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Irritable Bowel Syndrome

5 Oct

Guest Post by Moya Layton

Irritable Bowel Syndrome commonly referred to as IBS, is a widespread and distressing functional bowel disorder, which carries a considerable burden both for sufferers and the medical profession alike. About two in 10 people in the UK have IBS and it’s twice as common in women as men. Although not life-threatening, IBS can be extremely debilitating for those people who suffer from it. The pathophysiology of IBS is uncertain and currently no single cause explains the condition, which is characterized more by symptoms, suffering and disability than by any demonstrable organic abnormality.

IBS can develop at any age, but most people have their first symptoms between the ages of 20 and 35. Symptoms may come and go and you may not have any symptoms for months and then experience a sudden flare-up. Common symptoms include, abdominal pain, feeling sick, indigestion, headache, backache, combined with an altered bowel habit that can be either constipation or diarrhoea predominant or a mixture of the two.

Although specific IBS symptoms may respond to certain medications unfortunately to date no single medication or class of medications has been demonstrated to be consistently successful in relieving the full spectrum of IBS symptoms. Traditional treatments for IBS include dietary therapy, antispasmodic medication and antidepressants; however it is important to note that only 25% of people who suffer with IBS symptoms respond to these traditional treatments methods.

A new understanding of IBS

Currently IBS being redefined as a disorder of brain gut dysfunction that does not fit into a specific psychiatric or medical condition. Doctors therefore are now moving from the disease-based model to a biopsychosocial understanding of this disorder. This model proposes that biological, psychological (thoughts, emotions, and behaviours), and social factors interact to play a significant role in the initiation and perpetuation of the disease or illness.

Cognitive Behavioural hypnotherapy combines hypnotherapy, clinically proven to relieve symptoms, and cognitive behavioural techniques, to directly address the maladaptive thought processes and behaviours that emerge from and perpetuate IBS. This therapy approach exemplifies this biopsychosocial
understanding.

Hypnotherapy for IBS is widely recognised as one of the success stories. Response rates to treatment have been identified as 80% or more in most published trials with evidence suggesting that individuals who respond to hypnosis treatment for IBS can generally look forward to years of reduced bowel symptoms.

It has been also been identified that many people with IBS frequently suffer from anxiety and depression and worry excessively about their illness and symptoms. The combination of cognitive behavioural techniques with hypnosis therefore allows the client to directly focus on changing these maladaptive thinking patterns. Clients learn how to modify their beliefs about illness, chronic pain and discomfort. They also learn how to challenge the catastrophic thought processes they may be experiencing about the social and occupational consequences of their gastrointestinal symptoms. This allows them to change their morbid pessimism about their condition and any perceived helplessness about their ability to cope with this disorder.

If you already work with clients who suffer from IBS or wish to see clients who present with IBS or are simply interested in the subject then the Moya Layton CCBH Master Class on IBS is for you.

IBS is a complex and multifaceted disorder and the effective use of Cognitive Behavioural Hypnotherapy will teach you how you develop a well-established effective therapy programme for your client. This therapy not only addresses the IBS symptoms themselves, but also challenges the distorted dysfunctional thinking patterns that underpin and perpetuate this chronic and distressing disorder allowing clients to understand that they can finally gain control over their symptoms.

 

IBS is a complex disorder

History of Mental Health Treatment

6 Sep

For this blog post, we decided to write a potted history of the development of mental health treatment over the ages, having found an interesting article on this topic. It is amazing to see how treatment has progressed to where we are today…

Mental Health treatment has come a long way

The treatment and support offered to people suffering from mental health problemsthroughout history has been both complex and bizarre. Although well intentioned, the lack of understanding and knowledge often led to inhumane and distressing events.

Looking at early beliefs, we can see a pattern emerging. The most common cause was believed to be demonic possession or some other supernatural force. For example as early as 5000 BC, early man believed that mental health problems were the result of supernatural phenomena, as can be seen by   the discovery of trepanned skulls, where holes were made in the skull to release the ‘demon’. In ancient Mesopotamia, the sufferers were treated using exorcisms, incantations, prayer, atonement, and other various mystical rituals in an effort to drive out the evil spirit.

Hebrews believed that all illness was inflicted upon humans by God as punishment for committing sin, and therefore Priests would appeal to God as the ultimate healer to cure the sickness.  Ancient Persians attributed illness to demons and believed that good health could be achieved through proper precautions to prevent diseases.

As we move forward in time, there seems to be more understanding and attempts at therapy start to include engagement of the brain and thought processes. Indeed the Ancient Egyptians recommended that those afflicted should engage in recreational activities such as concerts, dances, and painting in order to relieve symptoms and achieve some sense of normalcy.

The Greek physician Hippocrates denied that people suffered from mental health problemsdue to supernatural forces and instead proposed that it stemmed from natural occurrences in the human body, particularly pathology in the brain. Although, of course a far more enlightened belief, this resulted in treatments such as emetics and laxatives being used or patients were bled using leeches. Not so enlightened!

By the time we arrive in the sixteenth century, the shame and stigma attached to mental health problems often caused people to hide their family members suffering from mental health problems or simply abandon them, leaving them to a life of begging and vagrancy. Asylums began to be established around the world, but living conditions were often deplorable and there were very little attempts at treatment or support of the patients.

Obviously reform was needed!

Philippe Pinel in 1792, showed that patients with mental health problems would improve, if they were treated with kindness and consideration. Further advances were made with the development of psychoanalysis by Sigmund Freud. Freud believed that anxiety arose as different parts of the human mind battled each other, resulting in mental health problems. The resulting treatments created by Freud are known as psychoanalysis, or “talking cures” and began with hypnosis.

Other treatments about this time included electroconvulsive therapy and psychopharmacology, which were designed to correct a patient’s chemical imbalance. This was further developed with the first shock therapy using electricity in 1938. Anti-psychotic drug therapy became more common in the 1940s, such as thorazine, valium and prozac, although these treatments were only able to control the symptoms. This led to many people being convinced that all illnesses could be effectively managed with medication, and resulted in patients once again being left unsupported.

So having looked at this history as a whole, we find there have been much needed developments in mental health care but improvement was still needed…

In more recent times we have seen the evolution of Cognitive Behavioural Therapy. This took place in three stages.  The first stage was when behaviour therapy started to emerge independently, in both UK and America. The second stage was the growth of cognitive therapy, which took place in America during the mid-1960s. The third stage was the merging of behaviour and cognitive therapy into cognitive behaviour therapy, in the late 1980s. CBT is now widely accepted and is practised by a growing number of clinicians.  It is, probably, the most broadly and confidently endorsed form of psychotherapy.  CBT dominates clinical research and practice in many parts of the world. CBT is also advocated by the NHS as part of the treatment process. Cognitive Behavioural Hypnotherapy (CBH), the combination of Cognitive Behavioural Therapy and Hypnosis, which is of particular interest to us at the college, is proving to be extremely effective in the treatment and support of patients.

Look out for another blog post coming soon with more on the evolution of CBT.

Back to School Worries

5 Sep

As the summer holidays draw to a close, it may not be the lack of sunshine that is in the forefront of many parents’ minds. After such a long break from the normal routine of attending school, many children can find the prospect of returning to school very daunting. There are lots of things to think about, such as, what will my new school be like, will I make some new friends, will my lessons be hard, will I be left out? These sorts of concerns can cause a great deal of anxiety.

Back to School can be stressful

Parents can also dread the start of the new term, if they anticipate their child will experience anxiety and distress. Fortunately for most children, once over the hurdle of getting through the school gates, the excitement of new friends, teachers and subjects takes over and they quickly settle down and enjoy the familiarity of school routines.

However, this is not always the case, as for some children, the anxiety can persist past the school gate, leading to psychosomatic symptoms or acting out behaviours. These can include feeling ill in the mornings and sleep problems, and if the anxiety problems are not resolved, the child may refuse to attend school.

To prevent an outright refusal to go to school, it is helpful for parents to talk with their child about their worries so they feel safe and secure. It is important to talk about school in a light and fun way, encouraging the child to talk about their thoughts and feelings, so any issues can be resolved quickly.

There are some simple but effective ways of allaying their anxiety such as:

  • When dropping children at school, parents should smile, hug, kiss and wave goodbye. It is important to create a light and positive atmosphere, so the child picks up on this instead of anxiety.
  • When shopping  for school supplies, take the opportunity to chat about school in a healthy, relaxed and fun way.
  • Make sure there is enough time in the morning to get your child to school in a calm fashion without rushing and shouting.
  • Let younger children know in advance what is happening. Nobody likes the unknown and  the anxious child struggles with it even more so. Surprises can be very hard to cope with when you are already in a state of anxiety.
  • Try to meet at the school gate with a fellow student so the child has company.
  • With a younger child, ensure they know where to look for you at the end of the day and make sure you are not late.

As we said earlier, most children quickly settle back to school without any major problems, but a child who becomes very withdrawn or experiences loss of appetite and lethargy may be experiencing depression. Any dramatic change in mood and behaviour, that does not seem to be diminishing as the term progresses, should be seen as a sign and it may be necessary to seek advice from a professional.

Of cold pizza and life’s recurrent demands

24 Aug

Guest Blog Article by Luke Shaw

 

So, picture me if you will, twenty years younger, several pounds lighter and full of the unbridled optimism that both these characteristics imbue. I had completed my three year acting course at LAMDA and our final day of term was spent in the prestigious Duke of Yorks theatre in London’s West End, giving our all (twice) in individually prepared and lovingly rehearsed solo speeches. My vision was naturally one of being cascaded with agents’ calling cards, all dying to represent me, and being waltzed off into the sunset. As I picked my way through the cold finger buffet that my dear Alma mater had spared every expense on, and waited for the inevitable tap on the shoulder, it eventually came just as I was picking bits of ham off the ‘non-meat’ pizza. I turned in anticipation and was greeted by one of London’s leading agents, “Hi, were you in the show?”, not a promising opening but I gamely responded in the affirmative, “Could you tell me where I might find Paul Hickey?”. And that, as they say, is show business!

Cold Pizza anyone?

The next day I was now considering life through the prism of having no agent and having to be master of my own destiny. My weighty life choices were balanced finely between whether to dress up as a dog for fifty quid for a mate or temporarily suspend any form of responsibility in finding a job by donning a backpack and disappearing round Europe for a month. A few weeks later and fifty pounds richer (woof!), as I was being strip searched on the Swiss-French border, I took a moment to reflect on how significantly 24 hours had changed how I viewed my life. On my last day of term as I marched confidently up as speech number 43 in front of a bored and diminishing audience, I had been a feckless and carefree drama student, safely cosseted in the lovingly protective arms of his nurturing college, the next day I was a wretched and troubled unemployed actor.

As I look back on it now I can laugh at the naiveté I displayed in my expectation of employment, like there was almost some entitlement to a living. Ha! Pathetic! I can hear the demands now, “I should have a job!”, “I have to be successful”, “I must do better than Paul Hickey!”. Even now I feel a growing wave of tension as I recall the historic catastrophising (how could anything in the world be worse than this?!). Of course now I am more mature and sanguine about such events, whereas at the time I naturally went out and blew lots of money getting paralytic and attempting to sleep with anyone who’d let me…. Ah halcyon days!

Fast forward to the present day and the safety of a new college, where my major discomforts were where to sit in the class each month and who will notice if I have too many of the biscuits that Beverley has lovingly provided. Of course I’m not trying to diminish the potentially troubling journey through the diploma, but as a comparison to actually qualifying and plying one’s trade in the same way, it is, when I look back, (even to the depths of weekend 7 when I spent most of Saturday blubbing like baby (apologies if you haven’t done that one yet!)), a considerably easier time. And so again having travelled the Rubicon through those critical 24 hours spent re-evaluating my circumstances during which I went from a cocky and largely comfortable CCBH student to just another troubled unemployed therapist, I have to report that the greatest challenges lie beyond the completion of the course. As I look back on it now I can laugh at the naiveté I displayed in my expectation of employment, like there was almost some entitlement to a living. Ha! Pathetic! I can hear the demands now, “I should have a job!”, “I have to be successful”, “I must do better than Paul Hickey!”…. wait a minute… something seems familiar here….

So my message, for anyone who cares, (and of course I don’t if you don’t, in a fallible way of course not a nasty way), is to enjoy the course, it is truly fantastic. And suspend any awfulising until after graduation (or better still, dispute the hell out of it before then!). Meanwhile I’m off to challenge my  limiting beliefs around self promotion and the procrastination that prevents me from trying to.

Luke Shaw (Class of 2011)

 

 

Emotional Blog Series #5: Hurt and Disappointment

23 Aug

Another common emotion we have all experienced and experience from time to time is hurt.  Hurt is an unhealthy negative emotion provoked by holding an unhealthy belief about being treated badly, let down or betrayed by someone (and you think you do not deserve such treatment).  It can also be provoked by unhealthy belief about someone who appears to hold your relationship less dearly than you thought.  Disappointment is the healthy version of hurt and is provoked by holding a healthy belief about being treated badly, let down or betrayed.

Disappointment is the healthy version of hurt

You feel hurt or disappointment when you have an emotional connection to another person.  They can be felt within different relationships such as family, friendships, intimate, special interest group and work relationships.  They are emotions associated with lack of care.  It is less common to experience hurt or disappointment towards a stranger.

When you feel hurt, you tend to exaggerate the unfairness of the other person’s behaviour towards you and you think the other person doesn’t care about you.  You will see you yourself as someone who is uncared for and you will recall other times when you have been hurt.  Your mind will also be focused on how the other person should put things instead of you.  As a result, you will tend to sulk and shut down communication as well as criticise the other person without telling them that feel hurt.

Disappointment is the healthy version of hurt.  When you feel disappointment, you will be more realistic in your judgement about the other person’s behaviour.  You won’t automatically jump to the conclusion that you are uncared for.  You will tend to judge the insensitive behaviour rather than personalise it.  You won’t see yourself as alone and uncared for and you won’t think of other times when you have been hurt.  You will explain to the other person how you feel and won’t shut down communication and criticise them unnecessarily.  So the mind set and behaviours that trigger disappointment are more balanced, realistic and assertive.

An emotion often associated with hurt is anger.  This combination is known is Anger-Hurt.  Hurt is directed towards the self because the person thinks they are alone and uncared for and anger is directed towards the other person and the other person is damned as bad.  The anger emotion is the most obvious and the most expressed emotion out of the two.  Hurt tends to be held under the surface emotion of anger.

 

Tips

  1. Take responsibility for your emotions and explain how you feel but do not make the other person the cause of your feelings.  Use expressions like ‘I felt hurt when you ignored me’ rather than ‘you hurt me when you when ignored me’.
  2. Ask but do not demand change from the other person.
  3. Do not pay the other person back by being overly critical about other things they are doing.  Express your feelings in a balanced way.
  4. Focus on the incident that you felt most hurt about and refrain from bringing past hurts into the same conversation.

Emotion Blog Series #4: Guilt and Remorse

2 Aug

Guilt is an unhealthy emotion

Guilt is the fourth unhealthy negative emotion in our Emotions series.  We experience guilt when we hold unhealthy beliefs about transgressing our own moral code, do not live up to our moral code or hurting the feelings of a significant other.

 

Guilt is mostly created by the rigidly held beliefs that you “absolutely shouldn’t have” thought or done something or that you “absolutely should have” done something.

For example, you may believe “I have done something morally wrong and I absolutely should not have done that wrongdoing and I am a bad person for doing that”

You can feel guilt about many things.  You may feel guilty about being depressed believing “I shouldn’t be depressed, it’s wrong to feel this way when I have so much, I should be grateful for what I have”.  This belief would lead to the self damning belief “I am a bad person” which perpetuates the cycle of guilt and depression.  You may experience guilt about some behaviour, for example infidelity, telling lies, getting unhealthily angry with a loved one, keeping secrets and so on.

 

Remorse is the healthy negative emotion that partners guilt, which occurs when you hold healthy or rational beliefs about breaking your own moral standards or about hurting the feelings of a significant other. For example, a healthy belief would be “I have broken my moral code and I wish I hadn’t done that wrongdoing and I accept that I have done something I perceive as morally wrong. I accept myself as a worthwhile and fallible human being even though I have done something wrong.  I will make amends and ask for forgiveness for what I have done.”

 

How do you know if you are guilty or remorseful?

When you think you are guilty you believe you have committed the sin and you tend to take all the responsibility for the transgression and tend not to think others have any responsibility.  For example, imagine you had promised to record your best friend’s favourite programme whilst she was away on a business trip and you failed to do so.  If you hold an unhealthy belief that, “I absolutely should always do what I am say I am going to do” you will disturb yourself over this failure to act in accordance with this belief.   You may tend to over apologise or compensate by buying a disproportionately extravagant gift to make amends or you may try to avoid contact with your friend.

If you held the healthy belief that” I strongly prefer to act in accordance with what I say I am going to do but I don’t absolutely have to” then you will experience remorse and will more than likely apologise  for your failure to your friend without begging for forgiveness.

When we experience guilt we also believe we will be punished in some way for that sin.

To escape the pain of guilt we try and escape the feeling in self defeating ways, avoiding situations or people so you are not confronted by your feeling of guilt, you may use alcohol or recreational drugs to suppress the feelings

When we feel guilty we may feel like begging for forgiveness and agreeing to never commit the sin again, we may even feel like punishing ourselves taking physical penance or by acts of deprivation.

If you are experiencing the healthy negative emotion of remorse you will be able to think of your behaviour in context, with an understanding and self acceptance as a “fallible human being”.  With remorse you do not think there will be some kind of retribution for your sin and you are able to keep perspective and recognise your responsibility as well as others in the given situation.

When feeling remorseful you make appropriate amends for your poor behaviour without making excuses and face up to the healthy discomfort.  Instead of begging for forgiveness as in guilt you ask for forgiveness and have no desire to punish yourself or become defensive about your actions.

 

TIPS

  • Become and remain aware of your values and the moral code you wish to apply to your life but don’t hold your values rigidly.  No one is perfect.
  • Take responsibility for your actions and acknowledge any transgression and then ask for forgiveness, make amends and learn from it.

 

If asking for forgiveness or making amends is no longer an option, then forgive yourself and accept that you are a fallible human being who has made a mistake.  Learn from it.

Emotion Blog Series #3: Anger and Annoyance

19 Jul

Unhealthy Anger is an unhealthy negative emotion provoked by holding an unhealthy belief or attitude about  i) you or another breaking your non moral rule  or ii) a threat to your self esteem or  iii) you experiencing frustration.

Healthy Anger or Annoyance is a healthy negative emotion provoked by holding a belief or attitude about i) you or another breaking your non moral rule or ii) a threat to your self esteem or iii) you experiencing frustration.

Anger is an unhealthy emotion but a natural one. Annoyance is a healthy anger

Anger is a common emotion and we all experience it.  There are two types though; healthy and unhealthy.  In this blog we will use the Anger to mean unhealthy Anger and Annoyance to mean healthy Anger

Both Anger and Annoyance can be intense.  You can feel Anger or Annoyance with yourself, with another person or with life and the world. 

You can feel Anger or Annoyance about all sorts of things.  The following are typical triggers.   This is by no means a complete list of triggers.

  • Rejection
  • Unfairness
  • Disagreement
  • Lateness
  • Rudeness
  • Criticism
  • Failure
  • Insensitivity
  • Hassles e.g. traffic jams, weather etc
  • Having an emotional problem
  • And so on

 

How do you know if you are feeling Anger or Annoyance?

The easiest way to understand your emotions is to check your thoughts and your behaviour or behavioural tendencies when feeling the emotion. 

When you feel Anger towards someone you will tend to exaggerate the actions of the other person, who has broken your personal rule.  You will think that the other person had malicious intent.  You will think that you are absolutely right and the other person is definitely wrong and you will not see the other person’s point of view at all.  You mind will be focused on revenge.

When you feel Anger towards you will like attacking the other persona physically or verbally.  You will feel like paying them back e.g. ignoring them or staying silent.  You will feel like recruiting allies against the other person.  Apart from feeling like doing all of these things, sometimes you will actually do them.

If you are feeling Anger with yourself you will tend to be extremely hard on yourself, call yourself ‘idiot’, ‘stupid’ and other self damning words.  You will feel like punishing yourself or you will indeed punish yourself.

If feeling Anger due to life frustrations then you will feel high levels of frustrations, be damning of the life and situations or God.  You may feel like taking your frustration on furniture, dashboard of your car.

When you feel Annoyance with someone your thoughts will be more balanced and you are less likely to see malicious intent behind someone’s actions.  You will be more open to the possibility that you may be wrong, able to listen to the other person’s point of view.  You mind will not be pre occupied with seeking revenge.

When feeling Annoyance you will feel like talking and behaving assertively but it will be with the right intent of solving the conflict.  You will feel like asking the other person to make changes to their behaviour but you do not demand it. 

When you feel Annoyed with yourself you thoughts will be focused on the wrong thing that you did but without damning yourself.  Your mind set will be accepting of the fact that some mistake was made but you also see yourself as an imperfect person who will learn and move on.

If you are feeling Annoyance with life’s hassles, your mind set will be accepting of the fact that there are hassles and frustrations in life but you also think that you can cope with it even though it is a pain in the backside.

 

Tips

Accept yourself as fallible and imperfect.

Accept that other’s as fallible and imperfect.

Accept that hassles and frustrations exist and are part of life and that you can cope with them even though you find them challenging.