Clinical psychologist Emma Offord talks to Steph Pollard about dealing with the emotional challenges of PH.
Living with pulmonary hypertension does not just have a physical impact – many aspects of the condition, its consequences and treatments can also have a significant impact on people’s mental health and emotional well-being.
Dr Emma Offord is a clinical psychologist attached to the PH team at Papworth Hospital in Cambridge. In this role, she has one day a week dedicated to working with PH patients and has supported more than 150 people over the last two and half years.
Emma says: “As part of the PH medical team, it is my role to explore the potential impact of PH on people’s emotional health and their quality of life. Individuals’ lives are affected in a number of ways, for example, loss of self-confidence, concerns about work or studies, giving up the things they enjoy, the impact on their relationships and their hopes for the future.
“As well as identifying difficulties associated with PH, my job as a psychologist is to explore how an individual might like their life to improve alongside their condition and help them to develop new and existing skills towards desired changes.
“At Papworth, we recognise the clear psychological and emotional challenges of PH, related to adjusting to the initial diagnosis; or learning to balance the restrictions of the condition and its treatments with living a meaningful and active life.
“Some people struggle with the changing perception of their identity and sometimes body image as they start treatment with, say, a Hickman line; use a wheelchair to conserve their energy or require daily oxygen.
“Some young women and their partners have to work through the fact that it may not be possible to have children.
PHA works in close partnership with Anxiety UK and funds access to a level of free support through this charity dedicated to helping people deal with anxiety.Emma offord
“Others with PH have gone through overwhelming experiences such as frequent episodes of breathlessness when they are out and about or alone at home – fear of this happening again can cause tremendous anxiety.
“Still others face the prospect of complex surgery, intrusive therapies and of course some have to mentally prepare for transplant.
“The condition can also transform relationships and we can support patients and their families to deal with that too.”
Emma says: “Typical problems can range from simply feeling low to being more deeply depressed. People may feel anxious, worried, angry, afraid or experience panic attacks. I talk to patients about a very wide range of issues prompted by PH.”
Emma makes an assessment of people’s needs and either offers support and therapy herself or refers patients on to support based closer to a patient’s home.
Her referral reports then help to outline the impacts of PH to those who may not be so familiar with the condition and its treatment. Emma often refers patients through Anxiety UK which has a network of qualified and competent psychologists and counsellors across the country.
PHA works in close partnership with Anxiety UK and funds access to a level of free support through this charity dedicated to helping people deal with anxiety.
PHA UK will fund the first session of any course of therapy a PHA UK member opts to take through Anxiety UK. Plus, there is a free Anxiety UK helpline for PH patients on 0844 332 9010.
Emma, who previously worked in paediatric mental health at Great Ormond Street Hospital, recommends the support offered via Anxiety UK.
“The relationship with PHA UK works really well and it is good to have a network of professional therapists across the country to refer patients on to for support.
“Some people still do struggle to ask for help or admit feelings of vulnerability when they are going through so much with their condition.
“Some people can find it helpful to cope with the changes to their life by challenging the physical and social restrictions. This can be a useful strategy, in terms of continued independence and confidence; however, it can also be exhausting and not always manageable. We encourage people to balance their health with their abilities and to seek support to maintain their independence. Sometimes therapy can make a really positive difference to their lives by addressing these issues.”
Emma uses a range of therapeutic approaches, including narrative therapy.
Emma says: “This approach encourages individuals to step away from a dominant story about their life and identity defined by their health condition, towards a preferred untold story with more possibilities for a meaningful and enjoyable life.”
She also uses mindfulness to help tackle anxiety and regain a sense of physical and emotional calm; plus cognitive behavioural therapy (CBT) to help people tackle their worries and develop more helpful thought processes and perspectives.