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Post surgery discussion

An exploration into Psychology - Could you benefit?

Part 3: Some more Psychological Therapies

Dr Liza Morton

In Part 1 we explored some of the unique emotional challenges that might arise from living with a heart condition from birth. These included feeling different, living with hidden symptoms, feeling out of control, enduring traumatic experiences, missing out and feeling unsafe. In Part 2 we considered what psychology can offer us, exploring Self Help, Emotional Support, Person Centered Counselling and Cognitive Behavioural Therapy (CBT) as possible sources of psychological support.

We noted that although not everyone who is born with a heart condition would need this support there is no harm in being aware of these options and deciding for ourselves, especially since a holistic account of living with CHD (congenital heart disease) might offer better physical and emotional health and a better quality of life.

Interpersonal Psychotherapy (IPT)

IPT focuses on reducing mood problems by developing a more supportive social circle. Early sessions review the key people in your life. Therapy focuses on one of four areas; an Interpersonal Dispute (such as an argument with someone who is important to you), a Role Transition (like moving house), a Grief or Loss and Interpersonal Sensitivities (general problems with making and keeping relationships). These four focus areas could be appropriate depending on the trigger for your current mood difficulties. A focus on Interpersonal Disputes might help if you are having problems navigating the medical system or if you are being bullied. Role Transitions might benefit you during the move from childhood to adult care, adapting to having a cardiac medical device fitted, enduring surgery or having a heart transplant. Role Transitions could also be useful if you are recovering from post-traumatic stress disorder (PTSD). A focus on Grief or Loss may help following the loss of a peer, a further loss of health or not being able to have children. Interpersonal Sensitivities is generally considered useful if you have a limited social network. The goal of IPT is to improve your social skills and increase your social network and it is perhaps more appropriate when you suffer from health problems since it connects life events to emotions. IPT is advocated in NICE

(National Institute for Health and Clinical Excellence) guidelines and is offered by some Chartered Psychologists and some other therapists both privately and within the NHS.

Body Psychotherapy

Recent approaches within psychology offer a more holistic account of human experience than previous approaches. During a threatening situation the body reacts by preparing to defend itself through its fight, flight or freeze response. Sometimes even though the threat is gone the body is left stuck in this mode which can cause a number of physical and psychological symptoms including sleep disturbance, panic attacks, exhaustion, feeling unsafe, flashbacks and nightmares. This is known as post-traumatic stress. Body psychotherapy is an integrated method of psychotherapy that addresses thoughts, emotions and bodily sensations. The aim of therapy is to help you manage your anxiety, establish feelings of safety and process traumatic experiences. This kind of therapy could be useful if you are suffering from post-traumatic stress as a result of medical trauma.

The Human Givens

The Human Givens approach is based on the idea that we each have a basic set of needs (such as security, attention, autonomy, emotional intimacy, status, meaning and purpose) and if they are not met then we feel emotional distress (see the Human Givens Institute This approach works to help you adjust your life so that all these needs are being met with the aim of reducing psychological distress.

Finding the right therapist

The quality of the therapeutic relationship is at least as important as the therapeutic method. Therefore, finding the right fit with a therapist that you feel comfortable and safe with is as important as finding the type of therapy that you feel would help you the most.

How to access help

Referral to a Clinical or Counselling Psychologist, CBT Therapist or Counsellor in the NHS should be done via your GP or another doctor

such as your cardiologist. Therapists typically charge between £35-70 per hourly session for private work and your GP may also be able to advise therapists who do private work locally. The British Association for Behavioural and Cognitive Psychotherapies ( lists accredited private CBT therapists.

Living with a heart condition from birth can present many challenges. It is normal to have an emotional reaction to these adverse life events. However, there is not always the opportunity to deal with difficult emotions when you are also having to cope with serious medical problems. For some these emotions can develop into periods of low mood or anxiety. Emotional Support, Self-Help, Counselling and Psychological therapies can offer the chance to process and manage these emotions leaving us free to make the most of our present and future. There are many different types of help available and different approaches will suit different people. In part 4 we will consider The Good News' by looking at how living with a heart condition from birth can also have a positive impact on our emotional and psychological wellbeing.

About the Author

Dr Liza Morton, born with complete Congenital Heart Block, was recently fitted with her 9th cardiac pacemaker.  She has also had an ASD repaired by Open Heart Surgery.  Liza, a volunteer for The Somerville Foundation, is a trainee Counselling Psychologist.  She has studied Psychology for many years, an interest that was driven by her wish to understand how her heart condition and extensive medical history had shaped her.  As part of her training she has undergone therapy with both a Counselling Psychologist and a Body Psychotherapist work she heels has helped her process the difficult aspects of living with a heart condition from birth. 

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