Category Archives: All Articles

Combining Hypnosis with Cognitive Behavioral Therapy.

empathy of bpd sufferers

Hypnosis And CBT :

Cognitive behavioral therapy, or CBT, is, essentially, a therapy which seeks to alter the way we think and behave in order to improve how we feel. CBT can be COMBINED with hypnotherapy in order to make it more effective. it is thought to make it more effective as it causes the individual being treated to become more receptive to the therapist’s suggestions, and, also, it enhances his/her ability to utilize imagery. Hypnosis can also help the individual being treated become more insightful into the causes of his/her psychological symptoms.

hypnosis and CBT

Above : Combining CBT with hypnosis lets us tap into both conscious and unconscious processing to help us find solutions to our problems.

Below, I provide some examples of areas of CBT in which hypnosis can help it become more effective in treating the patient:

1) THE USE OF POST HYPNOTIC SUGGESTION: For example, the individual being treated may be given the post-hypnotic suggestion (this is a suggestion made by the therapist to the effect that the individual will behave in a particular way once the hypnosis is over. An example of a post-hypnotic suggestion is: ‘whenever you have a negative thought you will challenge it and try to replace it with a more positive one.’

2) REFRAMING : Another area where it can be useful to combine hypnotherapy with CBT is by improving the ability of the individual being treated develop the skill of REFRAMING. Reframing refers to the skill, taught in CBT, of looking at a negative experience or situation and to try, with conscious effort, to interpret it in a more positive way.

3) INTRUSIVE THOUGHTS : Furthermore, it can help the individual under treatment identify INTRUSIVE THOUGHTS and more effectively control their emotional responses to such thoughts.

These are just some of the ways that hypnosis can be combined with CBT to both accelerate and augment its effectiveness. It is thought to do this by helping the individual under treatment FOCUS on the experience of therapy. It may, too, improve the therapeutic relationship between the therapist and the individual being treated, because, for example, the hypnotic experience tends to be comforting, and, also,to promote trust between the therapist and patient. Additionally, it can give the individual being treated a greater sense of security which often leads to greater compliance with the therapist’s suggestions.

.David Hosier BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma: How Those who Suffer Social Anxiety can Reduce Self-Consciousness.

social anxiety and self consciousness

Social Anxiety And Self Consciousness :

Self-consciousness, and concens about how others perceive us in social situations, both lie at the heart of social anxiety. At its worst, social anxiety can make interacting with others intolerably distressing, leading us to avoid social situations, or, as in my own case (especially in my teens, twenties, and, now I come to think of it, a not insignificant proportion of my thirties) resorting to the consumption of large volumes of alcohol in an attempt to ease social difficulties (once a certain amount is consumed, however, the difficulties can become immeasurably worse – an experience I am by no means a stranger to).

 

HOW DOES SELF-CONSCIOUSNESS MANIFEST ITSELF?

One of the main symptoms of self-consciousness is that we can become OBSESSED WITH WHAT WE BELIEVE OTHERS MIGHT BE THINKING OF US. The word ‘MIGHT’ in the last sentence is of great importance, however. Often, what we believe others MIGHT be thinking of us is not, in reality, what they are thinking at all; people, in very general terms, are very frequently indeed too preoccupied with their own worries and concerns to spend a lot of time dwelling on others. In other words, OFTEN, BECAUSE OUR TRAUMATIC CHILDHOOD EXPERIENCES LED US TO SEE OURSELVES IN A NEGATIVE LIGHT (maybe parents/step-parents treated us, as children, as though we were INTRINSICALLY BAD), we are prone, frequently, to fall into the trap of believing (FALSELY) that others, too, will always share a similarly jaundiced view of us.

We may also be fearful of how others may react to us. For example, if we experienced rejection as a child, we may have been ‘programmed’ to expect everyone, sooner or later, to reject us too. Of course, such an inference does not follow in any logical manner.

Social anxiety, then, frequently leads us to develop A DEEP FEAR OF SOCIAL INTERACTION. But what is it, precisely, that we actually fear? Research into this area suggests that, overwhelmingly, we fear how the social interaction will make us FEEL, rather than what may actually happen to us (someone being hostile, for example).

THE VICIOUS CYCLE THAT SOCIAL ANXIETY CREATES:

The fear generated by the social interaction can, and, very often, does, set up a VICIOUS CYCLE – THE MORE ANXIOUS WE FEEL, THE MORE DANGEROUS THE SOCIAL SITUATION SEEMS TO BE…SO WE FEEL YET MORE ANXIOUS…and so on…

SOME OF THE HALLMARKS OF SELF-CONSCIOUSNESS:

1) Self-consciousness can lead to PHYSICAL SENSATIONS; for example:

– shaking
– sweating
– physical agitation (eg clenching and unclenching the fists, fiddling with one’s hands etc).
– rapid and shallow breathing
– increased heart rate

2) Self-consciousness affects how we THINK about ourselves; for example:

– we may think that we are intrinsically unlikeable (let alone loveable), worthless, uninteresting, peculiar and odd. We may even consider ourselves a ‘freak’.

3) Self-consciousness affects how we FEEL; for example:

– fearful and at risk
– a sense of needing to escape or avoid the social situation
– selectively picking up (psychologists have termed this ‘SELECTIVE ATTENTION’) on ‘negative’ reactions towards us from others, whilst, at the same time, dismissing any positive feedback we may be attracting (I put the word ‘negative’ in inverted commas for good reason: this is because, very often, our social anxiety disturbs our perceptions – we may IMAGINE that others are responding negatively, when, in fact, this is simply a result of us MISINTERPRETING SIGNALS FROM OTHERS (eg misinterpreting body language, facial expressions, tone of voice etc).

HOW WE CAN REDUCE OUR SELF-CONSCIOUSNESS:

The main thing that the EXPERTS IN THIS FIELD SUGGEST is to:

FOCUS MORE ON EXTERNAL EVENTS (ie what is going on around us) and less on INTERNAL EVENTS (ie how we feel and the negative thoughts that may be running through our head). It helps, then, in social situations, to DIVERT OUR ATTENTION AWAY FROM OURSELVES AND RECHANNEL IT ONTO THOSE AROUND US.

Self-consciousness can also impair our ability to concentrate and follow exactly what others are saying to us in a social situation (ie we might frequently lose the thread of the conversation); because of this, experts also advise that we try to INCREASE OUR CONCENTRATION ON PRECISELY WHAT OTHERS ARE ACTUALLY SAYING. It is also important to keep in mind that the danger we perceive social situations to represent is ALMOST INVARIABLY FALSE.

We need, too, to attempt not to dwell on any unpleasant feelings social interaction gives rise to in us; if we pay too much attention to, say, our sweating palms, things tend to only be made worse. Any unpleasant feelings, then, that social situations may cause us to experience, need to be seen for what they are – merely feelings which FALSELY ANTICIPATE DANGER WHERE NO REAL RISK OF DANGER EXISTS. We need to just accept the feelings, non-judgementally, and view them as the FALSE IMPOSTORS that they are – then we are in a position to simply let them ‘wash over’ us.

Resources:

10-step hypnotherapy audio download program for Overcoming Social Anxiety click here.

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma: Mental Illness and Responses to Stigma.

mental illness and stigma

‘You must be the change you wish to see in the world.’
– Mahatma Ghandi

Mental Illness And Stigma :

As mental illness is dictated by a combination of environmental and genetic factors, it can happen to absolutely anyone. Even individuals a long way into adulthood, who have previously always enjoyed good mental health, can suddenly be plunged into a severe clinical depression by a single traumatic life event. Nobody is immune. Mental illness HAS NOTHING TO DO WITH PERSONAL FAILINGS.

However, stigma connected to mental illness is still far from uncommon. Others can stigmitize those of us who have suffered mental illness, and turn their backs in disdain and contempt with a feeling of smug, self-satisfied superiority, due to their lack of education on the matter; also, however, some people who suffer mental illness (having internalized society’s often less than compassionate take on the condition) can, in effect, self-stigmitize: because mental illness often causes negative thinking patterns and feelings of wortlessness, it is all too easy for us to fall into the trap of compounding our suffering by feeling bad about being mentally ill (we may see ourselves as weak, for example). In other words, we may add a kind of additional, unnecessary layer to our distress: feeling bad about ourselves for feeling bad about ourselves, as it were. This has been referred to by some psychologists as METAWORRYING.

It is, of course, generally easier to alter the way that we feel about ourselves than it is to change the way others feel about us; ignorance, after all, can have a dispiritingly tenacious quality. Therefore, a good place to start in the fight against stigma is to change how we see ourselves for having experienced mental illness: we need, in short, to stop stigmitizing ourselves.

mental illness and stigma

TACKLING STIGMITIZATION BY SOCIETY:

Whilst stigmitization by society, as I have said, still, obviously, exists, attitudes are improving all the time with greater public education and more and more individuals, with a prominent public profile, willing to talk openly about their own experience of mental illness (most notably, perhaps, in the UK, the writer, actor and comedian – and probably a lot of other things I can’t currently call to mind – Stephen Fry, who suffers bipolar disorder).

Progress has been made in society in relation to racism and homophobia, and, it would seem, there is no obvious reason why similar progress should not be made in relation to society’s attitude towards those unfortunate enough to experience mental illness.

THE FIRST STEP:

The first step we can all make, as I have suggested, is to stop blaming ourselves, and feeling bad about ourselves, for having suffered psychological difficulties (hence the reference to the quote by Ghandi at the top of this post!).

If you would like to learn more about fighting the stigma surrounding mental illness you may wish to pay a visit to www.shift.org.uk to see what they are doing in their campaign in relation to this. The campaign, for those who are interested, is run by The National Institute for Mental Health, UK.

David Hosier BSc Hons; MSc; PGDE(FAHE).

What Neuroimaging Tells Us About Hypnosis.

childhood_trauma_effects

Hypnosis And Neuroimaging :

Neuroimaging refers to a technique of examining which areas of the brain are active at any one time and can tell us something about how hypnosis works it involves the use of very expensive equipment which can display images of brain activity when the brain is involved with various tasks. I will start off by looking at neuroimaging in relation to the brain’s experience of pain.

NEUROIMAGING AND THE EXPERIENCE OF PAIN:

A study by Rainville et al (1997), using a brain imaging technique, showed that when a HYPNOTIZED subject was given the HYPNOTIC SUGGESTION THAT HE WOULD EXPERIENCE PAIN (ie he wasn’t exposed to a real painful stimulus), the degree of activity in a brain regions associated with the experience of real pain (SOMATOSENSORY CORTICAL AREAS) could be increased and decreased by the experimenter making the suggestions that the subject was experiencing more or less pain respectively.

Another study, by Derbyshire et al (2004), again using NEUROIMAGING, found that subjects given the hypnotic suggestion that they were experiencing pain showed a similar response in brain acivity. However, those subjects merely instructed to IMAGINE PAIN (WITHOUT HYPNOSIS) did NOT display the activity.

hypnosis and neuroimaging

These studies suggest that, under hypnosis, without the application of a real painful stimulus, subjects can be caused to experience pain by the hypnotic suggestion that they will experience it. It seems, too, hypnosis is having a real effect, as merely telling the subject to imagine pain (without use of hypnosis, does not have the same effect).

It seems as if, according to such studies, effects of hypnotic suggestion are GENUINE, not only at the subjective level, but also in as far as they have been shown to EFFECT BRAIN FUNCTION IN A MANNER WHICH SHOWS UP VIA NEUROIMAGING: it appears that hypnotically suggested experiences CAN CAUSE SIMILAR BRAIN ACTIVITY PATTERNS TO THOSE WHICH WOULD BE CAUSED IF THE EXPERIENCE WERE REAL.

POSSIBLE APPLICATIONS:

If hypnotically suggested experiences have a similar effect on the brain as real ones, there follow implications for treatment of conditions that make use of exposure therapy, such as phobias (ie the person suffering from the phobia could be given the hypnotic suggestion that s/he was exposed to the feared object as part of the DESENSITIZATION PROCESS; that is, getting used to the object feared so that the fear it induces gradually diminishes over time.

A caveat, however, is that  studies of brain imaging in relation to hypnosis have not given consistent results; more studies into this area of research need to be conducted.

NEUROIMAGING, HYPNOSIS AND MOOD:

Marquet et al (1999), using a neuroimaging technique, discovered that subjects given the instruction, under hypnosis, to re-experience pleasant memories from their own lives showed significantly more activation in related brain regions (eg the PREFRONTAL CORTEX and OCCIPITAL LOBE) than when they they were merely instructed to imagine the same events (not under hypnosis); again, this suggests that the HYPNOTIC EFFECT IS A REAL ONE, with real, OBSERVERABLE effects on brain activity. Again, however, a lot more research needs to be conducted in order to clarify the relationship between hypnosis and its effect upon brain activity.

David Hosier BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma: Treating the Root Cause of Related Symptoms.

childhood trauma and root cause of symptoms

I had been perplexed for a very long time, given the emotional symptoms I was experiencing, which, it had always been obvious to me, were in large part related to my childhood experiences, why I had never been offered therapy, by the NHS, which could specifically address this issue. In fact, the professionals I had seen, incuding GPs and psychiatrists, rarely, if ever, asked me about my childhood, nor did they seek, in any way that I could ascertain, to link my symptoms to it. I can only assume that therapy addressing emotional problems which are linked to childhood experiences are deemed to be too expensive; perhaps it relates to where you happen to live, as different regions have different budgeting priorities. I know, though, that such therapies are available.

MEDICAL MODEL :

It is a common problem. In the UK, mental illness is almost invariably addressed using the MEDICAL MODEL (ie drugs are used to alter brain biochemistry). Some studies have shown, however, that anti-depressants work no better than PLACEBOS. We must ask, then, if, in many cases, treating mental illness with drugs is simply inappropriate? Would it not be better, in a lot of cases, to address the root cause of the symptoms -childhood trauma and/or other relevant life experiences?

PSYCHODYNAMIC AND PSYCHOANALYTIC PSYCHOTHERAPY:

These tharapies both seek to address root causes of adult psychological difficulties. Many of my posts have already discussed the fact that childhood trauma, very often, lessens (often, through physiological effects on the brain) the individual’s ablility to cope with stress in adult life. Here is a recap of symptoms childhood trauma can lead to:

– alcohol/drug misuse
– dissociative disorders (see my post on this in the ‘EFFECTS OF CHILDHOOD TRAUMA’ category).
– self-harm (eg cutting self with sharp instrument, burning self with cigarette ends – see my post on this in above category)
– suicide attempts, suicide
– eating disorders
– acute depression
– extreme anxiety
– post-traumatic stress disorder (see my post on this in above category)
– obsessive-compulsive disorder

childhood trauma and treating the root cause of symptoms

Clearly, such difficulties can cause the individual severe distress, so it is important to investigate ALL the possible treatment options.

Psychodynamic and psychoanalytic psychotherapy aims, as I have already said,to address the root cause of distressing psychological symptoms: they are based upon the idea that we all SUPPRESS (ie bury deep down in the mind) feelings that, if they were allowed full access to consciousness, would OVERWHELM us with ANXIETY and EMOTIONAL PAIN. However, this requires psychological effort, and, in order to keep them suppressed, we must employ DEFENSE MECHANISMS (these may be employed both on conscious and unconscious levels). Examples of such defense mechanisms are PROJECTION and REACTION FORMATION:

– PROJECTION: this refers to how we EXTERNALIZE things we dislike about OURSELVES. For example, someone who is (needlessly) ashamed of being homosexual may go around calling everybody else ‘gay’ (using the word in a perjorative sense, of course)

– REACTION FORMATION: here, the individual feels the need to constantly proclaim s/he is not what, deep down, perhaps unconsciously, s/he feels s/he actually is. For example, someone who suppresses their aggressive instincts may feel the need to constantly proclaim how peace loving they are and how incapable of inflicting physical harm on others. In Shakespeare’s play, HAMLET, Iago seems to be aware of this psychological concept of reaction formation when he states, heavy with insinuation: ‘Methinks she protests too much’. Indeed, many of Freud’s ideas were anticipated in Shakespeare’s works.

There are other defense mechanisms which would take up too much space to go into here, but they all involve CUTTING OURSELVES OFF FROM OUR TRUE FEELINGS or trying to banish them in other ways, due to real, or perceived, societal and cultural demands.

It is thought that the MORE PAINFUL AND DIFFICULT KEEPING THE FEELINGS SUPPRESSED IS, THE MORE PSYCHOLOGICAL EFFORT THE MECHANISM OF SUPRESSION TAKES UP, and, therefore, THE MORE INTENSE THE REPERCUSSIONS, OR COSTS, IN TERMS OF PSYCHOLOGICAL SYMPTOMS, ARE (see list above for examples of these symptoms).

Psychotherapy aims to get us in touch with the feelings we are suppressing and work through them; some types of psychotherapy aim to bring what is buried in the unconscious into conscious awareness to enable such a process.

TYPES OF THERAPIES AVAILABLE:

1) SHORT-TERM PSYCHODYNAMIC PSYCHOTHERAPY: this usually consists of about 20 sessions spread over 20 weeks.

2) PSYCHOANALYTIC PSYCHOTHERAPY: this can consist of 2 or 3 sessions per week. There is no time limit – as many sessions are provided as required.

3) PSYCHOANALYSIS: this can comprise up to 5 sessions per week. Again, there is no time limit and as many sessions are provided as required.

By working through suppressed feelings (such as anger or fear) with the therapist, the rationale is that the past gradually loses its grip on the present, and, thus, its power to cause continued suffering.

DOES IT WORK?

Certainly, if considering such therapy, great care is needed when selecting a suitable therapist (eg checking their training, success rate, recommendations etc) as it is possible the treatment can do more harm than good if not properly implemented.

The psychologist, Hans Eysenck, argued that patients who underwent psychoanalysis recovered from their psychological difficulties no better than untreated controls. HOWEVER, there is, in fact, plenty of research which SUPPORTS its effectiveness; for example: Roth et al (1996) and, also, Holmes et al (1995).

David Hosier BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma: Identity Problems and How to Tackle Them.,

childhood_trauma_questionnaire

One outcome of childhood trauma can frequently be that the person who has suffered it is prone to develop IDENTITY PROBLEMS.

A person’s identity represents their attempt to pin down the essential elements s/he sees (rather than what others see) that make the individual who s/he are. One’s identity develops over time.

Our identity can be helpful to our psychological health (if we see ourselves in largely positive terms) or unhelpful to it (if we see ourselves in largely negative terms). People, especially if suffering from depression, lacking in confidence etc, extremely often view themselves FAR MORE NEGATIVELY THAN WOULD BE OBJECTIVELY WARRANTED; whereas many others (not suffering from mental illness, in many cases) may see themselves in far too glowing terms (this ‘over self-congratulatory’ view adopted by many is thought to have developed to confer evolutionary advantages on those who have it – appearing confident to potential mates, for example – provided, I suppose, it is not absurdly exaggerated).

Aspects of our lives which can affect our identities include:

– our values
– our physical appearance
– our mental/physical health
– our education
– our achievements (or lack, thereof)
– our work (Freud attributed especial importance to this, as he did to sexual fulfilment, the thwarting of which, he proposed, could lead to extreme neurosis)
– our relationships
– our age (please, don’t remind me)
– our financial situation
– our perception of our social status (or lack, again, thereof)

The identity which emerges from such factors is strongly related to our self-esteem and self-confidence.

IDENTITY DEVELOPMENT:

This begins very early in our lives. Ages 4 years to 6 years are thought to be a critical time; TRAUMA during this period is LINKED to the DEVELOPMENT OF IDENTITY PROBLEMS IN LATER LIFE. From the ages of about 6 years to 12 years, the child normally develops the skills necessary to MANAGE EMOTIONS, a skill strongly linked to identity (eg ‘cool’ versus ‘volatile’); indeed, if TRAUMA INTERFERES WITH THIS PROCESS AN EXTREMELY TEMPESTUOUS ADOLESCENCE CAN FOLLOW).

In ‘normal’ development, adolescents may experiment with various identities and this process gradually leads to the stage in which there is a sense of the identity becoming crystallized. Again, however, individuals affected by trauma will often find this period exceptionally stressful and find that NO CLEAR SENSE OF THEIR OWN IDENTITY EMERGES – THEIR SENSE OF THEIR OWN IDENTITY CAN BE CONFUSED AND THEY MAY FEEL THAT THEY ‘DON’T KNOW WHO THEY REALLY ARE’.

CONFUSED IDENTITY IN ADULTHOOD AS A RESULT OF CHILDHOOD TRAUMA:

By adulthood, then, those who have experienced childhood trauma will often find that their identity is UNSTABLE and FRAGILE – this will often mean that their attitudes, values and sense of who they are are all prone to wildly fluctuation; these changes are frequently dramatic (eg oscillating between feeling deep love and deep hatred towards the same person; or, sometimes, perhaps, feeling exceptionally important only to shift without warning or obvious trigger into a feeling of despair, self-loathing and worthlessness).

IDENTITIY PROBLEMS AND BORDERLINE PERSONALITY DISORDER (BPD):

Identity problems in adulthood are often a symptom of BPD. BPD frequently occurs as a result of childhood trauma and much more about the condition can be discovered in the by clicking here to read my article about it.

DEVELOPING A MORE CONSISTENT AND STRONGER SENSE OF ONE’S IDENTITY:

How can people with identity problems make their sense of identity stronger? One possible place to start this process, which needs to be gradually worked on over time, is for the individual suffering from the crisis in identity to consider the things which are of most importance to him/her in life; identities are largely formed based on these considerations. Prorities in life which people choose to concentrate on, and, which, therefore, contribute to making up their identities include:

– friendships/relationships/family
– academic interests
– career
– creativity (eg painting, writing, acting)
– hobbies
– choice of entertainment (eg musical taste, taste in film/cinema/theatre, favourite kinds of books etc)
– material possessions
– spirituality/religion/atheism/agnosticism
– charity work (eg for homeless, rehabilitation of ex-prisoners, environment, hospice, Amnesty International)
– physical appearance
– financial situation

This is not, of course, an exhaustive list and there may well be other areas that can be added, depending on preferences.

A starting point might be to pick out 3 or 4 areas of interest (this, in itself, reflects identity, and, therefore, can be seen as providing foundational pieces of the jig-saw yet to emerge, as it were) and to concentrate on these at first (other elements can be added later; merely starting the process may lead to other ideas emerging at a later time).

For each of the factors selected, it can then prove of use to set some goals relating to how these areas may be incorporated, or, more fully incorporated, into one’s life (these goals need to be quite specific and achievable; there is little point starting with such challenging goals that they may prove impossible to meet and thus damage morale).

Here are some examples:

– because academic achievement is important to me, I will enrol in a night-school class (investigate and specify appropriate course) and complete the course
– because family and/or friends are important to me I will attend an anger management course
– because creativity is important to me I will set aside two hours a week to write poetry/novel
– because my mental health is important to me I will seek out appropriate counselling and complete the sessios recommended (provided the therapy proves of potential value, of course)

The more the individual is able to incorporate and develop areas such as those listed above, which reflect his/her true values, interests and priorities, the more AUTHENTIC and REWARDING the person’s life is likely to be; the more, too, will the individual’s true and stable sense of self continue to evolve.

RESOURCES :

OVERCOME IDENTITY PROBLEMS MP3. CLICK HERE.

David Hosier BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma: Eye Movement Desensitisation and Reprocessing (EMDR).

EMDR

Individuals who have suffered severe childhood trauma may, as a result of it, later suffer from Post-Traumatic Stress Disorder (PTSD), or similar condition. Some professionals advocate a relatively new technique which aims to address this; it is known as Eye Movement Desensitisation and Reprocessing (EMDR).

WHAT IS EMDR?

The therapist administering EMDR will first examine the issues related to the individual’s psychological difficulties and, also, help him/her develop strategies to aid in relaxation and deal with stress. After this, the therapist encourages the individual to recall particular traumas, whilst, simultaneously, manipulating his/her eye movements by instructing him/her to follow the movements the therapist is making with a pen, or similar object, in front of the individual’s face). The theory is that this will facilitate the individual in effectively reprocessing his/her traumatic experiences, thus alleviating psychological distress.

THIS SOUNDS A LITTLE ODD; WHAT IS THE RATIONALE BEHIND EMDR AND, HOW, EXACTLY, IS IT THOUGHT TO WORK?

My first reaction to hearing about this particular therapy was that it sounded somewhat strange. However, the rationale behind EMDR is that disturbing memories from childhood need to be PROPERLY PROCESSED by the brain in order to alleviate symptoms associated with having experienced childhood trauma (eg PTSD, as already mentioned); this is because the view is taken that it is the UNRESOLVED TRAUMA that is the cause of the psychiatric difficulties the individual who presents him/herself for treatment is suffering. Those professionals who recommend the therapy believe that the EYE MOVEMENTS INDUCED BY THE THERAPIST IN THE INDIVIDUAL BEING TREATED LEAD TO NEUROLOGICAL AND PHYSIOLOGICAL CHANGES IN THE BRAIN WHICH AID IN THE EFFECTIVE REPROCESSING OF THE TRAUMATIC MEMORY, and, in this way, ameliorates psychological problems from which the individual had been suffering.

emdremdr

WHAT ARE THE STAGES INVOLVED IN EMDR THERAPY?

These are briefly outlined below:

1) The first stage is the identification of the specific memory/memories which underlie the trauma.

2) Next, the individual is asked to identify particular negative beliefs he/she links to the memory (eg ‘I am worthless’)

3) Then, the individual being treated is asked to replace the negative belief with a positive belief (eg ‘I am strong enough to recover’ or ‘I am a person of value with potential to have a bright future’ etc)

4) In the fourth stage, the therapist moves a pen (or similar object) in various, predetermined motions in front of the individual’s face and he/she is instructed to follow the movements with his/her eyes (eg repeatedly left and right). Whilst this is going on, the therapist instructs the individual to simply, nonjudgmentally observe his/her own thoughts, letting them come and go freely and without trying to influence them in any way – just to accept them, in other words, and let them happen.

5) This procedure is repeated several times.

Each time the process is undertaken, the therapist asks the individual being treated to rate how much distress he/she feels – this continues until his/her self-reported level of distress becomes very low. Similarly, each time the process is undertaken, the individual is asked to report how strongly he/she now feels he/she believes in the positive idea given in stage 3 (see examples provided above); therapy is only concluded once the level of reported belief becomes very high.

NB. The therapy is actually more involved than this, so the above should only be taken as a brief outline. There are, too, different variations of procedure outlined above which can be employed within the EMDR range of therapies available.

WHAT DO EVALUATION STUDIES OF EMDR THERAPY SUGGEST ABOUT ITS EFFECTIVENESS?

A recent meta-analysis of evidence (ie an overview of a large number of particular, individual studies of EMDR) supported the claim that it is effective, as have other meta-analyses. However, some researchers have suggested that it is not the EYE MOVEMENT PART of the therapy which is of benefit, but only the act of repeatedly recalling traumatic memories which is the effective component (based on the idea that these repeated mental exposures, under close supervision and in a supportive and safe environment, of the traumatic memories alone facilitates their therapeutic reprocessing).

In response to this criticism, its exponents (and there are many professionals who are), regard the EYE MOVEMENT COMPONENT of the therapy as ESSENTIAL in giving rise to the NECESSARY NEUROLOGICAL CHANGES which allow the EFFECTIVE REPROCESSING OF THE TRAUMA; these proponents also emphasize that the therapy only requires short exposures to the traumatic memory/memories, thus giving it an advantage over therapies which utilize far more protracted exposures.

Research into EMDR is ongoing.

eBooks :

borderline personality disorder ebook

 

Both above eBooks available on Amazon for immediate download. CLICK HERE.

David Hosier BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma: The Five Main Personality Disorders.

Because childhood trauma has frequently been linked to the later development of borderline personality disorder (BPD), I have devoted a whole category of this blog to the analysis of that particular condition (see CATEGORIES section). However, as childhood trauma can also contribute to other personality disorders, I have decided it might be of help to outline the symptoms of those I have not yet covered.

The five main personality disorders are:

– PARANOID
– SCHIZOTYPAL
– ANTISOCIAL
– NARCISSITIC
– BORDERLINE

I elaborate on these below; first, however, it is worth pointing out that it is estimated 14% of the population suffer from one of the personality disorders. Let’s look at them now:

1) PARANOID PERSONALITY DISORDER: it is thought that as many as one in twenty people could suffer from this disorder. Individuals who suffer from it find it very hard to trust others and view the world in general with suspicion. Some important features of the condition suffered by individuals include:

– a feeling others relentlessly victimize them
– a feeling of being unacceptable to society
– an expectation others will betray them / being on the look out (perhaps obsessively) for signs of such betrayal
– feelings of intense jealousy (particularly in relation to partner)
– a marked tendency to hold onto resentments against others
– a marked tendency to be excessively critical of others

Often, such individuals will not seek professional help as they will frequently have a deep distrust of therapists and may, too, lack insight into their condition. Whilst environmental factors are at play in the development of this disorder, genes are also believed to have a significant role.

2) SCHIZOTYPAL PERSONALITY DISORDER: about 2% of the population are thought to suffer from this. Those affected suffer social anxiety, lack social skills and avoid close relationships. Also, they frequently have strange ideas and bizarre ways of behaving. Key features of this condition suffered by individuals include:

– bizarre fantasies and superstitions (eg belief in telepathy)

– ‘ideas of reference’: this is the belief that events relate to the sufferer when, in reality, they do not. For example, a sufferer might believe that a newspaper headline refers to him/her or that a TV news item is about him/her.

‘poverty of speech’: this refers to speech which is vague, confused and difficult to follow or make sense of (over-use of inappropriate and odd metaphors is not unusual).

– paranoia (see above)

– beliefs that parts of their body (eg an arm) are being controlled by outside or supernatural forces

With this disorder, too, genetics are thought to play a significant role. It is linked to schizophrenia, a more serious condition, but does not necessarily lead to full-blown symptoms of this.

3) ANTISOCIAL PERSONALITY DIASORDER: about 2% of the population is thought to suffer from this condition; it is much more common amongst males. It is also believed that up to 80% of the prison population, at any one time, comprises individuals with this condition. Individuals with the disorder lack empathy, feel little or no remorse (ie lack what is commonly referred to as a conscience), care little about the generally accepted rules of society and can frequently be violent. However, not all are violent and many can function, even excel, in society by capitalizing on personality traits such as ruthlessness, manipulativeness, and, not infrequently, a superficial charm, to become, for example, successful politicians or CEOs. Key features of the disorder include:

– frequent lying
– lack of feelings of guilt
– aggression
– irresponsible behaviours
– indifference to the suffering of others/lack of compassion
– irritabilty and hostility
– frequent impulsivity

Individuals with the disorder very frequently crave power and this ‘power lust’ will usually take precedence over forming long-term, meaningful relationships.

4) NARCISSISTIC PERSONALITY DISORDER: some have speculated that this disorder is becoming more common in what is sometimes referred to as the current ‘ME-GENERATION’ or ‘X-FACTOR GENERATION’ (I never watch it. Honestly). At present, however, it is estimated about 1% of the population suffer from it. Individuals who are affected by it tend to be what many might term ‘attention-seekers’. They will also tend to have a grandiose self-image, believing that they are somehow entitled to special treatment. Their enormous self-regard and sense of self-importance can lead to them behaving in a very arrogant and off-hand manner. Key features of the condition include:

– self-absorption/self-obsessiveness
– a sense of great specialness
– a grandiose self-view
– a lack of empathy for others
– frequent feelings of great envy or jealousy
– a predisposition towards the exploitation of others
– intense competitiveness

These individuals may, too, greatly over-estimate their own talents, perhaps expecting to become an enormous success, rich and famous (X -FACTOR comes to mind again here, for some reason). Rather than engaging with others on a ‘normal’ emotional level, they may uniformly see others, essentially, as merely providing them with an audience.

5) BORDERLINE PERSONALITY DISORDER (this is covered extensively elsewhere in this blog; see CATEGORIES section).

I hope you have found this post interesting. I add new posts to this blog at least twice per week, and, you are, of course, welcome to FOLLOW it by clicking on the appropriate icon. The post can also be shared via FACEBOOK or TWITTER (see icons).

Best Wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma: Borderline Personality Disorder – Should Sufferers Tell Others They Have It?

childhood-trauma-fact-sheet

Deciding whether to tell others about the fact one is suffering from BPD presents a very difficult dilemma: on the one hand, there is the worry of being stigmatized and discriminated against, and, on the other, there is the possibility that others will become more understanding of one.

Because few people, through no fault of their own, are well educated about psychological issues, the decision a sufferer of BPD must make as to whether or not to tell others is one that cannot be taken lightly. However, it need not be an ‘all-or-nothing’ decision: it is obviously possible to tell some people (if reasonably believed to be entirely trustworthy) whilst not telling others; similarly, it is possible to decide how much detail it is necessary (or not) to go into.

First of all, let’s look at the possible benefits (and it important to note the word ‘possible’, as they are by no means guaranteed) which might come from telling others:

– those told might become more empathetic, understanding and forgiving
– those told might feel closer to you as a result
– those told might wish to offer some help and support

I REPEAT, THOUGH, NONE OF THESE POSITIVE OUTCOMES CAN, IN ANY WAY, BE COUNTED ON:

So let’s now consider some possible negative repercussions:

– those told may hurt the sufferer further by ‘not wanting to know’
– those told may tell others that the sufferer did not wish them to tell, thus betraying their trust. Then, sadly as we all know, some people have an unlimited capacity to entertain themselves with malicious gossip
– the sufferer may be met with discrimination
– if the sufferer tells people that s/he has a personality disorder, which carries with it very negative connatations, they may consider the sufferer ‘crazy’ or ‘mad’ due to their lack of knowledge and, conceivably, fear
– people told may lose the confidence or motivation to interact with the sufferer further
– people may cynically think that the sufferer is trying to provide an excuse for their mistakes

It is worth re-emphasizing that, because it is impossible to predict with complete accuracy how another will respond, the decision about what to tell and whom to tell should be given a great deal of thought.

THE USEFULNESS OF FIRST GETTING PROFESSIONAL ADVICE AND SUPPORT:

It is recommended, very strongly, that anyone suffering from BPD should seek professional therapy. With more and more research being conducted on the condition, positive treatment outcomes for those with BPD are continually increasing in likelihood. Professionals who can help treat BPD, and provide advice and support include:

– psychiatrists
– psychologists
– counsellors
– social workers specializing in mental health issues
– family therapists
– community mental health nurses

Such professionals can help the sufferer to come to a decision about considerations which may include:

– whether to tell others/whom to tell
– any treatment being received/considered
– specific symptoms the sufferer experiences which are believed to stem from the condition of BPD
– the causes of BPD (particular care is adviseable hear if explaining these to someone the sufferer believes may have contributed to their development of the condition).

NB Any decision to inform an employer of one’s condition should definitely only be undertaken once the relevant advice (including legal advice regarding the relevant discrimination laws, which are a mine-field) has been sought. It should be borne in mind that legal disputes with an employer, especially regarding such a sensitive issue as discrimination law, can be extremely stressful and emotionally draining.

Finally, it is worth saying that, in general, is easier to discuss the condition with others if one has spent some to researching it.

borderline personality disorder and childhood traums

Above eBook now available on Amazon for instant download.CLICK HERE.

Best wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).

Childhood Trauma: Its Relationship to Psychopathy.

Childhood Trauma And Psychopathy

What is the nature of the relationship between childhood trauma and psychopathy?

The term ‘psychopath’ is often used by the tabloid press. In fact, the diagnosis of ‘psychopath’ is no longer given – instead, the term ‘anti-social personality disorder’ is generally used.

When the word ‘psychopath’ is employed by the press, it tends to be used for its ‘sensational’ value to refer to a cold-blooded killer who may (or may not) have a diagnosis of mental illness.

It is very important to point out, however, that it is extremely rare for a person who is suffering from mental illness to commit a murder; someone suffering from very acute paranoid schizophrenia may have a delusional belief that others are a great danger to him/her (this might involve, say, terryfying hallucinations) and kill in response to that – I repeat, though, such events are very rare indeed: mentally ill people are far more likely to be a threat to themselves than to others (eg through self-harming, substance abuse or suicidal behaviours).

The word psychopath actually derives from Greek:

psych = mind

pathos = suffering

Someone who is a ‘psychopath’ (ie has been diagnosed with anti-social personality disorder) needs to fulfil the following criteria:

– inability to feel guilt or remorse
– lack of empathy
– shallow emotions
– inability to learn from experience in relation to dysfunctional behaviour

Often, psychopaths will possess considerable charisma, intelligence and charm; however, they will also be dishonest, manipulative and bullying, prepared to employ violence in order to achieve their aims.

As ‘psychopaths’ reach middle-age, fewer and fewer of them remain at large in society due to the fact that by this time they are normally incarcerated or dead from causes such as suicide, drug overdose or violent incidents (possibly by provoking a ‘fellow psychopath’ to murder them). However, it has also been suggested that some possess the skills necessary to integrate themselves into society (mainly by having decision making skills which enable this and operating in an context suited to their abilities, for example where cold judgment and ruthlessness are an advantage) and become very, even exceptionally, successful; perhaps it comes as little surprise, then, that they are thought to tend to be statistically over-represented in, for example, politics and in CEO roles (think Monty Burns from The Simpsons, though I’m aware he’s not real. Obviously.).

WHAT KINDS OF CHILDHOODS HAVE ADULT ‘PSYCHOPATHS’ HAD?

Research shows that ‘psychopaths’ tend to be a product of ENVIRONMENT rather than nature – ie they are MADE rather than born. They also tend to have suffered horrendous childhoods either at the hands of their own parent/s or those who were supposed to have been caring for them – perhaps suffering extreme violence or neglect.

Post-mortem studies have revealed that they frequently have underdeveloped regions of the brain responsible for the governing of emotions; IT APPEARS THAT THE SEVERE MALTREATMENT THAT THEY RECEIVED AS CHILDREN IS THE UNDERLYING CAUSE OF THE PHYSICAL UNDERDEVELOPMENT OF THESE VITAL BRAIN REGIONS. It is thought that these brain abnormalities lead to a propensity in the individual to SEEK OUT RISK, DANGER and similar STIMULATION (including violence).

IS THE PSYCHOPATHY TREATABLE?

Whilst there are those who consider the condition to be untreatable, many others, who are professionally involved in its study, are more optimistic. Indeed, some treatment communities have been set up to help those affected by the condition take responsibility for their actions and face up to the harm they have caused. Research is ongoing in order to assess to what degree intervention by mental health services can be effective.

David Hosier, BSc Hons; MSc; PGDE(FAHE).