Types of Therapy

Person-Centred Counselling

Person-centred counselling is one of the humanistic modalities or approaches. It was founded in the 1940s by the American psychologist Carl Rogers who believed that, given the right conditions, a person can reach their full potential and become their true self, which he termed ‘self-actualisation’. This actualisation process is innate and accessible to everyone.

To help you achieve self-actualisation, the person-centred therapist will offer:

• unconditional positive regard (UPR) – accepting and valuing you
• congruence - being honest and transparent in how they experience you and your world
• empathic understanding – seeing your viewpoint as if they were you

When you’re attending counselling sessions with a person-centred counsellor, you’ll be encouraged to bring your own issues to the session – the counselling is led by you and not directed by the counsellor.

Many clients, with no prior knowledge of counselling, believe that the counsellor will sort their problems out for them. A person-centred counsellor will help you to explore your own issues, feelings, beliefs, behaviour, and worldview, so you can become more self-aware and achieve greater independence.

Discover your own abilities

Your therapist will help you to realise what resources and support are available to you that you can use to work through your own issues, build your self-confidence and appreciate that you always have options. They will treat you as the expert on yourself, as no-one else knows exactly what it’s like to be you.

They will not judge you, no matter what you bring to the session. This helps build a trustworthy relationship in which you can feel free and supported to disclose whatever is troubling you. Eventually it will lead you to discover your own abilities and autonomy, so that you can cope with current and future problems.

BACP 2022

Hypnotherapy

How does hypnotherapy work? Here we take a closer look at what hypnotherapy can help with and what to expect in a session

Hypnotherapy is one of those therapies that seems to be shrouded in mystery. Many of us have heard of it and may even have preconceived notions, but often we don’t know exactly what it is and how it can help. This sense of the unknown can stop us from looking at it as a viable option, which is a shame.

The beauty of the therapy world is that there are so many different options: from traditional talking therapies and life coaching to complementary therapies and hypnotherapy.

We always recommend discussing therapies with your doctor if you’re looking for support with a physical or mental illness and following their advice. In some cases, hypnotherapy can be used alongside counselling or other therapies, or you may turn to it when other approaches have failed.

To start with then – what exactly is hypnotherapy? It’s a therapy that works on the subconscious, the part of our mind we’re not consciously aware of. The subconscious is responsible for a great deal of thought processes and behaviours; the aim of hypnotherapy is to encourage positive change by communicating with it.

How does hypnotherapy work?

In order to communicate with your subconscious, you’ll need to be put into a hypnotic state. This may sound a little scary, but really it is just a very deep relaxation. You will still be completely aware of what’s happening around you.

Hypnotherapist Lorraine McReight explains: “In hypnosis, a person will be more open to suggestion and therefore able to change patterns of behaviour that are unhelpful, but no one can make you do anything you don’t want to do.”

When you are in this state, your hypnotherapist will use suggestion techniques to talk to your subconscious. The idea is to help you uncover the root causes of issues, change thought patterns, and ultimately change behaviour. There are different tools and techniques hypnotherapists can use here, depending on what you need support with.

You may need multiple sessions or just one – again this will depend on what you’re seeking help for. Many hypnotherapists will also teach you self-hypnosis techniques so you can continue the work outside of your sessions.

What can hypnotherapy help with?

Hypnotherapy can be used for lots of different concerns. Any issue that could have roots in the way you think and behave may be addressed. Having said this, there are certain conditions that are believed to not be helped by hypnotherapy, including psychosis and personality disorders.

The most popular ways hypnotherapy can help is by changing habits, helping with stress-related conditions, and easing anxiety. Here we look at some common issues that can be addressed with hypnotherapy.

Changing habits

Habits become hardwired into our subconscious which can make them difficult to change using willpower alone. If you have habits or behaviours you’re looking to alter, hypnotherapy may be able to support you. By suggesting different reactions and more positive behaviours, many people find success. Two areas people often turn to hypnotherapy for are changing eating habits and quitting smoking.

Eating habits – If you’re unhappy with your eating habits and your relationship with food, hypnotherapy could help. Many of us have a complex relationship with food and we may turn to it as a source of comfort. If this relationship becomes unhealthy and you’re looking for support with weight management, hypnotherapy can help you make positive and healthy changes.

Quitting smoking – There are several different methods to try and quit smoking, from going cold turkey to using nicotine replacement therapy. Hypnotherapy can be a great complement to these or a stand-alone method to quit smoking. The aim of hypnotherapy is to break the thinking patterns associated with smoking.

Stress-related conditions

When stress builds up it can really affect us, both physically and mentally. Hypnotherapy for stress looks to change negative responses to stress and offer a healthier alternative. As well as helping with stress in general, hypnotherapy can help with many stress-related conditions such as irritable bowel syndrome (IBS) and sleep problems.

Irritable bowel syndrome (IBS) – The link between our digestive system and our brain is becoming more and more apparent. IBS, for example, is known to be triggered by stress. So, by easing stress, symptoms can be reduced. Learning how to manage stress through hypnotherapy can therefore be very helpful for those with IBS.

The National Institute for Health and Care Excellence (NICE) even recognise hypnotherapy as a treatment option for IBS.

Insomnia – Stress can often lead to problems sleeping and may lead to insomnia. When you struggle to sleep, the cycle of not sleeping and worrying about not sleeping can become a pattern in our subconscious. This is where hypnotherapy can help – by speaking to the subconscious and changing these thought patterns.

Anxiety-related conditions

Another area hypnotherapy is proving to be powerful in is anxiety and anxiety-related conditions. Encouraging relaxation and new responses to stress, this approach can, in some cases, reach parts of the mind other therapies can’t.

Anxiety – The suggestions used in hypnotherapy to help with anxiety will depend on what specifically triggers you.

Phobias – Phobias generally live in our subconscious, making them ideal to approach with hypnotherapy. Your sessions may include understanding what first triggered your phobia and offering positive suggestions to change the way you think and feel about the phobia in question.

What happens in a hypnotherapy session?

If you’ve made the decision to try hypnotherapy, having a clearer idea of what will happen in your session can be helpful. It’s important to note that hypnotherapists may differ in their approach and sessions will vary depending on your individual circumstances.

With this in mind, hypnotherapists will typically begin with a consultation. This is where you can discuss what you’re hoping to gain from hypnotherapy, and they explain how it will be able to help. You’ll be able to discuss here how many sessions you’ll need and ask any questions you may have about the process.

After your consultation, many sessions will follow this pattern:

• An initial chat where you can ask any more questions and get comfortable.
• You will be led into a state of deep relaxation by your hypnotherapist.
• Once you are in a state of hypnosis the 'change work' can begin. Various techniques and approaches will be used here to help you achieve your goal.
• Once this is complete, you will be gradually brought out of your trance.
• At the end you can ask any more questions you may have, chat through a summary of the session and progress made so far.

Kat Nicholls

02/02/2020

www.happiful.com

Cognitive Behavioural Therapy (CBT)

Over the past 50 years, cognitive behavioural therapy – or CBT – has become one of the world’s most popular talking therapies.

What is CBT?

Falling under the umbrella of talking therapies, cognitive behavioural therapy combines two approaches – the cognitive (how we think) and the behavioural (how we act). The theory is quite simple: our thoughts and actions affect each other, so by changing the way we think or act in certain situations, we can change the way we feel. CBT looks at behaviours we have learned over time, habits we’ve picked up, and negative ways of thinking. The aim is to challenge these habits and behaviours, and ultimately change them to be more positive.

While some talking therapies encourage you to explore your past, CBT is very much rooted in the present, and looks towards the future. Past experience will, of course, be taken into account and considered, but the focus is on your situation in the here and now. The name of the game here is to help you break negative cycles. CBT does this by taking what may feel like an overwhelming problem and breaking it down into smaller, easier to manage chunks.

The therapy is a hands-on approach, with structures, goals, and tangible tasks. It requires effort (you’ll even have some homework!), but it’s a collaborative therapy, meaning your counsellor will work with you to find solutions.

How did it start?

CBT was founded by psychiatrist Aaron Beck in the 1960s. At the time, he was working in psychoanalysis, an approach looking at deep-rooted thoughts and repressed memories from childhood. Beck noticed that his patients were having a dialogue with themselves in their heads but were only reporting a fraction of this back to him. Beck recognised the link between thoughts and feelings and coined the term “automatic thoughts”. This much-misunderstood term describes the emotion-filled thoughts we have, though we are not necessarily aware of why we have them.

Beck also found that identifying unhelpful or negative automatic thoughts was key to helping clients understand and overcome difficulties. The process was known simply as cognitive therapy, but as behavioural techniques were slowly introduced, it became known as cognitive behavioural therapy.

What is cognitive distortion?

This rather scary-sounding term describes the inaccurate thoughts that fuel negative emotions. Essentially, they are “faulty” ways of thinking that make us believe things that simply aren’t true. There are many different types of cognitive distortions. Below are just three types that CBT can help to change:

1. Catastrophising: This happens when we blow negative events out of all proportion, or when we expect the absolute worst to happen. For example, if you feel you’ve made a mistake in a personal relationship with someone at work, instead of thinking reasonably, you think your boss will give you a written warning; or worse, you’ll lose your job! And then what?
2. Filtering: Filtering is when we ignore all the good things in our day and instead focus on that one tiny negative thing. So, while almost everyone is praising the amazing dinner you prepared, you dwell on that one dry comment about the pudding. Night ruined!
3. Black & white thinking: Also called “polarised thinking”, black and white thinking happens when we fail to appreciate the complexity or nuance of a situation. Someone sent you a vague text? Instead of brushing it off, you ignore the grey and see only black or white. It’s usually black.

The theory is quite simple: our thoughts and actions affect each other, so by changing the way we think or act in certain situations, we can change the way we feel

What is behavioural action?

This sounds even scarier! Fear not, behavioural action is used in CBT to help reverse your cycles of depression and low moods. It works by encouraging you to engage in “valued activities” – basically, things you love doing. It usually involves the following steps:

• Activity and mood monitoring – becoming more aware of your mood fluctuations.
• Relationships between activity and mood – understanding how certain activities affect your mood.
• Better mood activities – scheduling more activities that improve your mood.
• Achievement activities – balancing the activities you enjoy with those you don’t, but get achievement from.
• Action before motivation – doing activities even though you don’t really feel like doing them.
• Rewards – rewarding yourself for completing activities to keep your mood lifted, and to reinforce change.

Time to experiment

Experimentation helps you understand which thoughts and behaviours are helpful in your progress, and which are unhelpful. Behavioural experiments encourage you to test out some thoughts on yourself. For example, you could say: “If I am hard on myself at work, I will be more motivated.” Or you could say: “If I am kind to myself at work, I will be more motivated.” Here are some examples:

1. Thought Records: This experiment is when you gather evidence for and against certain thoughts. For example, if you had the thought: “My friend doesn’t like me anymore,” then you would think about the evidence for and against this thought (for: she doesn’t reply to my texts; against: she calls me to see how I’m doing). The aim is to come up with balanced, logical thinking.
2. Pleasant Activity: This is all about having something to look forward to. Activities could include meeting a friend for coffee, enjoying a long bath, or even taking a long walk through the park.
3. Imagery Based Exposure: This involves visualising a past negative event (say, an argument with your partner) and identifying your feelings or urges. The aim is to expose you to tough emotions so that you can survive them, thus taking away some of their power.

Five key techniques

There are lots of different techniques and tools that can be used in CBT, depending on what’s bothering you. Here are a few essentials you’re likely to come across during your treatment:

1. PMR: Progressive muscle relaxation focuses on one muscle group at a time, as you’re instructed to physically relax them. You can practise this at home by listening to an audio recording or following a video online.
2. Interoceptive Exposure: Exposure to bodily sensations (interoceptive exposure), used to treat panic and anxiety, is a technique that requires you to actually feel panic. The aim is to expose yourself to panicky sensations to recognise that they aren’t dangerous.
3. Structuring: Once you’ve identified distorted thoughts, you can learn how they took root in the first place. You can then build a structure of more positive and helpful ways of thinking.
4. Honest Communication: Working with your therapist through talking (and journalling outside of sessions), you can recognise which cognitive distortions are actually affecting your thinking.
5. Journalling: Writing about your moods and thoughts is an easy way to gather “data” for CBT sessions. You may be asked to keep a mood journal or to note down negative thoughts. This can help you to spot patterns and triggers.

CBT is helpful for many different mental health conditions, but it’s particularly effective for problems that involve depression, phobias, or anxiety

Advantages & disadvantages

The Pros - CBT can teach you practical coping skills to help you deal with different problems. It can be carried out in different formats: one-to-one, group therapy, or online! It offers a structured and practical way of work.

The Cons - CBT may not be suitable for people with complex mental health conditions, or people with learning difficulties. It requires effort and work outside of the session on your part, which some people can find difficult. It focuses on the individual’s ability to change, rather than looking at wider problems in systems or families.

How can CBT help you?

Studies show CBT is helpful for many different mental health conditions, but it’s particularly effective for problems that involve depression, phobias, or anxiety. CBT can also help the following:

• Eating Disorders
• Panic Disorder
• Phobias
• Post-Traumatic Stress Disorder Problems related to alcohol misuse
• Obsessive Compulsive Disorder
• Sleeping Disorders

Evidence is proving CBT to be a helpful form of therapy for many people, but like any therapy it may not be suitable for everyone.

Kat Nicholls

02/11/2017

www.happiful.com

Eye Movement Desensitization and Reprocessing (EMDR)

With an estimated three in 100 people in the UK experiencing PTSD during their lifetime, finding effective ways to respond to traumatic events is essential for us to heal. One option, already proven to be highly effective, is EMDR.

What is EMDR?

EMDR (Eye Movement Desensitisation and Reprocessing) is a psychotherapy that enables people to heal from the emotional distress, and psychological symptoms, that can result from disturbing life experiences. Developed in the 1980s by American psychologist Francine Shapiro, EMDR was originally created to resolve post-traumatic stress disorder (PTSD), although nowadays it has much wider applications. More than 100,000 clinicians throughout the world use EMDR, and millions of people have been treated successfully over the past 25 years.

How does EMDR work?

Usually, when an experience is upsetting, our “adaptive information processing” capacity means that we digest and make sense of the experience, and in time our distress goes away. However, if an experience, or a set of experiences over time, overwhelm us, this natural process can be disrupted. When this happens, the memories get stored with negative emotions, uncomfortable physical sensations, and limiting beliefs. The unresolved memories are not then linked to our wider memory networks, and so these upsetting emotions, thoughts, and sensations, can colour our perception of what is happening now. This means that, in a very real sense, the past is present. We react here and now to what was actually there and then, and this can be extremely upsetting and disruptive.

EMDR makes use of the mind’s natural ability to heal from disturbing experiences. The therapist uses an eight-step process to safely prepare you to process troubling experiences, and to integrate your changed experience into your mind-body system.

The processing element involves alternating attention between the past and the present, with stimulation of both sides of your mind/body system when you attend to the past. This prompts spontaneous connection-making, re-interpretation of the past, and integration of previously stuck memories into your wider memory network. The result is that the troubling memories stop being troubling; they recede into the past where they belong. This leaves you free to live in the here and now.

Who can benefit from EMDR therapy?

EMDR was originally developed to assist people who had been traumatised and had symptoms of PTSD. But EMDR therapy can also be effective in treating the “everyday” memories that cause people to experience low self-esteem, feelings of powerlessness, and attachment difficulties. There are protocols aimed at addictions, OCD and many other conditions. EMDR may help if you have persistent feelings and/or body sensations that are just not going away, or if you are caught in cycles of undermining thoughts and behaviours. The therapy works by identifying when and where these were initiated and resolving those experiences.

What’s the evidence?

Many studies have been conducted on EMDR therapy; across a broad spectrum of conditions the treatment could help with. These include a study published in the Journal of EMDR Practice and Research in 2013 on the use of EMDR with cancer patients, which found that 95% of those treated with EMDR no longer had PTSD symptoms after eight treatment sessions.

Another study, published in Psychotherapy, found that 100% of single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after six 50-minute sessions. In a study published in the Journal of Traumatic Stress, 77% of combat veterans were free of PTSD in 12 sessions.

Alongside these examples, there has been so much research on EMDR therapy that it is now recognised as an effective form of treatment for trauma, and other disturbing experiences, by the World Health Organisation and the National Institute for Health and Care Excellence (NICE) in the UK.

What can you expect?

So how does EMDR work? Firstly, clarity is needed about what is bringing you to therapy, and what you want the outcome to be. With your therapist, you’ll spend time gently piecing together the key experiences that contribute to your symptoms and see which are the most pressing to address.

Next, safety will be considered, because EMDR is not appropriate for everyone. If it’s right for you, your therapist will assist with building your ability to stay with uncomfortable emotions, body sensations and thoughts, and sometimes in building resilient aspects of yourself in case they are needed during processing. For some people, doing this work alone is enough to resolve difficulties.

EMDR processing then involves getting you fully into your distress reaction, to open up the brain circuits that are holding the distress. This is done by targeting a specific memory, and experiencing its current emotional, physical, and cognitive effects. It’s sometimes uncomfortable but is generally not as unpleasant as people fear. Although one memory is targeted at a time, you may move about between memories as processing unfolds – your therapist will help the work stay focused.

EMDR is a dance of attention between there and then, and here and now, alongside stimulation of both sides of the body (called bi-lateral stimulation and done with eye movements, touch/holding buzzers, and/or using headphones). It works by enabling your mind-body system to make connections between vulnerable, isolated parts of you and the wealth of resources that you already have that can help them. You continue working with memories until your symptoms are resolved or reduced to your satisfaction. This can take a few, or many, sessions, depending on the nature of your history and symptoms.

How does EMDR help people?

Clients often want to know how the change will happen. The truth is, I’ve not seen two cases that are the same. While the specific way memories are processed is highly individual, what is common is that levels of distress invariably come down during EMDR processing.

Some clients may experience distress between sessions for a while, with emotion, vivid dreams and sleep disturbance, or troubling thoughts. But as the work progresses, people tend to experience changing beliefs about themselves and their past situations, with positive, enabling beliefs spontaneously appearing and becoming deeply held. Physical sensations and emotions also tend to change, with disturbance felt in the body to begin with, and not later on. The protocols used in EMDR ensure that the changes needed have happened, and that memories are fully resolved before the work is complete.

Fe Robinson

25/05/2021

www.happiful.com

Neurofeedback

Neurofeedback is direct training of brain function, by which the brain learns to function more efficiently. We observe the brain in action from moment to moment. We show that information back to the person. And we reward the brain for changing its own activity to more appropriate patterns. This is a gradual learning process. It applies to any aspect of brain function that we can measure. Neurofeedback is also called EEG Biofeedback, because it is based on electrical brain activity, the electroencephalogram, or EEG. Neurofeedback is training in self-regulation. It is simply biofeedback applied to the brain directly. Self-regulation is a necessary part of good brain function. Self-regulation training allows the system (the central nervous system) to function better.

Neurofeedback addresses problems of brain dysregulation. These happen to be numerous. They include the anxiety-depression spectrum, attention deficits, behaviour disorders, various sleep disorders, headaches and migraines, PMS, and emotional disturbances. It is also useful for organic brain conditions such as seizures, the autism spectrum, and cerebral palsy.

How Does it Work?

We apply electrodes to the scalp to listen in on brainwave activity. We process the signal by computer, and we extract information about certain key brainwave frequencies. (All brainwave frequencies are equal, but some are more equal than others...) We show the ebb and flow of this activity back to the person, who attempts to change the activity level. Some frequencies we wish to promote. Others we wish to diminish. We present this information to the person in the form of a video game. The person is effectively playing the video game with his or her brain. Eventually the brainwave activity is "shaped" toward more desirable, more regulated performance. The frequencies we target, and the specific locations on the scalp where we listen in on the brain, are specific to the conditions we are trying to address, and specific to the individual.

Is Neurofeedback a Cure?

In the case of organic brain disorders, it can only be a matter of getting the brain to function better rather than of curing the condition. When it comes to problems of dysregulation, we would say that there is not a disease to be cured. Where dysregulation is the problem, self-regulation may very well be the remedy. But again, the word "cure" would not apply.

What Conditions Can it Help?

We are especially concerned with the more "intractable" brain-based problems of childhood whose needs are not currently being met. This includes, Seizures and sub-clinical seizure activity, severely disruptive behaviour disorders such as Conduct Disorder and Bipolar Disorder, Autistic spectrum and pervasive developmental delay, Cerebral palsy, acquired brain injury, Birth trauma.

Many children have sleep problems that can be helped such as Bed wetting, Sleep walking, sleep talking, Teeth grinding, Nightmares, Night terrors.

We can also be helpful with many of the problems of adolescence including Drug abuse, Suicidal behaviour, Anxiety, and depression.

We can also help to maintain good brain function as people get older. The good news is that almost any brain, regardless of its level of function, can be trained to function better.

BEHAVIOUR:

While medication and behavioural interventions can do a good job treating the symptoms of children with ADD or ADHD, neurofeedback retrains the brain to regain better control and focus. This method is about building up the person, focused on the qualities they possess.

STRESS & ANXIETY:

Anxiety is a common response to stress, and sufferers often feel overwhelmed, exhausted, and fatigued. Neurofeedback can help guide your brain to change how it responds to stimuli that disturb our physical or mental equilibrium.

PEAK PERFORMANCE:

Concentration, focus, and emotional control are key to achieving optimal performance in all fields. Athletes and business executives are taking advantage of neurofeedback technologies to learn how to utilize the full potential of their minds to reach their peak.

www.eeginfo.com