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Mental Health Awareness Week

Mental Health Awareness Week aims to address the fact that approximately one in ten people in the UK will, at some point in their life, experience depression. Mental Health Awareness Week aims to  increase consciousness of and reduce the stigma surrounding mental health.

We are all waking up to the fact that mental health needs to be discussed openly. If you know someone who is struggling you may feel unable or unequipped to help or offer your support, causing feelings of powerlessness, frustration, confusion and anxiety. Helping someone to recognise symptoms and seek professional help involves trust, patience and understanding.

Depression isn’t the same for everyone and varies from person to person.

Indicators can include

  • Becoming withdrawn
  • Preferring to spend time alone
  • Making excuses to not see friends
  • Showing less interest in things that have previously been a source of joy
  • Problems with concentration and focus
  • Increased irritability
  • Reduced sex drive
  • Increase in anger or short temper
  • Changes in sleeping habit

The list isn’t exhaustive and everyone can have bad days or a low period in their life. Depression isn’t feeling fed up or a bit down; depression is more than this and can carry on for weeks or months.

In Mental Health Awareness Week, encouraging a friend to visit their GP is a good place to start, if they don’t have a regular GP who they feel that they can talk to, a recommended and trusted therapist is another option worth seeking out.

Therapy is a process, it offers a safe space to talk, helps with understanding where problems come from and with developing strategies and tools for feeling better. Change doesn’t happen overnight and your support may be needed during the process. Therapy isn’t a quick fix, but it does work.

Learning More

It’s worthwhile reading official NHS advice and MIND is a brilliant resource, both for those wanting to help and those suffering with depression.

Being there

This is the main thing you can do. Ask how you can help; there will be times when gentle encouragement to talk is needed and times when your friend needs solitude. You may need to remind them to take care of themselves, to eat well, exercise and get enough sleep.

Depression is very real and not something that someone can ‘snap out of’, in the same way you wouldn’t tell someone who has a broken ankle to go for a run.

The simplest way to help someone with mental health issues

It’s important not to pressure someone suffering from depression or make them feel inadequate. Ask them how they’re feeling, listen with empathy and encourage them to seek professional help, but understand that someone suffering from depression may not want to do this or even be able to.

Psychotherapy is a resource for helping those suffering from depression, so seek help if you or someone you know needs it.

 

Psychotherapy open questions

Psychotherapy open questions is another extract from my 2016 presentation at the International Hypnotherapy and Psychotherapy Conference.

While as therapists we all know about active listening and open questions, I’m often asked by students and colleagues about examples of such questions.

These are the kind of questions that can open up a discourse, and help a client to reflect in an area where perhaps clarity may have been lacking.

So to try and help, I’ve prepared a short list of interesting questions that although sometimes too challenging to be used ‘raw’ as it were, can be framed more gently by the therapist.

These psychotherapy open questions  have been gathered from various sources and I’ve used them (or versions of them) in therapy for some years, if any are of use then please feel free to incorporate them into your practice or self-reflection.

In no particular order then:

Why do you matter….? This question might initially ring some alarm bells but bear with me. Apparently one of Viktor Frankl’s questions with some depressed clients was to ask them why they had not taken their own lives? From that question, Frankl , it is said, could often find a thread (however slender) to begin to explore the meaning in the client’s life that kept them from doing that. This question comes from the same place, when self-esteem is challenged or low, a question in this vein can start a challenge to the negative self-talk and open up the client to challenge perhaps distorted beliefs.

What’s happened to you….? This is far subtler and touches upon how the client sees their own story. Have things happened to them? are they taking it personally when in reality they are collateral damage in something unrelated? Is the world unfair? Where does a lack of success come from, them or the outside pressures of the world? Again this question can open up many facets that may not have been visible before.

What do you want to achieve working with me….? I’m a great believer in sticking to the brief, what does the client want to achieve? This question can help clarify and set goals. It also has an element of de Shazer’s Miracle Question in there. The client can step even if only briefly into a future where the change has happened and ‘try it on for size’. Imagination is stronger than will after all.

What feels different…..? This is about seeing less in detailed pictures and beginning to connect with the feeling. That can be helpful in terms of chunking down to the root feeling that is driving the wish to change. Are you running away from something or towards something. It’s also a nice segue into the accessing of resource states for the client.

What am I doing to make life better for myself….? Here we begin to look at psychotherapy open questions centred around where we are at the moment. This comes from a solution-focused perspective, where are we now and where do we want to go? This can identify the differences between the two places and therefore sharpen that focus and highlight what’s missing.

What’s the one thing I can do today to make my life easier….? This has roots in the power of making a change today. It also touches on the step-by-step approach, if we tick off the easy things first, the little ones, we can begin to build the proverbial ‘yes ladder’ to achieve and create movement in the desired direction.

What does that fear need…..? From John Hartland’s theory that the client will only let go of symptoms when they feel ready to do so. This question allows the client to look at self-care, and what they already know about what they need to move on. Again it feeds into allowing the client to accept that they matter and that it’s ok for them to have needs. It can allow them perhaps to access the child within them and its needs.

And saving the best until last tell me about…?  This is my holy grail of open and encouraging  questions and is the glue that binds the rest of them together. If you only take one question from this blog, then I would suggest this is the one.

So hopefully these psychotherapy open questions will be of some use, please let me know any others you have that might helpfully be added to this list by email at info@talking-cure.co.uk.

Thanks

Stuart Cale

(Talking-Cure Hypnotherapy and Psychotherapy)

 

 

 

Anxious thoughts

Anxious thoughts can be a problem when self-reflection gets out of hand and becomes negative rumination.

As a health professional I accept that the Mental Health Foundation place this issue as a cause of anxiety and depression.

In 2013 the University of Liverpool published a study that  said that rumination (a word for constant repetitive thinking or dwelling that comes from the action in cows of chewing the cud) far from being a player in the most common mental health issues, is the largest predictor.

So what does this mean for us? It means that when we dwell on things, not only do our thoughts tend to spiral downwards but that can lead us to poor mental health.

This will come as no surprise to therapists, but the extent may. Most therapists see the link between persistent negative thought and self-blame and anxiety and depression, but as a causative factor?

It also means that psychological issues can lead to problems at a mental health level. Replaying thoughts over and over again makes us sad and anxious.

There is also evidence that rumination is at play in OCD and eating disorders, in fact anywhere our negative thoughts are stuck on repeat, we find the potential for problems.

So… what can we do about it?

Well firstly, we can learn to relax. Relaxation is often the key in early therapy to opening up the space into which the client can grow and change can be made.

Think about the amount of time that anxious thoughts or worried thoughts take up, or as some say, the amount of space they rent in your head. With all that time and energy freed up, what would you be able to do?

After that, we can look at the sense of threat that generally underpins anxiety, often being able to identify that threat can help us move forward to explore it and perhaps re-frame it or find ways to cope with it.

Please don’t think that anxious thoughts, constant thought repetition or rumination are something that you have to ‘put up with’ or suffer. If you need help to overcome these patterns, then please reach out to a professional.

 

 

Bolton mental health update

Bolton mental health update is a quick look back over the last 5 years since I moved back to Bolton.

Although not from there, I went to Bolton School so I made friends and connections in the town. When Talking Cure was set up it was my aim to provide specialist expert psychotherapy and hypnotherapy based in the town.

As a UKCP psychotherapist, CNHC hypnotherapist and psychologist, I take self-referrals, GP referrals and clients from BUPA and other major insurers. It’s been an interesting and enjoyable five years and I think it’s interesting to take a snapshot as to what Boltonians seem to struggle with most, hence the idea for a Bolton mental health update came about.

As you might expect worry, anxiety, generalised anxiety disorder (GAD) and panic attack issues are high on the list. It isn’t surprising, we live ever more frantic lives, ever faster, more information and more pressure.

When perceived demands are greater than perceived ability to cope then we can slip into anxious thought patterns. If left untreated, these can worsen and may lead to depression. Many of the clients I see need some help to re-frame their lives or challenges.

Teaching them to relax and building self-esteem and emotional resilience lie at the heart of treatment. The interesting thing about anxiety is that it is impossible to be anxious and relaxed at the same time.

If you can learn to switch on relaxation you can switch off anxiety.

From there, in therapy, we work to examine the reasons behind the negative thought patterns in the first place. Using a selection of techniques and psychological interventions, often with hypnosis, a change happens.

So, if I was asked to give you one thing that troubles the mental health of Bolton, I would say anxiety underpins most issues.

My own experience with panic attacks and anxiety is what led me to learn to help others. Now I specialise in anxiety and offer therapy face to face and online, partnering with some charities to improve reach.

I’ll keep you posted as to how things develop.

Best

Stuart

 

 

 

 

self-esteem

Emotional Intelligence

Emotional Intelligence?

What is it and how do we improve it?

We are all unique, all of our personalities are different and we have differing wants and needs. 

Some people have the ability to make you feel at ease as soon as you meet them, in any situation, either social or professional.

Others, not so much. 

Who are the people who we’re inclined to feel at ease with, and who we find ourselves gravitating toward?

They tend to be people with a great deal of emotional  intelligence.

Emotional intelligence (EI), regarded as being more important than IQ, is a complex quality. However, it can be learned.

EI is key to relating well to others; awareness of your own actions and feelings and how they affect others.

It definitely helps you to go through life more easily than someone who is quick to anger, gets upset or refuses to view themselves honestly.

Emotional Intelligence is

The ability to identify and therefore understand your emotions

Knowing how to manage your emotions in a positive way in order to

  • relieve stress
  • communicate effectively
  • diffuse conflicts

The ability to recognise what others are experiencing emotionally. It therefore allows you to understand and manage relationships effectively.

A process that, although non-verbal, will inform your thinking and influence how you connect.

There are several elements that define emotional intelligence:

Self Awareness

Being honest with yourself and acknowledging your strengths and weaknesses.

Understand your own emotions and therefore trust your intuition.

Be in control yourself rather than controlled by your feelings. 

Self Regulation 

Be able to control your emotions and consequently resist being impulsive.

People who self-regulate will think before acting,  don’t jump in with both feet and learn how to say no.

Empathy

Learning how to identify the wants and needs of others is especially relevant . People with empathy don’t rush to judge or stereotype.

Be able to recognise the feelings of others helps relationship skills.

Motivation

A high level of motivation leads to being productive, effective, hence able to enjoy life’s challenges.  

Social Skills

People with strong social skills are easy to talk to. People with good social skills find the building and maintaining of relationships easy and pleasurable.

They are keen to develop others and view a team achievement as more important than their own individual success.

How can you improve your Emotional Intelligence?

Pay attention to your emotions, they are valid. Learn to recognise them.

When you make decisions, integrate your emotions into the process.

Be present. Be here.  Don’t plan ahead or look behind.

Be aware of your body language and the signals you send others.

Happiness

Happiness comes in so many different guises that its really difficult to pin down exactly what makes up happy.

Unhappiness, well we know this immediately. We know what it looks and feels like. We know when it has us in it’s grasp.

Studies show that happiness has little to do with our own life circumstances. This is because happiness is mainly under our control. We synthesise it ourselves. So we either create it or we don’t.

Happiness is a product of our outlook on life.

Happiness – Learn What Makes You Happy

Discovering what works for you is of the utmost importance! Making happiness for yourself is good for your health as well as your performance in all areas of life. 

Here are just a few points, they may seem glaringly obvious but it’s surprising how much difference each one can make to our general happiness.

Exercise (I know I’ve been here before but it’s so important!) 

Movement, even a ten minute walk, lifts the mood and reduces anxiety, it is good for your head as well as your body.   

Maintaining your personal values.

Heeding your moral compass and standing your ground, in all of your relationships will therefore prevent feelings of regret and dissatisfaction.

Don’t worry about things beyond your controlThere is a huge difference between being informed about/understanding world events and worrying about them. 

Sleeping wellThe restorative power of sleep is well documented. We all know how lacklustre we feel if we don’t have enough sleep. 

When you’re asleep your brain literally detoxes and  recharges itself after the day’s activities. 

Not making sleep a priority means stress hormone levels rise and energy, motivation and memory all reduce. 

Improve your emotional intelligence.

Happy people do tend to have emotional intelligence as part of their skill set. Here’s a great link showing the importance of EI. 

Believe in the future.

Collect happiness memories but don’t fall into the trap of magnifying past pleasures so much that the present feels poor. Don’t lose faith in the promise of the future, you can out perform past experiences and as a result be happier.

Believe that the best is yet to come. 

Future Anxiety

Future Anxiety – do you live in the future?

I do. Sometimes. We all do, sometimes.

I used to live there much more, with all of the things I would have as well as all the places I would visit, the houses I would live in. There was a big long list in my head. 

I was very ambitious; I still am truth be told, but I had a slowly dawning realisation that I was almost solely focused on the future.

What I would do there? What things would I have there? 

The more plans I made and goals I set, I realised that my overall feeling was future anxiety:

This is future anxiety – ‘Today, this hour, this minute, is not good enough. I have none of the things I want and am working towards, therefore I’m not happy. Also I won’t be happy until I achieve a long (and possibly never ending) list of ‘wants’

You can see that I was blind to everything that I already have.

Can we be happy with what we already have?

Making a conscious effort in addition to realise just how beautiful life already is, bringing awareness to the ‘little things’ helped me become happier.

Five Minutes to Happiness” (Maxwell Maltz) was first published in 1962. A book written to help us learn the art of being happy.

Since then, many pages have been written about how we can be happier.  

The main gist is focusing on the good stuff, appreciating that which you have and being grateful for it. 

Making a list of just five things you’re grateful for may seem an odd way to help future anxiety. It’s not about what’s on the list, don’t judge yourself. It could be chocolate ice-cream, it could also be knowing that you’re family is fit and well. 

Just come up with five things

A nice meal maybe – it might’ve been a great salad or an enormous burger- remember not to judge.

No rain today.

Walking through the park first thing this morning perhaps.

Meeting a friend, for a particularly great cup of coffee.

Your health – even if you have a bad cold, perhaps you can be grateful that it’s not worse!

In addition, studies have shown that after making a nightly list for just one week happiness grows.

By doing this small, simple exercise you are retraining your brain to notice the good things, the positives. 

You start to look out for them as well as register them when they happen. 

Then you can enjoy and appreciate them all over again when you add them to your list. 

Caffeine panic

Caffeine panic – about 10 years ago now I cut caffeine from my diet.

Apart from a three day headache there seemed little effect at the time but I did it because I believed it would make things calmer in the long run, and on reflection, it did.

Although I can’t remember the hour or the day things felt different, they do.

It’s conspicuous by its absence caffeine.

Most people ingest a couple of hundred milligrams of this stimulant each day. The jury is out on what are the best levels, but as with many things, I think it depends on the individual.

For the anxious, it can make things a lot worse, and the anxious individual’s sensitivity is heightened.

This happens because caffeine mimics panic symptoms, it can make you jittery, nervous, filled with dread, irritable and restless. Caffeine can actually induce panic attacks.

Caffeine panic – It was this feeling of empty uneasiness and restlessness that I wondered about, and what had been causing it.

That’s the feeling that years later I no longer carry around with me.

Some symptoms of a Panic Attack include sweating, fast or irregular heartbeat, difficulty breathing, digestive issues. Also, it can bring on a feeling of dread, unreality, pins and needles, even chest pain. (APA, 2014)

Guess what? Caffeine can cause fast or irregular heartbeat, diarrhoea, racing thoughts, fast breathing, nausea, sweating… you get the picture, I’m sure.

Caffeine stimulates the central nervous system, the most commonly used psychoactive drug in the world. This is why we pay so much for it in Starbucks. It makes you alert, keeps you awake.

It can be natural or synthetic and is found in some unlikely foods and drinks, so if you are worried about caffeine panic and are anxious, then perhaps look at your consumption of chocolate, coffee, cola, tea and medicines and start to see where it is (Lucozade anyone?).

Are you struggling with anxiety, panic or stress levels?

Maybe have a look at whether that pick-me-up little helper is actually a part of the issue

 

Perfectionism or excellence

Perfectionism or excellence, that is the question….

Perfectionism or excellence is a choice.

While perfectionism can drive you towards fantastic achievements. Perfectionism can help to provide you with the motivation to keep going until you attain your goal:
Giving the perfect presentation
Doing the perfect job
Baking the perfect birthday cake
Perfectionism can really help you sustain the energy levels you need to reach your own personal challenge.

But pressure and anxiety all build when you try to be the perfect person.

Perfectionism is within you and therefore under your control.
Striving for perfectionism within yourself can lead to anxiety as you try to live up to your own expectations or how you perceive others’ expectations of you.
You will always be not quite there, not quite good enough, simply because the perfect person doesn’t exist.

Cakes, jobs and presentations are all measurable, people aren’t.

People make mistakes
People have imperfections

It’s part of what makes us human. Mistakes help us to learn.

Perfectionism, pressure, anxiety can take an enormous toll on you and your life in general.

You fear success because of the fear of maintaining success.
Fearing mistakes can be due to the fear of losing respect from others as well as yourself.
Fear of failure can mean that you never set yourself goals. Or setting goals so high as to be unattainable.
Being constantly aware and reminding yourself of your weaknesses, imperfections and failures.

Be Excellent Instead Of Perfect
Improving yourself can be an enjoyable journey.
Being great at something is an enormous achievement.
Take yourself (and life) a little less seriously, forgive yourself, be gentle with yourself.

Set small, achievable goals.
Reward yourself.
Be aware of the influence of social programming – social media, TV programmes, magazine articles.
Making the effort to change is an achievement in itself.
Just by being born, you literally won the race!

Therapy Ethics

 Therapy Ethics is a wide subject.

In the last post from my presentation at the NCHP conference we were talking about memory. Memory is not some ethereal concept, but is made up of specific neurons in the brain.

I work with a particularly scientific client, and  this principle opens up the idea that she is not stuck with a memory for life.

Memories change, re-frame.

Memory is malleable.

This introduces a sense of possibility and with unhelpful memories.

If things haven’t gone the way the client hoped, you’re often dealing with their attachment to how ‘it should have been’ .

Breaking the attachment to the memory (because it may not be entirely accurate) attaches the problem to the memory and not the client.

I’m not blind to the juxtaposition here with the person centred concept of self-actualisation and that the client is the expert in their problem.

I believe both these principles entirely but as with all things sometimes a perspective doesn’t work, and we need more creative solutions.

It’s strange to me too, that in therapy the idea of intervention against natural process is such a minefield

There is this idea that any sense of change in the client that they didn’t initiate themselves is somehow unethical. We do however change everything around us all the time.

We make different types of plants and foods by modification. .

It’s a complex ethical issue, and we will all have our standpoints. Putting male cells into a female body however is a different story when you’re doing it in the context of a bone marrow transplant to save someone’s life from cancer.

There always consequences to acting and there are always consequences to not doing anything.

All I am suggesting here is let’s not be hypocritical. Therapy Ethics is a lens.

Therapy Ethics are important when clients come to us as therapists to change, for us to help them change.

We work in an idiographic way of course, but change is nevertheless the brief. People will always be self-organising, adjusting to minimise discomfort but there are times when that isn’t enough on its own.

In Western medicine, we celebrate advancements and ways of changing things. One day we will beat cancer.

Will anybody be saying that we should have left that process to nature?

All I am suggesting is that we fit the methodology to the client.