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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  • Becoming withdrawn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.

 

Procrastination is good

Procrastination is good

Therapy is full of cycles, be they cycles of progress or the less helpful type.

One of the less helpful type is that stress hormones suppress the growth of new brain cells. The more stress we suffer, as well as expected anxiety or depression risk,the less brain development, the less brain development, the less adaptability….. and the more stress.

See what I mean…..?    Cycles.

 

In mice, if they are brought up in a solitary non-stimulating environment (not their natural setting) neurogenesis – the birth of new brain cells – does not occur.

If you put that mouse in a social setting with plenty of stimulus, it does.

I have seen in clients with depression that trying to get them to engage with their support network can be a challenge; this is the settled science that proves that that is an important step.

So let’s look at other ways that cycles of difficulty our clients face can be re-framed with the help of a little psychology.

Take procrastination.

The title of this piece, procrastination is good might seem the opposite of what our parents and teachers tell us.

Now let’s look at this not from the perspective of putting off the washing up for an hour while you watch X factor, but from that wider more insidious perspective of procrastination without time limits.

I find many clients get stuck here, often by that fear of not being good enough and that without time limits that shock the system into doing the task, they can get stuck in a never-ending loop that is hard for them to break out of.

But the plus side of procrastination is that is linked to creativity, not productivity but creativity.

Now don’t tell my students this – but starting early and finishing late is a sweet spot for procrastinators. It’s simple, and once again psychology proves it –

If you wait until the last minute to do something, you don’t get any new ideas, not enough time for creative thinking. If you finish too quickly, again original thought is lost.

By starting early and finishing late, you get the maximum opportunity for original thought and creativity.

Give yourself time to be creative…

Procrastinate just enough…

…find your perfect level.

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)

 

 

 

Therapy of dreaming

Therapy of dreaming… sounds odd perhaps?

Well, Freud called dreaming ‘the royal road to the subconscious’ 

We forget dreams when we wake up, and there’s a reason for this, and that is to prevent us confusing them with reality.

I remember reading from a biography of Keith Richards about the fact that he used to keep by his bed a tape recorder to record guitar riffs that came to him in his dreams. The story is that the riff to satisfaction was recorded in one of these night sessions, and he had completely forgotten that he had written it until he listened back to it on the tape recorder.

It’s this idea of Christopher Bollas’s ‘unthought known’ a phrase he coined from Freud who reported a patient saying something ‘ to the effect that he had always known something but he had never thought of it.

How many unthought knowns do you recognise in your own thinking? Those things on the edge of awareness or consciousness.

The science is therefore that dreams are the brain’s way of creating solutions to problems. That when we sleep, we process, much the same as we do in hypnosis.

The science supports this…

In dreams, if the smell of rotten eggs is sprayed into the nose of smokers directly after the smell of cigarettes, they will feel less of an urge to smoke.

PTSD sufferers have noticed a lessening of symptoms in the waking state after positive smells were introduced after trauma triggers during sleep.

So this is further evidence that memories are malleable, that they are changed as they are used, that they can be overridden.

And most importantly that they are interwoven with dreams and dream content.

A little science can serve to underpin the art of working with for example dream interpretation or dreaming in trance or the idea of the subconscious as a benevolent problem solver.

If we accept the principle of the subconscious or unconscious mind, then the therapy of dreaming must surely be worth a little more exploration?

 

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.

 

 

Tinnitus relief

Tinnitus relief is a subject close to my heart and one that I am passionate about.

This week I have been invited to present and advise again at the Bolton Tinnitus Support Group which is a truly wonderful organisation. They help tinnitus sufferers to cope with the symptoms and the difficulties that often come along with the diagnosis.

It will be no surprise that people with tinnitus can get anxious and depressed, but it may be a surprise to know that these three issues can be chicken and egg. One thing is certain though, that tinnitus is a subjective issue which is sensitive to mood.

It’s similar to pain in that way, a subjective perception which is worse at some times and less so at others. Often when the person is distracted or absorbed (what psychology calls ‘flow state’) then the symptoms are less noticeable.

In therapy we can access states of relaxation which we call ‘resource states’. When someone is relaxed, they can’t be anxious at the same time so accessing such a state of relaxed being is an early aim of tinnitus relief.

After that, then ‘anchoring’ the resource state can allow the person to bring on that feeling of relaxation when needed by triggering a subconscious memory of it. In times of stress, this is an empowering tool for the client.

It’s often about learning to manage the symptoms and that has behavioural elements of environment and thought as well as wider elements of meaning and perception.

All of these layers of the onion, we can work on peeling in the therapy room, working towards finding your peace.

The feeling of being worn down by the tinnitus is something I also often hear and this is what can lead to low mood. Again, in therapy relief can be gained by re-framing and building emotional resilience.

If you want to discuss further then, please contact me from my website Talking-Cure

Money worries

Money worries and financial insecurity are another often hidden issue. There can be links to self-esteem and the need to be very careful about how money is spent.

While this is a different situation to someone who may have heavy debts or spend too much, it is still an issue. I see in clients that often anxiety can stretch to include worrying about security or even begin there. Constant checking, planning and looking to the future.

The fear of losing a job.

Many people see money as security but it can also be many other things.

Money can be a reward, a replacement for love, a punishment, a tool to inflict pain, the list goes on….

It’s also important to realise that how we feel in relation to money can have nothing to do with how much we have in the bank. Some very wealthy people can concern themselves with money, money, money.

Decisions about money can also cause anxiety, and therefore add to it. It can be a battleground in the mind that is constant, which is the right way to go? Can I spend on this treat?

Sometimes the opposite, ‘I deserve it’ and then regret buying it afterwards.

Viktor Frankl saw the will to money as a basic form of the will to power, caused by an existential vacuum.

We live in a society that sees shopping as a form of therapy, but is it…?

Often money worries as a source of anxiety and depression go unspoken. Sufferers don’t tell partners, parents, GPs and the worry is turned inward which increases the sense of isolation and stress.

All I suggest is that we don’t discount money from the discussion about anxious thinking and suffering.

The ‘if I win the lottery’ fantasy keeps clients deeply rooted in the future, ignoring the mindfulness of today.

In therapy, we can look at what money means to you, and then start to look at what the threat is that is driving the anxiety. Re-framing is very important, challenging the rigid black and white thinking.

Most importantly, let’s not let money worries become money anxiety…

 

Gambling addiction Bolton

Gambling addiction Bolton people will be sad to know, now affects a quarter of the young male population. This is the finding of a study from the University of Bristol into men aged eighteen to twenty-four.

There was a higher likelihood of problems in those with depression or addictions to drugs or alcohol.

High  levels of being exposed to gambling in this generation (which is the first to have grown up with internet gambling) are thought to have led to the issue.

Unlike smoking or addiction to other substances, gambling addiction is more likely to cause mental health issues. There is also, worryingly a link to depression and anxiety.

A Royal College of Psychiatrists spokesperson has called for GPs to be aware of gambling addiction as a possibility in patients presenting with addiction problems and low mood.

So do I see clients with this problem? Yes, and are they mainly young men, again yes.

Whilst it’s a little early to call for a gambling addiction Bolton specific survey, if Bristol has this problem… Then so does much of the rest of the country.

Using hypnotherapy and psychotherapy the compulsion to gamble can be treated as can other addictions like online addiction. Internet addiction can also be linked to gambling addiction because we gamble more and more online.

Of the clients I see, there is a mixed bag of online and high street betting but smartphones have led to much easier access and therefore to almost 24 hour exposure in some cases.

There are also self-esteem and anxiety issues alongside gambling. Sometimes the need to ‘win back’ the money and the failure to do so directly affect the person’s self-image.

So , let’s be aware of the possibility of this issue in friends, family and loved ones. It’s another of those issues that can be viewed as shameful and hidden.

There is no need to hide it, let’s deal with it and improve our lives.

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.