Tag Archives: anxiety

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.

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?

Training to Be a Cognitive Behavioural Hypnotherapist – My experience

13 Aug

I have just completed my Advanced Diploma exam at CCBT. The journey to this point has taken just over a year to complete taking the fast track route Foundation, Diploma before the Advanced Diploma courses. In this time I have learned huge amounts about myself, my fellow students and people in general. I am now a practicing CBH therapist and believe the courses have equipped me for this demanding and rewarding role. All the staff at CCBT willingly share their wealth of experience (without breaking confidentiality of course), are skilled trainers and are all thoroughly good people. The course materials are packed with pragmatic, useful, and concise information and the course assessments are challenging and thoughtfully designed to embed the underlying principles, core structure and key concepts of CBT / REBT.

Becoming a therapist wasn’t the main motivation for me when signing up for the Foundation course. Initially, the main reasons were personal (I wanted to learn more about self hypnosis and to understand more about depression and anxiety as I have friends and family members with these conditions) and professional (as a learning and development consultant, trainer, coach and mentor, I often work with people who have lost their confidence, have limiting beliefs about their potential and do not have any effective strategies to cope with stress and mental anguish).

 

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With this in mind, whilst being absorbed by the subject matter in and for itself, the main question I always had at the forefront of my thinking was: ‘‘How will this new knowledge be useful to me and how can I apply it?” It quickly became clear to me that the CBH concepts, skills and strategies would help me in relation to: (i) coping with my own challenges, insecurities, irrational demands and unhealthy emotions; (ii) understanding how to help and guide (though not treat) friends when they experience unhealthy, negative emotions; (iii) my role as a learning and development coach and consultant; (iv) my role as a potential CBH therapist.

The course has been fantastic in exceeding my hopes and expectations. On a personal level I have become closer to a family member now I understand her behaviour more and at work there have already been loads of benefits. Recently, for example, I undertook a training event with participants from all over England, called ‘Mindset and Mindfulness’. This was heavily influenced by what I’ve learned on the three CBH courses.

There is a quotation from Abraham Maslow that has always resonated with me; “To learn and not to do, is not to learn”. This has become my guiding principle in relation to CBH. Even though at the moment I am busy with my primary occupation as a learning and development consultant, I have decided to always be working with at least one therapeutic client at any given time, to cement my classroom learning with real therapeutic experience. My short term goal is to help people to cope more effectively with challenging events and psychological conditions. Going forward five years or more, I would love to have the breadth of experience and competence as a therapist to deliver courses of this nature and inspire other people, as I have been inspired by the whole experience at CCBT.

By Bob Craig

You Don’t Have to go to the Wilderness to Conquer OCD!

5 Aug

The current BBC Three documentary “Extreme OCD Camp” highlights the excessive lengths that sufferers of Obsessive Compulsive Disorder will go to try to cope with their condition. However, it is not necessary to take such extreme measures, as you will find out later in this blog.

 

Surprisingly many very successful people suffer from OCD including David Beckham, captain of England, part of the Olympic bid and the face of numerous advertising campaigns. Beckham has admitted he hates odd numbers and is obsessed with symmetry – if there’s three of something; he has to hide the third somewhere out of sight. If something is askew, he can’t rest until the row has been straightened. Before he can settle into a hotel room, he says he puts all of the books and pamphlets together in a drawer. Others celebrities such as Cameron Diaz have admitted to washing her hands constantly and to opening the doors with her elbows. Does any of this sound familiar to you? Whilst some of this behaviour may sound bizarre and even faintly amusing, for people who struggle with more serious OCD however, it is absolutely no joke and completely dominates their lives.

 

The World Health Organization lists OCD as among the 10 biggest causes of disability, yet many sufferers keep their illness hidden and the condition is often the subject of skepticism and derision.

OCD has two main features: obsessions, such as constant unpleasant and intrusive thoughts about issues such as contamination and symmetry; and compulsions, the irresistible urge to behave in a certain way.

 

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Men and women are equally affected, and OCD is thought to run in families, suggesting it may have a biological cause. Some research has shown that changes in brain activity and pattern may also cause the condition, and it often occurs alongside other illnesses, such as depression and anxiety.

 

Most importantly Cognitive Behaviour Therapy and Rational Emotive Behaviour Therapy (REBT), an influential school of CBT, are recommended by National Health as the first line therapy for OCD

A central tenant of REBT is that it is not events themselves that cause psychological disturbance but the view that we take of these events, our beliefs, which may be rational or irrational. People with OCD believe that their obsessions will somehow lead to disastrous outcomes for themselves or others. This sense of responsibility leads to self-denigration and heightened anxiety. In order to reduce their anxiety, they perform compulsive behaviours. When their anxiety is reduced and nothing catastrophic happens, the compulsions are reinforced strengthening the likelihood of repetition.

 

REBT helps the people to recognize that their anxiety and distress are provoked by their irrational thoughts and beliefs. They are taught how to dispute these and replace them with more rational coping statements. They are helped to develop unconditional self-acceptance about themselves and their condition enabling them to understand that compulsions are only temporarily anxiety reducing. It helps them to learn to tolerate their anxiety without resorting to compulsive behavior. As well as minimizing their low frustration tolerance about their OCD it also shows them through the use of other to cognitive, emotive, and behavioral techniques to cut down OCD’s primary symptoms of self-defeating counting, checking, repeating, ordering, and other obsessive-compulsive rituals.

 

Many people leave it for years before seeking treatment for their OCD (typically 12 years). So you don’t have to go to the Wilderness and you don’t have to suffer in silence, learn and try REBT, the CBT therapy that works on the symptom as well as providing a philosophy on life. http://tinyurl.com/poy4ln6

I don’t know…

8 Apr

In this blog we will look at why it is difficult for some people to say ‘I don’t know?’
The answer is simple, anxiety. Our feelings and emotions like anxiety and depression are determined not by events but by the way we think about these events. An event can be about all sorts of things including imagining saying ‘I don’t know’ or actually saying ‘I don’t know’. The specific triggers can vary from person to person.

At the heart of anxiety is irrational or unhealthy thinking or beliefs about the threat or risk of saying ‘I don’t know’ (be it real or perceived) to ourselves or to our personal domain (the things and people that matter to us). Rational or healthy thinking about this risk leads to what we call healthy concern or nervousness, different to anxiety or to panic.

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Anxiety about saying ‘I don’t know’ is commonly triggered by two things:

• A perfectionist internal demand to always know and viewing ‘not knowing’ as something catastrophic, unbearable or proof of worthlessness or of being a total failure. Not knowing is not just perceived as bad, it is perceived as ‘end of the world bad’.

• An internal demand to always be thought of in a positive way by others and viewing negative judgement as catastrophic, unbearable or proof of worthlessness or of being a total failure.

Examples:
Irrational or unhealthy belief at the heart of ‘anxiety’ and avoidance:

I absolutely must know, if not it would be awful, catastrophic, I couldn’t bear it or tolerate it, it would prove I’m a total failure.

The above does not accept the possibility of not knowing, even though in reality the person may not know.

People must not judge me negatively, because it would be awful, I couldn’t bear it, it would prove I’m a failure.

The above does not accept the possibility of negative judgement, even though it exists for everyone. The worth is linked to other people’s opinions.

Rational or healthy belief at the heart of healthy ‘concern’ and non avoidance:

I would really like to know but I accept the possibility that I may not or don’t know. If I don’t know it would be bad but not the end of my world, I would find it difficult but I will tolerate and bear it, it would not mean I’m worthless. I accept myself as a fallible human being like everyone else.

The above attitude allows for the possibility of not knowing to exist without linking one’s worth to it.

I would prefer it if people always thought positively of me but I accept that some might not (when I say I don’t know). It would be bad but not the end of the world, I would find it difficult but I can stand it, it would not mean I’m worthless. I accept myself as fallible. My worth does not depend on whether people like me or not.

The above belief accepts that negative judgement exists without linking one’s worth to it.

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So how do you free yourself from the paralysis of anxiety about saying I don’t know?

1) Change your beliefs about not knowing. Accept that you are human and therefore fallible. None of us know all the time.

2) Keep the badness of not knowing in proportion. Of course not knowing something may be bad in some situations and may have negative consequences but nevertheless the world does not come to an end. So keep it bad but not the end of the world bad.

3) Develop resiliency to not knowing. Accept you will find it frustrating, difficult, uncomfortable, but the truth of the matter is that you do survive it. Telling yourself you can’t tolerate nor stand not knowing is simply not true but it does impact greatly on your feelings of anxiety. So tell the truth ‘it’s hard but bearable’.


4) Accept yourself as fallible. No one is perfect so not knowing something at times is human. Believing that you’re a total failure or a worthless person because of it is unhelpful and is at the heart of your anxiety.


5) Accept uncertainty. Accept that at times you are unsure.


6) Put it into practice and say ‘I don’t know’, ‘I’m not sure at the moment’, ‘Let me think about it and I’ll come back to you’, ‘I don’t know but I will find out’. Then in your head repeat ‘I accept myself as fallible. My worth does not depend on whether I know or not or on whether people judge me or not.’

Accepting ourselves as worthwhile but fallible human beings frees us from the anxiety of saying ‘I don’t know’. As a consequence, we then can be free to find out and learn and improve and it also connects us to people as we come across as confident and happy in our own skin.

You may be interested in learning more about self acceptance and ego disturbance in our new Master Class Treating Ego Disturbance on 1st June 2013.

Oh dear! I just can’t decide!

27 Feb

How many times have we all been faced with decisions that we find very difficult to make!

This blog is going to delve a little in to the mind processes that help or hinder us in decision making.

In order to make decisions we have to weigh up the costs and benefits of making a decision and then take action in accordance with our decision. This is much harder than it sounds to achieve!

Decision making is a cognitive (mental) process. This process can be conscious or sub-unconscious (below our conscious awareness).

So what stops us from making decisions about certain things in our life?

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The simple answer is us.

Here are some possible reasons as to why we may not make certain decisions or why we may find it hard to make a decision.

1) We require more information to help tip the balance ‘for’ or ‘against’ whatever we are mulling over. You have asked 3 suppliers to provide you with an estimate about something. You will then wait to receive all three quotes before choosing which to go for.

2) Because it doesn’t matter to us or we don’t care about it or we think it has no impact on us or on what we think is important and finally we think that nothing would change anyway.

3) Anxiety. This is really at the heart of whether we have problems with making decisions. So the question is why do we feel anxious?

Our feelings and emotions are provoked not by events but by the way we think about these events. At the heart of anxiety is irrational or unhealthy thinking or beliefs about risk (be it real or perceived) to ourselves or to our personal domain (the things and people that matter to us). Rational or healthy thinking about risk lead to what we call healthy concern or nervousness, different to anxiety or panic.

Obviously decision making is part and parcel of everyday life and we need to be able to do it!
So how do we free ourselves from the paralysis of anxiety about making decisions?

1) Change your beliefs about mistakes and about getting things wrong. Accept that you are human and therefore fallible. The possibility of making a mistake exists for all of us.

2) Keep the badness of getting something wrong in proportion. Of course making the wrong decision can be bad and may have negative consequences but nevertheless the world does not come to an end. So keep it bad but not the end of the world bad.

3) Develop resiliency to getting things wrong. Accept you will find it frustrating, difficult, uncomfortable, but the truth of the matter is that you do survive it. Telling yourself you can’t tolerate nor stand making the wrong decision is simply not true but it does impact greatly on your feelings of anxiety. So tell the truth ‘it’s hard but bearable’.

4) Accept yourself as fallible. No one is perfect so getting things wrong is human. Believing that you’re a total failure or a worthless person because of mistakes or wrong decisions in unhelpful and is at the heart of your anxiety.

5) Accept uncertainty. Accept that at times you are unsure.

6) Construct a cost and benefit analysis of the options. The costs and benefits of making a decision in short and long term and the costs and benefits of not making a decision in the short and long term. This may help you see that avoiding making a decision about something you deem important does not have any long term benefits for you.

7) Gather relevant information before making an important decision but be realistic about it. Allow for the fact that you may never have all the information. You are more likely to realise this if you accept risk and uncertainty.