CBH at CCBT

14 Jan

Cognitive Behavioural Hypnotherapy; training at the College of Cognitive Behavioural Therapies.

At our college, we train people in CBH using cognitive and behavioural theories and frameworks such as Rational Emotive Behaviour Therapy (REBT) which was developed by Albert Ellis. We also use other cognitive and behavioural therapies such as Cognitive Therapy, developed by Aaron Beck. So, CBT is the base theory and framework for integration with hypnosis. Cognitive Behavioural Therapy (CBT) is a talking therapy. At the heart of CBT is the premise that what people think can affect how they feel and how they behave. Within this broad definition are a number of cognitive behavioural psychotherapies such as Behaviour Therapy (BT), Cognitive Therapy (CT), Rational Emotive Behaviour Therapy (REBT), Mindfulness Based Cognitive Therapy (MBCT) and Acceptance and Commitment Therapy (ACT) to name but a few.

 

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The two pioneers of CBT, Albert Ellis and Aaron Beck, shared the view that most disturbances arise from faulty thinking and that the remedy is to be found in corrective actions. Both concentrate on present problems and present thinking in contrast to the earlier forms of psychotherapy. Also, both recommended the inclusion of behavioural exercises as key in effective change.

The CCBT course covers Ellis’s REBT model of emotional disturbance first for three reasons; firstly Ellis’s model deals with symptom treatment and advocates a philosophy of healthy living, in contrast to Beck’s model which primarily focuses on symptom treatment only. Secondly, Ellis’s model does not shy away from targeting and disputing client’s most disturbing events from the outset of therapy, whereas Beck’s model focuses on reality testing. The REBT model deals with the client’s ‘what if?’ question. Thirdly, there seems to be a convergence among Beckian therapists towards following one of the central pillars of the Ellis model; that of disputing rigidly held beliefs.

Cognitive Behavioural Hypnotherapy (CBH)

CBH is the practice of hypnotherapy, using the structure and philosophy of Cognitive and Behavioural Therapy (CBT) as the backbone of the therapy. It combines CBT and clinical hypnosis to become a form of psychotherapy. Counselling skills are also used, a full case history is taken, a therapeutic alliance established, problems and goals defined, any misconceptions dealt with, and therapeutic strategies clinically developed and implemented. A typical CBH session would comprise of both hypnotic and non-hypnotic parts. Hypnotherapists who work with CBH should develop a solid understanding of the theory and process of cognitive behavioural therapies and their therapeutic use in hypnosis. They also need to make a thorough clinical assessment of the client’s problem/s and learn how to integrate other psychotherapeutic approaches into the CBH framework. You can argue that CBH is integrative as opposed to eclectic hypnotherapy, in addition to the use of direct suggestions, the therapist may draw on inner child work, regression or ego states therapy to name but a few. However all of these approaches are firmly underpinned by the CBT structure and philosophy.

 

CBH also involves therapeutic work outside the trance state. From the outset, clients learn the core cognitive and behavioural skills of challenging unhealthy beliefs and strengthening their healthy counterparts. Other work may include the use of counselling skills, psychological education, assertiveness exercises and role playing. According to Kirsch et al. 1993, the average client receiving cognitive behavioural hypnotherapy, improved further than at least 80% of clients receiving cognitive behaviour therapy only.

To find out more or retrain in CBH please go to our website www.cbttherapies.org.uk and request a prospectus.

Low Self Esteem, Self Acceptance and REBT

6 Jan

According to Rational Emotive Behaviour Therapy (REBT), one of the main schools of cognitive behaviour therapy offering a humanistic and philosophic model, low self-esteem occurs when a person makes a demand on himself or herself, others or the world that is not met and then self-depreciates in some way.

The following are examples of themes that are commonly involved in low self-esteem. These themes are inferential in nature and people react to them as if they are true, whether they are or not.

* Failing to achieve an important target or goal.

* Acting incompetently (in public or private).

* Falling short of one’s ideal.

* Failing to live up to one’s standards.

* Breaking one’s ethical code.

* Being criticised.

* Being ridiculed.

* Not being accepted, approved, appreciated or loved by significant others.

 

According to REBT theory, people do not disturb themselves about events because of the assumptions they make about these events; rather they disturb themselves because they hold irrational or unhealthy beliefs about these events. When low self-esteem predominates in people’s problems, their unhealthy or irrational beliefs largely take the form of rigid demands and self-depreciation beliefs. Albert Ellis has argued that self-depreciation beliefs are derived from rigid demands. Rigid demands are essentially non acceptance beliefs.

 

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There are four types of unhealthy or irrational beliefs that disturb you and four corresponding health beliefs that can help you become rational in the face of life’s adversities.

Those beliefs are:

Demands

A demand is the rigid expression of a desire for something and takes the form of an absolute such as ‘must,’ ‘I have to’, ‘I absolutely should’ e.g. ‘I must not fail’.

Awfulising

‘Awfulising’ is an unrealistic rating of how bad it is that your demand has or has not been met. The badness of the situation is rated at 100% or more bad. You believe that it is the worst thing that you can ever experience. e.g. ‘it’s awful that I failed’.

Low Frustration Tolerance

Also known as LFT, this is an irrational rating of your ability to handle or cope with difficulty or frustration e.g. ‘I cannot tolerate failure’.

Self/Other/World Damning

This is a global negative rating of the self, other people and, even, the world around you. The self/other or the world is rated as ‘totally bad’, ‘total failure’ and so on e.g. ‘I am a failure or worthless because I failed’.

Each unhealthy belief will have a corresponding healthy alternative.

According to REBT theory, self acceptance or unconditional self-acceptance is the healthy alternative to self-depreciation or low self-esteem. Unconditional self-acceptance is found when people hold healthy beliefs. These are desires about the way they want themselves, others and the world to be, but which are not then transformed into rigid demands.

At The College of Cognitive Behavioural Therapies we specialise in accredited courses in REBT. To learn more please see more information on our website http://www.cbttherapies.org.uk

Stoicism and REBT, the philosophic CBT model

19 Nov

The austere times we are now living through may go some way towards explaining the revival of Stoic philosophy with its emphasis on self-control and self-determination. There have been a number of books and articles published in recent times citing the Stoic approach to living and in particular its influence on CBT. Rational Emotive Behaviour Therapy (REBT) is one of the main schools of Cognitive Behaviour Therapy (CBT). It was developed by Albert Ellis, one of the most respected psychologists of our time.

 

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Stoicism teaches the development of self-control and fortitude as a means of overcoming destructive emotions; the philosophy holds that becoming a clear and unbiased thinker allows one to understand the universal reason. For the Stoics, ‘reason’ meant not only using logic, but also understanding the processes of nature. Living according to reason and virtue, they held, is to live in harmony with the divine order of the universe, in recognition of the common reason and essential value of all people.

 

Stoicism had a profound influence on Albert Ellis. Ellis frequently referred to the famous Epictetus quote:

“Man is disturbed not by things, but by the views he takes of them.”

The Stoic principles of reason and logic are a cornerstone of his therapeutic approach, and by using them we can discover and dispute the irrational beliefs that create our faulty thinking, symptoms and behaviours. Ellis’s A-B-C model puts this process into action, where A is the ‘activating event’, which links to C (the ‘consequences’ – emotional, behavioural, symptomatic), via B which is the belief which has been ‘triggered’ by A.

 

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Along with the Stoics, Ellis held that we can choose how we view the events in our lives, and the choices we make will determine whether or not we become disturbed by them. Common themes between the two are also seen in the ideas of tolerating discomfort while acting in accordance with one’s (healthy) beliefs. Ellis often used humour as a very effective way to help people realise the extent of their illogical thinking. A favourite tactic was blowing up someone’s anxiety to comical proportions so they could see the absurdity of their faulty thinking.

 

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At the CCBT we hold fast to these ideas as REBT underpins our training and workshops. REBT is the humanistic and existential school of CBT. It provides a universal approach to psychological health based on changing dogmatic beliefs into their healthy versions.

Gratitude – is it useful? Apparently, it is.

21 Oct

 “Gratitude is not only the greatest of virtues, but the parent of all the others” ~ Marcus Tullius Cicero

Cicero argued that from gratitude springs hope, kindness, courage, patience, generosity, wisdom, wisdom and so on. So is it possible that simply by practising gratitude, we could improve our lives? Be more content?

Gratitude has been around in most world religions and philosophy for millennia and science is now catching up. Since Seligman’s announcement of 2000 the American Psychology movement has been researching Happiness of which an integral part of that research, under the direction of Dr Robert Emmons, has been on Gratitude; its nature, its causes and its impact on human health and well-being.

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Here is a brief summary of Emmon’s research findings:

· Those who kept gratitude journals on a weekly basis exercised more regularly, reported fewer physical symptoms, felt better about their lives as a whole, and were more optimistic about the upcoming week compared to those who recorded hassles or neutral life events.

· Participants who kept gratitude lists were more likely to have made progress toward important personal goals (academic, interpersonal and health-based) over a two-month period compared to subjects in the other experimental conditions.

· A daily gratitude intervention (self-guided exercises) with young adults resulted in higher reported levels of the positive states of alertness, enthusiasm, determination, attentiveness and energy compared to a focus on hassles or a downward social comparison.

· Participants in the daily gratitude condition were more likely to report having helped someone with a personal problem or having offered emotional support to another.

· Children who practice grateful thinking have more positive attitudes toward school and their families.

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So it seems the evidence is pointing towards the possibility that, when people express their gratitude and are of a grateful disposition, people tend to have higher levels of subjective well-being or happiness and are generally less stressed. They suffer less with feelings of depression or anxiety and self-worth issues. They tend to be more independent, learn well from life’s lessons, develop healthy coping strategies, are more generous, sleep better, have a greater sense of fulfilment. People who exercise gratitude also appear to have less negative coping strategies, being less likely to try to avoid the problem, deny there is a problem, blame themselves, or cope through substance use.

Gratitude has been said to have one of the strongest links with mental health of any character trait. Numerous studies suggest that grateful people are more likely to have higher levels of happiness and lower levels of stress and depression. In one study concerning gratitude, participants were randomly assigned to one of six therapeutic intervention conditions designed to improve the participant’s overall quality of life (Seligman et. all., 2005). Out of these conditions, it was found that the biggest short-term effects came from a “gratitude visit” where participants wrote and delivered a letter of gratitude to someone in their life. This condition showed a rise in happiness scores by 10 percent and a significant fall in depression scores, results which lasted up to one month after the visit. Out of the six conditions, the longest lasting effects were caused by the act of writing “gratitude journals” where participants were asked to write down three things they were grateful for every day. These participants’ happiness scores also increased and continued to increase each time they were tested periodically after the experiment. In fact, the greatest benefits were usually found to occur around six months after treatment began. This exercise was so successful that although participants were only asked to continue the journal for a week, many participants continued to keep the journal long after the study was over.

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What makes gratitude the parent of all other virtues? Well if we takea look at Albert Ellis’s model of CBT, Rational Emotive Behaviour Therapy (REBT), it has a strong basis in stoic philosophy and he, as the Stoics, recognised that we disturb ourselves by the beliefs we hold about events. REBT’s theory identifies four beliefs that generally lead us to disturb ourselves. They are:

* Demanding something must or must not be (when it blatantly is).

* Awfulising the end of the world catastrophe when the demand is not met.

* Low Frustration Tolerance to the unberableness of what is happening or is not happening with thoughts like “ It’s unbearable, I cannot stand it”

* Self. Other or World Damming

So practising gratitude helps us to maintain a wider perspective , keeps us from “awfulising” beliefs that lead us to think the world is about to come to an end when the washing machine breaks down. Gratitude helps us to recognise that our first world problems are exactly that, first world problems and our lives do not depend on their resolution. By stopping our “awfulising” beliefs we reduce our feelings of anxiety and experience greater sense of physical ease, in turn we are able to feel more comfortable, reducing our “Low Frustration Tolerance” to discomfort or the unbearableness of our situation.

“He is a wise man who does not grieve for the things which he has not, but rejoices for those which he has” ~ Epictetus

Ways to Practice Gratitude

Before you implement a gratitude practice, there are a few things you should know that might help:

Remember, the goal is to actively practice gratitude, not just wait around to feel grateful. It doesn’t matter exactly how often you practice gratitude; what matters is that you do it routinely. Every day, once a week, three times a week–whatever works for you, just keep it consistent.

* Gratitude journal: This is the most common gratitude practice, and one of the most effective according to research. Get yourself a journal and write down 5 things you are grateful for. Try not to repeat items too often. You can do this each night before bed, or once a week, but do it regularly. It’s not how often you do it that counts—it’s how regularly.

* Gratitude Letter & Visit: Think of someone who has made a powerful impact on your life, write a letter of gratitude, and then visit and read it to them in person is the most powerful gratitude exercise you can do according to Seligman’s research.

* Say “Thank You” more often. Just start saying it. For everything. Everyone likes to be thanked, and you will feel more joy just for saying it.

* Write Thank You Notes. When someone touches your heart, write them a note. “Thanks for being a great friend” is simple but very effective. Texts and emails are good second best.

Thank you for reading this

Grief and Rational Emotive Behaviour Therapy (REBT)

7 Oct

Grief is an intense and complex emotion. It is the natural and appropriate response to the loss of someone or something significant to your life. When it is the loss of a parent, spouse, sibling or child it can be very difficult to bear. When the death is sudden and unexpected the emotional response can be considered traumatic.

 

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Most people are familiar with Elizabeth Kubler Ross’ five stages of grief, developed when she was working with the terminally ill, and mistakenly apply it to the experience of coping with bereavement. In fact Elizabeth Kubler Ross’ book is called “On death and dying” and the stages she talks about come from the conversations she had with people who were dying rather than the bereaved. She identified the stages as a way of helping people come to terms with their own death.

Applying these stages to bereavement suggests that grief is a liner process and that there is an end. That people will “get over it”.

It is simply not helpful, and it doesn’t happen. What does happen is that in time the bereaved learn to live with their loss

There is no process to grief, it is not linear and there is no time limit on it.

 

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Every day can be a struggle, and the triggers to the emotion of grief are numerous. This is extremely hard to deal with for both the bereaved and the people around them. Albert Ellis, the grandfather of CBT and the founder of Rational Emotive Behaviour Therapy (REBT) which is a philosophical model of CBT, has stated life is not easy, it is not fair and bad things happen to good people, and we always have a choice about how we respond to events.

We can demand that the death should not have happened, that the loss is off the scale bad, and that it is unbearable, all of which are normal and natural responses in the immediate aftermath. However, staying in the grip of that irrational belief, no matter how understandable, is unhealthy and unhelpful. It maintains the intensity of the grief at a level which renders the bereaved person unable to function, to eat, to sleep and to look after others in their care. Such a belief maintains the denial of an extremely difficult reality.

The reality of grief is stark, it is painful, uncomfortable and untidy, and it is individual. In the early stages of grief there is no “normal”

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However, accepting that is difficult to accept reality is an important step in getting on with living and is part of grieving. Accepting the reality that this tragic event has happened without demanding that it shouldn’t have will change the present reality. Acknowledging the truth that the death of a loved one is as bad as it gets, and that whilst the world as previously known may have been forever altered, the world has not ended and life does go on. And to fully acknowledge that although it may ‘feel’ unbearable at times it is bearable and as tough as it is to get through each day it is possible to take one step at a time and get through.

This is the attitude that can allow the bereaved to grieve appropriately and healthily, without denial. It is difficult to understand how and why, particularly in sudden or unexpected death. Demanding that it shouldn’t have happened leads to a much greater pain for the bereaved than accepting that it has happened.

REBT is humanistic and existential model of CBT. It is concerned with the person as a whole and the experiences that exist for all of us including suffering. It teaches us how to respond to suffering and adversities in a healthy way.

Solitude – why it’s good

23 Sep

“the state of being or living alone; seclusion: to enjoy one’s solitude.”

Most of us lead extremely busy lives these days. We spend at least 1 hour and 30 minutes each week stuck in traffic, over 30 minutes waiting for public transport due to traffic and road works, over an hour waiting in queues and shops, at least an hour dealing with bureaucracy and even longer trying find things we have misplaced at home. On average we spend one working day per week in these time consuming activities. On top of that working days are longer and we have access to many stimulants like the Internet, Twitter, Facebook and computer games. Time for taking a breath is a luxury for most.

Socrates said “An un-reflected life is not worth living”. This may be a tad strong of course but the point is reflecting on one’s life and taking stock every now helps us to grow, be thankful, question if we are happy and hopefully find solutions; to do that we need solitude. Solitude also allows us to just stop and take a breath and just be.

Great ideas and solutions more often stem from being alone with one’s thoughts.

For many people solitude is also a time to connect with greater things, for some it may be God or the higher self, and for others it may be nature or just being. This may be going to a place of worship such as a Church or walking in the countryside or just sitting in a park. For many people solitude is a time for nourishing the spirit.

 

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Why is it hard for some people?

Solitude is hard for some people because they have grown accustomed to a particular life style where being busy or being engaged in something external like Twitter or Facebook or the Internet is a buzz. Children are growing with over stimulation as a result of fast moving action packed games. The child grows into an adult who is unaccustomed to being OK with quite alone time.

For others it has become a luxury due to long working hours as well as having a busy family life.

For others it triggers anxiety. This is rather common. Some people think ‘I have to be doing something, being productive, because if I’m not it’s unbearable and proves I’m lazy’. So some people link it to their self worth and have low frustration tolerance to it.

For others it triggers anxiety about being alone. We have worked with many people, using Rational Emotive Behaviour Therapy (REBT), the Cognitive Behaviour Therapy (CBT) model that it based on Laws of Nature, whose anxiety disorders such as agoraphobia would make it impossible to sit alone and enjoy the solitude. The anxiety disorder itself is an obstacle to having solitude.

 

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How to achieve helpful solitude?

If someone does not get anxious about being alone, then there are many practical things to do. The most important step in creating time alone and solitude is setting a goal and then committing to it. It is vital that solitude is seen as a beneficial state first. You have to think of the benefits of solitude and make it significant. It has to be your personal goal.

1) Make solitude a goal and commit to it

2) Think of options available to you e.g. meditation classes, sitting in the park on for half an hour, walking, spending time alone in your home reflecting and so on.

3) Choose one or two

4) Do it regularly and consistently.

You don’t have to do this daily even though some people do of course. You can choose whether it’s once, twice, three times a week or even every other week. That too would be beneficial. You may decide to drive to the countryside every month or two. There are many alternatives, so be creative.

Anxious at the thought of taking time out?

If however, you become anxious at the thought of taking time alone or even being alone, then you need to explore what’s at the heart of your anxiety.

REBT, the philosophical CBT, has a simple explanation about why we feel anxious. It states that we feel anxious because we hold unhelpful or unhealthy beliefs and thoughts about something. There are four types of unhealthy beliefs that can trigger anxiety.

1) Absolutist thinking e.g. I must have feeling of excitement when I’m alone, I must not be bored, I have to be busy

2) Exaggerating the badness if the internal demand is not met e.g. it’s horrible to be alone, it’s terrible not to be busy

3) Low frustration tolerance if the demand is not met e.g. I can’t stand being alone, I can’t bear it if I’m not busy

4) Damning the self if the demand is not met e.g. If I’m not busy it proves I’m lazy and worthless

Such beliefs would trigger anxiety and most people have a tendency to avoid situations or states like solitude if it triggers anxiety.

Solution to anxiety about taking time out?

The solution is change the above beliefs by reflecting and realizing that they are not based in reality and that they are unhelpful if you want to make solitude a personal goal.

1) So accept that you don’t always ‘have to be busy’ for example

2) It’s not horrible or terrible even if you don’t want to do it often

3) You can stand it and bear it

4) You are not worthless if you take time alone

Initially as you practice solitude you may feel uncomfortable but keep thinking in the helpful and realistic way above and sit with this discomfort. After practicing this a few times you will become accustomed to solitude and from then on you will begin to have feelings of comfort and positivity about it. Your mind will then be free to just be, or to reflect.

People with anxiety disorders must first see their GP and perhaps consider therapeutic help.

How to cope more effectively with work-related stress

16 Sep

Work-related stress is one of the biggest (and most modern) blights to our physical and emotional wellbeing. According to research last year from the Centre for Economics and Business Research (Cebr), staff sickness cost the UK over £6.5bn. The report also said that staff absenteeism cost the average company about £620,000 a year.

 

Meanwhile, The Labour Force Survey 2011/12 found that around 22.7 million working days were lost last year because of work-related illnesses, whilst another, more recent, study of over 3,000 people discovered that one in three said their stress was work-related.

 

That’s a lot of lost money, a lot of lost days and a lot of unhappy workers!

 

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Work stress can come in a variety of guises, be it long hours, a workload that’s far too heavy, deadlines that are way too intense, interpersonal difficulties (such as not getting on with your manager), performance expectations, boredom, the threat of redundancy, and more; the list goes on.

 

Stressed out employees are more likely too feel irritable, experience mood swings, feel unable to cope and generally lead less productive working lives than their more relaxed counterparts.

 

Work stress itself can lead to a multitude of disorders including anxiety, depression, anger management issues, panic attacks, insomnia, alcohol and drug problems, even tension headaches and migraines.

 

The Healthy and Safety Executive (HSE) define stress as, “The adverse reaction people have to excessive pressures or other types of demand placed on them at work,” while the British Standards Institution (BSI) says, “Stress manifests as a physical, psychological or social dysfunction resulting in individuals feeling unable to bridge the gap with the requirements or expectations placed upon them.”

 

Technically, stress is the manifestation of the flight-or-fight response, a much-needed safety mechanism that helps alert you to danger and take the appropriate action. However, it’s meant to be a one-off reaction to specific challenges and pressures. Once the danger is over, the body (and the person that inhabits it) can return to normal.

 

Sadly, modern life is a never-ending series of threats and pressures and so the chemicals associated with the fight-or-flight response are constantly dumping toxins in the body, creating physical and emotional ill health.

 

But, there are things you can do to help restore that balance and become a healthy and productive working member of society once more and no, we’re not talking about changing your job!

 

Sure, it’s an option but, it’s one that’s a little drastic for some and nigh on impossible for others. Also, it doesn’t change the nature of the beast. What if the new job is even more pressurised than the last?

 

Which is where cognitive behavioural hypnotherapy (CBH) comes in very handy indeed.

 

CBH follows the philosophy that it is not the events in life that disturb you, but the views that you take of those events that disturbs you. So, if you’re thinking, feeling and acting in a way that you don’t like, but don’t seem to be able to change, we don’t look at the ‘thing’ we look at what you are telling yourself about the ‘thing.’

 

Change what you tell yourself, and you can change how you think, feel and act.

 

Work, then, is the ‘thing’ CBH can help you change your perceptions of. A trained professional can help you cope with pressure more effectively, facilitate solutions to difficult workloads and deadlines, aid you in dealing with those irksome interpersonal difficulties in a better way, conquer your angers and anxieties and lead to an altogether healthier, happier and more productive you.

 

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CBH, in the form of therapy, is an excellent tool for helping you manage your work-related stress. However, when delivered in the form of workshops (and yes, we are talking to all you HR managers out there) it can be an excellent form of prevention.

 

Just think what it would mean for your company and your staff if you could head stress off at the pass?

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