• B.A. (Honours)
• Masters Clinical Psychology
• Australian Psychological Society (APS)

Yes.

Consulting Address	Location 1 833 Glenferrie Road Kew VIC 3101 Location 2 74 Bendigo Street Richmond VIC 3121
Contact	Phone: 9819 3671 Fax: Mobile: 0419 104 284 Email: catherine@socialanxietyassist.com.au Website: www.socialanxietyassist.com.au

Areas of Speciality	Generalised Anxiety Panic Disorder Social Anxiety Phobias Depression Self-Esteem Stress and Coping Sleep Disorders Pain Management
Treatment For	Adults Adolescents
Languages other than English	No
Hours/Consulting Times	Monday to Friday 8.00am to 8.00pm
Fee Details	$150 per hour $120 per hour with Health Care Card (The Medicare rebate for clinical psychological services is $110 per hour for individual therapy and $28 per group therapy session, with a referral from a GP)
Other

Therapeutic Techniques Used

• Cognitive Behavioural Therapy (CBT)

Outline of Treatment approach

Catherine uses cognitive behavioural therapy to treat anxiety, depression and chronic pain. Catherine specialises in social anxiety and offers individual and group therapy for social phobia.


EMERGING FROM SOCIAL ANXIETY

For those who suffer from a social phobia there's always a dark cloud overhead about to rain on their parade, writes the War Cry.

We have all, at one time or another, suffered from a bad (and ill-timed) case of nerves before a social or professional event.

Maybe it accompanied our first foray into public speaking or our first big birthday party, however, most of us find that after a while we get used to the situation, and are able to control our nerves. Yet for some people within our community the thought of having to place themselves in social situations can make them physically ill. Unsurprisingly, such people suffer from something known as "social phobia".

Research has shown that people most likely to suffer from a social phobia tend to display emotional personality traits and, as such, are more likely to become depressed, anxious and have panic attacks. Social Phobias can also develop through a combination of negative experiences, poor nurturing and genetic inheritance.

Growing up, we are each presented with situations that test our resolve and maturity, and in everyone's childhood there will be experiences that have affected us negatively. For some, these experiences carry more than just a resonance into their adult lives.

For example, standing in front of a class giving our first talk and being presented with a roomful of disinterested, maybe even hostile, faces would be a distasteful memory for most of us. But for those more sensitive to their external environment, the situation could spark an endless cycle of social problems.

People suffering from social phobia experience a variety of symptoms when faced with a social situation. The most common symptom is known as anticipatory anxiety. Catherine Madigan, a Melbourne-based clinical psychologist who treats social phobias, explains why suferers experience such a reaction.

"People with a social phobia have a fear of being negatively evaluated or judged by others. They worry that when they get into a social situation they will do something to embarrass or humiliate themselves."

When sufferers find themselves in this situation, the anxiety that occurs gets even worse. Some people experience panic attacks, sweating, heart pounding, nausea, shaking, blushing and a variety of other symptoms. These symptoms usually cause sufferers to avoid social situations, which, depending on the phobia, can cause them to lead isolated, perhaps even unfulfilled, lives.

Luckily for sufferers there is help available. In Melbourne, Madigan runs a treatment program, which, she claims, is 80% effective. The program, designed by a group of American psychologists, is also geared towards showing sufferers how to finally enjoy life in friendly group situations. Individual sessions are also available, however, this is not recommended.

"Just working with me is not a threatening or real life situation," Madigan explains. "Because sufferers have a fear of being negatively evaluated by others it is more realistic to be in a group."

While the program focuses on the treatment of social phobias, anyone who suffers from other phobias, such as agoraphobia, claustrophobia, or what is known as specific phobias, which can include fear of heights or dogs, can be treated this way.

The treatment is based on a three-point-premise - graded, repeated and prolonged exposure to the feared situation or object. Grading the treatment means you expose the sufferer to their least feared situation, then when they can cope with that they move onto the next hurdle, until they reach the hardest possible scenario for them. By repeating the exposure to the situation the sufferer gets used to feelings of anxiety, and becomes more able to deal with them.

Most importantly, the exposure to the situation has to be prolonged. The person is not allowed to leave just because they feel uncomfortable. "By prolonging the time in the situation, sufferers learn that after a while, their anxiety levels can come down and they can tolerate being there," says Madigan. "Furthermore, they learn that the next time they find themselves in the situation they feel more positive and relaxed."

The success of the program depends upon the amount of work people are willing to put into their own treatment, she says.

"Social phobias are something you need to keep working on, the treatment helps you to improve a lot but unless you keep up your social contacts, social phobias can start creeping back."

Receiving group therapy for the treatment of phobias can be a fun and effective way to come to terms with the problem. It not only helps people to deal with life-hindering problems, but gives group support. By introducing sufferers to a social environment, everyone can help each other get the best possible treatment for their problem.

Written by Danielle Johanesen.


DEPRESSION

Unfortunately, depression is a very common illness. In Australia, the 'black dog of depression' affects 1 in 4 women and 1 in 6 men at any time and often goes untreated. Anxiety sufferers are often also affected by depression, as if life isn't difficult enough!!

Am I sad or am I depressed?

Everyone experiences periods of sadness or feeling blue, but these are usually transitory lasting for only hours or days. When people are depressed they have been experiencing lowered mood for several weeks, as well as a number of physical and psychological symptoms.

The symptoms of depression

* Feeling sad, being tearful
* Sleeping significantly more, or less, than usual
* Eating significantly more, or less, than usual and associated changes in weight
* Loss of interest in one's activities, e.g. you don't enjoy or care about your hobbies, sports, work etc as much as you used to
* Decreased motivation
* Lethargy
* Decreased sex drive and impaired sexual functioning
* Poor memory and concentration
* Irritability
* Agitation (you can't sit still, are fidgety etc)
* Feelings of guilt or worthlessness
* Recurrent thoughts of death or suicidal ideation, plans or attempts
* Bodily aches and pains

The types of depression

Sometimes people become depressed in response to stressful life events such as: illness, stress, bereavement, divorce. This is called reactive depression.

Endogenous depression occurs for no obvious reason and is due to changes in brain chemistry.

Bipolar affective disorder (more commonly known as manic depression) is another biological type of depression, which involves periods of elation as well as periods of depression.

Who is likely to get depressed?Anyone can become depressed, but there are factors, which predispose people to developing depression. The factors include:-

* Old age
* Living alone, being widowed, divorced etc
* Chronic physical illness
* Chronic pain
* Substance abuse
* Obsessional personality traits, e.g. perfectionism
* Being female - premenstrual - menopausal - post natal

Children get depressed too!
Children may suffer from depression too and exhibit symptoms similar to those experienced by adults. However, children's depression may also manifest as:

* Anger, aggression
* School refusal
* Social withdrawal
* Physical complaints such as stomach aches and loss of bladder and bowel control

Depression can be treated
Mild depression may be treated by a psychologist using supportive counselling and/or cognitive behavioural therapy. Cognitive behavioural therapy's basic premise is that how one thinks affects how one feels, so if we change our negative thoughts, beliefs and attitudes into more rational ones, our mood will improve. Marriage counselling and/or family therapy may also be appropriate.

Moderate depression may be treated by cognitive behavioural therapy and/or antidepressant medication. Antidepressant medications generally take 3-6 weeks before the sufferer experiences the full benefit and it is recommended that people continue the medication for some months after they feel they have recovered. Some people experience adverse side effects on some antidepressants such as: dry mouth, sedation, impaired sexual functioning, increased anxiety, diarrhoea, nausea etc., and these should be reported to your doctor as perhaps another type of antidepressant would not have these effects.

Severe depression may not respond to medication or talking therapies and ECT, electro convulsive therapy may be required.

If you are feeling mildly depressed you may wish to seek counselling from a psychologist.

If you are moderately depressed, Cognitive Behavioural Therapy may be sufficient, but if you are experiencing suicidal ideation, it is time to talk to your doctor about whether antidepressants are warranted.

Where to get help?

* Your general practitioner (she/he may recommend a psychologist or psychiatrist)
* Community Mental Health Clinic
* Community Health Centre
* ADAVIC can provide referrals
* Lifeline - 131 114
* Care Ring - 136 169
* Clinical Psychologists

By Catherine Madigan, Psychologist