It’s the *beigest* time of the year and if you’re not consuming a stupid amount of batter morning, noon and night and working the kitchen a la Matilda, you’re doing Pancake Day all wrong, lads. 

Whilst the stuff straight from the bottle is a lifesaver for forgetful/lazy girls everywhere (@me), nothing beats the fluffy American sort made with your own fair hands. They will always reign supreme in the upper echelons of pancake hierarchy. 

With that in mind, we’re sharing three ways to whip up a 5* stack this Shrove Tuesday so if you like your eggs cracked into a bed of milk and flour, then hit save on Zoe’s all-time favourite – and easy to follow – recipe, courtesy of the pancake king himself Jamie Oliver. Crepe fans, step aside! 

Once you’ve got the batter recipe down, you can graduate to fillings and decorations. Whether you’re a traditional gal or a fiend for a mukbang challenge, these three toppings are guaranteed to make sure you lock lips with a top tier pancake in 2022. 

Fruit & Yoghurt 

Gorgeous, gorgeous girls do their morning pages and eat pancakes with fruit and yogurt. Fill each layer of your stack with a dollop of tangy Greek yoghurt, top with fresh berries, a generous drizzle of honey or syrup and a light dusting of icing sugar. Sublime! 

The Chocolate Overdose

Pancakes for breakfast? That sounds a lot like deprivation to us. Breakfast, lunch and dinner is the only MO for Shrove Tuesday. Pancake Day comes but once a year so bosh them in all their stunning iterations and die full, happy and bloated. 

Smother each pancake with a layer of Nutella, a handful of mini marshmallows and white chocolate chips for 11/10 texture and taste. Drizzle chocolate dipping sauce on top and finish with a smattering of your favourite chocolate (Zoe’s gone for Bitsa Wispa) for a decadent dessert destined to have you chanting Bruce, Bruce, Bruce. Gobble ‘em down like tomorrow doesn’t exist and regret nothing. 

The Classic 

If it ain’t broke! It wouldn’t be P Cake Day without the power couple of all power couples: lemon and sugar. Tart but sweet, it’s a firm favourite with those who prefer their pancakes on the plainer side but still fluffy, puffy and good as hell. When it comes to the lemon, a fresh squeeze is the way to go. Slice up a lemon and fan on top of your stack for Jamie Oliver style pizzaz and easy-access to more juice should you need a drop more citrus going on. Dust with caster sugar and eat them steaming hot whilst thinking about the imminent arrival of Bridgerton Season 2. Epic brunch? Completed it. 

Whilst the delights of storm Eunice truly made it feel like the outside world would be uninhabitable for good, the shortest month of the year is in fact nearly behind us and the promise of pancakes, lighter evenings and daffodils is starting to feel within touching distance once more. As The Devil Wears Prada’s Miranda Priestly once pointed out, florals for spring aren’t exactly groundbreaking, but there is something to be said about the reliability that comes from the annual unveiling of pastel colours, kitsch prints and organic shapes reminding us of a new Spring season that simply never get old. After what feels like another long AF winter, we’re so here for the small joys that remind us the end is in sight, most importantly adding Mini Eggs to the weekly shop and instantly levelling up your mid morning cuppa. Happiness, tick!

And when it comes to Spring cliches, there seems nothing more fitting during these months than leaning in to a good old fashioned Spring clean, sort out and rejig, freshening up your space and mind and clearing way for all the next few months have in store. Goodbye heavy velvet textures and jewel tones and hello to pastel shades and cotton everything- it’s good to see you! Our physical space can have a huge impact on our mood and mental health, so in the name of positivity, we prescribe a healthy dose of retail therapy. Enjoy!

*This post contains ad-affiliate links

Confusingly, under that high sense of self, was a man who needed constant validation. From myself and others around him, without it he’d get extremely upset

Ally, victim of narcissistic abuse

Narcissism: Selfishness, involving a sense of entitlement, a lack of empathy, and a need for admiration. 

Despite the worryingly toxic definition, it’s true that all of us exhibit narcissistic traits to some degree, be it struggling to accept criticism or occasionally prioritising our needs above others for our own gain at times. But in truth the insidious form of emotional and psychological abuse that can come from time spent with someone who fits the full definition, or has been diagnosed with Narcissistic Personality Disorder, is far from the norm. 

According to Trauma-Informed Therapist Caroline Strawson who specialises in narcissistic and domestic abuse, narcissism is born out of painful inner child wounds that can cause their internal protector to become extreme, abusive and controlling.

“This goes down to how I define a narcissist using Internal Family Systems- an evidence-based model of psychotherapy. We all have sub-personalities, for example, if you are asked to go to a party and a ‘part’ of you wants to go but another ‘part’ just wants to stay curled up at home and chill. We have them in many formats.

In Internal Family Systems, we work on the premise that we all have a true self which is actually the essence of how we are all born- someone who is compassionate, confident, creative and curious. It is innate within us, but as we go through our childhood, we perceive events in a certain way, and this is when we start to create beliefs about ourselves. For instance, the father who does not praise you can create a negative belief that you are not good enough, and this creates a core inner child wound that is deemed to be so painful that your system will do anything it can to minimise, soothe and distract you away from feeling. You may then have what we call protector parts that show up to take on this role such as people-pleasing, self-harm, addiction, emotional eating etc. In essence, we all have a true self, an inner child wound, or exiled younger part and then these protector parts which serve to move you away from pain, but very often have a destructive impact. Narcissists are exactly the same.

They all have a true self BUT their inner child wound becomes so painful, that their protector parts become very extreme and abusive and become that individual’s false sense of self. The collective name for an individual’s protector parts that are abusive in this way, and are what we call a narcissist.

They all have a true self BUT their inner child wound becomes so painful, that their protector parts become very extreme and abusive and become that individual’s false sense of self. The collective name for an individual’s protector parts that are abusive in this way, and are what we call a narcissist.

Caroline Strawson

There are two types of narcissism: covert and grandiose, both of which are pathological and stem from insecurity, but present in different ways. Grandiose narcissists wish to be seen by others in a very specific way, are driven by status and have an unrealistic sense of superiority, says relationship coach Stefanos Sifandos in a recent podcast episode on the subject with Mark Groves of Create The Love. Grandiose narcissists believe they are too good for the average, ordinary person and continually talk about their achievements and accolades to mask deep-rooted feelings of shame. In comparison, covert narcissists are far more emotionally sensitive and swing back and forth between feeling and presenting as inferior and superior. They can be incredibly possessive, insecure and paranoid in romantic relationships, often stemming from neglect or abuse in childhood. 

Knowing why a narcissist may behave in a particular way might help explain their choices, but it certainly doesn’t excuse them. The abuse those close to a narcissist face within every interaction can be so emotionally destructive that life feels unbearable, as Londoner Ally knows all too well…

“​​I met my ex at the age of 21 back when I was young, naive and had never been in a relationship. The first few months were magical and full of excitement – it felt like I was in a Taylor Swift song. We’d text everyday, spend all of our free time together and we’d quickly fall in love. Within 6 months we’d exchanged ‘I love yous’ and were living under one roof. It was my version of perfect and I was happy. 

It started with small digs, usually regarding my appearance and jokes about my race – I brushed them off at first even when it was clear I was uncomfortable with his comments. As this was our first time having any real conflict he was very sweet and understanding of my feelings, but as time went on, my feelings began to go unnoticed, apologies exchanged with anger and being shouted at became part of my everyday routine. 

Disagreeing with him or being upset for any valid reason would result in him having tantrums and going as far as punching holes in the wall instead of just communicating with me.

Ally

Whenever I tried to communicate my feelings he would shout in my face while I’d cry and tell me to stop feeling the way I was feeling, it was like he thought I was acting and could simply switch off my emotions. He’d have no empathy and would simply wait until I’d calmed myself down and then tell me how much he loved me and how I was the best person he had ever met. 

As the years went by I got more and more depressed, I’d suddenly found myself isolated from my friends and family, going to work crying every day and being treated like I was his property. 

He would tell me what to do, how to live my life and tell me how much of a disappointment I was.. he’d even started telling me I wasn’t allowed to ask him any questions. My life simply revolved around his and he’d tell me I was ruining our relationship if I wanted to do anything different with mine.

Part of the reason I stayed with him is because he was so nice to everyone else that no one believed me when I did speak out about the ways he was treating me. Friends and family thought I could’ve been taking things out of context and perhaps it wasn’t as bad as I thought it was because he was a “nice guy”. I would start to gaslight myself and think maybe I was taking things out of context even after 4 years together.

Unfortunately trying to leave a narcissist is difficult because they will manipulate and gaslight you just as you reach your breaking point. They make you doubt your own reality and tell you that things aren’t as bad as you believe, they’ll start to be nice and tell you about the future plans of getting married and having kids, being the only one they love and guilt-tripping you until you forgive them. 

The months leading up to our break-up were extremely difficult, his behaviour had somehow gotten worse and he was putting me through distressing situations almost everyday. I had gotten very depressed by this point and was waking up physically shaking with anxiety on a daily basis. 

I was so mentally drained and was finding it impossible to find the motivation to carry on living. 

The best thing I did for myself during my breakup was seek therapy, this helped me to gain control of my life again and taught me how to heal from the trauma I had experienced.”

Narcissistic abuse and behaviour is never a reflection of the worth or actions of the individual suffering at the hands of it, but accepting and coming to terms with this fact is far easier said than done. Therapist Caroline Strawson, who was also a victim of narcissistic abuse from her ex-husband, was forced to spend a long time working on dismantling this belief in her own personal life following her divorce.

Now as an adult, I know I was good enough, but this trauma was literally stuck in the body which is why when I work with my clients we have to do embodied work such as Brainspotting because you can’t think your way out of trauma.”

Currently, there is no known cure for being a narcissist, but psychotherapy is often helpful in building up a narcissist’s poor self-esteem, creating more realistic expectations of others, recognising their own strengths and weaknesses and learning to accept criticism and failure. It is possible for narcissists to relate and engage with others in more positive ways, but reaching a point of willingness for this is often the main barrier therapists face.

If you’re struggling with the impact of living with or knowing a narcissist, the Echo Society, a volunteer-driven not-for-profit organisation providing peer support groups and counselling services, may be able to help. Caroline’s podcast, The Narcissistic Trauma Recovery Podcast is another great resource which she created after leaving her marriage to help others understand more about narcissism, and provide support for those feeling at fault for experiencing this abuse. 

“It takes deep body work but this is at the core of my Narcissistic Trauma Recovery Programme. To move from surviving to thriving and what we call in positive psychology, Post Traumatic Growth. Growth and living an even better life because of the narcissist as they were actually the spotlight and catalyst for you to heal your inner child wounds at a deep nervous system level.”

Whilst the traditional meaning of celibacy typically refers to the state of abstaining from sex before or after marriage for a long period of time – often for religious reasons – as a modern practice, it can be so much more than going cold turkey on sex. 

There are a whole plethora of reasons why someone might choose to partake in voluntary celibacy at a certain point in their life. Some people explore the practice to heal from sexual trauma, recover from heartbreak or sub-par dating experiences (how long have you got?) and focus on connections that serve them rather than those that make them feel ‘less than’. 

For others, it’s a spiritual calling to undo self-destructive patterns and unhealthy coping mechanisms, such as co-dependency or reliance on intimacy as a form of escapism and distraction from uncomfortable emotions they’ve avoided. 

In a world of hook-up culture, unfulfilling casual encounters, and the trials and tribulations of the ‘swipe right’ marketplace mentality, it seems celibacy can offer an opportunity to unsubscribe from all of the above, happily abandoning sex in favour of mental clarity and inner peace. It’s one-upmanship on deleting all dating apps. It’s a hard pass on sex and all its subliminal implications, no matter your gender or sexuality, although it does seem particularly alluring for those of us dealing with cis-het men on the regs, we have to say. Do with that what you will. 

Living a sex-free life can be impossible to comprehend for many but an increasing number of people are turning to celibacy as a self-development practice to redefine what intimacy means to them. Like journaling, shadow work, therapy or cold water swimming, it’s a tool used to nourish the relationship we have with ourselves, providing space to dismantle heteronormative ideals of attraction and love. 

When sexual desire is no longer at the centre of your universe – and being desirable (namely to cis-het men) simply isn’t a measure of your self-worth – you can excavate what emotional intimacy and connection truly looks like to you, without using sex as a default medium for both. By raising your standards and creating healthy non-negotiable boundaries, you’ll never settle for anything less than the nourishment and safety you deserve, in turn, becoming the most embodied version of yourself. 

Whatever your stance on celibacy, your relationship with yourself is always worth working on and staying in your own seggs-free lane to reflect on your inner world without shame is one such way to do it. 

Jordan Jeppe practised celibacy for 13 months after a three-month fling left her heartbroken. Here she shares her journey to finding a deeper connection with herself and explains how celibacy became a catalyst for her healing and empowerment…

A Journey In Deeper Self-Love – Jordan’s Celibacy Story  

I started exploring celibacy after continuously losing myself in relationships. My heart was broken from a three-month fling and I was just starting my solo travelling journey. Celibacy wasn’t just about not having sex. It was an intentional journey of removing myself from partners, healing from the past and ultimately, becoming the person I wanted to date.

Setting an intention with celibacy helps give meaning to why you’re embarking on the journey. For me, it was to establish my self-worth in absence of men and to explore my inner world, without any self-pleasure, through committing to a self-development practice of shadow work.

Jordan Jeppe

This is the difference between celibacy and abstinence. Typically, celibacy refers to a longer period of time of no sex and includes no sexual relations. Abstinence, on the other hand, can mean abstaining from penetrative sex, but engaging in other sexual acts — and is often for a more limited period of time.

What I teach and support in my online course ‘Celibacy: A Journey to Deeper Self Love’ is to set your own rules around self-pleasure. However, this comes with immense responsibility to explore one’s relationship with self-pleasure before choosing to abstain from it while practising celibacy. I don’t say that lightly, this act of responsibility takes courage. 

What helped me see myself fully was exploring the practice of shadow work while celibate. Shadow work is all about revealing the aspects of ourselves that we suppress and deny. The shadow holds our deepest and most subtle traumas, which live within our subconscious minds. Because 95% of our reality comes from our subconscious minds, learning how to embody our shadow selves is how we truly heal and no longer attract, nor project our wounded self onto others – it is living in our authenticity.

Of course, with any journey as intricate and deep as this one, there were some downsides. 

At the time, I was solo travelling through Europe. There were moments the high of dating myself would dissolve. My old behaviours would urge me to download Tinder or Bumble, the thoughts would tell me I was only in Paris for so long – at times I was my own worst enemy. Then there was the fear of having to explain myself to a potential partner, or even worse being gaslighted by someone. 

Another popular question I receive on TikTok is how to know when to break your celibacy. To be honest, there is no right set amount of time because everyone has their own timeline for healing. One of the telling signs for me was this innate feeling that I was ready to put what I had intentionally spent so much time working on to the test. 

That strong feeling put me back on the apps and out into the dating world again, but not without my non-negotiable list. This list was something I constructed while celibate and contained everything I wanted in a partner. It was my guideline for my next partner, it made saying ‘no’ easier, it helped reinforce my boundaries and it wasn’t until a man checked everything on my list –  that I was intimate again. 

When I think back to that moment of wanting to explore celibacy for the first time it was not only an intuitive hit within my body telling me this is what I needed, it was also my life coach putting a mirror right in front of my face. She knew I was just ending a three-month fling and her words hit me right in the chest: “as soon as you let your boundaries down with someone you completely lose yourself.” 

She told me the truth and while it stung with honesty, I needed to hear it. Often we fear we cannot deal with what we see. Our patterns of destruction, low self-worth and codependent tendencies keep us from experiencing deep love – not with others, but with ourselves.

Celibacy, paired with a self-development practice, has the ability to return the power back to yourself. The exact power you were born with and what your authentic self is craving to be. I hope this piece serves as a mirror for whoever needs it.

Jordan Jeppe

If you’re interested in finding out more about celibacy or you’re wondering if it’s the right choice for you, you can sign up for Jordan’s journey to self-love online course at a special discounted rate here. 

From job interviews to first dates, the day you’re 99% sure you’re going to get engaged to the party you know your ex is going to be at (ugh), what you wear has a significant impact on how you feel, present yourself and show up in the world. But what about when inspiration is seriously … lacking? Enter: Team Zoella. We might be partial to re-wearing the same loungewear set one too many days in a row, but on the whole, we know a thing or two about nailing an outfit whatever the occasion, and we’re here to help you on this mission too!

We took to Instagram recently to ask about your fashion dilemmas- the style SOS missions keeping you up at night- and today 4 of Team Z’s most avid ASOS scrollers are here to save the day. From Harry Styles concert ‘fits to star sign themed party dresses, your newfound wardrobe agony aunts are here to save the day…

Lareese is styling…

A Pisces themed outfit for my Zodiac themed birthday at the end of the month

As a fellow Piscean, I totally get why deciding on a birthday outfit might be slightly overwhelming ha! Decisiveness is not our best trait after all. A Zodiac themed party is such a great shout and means you’ll have plenty of options to embrace your water sign with sequins, shine and 50 shades of blue galore. Or, if you didn’t want to lean into the fish sign that hard, you could go for a less is more approach with romantic silhouettes – a nod to your creative and artistic side. I’ve put in a couple of dresses for different budgets but I say the occasion calls for big fish energy. May as well splash out eh!

The Olivia & Alice embroidered organza dress is a vibe (and budget-friendly), and easily dressed up or down with boots, DMs or heeled sandals depending on your mood. Top it off with a headband (or hair tinsel could be fun?!) and you’re good to go for your birthday bash. If you’re not feeling a dress, you could also go for a Pisces power suit – I love this blue suit co-ord paired with a matching bralette and heels. Or, you could go the rental route. Try Hurr or By Rotation for a fancy pants wear-once outfit with none of the guilt! Whatever you end up wearing, you’re sure to look the part just by being your wonderful Piscean self. Happy birthday, I hope you have a ball! 

*ASOS, Labelrail x Olivia & Alice embroidered organza mini dress, £70
Na-Kd, Profile Sole Calf Boots, £44.95
*ASOS DESIGN headband with diamante detail, £12
*Etsy, FishMongersDaughter, Pisces Party Crown, £11.96
*ASOS, Topshop suit co-ord in turquoise, £130
*River Island, CREAM STRAPPY SANDALS, £45
Mango, Glossy baguette bag, £35.99
Hurr, VERSACE TRÉSOR DE LA MER MIDI DRESS, Rental Price £161 – £460

Charlotte is styling…

Harry Styles Love on Tour concert!

If I could start a styling business purely on helping people find their best outfit for a Harry Styles gig I would because the JOY I felt in putting this outfit together was unmatched. I love how instrumental Harry Lambert (very confusing, this is Mr Styles’ stylist for those who don’t know) has been in influencing trends and the style choices of H fans since he started working with Harry, and there are a few subtle nods to his incredible eye and role in Harry’s visual identity in this look.

Because Love on Tour is a celebration of the Fine Line album, I’ve also played homage to one of my favourite songs Cherry with the corset top and earring choice, which I think makes for a fun but a mature way of celebrating Harry’s music! I’ve added an optional feather boa because if you can’t wear one at HSLOT then when can you, eh!

*ASOS DESIGN Hope corset in cherry print, £28
*I Saw It First, Red Petite Tailored High Waisted Trousers, £30
*Claires, Gold 1.5″ Crystal Cherry Drop Earrings, £6
Party Delights, Black Feather Boa, £5.99
*Converse black & red chuck 70 crafted with love trainers, £85

Darcey is styling…

Girls night out for drinks – Stylish but not too formal

This is my go-to vibe for any night out so I hope I can deliver the goods! I personally think you can’t go wrong with a whole black outfit for any night out, it always looks stylish and also means if you spill any drinks it can’t be seen ha. Firstly, I think key staples for any wardrobe are a pair of leather trousers, a black blazer and some chunky boots.

These three items can be interchangeably styled with different tops and accessories so are super versatile. H&M are the best for affordable but good quality leather trousers and blazers, I swear by them. Chunky flat boots give a more stylish feel to your outfit than trainers, but look equally as good (if not better) as heeled boots or heels, cause who wants their feet hurting halfway through the night? For a top, I’ve gone for a basic long-sleeved ribbed top, which will keep you warmer under the blazer but also bring a more casual feel to the look.

Green is having a real moment so I’ve accessorised with a green shoulder bag from Zara with a chunky gold chain, but you could pick any colour really for the bag, it’s just nice to bring a pop of colour somewhere in the outfit. Jewellery wise I’ve gone gold to tie it in with the bag, but I think silver and gold jewellery both look equally as stylish on a night out. Hope this can inspire some looks, you might already have some of it in your own wardrobe too!

*H&M, Imitation leather trousers, £24.99
Mango, Ribbed cotton T-shirt, £17.99
*H&M, Single-breasted jacket, £34.99
Zara, QUILTED SHOULDER BAG WITH CHAIN, £25.99
*ASOS, schuh Anastasia chunky calf boot in black, £40
*ASOS DESIGN gold plated everyday hoop earrings, £12

Danielle is styling…

On my honeymoon trip next month, a cruise to the Bahamas. I need fancyish dinner outfit ideas.

I love this outfit quandary as I’ve done a fair few cruises and they’re SO hard to pack for. You need an outfit for breakfast, an outfit for the pool/beach/excursion and an outfit for dinner which of course needs to be casual, smart casual, or formal depending on the dress code for that night. The key to packing light for me is choosing a pair of heels and a bag that can go with most of your evening outfits, unless you’re a real accessories gal there isn’t much point in wasting case space on bags and shoes. I love this black strappy pair you could lace differently around your foot/leg to give a bit of variation.

For a bag you really don’t need to carry much as you’re always in walking distance to your room, I usually only take out my phone, sea pass and lip/powder product so choosing a chic small evening bag that goes with a lot means you can take the stress out of choosing each night. This beaded clutch from OB is gorgeous and you would get SO much wear out of this Vivienne Westwood pouch. As it’s you’re honeymoon I’ve picked out this lovely flowing off-the-shoulder white dress (which will look great with a tab) as you can dress it up and wear it for an evening and then re-purpose it as a beach throw on later in the week. I’ve also picked out a couple of silky dresses that you can throw in the case for an evening look then dress down and re-wear in the day later on in the holiday. I hope you have the most wonderful cruise!

*ASOS EDITION off shoulder midi dress in oatmeal, £52.50
*Nasty Gal, Strappy Lace Up Kitten Heels, £35
*Oliver Bonas, Dana Faux Pearl Box Clutch Bag, £45
*Farfetch, Vivienne Westwood logo-plaque clutch bag, £151
*ASOS, Topshop blue splodge flower wrap midi dress, £55
*ASOS, Stradivarius wrap midi satin dress in green, £29.99

Whilst in your youth it might have felt like the only people in therapy were the stars of American sitcoms and reality TV shows, as conversations have opened up, stigmas and taboos have lessened and mental health has moved to the forefront of discussion in healthcare, suddenly being in regular therapy feels both achievable and desirable.

If life, with its complex relationships, responsibilities and nuances wasn’t challenging enough, throw in a 2-year long global pandemic and suddenly the need for support in your day-to-day ups and downs has increased tenfold, yet again.

Recognising a need for therapy is one thing, but knowing where to start in finding someone to support you, and even which therapeutic style is right for you is a whole other ball game. Despite feeling overwhelming, finding the right person for you shouldn’t be a deterrent to your MH self-care practices, because life can change exponentially for the better once you have the right support systems in place, we promise. If you’ve been considering exploring therapy for the first time, or are well versed in CBT but considering a different avenue of support, keep reading for a lesson in therapy 101, and all you need to get started on your journey…

The difference between psychotherapy and counselling

Before delving into which approach is right for you, it’s important to be able to differentiate between therapy and counselling, for which you’d be forgiven for assuming they are the same thing! 

Counselling is typically offered on a shorter-term basis, and focuses on identifying and implementing potential solutions to a current issue or problem. A counsellor’s job is not to delve into the past and develop an in-depth understanding of your life and psychological history, but rather to assist you in developing solutions to a current roadblock.

In comparison, therapy is typically a longer-term commitment, focusing on long-standing thoughts, behaviours and feelings that have continued to have an impact on work, relationships and an individual’s quality of life. The two may cross over, for example focusing on a specific real-time issue within a therapy session, and to decide which is right for you it may be useful to speak to your GP or think about what it is you feel is currently holding you back in life and need support with. 

Choosing The Right Type of Therapy: The 7 Styles To Have on Your Radar

Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy helps individuals to change patterns of negative thought and is commonly used to treat anxiety and depression, in addition to other mental health problems. 

CBT may be useful for those in circumstances in which medication has not successfully managed their symptoms, and can provide relief in a relatively short period of time in comparison to other styles of therapy. CBT therapists seek to understand your thoughts and feelings to break down if they are rational or unhelpful and the ways in which they are impacting your life, before interrupting the vicious cycles of negative thinking we all fall victim to at times. The Royal College of Psychiatry says: “​​CBT aims to get you to a point where you can ‘do it yourself’, and work out your own ways of tackling these problems.”

In addition to depression or anxiety disorders, CBT can also help people with:

• Bipolar disorder
• Borderline personality disorder
• Eating disorders – such as anorexia and bulimia
• Obsessive compulsive disorder (OCD)
• Phobias
• Post-traumatic stress disorder (PTSD)
• Schizophrenia
• Sleep problems – such as insomnia

The structured approach CBT offers will be most beneficial to those in a place open to change and with a willingness to spend time on self-analysis and changing thought patterns. For those with any kind of resistance to therapy, it can feel difficult, but on the whole CBT is often viewed as the leading treatment course for the range of issues identified above.

EMDR

Eye Movement Desensitisation and Reprocessing (EMDR) therapy is a type of psychotherapy proven to help people recover from trauma and other distressing experiences, including PTSD, anxiety, depression, and panic disorders.

After the clinician has determined which memory to target first, he asks the client to hold different aspects of that event or thought in mind and to use his eyes to track the therapist’s hand as it moves back and forth across the client’s field of vision.  As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise and the clients begin to process the memory and disturbing feelings. In successful EMDR therapy, the meaning of painful events is transformed on an emotional level.”

EMDR can be useful for a whole range of challenges and mental health problems including:

• Anxiety, panic attacks, and phobias
• Chronic Illness and medical issues
• Depression and bipolar disorders
• Dissociative disorders
• Eating disorders
• Grief and loss
• And more!

To learn more about EMDR, check out the book EMDR: The Breakthrough “Eye Movement” Therapy For Overcoming Anxiety, Stress, And Trauma written by Dr. Francine Shapiro, the originator and developer of the therapy!  

Psychodynamic Psychotherapy

Be it depression, anxiety, panic attacks or stress-related physical ailments, psychodynamic psychotherapy focuses on the psychological roots of emotional suffering and the importance of the unconscious mind and past experience in shaping current behaviour. In simple terms: PP unpacks the ‘why’ of our feelings and experiences. Sessions of Psychodynamic Psychotherapy are based on free association (sharing thoughts, words, and anything else that comes to mind,  and this spontaneity allows for true thoughts and feelings to emerge without any concern for how silly they may sound to the therapist. Spoiler: there’s no such thing anyway!

Within these sessions a therapist may remain quiet and potentially more neutral than within other styles, however they will be highly attuned to your emotional responses and what these might say about past experiences and how these feelings are currently manifesting. A Psychodynamic therapist will support you in coming to conclusions about your past and moving forward with these issues, but will not provide tangible or practical advice, unlike CBT.

Give it a try if you struggle with:

• Anxiety
• Addiction
• Eating disorders
• Depression
• A loss of meaning or purpose in life

Integrative Counselling & Psychotherapy

Integrative Counselling looks at every aspect of an individual’s life, recognising their mental, physical and emotional needs and uses different therapeutic modalities to tailor an individual approach to the specific needs of the client. Integrative Counselling recognises the idea that we’re all made up of different psychological parts – some of which may be in conflict with one another– and aims to unify them using three main schools of psychotherapeutic thought: 

Humanistic theory – This theory emphasises the importance of being true to yourself and your inner feelings in order to lead the best life possible. 

Cognitive behavioural therapy (CBT)– As discussed above, this style of talking theory is based on the concept that our thoughts, actions, feelings are all interconnected, and that negative thoughts can easily leave you feeling trapped in a vicious cycle. 

Psychoanalytic therapy – This style of therapy is based on the idea that psychological issues are rooted within the unconscious mind, and that mental health issues such as depression and anxiety can be caused by repressed trauma, or issues that occurred during childhood. 

The blending of these techniques means therapists can draw from different methods in their therapeutic toolbox, making for a flexible, dynamic approach that helps clients who need a mixture of behavioural and relational approaches. The adaptability of this method means no stone will be left unturned in the name of healing!

Existential Psychotherapy

This unique form of psychotherapy looks to explore difficulties from a more philosophical perspective, encouraging us to take responsibility for our successes and confront anxieties and negative thoughts head on. Existential Psychotherapy focuses on personal responsibility for making decisions, and rather than delve into the past, is more focused on present day choices and feelings. Existential Psychotherapy promotes the idea that you are not defined by your past, nor destined to have a certain future because of it, and this liberating belief can then form the foundation for progress and create a new lease of life!

Humanistic Therapy

Humanistic therapy is an approach that emphasises the importance of being your true self in order to lead the most fulfilling life, working to create a safe, supportive space where an individual can explore their potential, mentally, emotionally and spiritually. This is accomplished through the development of unconditional positive regard, both from others and from yourself! This approach is especially suited to anyone feeling lost, struggling with low self-esteem and can be effective for people living with specific conditions, such as anxiety, panic disorders, addiction, depression, OCD, bipolar disorder and schizophrenia. 

Person Centred Counselling

Person Centred Counselling was created in the 1940s by American psychologist Carl Rogers who believed that “given the right conditions a person can reach their full potential and become their true self”- a theory he referred to as ‘self-actualisation’. For someone to achieve self-actualisation, a person-centred therapist will offer:

• Unconditional positive regard (UPR) – accepting and valuing an individual’s experience
• Congruence – being honest and genuine in building a trusting relationship 
• Empathic understanding – seeing a situation from the viewpoint of the individual

This approach creates an environment in which the therapist and client are both equals, which empowers and motivates positive action and change. Here, the client leads the session instead of the counsellor, and as a result individuals have a better understanding of themselves and increased confidence in their healing journey.

“When I work with clients experiencing deep sadness in their struggles with depression, I like to integrate Person Centred Therapy into our work together, along with other supportive theories, because it can help clients process their feelings in a deeply healing and self-compassionate way; processing and integrating our emotions and experiences is key to moving forward towards our life’s goals,” says Talkspace therapist, Kate Rosenblatt, MA, LPC, LMHC.

This approach can also be beneficial to individuals who are opposed to the idea of therapy as a result of their fear of judgement or criticism thanks to the atmosphere of unconditional positive regard fostered by client centred therapists. 

Finding a therapist near you

NHS Therapy

If you have access to the NHS then your local GP can refer you for therapy that is free of charge. Whilst it’s not always easy to speak openly about your mental health, your GP is there to support you, and Mind has some great advice available in preparing for this conversation. Some areas within the UK also run services which you can contact directly to refer yourself for therapy- contact your local GP practice to find out more. Unfortunately there are often long waiting lists for NHS therapy, however starting this conversation can be a helpful first step in feeling you have made progress, and making your GP aware of how you’re feeling means you don’t have to face your problems alone. 

Private Therapy

Counselling Directory

Whether you’re looking to start working with a therapist or counsellor, be it online or in person, Counselling Directory is a great website to begin your journey in finding the right person for you! With over 16,000 registered professionals onsite, there’s sure to be one who can help support you, wherever you are with your journey. 

British Association for Counselling and Psychotherapy 

The British Association for Counselling and Psychotherapy (BACP) website has an extensive register of therapists and counsellors with BACP membership- this means all those on the site have completed a BACP accredited course, or passed their Certificate of Proficiency and meet their standards of qualification to be best placed to help you!  

Pink therapy 

Pink Therapy is the UK’s largest independent organisation for therapists with LGBTQ+ experience. They recognise “the spectrum of different gender and sexual expressions and welcome those who are engaged in consensual sexualities who are seeking a place to understand and be understood.”

Important things to consider when choosing a therapist

Choosing someone to support you with your mental health is a very personal decision, and just because a therapeutic approach or individual has helped someone close to you, doesn’t mean they will be a good fit for you. Consider factors like gender, age and experience when seeking out a therapist as feeling comfortable, supported and understood are integral for a positive and productive relationship that will help you on your journey. Lots of therapists offer intro calls or discounted first sessions so you can see if you gel with each other and decide if you want to move forward, so always be sure to ask if this is a possibility!

Know that the first person you speak to or initial sessions with a new therapist aren’t always easy, as getting to know each other and opening up to a stranger can be incredibly challenging, but with trust and perseverance, you might find strength and progress may come sooner than you think. Be gentle with yourself and patient with your healing. 

We’re all familiar with the phrase ‘do the work’ when it comes to the practice of self-love but how many of us have considered our inner child within the framework of healing?

Everyone has an inner child but not everyone knows how to engage with them. The first step in the process of self-discovery is to acknowledge them, embracing their existence with self-compassion and allowing them to take up space in your adult life. 

Through mindfully accepting this part of ourselves, we can begin to understand which negative belief systems stem from our childhood and cause us to react the way we do to certain people or situations. 

We spoke to Doctify-reviewed Dr Venetia Leonidaki, Consultant Psychologist and Founder of Spiral Psychology, to find out how to let our inner child come to light in order to reclaim our childhood, reshape our reality and live a fuller, happier adult life. 

Exploring the “inner child” & why it’s important to us in adult life 

Everyone has an inner child but many of us subconsciously sever the connections when we transition into adults. When our needs aren’t met as a child, the inner child becomes wounded and the resulting patterns of behaviour can impact our self-esteem in adult-life, leading to unfulfilling personal relationships or the development of self-destructive life patterns. 

Dr Venetia Leonidaki explains, “The inner child describes an emotional state or a way of being, which is a remnant of the child that we once were. It is about the part of us that feels vulnerable, easily gets hurt or angry, acts impulsively but also has the capacity to experience pure joy and be spontaneous, playful, and innocent. As all adults have been children, we all carry a child part within us but how well connected each of us feels with their inner child varies enormously.” 

Connecting to your inner child allows you to explore the part of your personality that both reacts and feels like a child. Things that happen when you’re younger can leave a mark on the psyche. Healing your inner child focuses on uncovering and releasing the causes for the childlike aspects of your personality, so you can react to future challenges in your adult life as an adult, rather than a wounded child. 

“The concept of an “inner child” helps us recognise more fully our emotional needs, which could otherwise easily be dismissed as irrational and foolish. As children, we all have the same core needs for safety, love, validation, autonomy, spontaneity, and respect of boundaries. 

“In adulthood, we continue to have these same needs, which, if they remain unmet for a long time, could lead to a range of mental health difficulties. Learning to listen to our inner child, find ways to nurture it, and meet these core needs as much as possible will give us the best chance to enjoy a sense of contentment and fulfilment in life. Ignoring or being blind to our inner child could result in a sense of neglect or disconnection or our impulses taking over control, leading to self-destructive behaviours,” says Dr Venetia Leonidaki. 

No one’s going back for that inner child. Except you.

Tanya Markul 

Why we lose touch with our inner child  

As we grow up, we lose touch with our inner child’s needs, pains, hopes and dreams, often neglecting who they are to fit society’s version of who we have to be. When we are little, we are not concerned with what is real and what’s not, reality and make-believe run into one another like carefree watercolours. Then one day, we play for the last time. We neglect our inner child in order to make room for our adult lives and the various expectations we need to meet to be accepted.  

Dr Venetia Leonidaki says, “From early on in life, we need to strike a balance between the emotional needs that we feel inside and the demands made or restrictions imposed by other people around us. Our parents, teachers, and later on our partners, employers, children require from us to show a responsible attitude, control our emotions, be rational, and conform to societal norms. As we constantly have to negotiate our internal needs with external pressures, we often end up suppressing and cutting off from our inner child. 

“Our desire to please other people and our fear that we will lose their love if we don’t also result in neglecting our inner child. Neurobiology plays a role, too. Changes in certain areas of the brain, such as the prefrontal cortex, lead to new levels of sophistication in our thinking, which make us better prepared to regulate emotions and impulses. Our most sophisticated, grown-up, thinking capacity could make us rely less on raw emotions, which our inner child is mostly in touch with, driving us away from the childlike part of ourselves.”

5 ways to connect with your inner child

If you’re ready to embrace your inner child, here’s five ways you can open your heart to that part of yourself with compassion and kindness. 

1.   Be creative. Engaging in any artistic activity or game requires us to apply our imagination, loosen our defences, and tap into our emotions. You could try anything from artwork to playing pantomime or singing karaoke. Creative tasks unlock our childlike qualities, including being spontaneous, playful, inventive, and having fun. 

2.   Contact with children. Spending quality time with children, including your children, will give you a first-hand experience of a carefree but also highly emotional state of being. It could also make it easier for you to recollect memories and feelings from your own childhood. 

3.   Falling in love. This is not something that we can plan of course, but when we are in love, we will find ourselves experiencing a range of emotions that may be similar to what we experienced as children. Our increased need for affection and closeness, a sense of jealousy, separation anxiety are all examples of emotional states that we feel intensely when we are in love and have strong links to our childhood.

4.   Tap into childhood memories. We could simply close our eyes and allow our mind to take us to childhood memories, which can be recollected more vividly when we focus on small details or sensory elements. What did we look like? Any smells that we can recollect? Going back to look at old photos, re-discover childhood toys, or revisit places that we used to go as children can also help with this task.

5.   See a therapist. Having a therapist to guide us through this process can be extremely helpful. A therapist can help by pointing out any subtle or buried emotions that may belong to this part of yourself.  Some therapists also use experiential techniques to bring your inner child to the surface. Chairwork, where you are asked to sit in a chair representing your child self and talk from the child’s perspective is an example of such a technique.

May we raise the bar for how we live our lives. May we ridiculously increase the amount of peace, creativity, play, beauty, love and joy in everything we do. May we all slip from the wisdom of our suffering. And awaken to the courage to share our stories that can heal and free our inner and outer worlds

Tanya Markul

The benefits of inner-child work 

Though taking a deep dive into the past and how you felt as a child isn’t always comfortable work, it can provide a new depth of self-awareness and understanding, meaning adult-you can access a new level of self-compassion for the role that child played in who you are today. It can also teach you to reframe your way of thinking, putting enough distance between your inner child and who you are now. 

Once you’re able to identify where certain emotions or “life-traps” stem from, you can begin to heal the inner child, in turn healing your whole adult self too. Your inner child can also lend you great strength in your adult life, unearthing forgotten parts of yourself and regaining a sense of playfulness, creativity, optimism and the joy of simple things. 

Healing your inner child when trauma is present 

For anyone with unresolved trauma or difficult childhood memories, the thought of revisiting their inner child can be triggering. It might even feel counterproductive to revisit past events but, as Dr Venetia Leonidaki explains, with the guidance of a therapist, acknowledging that vulnerable person instead of ignoring them can help process painful deep-rooted emotions, meeting the needs of your inner child and giving them an opportunity to be seen, heard and loved. Working to heal your inner child cultivates self-worth, allowing you to express these repressed emotions in a healthy way. 

“If you experienced childhood emotional neglect for example, you may have to work extra hard as an adult in order to recognise how you feel inside and express it to others in order to satisfy any unmet needs for emotional connection and validation. Thus, practising any life skills that you may have not had the chance to develop fully early on in life makes it more likely for you to get your inner child’s unique needs met.”

7 signs your inner child could need healing

1.  Recurrent traumatic memories of childhood experiences that made you feel highly anxious, ashamed, or neglected.

2.  An absence of childhood memories of feeling loved, looked after, and cared  for.

3.  Current difficulties with anxiety or depression.

4.  Addictive behaviours.

5.  Relationship difficulties that prevent you from enjoying harmonious relationships or finding a trustworthy romantic partner.

6.  Trying very hard to please other people and finding it almost impossible to say no

7.  A strong drive to achieve constantly to prevent feeling empty or unworthy.

Types of therapy 

Whether it’s issues of abandonment, low self-esteem, mistrust and abuse, social exclusion, or dependence, identifying how these negative life patterns play out every day can help you break them down, empowering you to move forward with your adult life, validate your needs and begin nurturing your inner child. 

“Traces of the inner child concept can be found in various forms of psychotherapy engaging with childhood experiences. A contemporary therapy that explicitly uses inner child work as a cornerstone of the therapeutic process is schema therapy. All healthy adults can go in and out of different models, according to schema theory. Modes refer to states of mind, versions of oneself, which get activated at different times. Switching between modes is like changing gears. The child mode is one of the most important modes to consider clinically in schema therapy,” says Dr Venetia Leonidaki. 

Core tasks of the therapeutic work in schema therapy include how to:

1.     connect better with our child mode.

2.     help the child mode get their core emotional needs met, including the need for safety and love. 

3.     stop any inner critics from putting down or bullying our child mode.

“Schema therapy was originally designed for individuals suffering with a personality disorder. However, it has been found useful for a range of difficulties, including anxiety, depression, trauma, childhood adversity, relationship difficulties and substance use. Schema therapy is particularly useful for clients dealing with unhelpful long-standing patterns, called life-traps in schema language. Anyone who would like to feel better connected with themselves and integrate better the different aspects of self could benefit from schema therapy.”

Booking in for your smear test can be a journey. The thought of having to put your vagina in the face of a stranger, albeit a gloved-up professional one, does not usually make for a relaxing situation alas, it’s the best way to check the health of the cervix and to detect high-risk Human Papillomavirus (HPV) or precancerous abnormalities. 

If your cervical screening shows abnormal results, don’t panic (easier said than done, we know). Whilst 1 in 20 people with cervix will have an abnormal smear test result only 1 in 2000 will have cervical cancer.

An abnormal smear result usually means that minor changes were found in the cells in the surface membrane of the cervix, known as squamous cells. It takes many years for these abnormalities to develop into cancer but with regular screenings, cell changes that could potentially cause cancer in the future if left untreated can be picked up at an early stage. That’s why attending your smear test is so important!

To sort the facts from the fiction and make your next routine smear more bearable, we spoke to Senior Consultant Obstetrician and Gynaecologist, Dr Nitu Bajekal to find out what to expect when you get an abnormal test result. 

The importance of attending cervical screening 

Understanding why we’re invited for a smear test in the first place and what they’re looking for when they’re shining a bright light up there can be, well, enlightening! 

Whilst it’s hardly going to feature on your ‘three positive things that happened today’ list, knowing exactly why you’re going can help take the stress out of the appointment and put your mind at ease. 

There are plenty of reasons why someone wouldn’t want to attend a screening, whether it be down to embarrassment, concerns about the results or if the procedure will be painful and even access to convenient screening times, but showing up for yours is your best chance of preventing cancer. 

Cervical screening tests for a virus called human papillomavirus (HPV) and virtually all cases of cervical cancer are linked to high risk HPV.

If every eligible woman or person with a cervix attended cervical screening, 83% of cervical cancer deaths could be prevented (Cancer Research UK). 

Pap test, smear test and cervical screening – what does it all mean? 

The terminology used to refer to the test itself can be reason enough to feel confused and worried about attending yours. Essentially, they’re all synonyms for the same thing as Dr Nitu Bajekal explains, “A smear test is also known as cervical screening, cervical smear or Pap or Papanicolaou Smear or Pap test (after Dr Georgios Papanikolaou, a Greek physician, one of the pioneers in the early detection of cervical cancer). 

A smear test is NOT to detect cancer  

It’s a common misconception that the purpose of having a smear test is to detect cancer but cervical screening is used to detect abnormal cells years before they turn cancerous. It is a test to help prevent cancer. 

“A smear test is not used for detection of cervical cancer but is a screening tool to highlight those people with a cervix that need to be referred for further tests if abnormal cells are detected on a smear,” says Dr Nitu Bajekal. 

Let’s talk abnormalities

Getting an abnormal result can be daunting – it’s natural to be concerned about the severity of your cell changes and the implications this may have on your health – but it does not mean you have cancer. The result represents a precancerous abnormality on the cervix.

“For every 100 women or those assigned female at birth (AFAB) people who have a smear test, 94 will have a normal result (negative or clear smear) and return to routine recall. Six of them will have an abnormal test. Two will have no evidence of HPV infection and will return to the NHS national protocol of smear tests every 3 years from age 25-49 and every 5 years from age 50-64 if smears have always remained clear or negative for changes. Four people with a cervix will have precancerous cells of various grades (low or high-grade dyskaryosis) and will need to be referred for a colposcopy (a colposcopy involves inspecting the cervix with a special type of magnifying instrument),” says Dr Nitu Bajekal. 

Possible reasons for an abnormal smear result

“The most common reason for an abnormal smear test is the detection of early precancerous cells, known as low-grade dyskaryosis. A small group will have higher grade changes (high-grade dyskaryosis or detection of high-grade glandular changes),” says Dr Nitu Bajekal.

Other factors can also affect a smear result from pregnancy to menopause and blood. “Sometimes excess vaginal discharge, vaginal infections or blood contaminating the smear test may initially suggest an abnormal result such as a borderline or inadequate result (smears are ideally performed mid-cycle when plenty of cells are obtained and not during a period). Menopause, when periods have stopped cause a drop in oestrogen levels which can make the vaginal/cervix tissues atrophic (thinned out) so enough cells are not obtained in the sample from the neck of the womb and the result is known as inadequate. Pregnancy / postpartum (6-8 weeks) can also result in not having a clear smear report. However, in almost all these situations, the HPV test is negative, which means the person can be reassured.”

If there are symptoms of bleeding after vaginal sex, bleeding in between periods or pelvic pain, Dr Nitu Bajekal suggests seeking urgent medical advice, even if it is just for reassurance. Don’t wait for your routine smear. 

Understanding high-risk HPV

Human Papillomavirus is the most common sexually transmitted infection and is usually harmless, but some types can lead to skin warts, genital warts and some forms of cancer, including cervical cancer.

“Most people have no symptoms from the HPV infection and clear it on their own.”

However, for some people, the virus remains dormant in the body and if it is High-Risk HPV, it can cause changes in the neck of the womb known as dyskaryosis (low/high-grade changes) and precancerous cells may develop (Cervical Intraepithelial Neoplasia CIN 1,2,3) which over several years may turn into cervical cancer in a small minority over several years. It is usually not possible to trace the source of the HPV infection, as it may have been lying silent for several years before any symptoms are experienced.”

CIN grading 

CIN refers to Cervical Intraepithelial Neoplasia, these are pre-cancerous changes within the lining cells of the neck of the womb. 

There are three grades of CIN (CIN1, 2 & 3). CIN1 is considered low grade and CIN2 and CIN3 are high grade changes and need to be treated to prevent future risk of cervical cancer whereas minor changes such as CIN1 will often resolve on its own and revert to normal as the HPV clears.  

I have an abnormal result, what happens next?

Scenario one 

• Primary HPV testing from age 25 in the UK
• Tested for the presence of certain strains of HPV known as HRHPV (High- Risk HPV)If negative for HRHPV, no further tests required.
• Back to Routine 3-5 yearly recall.

Scenario two 

• Primary HPV testing from age 25 in the UK 
• Tested for the presence of certain strains of HPV 
• If positive for HRHPV, then the cells are examined for changes (dyskaryosis). These can then be treated before they get a chance to turn into cervical cancer.
• If it is clear or negative for cell changes, a smear and HPV test is recommended in 12 months in most situations. 

Scenario three

• Primary HPV testing from age 25 in the UK 
• Tested for the presence of certain strains of HPV 
• If positive for HRHPV and cells examined show evidence of changes (low grade or high grade dyskaryosis), referred to colposcopy where the cervix is assessed under magnification for precancerous cells (Cervical Intraepithelial Neoplasia CIN 1,2,3 – CIN 1 considered low grade and CIN 2and CIN 3 as high grade).

More on colposcopy 

“Colposcopy is part of a screening programme to ensure the cervix stays healthy. Your smear test has shown some changes in the cells, or you have tested positive for some of the HPV strains. In many cases these changes return to normal without treatment but sometimes the changes become worse and could lead to cancer in the future. We sometimes call these cells, precancer or early warning cells. As there is no way at present of knowing whose cells will get better or worse, it is wise to monitor everyone who has these changed cells, as a preventative measure.

“If there is no biopsy indicated and the cervix shows just minor changes, you may be asked to return in a year’s time for a further smear test as many women will clear the virus spontaneously. Depending on the results of the cervical biopsy, you may be advised just monitoring or to have treatment (LLETZ – Large Loop Excision of Transformation Zone) to remove the abnormal cells under local or a short general anaesthetic.”

What happens in the event of high-grade changes?

“If this is the case, a treatment to remove the abnormal cells with high-grade changes from the cervix is recommended (LLETZ, LEEP, Loop diathermy). This is usually an office or outpatient procedure performed under local anaesthetic, or local anaesthetic and sedation or under a short general anaesthetic as a day case depending on the patient’s wishes and certain findings at colposcopy (such as previous treatment, large lesion, highly anxious patient, difficult access).

“A deeper treatment such as a cone biopsy may be recommended, or occasionally if LLETZ or cone biopsy is not appropriate or the person has additional genealogical problems, a hysterectomy may be advised after all other options have been considered. These decisions are not taken lightly and only after a review of the entire medical history, the biopsy findings, and the patient’s wishes in a multidisciplinary team meeting (MDT). Similarly, in any case, that has unusual findings or if the patient is very young, discussions by a team of experts ensure the best treatment outcome for the patient.”

Treatment methods

“Ablative treatment such as freezing or cryotherapy is generally not a preferred option in the UK as there is no tissue removed to analyse that all precancerous abnormal cells have been removed, unlike the above procedures which are excision procedures where tissue that is removed is sent for detailed analysis by the histopathologist.”

Loop electrosurgical excision (LEEP) or LLETZ as known in the UK 

“An LLETZ (Large Loop Excision of the Transformation Zone), also known as LEEP (Loop Electrical Excision Procedure) or a loop diathermy procedure, is most commonly performed under a local anaesthetic to remove abnormal cells from the cervix. A cold knife cone biopsy is sometimes performed instead of an LLETZ procedure to remove abnormal cells, depending on the nature or type of cells seen. Your doctor will guide you as to the best option for your situation. The procedure takes a few minutes, with the entire appointment taking between 20-30 minutes, to ensure you are comfortable and the local anaesthetic is working properly. 

“After treatment, in most situations, once the cells removed have been analysed to confirm there are no serious concerns, you will be invited for a TOC test (test of cure) in six months. This is a smear test to confirm you have gotten rid of the HPV infection and that there are no persisting abnormal cells. You will be advised of the results of the tissue removed at the LLETZ procedure. Depending on these results, further management will be decided. You will usually be followed up with a smear in 6 months (Test of Cure). Most women will return to normal recall for smear tests. Further, follow up with colposcopy or further treatment may be needed in some situations.”

What are the possible risks of treatment?

LLETZ is the most common treatment for cervical cell changes. It uses a thin wire loop with an electrical current to remove the affected area of the cervix. Although it sounds petrifying, it’s a relatively straightforward treatment and you can always ask your colposcopist or GP before treatment if you’re concerned or want them to talk you through what to expect in your appointment.

As with any procedure, LLETZ has small risks but in many cases, the benefits outweigh the risks as Dr Nitu Bajekal explains:

“The procedure is only offered if it is thought to be in your best interests. The small risks include a 1 in 100 risk of heavy bleeding, or infection and a 5 in 100 risk of needing further treatment because of persistent abnormal cells or new abnormal cells developing in the future. 

Most women feel fine after having treatment to the cervix, but a few may feel the need to go home and rest. Either way, it is recommended you don’t plan to do anything else that day.

You may have some period type pains for the rest of the day once the anaesthetic has worn off, and it seems that having pain seems to be more likely in women who haven’t had children. You may take your normal painkillers or paracetamol.

Bleeding

“You should expect to have some bleeding or discharge after this procedure, sometimes up to 3-4 weeks, with the amount varying depending partly on the type of treatment you have had. Some women have none. The bleeding may stop after a few days but start again 10-14 days later. This is the scab coming away and nothing to worry about. It will stop eventually. You may also notice that your next period may be slightly heavier than normal, and again, this is nothing to worry about. If you are on the contraceptive pill, I recommend that you take the pill back-to-back for a couple of months to avoid the heavier period if you so wish. This is safe to do.

“If you start to bleed very heavily, you should seek urgent medical advice. Infection can occur occasionally, but to minimise this, do not use tampons or have sex for three weeks after the procedure. Heavy exercise and swimming are also not recommended for three weeks. If you develop an infection (pain, high temperature, unpleasant smell and/or generally feeling unwell) you will need to seek medical advice urgently.

“Avoid vaginal intercourse for 3-4 weeks to avoid disturbing the healing wound and reduce risk of infection. You should be able to drive when you feel comfortable. You should wait for at least 24 hours after a general anaesthetic.”

Can treatment affect future pregnancies and fertility?

“There is no real risk to fertility. There is a very small increased risk of preterm labour (babies born before 37 weeks gestation) or needing a stitch in the cervix (cervical cerclage) as a result of weakness of the neck of the womb after treatment to the cervix. There is also a small chance that the cervix may not dilate as it should during labour (cervical dystocia) and a caesarean section may be indicated in such situations. These risks are slightly more common with cold knife cone biopsy. 

“Depending on the results of the cells removed from the cervix and the amount of tissue removed from the cervix, you may be advised to inform your obstetrician so that you can be monitored during pregnancy and the length of your cervix measured by regular ultrasound scans to watch for any potential weakness developing. Recently, there has been some concern about sexual orgasm being affected after treatment. This is very uncommon and as mentioned, treatment is only offered when the benefits outweigh the risks. In my 35 years of practice as a gynaecologist, this has not been an issue for my patients who I have been following up for a while. However, I must stress all these risks are very small and should not deter from having necessary treatment.”

One thing Dr Nitu Bajekal would like everyone to know about smear tests!

Useful Resources

NHS, BSCCP, RCOG, www.nitubajekal.com , Jo’s cervical cancer trust. 

You can also buy Dr Nitu Bajekal’s book here.

For more information on what to expect from a cervical smear test, check out our article on Dismantling The Fear of the Smear. 

It’s term time at Euphoria High, and if you plan on enrolling you better strap in for the ride …

HBO’s hit coming of age show Euphoria is currently returning for its second season, after turning heads and sparking conversations everywhere when it debuted back in 2019, and if there’s one thing we’re obsessed with as much as the dreamy cast it’s their iconic wardrobe design. Heidi Bivens, journalist-turned-stylist-turned-costume designer, is behind the visual identity of each character’s wardrobe, and as a result has inspired trends Gen Z seriously can’t get enough of- think cut-out flares, pastel tracksuits and vintage style low rise jeans. The differentiation between each character’s deeply emotional journey’s and ever-changing identities are perfectly conveyed through their outfit choices each episode, and if you can bank on one cultural moment impacting 2022 fashion for the masses, it’s Bivens and Euphoria.

Pair this with the now iconic make-up direction by MUA and genius behind the Euphoria looks, Doniella Davy, and you’ve got a perfect storm of unique and exciting character identity’s everyone wants a slice of. Think face gems, wet-look lids, glitter lined eyes and understated skin and you’ll be well on your way to fitting right in with Rue, Cassie, Maddy and the gang.

If you want to jump on the trends everyone is pining for, keep scrolling and get adding to basket…

*This post contains ad-affiliate links

Restlessness, an inability to concentrate, mood swings, forgetfulness and an inaptitude for dealing with stress. Whilst all of the above are barriers to a peaceful life we all battle from time to time, the cocktail of them all, plus countless more, can be symptoms of attention deficit hyperactivity disorder,  known commonly as ADHD.  The disorder is estimated to affect 1.5 million adults in the UK (ADHD Action), but only a fraction of those – around 120,000 – are formally diagnosed making the journey to understanding why life can feel so challenging for those impacted even more so. 

According to Verywell Mind– award-winning resource for reliable, compassionate, and up-to-date mental health information- below are some of the most typical ADHD symptoms girls and women may experience:

• Appearing withdrawn
• Daydreaming 
• Difficulty maintaining focus; easily distracted 
• Doesn’t appear to be trying 
• Doesn’t seem motivated
• Forgetful 
• Hyper-talkative (always has lots to say, but is not good at listening)
• Hyperreactivity (exaggerated emotional responses)
• Appearing to be making “careless” mistakes
• Problems completing tasks 
• Seeming shy
• Seeming to get easily upset 
• Shifting focus from one activity to another
• Taking time to process information and directions; seems like she doesn’t hear you
• Verbally impulsive; blurts out and interrupts others

It’s important to note though that whilst common, ADHD in adulthood does not always carry a sense of chaos, and can in fact sometimes be perceived as a never-ending ability to be enthusiastic, energised and hyper-focused when a goal is in need of completion. In education, women with ADHD are bright and intelligent as their symptoms can present more subtly, however at critical times (such as during exams) they may underperform due to concentration issues, and the cycle of perfectionism begins again. 

Problems arise in such behaviours when someone does not possess the ability to focus on something they may not personally find interesting, and also in the inability to remove focus from an interesting subject when the time comes and other responsibilities call. Behaviours, such as hyper fixation, which typically present in women are documented, publicised and discussed far less in comparison to the more commonly associated ADHD symptoms and why it’s far less common for women to seek help.

Manchester-based mental health and style content creator Francesca Perks openly shared her experience of being diagnosed with ADHD in her twenties and both the challenges and relief that came with it. 

Fran’s route to diagnosis wasn’t necessarily typical, but comes as a product of the lifestyle changes many of us experienced during the pandemic, and the rise of the social media platform that’s seen screen time rocket: TikTok. 

“The day I got my diagnosis, although there was a plethora of flooring emotions swirling around, vindication was a large one. With the self-esteem issues that come with undiagnosed ADHD in women – largely, due to the issues we face with ADHD, we take inward and blame ourselves other than, god forbid, a neurodevelopmental disorder –  to keep on pushing through the most trusted opinions of people in your life in order to believe in yourself felt almost euphoric.

It’s changed my world over and over. Diagnosis alone, not even in regards to medication has given me a much better scope of who I am as a person, past and present, and given me the ability to forgive my past self for the missteps in my life that, up until the diagnosis, I took inwards and blamed myself for.

Francesca Perks

“However, the most profound takeaway I had from my positive diagnosis was a stark reminder to trust myself and my intuition for fighting to get the diagnosis, manoeuvring through the failings and missteps from my doctors and all the times when the process was stagnant and the peers in my life that dismissed me. It was the perfect storm for me to simply just give up, and settle with the notion that I was simply the problem. There is absolutely no harm in seeking answers, and whether that be a positive or negative diagnosis, you’re a step closer to understanding yourself, and potentially leading you in the direction of knowing yourself better. That can *only* be a great thing right?”

Thankfully, as attitudes change and new research continues to provide a clearer look at ADHD and its impact, the scope for seeking help and successfully managing symptoms grows. Companies such as ADHD 360 (used by Fran to receive her diagnosis) offers a no-fee initial screening which, if suggestive of a potential positive diagnosis, will lead to an official assessment and regulated treatment plan to help you on your ADHD journey. 

Help and Support

There is no cure for ADHD and the behaviours it presents, but there are plenty of options when it comes to managing and improving the quality of life of those who struggle with it. There are 5 types of medicine licensed for the treatment of ADHD: Methylphenidate (the most commonly used), Lisdexamfetamine, Dexamfetamine, Atomoxetine, Guanfacine which may help someone with the condition concentrate better, be less impulsive and overall feel a greater sense of calm.

Therapy is often suggested as a means of managing ADHD, in particular CBT, with a 2016 neuroimaging study of adults with ADHD showing improvements in ADHD symptom ratings and beneficial changes in the same brain regions that are typically monitored in studies of medication treatment after a 12-session course of CBT. This type of talk therapy works by helping to improve daily life struggles those with ADHD may face, including procrastination and time management, and not by treating the core symptoms of inattention, hyperactivity, and impulsivity. One of the most helpful means by which therapy can help someone with ADHD to feel more in control of their behaviours is through education, helping to normalise and manage their symptoms and understand that their tendencies are not character flaws. 

You are able to give yourself an air of grace with every ADHD-ish misstep you make, when before I would take that guilt inwards and it would simply be another strike on the quite lengthy tally of – God you really are quite bad at existing

Francesca Perks

For help, support and a sense of solidarity online, we love Instagram pages @iampayingattention (the badass neurodivergent membership platform designed with women in mind), @the_adhd_femme_collective (the vision behind the The ADHD Data Gap campaign passionate about normalising the experiences of women with ADHD) and @noranordfromnorway, founder of the ‘You & Me: Let’s Talk About ADHD’ podcast and photographer, whose portrait series sees her meet people who experience ADHD and hear their underrepresented stories. To accompany this work and support the community the project has formed, she has compiled an ongoing resources list of documents, books, and organisations most helpful, wherever an individual is on their ADHD journey.