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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 important – you 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!
Anxiety resources
Anxiety resources are one of the keys to feeling better. So what’s the first to understand?
It has to be relaxation.
Think of your anxiety a little like a light switch, on is anxious and off is relaxed. It’s simple but profound.
It’s physically impossible to be relaxed and anxious at the same time. Relaxation is the first practical tool I teach my clients to use in the fight against their anxiety. Why?
Because it puts the power back in the anxious clients’ hands, and an empowered client has made a first step towards recovery. That is one of the benefits of relaxation, we CAN all do it, sometimes we forget how, but it is an ability we all share.
A little like Carl Jung’s idea of the common subconscious, relaxation is a natural healing resource that we can all access to fight anxiety, with the right help.
I’m not talking about the bottle of wine and a film type of relaxation with Facebook pinging all the way through; I’m talking about deep relaxation of the autonomic nervous system. It’s kryptonite for anxiety.
And that is something most of us very rarely do.
And it’s the ultimate ‘me time’. If you don’t know that, do yourself a huge favour and try it out even if you aren’t struggling.
Hypnosis is a fantastic tool to kick start the relaxation process if it’s been long neglected, so is mindfulness or meditation. Whichever way it happens, once it happens, clients have a tool they can access anywhere to turn the intensity right down, like you would a radio.
Think of that from the anxious person’s perspective. They are often confused, frightened, lonely, and sometimes desperate but mostly they want tools. They want to help themselves.
In the toolbox, relaxation is the soft, soothing, comforting, velvety hammer of anxiety. You can use it and enjoy using it too. It’s not the medicine that made us screw our faces up as kids. It feels good and it helps, what’s not to love about relaxation?
You can feel it working too, slower heart rate, lower blood pressure, steady, easy breathing, benefit after benefit after benefit.
Every time you flick on or off a light switch, think of it… anxiety on, relaxed off.
Anxiety on.
Relaxed off.
Anxiety and you
ANXIETY AND YOU
So why did I decide to specialise in anxiety?
Well, anxiety chose me, not the other way around. As a busy Lawyer, I didn’t see the warning signs on the road to anxiety until all of a sudden… BAM!
Huge panic attack on the first day of a holiday, fear, confusion, feeling isolated and vulnerable, I felt like I was the only person in the world that this was happening to. I had no tools to help me help myself.
Fast forward ten years and I moved from anxiety’s latest victim to hopefully its worst enemy. How did I do this?
I condensed expert personal therapy, countless hours of study, became a therapist, researched and researched into my desire to understand anxiety and how to help others. It led to UKCP accreditation, thousands of hours of dedicated work towards helping people like you, but most importantly it gave me a skill set that really makes a difference.
So what does that mean to you?
It means you’re not alone in this struggle; people have been there before, while your route into anxiety is personal to you, the symptoms of anxiety, generalised anxiety disorder, social anxiety and that spiral of panic are very common to us all.
There are many useful ways to combat anxiety and find your peace, relaxation, CBT, hypnotherapy, reframing, behavioural methods and various forms of psychotherapy can all look at the causes and help move you forward.
You are not alone, I have been there and I have moved on.
You can move on with the right answers and methods. Therapy isn’t a magic wand, it’s sometimes hard work but the therapist collaborating with you as the client is the key to making that progress.
Whether anxiety strikes out of the blue or is a familiar part of your life when that feeling of dread, the fear of fear comes over you, you can use some of the resources posted on my last blog to help in the short term.
I find that with clients in my treatment room, learning about anxiety is a major part of the process and so I decided to put some of that knowledge out here to help you.
In the next blog, I will talk in more detail about therapy methods and how they work, but more importantly about how they can help you. Whether face to face or by online therapy, the more you understand, the more tools you have to combat anxiety.
I hope you’ll join me
Stuart
Help for Anxiety and Panic
HELP FOR ANXIETY AND PANIC
THE TEN TOOLS YOU CAN USE RIGHT NOW
1 – Remember that although your feelings and symptoms are very frightening, they are not dangerous or harmful.
2 – Understand that what you are experiencing is just an exaggeration of your normal bodily reactions to stress.
3 – Do not fight your feelings or try to wish them away. The more you are willing to face those feelings, the less intense they will be.
4 – Do not add to your panic by thinking about what “may” happen. If you find yourself asking “what if?” Tell yourself “so what!”
5 – Stay in the present. Notice what is really happening to you as opposed what you think might happen.
6 – Label your level of fear from 0 to 10 and watch it go up and down. Notice that it does not stay at a very high level for more than a few seconds.
7 – When you find yourself thinking about fear, change your “what if?” thinking. Focus on and carry out a simple and manageable task such as counting backwards from 100 by sets of 3.
8 – Notice that when you stop adding frightening thoughts to you fear, it begins to fade.
9 – When the fear comes, expect and accept it. Wait and give it time to pass without running away from it.
10- Be proud of yourself your progress thus far, and think about how good you will feel when you succeed this time.
Therapy for jealousy
Jealousy, something (often secretly) familiar to many of us. Jealousy and Envy (yes, they are different things, envy occurs when we lack a desired attribute enjoyed by someone else and jealousy when something we already possess is threatened by a third person) can both be very intense feelings that in turn can easily dominate aspects of our lives. Another problem is that they can be as hard to shift as they are to deal with, and often are not talked about or discussed.
Jealousy can destroy love, and it’s rare to find someone who hasn’t been touched by the classic signs of jealousy such as lack of trust, fear of losing someone we love, or anger at attention paid to others. When it comes, that intensity of emotion can render rational thinking impossible and even cause behaviours in the sufferer that drive people away and reinforce the self-fulfilling prophecy.
The emotional content of jealousy is complex, abandonment, loss, fear, sorrow, humiliation, betrayal; the list is long and infamous. Even violence can make an unwelcome appearance where jealousy is concerned, and it can be as irrational as it is damaging, Steven Stosny, a psychologist says, “The formula for jealousy, is an insecure person times an insecure relationship” and goes on to point out that it isn’t just sexual jealousy at play, sometimes children or any kind of friendship that diverts attention from the sufferer can be a problem.
With origins based in our far-distant evolution, perhaps to protect intimate relationships, in our current lives where we may change partners several times in the course of a lifetime, jealousy can become a painful burden. The feeling of inadequacy makes it seem a particularly poignant and difficult burden.
So, what can be done? Well, like many things, communication is often at the root of the solution, jealousy is often something we deny in ourselves so just recognising and acknowledging it are also important steps. It’s often too personal and complex for a list of self-help suggestions as seem to be so common in our culture that demands quick fixes. Jealousy isn’t something we can cast off like an unwanted coat when spring comes, it’s a treatment process, and moving beyond jealousy is a skill that often takes a little time to learn.
Having said that, as is so often the case, people can travel through life with often debilitating levels of jealousy, accepting that as their fate. Surely, if you’re affected, it’s worth taking some steps now to hopefully improve the quality of life and relationships still to come…?