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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)

 

 

 

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!

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)

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.

 

 

Hypnosis not for TV

hypnotherapy is a natural and healthy state of deep relaxation

Hypnosis not for TV but for clinical settings

Hypnosis is not for TV. “You’re back in the room”; ITV’s latest game show which features contestants being hypnotised by “master hypnotist” Keith Barry and longtime presenter Philip Schofield begins this weekend.

For decades, the hypnotherapy profession has worked hard to legitimise itself and leave the parlour trick stage hypnosis image in the past. With so much research into the efficacy of hypnosis in medical and psychological worlds, the public is now to be treated to ridiculous tricks performed by people most likely role playing and making hypnosis appear to be more magical than empirical.

Now, some in the public (and sadly some in the profession) will see a programme like this as a bit of fun and nothing to become agitated over. Some might even see this programme as positive press for hypnosis. I, however, see this programme as something very different.

In my practice, as with many other professionals, all the people I work with have genuine issues that they want to change. The decision to see a hypnotherapist is not always an easy one due to the portrayal of hypnosis as being some odd occult practice. When a person seeks out a mental health professional they are not looking for a sideshow act.

As professionals it is our duty to put the welfare of our clients and potential clients at the forefront of everything we do. This programme is potentially detrimental to them and so we must speak out. Programmes like this give a false idea of what hypnosis is, and I call upon all my fellow professionals and those with an interest in mental health to take to social media to voice your disquiet about this extremely tasteless and damaging form of entertainment. Let the public know what hypnosis is used for therapeutically and how programmes like this set the profession back in recognition terms, by years.

Remember there are no stage surgeons and there is a good reason for that, they are health care professionals who are take client care seriously. Should hypnotherapists see their profession in any less of a light?

Social Media problems

Addiction to social media, internet addiction and self-esteem are sometimes closely linked

Addiction to social media, internet addiction and self-esteem are sometimes closely linked

Social media problems examined. Social media has changed our world in many ways; it has brought pleasure, connection, re-united people and re-ignited old friendships. Recent research commissioned by Unilever however (in which a thousand women were surveyed and compared to a similar sample from 2004)  found some less than savoury effects of Facebook, Twitter and the like. In the findings, more than half of the participants reported that seeing photos of friends made them feel worse about their own bodies.

Another very surprising result was that ten years ago, 75% of the women surveyed reported that the media set ‘unrealistic’ standards of beauty, but that figure has now dropped to only 66%. So what’s going on, and why is it a concern? Is there resigned acceptance of the unrealistic standards, or is the pressure that society and the media places on us to look a certain way having a potentially damaging effect over time?

Low self-esteem is a very real problem for many of us, and the sometimes debilitating effects of low self-esteem are at the forefront of those issues that many people tolerate unnecessarily, and which reduce their quality of life on a daily basis.

It’s a changing and ever more competitive world in which we live and one where it seems that our friends have the highest influence over our idea of beauty. That pressure can cause anxiety, jealousy or any of a number of emotional or thought issues. This is why here at Talking-Cure we take the influence of social media in our lives very seriously, and we see ever-increasing levels of the effects that internet exposure can have on our clients. In our view, although the end results of these pressures are often the same, the causes are changing with each generation and as therapists we need to rise to meet these challenges.

So, if you find yourself struggling with any of the issues above, or any other problem which may be related to exposure to social media or the use of the internet generally, then please do not hesitate to pick up the phone and speak to us here at Talking-Cure.