Cortisol and Stress

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Cortisol is a hormone produced by the adrenal glands that is mainly used as a stress or alarm hormone in the body, but can also regulate metabolism and immune responses. Cortisol is produced when the hypothalamus and pituitary glands fail to sense high enough levels in the blood, they release their own hormones to stimulate the adrenal gland to make more cortisol, once enough cortisol is present in the correct hypothalamus receptors they cancel the production hormone and cortisol ceases being released.

It is used in the body for many reasons, it is fundamental in the body’s natural fight or flight response, as well as in regulating blood pressure, blood sugar, use of carbohydrates, proteins and fats, metabolism, foetal development, memory, reducing inflammation, controlling sleeping and waking, even boosting energy levels when needed. These are a lot of functions and almost every cell in the body has cortisol receptors in it, it is a very important hormone.

What is key is that in times of stress or fear it is released into the body where it can control whole systems. When under threat it can shut down digestion, reproduction, growth and immune systems to use the energy and resources the body has elsewhere, such as it increases blood pressure and heart rate.

Medical conditions causing high or low cortisol are: Cushing’s syndrome is when there is too much cortisol in the system causing increased weight gain, muscle weakness, diabetes, brushing of skin, high blood pressure, mood swings, low sex drive and loss of sleep. Addison’s syndrome is when cortisol is too low and causes skin discolouration, muscle weakness, diarrhoea/vomiting, loss of appetite, weight loss, low blood pressure.

However, in terms of therapy prolonged exposure to the hormone can have negative side effects on the body. This is usually caused by increase in long term stress reactions (like work place stress, monetary stress etc, or post-traumatic stress disorder) which continually tell the body that there is a risk and to release cortisol to be ready with the fight or flight response. This can lead to long term complications in health that are not purely caused by medical conditions as noted above, these are anxiety, depression, headaches, memory issues, heart disease, weight issues, sleep problems, digestive difficulties, and poor libido.

Therapy can help with excessive or repeated exposure to cortisol by assessing in the formulation stage of cognitive behavioural therapy what may be causing the increased cortisol and suggesting the following ways to deduce it as well as improving the causing factors where possible with behavioural experiments and exposure therapy.

Cortisol is known to be influenced by sleep patterns it is higher in the mornings and needs to be lower in the evenings. Regulated sleep patterns will help the body know when to produce or reduce the cortisol hormone (shift work can be very hard on cortisol and it is believed napping can help regulate it), thus low caffeine intake, reduced lighting and reduced stimulation in the evenings should reduce cortisol production aiding better sleep and regulating production. Exercise, either regular intense exercise (it increased production at the time but lowers it by evening) or moderate exercise can reduce cortisol levels. Recognising stressful thoughts and increasing relaxing can also regulate cortisol levels, this can be achieved by mindfulness (to recognise and regulate stress thoughts), meditation, breathing exercises, writing down positive thoughts in a diary, massage, calming music, yoga or tai chi, can all help with relaxation. Reduction of feelings such as guilt and shame which increase stress, replace them with love, forgiveness, anger reduction reduce cortisol and can all be brought about by well practised mindfulness.  Having fun can release positive hormones into the body to counteract the stress reaction such as doing hobbies, gardening, being outside, spirituality, being social with friends, good relationship, reduce arguments and avoid conflict, support and affection from a loved one have also show good cortisol reducing evidence. Pets have been shown to significantly reduce cortisol production especially studies with dogs. Eating healthily is also important, , fish, fatty acids, omega 3, probiotics, fruit, water, black or green tea, even dark chocolate can all lower cortisol. However continued high sugar levels can be detrimental to the over production of cortisol.

Overall it is the therapist job to ascertain the areas causing the clients increase cortisol production and suggest ways in which the client can reduce this, it is a holistic therapy combining all parts of the body, mind and emotions to reduce the behaviours, triggers, symptoms, and thus cortisol production.

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

Let it RAIN

Mindfulness is about self-compassion, self-awareness, recognition and understanding of our thoughts, emotions and senses, it is about quietening our thoughts and taking them under our control. Two mindful exercises are referred to by the acronyms RAIN and STOP aid in the learning of mindfulness. Below I will explore each in detail, including how to practice the technique, why it works and the purpose of it.

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RAIN is widely attributed to Michele McDonald, the acronym stands for R – Recognition. A- Acknowledge or Accept or Allow. I – Investigate. N – Non-identification or Natural Awareness. Although A and N are referred to slightly differently in some sources they have the same meaning of the action attached to the word.

R – Recognise or notice what is going on for you. Step back internally and consciously observe your thoughts, feelings and senses.

A – This is about accepting or allowing your thoughts, feelings and senses to just be. Acknowledge your current experience and be compassionate to yourself, do not attribute blame, reason, cause or self-judgement to your thoughts, feelings and senses.

I – Investigate your thoughts, feelings and senses, do this neutrally from your judgement less, accepting position. Wonder about the thoughts, feelings and senses, think about them, how they rest in your body, what sensations are there? What reactions do they call forward without conscious thought? What responses would you usually give?

N – Non-identification. This should come as a natural stage, which is why it is sometimes called natural awareness. I find it the hardest to put into words. This is the recognition that our sense of self is not intrinsically linked to our thoughts, feelings and senses. Our responses are not fused with our thoughts, feelings and senses. We do not have to be angry because we have felt angry. Do not identify with the automatic response.

 For example: we Recognise that we have felt the emotion anger, we feel physically hot, we clench our jaw or fists, we want to shout. We Accept this feeling, we allow it to be felt, to happen, we don’t try to push it down or cover it up, but we do not react to it either. We Investigate it, we wonder what about the situation called something in our learnt behaviour, or response system, we investigate our physical response too. Finally we Non-identify, or we know we felt anger but we do not respond with anger.

Over time our bodies will hopefully stop offering us the learnt behavioural responses automatically and we will be calmer and more analytical about our responses, thoughts, feelings and senses.

STOP is attributed to Jon Kabat Zinn, the key letters stand for S – Stop, T – Take a breath, O – Observe, P – Proceed. The aim of this technique is to introduce Mindfulness naturally throughout your daily routine and reduce the amount of auto-pilot behaviours or automatic negative thoughts that occur.

S – Stop, stop what you are doing, and pause for a moment.

T – Take a breath, breath in and out, notice your breathing, notice its speed, slow it down, relax into breathing for up to a minute if you like, anchor yourself to the present moment.

O – Observe, take a look at your thoughts, feelings and senses or behaviours. Name them, recognise them, be curious about them, what are they, inside and outside your body. Are you judging, are you reacting, assuming, are you sensing, feeling, thinking?

P – Proceed, you can now return to your activity, you can continue the same if you want to or you can adapt your behaviours and thoughts based on your observed moment, do you alter your action or reaction or are you happy with what you noticed?

For example if you Stop and pause just before entering a meeting, Take a few deep calming breaths, be aware of your breathing for a while, Observe your emotions and physical sensations and notice that you are sweaty, heart racing, and feeling anxious. Proceed by changing your plans, or adapting your thoughts or by recognising you were anxious you may be calmer and more productive in the meeting. You may even realise meeting anxiety is something you wish to take to your next therapy session.

Overall the aim of this technique is to increase awareness of activities, emotional and physical response to them and to notice our judgements or automatic thoughts and behaviours, then adapt them if necessary to help us be calmer, more relaxed and more self-aware and self-compassionate.

Both these techniques work well with cognitive behavioural therapy because they are about the recognition of the key elements in the cognitive triangle of our thoughts, feelings and behaviours and learning to recognise and adapt them.

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

Holistic Health

Holistic health may be seen as relatively new in terms of the word or phrase but the techniques and meaning behind it have been around for over 3000 words, ancient China and Greece practised therapies that follow holistic paths as well as the Indian concept of Ayurveda, “according to Ayurveda, one is considered as healthy when body, mind, and spirit are in the state of equilibrium, comfort, and bliss”. (www.sciencedirect.com).

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Overall the meaning of Holistic Health or Holistic Therapy is when the body is seen as a whole rather than the individual parts that it is made up of, it focuses on the wellness of a person as a whole rather than on a specific aliment, symptom, body part or diagnosis. It believes that you cannot understand the individual parts of a person alone but must see them as making up the person as a whole, they are all interconnected and in conjunction with the other parts of the body. Optimal health in holistic therapy is about balance, all sources suggest that the Mind, Body, Spirit, (or physical, mental, emotional) need to be observed and treated to treat the whole person. To do this it is suggested that certain areas are looked at including: physical, emotional, mental, social, and spiritual. The body is a working system and not a collection of organs, everyday medicine needs to be used in conjunction with looking at the above factors, and complimentary therapies or treatments. These can include: reiki, herbalism, massage, yoga, therapy/counselling, meditation, mindfulness, surgery, medication, nutrition, unconditional love, emotional support, sleep, self-care, environment, physical therapy and exercise.

It is suggested that the main areas to seek balance in and the ways to do so are:
Physical – improve sleep to a 7 or 8 hour period, improve diet to include balance meals, reduced fats and sugars increase nutrients to help brain and body chemistry, well balanced meal timings to maintain blood-sugar balance, minimum physical activity of 30 minutes as day, increase exercise, reduce smoking and drinking which put negative chemicals into the body. Maybe try massage.
Emotional – try therapy or counselling, mindfulness, meditation, journaling, talking, love yourself, and understand yourself better.
Mental – keep mind active, keep learning, solve puzzles, tired out your mind, and use your mind. Social/Spiritual – go outside and enjoy nature, plants inside can help too, make real contact with people, join social groups or activities such as religious groups, village communities, school communities, charities, hobbies. Set boundaries for social activity and who it is with to reduce stress and overtiredness, practise a faith if you have one.

Mental health is an integral part of the holistic health concept, you can see above the mind is one of the key areas that needs to be in balance with the body and spirit, therapy/counselling is also mentioned as a way to address this balance. Two examples of how holistic health can affect mental health are: depression and anxiety.

Depression leaves us feeling miserable, with low mood, it can also leave us with aching muscles, tiredness, slow movements, over sleeping and overeating. The questions on the PHQ-9 usually used to measure clinical depression include questions on: Trouble concentrating, Moving or speaking so slowly that other people could have noticed, Overeating, Feeling tired or having little energy, Sleeping too much.

Anxiety makes us move faster, fidget more, get physical pains like chest pain, breathlessness or tummy ache, eat less, sleep less. The GAD 7 used to clinical measure anxiety asked questions on: Being so restless that it is hard to sit still, Trouble relaxing, Becoming easily annoyed or irritable. (www.talk2gether.nhs.uk)

However, if we take these symptoms in conjunction with the key areas holistic health looks at we can see how improvement in some of the areas these symptoms manifest can improve overall health. If sleeping improves because of better physical activity making us tired and releasing good neurotransmitters into our minds and bodies our sleep patterns should improve. If we eat better diets with better nutrition then our bodies will have the right chemicals to exercise and have energy and to produce serotonin in our guts and brains (the gut brain hypothesis is currently the focus of research (www.health.harvard.edu)) to help us have more energy and feel less tired and want to exercise or move more, also improving physical aches and pains. If we meditate or practise mindfulness we will improve our stress and anxiety response and improve our mental wellbeing, thus improve our physical responses of tummy ache, chest pains, and headaches. If we attend therapy we may find reasons that make us anxious or depressed, healing these, and again by adjusting one key area we will improve the overall wellbeing of ourselves. It is believed that holistic health and thus mental health is improved if the client is given the power to address their own issues and own self, to look at their body and daily behaviours as a whole and to take control of them for themselves in a positive way. “Holistic Health is actually an approach to life.” (www.guidingwellness.com) is a very good way to describe this idea, it fits neatly within the concepts of cognitive behavioural therapy (CBT) which look at the overall behaviours of the clients and make changes in all areas where it is needed to being about lasting and positive change.

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If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

CBT Techniques.

I have been asked to discussed how behavioural experiments, homework, self-monitoring, Socratic questioning and systematic desensitisation are used in cognitive behavioural therapy (CBT), I will explore each of these individually before summarising.

Behavioural Experiments in CBT are said to be one of the most significant factors of the therapy. They are experiential activities designed to test or challenge cognitions or beliefs of individuals seeking therapeutic change for certain specific issues. They are used to recognise thoughts, challenge them, adapt existing beliefs and test newly formed ones. These activities use experimentation or observation to obtain new evidence or information to help clients reach positive, self-controlled change. To help clients revaluate negative automatic thoughts (NAT’s) and assumptions and encourage conscious process and give step by step guidance to acquire new skills.

This is done identifying the issue, cognition, behaviour or belief that client feels is causing difficulty, it helps is the problem is precise, and if the strength of the cognition is known. Then an experiment is designed with the client and carried out, this is then reviewed with the therapist and results are analysed and check against original cognition, if it is positive results it is discussed how this positive development may be sustained, if not it is seem as developmental learning and a new experiment based on this learning is devised. The pattern followed is engagement of client in therapy, activity design and scheduling, testing/experimenting, review and future planning.

Some of the types of experiment are as follows: hypothesis testing e.g. doing the opposite to the cognition to see what will happen; discovery e.g. when a specific cognition is unknown but a behaviour is known see if you can find the thought by recreating behaviour; observational e.g. watch others do something and see if this helps you change cognition; survey or research e.g. ask others if they feel the same or what they feel about you.

It tends to follow this pattern ‘Thought – If I do X then Y will happen’, sometimes added is a safety behaviour ‘Thought – If I do X then Y will happen, so I do Z’. To fill this in with an example ‘If I walk into a shop everyone looks at me, so I always try to look inconspicuous, rush to only what I need and leave’. The experiment here would be threefold first the therapist would explore the human nature concept that people look at anyone entering a room out of nosiness and safety; second they would get the client to observe others entering a shop or room and see that everyone gets looked at; thirdly they would use the practical experience of walking into a shop slowly just to browse and prove to the client by review afterwards that nothing bad happens if they don’t do their safety behaviour of rushing out again.

Homework in CBT is a method of helping the client to develop outside the therapy room. Studies show that clients who complete their homework are far more likely to achieve better results from their therapy (www.goodtherapy.org), thus it is believed that homework in CBT should not be optional for this reason. The Beck Institute have recently suggested that homework has negative connotations and have suggested a move to calling it Action Plan to help those clients who struggle with homework (www.beckinstitute.org). The bulk of work happens between sessions during homework and can be crucial for the next session because it can provided information to base new behavioural experiments on, it can help the client feel calmer and it can create evidence to prove to the client therapy is working. Homework can be breathing or meditation exercises, exercise, diet, journaling, behavioural experiments, record keeping of thoughts and actions association. Homework should be varied and tailored to suit the client’s needs and style, e.g. creative or scientific, with teaching or learning aids if needed, but it should aim to push the client slightly (but safely) out of their comfort zone or to make progress towards their goal and but suited to the stage of CBT the client is at.

Self-Monitoring in CBT can be part of the collaborative homework set by the therapist for the client. It should be routinely monitored to ensure that it does not cause additional anxiety, stress or negative feedback to the client during the recording process or upon analysis of the results. It can be in many forms, but its aim is to help change thoughts, emotions and behaviours of the client. Self-monitoring techniques focus mainly on the cognitive triangle in CBT which looks at the links between thoughts, actions/behaviours and emotions/feelings. It then allows the client and counsellor to be aware of a pattern and make adjustments in one of these areas to improve the clients presenting issue, tis adjustment can be in the form of a behavioural experiment discussed above. Types of Self-monitoring techniques are; making a daily diary, recording audio or visual images (photo or video), tables of the three cognitive triangle components (thoughts, emotions and behaviours), phone apps, fit bits, heart rate monitors etc, tally charts of incidents or feelings. It can help clients to recognise NAT’s, behavioural reinforcement actions, and allow the therapy to move forward when the results are evaluated in therapy sessions.

Socratic questioning in CBT can be used at different stages of the therapy to help challenge irrational or negative thoughts, in homework, to help gather information during formulation, and to help assess the outcomes of behavioural experiments. They can be used by the therapist to gain information or by the client to challenge their own negative thoughts. They are a set of guiding questions aimed at discovering, identifying, or defining a problem/thought/emotion/action/response. Psychologytools.com lists types of Socratic questions as those that – “identify their cognition and try to really understand their basis for it …ask questions to identify all the reasons their behaviour made sense at the time … and …expand their view of other causes and responsible parties.” (https://www.psychologytools.com)

It helps us to understand how types of questions are useful in CBT by looking at where they stem from, Socrates belief that by questioning assumptions, thoughts and well known beliefs we can reach our own conclusions and developed understanding. It is believed the questions are meant to reveal something the clients does not already consciously know about themselves or have previously overlooked and thus make new connections and conclusions based on answers. Good Socratic questions intend to reveal new perspectives or information. They help with problem solving, revealing new information, and educating the client about themselves. If the client learns the skill it is something they can take away from therapy to continue to use in their future preventing relapse.

Finally I shall discuss Systematic Desensitisation within CBT. This is the process of exposing the client to a fear or phobia while linking a good, calm or positive emotional or physical response to the same fear. It is based on the psychological technique of classical conditioning, and aims to remove a fear response and replace it with a new one. To do this the client must learn calming or relaxation techniques such as breathing exercises, meditation, muscle relaxation. Once the client has learnt these a hierarchy of the clients fears/phobias is drafted, least fearful first increasing in fear until phobia to be addressed is reached. This hierarchy is addressed one by one starting with the least fearful, and the client is asked to use the as breathing exercises, meditation, or muscle relaxation techniques while in the presence of the stimulus to help alter or replace the fear response and become desensitised to the fear or phobia. Then the next fear or phobia in the hierarchy is address and systemically the technique moves up the hierarchy until the clients address the issue that brought them to therapy. This technique needs to be carried out carefully so as not to traumatise the client more or to condition them in a negative way. It can be used as a homework technique or done within sessions.

These are all methods that can be used within CBT to help the client progress through their therapy and reach a positive conclusion, they can be built into the therapy plan between the client and therapist to produce progress.

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If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

Making Friends

If you are looking to make friends you could try this useful group

Stoke On Trent and Newcastle Under Lyme Meetup Group

Stoke-on-Trent, GB
102 Members

We are a group of people of all ages who enjoy getting together for a wide variety of social activities.We welcome new members. On joining we ask for a clear current photo so…

Next Meetup

A day out geocaching – possibly 3/4 mile walk.

Saturday, Aug 22, 2020, 11:00 AM
6 Attending

Check out this Meetup Group →

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

Open or Closed – that is the Question?

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Open questioning and closed questioning can be useful in therapy, particularly CBT, because it can give us facts about the client and allow the client to explore in more depth. Mostly open ended questions are used during formulation or assessment process in therapy to allow the therapist to collect as much detail as they can about the client while in the early stages. But sometimes a closed question is needed to find a clear answer. Closed questions are those that have short, often one word answers such as yes, no, last week, tomorrow, mother, father etc or maths type questions such as what is 2+2? Open questions allow the client or answerer to go into depth/detail about the information being sought. They can explore a memory or past event in their own words and give as many details as they like.

Below I have listed 15 questions I would most likely use in a formulation session with a client. They are mostly open ended questions to allow me to find out details about the clients past and experiences so that the client and I can build a clear and detailed picture of the issues bringing the client to therapy and the type of outcome the client would like.

  1. What issues have caused you to seek therapy?
  2. Have you had therapy before, what type was it and did you find it helpful?
  3. When did you first notice this issue? Or How long have you felt like this?
  4. Can you remember if that was the first time you felt like this? Can you describe the event you just recalled?
  5. What events or actions cause you to feel like this?
  6. How is this issue been impacting on your life?
  7. How does this issue make you feel?
  8. What do you do when you feel like this?
  9. Why don’t you like that behaviour/feeling?
  10. Where does this happen – work, home, friends, family, relationships, gym etc
  11. What part of the behaviour/issue do you want to change?
  12. How would you like to feel?
  13. Do you have any specific goals you would like to achieve?
  14. If you can wake up and the issue/problem had gone what would have changed?
  15. Are there any other issues impacting on this issue?

Overall these are the main 15 question I would use during a formulation with a client, mostly they are open questions allowing the clients to explore and understand their life in detail and make links to actions and events. These will help me create a therapy plan with the client and use the correct therapeutic techniques to aid the client to the best of my therapeutic skills and abilities. So if your counsellor seems to ask a lot of questions in an initial assessment this could be why.

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

The Feel Good Chemistry – Endorphins and Serotonin

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Endorphins

Endorphins are a peptide hormone produced by the body’s central nervous system in the pituitary gland and hypothalamus, they bind to the body’s opioid receptors and have an analgesic effect on the body. They are a not only natural painkiller released when we feel pain but can also be released in response to stress and depression as well as during pregnancy. They help us to function when we are injured but can also be released when we do certain other activities such as exercise, sex, dancing, eating, drinking, singing, art, or social activities, including laughing (they help us reinforce good social attachments). This means that when we are feeling low mood, stressed, anxious, depressed, aching, have sleep issues or self-esteem problems we can find relief by doing activities that create endorphins, sometimes however, the depression or stress causes us to be unable to do the endorphin releasing activity, it helps to have more than one way to release the natural opioid chemical. Endorphins are a very useful hormones to increase mood and social function and reduce pain or chronic illness.

Serotonin

Serotonin isn’t just found in brain cells and central nervous system but in the bowel/intestine/digestive system and blood platelets too; its sends signals between these areas. These signals can be about mood, sexual desire, appetite, sleep, memory, temperature or social behaviour. It is created by essential amino acid tryptophan a protein found in red meats, cheese and nuts. Serotonin can help us to be calmer, happier, more focused, less anxious and emotionally more stable.

Serotonin is a very varied chemical that is reported to have impact on various bodily functions such as: regulation of bowel movements, regulation of moods, impact feeling nauseous when our body wishes to push out a bad food, impact our cardiovascular system, our endocrine system, impact on blood clotting and wound healing by narrowing arteries and increasing blood platelets, it can also cause osteoporosis in bones if its levels are too high as well as having an impact on our sexual libido levels.

It is believed that serotonin regulates the many systems mentioned above, if we have too little serotonin in our systems we can have complications most commonly with depression, obsessive compulsive behaviour, panic, anxiety and insomnia. It is believed that depression could be caused by multiple factors including low production of serotonin in brain cells, lack of serotonin receptor sites (sometimes blocked by other chemicals), failure of the serotonin to reach the receptors, or a shortage of tryptophan. Lack of serotonin can also impact our libido, low serotonin usually has the result of increased libido or sexual desire. It could possibly impact on the condition known as irritable bowel syndrome giving a gut brain link that is currently being researched.

Low serotonin is often treated by chemicals most commonly known as anti-depressants – these are either SSRI’s selective serotonin reuptake inhibitors or SNRI’s serotonin and norepinephrine reuptake inhibitors (regulating which receptors and the number of receptors that bond with the serotonin, and how much can be used). It is also believed that sunlight (particularly for seasonal depressive disorder), exercise and diet can increase serotonin production and regulation. Low serotonin can have a negative impact on the body and the mind.

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

The A B C in Cognitive Therapy

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The A B C D E model of Cognitive Behaviour Therapy (CBT) was developed by Albert Ellis in the mid-20th century. He based it on his Rational Emotive Behavioural Model of empirical based psychotherapy which believed that irrational beliefs are developed by people in response to perceived goals being achieved or failed. He understood that people construct ways of thinking based on their experiences in life including philosophy, language, belief systems, educational experiences and upbringing. Sometimes these rational (positive and useful) or irrational (negative and damaging) beliefs link to emotions and thus impact on our future thoughts, feelings and behaviours.

Ellis believe there different types of irrational beliefs. These he suggests are:

  • Demanding – absolutism; very inflexible dogmatic and extreme terms used by individuals such as must, should, ought.
  • Demanding – love or approval; the need to seek love form people they view as important (parents, partners, teachers, friends)
  • Demanding – success; having to achieve or be best at what they do
  • Demanding – comfort; struggle with any form of discomfort or distraction in their lives (working with noise, untidiness, cold/hot)
  • Awfulsizing; events are categorised as the worst they could possibly be, rather than in context.
  • Low Frustration tolerance; as above they believe they can’t cope with distraction rather than they actual can’t
  • Depreciation of Self; global negatives all of them is bad because of one issue.

Ellis proposed the A B C D E solution to these issues. This is broken down as follows. It is often used by therapist to help clients understand themselves better and to make changes in previously help irrational beliefs and the subsequent behavioural responses.

A=Activating – this is the event, activity or adverse condition that causes the irrational thoughts to become a problem.

B=Beliefs – usually irrational, about the event

C=Consequences – the belief that develops has physical and emotional response or reaction

D=Disruption of beliefs – challenge and alter them. Argue against the irrational.

E=New Effect, or approach to emotions and irrational thoughts

An example I would offer is of a relationship where a fear of harm has developed.

A=partner has failed to arrive home with a reasonable time of when they were expected – the activating event.

B=thought process “oh dear what is they’ve been in an accident and they’re dead” irrational thoughts or beliefs. Can often develop from previous experiences – i.e. they may have had someone die in an accident or they may have learnt from a parent or traumatic event previously.

C=consequences can be mental, emotional and physical i.e. feeling sick, being sick, panicked, anxious, pacing, ringing people, hot/cold, headache etc.

D=disruption of these thoughts would be to use the question “what is here was an alternative?” then suggest answers – they may have had a meeting, there might be traffic, they may have gone to a friends, they’ve never had an accident before, they are often late, they may have got the time wrong.  It is about recognising the irrational thoughts and finding positive alternatives. About dislodging the old learnt behaviours and emotions.

E= Find a new emotion – I get to enjoy alone time, I trust them to drive safely, the worst doesn’t always happen, I would have been told by now if something was wrong, they came home late X times before and it was alright. Use a calming technique to find a new emotion to link to the situation.

This shows how Ellis believed thoughts and emotions can link together in a negative emotional way but that when challenge a new positive link can be created. Sometimes the stages overlap or aren’t clear cut but the therapist will work with the client using the ABCDE as a guide to their process of change.

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

The 3 B’s

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This is a combination of Mindfulness and Meditation that can be helpful to those who find clearing their busy mind a difficult task. It is designed to help you be both calmer and more in control of your own thoughts.

I call it the 3 B’s – feel free to try it, remember adapt it to yourself – you are an individual.

Sit quietly or lie in bed, use mood lighting, scent or music (see previous blog posts for more information) if needed.

The Technique:

B 1 – Tense and relax your muscle groups from head to toe to ensure relaxed – bodyscan

B 2 – Breath in and out, counting slowly to 4 or 5 for each breath in or out. Recognise thoughts if they happen but refocus on your breathing

B 3 – When you start to notice thoughts are calmer create a bubble around you, give it form, colour and texture, be creative, really focus on it. Now create your world inside it, is it hot or cold, does it have a smell or colour? Is it a beach or a snowy mountain, use all your senses to create your world,. Give it as much detail as possible. The more you focus on your senses and the detail in the world the more control of your thoughts you will have and the calmer you will become. Try to focus on it for as long as you can – usually 5 minutes is a good time.

Remember if it doesn’t work for you or feels detrimental please stop using it.

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

Self-Care

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Self-Care is well known as an important area of remaining functional and productive. This is not unique to the therapist’s world, self-care is good practice for everyone. To spend time finding out what recharges our batteries and then doing those activities is crucial to living a full, happy and productive life.

A lot of the time people say ‘oh you should try self-care’ or ‘have you done self-care today?’ but they fail to tell people what self-care is or their description is so vague people have no idea what is meant by self-care.

Self-care isn’t elusive, or known by a few, it is something you do have to put a little effort into finding out. So as children we are excellent at self-care, we know just when we want to nap, or play in the mud, or climb trees, or read, or take the video player apart, or make a Lego castle…. I could go on but I think you get the idea. As adults we get so busy with work, housework, children, etc that we forget the skill children have called ‘how to do what we feel we should be doing’. This is self-care, those little indulgences that make us smile or relax or feel happy. This is however, unique to everyone. For some people it is cleaning for others this would be a chore. For some it is building play scenery at the local theater for others it is being in a busy concert, for others it is reading a book by a stream. No answer is wrong if it is right for you and harms no one else in the process. You may need to experiment with things until you find ones that ‘feel’ right for you, these may differ based on your personality, mental health needs, physical health needs, circumstances, but everyone can find something.

I recently surveyed people and I will share the results with you in as helpful way as possible.

What people class as self-care

I asked for what people do as self-care to help give you a starting point of things to try, some of these are expensive, some are free, others are in between, remember be adaptive and be yourself. I have created a self-care bingo card using their answers. Have a go at making your own then when you are in need you can pick it up, choose an activity and hopefully feel revived. To download and use the full bingo document click on the word Bingo below

Self-care Bingo

Journaling Crochet Knitting Sewing Nails Hair Crafts Art/painting/drawing Sleep Set boundaries
Cup of tea/coffee Camping Holiday Mini break Cross stitch Weaving Taking photos Comedy club/you tube comedy Spa day Woodwork, building
Cycling Saying no Pilates/yoga etc Redecorate Musical instrument Play music Sex Bath Gardening Sitting in garden
Book/reading Board games Computer games Sudoku/crossword etc Writing hiking Walking Theatre Cinema Turn phone off
Films TV shows Roleplay Model making/ warhammer Swimming Friends Singing Family time Talking out loud through a problem Pets
Running Jigsaws Cooking Going out for meal Gym Martial arts Meditation Audio books Housework Socialising

Just click on the link above to download your PDF copy

Frequency of self-care

This all depends some activities require more time or money than others, or are only available at certain times, so it is always good to try and find a selection of items to put on self-care bingo to give you the best chance of finding one when you need to.

Out of 25 people who responded to my survey 15/25 (3/5) of them said they went out at least once a week (some said they went out to activities multiple times a week), 6/26 said they went out once a fortnight, 3/25 said they went out once a month and 1 said they went out less frequently than once a month. So the average answer here is that most people go out at least once a week.

Average Costs of Self-Care

I asked people how much they would spend on ‘going’ out or ‘treating themselves’. I published this in my last blog to show how therapy could cost the same as self care but just to remind you here are the results. This proves that self-care does not have to be expensive, especially if the average going out is at least once a week.

The average spend out of 22 participants was £60

The lowest spend was £15

The maximum spend was £120

If you need more than Self Help and would like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304