to a back injury, my focus became ‘psych OT’ which meant I worked full time with psychiatric patients.It is in this milieu that I discovered my passion.I studied for an additional five years to qualify (with distinction) as a clinical psychologist in 1982.At the University of the Witwatersrand, the focus was psychodynamic. My particular interest was in the work of psychoanalyst Melanie Klein and I worked within her model with extensive supervision for nine years.As a Kleinian therapist, I drilled deep into the unconscious without any overt treatment plan or direction. It couldn’t have been more different from my work as an occupational therapist.

In addition to working with private patients, I ran various groups in the 1980’s. As a young mother of four children, I had many acquaintances who begged me for practical parenting workshops where they obtained solutions to their problems. They just wanted to know how to communicate better without understanding the reason they were getting it wrong.Responding to this need, the occupational therapist in me wrote and ran parenting courses for parents of children and adolescents.

A common problem I noted amongst this normal population of parents was anger, frustration, stress and sadness. I realised that no number of strategies would help if an emotion such as anger got in the way. And so was born my interest in emotion regulation. In 1989 I began a weekly cognitive behavioural therapy (CBT) group for women to teach strategies for emotion regulation. It was highly successful and no one was more surprised than me. Without delving into the past, or developing insight, these women became calmer and happier, simply by learning tools. I wasbemused to find that CBT encourages exercise, socialising and keeping busy — precisely the activities which had attracted the corn of psychoanalysts in my earlier years.

In 1995, with the popularisation of emotional intelligence, I synthesised the process I had been teaching for six years into an emotion regulation program and began using it with my individual clients (feeling slightly guilty about it and hoping my Kleinian supervisor would not find out).Again and again, I observed the benefits of this approach with hundreds if not thousands of people from different cultures and of all different ages.

In 1997, I migrated to Sydney Australia with my family. I was excited to discover that the techniques I utilised benefited the multicultural Australian population. I also learned that working analytically with mums and dads was difficult in a culture where there is no home help. I was grateful for my experience as an occupational therapist which verified the usefulness of practical, relevant skills. I was also appreciative that I had experience with CBT as that is the dominant approach in psychology in Australia

What I have discovered after 42 years, is that there is not a one size fits all approach. Working in a psychodynamic way is very useful for many patients but does not yield results for a client suffering from a panic attack in the moment.When it comes to emotion regulation generally, and anxiety and anger in particular, practical, relevant, easy to use tools are the most effective way of managing symptoms.

Since 1972, I have studied and taught. I have worked with clients one-on-one, couples, families and groups. I have delivered workshops in corporate settings, schools and shelters for the disabled and disenfranchised.I have written 3 practical, self-help books for lay people. They all teach emotion regulation although the first two are niched as parenting books. I continue to write a blog and am frequently called on for comment by the media. I work full time in my private practice in Sydney and currently run 3 groups per week teaching emotion regulation.

It is no exaggeration to say that I have devoted most of my life to helping people. I have strived to empower and motivate and to look for the most effective, user friendly way of doing so. I believe that my treatment method achieves that aim.