Have you ever felt like your mental health doesn’t quite fit neatly into one box?
Perhaps you experience anxiety, but there is also a lot of overthinking, perfectionism or self-doubt. Maybe you have experienced trauma and notice that it affects not only how you feel, but also your relationships, confidence or ability to feel safe. Or perhaps you have been given more than one diagnosis and are left wondering how all the pieces fit together.
The reality is that our emotional wellbeing is rarely simple.
This is why I often take a transdiagnostic approach to therapy—looking beyond a single diagnosis to understand the patterns underneath what you are experiencing.
Looking at the Bigger Picture
A diagnosis can be helpful. It can give a name to what you have been experiencing and help guide treatment. But it doesn’t always tell the whole story.
As a psychologist, I’m also interested in understanding questions such as:
What tends to trigger your distress?
What happens when difficult emotions show up?
What have you learned to do to cope?
Are there patterns that keep repeating, even when you really want things to be different?
Sometimes the things we do to cope make complete sense in the short term. We might avoid something that makes us anxious, push uncomfortable feelings away, keep everyone else happy, strive to get everything “just right”, or become very hard on ourselves when we feel we have fallen short.
These strategies often develop for good reasons. The difficulty is that, over time, they can sometimes keep us feeling stuck.
A transdiagnostic approach helps us understand these patterns rather than simply focusing on reducing individual symptoms.
The Unified Protocol: Understanding Emotions Differently
One approach I draw upon is the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders.
Despite the rather long name, the idea behind it is quite straightforward.
Instead of treating anxiety, low mood and other emotional difficulties as completely separate problems, the Unified Protocol looks at some of the processes they have in common.
For example, you may notice yourself avoiding situations that make you anxious, trying very hard not to feel certain emotions, overthinking what might happen, or becoming frightened by your own emotional reactions.
Therapy can help you become more curious about these experiences, understand what your emotions are communicating and gradually develop greater confidence in handling uncomfortable thoughts, feelings and situations.
The goal isn’t to become someone who never feels anxious, sad or overwhelmed.
It is to help those emotions feel more manageable and less in control of your life.
Cognitive Processing Therapy: When Trauma Changes How We See Things
For people who have experienced trauma, I may also draw upon Cognitive Processing Therapy (CPT).
Traumatic experiences can change the way we understand ourselves, other people and the world around us.
You might find yourself thinking:
- “I should have done something differently.”
- “I can’t trust people.”
- “I’m not safe.”
- “Something bad will happen if I let my guard down.”
These beliefs can feel completely true, particularly when they developed in response to something frightening, painful or overwhelming.
CPT provides a structured way of gently examining these “stuck points” and considering whether there may be another way of understanding what happened.
This isn’t about dismissing your experience or simply replacing difficult thoughts with positive ones. It is about making sense of what happened without continuing to carry beliefs that may no longer serve you.
Cognitive Analytic Therapy: Understanding the Patterns We Keep Falling Into
Sometimes people come to therapy saying:
“I know I keep doing this, but I don’t know why.”
This might involve repeatedly putting other people’s needs first, feeling responsible for everyone’s emotions, withdrawing when relationships become difficult, fearing rejection, becoming highly self-critical, or finding yourself in similar relationship patterns again and again.
Cognitive Analytic Therapy (CAT) can help us understand these repeating patterns.
Together, we can explore how certain ways of coping may have developed through earlier experiences and relationships.
Importantly, the aim isn’t to blame the past.
Often, these patterns developed because they were useful at one point in our lives. They helped us adapt, protect ourselves, maintain relationships or manage difficult circumstances.
Therapy can help make these patterns more visible so you can begin to notice:
“There it is again.”
And, importantly:
“Maybe I have another option this time.”
Finding an Approach That Fits You
There is no single therapy that suits every person.
You are more than a diagnosis, and therapy shouldn’t feel like trying to squeeze your experiences into a particular treatment manual.
Depending on what brings you to therapy, I may draw upon approaches such as the Unified Protocol, Cognitive Processing Therapy and Cognitive Analytic Therapy, alongside other evidence-based psychological strategies.
What matters is developing a shared understanding of you—your experiences, your strengths, the patterns you may have developed along the way, and what you would like to be different.
Sometimes that means learning practical strategies to manage anxiety or strong emotions. Sometimes it involves understanding the impact of trauma. At other times, it may mean exploring deeper patterns in relationships, self-worth or the way you respond when things become difficult.
Most importantly, therapy is something we work on together.
Rather than asking only:
“What diagnosis does this fit?”
we can also ask:
“What has been happening for you, what might be keeping it going, and what could help things begin to feel different?”
Sometimes understanding the pattern is the first step towards changing it.