Category Archives: Therapies

Concise articles about many therapies for the effects childhood trauma and related conditions such as complex PTSD and borderline personality disorder, including cutting-edge treatments such as dialectical behavior therapy, EMDR and body-focused therapies (such as somatic experiencing).

Surprising Study On Reduction Of Negative, Obsessional Thoughts

intrusive-negative-thoughts

We have seen from other articles that I have published on this site that it is far from uncommon for those who have suffered significant childhood trauma to suffer obsessive, negative ruminations relating to the self as adults that become habitual and automatic. Frequently, too, these negative thoughts are irrational and unrealistic and researchers Gladding and  Schwartz have referred to them as deceptive brain messages.

In their book, entitled : You Are Not Your Brain, Gladding and  Schwartz provide examples of such intrusive and obstinately tenacious deceptive brain messages that include :

They argue that, in order to reduce such negative thinking it is necessary to take advantage of the brain’s neuroplasticity (i.e. its ability to change itself) to ‘rewire’ it.  In order to achieve this, they recommend their FOUR STEP treatment method. The four steps are as follows :

  1. RELABEL the negative thoughts in a way which disempowers them (i.e. by labelling them as deceptive brain messages).
  2. REFRAME attitude towards these deceptive brain messages by viewing them as unimportant and false.
  3. REFOCUS attention, even whilst being aware of these deceptive brain messages, to a productive and positive activityor mental process.
  4. REVALUE : adopt a dismissive attitude towards the negative thoughts (aka deceptive brain messages) as having little or no value.

Of course, this is very much a simplification of their treatment method, and, to read about it fully, it would be necessary to read their book (see below). Also, a caveat is that the researchers advise that the method is only suitable for those who are suffering mild to moderate symptoms, rather than those with very serious conditions.

Nevertheless, for the purposes of this article it is not necessary to have read about the method in great detail as I only wish to focus on a study, conducted at UCLA, that revealed that those suffering from OCD could be helped by the treatment method outlined above in a surprising (and very encouraging) way.

intrusive-negative-thoughts

THE STUDY

The purpose of the Four Step method is, as alluded to above, to rewire the brain in a beneficial way through the focusing of attention and, to test the hypothesis that this is possible, the study (referred to above) was conducted involving individuals who suffered from obsessive-compulsive disorder(OCD) and experienced continual, negative, repetitive intrusive thoughts which caused them distress.These individuals were then split into two groups, as described below :

GROUP ONE : These individuals were treated with MEDICATION.

GROUP TWO : These individuals were treated by learning the Four Step method (described above).

In order to measure the effectiveness of the treatment given to the participants from each group, each participant underwent a brain scan BEFORE the treatment and, also, TEN TO TWELVE WEEKS after their particular type of treatment (either medication or the Four Step method)

RESULTS :

It was found that the GROUP TWO (the Four Step method group) participants’ brains were positively changed JUST AS EFFECTIVELY as the brains of participants in GROUP ONE (the medication group).

These results add to the now overwhelming body of evidence that, due to its neuroplasticity, the brain can undergo beneficial biological changes in response to therapies that train the individual, over a period of time, to intensely refocus his / her attention (in connection to this, you may also be interested in reading my previously published article on mindfulness meditation).

SURPRISING FOLLOW-UP STUDY :

Even more encouragingly, a follow-up staudy conducted in Germany found that participants suffering from OCD experienced a statistically significant reduction in their symptoms JUST BY LISTENING TO A CD THAT EXPLAINED THE FOUR STEP METHOD. This finding adds to the pool of evidence showing that psychoeducation alone can be helpful to individuals suffering from mental health problems.

This suggests that just understanding what our mental health problem is, and how therapy can potentially help us, in and of itself, may help to ameliorate some mental health conditions

You can view more details about Gladding and  Schwartz’s book by clicking below :

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

Neurofeedback And Reducing Activity In Brain’s Fear Circuitry.

According to Mobbs, the brain consists of two areas involved in how we experience fear as shown below :

It is becoming increasingly recognized that overactivity in the brain’s fear circuitry may be of fundamental relevance to not only complex-PTSD and PTSD, but to many other psychiatric disorders as well and it clearly follows, therefore, that damping down the over-intensity of neuronal firing in this part of the brain may be key to effective therapy for the treatment of a whole array mental health issues. In relation to this, there is mounting excitement about how NEUROFEEDBACK can benefit many individuals who suffer from acute psychological distress.

  • the reactive-fear circuit
  • the cognitive-fear circuit

Let’s look at each of these in turn :

THE REACTIVE-FEAR CIRCUIT :

This circuit deals with threats that are IMMEDIATE and require an instant reaction (namely, activation of the ‘fight or flight’ response) ; it involves the interconnection between two areas of the brain as shown below :

  • the periaqueductal gray
  • midcingulate cortex

THE COGNITIVE-FEAR CIRCUIT :

This circuit deals with threats that DO NOT require an immediate response, allowing us time to consciously consider the risk they pose to us and how we should respond to them ; this circuit involves connections between the following brain areas :

THE SEE-SAW METAPHOR :

Mobbs asserts that the relationship between these two brain regions can be compared to the two ends of a see-saw ; in other words, as one goes up, the other comes down, which means :

  • The more activated the reactive-fear circuit becomes, the less activated the cognitive-fear circuit becomes.

And the reverse is also true, so :

  • The more activated the cognitive-fear circuit becomes, the less activated the reactive-fear circuit becomes.
Neurofeedback And Reducing Activity In Brain's Fear Circuitry. 1

Relevance To Those Who Have Suffered Childhood Trauma :

As we have seen from many other articles that I have already published on this site, if we have suffered severe and protracted childhood trauma we are at increased risk of developing various disorders as adults (such as comples PTSD and borderline personality disorder) which are underpinned by having oversensitive and overactive fear-response circuitry and, correspondingly, underactive cognitive-response circuitry.

What Is Neurofeedback ?

Neurofeedback is biofeedback for the brain and neuro-counsellors can provide their patients with such feedback simply by using special, computer software.

The neurofeedback the patients receive allow them to become aware of their brain function frequencies and how these relate to different emotional states.

How Does Neurofeedback Help Adults Suffering From The Effects Of Childhood Trauma?

Armed with this information, and by continuing to learn from the neurofeedback their brains provide them with (via the software mentioned above), the patients can then, gradually, be trained to exercise control over their brain wave activity (for example, by soothing it with visualization techniques, breathing exercises or calming thoughts etc.). With enough training, the patients’ dysregulated brains can be helped to heal and to become less fear-driven.

This results in the reactive-fear circuit become less sensitive and active which, in turn, provides the cognitive-fear circuit, as it were, ‘more room to manoeuvre.’ In this way, irrational feelings of fear that were originally being driven by the (unthinking and automatic) reactive-fear circuit can now be more soberly and rationally considered by the (reflective and thinking) cognitive-fear circuit and, therefore, more easily be dismissed as unwarranted, made impotent and deprived of their power to cause us anguish.

It should also be noted, however, that whilst a lot of excitement has been generated around this method of treatment, it is still early days and more research is needed to determine the extent of its effectiveness and to which disorders its application is best suited.

Beat Fear and Anxiety Pack | Self Hypnosis Downloads

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Neurofeedback And Reducing Activity In Brain's Fear Circuitry. 2

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

Does EFT Help Alleviate PTSD?

EFT stands for the emotional freedom technique and is used to treat sufferers of various disorders, including PTSD (complex posttraumatic stress disorder) and complex PTSD (and, in this article, I will be looking at its effectiveness in relation to these two disorders).

‘TAPPING’ :

EFT is also sometimes referred to as tapping for the simple reason that it involves using the tips of the fingers to tap on specific acupuncture (sometimes called acupuncture points or just acupoints) on the body.

EFT is based on the same theory as acupuncture (in which the acupuncture points are punctured with needles rather than being tapped with the finger tips) ; this theory proposes that ‘meridians’ run through the body which operate as pathways for the carrying of energy.

BLOCKAGES :

It is theorized that disease is caused by the occurrence of blockages along these meridians (or pathways) and that these blockages can be unblocked by tapping on specific points on the body (in EFT, these points are referred to as acupressure points, whereas, in acupuncture, they are referred to as acupuncture points ; in both cases, these terms can be abbreviated to acupoints). This unblocking, according to the theory, alleviates the corresponding disease.

SPECIALIZED TECHNIQUES FOR WORKING WITH TRAUMA :

Within EFT, there are three specific techniques which were devised for treating trauma. These are referred to as THE GENTLE TECHNIQUES, as described in the EFT MANUAL (Church, 2013).

EVIDENCE  :

RANDOM CONTROLLED STUDIES :

In terms of evidence for EFT, a random controlled study (Church et al., 2013), involving war veterans suffering from PTSD. found that 86% significantly improved after six sessions of EFT and 80% remained significantly improved after 3 and 6 month follow-ups.

This experiment was independently replicated by Geronilla et al. (2014), and this replication obtained similarly encouraging results.

Does EFT Help Alleviate PTSD? 3

TELEPHONE EFT VERSUS ‘IN PERSON’ EFT :

On further analysis of the data obtained from Church et al.’s (2013) study (see above), it was found that telephone EFT (in which the therapist talks to, and guides, the client over the telephone and the client ‘self-administers’ the taps) led to the significant improvement of 67% of the veterans with PTSD after six sessions, compared to 91% of the veterans with PTSD who significantly improved after the same number of ‘in-person’ EFT sessions. This suggests that whilst telephone EFT can be effective, it tends, overall, not to be as effective as ‘in person’ EFT.

GROUPS :

In a study by Gurret et al. (2012), seventy-seven victims of the Haiti earthquake were given a two-day training course in EFT. It was found that, before the EFT training, 62% fulfilled the criteria for having PTSD but this fell to zero per cent after the training had been administered, providing support for the effectiveness of group EFT.

META-ANALYSIS :

A meta-analysis, conducted by Sebastian and Nelms (2016), reviewed seven studies ; findings from this analysis found evidence that EFT for those suffering from the effects of trauma can :

  • regulate 72 different genes
  • increase the expression of immunity genes
  • decrease inflammation genes
  • is as effective as CBT and EMDR

and that :

  • EFT has no adverse side-effects
  • the number of EFT sessions required for the effective treatment of PTSD is 4 to 10 sessions

eBook :

Does EFT Help Alleviate PTSD? 4

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


Reducing Anxiety By Calming The Amygdala

We have seen from other articles published on this site that severe and protracted childhood trauma, resulting in the child being frequently subjected to extreme stress, can damage the development of the part of the brain known as the amygdala, which is intimately involved in generating feelings of fear and anxiety.

Indeed, in individuals who have experienced such serious childhood trauma that they have gone on to develop complex posttraumatic stress disorder (complex PTSD), the amygdala has been found to be overactive ; this can result in the affected person feeling constantly ‘on edge. hypervigilant, fearful, and, as it were, stuck on ‘red-alert’ / in a state of ‘fight or flight,’ with accompanying unpleasant bodily sensations such as a racing heart, rapid and shallow breathing (sometimes referred to as ‘hyperventilation), tense muscles, an unsettled stomach and nausea. Indeed, it is these very bodily symptoms that feed back to the brain leading to the perception of being afraid.

Reducing Anxiety By Calming The Amygdala 5

ANXIETY, DEPRESSION AND THE AMYGDALA :

An overactive amygdala is not only associated with complex PTSD ; it has also been found to be associated with depressive and (as one, of course, would expect) anxiety disorders (e.g. Dannlowski et al., 2007).

THE PREFRONTAL CORTEX AND CALMING THE AMYGDALA :

Fortunately, another part of the brain, known as the prefrontal cortex (which is involved in planning complex cognitive behavior, rational, logical and abstract thought, speech, decision making, reappraisal of situations, active generative visualization and moderating social behavior) can be harnessed to inhibit the overactivity of the amygdala, thus calming it to allow symptoms of anxiety to dissipate and dissolve away.

PREFRONTAL CORTEX DEPRIVED OF OXYGEN WHEN WE’RE IN FIGHT / FLIGHT MODE :

If we suffer from PTSD or complex-PTSD we are prone to experience extreme fear and anxiety when it is not, objectively speaking, warranted. And, when we become fearful we can become locked into the fight / flight state, causing our body’s oxygen to be diverted to our muscles (particularly in out arms and legs) so that we may fight or flee more effectively. However, this reduces the amount of oxygen available to the prefrontal cortex which, in turn, means that we are limited in our ability to think rationally so that we are unable to reassure ourselves that the danger we perceive is not objectively justified, and, therefore, we are also unable to inhibit our amygdala’s overactivity.

MAKING SURE THE PREFONTAL CORTEX RECEIVES SUFFICIENT OXYGEN TO FUNCTION OPTIMALLY :

In this fearful state, we need to control our breathing so that sufficient oxygen can reach the prefrontal cortex to allow it to function optimally ; we can achieve this by breathing in a relaxed and slow manner, and, when exhaling, breath out slowly from the stomach so that the diaphragm moves upwards to increase the pressure on the lungs and heart to expel air. This type of breathing beneficially affects the part of the brain stem known as the medulla which, in turn, sends signals along the vagus nerve, leading to increased activity of the parasympathetic nervous system and decreased activity of the sympathetic nervous system : in combination, this produces feelings of relaxation and ameliorates feelings of stress and anxiety.

VISUALIZATION : THE PREFRONTAL CORTEX AND VISUALIZATION :

To calm the amygdala further, we can also take advantage of the prefrontal cortex’s ability to visualization (see above) and undertake sessions of relaxing, guided imagery either with a therapist or using self-hypnosis.

RESOURCES :

Improve Visualization | Self Hypnosis Downloads

Learn Deep Breathing Relaxation Techniques Rapidly | Self Hypnosis Downloads

eBook :

Reducing Anxiety By Calming The Amygdala 6

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

Depression, Thinking Styles And Hypnotherapy

Hypnosis for Depression – Natural Treatment | Self Hypnosis Downloads : Try Introduction And First Module FREE.

We have seen from other articles published on this site that those who have experienced severe and protracted childhood trauma are, as adults, at an elevated risk of suffering from depression. We have also seen how hypnotherapy can benefit trauma survivors (in fact, research has shown that those suffering from posttraumatic stress disorder (PTSD) are, overall, more responsive to hypnotherapy than is the average person).

Depression And How People Think :

Those who are depressed tend to be, quite understandably, self-focused and self-absorbed, not least because they are in a great deal of mental anguish and turmoil (just as anyone suffering from excruciating tooth ache will inevitably be self-focused and self-absorbed). This is why it is unfair to accuse those who experience this extremely serious condition as ‘choosing’ to be ‘selfish’.

Another very common feature of depression is that it causes the person who is suffering from it to (falsely) believe that there is no hope of recovery.

A third hallmark of depressive thinking is that the afflicted individual tends to be extremely focused on the past, as opposed to on the present or the future.

Fourth. depressive thinking tends to be ‘ruminative’ as opposed to ‘experiential’.

Ruminative thinking is generalized and abstract and involves dwelling on distressing matters ; depressive rumination has been defined as ‘thoughts that focus one’s attention on one’s depressive symptoms and their implications’ (Nolen-Hoeksema, 1991). It is also decontextualized and self-evaluative. Such rumination has been found to be a major contributory factor to the onset of depression and its maintenance.

‘Experiential’ thinking, on the other hand, is specific to a current task being undertaken.

Depression, Thinking Styles And Hypnotherapy 7

Traditionally, ‘rumination’ has been regarded as a negative style of thinking, whereas ‘experiential’ thinking has been regarded as positive. Herman et al., 2008 suggested that the tendency to over-generalize when indulging in ruminative thinking (e.g. by thinking things like : ‘I’ve never done anything right in my entire life’, or. ‘everybody has always hated me and always will’) is the strongest predictor of the severity and duration of depression, as well as of the likelihood of relapse ; in other words, the more prone one is to ruminative-style thinking, the worse, and longer lasting, one’s depression is likely to be ; furthermore, the greater one’s chances of relapsing after recovery are likely to be.

It is important, then, that we attempt to adopt a far more ‘experienttial’ style of thinking and keep to a minimum our negative, ruminating-style thinking if we wish to reduce our feelings of depression or to prevent ourselves from relapsing into further depressive episodes.

HOW HYPNOTHERAPY CAN HELP IN RELATION TO THE ABOVE :

Hypnotherapy can :

  • encourage us to think ‘experientially’ e.g by thinking about and planning achievable tasks and goals as well as motivating us to carry out such tasks
  • focus on the present and future rather than on the past
  • help us to feel more positive
  • reduce distressing, intrusive thoughts
  • help us to reduce dysfunctional, generalized thinking
  • reduce self-crticism
  • reduce the judgmental, internal dialogues we have with ourselves
  • increase our ability to recall traumatic memories without attributing to them self-blame
  • increase our ability to change out thinking style from ‘ruminative’ to ‘experiential.’
  • calm the brain’s amygdala which, in turn, puts us in a much better position to resolve traumatic events from the past.

RESOURCE :

If you are interested in how hypnosis can help with all of the above and much more, you may wish to visit the affiliated site, hypnosisdownloads.com, which I have used to aid my own recovery.

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


Ten Ways To Build Resilience

Different people respond in different ways to trauma. One of the reasons for this is that some people are more resilient to its adverse effects than others and even manage to grow and develop as a person in positive ways (a phenomenon known as posttraumatic growth) that would not have occurred had they not experienced the traumatic event/s.

However, resilience is not something that a person either has or does not have, rather, it is something that we can build and develop. According to the American Psychological Association there are TEN MAIN WAYS WE CAN INCREASE OUR RESILIENCE and these are as follows :

resilience
  1. Develop social connections : e.g. with supportive family members, friends, community support groups (in general, the more social / emotional support we have, the more psychologically resilient we are likely to be. Research has also found that working as a volunteer and helping others is another good strategy for resilience-building.
  2. If changes have occurred which are irreversible, accept that this is just part of what life involves and direct energy towards things that can be positively changed.
  3. Take decisive action : when one has suffered trauma it is easy to fall into the trap of endlessly ruminating upon what has gone wrong and feel helpless ; it is necessary to avoid this, and, instead, take decisive action to change things for the better (see my previously published article on childhood trauma and depression which includes information on LEARNED HELPLESSNESS AND BEHAVIORAL ACTIVATION).
  4. Try to keep an optimistic outlook – rather than negatively ruminate, attempt to visualize solutions / how you would like the future to turn out.
  5. Try to maintain perspective by seeing things in the context of the ‘bigger picture’ / taking a long-term view.
  6. Self-care : Treat yourself with compassion, do things you enjoy (or used to enjoy), exercise, eat well and generally look after your needs and feelings (especially by avoiding stress as far as possible.
  7. Consider if the trauma may, in some respects, help develop you as a person ; there may be opportunities for posttraumatic growth – for example, some trauma survivors report improved relationships, increased inner strength and coping ability, spiritual growth, a greater sense of self-worth (knowing they can survive great difficulties, for example) and increased empathy for the suffering of others as a result of their adverse experiences.
  8. Focus upon maintaining a positive self-view, especially in relation to your problem solving abilities.
  9. Try to set goals each day that help you to move forward, however small, so that at the end of the day you can know you have done at least one positive thing.
  10. Avoid ‘catastrophizing’ (seeing crises as insurmountable problems) – cognitive behavioral therapy can help with this, as well as with other so-called ‘thinking errors’).

RESOURCES :

Develop Powerful Resilience | Self Hypnosis Downloads

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

Electroshock Therapy

personal experience of ect

Childhood trauma can lead us to become severely clinically depressed as adults, and this happened to me. Electroshock therapy, or Electro-convulsive therapy (ECT) is only used as a last resort on people who are at high risk of suicide and/or are unable to function in even the most basic areas of life.

ECT is, in fact, misunderstood by the vast majority of people – many see it as barbaric and frightening. Such views, in large part, derive from the popular media (eg from films such as ‘One Flew Over the Cockoo’s Nest’).

However, most controlled research suggests that ECT is helpful as a treatment for severe depression (eg Pagnia et al., 2004). It is normally only used when other interventions, such as psychotherapy and drug treatment, have failed.

There are, though, some risks. Approximately 2-10 patients per 100,000 treatments (ie less than 0.01%) die during the procedure – however, this is no higher than the risk of dying from anesthesia alone (patients have a general anesthetic before undergoing ECT).

After the treatment patients might have headaches, aching muscles or nausea. Also, some patients experience some memory loss (but, generally, only mildly) which can last up to six months (Sackeim et al. 2007).

Patients who undergo ECT, however, tend to view it positively. In one study, 98% of patients who received it said they’d undergo it again if their depression recurred (Pettinati et al., 1994).

personal experience of ect

MY OWN PERSONAL EXPERIENCE OF ELECTRO-CONVULSIVE THERAPY (ECT).

My own depression was so severe and protracted that I underwent ECT sessions (an ECT treatment session normally comprises blocks of 6 individual treatments) on more than one occasion. I was suicidal and almost completely unable to function (not even able to carry out the most basic self-care, such as shaving, brushing my teeth or taking a bath or shower). As I say, these periods went on for several months, or years, at a time.

Frankly, I did not care whether I lived or died (actually, that’s not quite true, I wanted to be dead), nor what happened to me. Thus, when I was hospitalized, my psychiatrist strongly advised me to undergo ECT. I put up no resistance, nor would I have had the energy or will to do so.

Over the years, each time I underwent ECT sessions, the results were pretty much the same, so I’ll just describe the effect of one set of treatments:

The best thing about it was being given the general anesthetic – such was the extreme nature of my mental anguish that I constantly longed to be unconscious (or dead). Unfortunately, however, the treatment is quick so one is only unconscious for a few minutes!

When I awoke, I’d have very bad, pounding headaches and many of my muscle groups would be painful. Sometimes, I’d need to walk with a stick for a few days after the treatment until the muscles in my legs recovered.

Also, and this was frightening, for about the first five or ten minutes after the treatment I would be so disoriented and confused that I did not know where I was, or even WHO I was. It is impossible for one to imagine how disturbing this is until one has experienced the sensation for oneself. Fortunately, as I said, this did not last long.

On the topic of memory, it felt to me that my memory was impaired for a couple of years after the final treatment session (though not severely). I would make the point, however, that severe clinical depression in itself can impair memory so I cannot attribute it to ECT without some equivocation.

Finally, and most importantly, my own ECT did not have any beneficial effect on me whatsoever; my depression was not even slightly ameliorated.

Obviously, overall, my experience of ECT was fairly negative. However, it is necessary to stress that I am, of course, just one patient out of thousands who have received ECT, so not very much can be concluded from my personal experience it. The research I have already quoted suggests that, for the majority, it is beneficial. Indeed, there are many who believe it has saved their life.

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

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

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