Hi Everyone! I hope 2019 is faring well for you all! I have been remiss in my job of late- I have not updated my blog since the New Year. There has been a very good reason for this; last year, I had a loss in my family that was incredibly profound. It wasn’t my first loss, but it was my first loss as an ‘adult’, and it did hit me hard. Since then, as anyone who has experienced loss, I have been trying to figure things out and make sense of my, now changed, world. That’s not been an easy thing for me to do.
My first experience of loss was as a 7-year-old at school, my favourite teacher died of an asthma attack. I remember being so sad, but not understanding how something as simple as an asthma attack could kill someone. Being a young child, I quickly got over that loss and carried on with my life, back in my safe cocoon of knowledge that people don’t really die, unless for a ‘special’ reason. I carried on quite well for a few years and then experienced my first loss of someone who was personally important to me, as a young teenager- my Grandmother died (being that I am half Polish, she was my Babcia) and my whole world was shaken. Everything I thought I knew had been capsized.
A few years after, I lost my Grandad (Dziadek) and I think I was much better equipped to deal with that loss, as I had already experienced a loss that felt so huge, it would crush me. I can now see, with my Psychological training, that what I was experiencing was perfectly healthy! Had I not responded in the way I did, perhaps then there would have been something ‘wrong’, but we dealt with it as a family and we carried on. There is no ‘right’ way to grieve or process your loss. Psychologists and Psychiatrists have spent a lot of time trying to work out how our grieving processes work- Swiss-American Psychiatrist, Elisabeth Kübler-Ross was frustrated by the lack of education that medical schools gave, in terms of the response to death and dying, so she started a series of interviews with patients, conducting her own research into the work that was already available, with regards death and dying.
1969 came and Kübler-Ross published her book, ‘On Death and Dying’ which published her idea that we go through stages of grieving, which she called the ‘Stages of the Grief Cycle’. Kübler-Ross initially assumed the stages to be linear, that is that one follows another, follows another, in order. However, later in life, she realised that the process was not linear, and that as individuals, we go through the process in differing stages, going back and forth as our own personal grief is processed. This kind of makes sense to me- I mean, we are all fundamentally human, so it would be sensible if we all reacted within some boundaries of a cycle, wouldn’t it? Or does that not account for our individual differences?
Kübler-Ross’ model does have criticism levied towards it, however. There are many reasons why the model might not be applicable; life is very different since KKübler-Ross created the model There is no definitive evidence that we actually pass through these stages; I use the model with clients to show that we all experience different reactions to loss, but that all of these reactions are part of a natural process. George Bonanno, a Clinical Psychologist at Columbia University in America has reviewed a number of peer-reviewed studies and journals and has come to the conclusion that we adapt and cope with trauma and loss through Psychological Resilience and some resilient people show no grief at all- but this doesnt mean they haven’t experienced the loss profoundly- this brings to mind an article I read about hypersensitivity, which would make an excellent blog post in the future. (Follow the links to read more about Psychological Resilience- it really is interesting!)
Whatever the theory behind grief and loss, we all experience it in our own way. For me, I felt the need to slow down my pace of work and to focus on the present more deeply. By doing this, it helped me to appreciate the here and now, rather than the what is going to happen in two weeks time, or the rumination on the past! Mindfulness, as always, has been a huge support for me. I guess this is my own personal resilience kicking in, acknowledging that there has been change in my life, and for me, change needs to be adapted to and worked with. Some changes happen quicker than others, I guess, and there are no rules as to how your own personal psychological resilience will kick in and work for you.
One year ago today, the world was rocked by the unexpected death of Robin Williams. He had been suffering from severe depression and, sadly, took his own life. What caused him to do this is unknown, and sadly, suicide remains very prevalent in our modern society.
According to The Samaritans 2015 report, Suicide Statistics 2015,
In 2013, 6,233 suicides were registered in the UK. This corresponds to a rate of 11.9 per 100,000 (19.0 per 100,000 for men and 5.1 per 100,000 for women).
The male suicide rate is the highest since 2001. The suicide rate among men aged 45-59, 25.1 per 100,000, is the highest for this group since 1981.
So, why is this happening and what is going on? The rates of suicide are increasing- but aren’t we more aware of our mental health now, more than ever? The Mental Health Foundation estimates that;
One in four people will experience a mental health problem at some point in their lives.
Around one in ten children experience mental health problems.
Depression affects around one in 12 of the whole population.
Rates of self-harm in the UK are the highest in Europe at 400 per 100,000.
450 million people worldwide have a mental health problem.
So, mental health issues are pretty common place- so why are the suicide rates increasing? One reason that is consistently studied is the idea of stigma that is attached to admitting that one is suffering from a mental health difficulty. Different forms of stigma include personal stigma (negative attitudes towards others), perceived stigma (perceived attitudes of others) and self-stigma (self-attribution of others’ negative attitudes), so we can see the possible effects of ‘owning up’ to a mental health difficulty.
A study published this year asked 350 members of the public and university students to complete an online survey assessing their knowledge and contact with depression and anxiety, perceived stigma and self-stigma for both anxiety and depression (Grant, Bruce and Batterham, 2015). They found that (surprise, surprise!) the more contact you have with anxiety and depression- be it yourself or a friend or colleague- the less stigma you perceived from other people.
Men reported that they felt more personal stigma around depression and anxiety than women and the more the participant had personal experience of anxiety and depression, the higher their levels of self-stigma were towards mental health illnesses. So, really, there were no surprises. The more you experience mental health difficulties, the more you think other people will judge you negatively. So, now are we getting to the crux of why suicide’s are rising year on year? Despite the fact that we all think we are tolerant towards mental health illnesses, there is still a huge amount of perceived stigma, particularly from people who are suffering.
If you are feeling bad, who is going to want to risk telling people, who may then judge them and make them feel worse? Or just the idea that we have a mental health difficulty can be enough to stop you even acknowledging it, and certainly stop you getting help for it. What this study found was that we need to increase interventions aimed at increasing help-seeking behavior- we need to make it easier and less traumatic and worrying to get help.
We still assume that we are going to be penalized, personally, financially and professionally if we admit to having difficulties; but, and here is the crazy part, ONE IN FOUR PEOPLE will experience mental health problems at some point in their life. It could be you, your mum, dad, partner, children, best friends or colleagues from work. How would you feel if your loved one was feeling depressed, or, heaven forbid, suicidal, but didn’t want to tell anyone for fear of shame?
We really like to think of ourselves as sophisticated and non-judgmental, but, if this were the case, more people would seek help for their health, and surely, suicide rates would decrease? Mental health difficulties don’t discriminate; the old, young, rich, poor, male, female, cultural differences- it doesn’t matter. So, if mental health illnesses don’t discriminate, why should we?
What Robin Williams sad death highlighted for our society was the fact that no matter how rich or successful you are, if you are feeling low, depressed or anxious, money and fame and success won’t fix it- it’s time we were more open about mental health. Life is hard, sometimes, and we all need help from time to time; why should we have shame and stigma attached to that?
I wrote a blog piece earlier in the year on teenage depression, but, you know what? A lot of the symptoms are the same! The other point about this piece I am writing, is that even if you are not suffering from depression or anxiety, it’s really helpful to know what the symptoms are, so we can help and support our friends and family! Also, what’s the harm in spreading information and destigmatizing the issue of mental health? Anyway, back to the point of this particular paragraph; when it comes to mental health illnesses, please seek some help if you are experiencing three or more of these;
Do you feel a sense of hopelessness or sadness? It can be for no reason at all.
Do you have thoughts of death or suicide? ‘Everyone would be better off if I wasn’t here’ can sometimes be a common thought.
Do you suffer from a lack of energy? Are you fatigued more than normal?
Are there any changes in your eating habits? Eating more, or less?
Are there any changes in your sleeping habits? Sleeping more, sleeping less, night waking and being unable to return to sleep, waking up early?
Have you withdrawn from family and friends? Does work seem harder than usual, for no particular reason?
Are you tearful? Do you cry easily? Are you crying frequently?
Have you lost interest in your usual activities? Is there a sense of apathy that wasn’t there before?
Are you agitated? Restless? Unable to sit still?
Are you suffering from feelings of worthlessness and guilt?
Have you developed difficulties in concentrating?
Have you lost your usual enthusiasm? Have you developed a lack of motivation?
Are you feeling irritable? Angry? Hostile?
Have you any increased feelings of anxiety?
Have you become extremely sensitive to criticism?
Do you have unexplained aches and pains? Headaches or stomach aches, for example?
Please do go and see a Doctor. Seek out some help. Everybody goes through a rough patch at some point or another and sometimes things are just really difficult to deal with.
There are lots of different ways to tackle depression- medication is not the only thing available! I work in the NHS with clients who are referred from their Doctors surgeries. Sometimes, just talking to someone can help. Knowing that you are not the only one who feels that way can help to normalise what is going on for you. The NHS offers CBT therapy and courses to help deal with depression, anxiety and other issues. Please believe me when I say that you are not alone, many, many others feel this way too.
It might sounds ridiculous, when you are feeling so rough that you don’t want to get out of bed, but try and see your friends and family- research shows that getting out there and talking to people really does make you feel better. It is hard work, I know, but the more you see your friends and family, the easier it gets to go out and see them and the less you isolate yourself from the people who care.
Get some exercise! Go for a walk, run, swim- whatever it is that makes you feel better! Exercise releases endorphins, which are the feel good hormones in our body, so after we exercise, we get a hit of endorphins that makes us feel good. Even If it is just a walk- it will still do the same!
Concentrate on ‘me’ time- whether that’s a face pack, a bath, and meeting friends, going to the cinema. Whatever it is that will relax you. I know, I know, there are far too many things that need to be done before you can have some relaxation. But, the dishes will still be there when you have spent some ‘me’ time, and you know what? Doing those dishes might not be such a big deal when you have had time to relax.
As adults, especially if we have families to look after, we don’t feel like we deserve to have ‘me’ time, but realistically, having some ‘me’ time can help you so much more than you think it will! Spending a small amount of time de-stressing yourself will make all those things you need to deal with easier. Go on, try it- what have you got to lose?
Are you worrying too much? Do you find yourself spending all your time worrying? One thing that can really help is to have a ‘worry book’ on hand. Every time you have a worry, write it in your worry book. Then allocate yourself a period of time during the day to acknowledge your worries- make sure its not bedtime though, as those thoughts will just swim around your head! Take 30 minutes (no more- it’s worry time, not worry hours!), perhaps after dinner, or when you’ve put the kids to bed, and get your worry book out. Have a look at your worries. Can you do something about it? If so, it’s a problem, not a worry- and problems we can do something about!
If it is something in the past, or something that we physically cant do anything about, it is a worry. Write it in your worry book, acknowledge it in your worry time, and whenever it pops back in to your head during the day, say to yourself ‘Yep, that’s a worry for me- but, it’s in my worry book/I’ll put it in my worry book, and I will look at it later in worry time!’ distinguishing between what is a worry and what is a problem can be very helpful and give us some perspective about things we can do and things we cant.
Finally, seek out help- if you are feeling low, call a friend, call the Samaritans, CALM or SANE to talk to someone. Don’t suffer alone! If you don’t feel like your GP is taking you seriously, talk to another one. Just like some people specialise in holiday insurance and others in pet insurance, GP’s have specialisms too! Some are just better dealing with mental health difficulties than others!
If you do decide to go for counselling, it is really important that you find a counsellor who fits with the way you think and feel. If you don’t feel safe and listened to by one counsellor, go to another- as counsellors, we really want you to feel confortable with us; we wont take offense if you don’t! You cant like everyone in this life!
So, don’t let your mental health get to the point that you feel there is no hope. There is help out there, if only you can find it. And, you know what? People are a lot less judgemental than you think, and that stigma you perceived from your colleague? Well, maybe they just don’t really know what to say, but they do want to help!
Grant, J.B., Bruce, .P. and Batterham, P.J. (2015) ‘Predictors of personal, perceived and self-stigma towards anxiety and depression’, Epidemiology and Psychiatric Sciences, vol. 1, August, pp. 1-8.
I have been on a lot of training lately- some I have loved, and some I have found less impressive- the techniques just don’t resonate with me, so I have decided not to adopt them in my therapeutic work. That isn’t to say that the types of therapy do not work, I just don’t see them fitting in to my practice, be it because of a lack of a rigorous scientific background, or I just didn’t like the form of therapy! This got me to thinking- who is to say what works and why? Whilst pondering this (eternal) question, I found a study in the Psychological Bulletin that really intrigued me.
The study is called The Effects of Cognitive Behavioural Therapy as an Anti-Depressive Treatment is Falling: A Meta-Analysis, so perhaps from this, you can see why my interest was piqued! The study is a meta-analysis, which means that they have taken all the studies (between 1977 and 2014) that are about CBT (Cognitive Behavioural Therapy) (Johnsen and Friborg, 2015) and have analysed them to produce an overall investigation in to the efficacy (how it is working) of CBT. The results are, interesting, to say the least!
The study tracked the fluctuations in the effectiveness of CBT over time, and what the study found was that CBT appears to becoming less effective over time. This is not good news for the NHS, as this is the main type of therapy that they advocate. So, why does it appear to be falling out of grace, and why?
The study shows that over a period of time, 1977 to 2014, CBT has become roughly half as effective in treating depression as it used to be. I have to say, that from my clinical practice, I am finding that clients are becoming more and more resistant to CBT- in my (limited!) opinion, it is because we are becoming more self aware, and the more self aware we become, the less we can justify it to ourselves. But then, I am just one psychologist and that is my opinion!
One theory that is being bandied around is the idea of the placebo effect, which I am sure you have all heard of. The placebo effect is the idea that if you take a pill for your headache, and you believe it is paracetamol, but it is actually just a sugar pill, that the power of your mind is so strong that you will believe that this ‘tablet’ has made you better and your headache disappears, even though there was no ‘active ingredient’ in the pill you took.
Perhaps, like a popular friend in your network of friends, CBT’s reputation precedes it; the fact that CBT was hailed as a miracle cure, could mean that people really thought it worked (the placebo effect) when in actual fact, it didn’t work as well as was expected.
Part of this theory is about our expectations, which kind of ties in with my theory on the efficacy of CBT- in comparison to when CBT came about, when it was developed by Dr Aaron Beck in the 1960’s, our expectations of life have changed greatly. We are more realistic about life, in general. So, perhaps we do not expect a ‘miracle cure’ anymore? Perhaps we accept that we are who we are, and we can only change things if we want to? Who knows? That, my friends, is another study waiting to happen!
Another theory is that, as any therapy develops and becomes more popular (which is inevitable!), that the number of incompetent or inexperienced therapists applying these techniques increases. This means that the efficacy of the therapy decreases- if you are not attending CBT therapy with an experienced practitioner, it is not going to work as well. It’s like taking your Porsche to the Skoda garage- it’s similar, but not quite the same, and a Porsche has a specialist management system, so a Skoda garage wont be able to give you as good service as the Porsche garage will; although your car may be fixed to a certain extent, there is still work left to do.
Whatever the reason, life has changed and therapy changes with it. Who is to say that the placebo effect can’t actually help? I mean, if CBT works for you, who cares if it is the placebo effect at work? As long as it works, right? The problem though, lies in if it doesn’t work for you because you have been to an inexperienced therapist, or perhaps, as in my experience, you are actually self-aware and you know what is happening for you. Either way, if the only therapy available to you is CBT, and it doesn’t work, what do you do?
Well, the current therapy du jour happens to be mindfulness. Now, I have been using mindfulness for a few years, and just attended a course to brush up on my techniques, learn any new theories and to make sure I am not an inexperienced practitioner! But, is mindfulness just the next buzz word- in 40 years time, will the studies be there to show us that, just like CBT, mindfulness has become less effective also?
Last week I attended training on a course called Havening Techniques®. Yes, yet another new form of therapy. I have not had enough experience with Havening to fully make my mind up about it, which is why I need volunteers to work with. But, this brings in to question, again, the efficacy of a therapy and the placebo effect- who is to say what is right and what is wrong? If a therapy works for you, and a competent therapist is treating you, then does it really matter what the modality of therapy is? Perhaps, in our ever-changing world in which we live in, the changing modality of therapies is actually useful. Perhaps therapy is adjusting to our different lifestyles and expectations in life?
Back when Freud was just at the beginning of his Psychodynamic theory, life was very different. People did not understand how their emotions effected, and affected their lives. The ‘new therapy’ gave us an understanding of what was happening in our lives. But now we understand, we want to solve our problems. And, in true modern fashion, we don’t want to wait; we want to fix them NOW.
Perhaps this is where Havening® could fit in? Dealing with trauma and emotions in a focused way, whilst, at the same time, giving you techniques to practice at home, where you do not have to be an expert? I don’t know, but I do know one thing- I am looking forward to finding out!
★ if you have contacted me with regards Havening therapy; I am in the process of writing contracts etc. to begin the therapy. I hope to be in contact with you in the next week or so to book appointments!
Johnsen, T.J. and Friborg, O. (2015) ‘The Effects of Cognitive Behavioral Therapy as an Anti-Depressive Treatment is Falling: A Meta-Analysis’, Psychological Bulletin, May.
Procrastination. We all do it at some time or another. I know I have- if there is a deadline for an assignment, you will always find me playing a game, or anything to avoid the inevitable! But, I always start with just enough time to get it done. For some people, procrastination is far more stressful- it really affects their lives and can change things for the worse.
So, why do we procrastinate? And does it do us any harm? I read a study posted in the Association of Psychological Science last month, the study stated that procrastination, or rather Trait Procrastination– the tendency to delay important tasks despite the negative consequences- was significantly associated with hypertension and cardiovascular disease (Sirois, 2015). So, although this study highlighted that procrastination was associated with hypertension and cardiovascular disease, it did not provide a causal link- phew, all you procrastinators out there, we can breathe a sigh of relief. For the moment.
20% of people identify as chronic procrastinators (Marano, 2003); meaning that procrastination cuts across all aspects of their lives, from paying bills on time to filing tax returns. Luckily for me, my procrastination only seems to affect writing reports and studies (and yes, this blog, too!), but for other people, procrastination can be literally life ruining.
Chronic procrastination is not a problem of time management, believe it or not! Procrastinators are actually more optimistic than other people- they genuinely believe they will get the work/project/bill paid completed in time! We are also not born procrastinators- procrastination is a learned habit, generally from our familial habits, albeit not directly from our families- it is generally our own responses to being raised within an authoritarian lifestyle.
So, for example, having a harshly authoritarian father will keep you from developing an ability to regulate yourself, by internalizing their own intentions and then learning to act on them. Procrastination can also be a form of rebellion- one of the only ways we feel we can act out within our familial situation. Sometimes parental support is not there, so we tend to look to our friends for support. Now, the thing with friends is that they tolerate our BS, don’t they? They don’t call us on it when we say ‘yeah, sorry, my dog ate my homework’. They empathise with us and let it go- thus reinforcing our procrastination techniques and habits.
Situational procrastinators, on the other hand, make delays based on the task at hand. Procrastination becomes a form of self-regulation failure- you know you should do it, but you just can’t bring yourself to do it, for whatever reason it is, you just cannot get around to doing it, till it is either too late, or it has caused you a problem.
What wont come as a surprise, is that procrastinators actively look for distractions! I remember writing my dissertation and finding that the whole house was ‘desperately’ in need of a clean before I started the work! The thing is, procrastinators tell themselves lies- we say ‘I work best under pressure’ or ‘its not important, I have plenty of time to do it if I start tomorrow’. So, what happens is, procrastinators run out of time- the work that is produced is not of a high enough standard, or we missed buying those bargain tickets to the next gig we wanted to go to.
It may also surprise you to know, that there are three different types of basic procrastinators;
The first type is the ‘avoiders’- avoiding fear of failure or fear of success. They would rather that people think they lacked effort than ability.
The second type is the decisional procrastinators- when you find it difficult to make a decision. You know, when your friends or partner say ‘where would you like to go for dinner?’ and your response is ‘I really don’t mind’.
The third type is ‘arousal type’ of procrastinator- the thrill seekers who are waiting for the last minute for the rush of adrenaline they experience.
So, have you identified which type of procrastinator you are? Are you a chronic procrastinator, or just a casual one- procrastinating in one field or area only? But hey, there’s no problem with procrastination, is there? It doesn’t really matter? Well, actually, that is not true. As I said earlier, there is a study that links procrastination to heart problems, but there is also evidence that procrastination harms the immune system- over the course of one academic term, college students who procrastinated suffered more colds, suffered from insomnia, suffered more gastrointestinal issues and more cases of flu.
Procrastinators have higher levels of stress and lower levels of emotional and harmonial wellbeing. Joseph Ferrari, Professor of Psychology at DePaul University in the USA found that ‘everybody may procrastinate, but not everyone is a procrastinator’ (so, there is hope for me after all!). The Professor says ‘telling someone who procrastinates to just do it, is like telling someone with chronic depression to cheer up’ (Ferrari, 2010). So, what can we do then?
Well, the current level of thinking is that what lies behind a procrastinator’s thought patterns are actually based on our Emotional Regulation. If we can regulate our emotions, and deal with them, then we can stay on task. If we are not enjoying the task, we are more lightly to procrastinate. Ok, so, that’s fine, but as humans, we need to do things on a weekly or daily basis that we don’t want to do, or that we don’t enjoy. So, how can we go about changing ourselves, to reduce our stress and make ourselves feel more harmonious, and less likely to get sick?
One thought of how to do this, is to try to make your current mood a positive one- if we handle this situation well, then our ‘future self’ will be better equipped to deal with these issues in the future (Wohl, Pychyl and Bennett, 2010). Sounds simple, but how do we go about doing it?
One-way could be through Counselling- by attending Counselling we can help the client to realise that they are compromising their long-term goals and aims for short term happiness. Perhaps there is a way that we may feel like we are punishing ourselves for past transgressions- until we open up the emotions and reasons why a client procrastinates, then we cant really get to the core of what we can do to stop it, or improve the situation.
Mindfulness therapy can be really helpful with this- by really appreciating the current moment, and not thinking so far in to the future. By learning Mindfulness skills, you can really put yourself in the present moment and appreciate that moment for what it is. Perhaps then, you can possibly see the damage that procrastination is doing to your self, your stress levels and your ability to actually ‘get the job done’.
Secondly, the procrastinator could split their goal down to smaller tasks- this is basic CBT and can be achieved by you or with the help of a Counsellor. Finding and exploring ways in which you can work with your procrastination can be difficult to see or achieve; sometimes it is only when we talk to some one else about what we are doing, that we really see what is going on before our eyes. After all, as I said earlier, our friends kind of let us get away with our procrastination, a Counsellor will not. We wont be mean or cruel, but we will challenge your beliefs and expectations; that’s our job, it’s what we are good at and we do it in a way that is safe and guided by you.
You could also start by imposing your own personal goals and deadlines- if your bill is due to be paid on the 30th of the month, start splitting the task down at the beginning of the month. Start small; with achievable steps that you can tick off when they’re done- nothing encourages us to carry on with our goals than when we actually start to see results!
Emotionally, this can be a slightly tougher nut to crack- you’re going to need to find something positive in the task that you are trying to achieve, which could lead us back to breaking the task down to smaller components and allowing ourselves to be proud of our achievements, not matter how small or trivial they may seem. When it comes to our loved ones, perhaps it is a good idea to not let their procrastination go- challenge them, did the dog really eat your homework, or could you just not be bothered?
But the key to procrastination could be as simple as self-forgiveness- forgive yourself for procrastinating and acknowledge the fact that you did procrastinate. The next time, maybe you will find yourself actually doing the work a little quicker, and hitting your goals and achievements on time.
Ferrari, J.R. (2010) Still Procrastinating? The No Regrets Guide to Getting It Done., 1st edition, Hoboken: Wiley.
Marano, H.E (2003) Procrastination Psychology Today; https://www.psychologytoday.com/articles/200308/procrastination-ten-things-know. Accessed May 2015
Sirois, F.M. (2015) ‘s procrastination a vulnerability factor for hypertension and cardiovascular disease? Testing an extension of the procrastination–health model’, Journal of Behavioral Medicine, vol. 1, no. 12.
Wohl, M.J.A., Pychyl, T.A. and Bennett, S.H. (2010) ‘I forgive myself, now I can study: How self-forgiveness for procrastinating can reduce future procrastination.’, Personality and Individual Differences, vol. 48, pp. 803-808.
Depression- we all know the signs, right? Wrong. I have lost count of the amount of clients I have seen, who have sat in front of me saying “But, I’m not depressed though, am I?” after having reeled off a very impressive list of depressive attributes. Depression creeps up on you, slowly. At first, you’re just having a bad day. Then a bad week, and before you know it, you’ve had so many bad weeks; they’ve turned into months and possibly years.
There has been a lot of academic argument lately, within the Institute’s of Psychiatry and Psychology- an argument is being put forward that the long-term use of psychiatric medication is causing more harm than good. Professor Peter Gøtzsche, the director of the Nordic Cochrane Centre at Rigshospitalet in Copenhagen is currently arguing that the ‘minimal’ benefits of psychiatric drugs are exaggerated and the harms (including suicide) are underestimated (Gøtzsche, Young and Crace, 2015). For those people who are on medication, and find it works, I am sure that they would argue the odds with these authors, and be angry at their assertion that medication has minimal benefits. Medication, which for some people is a lifeline, seems to be being dismissed so out of hand and so easily.
There have also been articles with regards to Mindfulness – and other talking therapies, that have appeared recently, advocating the benefits of Mindfulness Based Cognitive Therapy (MBCT), which was developed as an explicit intervention to reduce relapse and recurrence in depression; the study goes on to find that there is no evidence that MBCT is better at avoiding depressive relapses than antidepressant treatment (Kessler et al, 2015). So, what does that mean for the ‘layperson’? Well, it means that talking therapies can be as effective as medication, but that it depends on the illness that is being treated and the person themselves, but also how that person responds to the medication and the talking therapy.
Let’s not forget- medication needs to be taken regularly, and may need to be adjusted to find a dose that works for the person effectively, or that the medication prescribed is not actually working for the individual and a change of medication may be needed. But also that, in terms of talking therapies, it is crucial that you find a therapist that you can get along with, that you trust and that you can open up to- creating the working alliance of the therapeutic relationship is key to ‘good’ therapy (Clarkson, 2003).
The combination of using medication and talking therapies can prove to be very useful for some people- the medication can work to combat the symptoms of the depressive illness and the talking therapy can help to support the patient to deal with any underlying issues that may have caused the depression (Hollon et al, 2014). So, as you can see, a two-pronged attack seems to work also. There was another study in 2013 that suggested that neither medication nor talking therapies worked any better than each other (Cuijpers et al, 2013) which was a meta-analysis- a meta-analysis is where all the current studies for the related field are looked at, and an overall summation of the findings is given.
So, what does that leave you with? You are not a study, cohort or focus group- all the studies I read tell me what I may find, but in reality we are all very different and we each need to find what works for us. A doctor can help you find the right medication, and a therapist can supply the therapy – the important thing is that whether its meds of therapy type, if it did not work for you, don’t give up, try something else; another therapist, go back to you doctor, go to a new doctor. Keep trying until you find the help and support you need.
Well, in my experience, medication is great- if you can find one that works, get the dosage right, then it can really help to resolve the physical manifestation of depressive illness. Sometimes, we do not know what has triggered the depressive illness, and sometimes we do- when we do know what has caused it, coming to therapy can really help gain a sense of perspective, or put old ghosts to rest. Even if you don’t know what has caused your depression, talking to a professional can really help and may even help you understand the cause. As therapists we are there to listen and be non-judgmental; we wont tell you to ‘buck up’ or ‘snap out of it’, as we know that saying that to you wont help you and it certainly wont work! If you could really just ‘snap out of it’, wouldn’t you have done that months ago?
The World Health Organization (WHO) believe that 1 in 10 of us will suffer with depression at some point in our lives, and it is the leading cause of disability in the world (yes, really!). Depression can affect anyone, at any time. We don’t know what causes depression and much, much more research needs to be done in the area. Depression does tend to run in families and it can be caused via a genetic and environmental combination. You may not realise you are depressed to start with, other people may recognise it in you first, or you may recongise that you are just not feeling as good as you used to.
It can be difficult to support someone going through a depressive illness, especially if you have no experience of depression and don’t understand what is happening to your loved one or friend. The important thing is to listen to them; be patient and encouraging, but above all, show kindness and compassion. And, you know what? The same applies to yourself, if you are suffering with depression- be kind to yourself, acknowledge that you are going through a bad period and do not beat yourself up over it. Something I like to say to my clients is “What would you say to a friend, if they were in your situation?” because, you can guarantee, you wouldn’t be harsh on a depressed friend, so why be harsh on yourself?
Clarkson, P. (2003) The Therapeutic Relationship, London: Whurr Publishers.
Cuijpers, P., Sijbrandij, M., Koole, S.L., Andersson, G., Beekman, A.T. and 3rd, C.F.R. (2013) ‘The Efficacy of Psychotherapy and Pharmacotherapy in Treating Depressive and Anxiety Disorders: a Meta-analysis of Direct Comparisons’, World Psychiatry, vol. 12, no. 2, pp. 137-148.
Gøtzsche, P., Young, A.H. and Crace, J. (2015) ‘Does long term use of psychiatric drugs cause more harm than good?’, British Medical Journal, vol. 350, May, p. h2435.
Hollon, S., DeRubeis, R., Fawcett, J., Amsterdam, J., Shelton, R., Zajecka, J., Young, P. and Gallop, R. (2014) ‘Effect of cognitive therapy with antidepressant medications vs antidepressants alone on the rate of recovery in major depressive disorder: a randomized clinical trial.’, JAMA Psychiatry, vol. 71, no. 10, October, pp. 1157-64.
Kessler, Lewis, G., Watkins, E., Brejcha, C., Cardy, J., Causley, A., Cowderoy, S., Evans, A., Gradinger, F., Kaur, S., Lanham, P., Morant, N., Richards, J., Shah, P., Sutton, H., Vicary, R., Weaver, A., Wilks, J., Williams, M., Taylor, R.S. et al. (2015) ‘Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial’, The Lancet, April, Available: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62222-4/fulltext [20 May 2015].
Here in the UK, we have just had our General Election, which we have once every five years. Now, I know that some of you out there are going to be left feeling disappointed and disenfranchised, but others will be feeling the opposite (I will not be pledging my own Political allegiance here- I learnt at a very young age not to argue about Politics, Religion and music!). And this is where this blog is going- disappointment and how it affects our lives.
There is a general feeling of apathy and dysphoria in the Nation, at this moment in time- I am wondering, have you ever felt that in your life? Do you sometimes wonder where you are going with your life, why you are in a cycle of repeating mistakes, or just that you seem to be disappointed with your lot in life? We all do, at some point in our lives, but it can become a problem if this is our outlook for extended periods of time. In fact, for some people, even just a short period of time feeling like this can be extremely detrimental to their mental health. You know, ‘cos Mental Health Matters, don’t it?
Lots of people are sceptical about therapy- I encounter it all the time. “Oh, you’re a Psychologist? Read my mind then” or the other familiar “Oh. You’re a Psychologist.” Then nothing. They don’t want to talk because they think I will psychoanalyze them the whole time! This doesn’t happen, I just want you all to know this- even Psychologists need time off to kick off our DM’s and enjoy a party!
Saying that, there has been some articles in reputable UK publications of late, to do with something you may never have heard of; Mindfulness. “What is Mindfulness?” I hear you ask! The Dictionary definition of Therapeutic Mindfulness is;
“A mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique.”
I bet you’re thinking “Mumbo Jumbo?” Well, according to a recent study published in the most ‘reputable’ of medical publications, The Lancet (Kuyken, 2015), Mindfulness-based Cognitive Therapy (MBCT) is nearly as effective as taking prescription Antidepressants alone- out of 424 participants, after two years, 44% of the MBCT patients relapsed as opposed to 47% of Medication only patients. So, what does this tell us? Well, surprisingly, MBCT is more effective than first believed.
There are a few issues here, with the Mindfulness study- the scientific description of Mindfulness changes from provider to provider. Now, because it is available on the NHS, MBCT has proven its efficacy (that it works) and so, if it can work on the NHS, then maybe, going to a reputable provider (if seeking private therapy), will also be the same.
The main critique with this study is that the Mindfulness patients had already suffered three or four bouts of depression (depression can be a right b*gger that way) and were already on a maintenance dose of medication. The common thinking has been that the combination of talking therapies, be it MBCT or CBT or Person-Centered, with medication is the best form of support for someone with recurring depression.
So, where does this fit in with disappointment? Well, disappointment and depression can both be caused by life’s tribulations. In one study, disappointment was ascribed to being the resultant causes of ‘what might have been’ or the ‘outcome of unfavourable decisions’ (Zeelenberg et al., 1998). Sound familiar to anyone? Mixed up in there is also the emotion of regret; perhaps you regret your vote yesterday? Perhaps you regret making a decision that ‘could’ of had a more favourable outcome? Whatever it is, life is full of mistakes, disappointment and regret- as well as happiness, joy, love and positivity! The problems only come when these two opposing forces are unbalanced.
So, that Mindfulness stuff, eh? How does that work then? Well, MBCT blends Mindfulness with CBT, so we learn to be in the present, instead of focusing on the future and the past. It helps us to come to terms with the decisions we have made; the disappointment, the regret, and focus on the here and now and how we can make the most of our lives as they are.
MCBT looks at what is going on for you now, and how the impact can be lessened for you- it gives you a specific set of skills, to practice for everyday life. No, it is not just meditation, it is being mindful of what is happening, your surroundings and not skipping forward to the end result.
According to the London School of Economics, 1 in 6 adults will be affected by depression during their lifetimes. That is a significant number; really, a lot. So, if you are feeling that way, please know that you are not alone and there is help available.
If you are interested in Mindfulness based therapy, have a look at the NHS website for more information. Many of your local GP surgeries, in the UK, will also offer free courses in Mindfulness. So, what are you waiting for?
Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial; Dr Willem Kuyken, Rachel Hayes, PhD, Barbara Barrett, PhD, Richard Byng, PhD, Tim Dalgleish, PhD, David Kessler, PhD, Glyn Lewis, PhD, Edward Watkins, PhD, Claire Brejcha, BSc, Jessica Cardy, BSc, Aaron Causley, BSc, Suzanne Cowderoy, MSc, Alison Evans, MSc, Felix Gradinger, PhD, Surinder Kaur, BSc, Paul Lanham, Nicola Morant, PhD, Jonathan Richards, BSc, Pooja Shah, Harry Sutton, Rachael Vicary, PhD, Alice Weaver, BSc, Jenny Wilks, MSc, Matthew Williams, MSc, Rod S Taylor, PhD, Sarah Byford, PhD The Lancet, April 2015.
Zeelenberg, M., Dijk, W.W.v., S.R.Manstead, A. and Pligt, J.d. (1998) ‘The Experience of Regret and Disappointment’, Cognition and Emotion, vol. 12, no. 2, pp. 221-230.
I spent the whole day in London, UK today. As I was leaving, there were crowds and crowds of people; traffic was snarled up and it was getting noisy. I had totally forgotten that today was May Day, and, as per the usual tradition, demonstrations were going on in our capitol. The voices were so loud- everyone there seemed to be clear about one thing; what they wanted.
It made me wonder, are we always clear about what we want? I know we like to think that we are, but are we, really? When it comes down to it, don’t a lot of us honestly think that people are mind readers- if we have been upset by something, we expect people to guess at what has upset us! It is then difficult to have a conversation; if you think you know what the other person means or intended, when actually, you’ve got it quite wrong! Does this ever happen to you? Maybe you have noticed that other people do it to you? Are we really being clear about what we want, or are we just hoping that others guess?
Relationships can be difficult, even at the best of times! Our relationships with out friends, partners and family are all different. The way we communicate with these people may also be different! We have expectations of people, and ourselves, that sometimes, just really aren’t sensible! Do you think that anger is a negative emotion? Do you think that it’s best to hold your anger in?
Well, it may (or may not!) surprise you to know that, actually, anger can be a very cathartic emotion! By expressing our anger, we are communicating our displeasure and upset to others- no need for mind reading here! If we bottle up our anger, we can become resentful; we expect people to know why we are angry (there’s the mind reading again!) and we don’t necessarily give them a chance to communicate with us about what is wrong!
If we supress our anger, we are a bit like a bottle of pop (no advertising here!) that has been shaken and shaken- when we take off the lid, the pop is going to explode outwards! Does that sound familiar to any of you? By supressing your anger, it can lead to your emotions coming out in other ways- sometimes by verbal explosion, sometimes physical, but none of them particularly helpful! So, what to do? Well, when you first start to get angry, I would suggest that this is the point at which you should express your anger- don’t wait until it builds up and leads to resentment. Violence, physical or verbal abuse is never the answer to being angry- perhaps dealing with your anger before it gets to tipping point, could help you to control the other emotions that spill out, when your anger gets too much.
Sometimes, we bottle up our anger and emotions, because that is what we were taught to do- from an early age! As we are born and grow, we are constantly surrounded by rules- some of them are there for good reason (don’t cross the road on a red light, for example!), but some of them are rules we have kind of inherited along the way. Did your parents ever teach you that ‘if you have nothing nice to say, don’t say anything at all’? This is an example of what we term ‘Rules for Living’ and is a Cognitive Behavioural Therapy concept- sometimes our rules for living are just too difficult to live by; sometimes we need to soften them, to make things easier.
If you have a rule of ‘I must always be liked’, well, that’s a difficult rule to adhere to! Not everyone in this world can like everybody else, so, when your rule is broken, and somebody doesn’t like you (for whatever reason!), how does it make you feel? Do you feel good about it? Or do you feel terrible, guilty, and anxious or any other number of emotions? This is a very rigid rule to hold dear- perhaps you learnt it from your parents, or from school, church, your friends, the newspaper or social media. Wherever you have learnt it from, it isn’t helping you to get what you want in life- happiness. So, what can we do about it?
There are a number of things we need to do;
What is your rule? In this example, I am going to use the rule that ‘I must always be on time’
Where did the rule come from? In this case, we will assume parents (sorry Mum and Dad!)
Is your rule realistic? Is it reasonable? Is it achievable? No- sometimes you can’t help but be late- for example traffic queues. So this means it is not achievable.
What are the negative consequences of this rule- how does it impact your life? It makes me stressed all the time- I am constantly rushing around to be on time everywhere!
The rule came from our parents, who would always tell us to be on time as it is incredibly rude to be late, and only naughty people are late. As we have lived with this rule through growing up, it is something that we hold dear to us- after all, Mum and Dad are always right, aren’t they? This rule was then enforced when you went to school- remember being late for a class? Getting detention because you weren’t on time? Then you go to work, and the rule is again reinforced- it is wrong to be late!
But the thing is, life isn’t always straightforward- you’re rushing to get out of the house to meet friends for a play-date and the baby tips their milk all over them; which means that you need to change their clothes, making you late! There was a traffic accident on the way to your interview. The train was delayed. These are things that are simply beyond your control- you cannot change these. So, as you can see- being on time, always, is not reasonable rules to have- complications arise and for reasons beyond our control, sometimes, we are late!
So, what are the negative consequences of holding on tight to this rule? Well, rushing around to be on time all the time- how stressful is that? When you are late, and there is nothing you can do- do you beat yourself up about it? Do you feel cross and angry that you were late? What other negative impacts does your rule have on you?
Now you’ve worked out that your rule for living actually are hindering your goal in life- to be happy- what can you do about them? Well, you can do what we call to ‘soften’ the rules- turn a rule into a guideline. Be kinder to yourself and accept that sometimes, you just cannot be on time. Softening your rule from ‘I must always be on time’ to ‘I will try to be on time, but sometimes, this will not happen and I am ok with that’.
I am not saying this is easy to do, and it does take practice, but by doing this, you can make stressful or unpleasant situations a little easier for yourself. By softening your rules, you are hopefully not going to get as angry, and that bottle of pop isn’t going to explode everywhere! It seems so simple to do, but the tricky part here, is actually recognising your rules and working out how they affect you! We cant expect others to change for us, or to have the same rules for living that we do, but by softening our rules, it makes living with them much easier.
So, what’s stopping you? What are your rules and how do you think they are stopping you from getting what you want? It might not be happiness you are after; perhaps it is just not expecting everyone you meet to be polite. By making little changes to our lifestyles, we are making massive changes to our lives, and, over time, hopefully making our relationships and the way we deal with problems, a little better and a little easier!
So, tonight is going to be a really quick blog post- I have been training all day and am shattered (remember back to a previous blog where I said it was ‘ok’ to give yourself a break? Well, this is it!). I will be writing about my training today in next week’s blog though- so look forward to a long in depth article then!
I was working this week with a new client- new client’s are always interesting, as you don’t know their story and it is a ‘process’ to develop a rapport with your client, into what we called the ‘working alliance’ (Clarkson, 2003). The Working Alliance is basically a term for the way in which we work with our clients- in order for you to tell me about yourself, we have to get on, you have to engage with me enough to feel comfortable enough to talk about issues that can be very challenging.
Now, notice how I didn’t say ‘we’ need to engage with each other? As a therapist, my work is all about engaging with you, as the client. I am ready from the moment you walk through that door- you could tell me the very worst thing in the world, and I will openly accept, listen and empathise with you. You don’t even have to know me. That is my job. As a therapist, I am a keen listener and what a therapist does do, is to afford you Unconditional positive regard (Rogers, 1951)- that whatever you say to me, whatever your experience is, even though I many have never experienced it myself, I can listen to you without judgement. Accepting all that you tell me and actually caring about it, too.
As a therapist, I am ethically bound to be empathetic and congruent to you, as a client. What this means, is that I am open to what you say, and am listening- I can understand and imagine, or empathise with you about how that must feel and how difficult/challenging/funny/scary it is. After all, it is about being genuine and if I am not genuine with you and honest, how could you hope to gain anything from our meeting?
These are the core conditions of my training- I hope it is what makes me an understanding and empathetic therapist. But, sometimes, for some clients, this isn’t enough. They still experience difficulty in the therapy room and it can take some time to get to know each other well enough, for you to feel like you can open up to me. And you know what? That is fine. It is ok to take your time!
I was reading a study about how, after laughing, we are more inclined to open up and tell others personal details about ourselves (Gray, Parkinson and & Dunbar, 2015)- the study used groups of participants, who were each shown a different video, prior to writing down five pieces of personal information about themselves, which they were prepared to share with their companions. They were shown either a comedy clip, an uplifting but sobering clip or a neutral clip from an instructional golf video.
The only difference in their reactions was laughter. I remember doing a similar experiment during my Psychology degree, except we were measuring our heart rate. Laughing, for obvious reasons raised our heart rate. I remember thinking, well, how can this be linked to anything interestingly Psychological? But here it is- the laughter made that group of participants share more intimate details about themselves than the other clips.
So, I guess you will be wondering, what does that have to do with being in the therapy room and talking about yourself? Well, as therapists, we are only human, you know. We smile, we joke and we are guilty of laughing at the wrong thing, sometimes. So, perhaps, when sharing our information, a more light-hearted approach could be used? Maybe we should share a joke or two, before we start our sessions? I know that, the longer I see you for, the more we talk about, the more we exchange pleasantries and the more we will laugh or smile at the beginning, middle and end of a session. So, I guess, laughter does actually bring us closer together- it helps us to feel comfortable with the person we are with. I imagine, that laughter is a great leveller for all people.
It has been found that when we disclose information about ourselves, it increases liking of us in the other person, and increased liking increases the likelihood of laughter. Increased liking leads to further self-disclosure and before you know it, you are part of a disclosure liking cycle! (Collins and Milner, 1994) So you can see how talking about ourselves, liking and laughter all go together hand in hand.
Unfortunately there is also an opposite cycle where by fear of rejection in the face of disclosing prevents disclosure – leading to increased isolation, loneliness and depression. (Wei, Russell and Zakalik, 2005). The thing is, in therapy, I won’t reject you. I won’t laugh if it’s not funny and I won’t make you feel bad about a decision you regret.
So if you are feeling low, and someone invites you out somewhere, and you don’t really feel up to it, you need to ask yourself a question. Which cycle do you want to ride? The fun bike to town? Or the same one you have been riding in the rut you have been stuck in?
The flip side to this, I would assume, is when we are out and about socialising. Perhaps if we are giggling too much, we relax too much and allow ourselves to say things we didn’t mean to? Perhaps it isn’t just ‘all the alcohol talking’. The study described how laughing could be a ‘social lubricant’. By the very nature of therapy, this seems to go against the grain; after all, I am supposed to be empathic and congruent towards you. But, perhaps you would like to see me laugh or smile? Maybe that makes me more real to you? Whatever it is, and however we are in the therapy room, I am there for you and we can talk and develop a rapport; even if we don’t laugh!
Clarkson, P. (2003) The Therapeutic Relationship, London: Whurr Publishers.
Collins, N.L. and Milner, L.C. (1994) ‘Self Disclosure and liking; A Meta-analytic review’, Psychological Bulletin, vol. 116, no. 3, pp. 457-475.
Gray, A., Parkinson, B. and & Dunbar, R. (2015) ‘Laughter’s Influence on the Intimacy of Self-Disclosure’, Human Nature, vol. 26, no. 1, March, pp. 28-43.
Rogers, C. (1951) Client Centered Therapy, London: Constable.
Wei, M., Russell, D. and Zakalik, R. (2005) ‘Adult Attachment, Social Self Efficacy, Self disclosure, Loneliness, and subsequent Depression for Freshman College Students; A Longditudinal Study’, Journal of Counselling Psychology, vol. 52, no. 4, pp. 602-614.
So, it is nearly mid week, and I have been busy at work- Counselling and Therapy is a job I love and have great passion for, so I am very lucky when I am busy! Somebody absolutely exploded in frustration at me today- it wasn’t my fault, but sometimes it is to be expected! However, after the explosion, the person said “I am sorry, I never lose my temper, ever. But, when I do, it is really explosive! It’s really wrong to be so angry”.
This got me thinking- is it really wrong to be so angry? And if it is, who told us it is? For me, anger is a way of expressing how I feel/felt at a situation- if I don’t express my anger, how is anyone to know that something is wrong? Maybe this comes from the fact that this is what my parents taught me to do, and as is well documented, what our parents teach us really does affect what we do in life!
A lot of the time we don’t express our anger- because we are afraid of the ramifications of doing so. But, this person expressed their anger towards me, when it really wasn’t my fault. So, who has been helped in this situation? Was it the person who was angry, or was no-one really helped? I mean, sure, getting the anger out of themselves was a great thing to do- sometimes, we are like a bottle of fizzy drink that has been shaken up. All that shaking up creates pressure, just as anger, bottled up, can create pressure, and at some point, as sure as the bottle will explode when opened, so will we when our anger gets too much to bottle up!
So, in some ways, anger is a good thing, right? Yes, but what could have made that situation easier? Perhaps talking to the person who angered you in the first place? Dealing with the main reason that you are angry, in a rational way? After all, none of us are mind readers, so how do we know that by discussing the issue, we won’t resolve it in a peaceful way; thus negating the need to bottle up and explode?
Counselling and Therapy can be really helpful when dealing with stressful emotions- the therapy room is a safe space to talk about what has upset you and made you angry. There are ways we can look at anger and how to deal with it. For example, relaxation and time for yourself can be really helpful when you are feeling stressed and angry. Did that ever occur to you? Perhaps taking some time out to have a long bath, a yoga lesson, a run, walk the dog or read a book can help calm you down. Maybe then, you could be in the right frame of mind to address the issue that has got you so angry in the first place?
Communication is SO important to everything in our lives- Dr Albert Mehrabian (Mehrabian, 1981) pioneered language communication in the States and discovered that;
7% of message pertaining to feelings and attitudes is in the words that are spoken
38% of message pertaining to feelings and attitudes is paralinguistic (the way that the words are said)
55% of message pertaining to feelings and attitudes is in facial expression
So, if that is the case, even when our words are unspoken and our anger is bottled up, perhaps we are displaying our anger in other ways and maybe that is why people react to us in a negative fashion. Is this something you have experienced? I wonder?
Communication is so important in life- we are communicating all the time, all day long. Some of it is subconscious, some of it is very conscious. Some of it is controlled, and, as in the case of anger, not so controlled! Therefore, how do we communicate with people when we feel the need to vent our frustrations?
Are you a passive communicator? Do you put others needs before your own, only to find that, eventually, the frustration of it all gets too much? Sometimes, being passive is a wonderful asset, for example if you really do not mind which take-away you have tonight. But sometimes, it can get in the way- feeling that other people should come first, when you really wanted a Chinese tonight, but your partner has ordered Pizza. You sit and seethe silently, displaying all those non-verbal communicative, anger emotions towards your partner! Do you recognise this pattern?
Are you an Aggressive communicator? Are your needs greater than everyone else’s? Is that a really fair way to be? Does it get you far, or are you finding yourself angry all the time when other people challenge you? Perhaps it is time to try and be a bit more co-operative and see the other side of the story?
Are you Passive-Aggressive? Finding ways to ‘get your own back’ on people who have upset you, without letting them know they have actually upset you? Did your neighbours make a lot of noise until late last night, so this morning, you got up at 6am and revved your car engine knowing it would annoy them? Perhaps, with communication, you could discuss a resolution to the problem, instead of frustrating yourself even more?
And finally, are you an Assertive person? If something is troubling you, do you talk about it and work with your colleagues/friends/partner to resolve your issues? Do you consider the other persons side of the story?
I am sure, most of the time, we are a mixture of all of these, but perhaps thinking about what we want to achieve from the situation could help us- do we want to stay angry? Is it helping us to be angry? What would we really like to do? We all behave in these manners at some point, so, just to show that we are all human, and we all do theses behaviours, I have included an anonymous poll to fill in- just for fun!
Perhaps therapy will be a helpful way for you to work out what is going on for you, perhaps not. If you are unhappy with your anger issues, perhaps it is time to look at whats causing it, and change what you are not happy with? Cognitive Behavioural Therapy (CBT) can be really helpful with looking at current anger related issues, but if the anger stems from an earlier time in your life, perhaps a longer term form of therapy and counselling would be more appropriate? Only you know what is going on for you and how you want to deal with it!
So, what type of Communicator are you?
Mehrabian, A. (1981) Silent messages: Implicit communication of emotions and attitudes. Belmont, CA: Wadsworth (currently distributed by Albert Mehrabian, email: email@example.com)
In response to a question that I have been asked on the Facebook group, here is a piece I have written on CBT (Cognitive Behavioural Therapy) and how it works, or may not work for you!
CBT, or Cognitive Behavioural Therapy is a kind of therapy that is popular within the NHS. The reason that it is so popular is that it is an evidence-based practice; meaning that there have been scientific studies which prove that the therapy works (Whitfield and Williams, 2003). That isn’t to say that Cognitive Behavioural Therapy (CBT) works for everyone, just that it works quite often! We are all incredibly individual- just as you and your friend have very different needs when it comes to relationships; so do we all have very different needs when it comes to therapy!
Cognitive Behavioural Therapy works by looking at how our thoughts affect our feelings, which affect our behaviours, which in turn, affect our physical feelings- it’s sometimes called the CBT donut, as all of these behaviours and emotions affect each other! An outside situation happens, which in turn, makes us think and feel an interaction- sometimes these are good, and sometimes these are bad. When the interactions are negative, this is where Cognitive Behavioural Therapy can work.
CBT can be very helpful for certain conditions; Panic Attacks, Anger, Depression, Phobia’s, OCD (Obsessive Compulsive Disorder), PTSD (Post Traumatic Stress Disorder), Sexual problems and Health problems. In simple terms, if your issue is quite specific, (for example a phobia of spiders) the more likely it is that CBT could help you. That is not to say that Cognitive Behavioural Therapy will work for you, if you have one of these issues!
During the Cognitive Behavioural Therapy sessions, you will set goals with the Therapist; specific goals, that you will work towards each week. The techniques that you learn to achieve your goals during your Cognitive Behavioural Therapy, can be utilised in other areas of your life, and are tools in your toolbox for dealing with issues as you go through life, and let’s be honest, we could all do with learning tips that might make the journey of life a little easier!
CBT tends to deal with the present, the here and now, which is where Cognitive Behavioural Therapy differs from other talking therapies. With CBT, we do not go in to the past and deal with issues you may have had since childhood; and for some issues, this is ok, as you only seek to change how you make sense of, and react to, certain situations.
However, for some people, Cognitive Behavioural Therapy is not enough- they need to go back into their past and to deal with the issues that they have experienced during their lives. Talking therapies are non-directive, and deal with support and empathy. Although your CBT Therapist may well be empathic and supportive, it is within the remit of Cognitive Behavioural Therapy to be directive- this means that the Therapist will give you advice, ideas and techniques as to how to help your issues. This, though, is very different from being told what to do- and I am sure you will agree, nobody likes being told what to do!
My practice is considered to be Integrative- this means that I utilise different types of therapeutic techniques. My main modality is to be Person-Centered; which, to you and me, just means that I am empathic, supportive and offer a non-judgemental listening ear, whilst we work together to get to a therapeutic ending. Sometimes, this does mean that I use Cognitive Behavioural Therapy; but I am not limited to just that. Perhaps a mix of therapies is what you’re after? After all, sometimes we just don’t know what the issues are, or that the issue is grounded in our experience from a long time ago. Either way, perhaps CBT may not be for you, but it could be worth a try!
Whitfield, G. and Williams, C. (2003) ‘The evidence base for cognitive–behavioural therapy in depression: delivery in busy clinical settings’, Advances in Psychiatric Treatment, vol. 9, no. 1, Jan, pp. 21-30.