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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.

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.

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.

Maximise Your Full Potential with REBT!

12 Aug

A great Summer of sport has highlighted several major achievements by our British athletes, Andy Murray winning Wimbledon, Chris Froome winning the Tour de France and of course Mo Farah to name but a few. Clearly all of these individuals have worked hard both mentally and physically to unleash their full potential

 

Maxisport/Shutterstock.com

Maxisport/Shutterstock.com

 

In the 1950s, Albert Ellis pioneered a new type of psychotherapy called Rational Emotive Behaviour Therapy. Ellis held that the real reason his clients disturbed themselves had nothing to do with their childhoods (as advocated by Freud) but everything to do with their irrational beliefs. Intriguingly Ellis discovered that all his clients shared a number of similar irrational beliefs and that these irrational beliefs are usually accompanied by “shoulds” and “musts”.

A person may believe for example that he must have the love of a particular person, or that he should not have to go on multiple job interviews and risk rejection, or that he should never have to control anger, or that he must have the continual, unfailing devotion of loved ones…or it is the end of the world. Ellis also believed that humans are flawed and highly fallible, no matter how great our strengths. We may feel terrific after a great action or turn of events, but we also feel bad after something bad happens. Managing the opinions of others is even more difficult, because we can never please everybody. Instead of basing our self-worth on our actions and accomplishments we should accept ourselves unconditionally. We may rate our actions as good, bad, successful or unsuccessful, but this does not mean that it has to reflect on our self worth. REBT demonstrates that challenging these irrational thoughts allows you to focus on reality and make decisions based on rationality. Rather than avoidance taking constructive positive action allowing you to maximise your full potential.

So as we observe Murray and his preparations for his challenge to regain the American Open Title we can reflect that had he believed he absolutely “must” win Wimbledon or it was the “end of the world”, or based his self worth on the opinion of others (which for a long time was definitely not positive!) we may well have been waiting for another 77 years for a British champion.

 

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Four Levels of Happiness – Aristotle and REBT

15 Jul

Four Levels of Happiness – Aristotle and REBT

National Feel Good Day is launching on 19 July 2013 across the UK, where the entire nation is being called upon to dedicate time to paying compliments to friends, family and strangers alike and to celebrate feeling good.   Doing something for the benefit of another is one way to help your feel happier.

The Greek Philosopher Aristotle (384 BC – 322 BC) wrote that people strive for happiness and that happiness was the only thing that man seeks for its own sake.  Everything we strive for was for the purpose of happiness.  He said there are four levels of happiness.  This blog briefly looks at these four levels and explains the REBT (Rational Emotive Behaviour Therapy) philosophy and view point in each.  REBT is one of the most influential schools of Cognitive Behaviour Therapy and the one that underpins the teachings at The College of Cognitive Behaviour Therapies.

 

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Level 1

Aristotle said that the Level 1 happiness is felt when we get instant gratification.  This is feelings based, doing the things that feel instantly good.  Examples of instant gratification include: enjoying a good meal, sexual gratification, buying something we want, watching something we love like Tennis, Football or a Film, and so on.  He said that this type of happiness is short lived.  He also said it is unhealthy if one only pursues this type of happiness. 

This is similar to the REBT concepts of demanding beliefs where a person holds a core belief ‘I must feel immediately happy and therefore must do the things that provoke instant gratification’.  Obviously, wanting instant gratification is fine but insisting that you must have it becomes unhealthy because the demand must always be fulfilled in order to be happy at Level 1.  It can’t always be fulfilled.

 

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Level 2

Aristotle said another way to feel happy is to strive for ‘ego’ gratification.  This is Level 2 happiness.  Examples of achieving Level 2 happiness include: being the best in the class, best looking, wealthiest, most liked, admired or respected, being the most powerful.  Again, there is nothing wrong with wanting these things provided you pursue them in healthy and balanced way.  Aristotle said such pursuits become unhealthy if you only pursue this type of happiness.  In REBT we say pursue your ‘enlightened self interest’, meaning do not demand it and do not define your worth by it.  It’s healthy to want to be the best but it doesn’t mean that it MUST be so.

 

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Level 3 – National Feel Good Day

Another way to help your feel happy is to do things for the benefit of others. This is Level 3 happiness and it is about moving away from doing things just for your and doing something for someone else.  Examples of Level 3 happiness include: commitment, giving, loyalty, care, concern, forgiveness, acceptance, compassion and above all self-sacrifice.  This is a good thing to do and National Feel Good Day is about recognising this and doing it.  You know that you feel good when you receive a gift and also when you give a gift.  Receiving a gift is out of your control because it depends on someone else.  Giving a gift is within your control and it also provokes happiness.

 

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Aristotle also recognised that this can be unhealthy you if this becomes your only way of making yourself happy.  In REBT we say that if you demand this of yourself, put yourself down when you don’t always put others first then you will experience emotional problems.   REBT says give love, you are in control of giving love to a project, to a hobby, people, society, animals but do not demand that it always has to be this way and do not define yourself as worthless if you don’t always give love. 

 

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Level 4

Aristotle said that Level 4 happiness acknowledges that we all desire certain things and we all want life and other people to be a certain way you but there is acceptance of truth.  The truth that we are all imperfect human beings and that life is not always perfect.  Such a person enjoys a great inner peace because he or she no longer needs to be perfect and no longer needs others to be perfect.     This is idea is at the heart of REBT philosophy of healthy beliefs.  REBT says give up the demands.  Accept that you have desires and wants but that you do not need.  Accept yourself as imperfect, accept others are imperfect and accept that life is also imperfect at times.

So, be balanced and do Level 1, Level 2 and Level 3 happiness but if you strive for the philosophic Level 4 happiness you will feel better and happier.  Mix it up and for this week let’s all go for Level 3 happiness and do something nice for someone else.

 

 

  

Emotion Blog Series #2: Depression and Sadness

5 Jul

Depression is the second emotion we are looking at in our series on Emotions, there are eight altogether along with their “healthy counterparts” that are identified in the Ellis Model of RECBT.

Depression: An unhealthy negative emotion

Depression (an unhealthy negative emotion) is mostly provoked by holding unhealthy beliefs or attitudes (Demands) about loss or failure.

Its healthy counterpart is Sadness and occurs when we hold a healthy belief or attitude about loss or failure.

Depression is an unhealthy negative emotion and we can be depressed about many things.  Some examples are:

 

  • Loss or failure of job
  • Loss or failure of relationship
  • Death
  • Loss of freedom
  • Loss of control
  • Failure of success

               

How do you know if you are depressed or sad?

Depression is experienced by many people in a life time usually in reaction to external circumstances and it has a distinctive thought and behaviour pattern that we can identify.   When you feel depressed your thoughts become preoccupied with negative experiences and are unable to find the good or positive about anything in life. Thoughts have a historical focus with a tendency to remember old past losses or failures and rumination becomes more and more part of your thought processes.  If you are experiencing Depression you tend think you are a failure as a person and that in the future there is no hope so a pervading sense of helplessness and hopelessness is experienced. 

When you are depressed you feel like avoiding the world and the people in it, withdrawing into your head rather than going out; you pull away from people and life in general.   You may not feel like getting out of bed or going to work or meeting your friends.  Looking after yourself or your surroundings becomes unimportant.  When you are feeling depressed you are not interested in looking after yourself and, in severe depression, not bothering to wash or get dressed. You don’t feel like washing up or hoovering, tidying may become a thing of the past.   

When you are depressed you have a tendency to behave in destructive ways to try and avoid the feeling of depression.  It can lead to over eating or under eating, using alcohol or drugs to excess to avoid those feelings.

The thoughts experienced when feeing sadness, in contrast to depression, are more balanced.  You are able to think about both positive and negative aspects of the loss or failure. When you are experiencing sadness your thoughts do not remain focused in the past and previous failures instead you think that you will be able to deal with the current loss appropriately.  The thoughts of helplessness and beliefs that you are failure are not present in sadness.  Your thoughts are helpful and hopeful.

When you are sad you will tend to share your feelings and express what is happening to those around you.  You remain able to look after yourself and your environment recognising you have experienced a loss or failure and take constructive and helpful actions to support yourself through the experience.

If you recognise the thoughts and behavioural patterns of depression consider the changes that would support experiencing healthy sadness and begin to think and act in accordance with them. For example, if you are thinking everything is hopeless, recognise you are thinking this and you can begin to challenge that thought as you check reality and begin to recognise not everything is hopeless and continue to challenge your thoughts consistently, even if you don’t feel like it.  If getting out of bed and getting out of the house is your problem set yourself small achievable goals, like getting out of bed and taking a shower, eat something healthy, and do them consistently.

It will feel uncomfortable to start with but each day it gets easier, just as the same as when you learnt how to ride a bicycle, tie your shoes or make eggs for the first time.

Tips

1)      Make some goals

2)      Identify and take some immediate action to make your goals happen.

3)      Identify the regular actions to make the goals happen and do them.

4)      Stop telling yourself you are “Rubbish or the world is”

5)       Remember “you matter” and you are part of the human race which is fallible and chemically amazing at the same time.

6)      We generally think ourselves into misery, begin to change the way you think – unhealthy thoughts are normally rigid/illogical/inconsistent with reality and unhelpful healthy thoughts are – flexible, logical, consistent with reality and helpful

7)      Seek help if you continue to feel miserable.

 

Emotions

22 Jun

Over the next few months we will be writing about the different types of emotions we feel and why we feel them.  The explanation will be based on the Rational Emotive Behaviour Therapy (REBT), one of the main schools of cognitive behaviour therapy. 

REBT posits it is not the event, but the belief or view you hold about the event, which is at the heart of emotional states and behavioural tendencies.   The event can be something that has happened in the past, something that is happening now or something that could happen in the future.  It can also be real, imaginary or internal or external. 

Beliefs can be healthy or unhealthy.  Healthy beliefs provoke healthy negative emotions about adverse events, whilst unhealthy beliefs provoke unhealthy negative emotions about adverse events.  Many people think mistakenly think that any negative emotion is a problem and as such should be ‘worked on’.  This is not true. 

Unhealthy beliefs provoke unhealthy negative emotions like anxiety, depression, anger, guilt, hurt, hurt, jealousy, shame/embarrassment and unhealthy envy.

The healthy counterpart beliefs provoke healthy negative emotions like concern, sadness, annoyance, remorse, disappointment, concern for one’s relationship, regret and healthy envy. 

Diagram 1 shows the relationship between events, beliefs and their consequences.  Diagram 2 shows the emotional pairs and the themes of the beliefs that provoke them.  For example, Anxiety and Concern are emotional pairs.  Anxiety is the unhealthy emotion provoked by an unhealthy belief about a perceived threat or risk, while Concern is the healthy negative emotion provoked by a healthy belief about perceived threat or risk.

Events, beliefs and their consequences

Events, beliefs and their consequences

Beliefs

Healthy and unhealthy beliefs

The first blog will be on the emotional pair of Anxiety and Concern.   This will be published next week.  We hope you will find it interesting and helpful.