It’s been a Mental (Health Awareness) Week!

May is Mental Health Awareness month and this week, 10-17th May, is Mental Health Awareness week. I wonder if you know this, and I wonder if you care? Mental health is still a stigmatised subject to discuss; we’re getting better at talking about it, but we’re not getting better at dealing with it.

Antidepressant use has sky-rocketed since 1992- prescriptions for antidepressants have increased 100% since 2015, or 500% since 1992 and 1.1 million people are, unfortunately, on benefits because of their mental health difficulties. Mmmh. I wonder what this is telling us? I wonder what the trend is that is making antidepressant use increase, year upon year? Don’t get me wrong; I am not against medication for mental health difficulties; I know in some cases the medication taken can be life-changing for some people. I am more interested in the deeper causes than that. What is going on in our society, and why are we getting sadder and less fulfilled, as a nation?

I have been studying for my (final ever!!!) exam in Professional Issues in Counselling Psychology, and, given that this is Doctoral level, I did a LOT of reading for this. In fact, I ordered several books, too 🙂 But seriously, I was engrossed in what is a mix of theory, lived experience, political discussion and the psychology of the changes that we are being forced through. These changes are being pushed on to us from so many different areas; by the society around us, work, school, government, media, social media and peers- you name it, we’re getting pressure from every direction, so just how does it affect us?

I’m really not going to go into masses of theory, so don’t worry there; but hang in there, it’s worth it, I promise! Do you know we have a Minister for Loneliness in Parliament in the UK? Yes, yes we do. She’s called Tracey Crouch, and she is here to cure our loneliness. Or is she? How is she going to make us feel better and less isolated? Is it flinging money at more therapists in what is an already hugely overstretched NHS? Or is it at a more fundamental grassroots level?

Have you been into a GP surgery recently? A health centre or hospital? Have you ever noticed the signs on the walls? What are they telling you? Are they telling you to lose weight? Are they telling you to stop smoking? Join a gym? Practice some yoga or Mindfulness? Those are all great suggestions, sure, but what is at the root of all of this? Why are people unhappy?

Think about your life, what makes you unhappy? Is it your job? Your house? The fact that you are struggling to get from pay day to pay day- or even just through the first week of the month would be good! What do you see when you look in the paper, or on social media? Are these concepts/material goods/lifestyles attainable for us, in this economic climate? The answers you come up with are probably not very positive answers. Things need to change. People need to start getting involved in their lives, and the lives of the community around them- it’s the only way we can affect social change, and as I am about to show, no matter who you are, social interaction is massively significant for us all.

As a (terrible) beauty advert states- here comes the science bit! As homo sapiens, we live for groups. Really, quite literally live because of them, and for them. We’ve talked about the whole caveman thing already on this blog- we wouldn’t have survived alone- so what makes this any different now? We need to feel like we belong. We need to feel needed. Social connection is so vital for our mental health- I’ll start at the beginning and make it as quick and painless as possible, I promise!

Back in the late 1970’s a Polish Social Psychologist, Henri Tajfel, after experiments in the lab, proposed a new theory relating to the way we function as humans; Social Identity Theory (Tajfel & Turner, 1979). What Social Identity theory tells us, is that we favour the groups of people we are with and feel comfortable with- your rugby club? That’s what we would call your ‘ingroup’ and the opposing team, well, they would be… yes, you guessed it, the ‘outgroup’. So, whose side do we take in a situation like this? Well, the people we are in the same group as, of course. Why is that, I hear you ask? Well, how does being a part of that group make you feel? Accepted? Happy? Fulfilled? Yes, we all feel that way when we are accepted, welcomed, supported and helped in a group. We all feel the need for that acceptance. ALL of us. And when we have groups that we are happy with, it makes our lives better. We have something to look forward to and enjoy, and in turn, this increases our mental health and wellbeing.

Taking care of your mental well-being is just as important as taking care of your physical well-being and is something that you can take an active part in- taking an interest in your own life and community! Getting involved in your community will not only make you feel included, but it will give you a sense of purpose and happiness. Yes, I really do know, and understand, that it’s so hard to get out and about when you’re feeling unwell and low, but if you can get yourself out, you really will benefit from it.

Any group works- reading club, gardening club, pole dancing classes, swimming, boules, poker (no betting here!), cooking club, art, debating, ecological, photography, football, rugby, ballet, environmental, tap… the list goes on, but the more involved you get, the better you will feel. Don’t trust me, trust these fantastic psychologists who have performed research into this fascinating, and helpful area; a group of Psychologists who used Social Theory intervention to create social groups, Groups 4 Health, for people with mental health difficulties; the result was improved psychological health and well-being (Haslam, Haslam, & Cruwys, Groups 4 Health, 2016). One group of scientists worked out that even belonging to a group of people who feel stigmatised, such as a support group, your mental well-being increases (McNamara, Stevenson, & Muldoon, 2013). There are also some scientists who believe that social identity and feeling part of a group and being included is so important that they even wrote a book about it (Haslam, Jetten, Cruwys, Dingle, & Haslam, 2018). Connection is key!

Sadly, there are other elements that we need to keep us happy- enough money, safe and affordable housing, jobs, jobs that are well paid, jobs that are not zero contract and what about social spaces that we can all use safely? A psychological theory doesn’t cover these, I am afraid, but Politics does. And it’s up to us to influence and create change in these things, if we want to feel better. The tragic school shooting’s in the USA have awoken the frustration and anger in school children across America (even across the world), who can see precisely how unfair their lives are; subject to the rules and regulations of people who do not understand the complexities of their lived experiences- as a parent, I cannot even imagine how scary it is to send your children to school every day, unsure if that is the day that a tragedy may happen at your school.

Politics aside, don’t we want to take a little bit more interest in our lives? Improve our situations- for those we love, those around us, our (future) children and families, and even just for the health and well-being of all? What do you think?


References:

Haslam, C., Haslam, S., & Cruwys, T. (2016). Groups 4 Health. Journal of Affective Disorders, 188 – 195.

Haslam, C., Jetten, J., Cruwys, T., Dingle, G., & Haslam, S. A. (2018). In The New Psychology of Health: Unlocking the Social Cure.Abingdon: Routledge.

McNamara, N., Stevenson, C., & Muldoon, O. T. (2013). Community Identity as Resource and Context. European Journal of Social Psychology, 393 – 403.

Tajfel, H., & Turner, J. C. (1979). An integrative theory of intergroup conflict. In W. G. Austin, & S. Worchel, The social psychology of intergroup relations(pp. 33 -47). Monterey, CA: Brooks/Cole.

 

 

Is it time to give yourself a break?

My word, it’s been a long time since I updated on my blog- life has well and truly got in the way. But, you know what? I am not beating myself up about it, and do you know why? Because life is hard enough as it is, without me making myself feel worse!

How many of us are really kind on ourselves? Honestly? If you get a compliment today, what’s your first reaction? Is it to dismiss it? Or do we thank the person who gave us the compliment? Well, being that we are such a negatively biased species, we tend to dismiss the compliment in favour of self-rebuke; “What? This old dress? I got it in a sale and it doesn’t even fit me well!” Instead of “Thank you- it’s a pretty dress, isn’t it?”

So, why don’t we accept a compliment? Why is it so hard for us to do that? Well, only you can answer that question for yourself. I know why I do it- I feel that it might make me sound big headed. But then, like my Mum says- “If you’re not going to blow your own trumpet, who else will?”

The hardest thing I have had to do, was to create this website! I had to list ALL the good things about me, as a Counsellor. That was tough- trying to ensure that I did justice to my training, and myself, without making it sound pompous. I hope I got the balance right!

I was reading an article today about how being kind to yourself doesn’t make you weak or immodest- see, there is an article and study that was written, purely to show us all that being kind to ourselves is actually a good thing!

The article Resisting self-compassion: Why are some people opposed to being kind to themselves? (Robinson et al., 2016) took 161 young adult participants and asked them about their self-compassion and rated these based on 18 character dimensions. They were then given two scenarios where in one, they treated themselves with self-compassion and the other where they treated themselves harshly and were critical of themselves.

The cohort was then split in to two groups- those who were more self-compassionate and those who were more self-critical. Surprisingly, both groups, those who were more self-compassionate, and those who were less self-compassionate, tended to not differ in their opinions of self-compassion, or the fact that self-compassion is good for oneself and one’s wellbeing. However, the less compassionate group of the cohort said that after showing any self-care, they felt that they would see themselves differently; specifically, the less compassionate group felt that they would feel less ambitious, responsible, modest, careful, industrious and competitive, compared to those in the group who were rated as more self-compassionate!

Added to this, the less self-compassionate participants felt that after being self-critical, they would feel stronger and more responsible. So, what does this mean? Well, both groups of people are just as interested in success and achievement as each other, but the less compassionate group felt that being kind to yourself meant that you were weaker, as a person. Is this true? Is this really the case? The implications of this study is that we need to challenge the negative assumptions we have about being kind to ourselves, because it doesn’t change what is happening, but life is easier and less imposing if we do show ourselves a little self care.

So, how do we show ourselves self-care? Well, it really depends on what floats your boat.. Do you enjoy going to the gym, cooking, having your hair/nails done, walking the dog, yoga or just playing some games on your Xbox? It really doesn’t matter what it is you do, as long as you give yourself a little ‘downtime’ to concentrate on yourself.

It isn’t being selfish; it is taking care of yourself. If we don’t take care of ourselves, how can we take care of anyone else around us? How can we cope when things get bad, if we don’t have a source of stress release? It is really up to you how you do this, but the main thing is that you do it!

I know, I know- life is busy and you haven’t got the time to take time out for yourself.. this is a real circular argument, however. If you are feeling stressed, because there is so much to do, then you need to take some time out for yourself, to de-stress yourself. Yes, there are kids to look after, washing to put on, dinner to cook. But all of that will still be there, even if you do take 30 minutes out of your day to focus on yourself.

After you’ve taken some time out, how do you think you will feel? A little better? Re-energised? Raring to tackle those problems? Yes, actually, it will make you feel better. I cannot promise you that you will be dying to wash the skirting boards clean, but you will certainly be looking forward to your next little bit of me time!

Everybody needs some time out, from time to time, and there is nothing wrong with saying so. We need to find creative outlets- life isn’t one single journey, from a-z, it is a great big wild adventure, and all those small moments in between, that’s what makes up life. So why not go out for coffee and cake, if it makes you feel better? Why not buy a new bag, if you can afford it? Visit that park you’ve been meaning to, because if you don’t enjoy the small moments, you certainly wont be prepared for the bigger ones.


Robinson, K.J., Mayer, S., Allen, A.B., Terry, M., Chilton, A. and Leary., M.R. (2016) ‘Resisting self-compassion: Why are some people opposed to being kind to themselves?’, Self and identity, vol. 15, no. 5, April, pp. 505-524.

 

 

T’is the Season To Be Jolly.. Or Else?

So, I returned from an appointment the other week (back in November, actually!), to discover that my neighbours had already started decorating for Christmas 😐 this is something that does not make me happy; in fact, I had been hoping to hold off on the ‘Christmas Blog’ for a few more weeks yet. But, when another neighbour decorated with lights outside their house (in a bizarre pattern!) last week, I felt that I could not contain this blog anymore; batten down the hatches, Christmas is coming (not said in a Game of Thrones style, I promise).

So, when DO we start getting ready for Christmas and how does all this affect us? I am a bit of a traditionalist; to me, Christmas decorations and trees should not appear before the 15th December, as the earliest! However, there has been a growing pattern of people starting the festivities earlier and earlier; the first year we moved in here, four years ago, the decorations came out the first week of December and they have crept earlier and earlier every year since!

This made me think- am I being ‘Bah humbug’ or are other people feeling the same as me? I found a study by (Werner, Peterson-Lewis and Brown, 1989) that suggests that neighbours who decorate their houses, and perhaps do not have many friends in their street, are doing so to show their openness and cohesiveness in their local community. So, does that mean I don’t want to get involved with my neighbours? Well, yes, to a certain extent, but this doesn’t explain WHY people decorate so early? Maybe it is to welcome the neighbours to the coming festivities?

What about those people whose decorations are ridiculous to the extremes? And I am thinking this;

http://www.bbc.co.uk/news/uk-20669944

Now, perhaps this level of decoration could actually alienate the neighbours? Who wants to live next door to lights of that extreme, or that many visitors during December? The only positive thing I can think of, is that I think your house would be fairly safe from burglars throughout the whole of December?

So, if lights can either make you more (or less) tolerant and accepting of your neighbours, what does give you the ‘Christmas Spirit’? Well, a popular study I have found, cited by all the Christmas Naysayers, is from a couple of scientists in the Journal of Happiness Studies. (Kasser and Sheldon, 2002) asked 117 people, ranging in age from 18-80. They asked them to answer questions about their satisfaction, stress, and emotional state during the Christmas season, as well as questions about their experiences, use of money, and consumption behaviors during the festive period!

Now, I don’t know if this was what you were expecting, but peoples satisfaction was actually greater for the festive period, when it was based around family and religious experiences, rather than spending loads of money and giving/receiving gifts. Was that what you were expecting? I don’t know if I was; I know that, for me, I am very lucky and have a wonderful family, so Christmas is all about being with them. I don’t really mind present giving and receiving, or maybe that is because I am far too old, and bah humbug!

I find it hard to get too exited about Christmas until late December because, for me, it can’t start without my family. So until I am doing those activities like the Christmas food shop, or the kids start the school holidays it really is not Christmas time.

The Christmas period starting in late November, or early December is more about retail. Shops have to be able to sell goods and toys for two paydays before the 25th to give people a chance to buy things. For many people this leads to Christmas fatigue before Christmas arrives, and this is why I choose to ignore the holiday season for as long as possible.

So, I guess this brings us to the crux of the issue; what if it isn’t about spending, money and presents. What if it is about spending time with loved ones. And, lets just say, you are alone and don’t have any loved ones to spend it with. What then? What if you are left alone for Christmas, and I don’t mean in a cutesy ‘Home Alone’ movie style? What happens then?

It can be very hard to be alone for Christmas, but conversely, some people love being alone at this time! So, what can you do to keep yourself from being lonely at Christmas?

Scouring the Internet, the ideas are all the same;

  • Volunteer- helping others always makes us feel good about ourselves, and lets be honest, Christmas is probably the best time to volunteer!
  • Say YES to everything you are invited to- even if you are not feeling up to it, say YES! You can always leave early and go home; you never know what you might be missing out on, if you don’t even try
  • Work, Work, Work- if you enjoy working, then work! We are all different and different things make us happy. If it isn’t interrupting your life, perhaps you can get a jump-start on next quarters budgets!
  • Indulge yourself- comfort food, stay in your pajamas all day, dancing around the front room, watch your favourite movies all day long, whatever it is, DO IT!
  • Don’t wallow in your loneliness; find some support, internet, friends, chat rooms, whatever- just don’t feel like you are on your own!
  • Planning your time in advance is a good way of staving off the loneliness; if you have planned your time in advance, you know that you are not going to get bored and lonely, as you have a full itinery of things to do. Sounds like a plan to me J
  • Random acts of kindness and having faith can be quite important; I don’t mean an all encompassing faith that demands your presence at church 24/7, but perhaps some Mindfulness meditation, some relaxation or just getting in touch with your spiritual side and your ideas of what life is all about. Whatever it is that can make you happy.

So, there you have it, you’ve got some ideas to get you going. But what if none of those things appeal to you, and you don’t have anyone special to spend the holidays with? Well I would say that you do… You are special, buy yourself a present and enjoy it, you deserve it!


Kasser, T. and Sheldon, K. (2002) ‘What Makes for a Merry Christmas?’, Journal of Happiness Studies, vol. 3, no. 4, December, pp. 313-329.

Werner, C., Peterson-Lewis, S. and Brown, B. (1989) ‘Inferences about homeowners’ sociability: Impact of christmas decorations and other cues’, Journal of Environmetal Psychology, vol. 9, no. 4, December, pp. 279-296.

 

 

Social Media; Friend or Foe?

So, hello everyone! I have been out of the loop on social media lately- work, family, study and other commitments have kind of got in the way; and for that, I apologise.

Hang on, why am I apologising? Surely it is up to me what I post, when I post, how often I post, what I am exposed to and how it affects me? Right? Well, maybe that’s not necessarily the case- particularly if you have a large ‘friend’ base on social media!

I thought this might be quite a relevant topic with which to re-enter my social ‘sphere’. The thing about Facebook, Instagram and other forms of social media, is the control (or lack of it) that we perceive we have.

A recent study by Sarah Buglass from the School of Social Sciences at Nottingham Trent university, in the UK, suggests that ‘as our network size increases, the ability to remember who, or in the case of misclassified profiles, what you are connecting to, becomes increasingly more difficult, and the management of these networks more complex’ (Buglass et al., 2016).

The researchers studied 177 UK based Facebook users, of these 89% had their settings set to ‘friends only’, but just 22% used additional filtering option to improve their online safety. People who had smaller networks (less than 150 friends) were found to be more able to manage the information that they were posting and who they were posting to, as they were more aware of whom they share their posts with.

People with large networks (150+ friends) were more likely to be exposed to unsuitable material, which could cause them Psychological harm. These people are leaving themselves vulnerable to who is able to see their information, which can lead to a risk of damage to their own reputations and that of others, harassment from disgruntled parties, but also the fact that these people were more likely to fall victim to potential data misuse.

Personally, due to the nature of my work, I do keep my private social media accounts, private, but I still do see posts from ‘friends’ that I don’t want to see- be that because I don’t agree with their content or that it is just not that relevant to me.

I know how to change my privacy settings to stop seeing these images and posts, but do you? Have you stopped to think about just who is seeing your personal data? Have you thought about how those ‘shocking’ posts are affecting you?

Having more Facebook friends doesn’t mean you are popular, it means that you collecting people on a list, some of whom will share your ideologies, some of whom will be remarkably different from your own.

Perhaps a friend has let you down? Perhaps you have become distant from your close friend, for whatever reason? Well, seeing them on a daily basis, on your Facebook feed could actually be damaging your psychological welfare- do you really want to be reminded that someone has hurt you deeply, or that you are no longer seeing your friends, whilst they are off having fun with new friends?

Whatever the reason, we need to take care of ourselves on social media- not only for data reasons, but our own psychological reasons. Everyone’s life is different; we don’t need to be measuring ourselves on the virtual achievements of others!

In the mean time, I am going back to my privacy settings and just checking for sure, that you can’t see how old I am!


 

Buglass, S., Binder, J.F., Betts, L.R. and Underwood, J.D.M. (2016) ‘When ‘friends’ collide: Social heterogeneity and user vulnerability on social network sites’, Computers in Human Behaviour, vol. 54, January, pp. 62-72.

 

 

One Year On and Has There Been Any Real Change?

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.

SuicideChart

 

Screen Shot 2015-08-11 at 18.10.11

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.

Samaritans 08457 90 90 90

SANE 0845 767 8000

CALM 0800 58 58 58 or by text on 07537 404717

 

 

 

When is a Therapy not a Therapy?

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.

Being Mindful of Mindfulness!

I was on a Mindfulness course last week- Mindfulness is a really hot topic with Mental Health workers at the moment. I have been working with Mindfulness for around 4 years, so I thought I would scrub up on my techniques and ideas and get back into my Mindful practice for myself!

Did you know that in 2012 there were 40 new papers on mindfulness published every month according to Google Scholar? Guardian journalist Barney Ronay noted that 37 new books had been released that week alone! I think that this demonstrates just how popular mindfulness has become.

Mindfulness, the act of paying attention, in a non-judgmental way, to ones own experiences of the here and now. So, what exactly does that mean? Well, exactly what it says- paying attention to what is happening to you, around you, in the moment that you notice them.

Whenever anyone is going on a mindfulness course, the first thing people who are experienced in mindfulness will say to him or her is “Wait until you do the raisin exercise!” What? What on earth is that? Well, a good way to explain mindfulness is to take a raisin. Don’t eat it- you are jumping the gun there! Hold it in your hand. Have you ever really looked at a raisin? Have you noticed the colours? Have you held it up to the light and looked at the brown and amber hues that are in front of you? Have you ever looked at the creases, the ridges, and the folds? The size of the raisin or the shape of it? Have you felt it between your fingers? Is it squishy? Hard? Smooth? Textured?

No? I am sure you haven’t. Not really. Not closely.

Well, let’s not stop there! Pick up the raisin. Put it to your ear. Do you hear anything? No, of course you don’t, but then roll the raisin between your fingers. Can you hear the squeakiness of the raisin now? The slight grinding as you roll the raisin between your fingers?

Take the raisin and hold it up to your nose. Take a deep breathe in- can you smell it? What does it remind you of? Christmas cake? Cinnamon rolls? Is it a slight smell, or pungent?

Now, put the raisin in your mouth- but don’t chew it or swallow it! Roll it around in your mouth and really feel it. Put it between your teeth, give it a little squeeze. Can you feel the textures and the taste starting to spread? Gently chew the raisin, experience the flavour. Is it sweet? Bitter? Finally, swallow.

Now. I bet you haven’t experienced a raisin like that before, have you? You could do the same with making a cup of tea or brushing your teeth- any activity that you do during the day, that you can break down and really pay attention too!

So, what on earth has fiddling with a raisin for the last 10 minutes done for you, eh? Well, by exercising all of your five senses, your cortisol level has decreased (stress hormone) and you will feel calmer than you did before you started. By looking at things from a visual, auditory, kinaesthetic, gustatory and olfactory sense (see, hear, touch, taste, smell!) you have brought yourself into the present moment. You are not thinking of that annoying colleague today at work and you are not thinking of all the work you need to do tonight to prepare for tomorrow. You are in the moment, and that moment is peaceful and calm.

So, by practising this every day (for those of you in the know, it is VAKGO. Yep, snazzy, eh?) we can just stop what is happening, take a few minutes out of life to relax and calm down, before we go on to the next busy period of the day.

So, how exactly does being mindful, which can actually be a personality trait anyway, actually be beneficial? A study in 2011 suggests that

Evidence suggests that mindfulness practice is associated with neuroplastic changes in the anterior cingulate cortex, insula, temporo-parietal junction, fronto-limbic network, and default mode network structures” (Hölzel et al., 2011)

Say, what?! Well, what this means is that by practicing mindfulness, area’s of the brain, associated with neuroplastic changes (referring to changes in neural pathways and synapses that occur due to changes in behavior, environment, neural processes, thinking, and emotions – as well as to changes resulting from bodily injury) in areas of the brain that are responsible for attention, focus and regulation. Simply put, by utilizing mindfulness you can actually change the structure of your brain (the area’s that are ‘plastic’) for your benefit; to increase your sense of personal perspective awareness, your attention and focus, your emotional regulation and your body awareness.

Nah, that’s not real. Once your born, your brain doesn’t change. Well, actually it does- as we grow so does our brain. Our neural pathways and synapses develop and change, according to our environment, what we learn, what we don’t learn and genetics. So, if we train our brain to be present in the moment, really present, we can grow the area that we use to focus and pay attention. What magic is this, I hear you ask? Well, it is simply the wonder of the human mind- although science has come along way over the last 100 years, we still do not really know how the brain functions; we are learning more every week.

So, if mindfulness is so magic, why isn’t everyone doing it? Well, I cannot answer that one, I am afraid! What I can say is that mindfulness is NOT a cure all. It is a technique you can use to develop and enhance your day-to-day life. In fact, there are studies available that say certain people should not practice mindfulness; a study in 2012 concluded that there was not enough data available to fully analyse who should or should not partake in mindfulness meditation or therapy, but that people for whom there are deep-seated mental health difficulties or long term psychological affects, mindfulness meditation may not be appropriate (Dobkin, Irving and Amar, 2012).

The reason that mindfulness may not be appropriate for some people is that the act of mindfulness takes us deep in to meditation- by doing so, we are relaxing and allowing ourselves to be in the moment. If you have any traumatic experiences that you perhaps haven’t dealt with, or that still trouble you, the by going in to the mindful state can reduce your inhibitions, and the safety mechanisms, the defence mechanisms you have in place, to protect you from your difficult thoughts, are suddenly lowered, which can leave you in a very troubled place.

So, this blog then becomes a cautionary tale! Mindfulness, to some, seems like it is a waste of time, however, this is not what we are seeing from the studies that are coming out. Mindfulness has been shown to reduce anxiety and depression and to help with many other issues people have. However, it is not a one size fits all therapeutic achievement. In fact, if you are not in the right place in your life, in the right state of mind, mindfulness could in fact be quite dangerous for you- raising traumatic memories that you have repressed, hidden deep down or simply memories that you actually don’t want to, or can’t, deal with. Mindfulness is not the be all and end all that we originally thought it to be, the studies are showing this, but. That said, it could really work for some people.

So, if you are having difficulty sleeping, or are feeling stressed from your busy life, why not take 10 minutes out of your busy day to practice some mindfulness meditation (as long as you are not in the group of people discussed above, for whom mindfulness is contradictive!)? It doesn’t have to be the raisin, although, why not? Perhaps you are just going to use the VAKGO to notice what is going on around you, or you are just going to close your eyes and concentrate on your breath. In and out, slowly, clearly, purposefully. You never know. After 10 minutes of it, you may feel like a whole new person!


 

Dobkin, P.L., Irving, J.A. and Amar, S. (2012) ‘For Whom May Participation in a Mindfulness-Based Stress Reduction Program be Contraindicated?’, Mindfulness, vol. 3, no. 1, March, pp. 44-50.

Hölzel, B.K., Lazar, S.W., Gard, T., Zev, S.O., Vago, D.R. and Ott, U. (2011) ‘How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective’, Perspectives on Psychological Science, vol. 6, no. 6, November, pp. 537-559.

 

 

Medication or Therapy- Which is Better?

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].

 

 

Disappointed with the Result? Bear this in Mind!

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.

 

 

Laughter- the friendly medicine.

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.