Cognitive Therapy of Depression

Children for a variety of reasons often are reluctant to talk about their feelings and concerns in therapy whether individual, group, or family therapy. Therapists sometimes need to be resourceful to help children who are anxious to participate in a meaningful way in the therapy process. It is important for children to feel included in the process. Some children may not feel they can express themselves because they may be too young, others may be silent due to anxiety, anger, fear, resentment, and a few may not be able to talk due to trauma events.

Therapists need to have various strategies that do not rely on language such as symbolic play either directive or non-directive, drawing, storytelling, or therapeutic work with symbols. Many therapists, irrespective of the therapeutic modality (e.g. CBT, Interpersonal, Psychodynamic), have integrated play techniques in their work with children.

Most children do not choose to come to therapy, rather they are “brought” or “sent” by parents, teachers or other professionals who in turn are sometimes pressured to do so by extended family, social services, or courts.  The child’s experience upon arrival at the therapist’s office is often like being punished and sent to the principal’s office.

Creative methods of engagement are dictated by necessity because good therapy doesn’t usually take place in a context of fear and punishment. The therapist must think out-of-the box for ways to transform the experience for the child and make the context a safe, comfortable, and playful context that gradually allows for trust to build and for the child to be able to use the therapeutic space in a helpful way.

for more information go to: http://cognitivetherapyforchildren.net

SOME SAY HOW WE DEAL WITH FEAR IS A CHOICE! But for thousands a spider, a thunderstorm, a short hop on a plane or standing up to talk at a business meeting can send them into a panic so severe that it apears to them to be beyond their control

Sometimes such as a fairground roller coaster ride or driving a fast car we choose to face fear head on and we are exhilarated by it and love the experience. 

 But sometimes it floods our whole being with anxiety causing mental anguish and even physical illness

Many would argue that you have the choice to be brave or cowardly, So why not always choose to be excited and exhilarated by it and face it head on and with head held high?

Can it really be that easy to overcome fear? In the first world war many good men with shell shock were shot for cowardice when we now know they were in the grips of post traumatic stress disorder.  They had the maximun incentive to ‘just pull themselves together’ and shake off their fear but they simply could not and they died as they lived in fear and trembling. 

It is undoubtedly true that often, when we firmly decide to do something, (even if it is scary) that strong dominant thought will enable us to override fear and get on with it. We can never prevent that scary thought from popping up but, usually in daily life we can, and we do exercise the choice of how to deal with it.

Unfortunately in some situations no matter how our logical brain rationalises these fears, our subconscious takes over.  We can usually be thankful for that.  If you drive you may have had the experience of pulling off on a green light only to have some idiot jump a red light and drive right across your path.  I will bet that without a thought you stamped on the brake and clutch and skidded to a stop, heart pounding, beads of sweat on your brow and a curse on your lips. You didn’t think about doing all that – your subconscious thought you were in danger and just took over.

It is natural to be fearful, we are programmed that way and it is a good thing that we are. That is why we have survived as a species.  When our conscious and subconscious don’t agree it’s usually the subconscious that wins because it believes that it is acting in your best interests. 

Unfortunately our subconscious doesn’t have the logic or reasoning capabilities of our intellectual brain, just an automated patterned response to danger and it often gets things wrong.  When that happens, just saying ‘Get on with it’ can be as effective as King Canute trying to hold back the tide.

Thats what we do at the Life Design Studio, Using a powerful mix of therpeutic techniques including CBT (Cognative Brief Therapy) NLP (Neuro Linguistic Patterning) life coaching and clinical hypnotherapy we help people to stem the flood of their anxiety and reverse the tidal overwhelm of their stress reaction.  Fortunately it is often relatively easy for a skilled therapist to ‘reprogramme’ these responses, to assist a client to inform their subconscious that a different response is required now and it’s ok now to let go of old patterns of behaviour.

Many of our clients want to be able to perform better at public speaking, job interviews or to improve sports performance. Some wish to overcome fear of flying, spiders or snakes.  It doesn’t make sense to ‘bluff it out’ and ‘soldier on’ getting more and more stressed when there are many excellent therapists who can help.

Our clients are often amazed that a problem which they have regarded as a long established part of their makeup can be can be resolved in a few short sessions and debilitating fears removed forever. 

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There are many interesting articles about the workings of the human mind at www.thelifedesignstudio.comMy partner Bee Milbourn and I are always happy to advise on the right therapeutic approach.

Please feel free to write to Bee or I at info@thelifedesignstudio.com

Anthony Bennett DHP, MNCH(Lic),

Are you one of those people who has been trying desperately to lose weight but has not had any success? Hypnotherapy might just be the answer you’ve been waiting for!

Hypnotherapy is the use of hypnosis, typically via verbal suggestions, in order to induce a trance-like state of mind. This is usually done by a hypnotist, but can also be sellf-induced. Hypnotherapy is being used and has been studied as a form of therapy for a variety of medical conditions.

It is currently being used to relieve anxiety and pain, such as in pregnancy and cancer; as a treatment for different skin diseases, including warts and atopic dermatitis; and as an adjunct in the management of obesity.

There have been many researches done investigating the efficacy of hypnosis in inducing weight loss, majority of which have generated positive results. One such research is a meta-analysis done in 1996 in the United States, which revealed that the use of hypnosis combined with cognitive-behavioral therapy (CBT) can result in a significantly larger amount of weight loss than the use of CBT alone.

A more recent systematic review was done in 2005 in the United Kingdom, which revealed that hypnotherapy was able to consistently produce weight loss in a safe manner.

Hypnosis is believed to help induce weight loss via several mechanisms. Hypnosis attempts to alter the individual’s subconscious programming, thus breaking down old eating habits and stopping food cravings, while simultaneously helping the individual build new habits that are much healthier.

Under hypnosis, an individual is more focused and thus tends to respond better to suggestions, including recommended changes in behavior. Also, since overeating is usually linked to stress or to one’s emotional state, hypnosis can help minimize this habit by reducing stress, developing a more positive self image and boosting the ego. Through hypnosis, an individual learns new coping mechanisms that can target the core issues of their weight problems, allowing them to lose weight and keep it off.

The primary advantage of hypnosis over other weight loss options is that hypnosis is a natural weight loss solution that allows you to permanently lose weight with minimal, if any, adverse effects. It is important to remember, though, that hypnosis works best when combined with other weight loss treatment methods, such as regular exercise, a balanced diet and cognitive-behavioral therapy. Also, make sure that you go to a hypnotherapist who has undergone adequate training, so that you will be able to lose that unwanted weight successfully and safely.

Both NLP ( Neuro Linguistic Programming ) and CBT ( Cognitive Behaviour Therapy ) are effective techniques for treating people who are suffering from panic attacks. At my practice in Hertfordshire I have treated many clients for panic attacks. Panic attacks can be more serious then people imagine. Some severe cases can cause the person to experience physical pain to such an extent they feel they are having a heart attack. Also in some severe cases people go on to develop Agoraphobia which can affect their daily life. I use both NLP and CBT techniques at my practice in Hertfordshire to treat clients suffering from panic disorder. I use both techniques as it really depends on the client. Some clients respond better to NLP and others respond better to CBT.

 Cognitive Behaviour Therapy works by looking at the relationship between what people think, do and feel. It is based upon the principle that what you are thinking will affect what you feel and what you do, and what you are doing will have an effect on what you are thinking. Within CBT Herts, people learn to change the way they are thinking and feeling. Part of the CBT therapy I offer in Hertfordshire involves helping clients overcome their fear of panic attacks by going through whatever gives them a panic attack, for example a train ride or being in a lift. CBT, Herts, encourages you to challenge your fears, however, this does not mean forcing the person to go into that situation. This will come at a later date and really will depend on the individual. It is about working with the client and asking them questions so that they can devise their own programme to overcome panic attacks.

Nuero Linguistic Programming Herts is different from CBT as it looks at the language people use in their own mind. NLP Herts is about finding out what’s going on in a person’s head to allow panic attacks and then teaching them new ways of conquering panic attacks. An NLP Practitioner will ask clients to describe what happens before a panic attack comes on. This would involve asking a client if they see, feel, hear anything just before the attack takes over. The practitioner can put the client in a deep state of relaxation by using hypnotic techniques to try to combat the fear. At my practice in Hertfordshire I find it helpful to teach clients ways of calming their mind by teaching them relaxation techniques such as breathing techniques.

Ultimately the test will be asking the client to go back into the situation that causes them to experience panic attacks such as getting in a lift, being in a large crowd of people etc……….

At my practice in Hertfordshire I would assess a client to see which therapy NLP or CBT would be most effective for them. Sometimes it is good to use a mixture of both therapies in order to create the desired solution.

Get Paid to Submit Article like “Can Psychotherapy Really Help?”Therapy in this case means behaviour change or at least behaviour modification, which can be achieved in a number of ways. Psychotherapy all started with Freudian psychoanalysis, but protracted therapy sessions with an analysis slowly grew less popular as people looked for quicker ways to solve their problems.

More recently CBT or Cognitive Behaviour Therapy which has evolved from behaviour Modification Therapy has become increasingly more popular. It is now in common usage as a treatment option and is widely accepted as an empirically based and cost effective treatment alternative by the medical establishment. Thus it is used to address many disorders and psychological problems. If for instance somebody is suffering from an anxiety state such as the fear of flying the person will set up a number of protective behaviours that will guard them from the belief that flying is inherently dangerous. Overall they will probably avoid flying in an aeroplane at all. If forced some people will travel by air but in great discomfort and under a lot of stress. In some cases anti-anxiety drugs may alleviate this. However, if the individual avoids flying altogether they will find that the behaviour inhibits them in many avenues of life. For instance it will be difficult to travel on overseas holidays which might result in family pressures. More likely the real crunch will come when the person is required to travel abroad for work reasons. A refusal or inability to fly could have huge repercussions on work prospects and could lead to the loss of a job. However, we all have feelings about flying which can range on one hand to an exhilarating adventure and to the other to something that is dreaded, I think all will agree it would be nice to have a choice in the matter. CBT is able to help in situations like this by getting the subject to examine the beliefs that came into being that designated flying as something dangerous. Frequently the cause events go back to childhood. However, CBT is unable to deal with a problem like fear of flying quickly. It will take several months to come to a place where the subject is able to take a plane and travel to a destination with acceptably reduced stress levels. Unfortunately people in need of this treatment to offset the fear of flying usually do not have the luxury of this elongated time frame. Very often business executives are notified of overseas business trips just a few short weeks before departure date. Moreover treatment requires severall therapy sessions and this can work out costly. However, it must be said that treatment techniques like CBT are considerably better than those that preceded them, so it seems we are on a gradually improving learning curve.

However, when we go outside the empirically proven techniques that fit within the belief structures of the scientific principals favoured by the medical profession we do come to therapies that are quick and effective, Hypnosis or more precisely hypnotherapy has gained favour over the years because it can be effective and it can be quick. Some people are afraid because there are so many misconceptions about hypnosis. Many people think that a cloaked Svengali figure will take possession of their minds whilst waving a pocket watch in front of their eyes. This is nonsensical but stereotyped images like this get in the way of the true effectiveness of hypnosis.More recently the Meridian Energy Therapies have gained some popularity. The best known of these therapies is EFT or Emotional Freedom Technique. There is no hypnosis involved merely the tapping of the end points of the acupuncture meridians in a form of acupressure. EFT has had some amazing results from ridding people of life long phobias in a matter of minutes to curing Dengue Fever! It can be effective and is worth checking out because psychotherapy in the expert hands of a capable practitioner can result in truly amazing long-term benefits.

We are all encouraged to have goals – to set objectives and have targets. When we think of goals, usually we only consider the big long-term goals, such as buying a home. However it is often our everyday goals and actions which we need to focus on in order to increase our happiness and make life more enjoyable. Our thoughts, emotions and behaviour can either support or undermine us in our pursuit of goals and objectives. Goal directed thinking and behaviour supports us in our aims, objectives and survival. In this newsletter I have included some tips and examples to keep you goal directed and mindful of your everyday goals.Staying goal directed means that we are personally responsible for our thoughts, emotions and behaviour. Therefore we are personally responsible for our outcomes and are in control.It is our thinking and beliefs that cause us to have negative or harmful emotions such as anger, frustration and irritation. These emotions can then have an impact on our behaviour towards situations and other people.For example, I may go to a party – think that I’m unattractive (thoughts) – feel depressed (emotions) – drink two bottles of wine (behaviour) – have a fight with my best friend (outcome). Does this sound familiar? (My details are at the bottom of the page)So, by recognising that our thoughts and behaviour are not supporting us and are self-defeating, we can dispute them and choose realistic thoughts to maintain perspective and stay goal directed. To stay goal directed we could ask ourselves simple questions about our current situation and circumstances.What is my goal here? To have a pleasant journeyTo enjoy my eveningTo have a loving relationshipTo get on with peopleTo effectively communicate with my childrenTo stay healthyTo have a successful careerTo work harmoniously with my colleaguesWhen having negative thoughts and emotions we can stay goal directed by asking ourselves this pragmatic question:How does thinking or behaving this way help me to feel good or achieve my goals?Does being angry with peoples’ noisy ipods and phones help me relax and have a pleasant journey?Does worrying about how I look help me enjoy my evening?Does blaming my partner and staying angry help me have a loving relationship?Does demanding that others have the same beliefs as I do, help me get on with people?Does shouting help me to communicate with my children?Does eating fatty foods help me stay healthy?Does being late help me have a successful career?Does blaming and labelling my colleagues help the team effort?Simple isn’t it? As long as we remain mindful of our goals and objectives in everyday situations we can adapt our thinking and behaviour to obtain those goals. It’s just a case of taking a moment to reflect on our goals, before harmful emotions such as anger take a hold of our actions.Put this into practice today, maybe before you make that phone call, enter that meeting or… go on that date.

You may often hear the phrase “you are what you eat” and clearly there is some truth in that; we are constantly reminded by the media and government to eat healthily. However, what we think is more important and in particular, that inner critical voice which we hear all day long. Our inner voice either supports us and makes us feel good or undermines our self-esteem and self-worth causing us to feel down. With that in mind I have included in this article a common thinking error called labelling, which can make anyone feel lousy. The simple truth is “You are what you think!”These days we are more brand aware than ever before. We may not all wear designer clothes or drive expensive cars or even eat designer food, but we are all aware of brands and labels. We make conscious and unconscious judgements about people, their identity and status based on the items they use. Consequently, we will then make judgements and evaluations about our own identity and self-worth.We may also label others and ourselves by traits, behaviours and actions. Rather than look at the whole person and all their good and bad points, a specific evaluation is accorded to their whole being. For example, “He did a stupid thing, therefore he is stupid”. “She broke a plate, therefore she is clumsy”.  It is more helpful to acknowledge when we and others have done something wrong or made a specific error. For example “that was a silly mistake” “that didn’t go down too well”, then we can distinguish between the actions and the person as a whole. Labelling people makes it more difficult to get on with others and causes hostility if we see them as one-dimensional For example “that guy is a jerk”, “She’s an idiot”. I once worked in a company where one of the IT staff made an error that caused the network to temporarily crash, he soon became known as “TITI” (Titty – The IT Idiot). Needless to say this was very upsetting for the individual concerned – he left a short time afterwards. Labelling is more than name-calling; it is mud that sticks.When directed at ourselves labelling can cause diminished self-esteem, guilt, self-loathing and depression. We will often acquire negative labels in childhood and early relationships; it is important that we challenge and dispel them rather than continue to wear them on the inside.A useful exercise is to monitor your inner critic; that voice that you hear through the day that says things such as “I’m not smart enough”, “I’m boring and uninteresting” “I’m too old” “I’m unattractive”. Write these comments down and then dispute, challenge and replace them with more helpful and rational statements such as “I’ve learned a lot and continue to learn”, “I am as interesting as anyone; I have my unique style”, “Age is an irrelevance”, “I’m as attractive as anyone”. This takes a bit of effort, but “you’re worth it”. You will feel better about yourself, increase your self-esteem and discard unwanted mental baggage.Choose your labels with care!RegardsPhil Pearl DCH, DHP, MCH, GHR Reg

The following article looks at “demanding” and “preferring”. Understanding the difference between these types of irrational and rational thinking is key to Mental Toughness. Demands are rigid thinking patterns and rules, where we insist that others, the world and ourselves must be a certain way, in order for us to be happy. Albert Ellis, who pioneered Rational Emotive Behaviour Therapy (REBT), called this rigid thinking “demandingness”.Demands are rigid and inflexible rules about how other people, ourselves and life must or must not be, in order for us to be happy. Having rigid beliefs and rules can make us anxious, frustrated and depressed. Demands will often contain the words “must” and “should”, such as:”Everyone must like and approve of me”.”I must be absolutely competent in everything I do”.”The world should always be a fair place”.Preferences are flexible ideas regarding how we would like things to be, without demanding and insisting that they must always be that way, such as:”It would be nice if everyone liked and approved of me, but they don’t have to”.”I want to be competent in everything I do, but I don’t have to be.”"I would like the world to be a fair place, but unfortunately it doesn’t have to be the way, that I want it to be”.Having preferences rather than demands does not mean that we shouldn’t have high values or standards; the point is whether our demands are pragmatic and helping us in our aims and objectives, or are rigid, unrealistic and impractical. The key is to be flexible and accept that people and things will not always go our way and that having rigid and fixed rules is unhelpful and irrational. Here’s an example regarding perfectionism. Let’s suppose that I have a demanding rule that “I must give an absolutely, perfect presentation or I will look hopeless and inept”. If I hold on to this irrational belief, the consequences are likely to be that I will be unnecessarily anxious, and my worry will cause me to lose sleep. I will over-prepare and have too many notes, which will cause further worry as to how I will cram all the material into a set presentation time. I will be over-nervous and worry that I will freeze and my mind will go blank. I may predict catastrophe, attach too much importance to the presentation and imagine I will lose my job. Alternatively, I can hold a preference such as “I would like to do a perfect presentation, but it does not have to be 100 per-cent perfect”. In this case I am more likely to focus on covering the essential points rather than worrying about trying to be perfect, and further realise that there is no such thing as a “perfect” presentation. And besides, it is unrealistic to expect that all of the audience will be paying attention, all of the time. If the audience are students, it is likely that they will have hangovers or be tired.Here’s another example for anyone visiting or living in London and using the Tube trains; where we are expected to let passengers off of the train before boarding. If I have the demand that “people must always let me off the train first, before they start getting on” then I am going to be upset and annoyed on a regular basis, as often people will start getting on in order to get a seat. Of course, a lot of the time people will wait for me to get off, before they get on, but because I have such a rigid and demanding rule, I will still feel tense in the anticipation that my rule will be broken at any second.Alternatively, rather than have such a rigid and demanding rule, I can hold a preference such as “I would prefer it if people let me off first, but in reality this will not always be so”. By holding a preference rather than a demand, I am being realistic and can accept that others do not have the same rules. By holding a flexible preference I am less likely to become angry or upset.Often we seek to change other people and become frustrated in our attempts, however we can change ourselves and how we react to other people and events; we can remain in control and fully responsible for our actions, thoughts and emotions.Being flexible and able to adapt is key to Mental Toughness. Regards

Phil Pearl

Those who work in the field of healthcare have known for some time that a connection exists between our underlying beliefs and thoughts and the functioning of our bodies. Dr. Herbert Benson, in his 1970’s landmark book, The Relaxation Response, articulated the concept that stressors can trigger a “fight or flight response”, an inner startle response that indicates we are about to experience an unpleasant event. Although there is a healthy fear that protects us from harms way, many times how one interprets stressful events and one’s ability to manage it, can affect the immune systems functional capacity. There is now sufficient research to validate Benson’s work, that relaxation techniques such a meditation, can have a direct link to minimizing the effect of a wide range of disorders such as high blood pressure, irritable bowel syndrome, back problems, neurological pain, and headache problems. Relaxation strategies calm the sympathetic nervous system, making it easier for the body to heal.

In Barbara Levine’s book, Your Body Believes Every Word You Say, she explores how our thoughts and underlying beliefs about our physical maladies affect our auto-immune system which regulates our ability to ward off illness, manage pain, and promote healing. In other words, legitimate pain from various illnesses and somatic complaints can be intensified by the kind of messages we tell ourselves. Spontaneous self-defeating thoughts such as, “What’s the use, my body will always betray me and never get better.” can reinforce the pain cycle of making things worse. People with such chronic self-defeating reactions have been shown to create inner chemical changes and constricted blood flow which further erodes the individual’s ability to manage pain. How we respond to our bodily disorders, in terms of core beliefs and inner dialogue, may affect the outcome of our health. 

 Some time ago, I attended a presentation by psychiatrist M. Scott Peck. He talked with mental health providers about his struggles with neck pain, a problem that had plagued him for years. An operation resolved some of his pain, but he felt that there might be some negative underlying belief that was also contributing to the problem. He ultimately concluded that he was a conflict-avoider, lacking the ability to appropriately assert himself, refusing to “stick his neck out.”

 Physical illnesses can be intensified by self-defeating underlying thinking that is a metaphor for the chronic condition experienced. For example, people with back pain may at times lack the “backbone” to express their thoughts and feelings courageously. Individuals with gastrointestinal problems may not be unable to “stomach” certain intolerable thoughts and feelings. People with headache syndromes may experience beliefs and thoughts about events that make them want to say, “Life is making my head hurt.” Eating disordered people may experience core assumptions such as, “I’m so angry that I could just vomit, or if I monitor my weight and eating habits, at least it’s one area in my life that I can control!” People with neurological pain such as inner ear disorders may exacerbate their pain by experiencing thoughts of panic such as, “Oh my God, here it comes again, that nasty, annoying pain. I’ll never get over this because the volume in my life is turned up too high.” 

Anxiety, panic, and depression are typical characteristics associated with physical pain. The more effectively one manages these symptoms, the less troublesome the pain may be. Learning to cope with anticipatory anxiety by rationally responding, “Ok, I know that this pain can be troublesome, but when it comes I will do my deep breathing and manage just fine!”, or dealing with panic, “When a wave of pain comes, I’ll just go with it. It’s not a big deal, my scary feeling are time-limited, they’ll be over soon”), and managing depression, “Just because I feel awful doesn’t mean I can’t do things to stay active and make me feel involved” are important ways of adaptively responding to pain

The following ideas are some guidelines for managing pain more effectively

·         Try to get you pain in perspective. Make a realistic appraisal. “In the scheme of things, how bad is my condition?

·         Don’t fight with your symptoms, it only makes them worse. The more you accept your symptoms, the more they are likely to diminish

·         Use various activities to refocus away from your pain. Dwelling on pain makes it more    painful. Stretching, music, swimming, meditation, and other activities are important

·         Seek a multidisciplinary approach to your problem, if necessary. Get a team of healthcare specialists, including a quality physician, psychotherapist, physical therapist, message therapist or other providers of pain management

·         Develop a solid support system of family and friends. Also, there are many support groups in our community for people suffering from a variety of physical ailments

·         Remember, that the things we tell ourselves have an impact on our physical and emotional well-being.

In the dictionary “cognitive” is simply defined as the way one thinks. “Behaviour” is simply defined as the way one behaves. Therefore the subject of “cognitive behaviour therapy” is looking at how one thinks in relation to how one behaves.As discussed in previous arictles, counselling is the means of looking inwards to find one’s truth and in short, build a better life for one’s self.  Needless to say as technology develops, likewise our understanding of the human mind. So we find better ways to help the individual locate those thoughts and feelings so the individual can undestand his or her thoughts.  Only by truly understanding them can one hope to change them. Cognitive behaviour therapy is one such route. For example an indiviiduals may become agressive when or she is having a discussion about Money. Now in every day life, for an individual to actually get agreesive is an extreme gradient. Nevertheless with Cognitive behavious therapy, we are interested in the thoughts and feelings of that particular situation and how that effected the overall bevaviour pattern. By looking and understanding those thoughts and feeling together with your counseller, can one begin to understand where those thoughts came from and what they mean ensuring that should the  situation arrise again. The mind does not look at the situation in the same way. In other words, he she does not get aggressive. Cognitive behaviour therapy looks at the aspects of how one thinks about him or her self, what he or she thinks about the people and the world. As the therapy continues, understanding how those thoughts and feeling create both the reality in which that person lives and how this in turn effects the individuals behaviour. As one progresses with CBT otherwise known as Cognitive Behaviour therapy, (home work) may be issued, this is basically a case of keeping a journal or a diary up to date so as to monitor your thoughts, feelings and reactions.