Tag: CBT

4 Helpful Treatment Options for those who suffer from PTSD- Guest post by Rachelle Wilber

~ Eleanor Segall ~ 1 Comment

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Post-traumatic stress disorder (PTSD) is a serious mental health condition that affects people who’ve experienced major trauma events. Common among military service members who’ve fought in combat zones, PTSD can also affect people who’ve lived through other terrifying episodes that have resulted in physical and/or mental harm. If you believe that you suffer from PTSD, you can work with a therapist and try any of these four different treatment methods to overcome the condition.

Cognitive Behavioural Therapy (CBT)

This type of therapy works to alter thought patterns that often cause people to relive the traumatic events in their minds. As Mayo Clinic states, the goal of cognitive behavioural therapy is to make you more aware of negative or inaccurate thoughts so that you can adopt a healthier perspective of challenging situations and respond in a better way. Undergoing this therapy may also help prevent relapses that could jeopardise your mental health.

Exposure Therapy

Your therapist may also try exposing you to things that trigger traumatic thoughts as a way to alleviate them. This is done in a safe way, and your mental health care provider will be there to help you process your thoughts and feelings and give you tools to overcome your anguish. You may be shown pictures, see writings or even revisit a place where the traumatic episode occurred. Gradually, these negative thoughts should lose their power and cause you less mental grief the more that you’re exposed to them.

Eye Movement Desensitizing and Reprocessing (EMDR)

Also known as EMDR therapy, this treatment method involves recalling distressing thoughts while a therapist’s fingers move in front of your face. You’ll be asked to follow these finger movements with your eyes while discussing your feelings, however, you generally won’t be required to talk about your thoughts in great detail.

Some therapists use foot or hand tapping or musical notes instead of finger movements in front of the face. This more active approach to therapy is intended to minimise the effects of bad thoughts.

Medication

Medication is sometimes prescribed by mental health professionals to work in conjunction with other types of therapy. Prozac, Zoloft and similar antidepressant medications are formulated to boost serotonin levels in the brain to alleviate negative thoughts and emotions. Your doctor may also prescribe Depakote to stabilize your moods. Prazosin often works well in stopping nightmares.

You don’t have to continue letting PTSD dominate a large part of your life. Seeking professional help and undergoing any of these therapies will likely give you positive results.

 

This article was written by freelance writer Rachelle Wilber from San Diego, California

4 Things Holding You Back from Therapy and Why They’re Not True: Guest Post by Time With

~ Eleanor Segall ~ 4 Comments

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(image: Feminist Current/ Snoopy)

Taking a leap into the unknown always requires bravery. Now think of that ‘unknown’ as yourself. All those dark, niggly or somewhat strange parts of ourselves we keep buried away in the hope that they might just disappear if we keep pushing them away for long enough. Yup, therapy is totally exposing – and frankly, terrifying. So it’s little wonder we find ourselves coming up with a million and one excuses to explain why it’s not for us. Avoidance runs through our veins – it’s human nature. But it also holds us back, and at its very worst, avoidance can stall us from moving forward and reaching our potential.

 

Sometimes it’s worth digging a little deeper to properly explore our reasoning. That way we can be sure we’re not standing in the way of our own progress. Below we’ve listed some of the most common excuses we hear when it comes to therapy (and why we think they’re mostly rubbish!)

 

“I don’t know where to start”

It’s true, in the past finding a therapist has been anything but easy. Sifting through directories packed full of conflicting approaches and unfamiliar terms… It’s hardly surprising we’re left scratching our head wondering what any of it means. But fortunately, those days are now firmly in the past. Searching for a therapist online is quick and easy. There’s no need to get carried away in lots of research, now you can just work your way through a few simple questions and be connected directly with the right therapists nearby. If you’re interested in finding a therapist best matched to your needs, TimeWith’s online questionnaire matches you with suitable therapists in minutes.

 

“I can’t afford it”

This is valid- there’s no two-ways about it, therapy isn’t cheap. But in reality, it’s a small price to pay when weighed up alongside its many benefits. Good therapy has the potential to completely transform your life. Whether you want to learn how to relate better in your relationships, manage stress and flourish in your career, or you simply want shed light on recurring behaviours or patterns… Therapy has the potential to do all those things (and more).

 

Also, it’s important to remember that therapy isn’t forever. It’s not about making a lifetime commitment. It’s an investment, and there’s a really wonderful feeling that comes with the decision to invest in your own mental and emotional wellbeing. If money’s an issue, never be afraid to ask your therapist about concessions. Lots of therapists offer what’s known as a sliding scale meaning they can offer a discount according to your financial situation.

 

“What can a stranger offer me that my friend’s can’t”

To think of therapy as a friendly heart-to-heart is to misunderstand it completely. There’s no doubt in the value of having a good, solid support system in our friends and family. But your therapist isn’t your friend – in fact, there are very strict rules around that in therapy. Your therapist will always remain neutral allowing them to take a uniquely objective standpoint. It can be easy to get so wrapped up in our own story that we don’t see the broader picture. By extension, friends and family are part of our story. They can be happy or sad for us, but they will always have something at stake in our life. It’s only inevitable that this colours their advice and approach, whether they mean to intentionally or not.

 

Habits, patterns, thoughts… Whether we like to admit it or not, we’re more alike than we think. Whilst our experiences in life will be completely different, the coping mechanisms we adopt to deal with what happens to us in life very often follow similar patterns. Therapists are trained to recognise these signals and guide us towards coming to our own realisations. The best moments in therapy are those a-ha moments – the kind that friends and family struggle to provide us with, no matter how much they love us.

 

“What’s going to change”

Everything, potentially. But of course, what you get out of therapy comes down to what you’re prepared to put into it – as with most things in life. Film depictions of therapy have done us a disservice for the most part. Despite appearances, therapy isn’t about rambling on Woody Allen-style about our neuroses. Don’t get us wrong, the talking part’s great! But what therapy’s really good at is finding solutions.

It’s all too easy to bulldoze our way blindly through life living out the same patterns time and time again. Good therapy is about taking accountability for the way we are. But that can only happen when we dig deeper and understand the whys. Far from self-blame, this process actually allows us to forgive ourselves for thoughts or behaviour we haven’t liked. To understand that it was the only way we knew how. But with this new awareness also comes the responsibility to change… There aren’t any excuses anymore.

This is the heart of therapy – we slowly peel back the layers to see ourselves in the clear light of day, no pretences. It might seem scary at first, but in reality, it’s liberating.

TimeWith is a service dedicated to helping people reach the right therapist. Run through a quick online questionnaire and connect with suitable therapists in your area.

Guest post: How nOCD App helps thousands with OCD- Obsessive Compulsive Disorder by Stephen Smith

~ Eleanor Segall ~ 2 Comments

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In the summer of 2014, I was tired of struggling with OCD, Obsessive compulsive disorder, so I decided to do something about it and begin my app, nOCD. nOCD, standing for “No OCD”, is an online platform that I believe would have helped me during the worst of my struggles and that currently is already helping thousands of others with OCD today. The platform is designed to help people with OCD during all four phases of treatment: 1) coping with the onset of OCD symptoms, 2) selecting a care team, 3) actively managing OCD treatment, and 4) maintaining OCD treatment progress.

My team and I at nOCD are able to address each phase of treatment using a unique combination of highly vivid content and 21st century technology. For instance, people with OCD can view our content on Instagram or Twitter at @treatmyocd and download nOCD for free on the App Store (m.treatmyocd.com/saveslives).

People with OCD say the app has been a major difference maker. It gives people guidance in the moment of OCD episodes, a structured platform to do Cognitive Behavioural Therapy (CBT) exercises, a community to talk with others (in beta), and real-time data 24/7. Here is more information about how it works:

  1. SOS Guidance: nOCD offers members clinically effective guidance in the moment of any OCD episode, using OCD specific Cognitive Behavioural Therapy. During an episode, members can hit the button “SOS” on their phone, which tells the app to immediately provide Mindfulness Based Cognitive Therapy and Acceptance Commitment Therapy (Response Prevention). For instance, if the member is obsessing, nOCD will ask questions such as: “Are you experiencing an Obsession or a Compulsion?”,  “What Obsession are you experiencing?”. “What triggered the Obsession?” And “How intense is your anxiety?” Then, based on the answers, nOCD will offer specific Acceptance Based Therapy guidance, to help the member effectively respond to the obsession without doing a compulsion. We believe the SOS feature can empower people with OCD to live their lives fully, knowing help is always in their pocket.

  2. Structured ERP Exercises : nOCD provides members with the tools and organization needed to consistently do planned OCD treatment exercises regularly and effectively, acting like a mental gym. The main challenge with doing these planned mental exercises is that they instigate anxiety. Since the anxiety alone can reduce OCD treatment adherence rates, the app attempts to remove all pain point. It offers members the ability to create loop tapes, scripts, and drawings. It also has built in exercise reminders and educational tips.

  3. Custom Therapy : nOCD customizes the entire treatment process to each member, helping augment therapy with licensed clinicians. Patients can customise their hierarchies, their compulsion prevention messages (acceptance based messages), their ERP schedule, and more.

  4. 24/7 In-App Support Group :Inside the nOCD app, people with OCD can join different support groups and anonymously post to each groups wall. We’ve created a platform where people can support each other through treatment and learn quickly that they are, in fact, not alone.
  5. Real-Time Data Collection: It collects real-time data about every aspect of the patient’s condition and treatment. It also longitudinally displays the data for every patient and clinician to see at any time. nOCD protects each users PHI data to the highest degree possible. For example, it uses a dedicated (encrypted) Ec2 instance on Amazon Web Services, SSL connection, Touch ID login access, LastPass Password security, and new, monthly, VM keys. nOCD is a HIPAA compliant commercial enterprise.

 

Guest Post: The Efficacy of Online Cognitive Behavioural Therapy- CBT by Dr Stacey Leibowitz- Levy

~ Eleanor Segall ~ 1 Comment

We are delighted to have Dr Stacey Leibowitz-Levy, psychologist writing about Cognitive Behavioural Therapy for us. As with any therapeutic practice, it is very much individual as to whether it will work for you and CBT will not work for everyone- but has been proven to work for many. Here Dr Leibowitz-Levy explains how it can work online.                        

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Online counselling is a growing field with more and more people turning to the internet to seek out counselling help. Counselling services offered online incorporate the range of therapeutic approaches that have been developed within the field of psychology. Approaches to understanding mental ill health and treatment include therapeutic approaches such as logo therapy, psychodynamic therapy, systemic therapy, psychodynamic therapy and Cognitive Behavioral Therapy (CBT). How do these therapeutic modalities translate to the online environment? This article will address the compatibility of CBT in particular as an online counselling approach.

CBT is a widely-utilised mode of therapy that focuses on an awareness of the relationship between thoughts, feelings and behaviour. The aim of CBT is to address difficulties through modifying distorted thoughts, unhelpful behaviour and unpleasant emotions. In order to achieve this end, the client works collaboratively with the therapist in building awareness and understanding of his/her condition, and an accompanying skill set for evaluating and changing distorted beliefs (as well as modifying dysfunctional behavior). The therapist develops clear objectives and a treatment plan that requires active participation from the client during sessions, and follows through on homework assignments between sessions.

This form of therapy is characterized by a structured, time limited and outcome focused approach to managing mental health challenges. Often CBT is focused on a specific issue such as anxiety or managing depressive thoughts and, as such, many CBT interventions are available in a protocol format. CBT offers a delineated and clearly defined intervention that is largely directed by a clearly defined process and structure. This is in contrast to many other therapeutic approaches that have less defined parameters and take their cue on a session to session basis from the client.

The format and approach of CBT lends itself to an online format in that the structure and process are not only defined and constrained by the relationship between therapist and client but are also defined by a clearly delineated therapeutic procedure. This procedure offers a framework within which to deliver support which can easily be translated to an online process. CBT follows a set format. It is driven by the imperative of building an understanding of the issues the client is experiencing and imparting a certain skill set to assist the client in managing his/her mental health issues. CBT is thus based on specific content and has a strong psychoeducational aspect, which means that delivery online can be located in tangible and clear cut content and outcomes for the client.

This also allows for versatility in the delivery of CBT online. While face to face time with a therapist may be desirable for some clients, the option of online delivery of psychoeducational as well as skills based elements in other formats also works well. For instance, the psychoeducational aspect could be communicated very effectively through a video delivery. CBT lends itself to the format of online courses where clients are guided through a process of identifying and understanding their particular issues and developing the skills to manage them. Interspersing this with face to face time or the opportunity to clarify or ask questions in a chat or e-mail format makes for a very effective online intervention.

While many of the issues addressed in CBT are personal to the client, the possibility of locating these issues within a more general format is very much part of the CBT approach. There is a set way of getting information from, and accessing and understanding the client’s experience, with the client having to act on this information between sessions. This more “scientific” process also makes for an approach that lends itself to an online format.

The efficacy of CBT as an online intervention is borne out by the number of sites specifically offering online CBT in a variety of formats (for some examples, see here and here). The online availability of this well researched and well-verified approach to managing mental health problems offers increased affordability, accessibility and greater choice for mental health consumers.

Dr. Stacey Leibowitz-Levy is a highly-experienced psychologist with a Master’s Degree in Clinical Psychology and a PhD in the area of stress and its relation to goals and emotion. Dr. Stacey has wide ranging skills and expertise in the areas of trauma, complex trauma, anxiety, stress and adjustment issues. Stacey enjoys spending time with her husband and children, being outdoors and doing yoga.

Therapy Tales Part One.

~ Eleanor Segall ~ Leave a comment

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My therapy journey began at just 15 years old- when I went to see the school counsellor for talking therapy due to suffering my first anxious and depressive episode (before I was diagnosed as bipolar).

Since then- 13 years later, I have tried many different kinds of therapies to help heal me from my anxiety disorder and help manage my bipolar disorder. Therapy still has a stigma, which is wrong,- but it is vital to the healing and recovery of mental illness and general healing from stressful life events eg deaths, divorce, moving house, illness.

I have done many forms of therapy, starting off with talking therapies- where you talk to your therapist about whats going on in your life (and sometimes they psychoanalyse in order to help you). I then did 3 lots of Cognitive Behavioural therapy (CBT). This is where you unpack your negative thoughts and assumptions that cause your illness in thought records, where you learn to challenge thoughts and change behaviour. However, for me, CBT was frustrating. I felt like I couldn’t fully apply it and it didn’t click with my brain.

I felt that the anxiety and panic I was dealing with was very much in the subconscious- and so the CBT could not eradicate the emotional, deep response that had formed within me to certain situations. It was then I began to realise the power of exposure therapy- which is essentially, exposing yourself to your feared situation slowly, with support. The more I went out, the more people I saw and the more I did, the anxiety began to lessen. It boosted my self esteem too to know I could overcome my fears. It is something that has to be practised and you have to be kind to yourself too and in the right head space for it to work,.

Of course, therapy works in conjunction with medications and it is also vital to make sure you like your therapist and have a good relationship with them. If you dread seeing them and you aren’t getting much from it, they are likely to be the wrong therapist for you.

I have done many other therapies: art therapy (which I loved and recommend hugely if you enjoy it), meditation and deep breathing (which I still do and which really helps my anxiety) and of course the unique therapy that friends and family bring. There are more therapies out there including ACT and its always worth googling therapies.

Ultimately, don’t be too scared about sharing with a therapist. They are trained professionals, have seen it before and they are there to support you. It is also very much trial and error. Even though CBT wasn’t for me, I found other therapies which have worked.

Just be aware that NHS therapy waiting lists are months long, so if you have the money to get private care, do.

I have worked with both psychologists, psychotherapists, occupational therapists (during a period of group therapy) and of course psychiatrists in order to keep well. It is very much a collaborative effort and now I am much better, I can deal with it with my support network (with my psychiatrist in the background)

I hope you find the right course of therapy for you and know you can heal from whatever stresses you are dealing with.

Guest Post by Richie: Dealing with anxiety, Live Your Now

~ Eleanor Segall ~ 2 Comments

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(image:weheartit.com)

I was honoured to be asked to write a piece on anxiety for this wonderful blog.  I’m Richie, and I’m a mindfulness coach – one who happens to have had anxiety for as long as I can remember.  The thing is, I didn’t always know I had it.  I’ve been researching positive psychology methods etc for many years, but I wasn’t coping so headed to see a counsellor who referred me for a course of CBT after having pointed out – Sir, you have bad anxiety.

Me?

Yes I’d had panic attacks, people would describe me as quite reactive, amongst other things – and after all these years, to discover it was my “fight or flight” mechanism going into overdrive & attaching to situations in had no business being in, well, I was not impressed to say the least! How did I miss this? I felt initially extremely put out by this, I saw myself as a “fighter” – I got on with things, my panic attacks were just “stage fright” (I was in radio/music performance etc), my OCD a quirk of creativity and all that jazz! Right?

Wrong.

This is when I began to understand more fully the stigma associated to “mental health”. A somewhat wishy-washy term to people not familiar, or plain ignorant of the facts (as I myself was), as it’s often attributed to needing to just “chill out” or, “stop being so depressed” etc. At some point in life, many people will experience bouts of some kind of mental illness – after traumas, disappointments, or for some no seeming reason at all! But then, even the most healthy people can catch a cold.  And that’s the issue. Mental Health is a physical issue, that cannot be seen, and therefore for some is like trying to see oxygen.

My advice is simple on this matter; for brevity.

Acceptance & ownership

Firstly, accept it’s a physical thing, and take ownership and understand the physical things in the mind that are taking place. This helps separate you from the thought that you ARE your anxiety/depression etc. This is simply not the case.

If you catch a cold, you don’t say you ARE your cold. CBT helped me understand the mechanics of it, and have useful approaches, but for me (and we’re all different), I find mindfulness to have been the most helpful because it teaches to not identify as “being” depression/anxiety etc. This begins a process of dissociation of identifying as “being” depressed/anxious, and instead acceptance of what it is, how it functions, learning how it feels, and gradually gaining a level of understanding and feeling of when it’s occurring – and how it can shape/affect our feelings/emotions and therefore behaviours/reactions.

Experiment with techniques

Secondly, experiment with ways that can help you day to day – of course, seek professional help, but there’s also much that you can do independently. Breathing exercises (massively effective!), reminding yourself that the depression/anxiety doesn’t make you who you are, try things like mindfulness which teach us to detach from thought.

I also personally use meditations, guided or technological, hypnosis, even things like “EFT” (emotional freedom technique – or tapping), reading positive books, listening to uplifting music, and actively managing thought processes as and when I can.  Using mindfulness to compliment allows for being more in touch then, with which techniques are being more effective for you in the moment.

Is anxiety still there? Oh yes! But the more I practice these techniques (and you will find what works for you) and indeed, share them with others, the more aware I become of “anxiety”.

Reframing

Lastly; I have also reframed my anxiety, because without that fight or flight mechanism, our species would not likely still be here! So it’s important! It’s evolved in our species to protect us – and there are times that flood of adrenaline etc is critical. We certainly would not wish to be without it, but the chances a tiger is going to jump out and eat us are hopefully not too prevalent in your neighbourhood…

My experiences prompted me to begin @LiveYourNow & @Rmindrs on Twitter where I post daily mindfulness reminders, engage, and encourage others to talk – and hopefully create a few laughs too! (Laughter releases great neuro-chemicals!)

Be forgiving of yourself, understand you’re on a journey, and when you find things that help you, share them with others. The more we speak openly, the less stigma is attached, and the more others who may be suffering in silence may feel comforted and confident to speak out and seek assistance.  I have been witness to that now multiple times, and it’s truly a wonderful thing when we accompany each other, in compassion, on our healing journeys.

Thank you for reading! I hope it brings even just one person comfort/hope.

To your greatest life,

Richie – @LiveYourNow