Today I spent some time in the office Caroline Adamson (Senior counsellor / clinical lead of the University of Dundee Counselling service) chatting to her about the counselling service’s approach to helping anxious ‘clients’.

The interview remained open, allowing for us to meander into topics which are relevant but not directly related to my project. Ultimately the insights which came out were invaluable in becoming a point of triangulation for insights from previous research as well as contradicting some popular assumptions about anxiety.


  • Different approaches work for different people. As a result, all sessions are self led by the client with the counsellors only acting as facilitators to their own thought process. They view the sessions as a collaboration between client and counsellor and outright state that they are not the cure. “Clients have to recognise that they must do all the work. This is no magic cure.” The end goal is to help their client get to the stage where they are self-reliant & can handle their anxiety issues on their own when they resurface.
  • “The brain only allows us to consciously process 10 thoughts at a time, however, there are thousands of things going on in the unconscious mind. If you think of the brain as a big textbook, you can only see the front cover”
  • Anxiety works in a primal way. When faced with a situation the brain perceives as potentially dangerous, an individual is faced with a “Fight or Flight Response” which manifests through a variety of physical symptoms. These can accelerate the person into a vicious circle.
  • Avoidance makes anxiety worse. Caroline gave me papers detailing this. There is enough content for a standalone blog post, but here is the gist of it: When an individual tries to avoids a situation the brain perceives as dangerous, the brain further cements the idea that the situation is dangerous because the person has made the conscious decision to remove themselves from it. The brain begins to look for patterns, creates fear associations which chains triggers together – exacerbating the problem.
  • The typical steps to treatment of anxiety are:
    • Recognise
    • Understand
    • Change
    • These all aim to connect the rational side of the brain with the irrational in order to overcome situational anxiety.
  • When overwhelmed with anxiety a counsellor looks to encourage their client to ‘slow down & be objective’, ‘stop & think’ and to recognise their response. Later, they want to find out exactly what their client has been thinking so they can pinpoint irrationality while they are in a rational state which will encourage awareness during the next episode.
  • At any time, 10% of the population are seeing their GP about anxiety related issues. Yet anxiety clients still feel an overwhelming feeling of isolation – as if they are the only one. This is because there are no outward facing suggestions that an individual has anxiety. “There are no speech bubbles.”
  • The counselling service acknowledges that they are not ‘technically savvy’. Rather than recommending apps/technologies, they recommend their clients look at the NHS’ webpage showcasing anxiety support apps. The onus is on the client. Once their client has been using this app for some time, they take on board any of their feedback and note how it could be used to help other clients. Journalling works well for some clients.