Walk and talk therapy marries two of the things that I believe are most beneficial when we’re struggling with our mental health: talking about problems openly, and being outside in nature. Here’s how it works...

Talking to someone in confidence, especially someone who'll be open, non-judgemental, empathic and accepting, can help you make sense of how you're feeling, whether that’s because of anxiety, depression, major life changes such as bereavement or divorce, or any number of other issues. And simply being in nature is hugely beneficial for our wellbeing – lowering levels of stress hormones and improving mood. Breathing in the air, feeling the sun on our skin, listening to birdsong – these are all things that can help to ease tension. You may feel your senses awakening, overwhelming pressures may begin to ease, priorities begin to shift. You may breathe easier, you may feel your muscles relax. 

Walk and talk therapy works just like a regular counselling session, except it takes place outside. There doesn’t even need to be much walking, and you certainly don’t need to be fit. It might be that you’d prefer to sit on a bench or a patch of grass. Perhaps we'll wander for 10 minutes, then take a break. Or perhaps you like to walk briskly as you talk. You are free to set the pace of the sessions, and I will tailor them to your needs.

Benefits of walk and talk therapy:

• For those who find telephone, online or face to face sessions challenging, either because of issues around accessing technology, or making prolonged eye contact, a walk and talk session can feel easier and less intense.

• If you find it hard to sit still and tend to feel agitated or stressed, an outdoor counselling session can release some of that bodily tension, which in turn can help you talk freely and openly.

• Being outdoors can be relaxing and help to awaken our senses and free our minds to be more open and flexible.

• Walking while talking through your problems may help with feelings of being ‘stuck’, because the motion of the session is literally helping you move forward.

• Being out in nature can boost your mood, releasing happy hormones (endorphins), which can also have health benefits, such as reducing blood pressure and aiding digestion.

• Mindfulness has been proven to help in times of distress, helping us to notice and accept our thoughts and feelings, while remaining in the present. Having a session outdoors is an ideal way to learn grounding techniques such as deep breathing and mindfulness, that can help with anxiety, stress, depression and insomnia.

Where will we walk?

Outdoor therapy sessions with me are held in an open heathland space near St Albans and Harpenden. It is a beautiful and tranquil spot in central Hertfordshire, easily accessible from the M1 and M25. To find out whether walk and talk therapy is for you, contact me for a free, no-obligation chat to discuss your needs.

Anxiety is a feeling of worry in response to fear, stress or tension. It is a very normal response that we all feel at times. When children are changing schools, doing an exam, or taking a driving test, it’s completely understandable for them to be anxious. They may experience it as a feeling, as thoughts, or as sensations in their body, such as feeling hot, dizzy or shaky – or all three.  

However, the usual stresses and worries of life can become an issue over time if not addressed. Children may start avoiding the thing that worries them, or they may use unhelpful coping strategies. Anxiety may be a problem for your child if:

• Their feelings of anxiety happen regularly, last for a long time, or are very strong or overwhelming.

• Their fears seem out of proportion with what’s happening in reality.

• They want to avoid situations because of their fears.

• They become overwhelmed by their feelings – for example, having anger meltdowns or becoming distraught in challenging moments.

• Their anxious feelings stop them from doing what they enjoy or even going about their everyday life.

• They experience panic attacks.

Everyone is different in how they experience anxiety. Some children will have specific thoughts that trouble them, others may have a general feeling of worry all the time. Some will have episodes of panic (commonly called panic attacks), others will struggle with angry outbursts.

If you’re noticing that your child seems to be struggling with day to day life and is becoming overwhelmed by their thoughts and feelings – whether it's about exam stress, social situations or coping in school – they might benefit from talking to someone confidentially. I can help them understand what’s happening and find ways to manage and reduce their worries. Contact me for a free chat about their needs.  

Q “I’d like to go to a new hairdresser but how do I ‘break up’ with my current one?”

A There’s so much more to any visit to the hairdresser than just cut, colour and making conversation – the worries around tipping, the awkward small talk, the compulsion to say ‘you’ve done a great job’ while secretly seething. But for some of us, the relationship we build with our hairdresser can be a great comfort, offering friendship and connection. But what if we’re no longer happy with the way they cut our hair, or we just want to try someone new?

If the thought of telling someone you no longer require their services strikes fear in your heart, it could be that you see this as a confrontation. Perhaps you grew up in a household where disagreements took the form of shouting matches, or where expressing yourself led to the silent treatment. Perhaps you never had the opportunity to see that respectfully having different opinions, or wanting different things, is OK. You may have absorbed the message that you have to be ‘good’ – compliant and helpful – in order to be acceptable. This people-pleasing tendency can be so strong, we develop the idea that our own wants and needs don’t matter. This leads to difficulties in saying no to things we don’t want to do; we may end up sidestepping uncomfortable situations, or leaving issues unresolved, all of which can cause a build-up of resentment and feelings of anxiety.

It could also be that 'breaking up’ with your hairdresser feels like you’re rejecting them, which could be a hangover from your own past experience of feeling hurt. It’s very easy to assume we know what someone else will be feeling, when we’ve felt that way ourselves. But the truth is, your hairdresser will be well-used to clients coming and going. As a paying customer, you have every right to try different options, and your hairdresser knows this and will most likely be fine with you letting them know. Open, honest communication is freeing and empowering. Far better to say, ‘There is a new place I’m going to try, but thank you so much for all the years of great cuts’, than just slinking off quietly. Avoiding the conversation may be tempting, but it can leave a lingering sense of unfinished business. Especially if you later bump into them in the supermarket. Consider your values – is it important to you to end on a friendly note? If a face-to-face conversation just feels too difficult, then sending a hand-written card, or even a bunch of flowers if it’s a very long relationship, might put yourself and them at ease. Allowing yourself to discover that conflict doesn’t need to be feared, can help you build confidence – and healthier relationships.

Your heart is racing, your hands are sweating, you feel hot and shaky, you feel out of control. You may feel convinced you’re going to pass out, or even that you’re having a heart attack. The truth is, as overwhelming as panic can feel, it’s not dangerous. I actually prefer the term panic episode to panic attack. Attack is such a loaded word, and while panic is frightening in the moment, it’s important to realise that you’re not under attack. In fact your body is trying to help you. Understanding what’s happening can help with these distressing feelings. So, what’s actually going on?

When we’re faced with danger, our brain sends our nervous system into fight or flight mode. We’re flooded with chemicals, including adrenaline, which cause those really unpleasant symptoms, such as an increased heartbeat and rapid breathing. An increased heartbeat sends more blood to our muscles, and breathing becomes shallow so we can take in more oxygen – all great if we need to run away from, or fight back against, danger. These responses have helped our species survive. The problem is, our brains have a hard time distinguishing between real external threats and our own internal fears. And often even the fear of the symptoms can themselves become a trigger, leading to an unhelpful cycle.

How to manage the symptoms:

• Check your breathing – when we enter that fight or flight state, commonly our breathing quickens, which can increase the feeling of being out of control. Try to slow your breathing, and breathe deeply from your stomach, rather than your chest, so that you can see your stomach rise and fall. 

• Listen to your self-talk – is it angry , fearful or judgemental, such as ‘what’s wrong with you’ or ‘just calm down’. Instead, talk to yourself in a soothing, calming way: ‘It’s OK, I’m OK’.

• Focus on something outside of your body, using your senses. What can you see, smell, hear? One trick I often suggest is to look for shapes around you, such as rectangles in window frames, furniture, street signs.

• Try to accept your feelings. The impulse to flee can be very strong, but this is a short-term solution. If you can sit with your panic and wait for it to subside, over time it will be less likely to hijack you.

Asking for help:

• It can really help to talk to someone, to help you understand what’s behind your anxiety and where these feelings are coming from. Perhaps there has been a life change that you haven’t processed, perhaps you’re feeling pressure, stress, loneliness, trauma, bullying or abuse. Whatever it is, counselling for anxiety can help you make sense of it all. I think of anxiety as a warning light going off, telling you something is wrong. By paying attention to it, we can find out how to make it right. 

• I’m experienced in helping people with anxiety, including finding strategies that help, but also understanding where the feelings are coming from. If you think I can help you, please do get in touch.

Q “I overthink every little thing. What can I do?”

A We all overthink at times, especially when stressed about something specific. But overthinking can become chronic and impact our wellbeing. The thoughts circle constantly, draining our energy and causing sleep problems.

There are lots of reasons why it happens. For some people, overthinking may stem from perfectionism and fear of making mistakes. They may go over conversations they’ve had, second-guess decisions, or imagine things going wrong. For others, it can be an unconscious coping strategy to avoid difficult feelings like guilt, shame or fear – they try to think their way out of things, to feel more in control and less vulnerable.

Overthinking can become such a habit that you don’t even recognise when you’re doing it, or you may spend time ruminating on things that really don’t matter.

It’s important to realise that overthinking is not a character flaw – it comes from a place of wanting to feel safe. Berating yourself for your thinking patterns will only add to the cycle of worry and anxiety. Instead, it may help to get curious about your thoughts and feelings. Acknowledge them, be grateful for them, but then look for some perspective. For example: ‘I’m worried I might have upset my friend yesterday. How do I feel about what I said? How realistic are my thoughts? Is it likely that they’re upset? Is there any action I could take? Or can I let this worry go?’ The key is to start paying attention to the way you think, so you can understand yourself better, and break unhelpful habits.

Making new habits can also help. You could try these strategies and find the one that works for you:

• Schedule ‘worry time’ to think about what’s bothering you. Writing your thoughts down, or recording voice notes, can help you set aside your worries and get on with your day.

• Practise mindfulness to help you stay in the present, rather than worrying about the past or future.

• Tune in to your body rather than staying stuck in your head. It could simply be breathing more deeply or letting go of muscle tension. Move around, get creative, sing, go outside.

• Try positive visualisation – picture a situation turning out the way you want it to.

• Be kind to yourself. Try telling yourself, ‘Thank you for my thoughts, but I’m going to move on to something else now.’

Overthinking is a hard habit to break, so don’t beat yourself up if it takes time, and be sure to reach out for help from trusted people, or a professional, if you need to.

Q “I’ve missed out on so much in life because of my chronic depression and anxiety. I grieve the life I lost. Is there anything I can do to come to terms with it?”

A I often see clients who’ve struggled with years of difficult feelings. They want to process what’s happened in their life, but often find themselves grieving for the life they didn’t have. The years when they felt friendless and alone, or the time spent stuck in survival mode, or the constant longing for something that hasn’t worked out. 

The first step can often be to truly acknowledge the feelings of loss. Spend some time reflecting on what you’ve lost and the effect it’s had on you. This isn’t ‘wallowing’ in your pain. It’s naming your feelings, honouring them and accepting they’re valid. Perhaps you feel sadness, regret, anger or resentment. Allowing yourself to experience your feelings – perhaps through talking to someone, or writing them down – can be uncomfortable at first but can also be hugely liberating. 

Once you’re able to spend time with your sense of loss, you may begin to think about it differently. Maybe your years of feeling anxious and depressed have taught you resilience and determination to keep going, even when things are hard. Perhaps it’s given you great empathy for others who are in pain. The aim is to adapt to your loss, to find its meaning and discover if it brings with it opportunities for change. You may still feel you’ve missed out, but can you adapt to this reality and work towards a different future?

As you reflect, you might begin to think about how you’ve coped with difficult feelings in the past. It’s common to isolate ourselves when we feel sadness, anxiety or shame. If you’ve spent your lifetime wanting to curl up into a ball and hide, it can seem frightening to reach out to others, but we all need connection and community. If you can, step outside of your comfort zone and find your tribe, whether that’s by joining a support group (in person or online), a club that interests you, or through learning a new skill. 

By reflecting on yourself, and connecting with others, you may learn many new things about your authentic self – the person you truly are, rather than the person you felt you had to be. You may start to shed some of the false beliefs – that you’re not good enough or not worthy of love – that you’ve been living with. You may discover a new compassion for yourself that means you can be liberated from the past and begin to feel hope for the future.

Q “My brother and I are carers for my mother who has Alzheimer’s. We both work full-time and struggle to look after Mum too. I know it isn’t her fault but I miss having my own life and being able to make plans. I feel guilty when I think I’ll only be free once she passes. How do I get past this?” 

A Caring for a parent with dementia can be incredibly hard. It is often made much more challenging by having to juggle other responsibilities, too, and it can lead to a mix of very difficult emotions. You may feel that you no longer know your parent, leading to a great sense of loss and sadness. This can cause some people to want to protect themselves – you may unconsciously create friction or distance in the relationship, so that the loss feels less painful. You may also feel frustrated and resentful – that your life seems to be on hold. You may get angry with your loved one, or think about how much better it would be if they were to pass away – and then feel plagued with guilt for having such thoughts. All of these feelings and reactions are normal and very common. It is natural to want their suffering – and your own – to be over.

You may also feel that you are grieving for someone who is still alive. This is called anticipatory grief, and while it can be helpful in preparing you for the bereavement to come, it can also create feelings of anxiety and dread, sapping energy and making it even harder to cope. If your relationship with your parent wasn't a secure or loving one, it can still be very difficult to process the loss, and understand quite how you feel about it.

Whatever you're feeling, it's important not to judge yourself. Instead, think about whether there is anything that will help. Are you trying to do too much? Do you need to ask for more help? Are you taking good enough care of yourself? Take regular breaks, look after your health, and set aside time to do things you enjoy and to connect with friends, because if you're not taking care of yourself, you definitely can’t take care of someone else. 

It might be that you also need more professional assistance with caring duties. Remember, you’re not a trained nurse or a 24-hour GP service. Much of your mum’s care needs to be in the hands of professionals, which leaves you to be who you are – a person who is losing someone important. It might be helpful to talk about how you feel, whether that’s with someone who’s been through a similar situation, or a counsellor who can help you process your feelings. Most of all, take things one day at a time, and always be kind to yourself. 

Q “How do I begin to recover from having a narcissistic, toxic, abusive mother now that I’ve cut her out of my life?”

A Being raised by a narcissistic parent is highly challenging, and its legacy can be devastating. It’s important to understand you did nothing to deserve your abuse. It’s likely your narcissistic mother saw you as an extension of herself, rather than as a separate person with your own needs. She would have lacked empathy, and had difficulty acknowledging your feelings – getting anxious, defensive, angry or shaming you whenever you showed emotion. She may have outwardly seemed self-sacrificing. But any involvement in your life would most likely have been self-serving, ensuring she received praise and attention, and putting her at the centre of your achievements. As the child of a narcissistic parent, it’s very common to feel used, rejected, blamed, criticised, unheard and unseen.

Boundaries are essential, and you’ve set a solid boundary by deciding to cut your mother out of your life. The healing journey that follows will be very individual. There may be many things unsaid, feelings unexpressed, traumas unprocessed. You may feel grief for the loss of a relationship that never was. Or you may be full of rage that seemingly has nowhere to go. It might help to release your rage through exercise such as boxercise; by making something that represents your anger then destroying it; by screaming into a pillow; or writing a journal with your angriest, most vitriolic thoughts. You could write a letter to your mother explaining just how her treatment of you has affected you – post it to her, or rip it up or burn it, or keep it to remind yourself of how far you’ve come.

As your mother wasn’t able to teach you about healthy relationships, boundaries, self-care or trusting your feelings, can you begin to reparent yourself? This may involve learning to self-soothe, growing your self-awareness and communicating your needs. It’s likely that you have a critical internal voice that invalidates how you feel. Try listening to this self-talk and begin to change it. Start naming your emotions – there are ‘feelings wheels’ online that can help. Search online for positive affirmations, such as ‘I am good enough’ or ‘I matter’; find one that means something to you and say it daily. Build a network of trusted people who are helpful and supportive. Find enjoyment and fulfilment where you can, but remember to accept there will be days when you feel the weight of the past. Those days can be welcomed, too – they are opportunities to practise self-compassion and create a new way of being.  

Q “How do I manage my health anxiety?”

A When a person is experiencing health anxiety, they are preoccupied with fears of becoming ill. It’s likely you’re checking your body for signs of ill health, and searching symptoms on the internet. You may avoid people for fear of catching an illness. You might obsess over the slightest dizziness or pain. You might become so sure you’re unwell, you behave as if you are – avoiding activities that you’d normally enjoy.

The fearful thoughts can cause symptoms in themselves – racing heart, light-headedness – which are normal, harmless sensations triggered by stress hormones, but they’re taken as signs of illness, leading to more anxious thoughts. It’s common for people with health anxiety to seek constant reassurance from family, friends and doctors. This brings relief but it tends to be temporary. The doubts creep back: “What if the doctor missed something?” “What about this new symptom?” Then the cycle of internet research, self-diagnosis and reassurance-seeking begins again.

It’s always a good idea to get persistent symptoms checked by a doctor. But when unfounded health worries impact your life, it might be time to break the cycle. Looking up symptoms and seeking reassurance are what’s known as safety behaviours. These are things we believe we must do in order to feel in control. Safety behaviours can include touching wood after an unpleasant intrusive thought, or sitting close to an exit “in case something bad happens”. The behaviour is intended to help us, but in reality it exacerbates the fear, as it confirms the thought rather than challenges it. After all, thoughts are not facts. It may be true that you have a headache, but the thought of it being something serious is a meaning you’ve attached to it; it’s not a fact. Rather than relying on your safety behaviours, try doing something else. Distract yourself, go for a walk, chat to a friend. Give yourself time to discover that the headache goes away on its own. It might help to write down your thoughts. Create two columns: one to notice the thought, one to challenge it. For example: “I’m worried that feeling dizzy means I’m seriously ill”, and “I had this worry before and I was fine”.

Also, take notice of when the thoughts come – are they worse at times of stress, or when you feel overwhelmed by other things going on in your life? You might benefit from talking through any stresses or other difficulties, either with a trusted person or a counsellor.

Q “How do I know when to conclude counselling sessions?”

A This is my final column as Happiful’s first-ever agony aunt, and as I pass the baton to a new counsellor, I’ve been thinking about endings, which makes this the perfect time to answer your question.

The relationship you build with your counsellor is unique. This may be the first time you’ve felt able to be vulnerable with someone, or the first time you’ve really felt heard. You may have said things to your counsellor that you’ve never been able to talk about with anyone else. It’s natural that bringing this relationship to an end might feel awkward, sad, or even anxiety-inducing. And it can be hard to know when and how to do it.

Sometimes schedules or finances make ending necessary, but often counselling ends because clients feel they’ve made sufficient progress – their aims have been reached, and they’ve even developed their own internal counsellor. Perhaps the sessions are beginning to feel conversational rather than therapeutic. Though ending might be a very positive step in such situations, it can still bring up natural feelings of worry or loss, and it’s important to talk these through with your counsellor, to understand what you’re feeling and gain closure as you say goodbye.

Alternatively, you might feel your sessions have hit a wall – that you’re stuck and no longer moving forward. Again, it’s important to talk about your experience. A good counsellor will try to help you through this ‘stuckness’, and challenge you to understand its purpose. For example, is there a part of you that’s afraid to make changes? Or, you might decide you want to try a fresh approach with a new therapist, perhaps one who specialises in a specific issue or modality.

Some people find saying goodbye difficult and simply stop showing up to sessions. But I believe the end of a therapy journey deserves recognition. Having an ending session is a chance to acknowledge how far you’ve come, and make a plan for maintaining any changes you’ve made. Most counsellors will also leave the door open for you to return. You might want sessions at a reduced frequency, or on an ad-hoc basis; you might return years later because of fresh challenges.

When two people connect in counselling sessions (or through writing and reading an agony aunt column), real change can happen, and it can be a great privilege for both people. And ending that connection can be a hugely positive step, allowing for new possibilities and continued growth.