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Therapy Ethics

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 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

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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)

Fearing Anxiety

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Fearing Anxiety comes from how we shape reality. Our focus determines our reality, change the focus and as a result, change the reality.

You see,  your fear can  distort your reality. When we focus on avoiding uncertainty, we skew our logic, taking anything over dreaded uncertainty.

The good news is that you can create your reality.

Fearing anxiety makes the things you dread seem like things you know. We assume rather than reasoning.

As therapists, one word we use for this is ‘Awfulising’.

Fearing anxiety changes uncertainty from possibility to threat. The fear of fear works its way deep inside and prevents us from critical balanced thinking, often when we need that ability most. It blurs our ability to think rationally with emotion, The Chimp in our minds is in charge.

Fear can also make you inactive when there is an opportune moment, becoming a self-fulfilling prophecy.

This is a fictional version of the world born of and bred by fear, but it isn’t always the reality.

Confronting fearing anxiety behaviour within ourselves is key to relief from it and here are some useful tools:

Identifying assumptions  helps, what is real and what is assumed on the basis of the fear?

When is the poisoned parrot on your shoulder feeds negativity into your ears, silence it.

Are you rationalising? justifying? projecting beliefs onto unrelated situations, or simply making excuses?

Do you notice yourself jumping to conclusions while stuck in those familiar shortcuts to them?

Are you seeing fiction as truth?

Are you thankful for what you do have, or struggling because you’re counting curses rather than blessings? Can you identify the difference between your strengths and your weaknesses, and can you live with your weaknesses?

Can you let go of your pain or are you identified by yourself (or others) due to it?

Are you building your own reality from guesses and maybe untruths, or your fears?

Most importantly, what are you missing out on?

Hypnotherapy and Psychotherapy aren’t magic wands, they’re spades, hard work in therapy challenges the above.

You as client do a job and so does the therapist, if the therapeutic relationship is strong then results are best when the right therapist, right client and right time coincide.

Using the questions above, and with professional focused help, you can identify the negative patterns in your thinking and begin work to check them out, perhaps challenge them…

… and maybe change them.

 

 

 

 

Anxiety Support Bolton

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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

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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.

 

 

Improving Memory

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Improving Memory is the third part of my presentation at the International Hypnotherapy and Psychotherapy conference. Earlier parts are here and here.

Changing your outlook from ‘I am like this’ to ‘I can be different’ however – is a first step towards positive thinking. To do this therefore let’s focus first on memory.

Here are some points you need to know about improving memory;

Repeat – As humans we need to process information immediately and repeatedly. It’s why learning to play a musical instrument demands repetitive practice. Repeat to learn.

Match – Because when new knowledge comes along, we fit it to what we already know.

Picture it – We think in pictures and not words.

Slower – If we slow down,  we move information from our working memory into our long-term memory.

Structure –  we are meaning making machines, we search for meaning. It’s a classic part of the psychology of teaching. Tell them what you’re going to tell them, tell it to them, and then tell them what you’ve just told them, therefore creating a structure.

Creative – our memory is both creative and re-creative, as in the movie ‘Inception’ starring Leonardo DiCaprio, where he implants memories to change reality.

Obviously (and ethically) therapists don’t do this, but many of my therapy clients are stuck in thoughts, one client for 20+ years.

We all know thoughts are important in therapy, take negative automatic thoughts in CBT. Thoughts and memories obviously connect, but importantly memories are not always fixed.

We think the memory works like a recording device

This is not true.

And changing this can create a new sense of possibility – a space where we can become

Psychologist Elizabeth Loftus is especially relevant in this area. She described memory as like a Wikipedia page because you can go in and you can change it, and so can other people.

As therapists we can’t plant memories, this is the reason that I don’t do Hypno-Gastric band work. If our memories represent our identity, it helps to know we can change it.

We can recreate a sense of self.

Memories are not cast in stone, there is room for change,  you are not painted into a corner. How many times have you heard people say “well, it’s just me, it’s just who I am”?

it’s because memories are a foundation to identity that if you can challenge them, then you can ask yourself, “what else can you challenge?”.

What can you change?

Brain and Memory

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Brain and Memory is the first part of my serialised lecture from the recent International Hypnotherapy and Psychotherapy conference.
It’s a free resource to help you and the introduction is here.
 So let’s begin with the brain and memory. Now the human brain is a remarkable thing. It represents 2% of our body weight yet uses 25% of our daily calories.
Why is the human brain is different from the brains of the other great apes?
In fact the answer is cooking. We don’t eat raw food like for example gorillas or chimpanzees, so we’re not involved in a trade-off. The trade off between the amount of neurons in our brains and our body size.  You can’t have both a big brain and a big body on raw food.
It’s impossible for us to obtain the number of calories necessary to keep our brains working from raw food. So,  we predigest our food by cooking it.  Otherwise we would simply run out of hours in the day to eat.
As humans, our brains are very neuron rich, they’ve grown that way. If  you count the nuclei in a rodent brain, you find that they are far fewer than in ours.
We have 86 billion neurons in our brains and if a rodent brain had that many neurons, it would weigh 36 kg!
We use 6 calories per billion neurons of brain every day. Gorillas are physically much larger than us but their brains are smaller. This is because of the fact that to maintain that body size, they have to sacrifice neurons.
What makes our human brain and memory unique are our cognitive abilities. We have a very dense concentration of neurons in our cerebral cortex. This is what gives us our cognitive abilities.
That rich concentration of neurons fuels our working memory.
Now what working memory does is that it interfaces between what’s going on now, our experiences – and our stored knowledge, the long-term memory.
Now this is a mix that we re all familiar with. What it goes to is meaning
and we are all aware of the fact that how we attach meaning to memory is very important That’s also true in therapy.
In physical terms that working memory is about the size of a pea. We can think of the working memory in terms of RAM, random access memory. It is for example, what allows us to listen into other people’s conversations while we’re pretending to pay attention to the person in front of us.
It always amazes me how many tips and techniques exist in the self-help books relating to making sure that you appear to be paying attention to someone. There is only however one fool-proof method of making sure that you do this and I’m going to let you in on the secret…
 and that is to actually be paying attention.
There are limits to working memory though, losing your keys for example, forgetting what you were going to say, the good news? There are also strategies to improve it.
More of those in the next installment….

Therapy Art & Science

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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

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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

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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.