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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.

 

Workplace Bullying

Workplace bullying.

The impact of workplace bullying increases stress, anxiety and depression. It can have a major effect on home life and take a toll on relationships too.

Bullying in the workplace and uncomfortable work situations can cause upset and turbulence at home. As a result stress levels rise, sleep is disturbed, symptoms of anxiety and depression increase.

Maybe it’s difficult to discuss work related issues at home because:

  • You may convince yourself that you can hide your feelings from your partner.
  • The bully has made you feel responsible for the situation and you don’t want to share your experiences.
  • You feel that your partner will not be supportive and as a result will probably blame you for bringing the situation on yourself.

It is very likely that increased stress and anxiety from workplace bullying will bring about a noticeable personality change and your partner will realise that something is wrong.

  • Frayed temper due to worry and bottled up feelings may mean that bullying in the workplace causes you to lash out at those around you.
  • There may be financial worries hence making you feel lucky to have a job at all.

Your partner could be incredibly supportive and help fight with you end the bullying. Finding out that a loved one is suffering bullying in the workplace is upsetting, especially if it has been kept secret.

Emotional health and personal relationships may be under enormous strain due to bullying in the workplace increased stress, anxiety and depression.

It’s really important to look after you

  • Keeping a diary will serve as a written account of events and also help you express how you’re feeling.
  • Taking some time off work may help you feel calmer. Don’t feel guilty about doing this; bullying in the workplace is not acceptable.
  • Listen to your body, it is speaking to you. It may be worthwhile booking a check-up with your GP.
  • Exercise is proven to release stress and anxiety and need not be expensive. A swim, walk or bike ride are all great stress relievers
  • Talk to a UKCP therapist (had to slip it in somewhere)

Relaxation Ease Depression

Relaxation ease depression and make yourself feel better.

Many people make the mistake of thinking that sadness and depression are one and the same.

Sadness is a natural, normal emotion that comes and goes.

Although feeling sad and cheerless is an unhappy state, it usually passes.

Depression isn’t sadness.

Depression is constant.

It can last for a period of weeks, months or even years.

Willpower alone won’t overcome depression, however, there are a number of ways that the methods of relaxation ease depression symptoms and hopeless feelings.

Connection – resist isolating yourself and talk to a trusted person like a family member, friend or therapist This can help make problems feel easier.

Exercise – the link between exercise and feeling good is well established. Exercise doesn’t have to mean joining a gym; a brisk walk has been shown to improve mood and positively affect symptoms of mild to moderate depression.

Relaxation – Anything that makes you unwind and feel good will benefit your emotional health

Again – for many of us relaxing may simply mean flopping on the sofa and maybe watching the TV, that may feel relaxing, but it doesn’t reduce the effects of stress.

These techniques can all help to relieve stress because they make you feel relaxed and hopeful.

  • Deep breathingand here’s how.
  • Guided imagery – remember imagination is stronger than will.
  • Yoga– Exercise and connection – maybe take a class

Find techniques that suit you, a massage or pedicure may be good for some but stressful for others.

Make a little time each day for something that you look forward to – like a bubble bath or a walk

These are useful ways to show how exercise and relaxation ease depression, of course, a therapist will help you to improve your symptoms and you should seek out a suitable therapist through UKCP.

 

Anxiety Support Bolton

Anxiety Support Bolton is a resource to help understand anxiety from experiences and feedback of clients in Bolton whose anxiety I work with. See other resources here.

Perhaps a sense of interior discomfort or a feeling that their bodies are troubled by physical warning signs, it leads to the same outcome.

In trying to gain control, they can ignore the gut feelings and avoid internal awareness which can mean they hide within and from themselves.

Ignoring these feelings leads as a result to secondary feelings of confusion, and shame. That can mean closing off or panic symptoms because any sensory change makes them feel like a “little boat on a big sea”.

The result can be a fear of fear itself.

Fear comes from a primitive response to a threat where escape is difficult, impossible or embarrassing.

Perhaps we’re stuck on motorways, in planes, in meetings or in crowds.

Relief comes not just from external aids such as drugs, but more helpfully from changing how we feel by how we think, or react subconsciously.

Such fear is no respecter of intelligence, creativity, gender or status.

However it does have common threads.

The sufferer’s field of vision is probably inward not outward.

It can cause people to freeze.

Everything can suddenly seem blurry.

Making decisions, even simple ones is hard.

We can feel self-conscious.

Maybe it comes from the need to please others or conform. Perhaps fatigue, repressed emotions, setting the bar too high or too much responsibility.

Some of the feelings can include shame, self-blame, or frustration at being trapped in a repeating cycle.

In all the years, we haven’t made enough progress to break this negative mind/body link.

Psychology can explain  but those primitive parts of the brain don’t switch off so easily.

By being over-vigilant and reacting to inappropriate or misunderstood danger signals, we see danger where there isn’t any.

We become overwhelmed and therefore we dread.

We don’t feel fully alive, our senses work overtime but feel dulled, the body keeps a score.

Language, and the Talking-Cure of therapy is our solution in Anxiety Support Bolton.

By communicating, learning to move back into our inner selves and finding meaning, we can make some sense

In conclusion, We can find our peace.

Anxiety Help Bolton

Anxiety Help Bolton.

I’ve heard a lot about anxiety and panic attacks. I’ve heard anxious people say “I feel like I’m going mad, like I’m going to die, I feel out of control, I worry about everything”.

It can be constant and therefore they become exhausted.

They also worry that someone will find out.

It can strike out of the blue.

It can prevent travelling.

It can cling on to them.

They feel dread.

Alone.

I know a lot about anxiety and panic attacks because it’s my main focus of work.

Most of all, I know it’s treatable.

I know that Psychiatrists believe up to 30% of the population suffer with anxiety at any one time, that it costs the economy £80 million every year. That it can commonly be found alongside depression.

I also know it isn’t new, but maybe what triggers it is new.

Often the future is where the problem begins. Sometimes it’s society because if we compare ourselves with others and come off worst in social media, it can feel like a competition.

Perhaps it’s a build-up of things that finally reaches a tipping point. Maybe a single life event that maybe brings it on.

Whatever the cause, Anxiety Help Bolton therapy first of all gives you tools to rationalise, a strategy.

Because you’re not alone.

You don’t have to feel the dread.

You can challenge those negative thoughts.

You can learn to recognise patterns in the negative voices

No one should have to spend their days being afraid of being afraid.

Use integrative therapy, drawing from hypnotherapy, counselling, analysis or behavioural methods (such as CBT) to help.

I know that you can learn the coping skills and methods that can bring you back from that exhausting hamster wheel of worry and panic to embrace the life that is waiting for you.

I know as an Anxiety UK therapist that psychotherapy and hypnotherapy can help.

I know this because it happened to me.

For help first of all contact me below.

 

 

Therapy Art & Science

Therapy art & science information for you.

It was both an honour and a pleasure to have been invited to speak at the 8th Annual International Hypno-Psychotherapy Conference in Leicester this last weekend. Many thanks to Shaun and Fiona from NCHP&M for asking me, and to all the delegates, students and my fellow speakers who included Pat Hunt from the UKCP and Professor Windy Dryden.

In the forthcoming blogs, my lecture ‘The Holism Grail – The Science Behind the Art of Therapy” is going to be serialized as a resource for Psychotherapists and Hypnotherapists alike as well as anyone who wants to understand a little more about linking Psychology and Psychotherapy in the clinical setting.

So if you weren’t there, you don’t miss out. This resource is aimed at casting some light on the science of  hypnotherapy and how that can help clients to achieve lasting change. It is designed to also be interesting to clients, patients and psychologists as well as psychotherapists and anyone remotely interested in the mind and the brain. Topics include anxiety, self-esteem, stress, depression, panic, worry, habits, PTSD, OCD, addiction and many more.

The aim was to provide a useful resource on therapy art & science to therapists and sufferers alike about why talking therapies help as well as just how. The content is drawn from my UKCP and CNHC practice working with private clients in my specialist areas of anxiety and self-esteem,  and from The University of Liverpool MSc in mental health psychology.

By understanding the reasons that treatment works we can make it more effective and save time and money in the treatment room. A belief in giving back to the therapy community and spreading knowledge and experience as an open resource are what encouraged me to release this material free of charge.

I hope you enjoy it and please don’t hesitate to contact me here if you wish to comment or ask anything at all.

Stay tuned for the first part of the content in the next blog, and thanks for reading.

Stuart Cale

Anxiety perfectionists

Welcome to the second part of my anxiety perfectionists tools designed to help you feel better faster, if you missed the first installment, you can access it here.

OK, let’s carry on..

Really important this next one – You create the pressure in any given situation, it comes not from external pressures, but how you frame and respond to those pressures. You make pressure and if you make it, you can unmake it. Remember, If there is no perfect way to do something, then there is no pressure to do it any other way than your way, and you’re the world’s leading expert in doing things your way already.

 

Other peoples’ opinions do not have to determine how you feel, your opinion is most importantyou have the right not to have to justify what you do. Your opinion of how efforts are, is more important than anyone else’s.

 

You have the right to say, “no”, “I don’t care”, “I don’t want to” or ‘I don’t understand’. That’s empowering just in itself and deserves its own post but for the meantime, turn it over in your mind, maybe try it, maybe little things at first just to see how it feels…

 

Avoid words like ‘must’ ‘should’ and ‘ought’. These are judgmental words that paint you into a corner. They are not part of your anxiety perfectionists toolkit. More importantly, they set up pressure and expectation upon you to behave a certain way when you might not feel that way. We’re working toward authenticity, the conscious and subconscious being in harmony. Try ‘could’ instead and be more gentle with yourself.

 

Finally, just get on and do it. Putting things off and going over them endlessly feeds perfectionism. It’s the ‘Analysis = Paralysis’ equation. Remember the successful people mentioned above? Many of them failed many many times before they were finally successful in a goal.

 

Instead of aiming for perfection, try aiming for excellence, and remember that as long as you’ve done your best, then no-one can ask any more of you than that.

Perfection anxiety

Perfection anxiety happens when we put pressure and expectation on ourselves, when perceived ability to cope is less than demands. It can have an effect on confidence and self-esteem, causing all those symptoms set out in my other posts on anxiety here.

 

One of the causes of perfection anxiety is a fear of  not being good enough, so what can we do in the short-term to reassure ourselves? Do you remember re-framing from this earlier post?

Here are some of the themes and re-frames I sometimes work into therapy with perfectionists and perfectionism, if you struggle with needing to be perfect, why not try them on for size…?

 

First, you don’t have to be perfect, nobody else is. Remember the old saying, “Never judge someone until you’ve walked a mile in their shoes?” – that’s the point, no matter how much ‘perfect’ we project onto someone else, from the inside their world is probably every bit as difficult as everyone else’s, and if you don’t believe me, just ask them.

After all, how many ‘perfect’ celebrities with their perfect bodies, houses, partners and lives have you seen end up in rehab, the divorce courts or worse?

 

Second, there is no perfect way of doing anything. As we get older, this becomes an easier concept to grasp but there really are many ways to achieve a specific goal in life. What’s also important is to realise that the getting there is part of the process, and often the fun.

Think about a goal you set yourself, maybe an education or fitness course or saving for something. I expect that when you got there, it was different from how you imagined it at the beginning, that the journey changed you as much as the goal.

 

Next, if you’re not doing something as well as you’d like, just accept it. Sometimes trying harder increases the pressure on you, makes you miserable and hurts your performance. You won’t be good at everything all the time, sometimes you’ll struggle or fail. If you study the lives of successful people, you’ll find that failing is a vital part of how they succeeded.

 

Be sure to catch the second part of this blog for more resources to use today to relieve perfectionism.

How anxious brains work

How anxious brains work is an important part of the understanding of anxiety and panic. So let’s begin to understand it.

Let’s start with the anxiety response. If we can understand what’s going on, we have a useful starting point. This is another in the series of learning how anxiety works.

Triggers begin the process; we’ve all had those feelings of being in a dangerous place, even when physically we aren’t. Clients often describe this as a feeling of ‘dread’. So what happens when anxiety is triggered in this way?

The parts of your brain responsible for anxiety are the amygdala and the thalamus, the limbic system. The aim of the thalamus is to keep us safe. The thalamus scans for potential dangers around us all the time, monitoring all our senses, a little like anxiety radar.

If it detects a potential threat, rightly or wrongly, even if something that isn’t a threat is recognised as a threat, it sends a message to the amygdala.

The amygdala then does all those things that we recognise as unwelcome and unpleasant. It may raise heart rate, cause sweating, shallow breathing, and tense our muscles. We are from that point hyper-vigilant.

This is the ‘fight or flight’ response that I am sure you are familiar with; it’s a natural and useful response to dangers around us.

The problem here is that in anxious people, this process can begin at any time, sometimes even for no apparent reason. It can happen on an otherwise good day – it makes us anxious, panic and want to escape.

This trigger can be tied to danger or it could be a trigger from the past, wrongly recognised in the present, it could come from a sight, sound, smell, touch or any of our senses.

Once the thalamus has signaled the amygdala, the amygdala takes over and shuts down our rational thinking. We are left with instinctive simple reactions such as fight or flight; we are out of reason and into instinct.

Importantly, we are responding to the stimulus without choice, the amygdala is preparing the body to deal with the threat.

What is needed to combat this response are methods that reassure the amygdala so that we can regulate the body, regulate the breathing and by doing that, tell the brain that everything is alright.

By doing that we turn back on the rational part of our brain and we no longer have an anxious brain.

Stay tuned for more resources on understanding and treating the anxious brain.

 

Learn about anxiety

No learn about anxiety resources would be complete without looking at emotional resilience. The word comes from ‘resili’ – the Latin word for ‘spring back’ – it’s the process of adapting in the face of adversity.

Think of anxiety a bit like a see-saw with ‘perceived’ ability to cope on one end and demands on the other. When demands are lower that ability to cope, we are OK, when the demands are bigger than our perceived ability to cope, we have a problem, we can learn to be less anxious.

Ego strengthening and emotional resilience are about improving ability to cope. We all use scales of 1 to 10, if our ability is say a grade 4 and a grade 6 problem comes up, we can struggle, if the ability is a 9, then the grade 6 problem is easily handled.

This resilience can be cultivated. The more we learn about anxiety, the more tools we have to cope.

The first step is Realism, being realistic about a situation, for example one of the difficulties with depression is that people often attach inappropriate meaning to events. If a depressed person telephones a friend and they don’t ring back, they might think ’my friend doesn’t like me’ when the actual reason may be that they didn’t even get the message.

Next we look at establishing a goal that we can work towards, a favourable outcome. Now here hypnosis can really help with what we call ‘future pacing’. We all know that hypnosis can help us look back at past problems by regressing. The other side of that coin is looking forward which is equally (if not more) powerful.

Self-discipline is important, abandoning those ‘crutch activities’ that feel safe and familiar. It might be drink or drugs or avoidance. Ego strengthening techniques can really help with this process.

Cultivating wider interests helps because it gives us different versions of ourselves. Think of all the energy an anxious person uses just being anxious, once they are less anxious they have a surplus or energy and time to spend, space to ‘grow into’.

Re-framing is seeing something through a different frame and really important if you want to learn about anxiety. Say you suffer an ankle injury; you may well be focusing on how it stops you doing what you want to do. If you’re a soldier on the front line of a war zone, a simple ankle injury might mean rest and relaxation away from stress and danger.

Here’s a great re-frame that goes directly to the next in our list – Identity. It’s easy to concentrate on all our difficulties and things that have gone wrong. Look though at the old saying ‘what doesn’t kill you makes you stronger’. That’s re-framing from victim to survivor, think of all the strengths you’ve built up in those hard times!

Flexibility is also key, changing change, making change into opportunity rather than threat.  Flexibility is vital for surviving life’s storms, if you bend with the storm winds, you don’t break.

Hypnosis, mindfulness and meditation can all help to moderate outbursts and reinforce neural pathways. Think of your mind like a cornfield for this one. The old outdated negative patterns of thought are like well-trodden paths in the corn, easy to tread again and again. By treading down new paths of positive neural pathways in the corn, like the old ones, they get flatter and flatter, and easier to tread.

A strong social network is good for emotional resilience; reach out in times of difficulty. Today, we live more and more isolated lives, often secure in the belief that Facebook friends mean we’re well supported. Look for support in times of difficulty; seek out therapy if you need to.

For control, look to Victor Frankl, “Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way.” Moving your locus of control internally rather than externally can make a big difference.

Finally, test the changes, keep a journal and monitor your progress, learn about anxiety with free resources posted on this blog,  after all this isn’t work, it’s your life’s work!