Effective Therapy from Psychologists

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Counteract Stress and Difficulty by ‘Taking in the Good’

Posted: 28/05/2015

At times of ongoing stress or difficulty, have you ever noticed that when you schedule in something enjoyable to counteract stress and difficulty that it only works momentarily or ‘to a point’?

One reason can be that ‘taking in the good’ from any interaction or event is challenging as our brains are ‘elsewhere’ and are hard wired to focus on the negatives. So we know we ‘should be’ enjoying ourselves but somehow the effects of what we are doing are diluted – which can leave us feeling more dejected.

We know that our ancient ‘reptilian’ brains have a negativity bias – for survival ­ – and in everyday life this can make it difficult to for us to feel good, particularly when we feel bad. This is evident in research by relationships expert Gottman who found it typically takes around five positive interactions to overcome the effects of one single negative interaction like an argument. Or on an individual level, Seligman and colleagues have shown that it can be very hard to undo feelings of failure from one or two events even with many subsequent successes.

So we have work on our hands – to overcome our brain biases takes effort and practice.

To take in the good from something we need to attend to that thing for longer for the neural connections to start taking place. One way to do this is to be fully aware of what’s happening in the moment, to connect with how it feels to be here, now, doing this – in our bodies, in our feelings, in our minds. Then bathe in this ‘goodness’ for 5, 10, 20 seconds and feel the impact of this on you, on your day, or on your stress. One metaphor I particularly like is the idea that a stress or difficulty is ‘a wound’ and taking in the good from things is ‘the balm’ to soothe, heal and counteract the effects. For more on this see https://www.rickhanson.net/take-in-the-good/

 

Dr Samantha Leaity, Clinical Psychologist, Become Psychology

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Robin Williams tragic death and why shame is so important to combat in depression.

Posted: 13/08/2014

The sad and tragic death of actor Robin Williams by suicide is a powerful reminder that depression is a serious mental health problem affecting most people at least once in their lives.   Such deaths may leave you feeling worried about people in your life who you are close to who are suffering from depression, or way re-awaken painful feelings about love ones you may have lost to suicide.  This is understandable.  You may be someone who has or is suffering from depression and Robin Williams suicide may have left you feeling perhaps frightened or hopeless about overcoming your own depression.  One of the things that his death got me thinking about again is how often because of feelings of shame and stigma about having depression, people can struggle to open up and talk about their feelings.  Shame can make it very difficult to let someone in and for you to feel able to acknowledge to yourself what you are feeling.  Sometimes people feel they have to put on a front to the world and be cheerful, whilst on the inside they may be feeling terrible or perhaps shut-off or disconnected from their emotional pain.  To some extent we probably all do this sometimes to some degree – after all, have you ever said “I’m fine” to someone who asked how you were, when you were feeling bad?  I certainly have.  The relationship you have to your feelings will be influenced by the kind of upbringing you have – were you taught to keep your feelings to yourself because feelings were “embarrassing” or did it feel like you had to please others by keeping your feelings inside or putting your own needs aside?  In my experience as a Clinical Psychologist and Cognitive Analytic Therapist – the ways you relate to difficult feelings and to those close to you can make a difference in depression and indeed any other psychological problems you may be facing.  You can change these relationships for the better.  If you are concerned about someone else or worried about your own depression then I would encourage you not to suffer in silence.  Help is available – and please do contact me at www.become-psychology-london.co.uk if you want to discuss arranging an appointment.  Helpful information about Cognitive Analytic Therapy is available at www.acat.me.uk including a directory of therapists.

Dr Robert Watson, Clinical Psychologist, 13/08/14

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Nature or Nurture?

Posted: 23/07/2014

If you experience persistent anxiety or depression, its easy to feel that there is something fundamentally, innately wrong with you – hard wired into your nature. Its been known some time that the presence of a particular form of a gene (called the 5-HTTLPR) is associated with a range of mental health problems, but the mechanism of the link has been unclear. Recent research now suggests that this form of the gene may signal greater emotional sensitivity rather than anything inevitably problematic. The ‘Differential Susceptibility Model’ (Belsky & Pluess, 2009; 2010) proposes some individuals are more sensitive or ‘susceptible’ to their interpersonal context than others, particularly in childhood. The idea here is that with very good parenting (and an absence of any abuse) people with this form of the gene do extremely well in life, however, they struggle more than others if mistreated (see footnote for details). Interestingly, individuals with the sensitive version of the gene have more pulvinar neurons (Young et al, 2007). These neurons are involved in the processing of visual signals and maybe associated with a greater capacity to detect the emotional context of our environment, making the individual more emotionally sensitive. Pulling it together, it maybe that some of us need more from our interpersonal environment in childhood than others but, as adults, when we learn to seek this out and understand our sensitivity we can thrive.

Another hopeful finding is that recovery from psychological problems in therapy is associated with measurable changes at a structural and functional level in the brain. A raft of studies using functional MRI show that the brains of patients suffering from mental health problems look and behave differently from controls (those similar in other ways but without mental health problems). However, after successful therapy they are anatomically and functionally indistinguishable. Our brains appear to be highly ‘plastic’ even in adulthood, changing as a result of interpersonal and other significant experiences, including therapy. Personally, I like to image people’s neurons firing and connecting in therapy, changing the old patterns linked to fear and loss and creating new ones which combine sensitivity with a new found confidence and flexibility.

Foot Note

In a study on Macaque Monkeys (Suomi, 1997), baby monkeys with the ‘sensitive’ form of the gene raised by parents with exceptional parenting skills had much better developmental trajectories and adult functioning than all other groups. However, when raised by parents with poor parenting skills they struggled much more than their less sensitive peers. Monkeys with less sensitive versions of the gene were much less effected by the quality of parenting.   In line with these findings, a study of university students (Antypa & Van der Does, 2010), showed that childhood emotional abuse (measured retrospectively) appeared to have a much greater impact on adult depressive thinking for students with the more sensitive form of the gene. However, with low/absent levels of childhood emotional abuse, the sensitive group showed very healthy thinking styles. Students with the least sensitive version of the gene scored moderately, irrespective of the level of abuse reported.

By Dr Gill Heath, Become Psychology

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Why prejudice surrounding HIV still needs tackling: the Dallas Buyers Club.

Posted: 01/07/2014

I watched Dallas Buyers Club recently, which if you haven’t seen, is a film about a Texas Rodeo who contracts HIV in the 1980s, and sets up clandestine treatment centres for people living with HIV.  The film reminded me of the extreme prejudice and discrimination that people with HIV faced in the 1980s and some of the horrific stories of discrimination I was told about by my clients who lived in the 80s.   And how fear about HIV/AIDS brought out the best and the worst in people.   I have worked as a clinical psychologist in Sexual Health and HIV for over a decade now, and thankfully the bleak days of the early HIV epidemic are gone.  New treatments mean people with HV can have a normal life expectancy and treatment can prevent transmission.  Recently I have heard stories from clients and friends where people with HIV were rejected or shunned by someone because they disclosed their status.  This made me think that perhaps attitudes to HIV have not evolved as much as the medical treatments.  I think shame and stigma were always the biggest obstacles to HIV prevention and treatment efforts – they are a key reason why people don’t test – and starting treatment late can affect treatment outcome.   Prejudice may not be expressed as grotesquely as in Dallas Buyers Club any more, but the shame and stigma surrounding HIV needs to continue to be an important part of prevention and treatment efforts

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Is self-criticism helpful?

Posted: 22/06/2014

Competition and striving can be healthy ingredients for self-improvement and moving forwards but its how we achieve this that can be problematic. Over many years of working with people struggling with depression or anxiety I’ve  seen that more often than not at the heart of these difficulties lies an internal self-critic which undermines them, puts them down, and goads them, all in the name of so-called self-improvement. Repeatedly I hear how important self-criticism is to people and that without it they fear they will become lazy, demotivated, average or fail. Not only that, but when people are highly skilled in criticising themselves they can become equally critical and demanding of others around them – again often in the guise of improving things.

Self-criticism can be subtle, an internal message that ‘you’re not quite there yet’, or that ‘you should do better or do a bit more’. Our brains feed on this – in fact neurologically speaking that’s how they function – being Teflon for positive experiences and Velcro for negative experiences. So our brains are already primed to notice and remember when we get things wrong and when we fail. Unchecked, the long-term effects of self-criticism can be corrosive to our self-belief and faith in our ability to change. And it can be a major obstacle for change in therapy. Indeed, it often starts with people feeling to blame for having problems in the first place, which can translate into feeling that they don’t deserve to get better.

We know from research that when we are feeling bad self-criticism, and a coupled lack of self reassurance or self-warmth can make us vulnerable to depression and other emotional difficulties such as shame.  As an alternative, treating ourselves with self-compassion and kindness yield positive results for feeling better, feeling more motivated and unsurprisingly then for achieving things. Eastern ideologies such as Buddhism have drawn on these ideas for centuries and psychological research has now proven that self-compassion and loving kindness are not only important anti-dotes to emotional distress but also effective for overcoming anxiety, depression and other psychological issues – see www.compassionatemind.co.uk. One easy way to think of this is the ‘double-standards’ concept: think of a close friend who you care about deeply, who tells you they were feeling really down – what would you do and say? Would you criticise them in to action? The majority of people I ask say they would listen, understand, and actively encourage them with kindness, and wisdom. With practice we can learn to be our own supportive friends and treat ourselves with compassion. In turn, we are actively challenging the ‘Teflon for positive memories’ function in our brains and training ourselves to think, store and recall information differently. This can require a leap of faith on your part if you fear failure in the absence of self-criticism – but there is now robust evidence that self-criticism can sabotage change, wellbeing and happiness.

Samantha Leaity, Clinical Psychologist, Become Psychology

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