7 things they don’t teach you at therapy school

When I graduated as a psychotherapist in 1990 I had been taught a lot of things that were never any use in therapy – watching out for ‘transference issues’ was one of them. I had also not been taught a lot of things that I really needed to know but only found out later. So like most therapists I had to make it up as I went along. But now I have been doing it for 23 years I have learnt a few things I am going to share with you.

Here is my list of seven things that really do work.

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A new solution for anxiety, worry, obsessions and lots more besides

Obsess
Research shows that at least 10% of the population, at any one time, suffer from an anxiety disorder. But if you take into account the figures for those experiencing stress-related problems – which are clearly related to worry and anxiety – the figures are likely to be far higher. And most of us have problems with negative thinking: gloomy thoughts about the future, guilt over the past, the idea that we can’t cope with the present and obsessions about having to get it all right.

On that subject the National Institute of Mental Health – NIMH – calculates that around 1% of the population in the USA suffer from Obsessive-Compulsive Disorder – or OCD – (that’s over 3 million people). But millions more are bothered by obsessions about work, about our personal appearance, about our success or failure in life and anything else that might have to do with the Ego. Incidentally, obsessions are also the driver for addictions to drugs, alcohol and gambling, about which I wrote in my last series of articles.

I have recently been carrying out renewed work with clients suffering from chronic worry, panic attacks, OCD, negative thoughts and anxiety. As a result I have been refining my method of working with these problems. The next few articles show the way out.

The method comprises four basic steps as follows:

  • 1. Change Position
  • 2. Change Attitude
  • 3. Change Focus
  • 4. Practice Mindfulness

For any worry, obsession or negative thought you first change your position to it. Instead of identifying the thought as coming from you, instead you change to seeing the worry as coming from IT – meaning Headmind at it’s worst.

Next you change your attitude to these ‘Headmind tapes’. Instead of getting upset by them you learn how to get bored with them, or to laugh at them, or to treat them with the contempt they deserve.

Then you change your focus of attention, immediately engaging Headmind with something focused, productive, entertaining or calming to do.

Finally, you practice Mindfulness on a daily basis. This could entail Meditation, Yoga, Tai Chi, Qui Gung, Sensate focusing or a myriad other ways of focusing on Bodymind or on present moment awareness. This isn’t strictly a ‘fourth step’ but a way of making the other three steps easier to practice.

More on this method in the articles that follow.

So stay tuned.

The brain and addictions

Addict1

This is the start of a new series on addictions.

Addictions to alcohol, to heroin, to cocaine, to mephedrone, cannabis, ketamine and pain-killers. There are also addictions to (inappropriate) sex, gambling and to junk food. I have worked with all of these over the years and, initially, found them tough to work with. But I have found an approach that is successful, which I will share with my readers in a later article.

But firstly it is important to understand how addictions get established. In the brain.

Three key points to bear in mind before you read on are that addictions are created by a) changes in dopamine levels, b) obsessions created in Headmind in the pre-frontal lobes and c) a loss of emotional connection through Bodymind.

From one point of view – the Bodymind view – the brain is a superbly engineered chemical factory. Chemicals for growth, chemicals for energy creation, chemicals for digestion and metabolism, chemicals for defence against infection, chemicals for tissue repair, chemicals that activate the muscles, and chemicals for emotions, mood, sensation and so on.

Some of these chemicals are simple protein chains called peptides, which act as messengers to other areas in the body such as the immune system, while others are more complex, such as the hormones that lock to particular glands further down from the brain (adrenalin, for example) and the neuro-transmitters (such as dopamine) that work on the central nervous system within the brain itself.

Hold fast to the fact that all chemicals are ‘drugs’, just as all drugs are chemicals. Meaning, that they influence brain function. In that sense even oxygen is a drug.

Dopamine is an interesting drug because Bodymind uses it to tell you whether or not one course of action will be more satisfying than the alternative. For example, if you are faced with a choice between doing the garden now and watching tv your body might use dopamine to tell you to do the garden now if you have a passion for it or it might tell you to watch tv if one of your favourite films is on. In this connection it is important to bear in mind that dopamine mimics your passion. If your long-term desire is to write good blog articles then you are more likely to write one instead of going to the pub. The important point here is that a dopamine rush will support you when you decide to go for goals that are important to you rather than short-term distractions (but see below for some information on how this can go wrong as addictions develop).

The fact is that some Headmind-based obssessions (or ‘cravings’ if you will) – particularly those for alcohol, cocaine and heroin – disrupt Bodymind’s finely-tuned reward system.

Using hard drugs like alcohol triggers an explosion in Dopamine levels and when Bodymind notices this it damps down the production of Dopamine in order to restore balance. As Dopamine levels drop below the norm (typically the day after drug abuse) the person experiences tedium, apathy, lethargy and numbness. This, in turn, is interpreted by Headmind as a need to take more of the drug. Dopa Which leads to an escalating cycle of abuse-depletion-cravings-increased abuse and increased cravings. In time, this leads to a state in which the individual obtains no relief whatever from the original drug and goes on to try other drug combinations. Which is why many addicts are frequently addicted to two or more drugs at the same time.

The Brain scans reproduced here illustrate the difference in Dopamine depletion between four groups of addicts and normal controls. The reddish-yellow scans on the left are normal, while the weaker, greenish scans on the right are abnormal, showing up that Dopamine receptor activity is much reduced. In sex and gambling addictions the same phenomenon will appear on a slightly weaker scale.

Although these addictions have a catastrophic effect on the central nervous system they are reversible. Dopamine levels can be restored over a few weeks with abstinence. But to achieve that changes in thinking are required and a re-connection to Bodymind. And I will write about those when I describe the cure.