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

As a long term yogic and vipassana meditator, and a mindfulness-based psychotherapist who regularly teaches meditation practices to my patients, I find the growth of mindfulness as a clinical intervention very timely. Last year, I attended two conferences focused on the use of mindfulness as a clinical intervention:  “Meditation and Psychotherapy” at Harvard Medical School and “Mindfulness and Psychotherapy” at UCLA. Interestingly, the conference at Harvard featured a greater percentage of presenters who do not use meditation as an intervention in their clinical work. For them, mindfulness is a teachable skill set, extrapolated from a way of viewing life gained from sustained Buddhist meditation practices. These presenters included: Steven Hayes, founder of ACT, Lizbeth Roemer, U Mass GAD researcher and clinician, Tal Ben-Shahar, Harvard Lecturer on Positive Psychology, and Jayme Shorin, LICSW, sensorimotor trainer. The fact that the organizers of the Harvard conference felt it necessary to devote over half of the presentation time to methodologies that do not include meditation was, for me, significant. Though this might be expected at a “Mindfulness and Psychotherapy” conference, in fact the UCLA conference featured more presenters discussing the use of meditation and compassion practices as a clinical intervention. These presenters included: Thich Nhat Hahn, Vietnamese Buddhist monk and meditation teacher, Jack Kornfield, Tara Brach, Harriett Kimble Wrye, and Trudy Goodman, all psychologists and meditation teachers, and Dr. Daniel Siegel & Harvard neuroscientist Sara Lazar presenting the neurobiology of meditation.Due to the continuing trend in mental health toward brief, CBT methods and away from depth-oriented, psychodynamic therapies, one can easily see how a reduction of “mindfulness” to an easily deliverable skill set would be a natural outcome of the environment in which it is delivered. But is the doing away with meditation practice psychotherapeutically wrong or ineffective? Not necessarily. Even in the East, Karma Yoga is an example of a path to liberation which eschews formal meditation practice in favor of a commitment to the work one does in the world as spiritual practice. Also, with neuroscience showing significant brain changes from long-term mindfulness meditation, one can easily see how a researcher like Steven Hayes could create mental exercises that simulate, through active questioning of the validity of language, the realization of the contextual nature of the self., i.e., “Am I really these thoughts and beliefs that my mind continually comes up with?” Years of meditation cultivates a natural non-reactivity to experience. But why wait years, when simple instructions for distress tolerance, like those featured in DBT can be dispensed to patients suffering from emotion dysregulation? Following in the footsteps of ACT is Acceptance-based psychotherapy which focuses on delivering skills for realizing and accepting here and now experience with compassion; something vipassana meditation and metta practices are well documented at cultivating in long-term practitioners. Yet again, why practice meditation at all when mindfulness skills can be learned and behaviors changed?Additionally, it must be acknowledged that most psychotherapists will not want to learn and commit to a daily mindfulness meditation practice, or be trained to teach mindfulness meditation. Therefore, it may be more desirable and practical in clinical settings to deliver a CBT-like mindfulness skill set rather than teach meditationIn light of all these benefits, what do we lose in clinical practice when we allow instruction of vipassana/mindfulness meditation to fall into disfavor or become outmoded? The following list is my best guess at an answer to this question: 1.The long and short term stress-reducing physical effects of meditation2.The plethora of profoundly, positive neural changes evidenced in the brains of long term vipassana/Tibetan Buddhist meditators 3.The deep emotional healing that comes from metta/forgiveness/compassion meditation practices 4.The benefits of setting aside time in our busy lives for silence, meditation and contemplation5.The cultivation of peacefulness6.The deepening of connection with and respect for our planet and all living things upon it, which naturally arise from sustained meditation practice7.The shared joy of a community of meditators; whether traditional sanghas or 8-week mindfulness-based groups like Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy for Depression Relapse Prevention (MBCT), or Mindfulness-Based Relapse Prevention for addiction recovery (MBRP). I have seen patients experience radical change from incorporating mindfulness meditation and mindfulness skills into their daily lives and I am excited to offer MBRP, a mindfulness-based intervention for addiction relapse prevention in San Jose, CA in March 2008. Please contact me for more information.

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.

Post-traumatic Stress Disorder (PTSD) first came to the attention of doctors during the First World War when relatively large numbers of soldiers returned from combat exhibiting intense emotional distress in which they seemed to re-live the terrifying events of war long after the event. However, war is only one context in which PTSD arises. Later, it became clear that this phenomenon of delayed emotional reactivity could result from many other contexts such as accidents and illness, physical assault, rape or witnessing acts of violence and devastation, natural or man-made. Childhood abuse is now recognized as one of the major sources of PTSD.

In general PTSD can be defined as severe recurrent emotional anxiety reactions that originate from an intense and traumatic experience. A trauma occurs when there is a combination of sensory and emotional overload that cannot be processed and integrated into the psyche. A war scenario provides many intense visual, auditory and contextual stimuli that are completely foreign to the average person, as does sexual abuse, rape or witnessing a car accident. Context plays a very important part as in the case of childhood abuse, where the child’s model of how his parents should behave cannot be reconciled with the parent’s actual behavior. The experience of intense fear that accompanies trauma becomes encoded into the internal memory imprint of the associated sensory experiences. The unprocessed sensory experiences and associated emotional reactivity become submerged and repressed in the subconscious mind as a core emotional complex. When the appropriate stressors are present or when the suppressive activities of the ego are weakened, as is the case during sleep this repressed emotional complex is activated leading to a repeat experience of the emotional trauma, often with the associated visual imagery in the form of flashbacks. Like other core emotional complexes, the repression is never complete and negative emotional energy leaks into present experience leading to general anxiety, phobias, recurrent anger, sleep difficulties, depression, obsessive-compulsive behaviours and substance abuse. These can be described as the layers of secondary reactivity that form around the primary trauma reaction and which, in their own way, shield the core emotional complex from further processing and integration by the psyche.

There are many approaches to treating PTSD, some involving medication and others focussed on psychotherapy. Cognitive Behavioral Therapy (CBT) is a particularly useful approach, because it focuses on the client’s actual patterns of habitual negative thinking and beliefs and attempts to change these into more positive and functional forms. The form of cognitive therapy described in this article is called Mindfulness Meditation Therapy (MMT), which can be defined as the direct application of mindfulness to an emotional complex to facilitate transformation and resolution. Mindfulness describes a particular form of awareness that is present-centered, direct and non-reactive towards an object of awareness. It is best described as the combination of PRESENCE and INVESTIGATION in which there is an openness of mind and heart to fully experience and know what is present in our field of awareness. Presence is one of the most important components of sensitive listening as when we are listening to a friend who is suffering. As we know from experience, simply being there with him or her in this way with complete attention and presence is often more important than what we say or do. In this same way, learning to be fully present for our emotional suffering is highly therapeutic and is perhaps one of the major contributions to the healing process. The other aspect of mindfulness is simply learning to recognize all the patterns of habitual reactivity that takes us away from being fully present for our emotional suffering. Meditation in the context of MMT refers to the direct application of mindfulness and presence to the emotional suffering itself, which becomes the object of our meditation. In general, during MMT, we allow the emotional complex to unfold and differentiate into more and more subtle content. This differentiation into specific feelings, memories and sensory content leads to direct transformation of emotional complexes and literally makes the complex easier to digest.

Traumatic memories have a specific internal structure in the form of intense imagery. This imagery may be photographic in quality, revealing the actual memory of the traumatic event, but more often it also includes abstract elements of color, shape and movement in something resembling a surrealistic collage. Whatever the form of the imagery, this internal representation is an essential part of what is required to produce intense emotional reactions. This is referred to as the Structural Theory of Emotions, where emotional energy is encoded in the specific sub-modalities of size, color, intensity, movement and texture. An intense emotion is likely to be encoded in intense colors such as red and orange and the imagery is likely to be large and close in the person’s inner visual field, whereas neutral emotions are likely encoded in neutral colors such as pale blue or white and appear small and far away. It is by becoming aware of this internal structure of the imagery that encodes the emotional energy of the trauma that we can explore the possibility of changing the imagery and thus changing the emotional intensity of a traumatic memory. This concept is developed to an art in the therapeutic modality called Neuro-Linguistic Programming, or NLP. Just as language is made of words that represent internal experience, imagery represents the natural language of the mind – the mind thinks in pictures and uses inner imagery to organize experience and memory.

The Structural Theory of Emotions proposes that by changing the structure of the imagery it is possible to change the intensity of the emotional reaction. Thus, if the color changes from intense red to soft yellow and the imagery becomes smaller and further away, it is very likely that the emotion will be much less intense. However, for this to work effectively the imagery must arise experientially from the emotional felt sense, rather than be created through deliberate visualization. Similarly, the direction of change must arise experientially, rather than be imposed externally. In this way, the client maintains close presence with his inner experience and knows that what happens is meaningful and relevant to his or her specific transformational process. This is why mindfulness is such an important part of the transformational process, because it allows us to be exquisitely sensitive to what is meaningful and what is not. The investigative dimension of mindfulness also provides the best approach to uncover the detailed inner structure of the emotion and provide meaningful content.

A central focus in MMT is to uncover this internal structure of the traumatic memory and then to investigate this experiential content. There is no attempt to interpret what arises, only to experience fully and know completely whatever arises. This process essentially de-constructs the emotional complex into smaller parts that the psyche can digest and integrate into more stable configurations that do not continue to generate emotional suffering. Of course, this requires considerable preliminary preparation so that the client can experience the internal imagery without becoming overwhelmed by it. This preliminary phase of MMT is focussed on establishing the Mindfulness Based Relationship (MBR) in which there is sufficient stability and non-reactivity to allow the imagery to unfold into present awareness. There are many approaches to achieve the right MBR, such as watching the imagery as if projected on a screen or placing the imagery at some distance in front. Through mindfulness and careful investigation, the client can discover for himself what works best for establishing the MBR. However, once a client begins to witness specific details about the imagery, he inevitably finds it much easier to establish the MBR, because the specific content gives him a specific focus and this tends to prevent hyper-reactivity. The MBR is an essential part of the transformation process for many reasons, the primary reason being that it allows the compacted emotional complex to unfold into more manageable parts. At another level, the MBR allows the client to fundamentally change the way that he relates to his inner emotional experience and he begins to break free from seeing himself as a victim of the emotional trauma. This in itself is an essential requirement for change.

Throughout the whole process of MMT, the client is repeatedly exposed to the source of his fear, but in new ways that don’t involve being overwhelmed. This exposure desensitization effect is regarded by most schools of psychotherapy as an essential part of overcoming PTSD and Mindfulness Meditation Therapy provides a very subtle and effective way of doing this.

Peter Strong, PhD is a scientist and Buddhist Psychotherapist, based in Boulder, Colorado, who specializes in the study of mindfulness and its application in Mindfulness Psychotherapy. He teaches mindfulness-based techniques and meditation to individuals and couples to resolve core patterns of emotional reactivity, including anxiety, depression, phobias, grief and post-traumatic stress. Besides face-to-face work, he also works with individuals and couples online and also teaches seminars to companies and groups.

http://www.mindfulnessmeditationtherapy.com/

THE IMPORTANCE OF A MINDFULNESS-BASED RELATIONSHIP WITH CORE EMOTIONS

Intense emotions like anxiety, grief, fear, anger or phobias or post-traumatic stress are formed when emotional feeling energy becomes concentrated in the form of an internal belief. Psychotherapy modalities such as CBT focus on these dysfunctional internal beliefs and attempt to change them through exposing the irrational nature of the belief and offering new belief models to the client. However, the real challenge is always in how to change the associated feeling level that empowers the belief. If this emotional energy remains unchanged then the beliefs and habitual reactivity based on them will simply return. Therefore, to change a belief structure and associated compulsive reactivity, the therapist must help the client form a high quality relationship with his inner feelings in which he can observe and learn the feeling without falling into the trap of further reactivity. This secondary reactivity most often takes the form of ruminative thinking, emotional reactivity or avoidance.

This is where mindfulness becomes an invaluable tool for both the client and the therapist. Mindfulness is defined as the non-reactive present-centered awareness of an experience. It is the art of sensitive listening, being fully present and receptive to whatever is being experienced. In Mindfulness Meditation Therapy, mindfulness is applied directly to the felt-sense of the emotion to cultivate this quality of presence. We choose to make the emotion the primary object of our meditation and our task is to develop a relationship with the emotion, with the anger or fear in which we can observe the emotion and allow the emotion to unfold. The purpose of cultivating the mindfulness-based relationship is so that we can move from the superficial surface structure of the emotion to the deep internal structure and reveal the subtle internal structure.

In practice, mindfulness is the sensitive awareness to reactivity itself. It is the art of continually recognizing when we become reactive, when we become lost in thinking and judging or reacting with aversion or resistance or wanting things to be different than they are. All of these reactions take us away from the direct experience of our inner felt-sense of the emotional complex, a phenomenon that I call Reactive Displacement. Mindfulness allows us to tune into all the subtle movements of wanting, aversion and delusion and allows us to return our attention to the primary object, which in this case is the felt-sense of the emotion. We stay at this interface and return to this interface over and over again. The effect of mindfulness focused in this way is to open a “space” around the emotion, to silence secondary reactivity and allow ourselves, for perhaps the first time, to fully be with the emotion, without reacting, without trying to fix things, without trying to control things.

The practice of mindfulness meditation in this way opens up a therapeutic space that allows for the possibility of change. Reactivity keeps things the same and inhibits change; mindfulness counteracts reactivity and restores freedom into the psyche. Now, how an emotion undergoes transformation and resolution is a big topic that will be discussed in another article. Suffice it to say that any emotional complex has the property of being highly unstable and the psyche is very efficient at resolving instability if given the freedom to operate – and this is the key point. Reactivity inhibits the freedom to operate, while mindfulness restores the freedom to change. What is observed is that when we have a sustained mindfulness-based relationship with a dissonant emotion, the emotion will spontaneously undergo transformation in a direction that leads to its resolution. This, I call the principle of Psychological Homeostasis – but the key is freedom to change. No freedom, no change.

Peter Strong, PhD is a scientist and Buddhist Psychotherapist, based in Boulder, Colorado, who specializes in the study of mindfulness and its application in Mindfulness Psychotherapy. He teaches mindfulness-based techniques and meditation to individuals and couples to resolve core patterns of emotional reactivity, including anxiety, depression, phobias, grief and post-traumatic stress. Besides face-to-face work, he also works with individuals and couples online and also teaches seminars to companies and groups.

http://www.mindfulnessmeditationtherapy.com/

Email enquiries welcome.

THE IMPORTANCE OF A MINDFULNESS-BASED RELATIONSHIP WITH CORE EMOTIONS

Intense emotions like anxiety, grief, fear, anger or phobias or post-traumatic stress are formed when emotional feeling energy becomes concentrated in the form of an internal belief. Psychotherapy modalities such as CBT focus on these dysfunctional internal beliefs and attempt to change them through exposing the irrational nature of the belief and offering new belief models to the client. However, the real challenge is always in how to change the associated feeling level that empowers the belief. If this emotional energy remains unchanged then the beliefs and habitual reactivity based on them will simply return. Therefore, to change a belief structure and associated compulsive reactivity, the therapist must help the client form a high quality relationship with his inner feelings in which he can observe and learn the feeling without falling into the trap of further reactivity. This secondary reactivity most often takes the form of ruminative thinking, emotional reactivity or avoidance.

This is where mindfulness becomes an invaluable tool for both the client and the therapist. Mindfulness is defined as the non-reactive present-centered awareness of an experience. It is the art of sensitive listening, being fully present and receptive to whatever is being experienced. In Mindfulness Meditation Therapy, mindfulness is applied directly to the felt-sense of the emotion to cultivate this quality of presence. We choose to make the emotion the primary object of our meditation and our task is to develop a relationship with the emotion, with the anger or fear in which we can observe the emotion and allow the emotion to unfold. The purpose of cultivating the mindfulness-based relationship is so that we can move from the superficial surface structure of the emotion to the deep internal structure and reveal the subtle internal structure.

In practice, mindfulness is the sensitive awareness to reactivity itself. It is the art of continually recognizing when we become reactive, when we become lost in thinking and judging or reacting with aversion or resistance or wanting things to be different than they are. All of these reactions take us away from the direct experience of our inner felt-sense of the emotional complex, a phenomenon that I call Reactive Displacement. Mindfulness allows us to tune into all the subtle movements of wanting, aversion and delusion and allows us to return our attention to the primary object, which in this case is the felt-sense of the emotion. We stay at this interface and return to this interface over and over again. The effect of mindfulness focused in this way is to open a “space” around the emotion, to silence secondary reactivity and allow ourselves, for perhaps the first time, to fully be with the emotion, without reacting, without trying to fix things, without trying to control things.

The practice of mindfulness meditation in this way opens up a therapeutic space that allows for the possibility of change. Reactivity keeps things the same and inhibits change; mindfulness counteracts reactivity and restores freedom into the psyche. Now, how an emotion undergoes transformation and resolution is a big topic that will be discussed in another article. Suffice it to say that any emotional complex has the property of being highly unstable and the psyche is very efficient at resolving instability if given the freedom to operate – and this is the key point. Reactivity inhibits the freedom to operate, while mindfulness restores the freedom to change. What is observed is that when we have a sustained mindfulness-based relationship with a dissonant emotion, the emotion will spontaneously undergo transformation in a direction that leads to its resolution. This, I call the principle of Psychological Homeostasis – but the key is freedom to change. No freedom, no change.

Peter Strong, PhD is a scientist and Buddhist Psychotherapist, based in Boulder, Colorado, who specializes in the study of mindfulness and its application in Mindfulness Psychotherapy. He teaches mindfulness-based techniques and meditation to individuals and couples to resolve core patterns of emotional reactivity, including anxiety, depression, phobias, grief and post-traumatic stress. Besides face-to-face work, he also works with individuals and couples online and also teaches seminars to companies and groups.

http://www.mindfulnessmeditationtherapy.com/

Email enquiries welcome.

There has been a growing interest in Online Therapy using email, correspondence and live video conferencing using Skype or similar free services. The convenience of this approach for the client is very apparent: The client can take control of the process, paying only for the time that he or she wants to pay for. The client can have his session at a time that is convenient to him, and can take the time to compose his email questions and feedback at his leisure, instead of feeling pressured to perform during a traditional session. Of course, not having to take time off work to drive to a therapist’s office is always a plus. Generally the cost for online sessions is much lower too since the therapist doesn’t have to pay for office space. Generally, it is well recognized that if you make therapy more accessible and more convenient, then people will be more likely to stick with it, and this is always a major factor in the successful outcome of psychotherapy.

What about effectiveness?

Well, in a clinical study published in the Lancet in August, 2009, Online Therapy, via instant messaging, resulted in a significant recovery rate for patients suffering from depression. The treatment method used was Online Cognitive Behavioral Therapy (CBT).

In general online therapy works best when clients are offered specific strategies with which they can experiment at home. Techniques such as CBT, Neuro-Linguistic Programming (NLP), Mindfulness-based Psychotherapy (http://www.mindfulnessmeditationtherapy.com) are particularly appropriate.

The very process of writing down your thoughts in an email is an immensely powerful tool for helping you develop a more objective relationship with emotions, which can be very abstract and difficult to verbalize. This is why journaling has long been encouraged in many schools of psychotherapy. Then taking the bold step of sharing this with another person is also very empowering for most people. Some people are good at doing this face-to-face, but many actually feel intimidated and need more time to formulate the right words, without a therapist pressing them for content.

The online approach can also be good for the therapist, because he or she can take time to design the right strategies to offer the client and not feel pressured to provide a solution on the spot.

Is Online Therapy a substitute for face-to-face sessions?

No, probably not, but it is clearly an excellent addition, and provides an alternative for those who don’t feel comfortable with traditional therapy sessions, or are unable to attend such sessions. It may be particularly useful for those suffering from social anxiety or agoraphobia. One thing is for certain: the internet has become a major part of most people’s lives, and we should develop the extraordinary potential of the World Wide Web for bringing people together to promote healing.

Internet Psychotherapy and Counseling provides a vehicle that will allow many more people to connect and find wise counsel for working with their emotional issues than is possible through in-person sessions alone.

In my work in online counselling, mostly by email, I am always pleased to see how clients become more empowered through the process. Recently, I helped a person in South Africa, who was struggling with anxiety following a recent personal trauma. It was a joy to see his emails in the morning and then take the time to suggest the next exercise to practice to help him resolve his inner pain. We never met in person and probably never will, but nevertheless, I have been able to help heal his inner trauma, and that is immensely satisfying to me as an online therapist as it was to him as an online client.

Peter Strong, PhD is a scientist and Psychotherapist, based in Boulder, Colorado, who specializes in Mindfulness Meditation Therapy and NLP to treat anxiety, depression, phobias, grief, and post-traumatic stress. He specializes in Online Psychotherapy and teaches individuals and couples strategies for overcoming emotional problems. Visit

http://www.mindfulnessmeditationtherapy.com

Email enquiries welcome.

THE IMPORTANCE OF A MINDFULNESS-BASED RELATIONSHIP WITH CORE EMOTIONS

Intense emotions like anxiety, grief, fear, anger or phobias or post-traumatic stress are formed when emotional feeling energy becomes concentrated in the form of an internal belief. Psychotherapy modalities such as CBT focus on these dysfunctional internal beliefs and attempt to change them through exposing the irrational nature of the belief and offering new belief models to the client. However, the real challenge is always in how to change the associated feeling level that empowers the belief. If this emotional energy remains unchanged then the beliefs and habitual reactivity based on them will simply return. Therefore, to change a belief structure and associated compulsive reactivity, the therapist must help the client form a high quality relationship with his inner feelings in which he can observe and learn the feeling without falling into the trap of further reactivity. This secondary reactivity most often takes the form of ruminative thinking, emotional reactivity or avoidance.

This is where mindfulness becomes an invaluable tool for both the client and the therapist. Mindfulness is defined as the non-reactive present-centered awareness of an experience. It is the art of sensitive listening, being fully present and receptive to whatever is being experienced. In Mindfulness Meditation Therapy, mindfulness is applied directly to the felt-sense of the emotion to cultivate this quality of presence. We choose to make the emotion the primary object of our meditation and our task is to develop a relationship with the emotion, with the anger or fear in which we can observe the emotion and allow the emotion to unfold. The purpose of cultivating the mindfulness-based relationship is so that we can move from the superficial surface structure of the emotion to the deep internal structure and reveal the subtle internal structure.

In practice, mindfulness is the sensitive awareness to reactivity itself. It is the art of continually recognizing when we become reactive, when we become lost in thinking and judging or reacting with aversion or resistance or wanting things to be different than they are. All of these reactions take us away from the direct experience of our inner felt-sense of the emotional complex, a phenomenon that I call Reactive Displacement. Mindfulness allows us to tune into all the subtle movements of wanting, aversion and delusion and allows us to return our attention to the primary object, which in this case is the felt-sense of the emotion. We stay at this interface and return to this interface over and over again. The effect of mindfulness focused in this way is to open a “space” around the emotion, to silence secondary reactivity and allow ourselves, for perhaps the first time, to fully be with the emotion, without reacting, without trying to fix things, without trying to control things.

The practice of mindfulness meditation in this way opens up a therapeutic space that allows for the possibility of change. Reactivity keeps things the same and inhibits change; mindfulness counteracts reactivity and restores freedom into the psyche. Now, how an emotion undergoes transformation and resolution is a big topic that will be discussed in another article. Suffice it to say that any emotional complex has the property of being highly unstable and the psyche is very efficient at resolving instability if given the freedom to operate – and this is the key point. Reactivity inhibits the freedom to operate, while mindfulness restores the freedom to change. What is observed is that when we have a sustained mindfulness-based relationship with a dissonant emotion, the emotion will spontaneously undergo transformation in a direction that leads to its resolution. This, I call the principle of Psychological Homeostasis – but the key is freedom to change. No freedom, no change.

Peter Strong, PhD is a scientist and Buddhist Psychotherapist, based in Boulder, Colorado, who specializes in the study of mindfulness and its application in Mindfulness Psychotherapy. He teaches mindfulness-based techniques and meditation to individuals and couples to resolve core patterns of emotional reactivity, including anxiety, depression, phobias, grief and post-traumatic stress. Besides face-to-face work, he also works with individuals and couples online and also teaches seminars to companies and groups.

http://www.mindfulnessmeditationtherapy.com/

Email enquiries welcome.

Depression is often thought of as a female issue, which derives from the fact that women are twice as likely to experience this condition, but it’s also because women are more likely to seek help. It makes sense in a weird sort of way. I mean, if a guy won’t even ask for directions, how likely is it that he’ll ask for help? That being said, I do believe that, more and more, men are choosing mental health over machismo, a trend that has, no doubt, gained momentum in these times of economic hardship.

I, myself, have struggled with depression for as long as I can remember, going as far back as elementary school. Equal opportunity in nature, this illness can affect anyone, regardless of age, ethnicity or religion; although, it has been said that people with strong religious convictions do fare somewhat better when dealing with the negative thoughts associated with depression. It’s certainly understandable how the fear of going to hell would discourage someone from killing him/herself, but it’s more than that; there’s also the belief that things will work out, that eventually things will get better.

Depression can result from a combination of various contributing factors: genetic, biochemical, environmental and psychosocial.  It manifests differently for different people. A major depressive episode lasts at least two weeks and is characterized by five or more of the following symptoms:

If your or a family member’s depression is accompanied by the following thoughts and/or behaviors, you should contact a health care professional immediately.

Depression affects, not only the person experiencing this debilitating condition, but basically anyone the person comes into contact with. Children, spouses, pets and other family members may be neglected or physically/verbally abused. Coworkers may feel the brunt of a depressed person’s irritability. Mere strangers may become the victim of a depressed person’s aggressive and/or dangerous behavior.

Common methods used to treat depression are prescribed medications, psychotherapy, healthy living and, for severe cases, electroconvulsive (electroshock) therapy. Prescription medications used for this condition fall under the categories of SSRIs (selective Serotonin Reuptake Inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors). Whichever medication is prescribed, it’s important to be aware that therapeutic results can take 6-8 weeks to occur.

The two main types of psychotherapy are CBT (cognitive-behavioral therapy) which reduces depression by challenging negative beliefs and attitudes and IPT (interpersonal therapy) which helps the individual to overcome social deficiencies that may contribute to their depression.

Healthy living in the form of eating right, getting enough sleep, exercising and actively reducing stress, can go a long way in providing relief for some of the symptoms associated with depression. Unfortunately, in some cases, depression will persist despite one’s best effort. This is when one turns to ECT (electroconvulsive therapy).  ECT is a procedure that involves using electric current passed through the brain to cause a brief seizure, thereby altering the brain’s chemistry.

Whichever method you choose, it’s important to have a support system of understanding friends and family. They say it takes a village to raise a child; this, too, can apply to dealing with depression. Remember, being depressed is not a sign of weakness. There is no shame in asking for and receiving help.

Depression is a condition that we see increasingly often in our hypnotherapy practice here in the UK. Here are my top 10 tips for dealing with this debilitating state:

Peter Field is a leading British hypno-psychotherapist with practices in London and Birmingham, England. He is author of numerous articles on psychotherapy and hypnosis, a Member of the British Association for Counselling and Psychotherapy and Fellow of the Royal Society of Health. For more interesting articles and information visit his website: Peter Field Hypnotherapy