Toilet Phobia and CCBT
Chat Room Session on Monday 9th January with Dr Chris Williams
“Dr Chris Williams is a Senior Lecturer in Psychiatry and Honorary Consultant Psychiatrist at the
University of Glasgow. His main clinical and research interest is in the development and evaluation of
the Five Areas CBT model - which aims to provide wider access to CBT approaches, including the
www.livinglifetothefull.com life skills course. He has developed written and computer-based self-help
treatments for anxiety, depression and bulimia and is a well-known CBT trainer and teacher. He is a
Past-President of the British Association for Behavioural and Cognitive Psychotherapies - the lead
body for CBT in the United Kingdom (www.BABCP.com). He is also a Trustee of the charity Triumph
over Phobia and a Patron of the National Phobics’ Society.”
What is CCBT?
CCBT is the computerised version of cognitive behavioural therapy. Dr Chris Williams is the
creator of such a package called Living Life to the Full.
How does CCBT work?
I asked Chris the basic principles CBT works on. He suggested it is a great therapy for
anxiety and works by helping us examine how what we think can affect how we behave and
what we do. He mentions that our thoughts or fears affect us physically and emotionally and
that each of these areas can affect each other and the end result is that we tend to avoid
things that scar us or do all sorts of things that make us feel safer. He suggests that
sometimes these reactions can backfire and become part of the problem. He sums it up by
suggesting CBT helps us identify and change our fears, overcoming avoidance and switch
instead to helpful responses.
Does CCBT work for Toilet Phobia?
Chris mentioned that his website (www.livinglifetothefull.com) is not aimed at Toilet Phobia
per se but lots of its content is generally useful for anxiety. He mentioned that as a site it is
more aimed at wider life skills, but the thinking section and also the section on planning
activities/boosting confidence might fit well. He gave the example of identifying scary
thoughts that worsen how we feel and learning ways of changing them.
I then proposed to Chris that the package although not specifically designed for Toilet
Phobia it could help understand your negative thoughts better. Chris agreed and suggested
that it would help identify patterns of thinking that upset us or give us a sense of panic and
look at ways of moving the focus of our thoughts onto to other topics. He gave the example
in Toilet Phobia the focus being on selective bladder sensations.
Chris mentioned that he has not come across any CCBT packages that focus specifically on
Toilet Phobia but suggested that Fear Fighter, another package, might help as it allows you
to choose your own focus or fear for the work. Unfortunately fear fighter is not as easy to
access as LLTTF, but is still free depending on where you live as only certain Primary Care
Trusts have bought licences. You will need to book an appointment with your GP who will
conduct a quick screening questionnaire and provide you with a username and password. If
you wish to find out more you can visit: www.fearfighter.com. Chris mentioned that the
author of that site, Isaac Marks, has written a book called Living with fear which contains
materials that might fit well. If anyone wants to buy this book it is available on Amazon for
£15 or you can buy earlier pre owned editions from under £5.
Mike, a regular visitor to the chat room suggested that toilet phobia has its own unique set of
problems. Dave another regular visitor gave an example of such a unique aspect, he said he
is quite confident until the point of failure and the anxiety sets in as the bladder pressure
builds. Chris suggested that the problem is unique but said so is every other problem of
anxiety. He suggests what matters is learning exactly how for us out thoughts and
responses, and sometimes the responses of others play a part. He suggested by looking at
what thoughts, situations and physical reactions and responses we make occur, we can then
begin to sport the patterns and change things around and it is making these changes that
boosts confidence in out ability to do things. He gave the example of felling confident
enough to go to the shop and not look for where the toilets are.
How does the website www.livinglifetothefull.com work? What modules does Chris
I proposed to Chris that a site such as LLTTF could in theory work for any anxiety; helping
us examine our thoughts and behaviours. Chris suggested that is correct but the key is
making it specific to ourselves, therefore when using LLTTF it is important to remember the
site talks generally about fears/worries and negative thoughts and the user must think about
how they can relate to them, which Chris suggests is easier with support. He mentioned that
one way to get this support is through the very popular forums on the LLTTF site.
I asked Chris what he would recommend doing on the LLTTF site if someone was to start
using the website. He suggested the following:
The starting out module, which helps you think about how and why we feel the way
we do and generally the thinking and activity ones.
The rating our mood using the anxiety and depression scale called the HADAS scale.
The forum to get some help and support from likeminded sufferers.
How to gain support while using LLTTF?
As Chris mentioned there is the extremely popular LLTTF forum in which people can gain
Another way is by using group of people as a sort of working group, a group of people all
using the therapy at the same time. Chris mentioned such an idea that has been tried on
LLTTF. They approached a small number of people when accessing the site for the first time
and asking if they want to meet for a live chat on a weekly basis. Chris mentioned this is a
really good way for likeminded people to share hints/tips and encouragement, keeping each
This idea can be extended to the National Phobics’ Toilet Phobia chat, in the open sessions
if people are using LLTTF or other CCBT packages, there is the opportunity to talk to others
in a similar situation and keep each other going.
Does Chris recommend CCBT to be used? What other help is there?
I proposed to Chris that suffers with toilet phobia should at least try CCBT such as LLTTF;
Chris suggested that it is an option that everyone can think about.
He suggested that there are other options such as the book living with fear as mentioned
earlier or a CBT focussed face to face therapist. He mentioned the British Association of
Behavioural and Cognitive Psychotherapies (www.babcp.com) has a useful list of NHS and
private CBT practitioners who are accredited by the association. He also mentioned this site
is a good overall resource as it contains leaflets etc.
What we do we do at the National Phobics’ Society?
As Chris mentioned one of the therapies that is recommended for specific phobias such as
Toilet Phobia is Cognitive Behavioural Therapy (CBT). Through our nationwide network of
trained therapists we are able to offer CBT both face to face and over the phone at much
reduced rates. If you would like to find out more about the benefits of the society you can
As many of you may already know we have specific funding to help with Toilet Phobia and
due to this we offer a weekly chat room to help likeminded suffers, if you haven’t visited for a
while, don’t worry it is very much open to new members. To find out more you can visit:
If anyone would like any help or support don’t hesitate to call (08444 775 774) or email the
National Phobic’s Society (email@example.com).
Written By, Nicholas Todd
Chat Room and Bulletin Board Moderator