9 STEPS TO MANAGING YOUR ILLNESS
1. TAKE CHARGE OF YOUR LIFE.
Manage your illness; adopt and maintain a positive belief system; allow time for love, wonderment and serenity; don't do it alone; and forgive yourself for past mistakes. Steps 2 through 9 which follow provide the basis for Managing Your Illness. Put as many of these positive steps as possible to work for you each day. New Directions' four+ meetings per month will help to focus on the skills that you require to take charge of your life.
Develop a Positive Mental Attitude (PMA) and use it to attain success. Believe strongly in your ability to achieve and sustain a functional, productive, and happy life and use the resources and experience of New Directions and other support group members to aid you in this objective.
Don't fight the enemy -- depression or mania -- alone. It is cunning, recurrent and exhausting.Provide time each day for fun, relaxation, mindfulness and love. Remember that depression thrives on your stress, aloneness and despair. Expect miracles each day and allow time to wonder at the world's beauty and diversity.
2. FIND A GOOD PSYCHIATRIST.
Find the very best psychiatrist you can to work with you. Don't settle for anyone less. Your choice of psychiatrist is one of the most important decisions you will make in the management of your illness.Choose someone you intuitively like and feel comfortable with, someone who treats you with respect and is comfortable answering your questions.Your psychiatrist should be an expert in prescribing medication. He or she should be up to date on the latest medications and latest medical developments. In addition, he should schedule you for necessary blood work if you're on medications such as Lithium or Tegretol.
Today it's quite common for some psychiatrists to specialize in medication only, while others do both traditional "talk therapy" plus medication. Many people see two kinds of mental health professionals: a psychiatrist who dispenses medication and a psychotherapist for "talk therapy. " (More about talk therapy in Step No. 6).It's important to have that good psychiatrist NOW, while you're well, instead of waiting until you're in the midst of a crisis. Check with group members or your family doctor for a referral. Referrals are preferable to picking out someone at random from the phone book.
3. TAKE THE RIGHT MEDICATION.
Once you've found a doctor to put your trust in, the two of you can work on getting just the right medication(s) -- if necessary -- to keep you healthy. Sometimes it takes patience and diligent trial and error effort to hit upon the right combination of drugs for you. Remember that the medical arsenal has greatly expanded over the years and chances are extremely good that you can be helped.Take an active part in learning about your medication. Ask questions: What exactly is the medication supposed to do? What category does it fall under? Antidepressant? Antianxiety? Antipsychotic? How soon will it work? What side effects might you expect? How long should you stay on a medication before you and your doctor conclude it doesn't help you? Are there other meds you can try instead?While the doctor is the undisputed expert, it's in your very best interests to be an informed consumer. (See New Directions "Guide to the Most Commonly Used Psychiatric Drugs.")
4. EDUCATE YOURSELF ABOUT YOUR ILLNESS.
Most illnesses have a frightening ring to them. Shed light on the facts about depression and manic depression. Don't rely on hearsay reports, much of which contain half truths or distorted myths. Find out the truth. The more you know about your illness, the less intimidated and the more in charge you will feel.Knowledge is power. Many feelings of helplessness are reduced as people take bold steps to gain knowledge and learn the "good news" -- that highly effective treatments are available, that medical progress has been made in the past years and continues to be made, and the fact that so many people share your illness and you are not alone.
Information on mood disorders is available from numerous sources: the public library, bookstores, group members, your psychiatrist, psychotherapist, videos, lectures at local hospitals and New Direction's library. New Directions has established a psychoeducation program providing professionals to speak to our members on topics pertinent to diagnosis and treatment of the illness.
5. LEARN TO PREVENT EPISODES.
Both depression and mania can often be caught in their earliest stages and, with appropriate treatment, brought under early control.Learn what your early warning signals are. Then take action to combat them. Call your doctor when your earliest symptoms appear. You and he can then plan a strategy which hopefully can nip the illness in the bud. This can range from using medication ... to having therapy sessions ... to making changes in your personal life that may cause you distress.The ability to take action when we feel an episode coming on puts us in a powerful position to prevent a full-blown episode. (See "Catching a Manic Episode Before it Gets Started/How to Stop a Hypomanic Episode.")
6. GET "TALK THERAPY" IF NEEDED. In addition to medication, many people benefit greatly from one-on-one therapy.While medication is invaluable in alleviating symptoms of depression or mania or in stabilizing the mood, some people are still left with a residue of unresolved personal issues that may interfere with living well. These issues may include relationships with others, job success, personal growth and fulfillment, negative thinking, etc.One especially common problem is the lack of self-esteem people feel after having been diagnosed with a mood disorder -- or after suffering a major episode of the illness.In this and other cases, therapy with a skilled psychotherapist can prove of tremendous value. In therapy, we gain an understanding into our inner selves: our strengths, our conflicts, our patterns of behavior. Through this understanding comes the ability to change and to grow.
7. GET INVOLVED WITH WORK OR OTHER MEANINGFUL ACTIVITIES.
Staying healthy begins with having something meaningful to do each day. People who work at jobs they enjoy feel productive, needed and important. They feel a sense of belonging, a part of society. The pride they feel in their jobs is reflected in their self-esteem and self-confidence.
Work comes in many varieties. Some people find satisfaction in a relatively low-stress job, while others enjoy the challenge of having lots of responsibility. What matters is that your job fits your emotional needs -- which may change from time to time -- and that your job bring you that vital sense of satisfaction.Not everyone is able to work. Fortunately there are several options to keep people stimulated and to take them out of their homes. Volunteer work offers a cornucopia of opportunities in almost every field imaginable. Volunteer work can be a prelude to entering the work force or it can be a valuable end in itself.Another option is the "Day Program", also called "Partial Hospitalization program". Like volunteer work, it may be temporary or on a more permanent basis. Day programs offer structured days of activities, therapy groups and fellowship with others.But no matter what you choose to do each day, staying healthy means leaving home, getting out into the world and making a contribution.
8. JOIN A SUPPORT GROUP.
Support groups are unique. They offer an all-important sense of validation, a feeling that, "Hey, I'm not the only person with this condition, I'm in good company."Groups offer role modeling, practical information on how to cope, education on the illness and medication, doctor referrals, friendship and camaraderie, and a safe place to unburden yourself about things you may not be able to share anywhere else.
9. REACH OUT. There is a magic in being able to help someone else. Put your unique experiences to work. You are in a privileged position to help out others who share your same illness ... to lend an understanding ear or to offer a message of hope.No one can understand like someone who's been through it. Your experiences can make a difference in someone else's life.
Showing posts with label cognitive therapy. Show all posts
Showing posts with label cognitive therapy. Show all posts
Cognitive Dissonance
Question: What Is Cognitive Dissonance?
Answer: People tend to seek consistency in their beliefs and perceptions. So what happens when one of our beliefs conflicts with another previously held belief? The term cognitive dissonance is used to describe the feeling of discomfort that results from holding two conflicting beliefs.
When there is a discrepancy between beliefs and behaviors, something must change in order to eliminate or reduce the dissonance.
Examples of Cognitive Dissonance
Cognitive dissonance can occur in many areas of life, but it is particularly evident in situations where an individual's behavior conflicts with beliefs that are integral to his or her self-identity. For example, consider a situation in which a woman who values financial security is in a relationship with a man who is financially irresponsible.
The conflict:
It is important for her to be financially secure. She is dating a man who is financially unstable. In order to reduce this dissonance between belief and behavior, she can either leave the relationship or reduce her emphasis on financial security. In the case of the second option, dissonance could be further minimized by emphasizing the positive qualities of her significant other rather than focusing on his perceived flaws.
A more common example of cognitive dissonance occurs in the purchasing decisions we make on a regular basis. Most people want to hold the belief that they make good choices. When a product or item we purchase turns out badly, it conflicts with our previously existing belief about our decision-making abilities.
How to Reduce[/u] Cognitive Dissonance
There are three key strategies to reduce or minimize cognitive dissonance:
Focus on more supportive beliefs that outweigh the dissonant belief or behavior. Reduce the importance of the conflicting belief.
Change the conflicting belief so that it is consistent with other beliefs or Behaviour. Why is Cognitive Dissonance Important?
Cognitive dissonance plays a role in many value judgments, decisions and evaluations. Becoming aware of how conflicting beliefs impact the decision-making process is a great way to improve your ability to make faster and more accurate choices.
Answer: People tend to seek consistency in their beliefs and perceptions. So what happens when one of our beliefs conflicts with another previously held belief? The term cognitive dissonance is used to describe the feeling of discomfort that results from holding two conflicting beliefs.
When there is a discrepancy between beliefs and behaviors, something must change in order to eliminate or reduce the dissonance.
Examples of Cognitive Dissonance
Cognitive dissonance can occur in many areas of life, but it is particularly evident in situations where an individual's behavior conflicts with beliefs that are integral to his or her self-identity. For example, consider a situation in which a woman who values financial security is in a relationship with a man who is financially irresponsible.
The conflict:
It is important for her to be financially secure. She is dating a man who is financially unstable. In order to reduce this dissonance between belief and behavior, she can either leave the relationship or reduce her emphasis on financial security. In the case of the second option, dissonance could be further minimized by emphasizing the positive qualities of her significant other rather than focusing on his perceived flaws.
A more common example of cognitive dissonance occurs in the purchasing decisions we make on a regular basis. Most people want to hold the belief that they make good choices. When a product or item we purchase turns out badly, it conflicts with our previously existing belief about our decision-making abilities.
How to Reduce[/u] Cognitive Dissonance
There are three key strategies to reduce or minimize cognitive dissonance:
Focus on more supportive beliefs that outweigh the dissonant belief or behavior. Reduce the importance of the conflicting belief.
Change the conflicting belief so that it is consistent with other beliefs or Behaviour. Why is Cognitive Dissonance Important?
Cognitive dissonance plays a role in many value judgments, decisions and evaluations. Becoming aware of how conflicting beliefs impact the decision-making process is a great way to improve your ability to make faster and more accurate choices.
Panic Disorder, Your Questions Answered
Answers to Your Questions About Panic Disorder
Panic Disorder is a serious condition that around one out of every 75 people might experience. It usually appears during the teens or early adulthood, and while the exact causes are unclear, there does seem to be a connection with major life transitions that are potentially stressful: graduating from college, getting married, having a first child, and so on. There is also some evidence for a genetic predisposition; if a family member has suffered from panic disorder, you have an increased risk of suffering from it yourself, especially during a time in your life that is particularly stressful.
Panic Attacks: The Hallmark of Panic Disorder
it occurs suddenly, without any warning and without any way to stop it.
the level of fear is way out of proportion to the actual situation; often, in fact, it's completely unrelated.
Panic Disorder is a serious condition that around one out of every 75 people might experience. It usually appears during the teens or early adulthood, and while the exact causes are unclear, there does seem to be a connection with major life transitions that are potentially stressful: graduating from college, getting married, having a first child, and so on. There is also some evidence for a genetic predisposition; if a family member has suffered from panic disorder, you have an increased risk of suffering from it yourself, especially during a time in your life that is particularly stressful.
Panic Attacks: The Hallmark of Panic Disorder
A panic attack is a sudden surge of overwhelming fear that comes without warning and without any obvious reason. It is far more intense than the feeling of being 'stressed out' that most people experience. Symptoms of a panic attack include:
racing heartbeat
difficulty breathing, feeling as though you 'can't get enough air'
terror that is almost paralyzing
dizziness, lightheadedness or nausea
trembling, sweating, shaking
choking, chest pains
hot flashes, or sudden chills
tingling in fingers or toes ('pins and needles')
fear that you're going to go crazy or are about to die
You probably recognize this as the classic 'flight or fight' response that human beings experience when we are in a situation of danger. But during a panic attack, these symptoms seem to rise from out of nowhere. They occur in seemingly harmless situations--they can even happen while you are asleep.
it occurs suddenly, without any warning and without any way to stop it.
the level of fear is way out of proportion to the actual situation; often, in fact, it's completely unrelated.
it passes in a few minutes; the body cannot sustain the 'fight or flight' response for longer than that. However, repeated attacks can continue to recur for hours.
A panic attack is not dangerous, but it can be terrifying, largely because it feels 'crazy' and 'out of control.' Panic disorder is frightening because of the panic attacks associated with it, and also because it often leads to other complications such as phobias, depression, substance abuse, medical complications, even suicide. Its effects can range from mild word or social impairment to a total inability to face the outside world.
In fact, the phobias that people with panic disorder develop do not come from fears of actual objects or events, but rather from fear of having another attack. In these cases, people will avoid certain objects or situations because they fear that these things will trigger another attack.
How to Identify Panic Disorder
Please remember that only a licensed therapist can diagnose a panic disorder. There are certain signs you may already be aware of, though.
One study found that people sometimes see 10 or more doctors before being properly diagnosed, and that only one out of four people with the disorder receive the treatment they need. That's why it's important to know what the symptoms are, and to make sure you get the right help.
Many people experience occasional panic attacks, and if you have had one or two such attacks, there probably isn't any reason to worry. The key symptom of panic disorder is the persistent fear of having future panic attacks. If you suffer from repeated (four or more) panic attacks, and especially if you have had a panic attack and are in continued fear of having another, these are signs that you should consider finding a mental health professional who specializes in panic or anxiety disorders.
What Causes Panic Disorder: Mind, Body, or Both?
Body: There may be a genetic predisposition to anxiety disorders; some sufferers report that a family member has or had a panic disorder or some other emotional disorder such as depression. Studies with twins have confirmed the possibility of 'genetic inheritance' of the disorder.
Panic Disorder could also be due to a biological malfunction, although a specific biological marker has yet to be identified.
All ethnic groups are vulnerable to panic disorder. For unknown reasons, women are twice as likely to get the disorder as men.
Mind: Stressful life events can trigger panic disorders. One association that has been noted is that of a recent loss or separation. Some researchers liken the 'life stressor' to a thermostat; that is, when stresses lower your resistance, the underlying physical predisposition kicks in and triggers an attack.
Both: Physical and psychological causes of panic disorder work together. Although initially attacks may come out of the blue, eventually the sufferer may actually help bring them on by responding to physical symptoms of an attack.
For example, if a person with panic disorder experiences a racing heartbeat caused by drinking coffee, exercising, or taking a certain medication, they might interpret this as a symptom of an attack and , because of their anxiety, actually bring on the attack. On the other hand, coffee, exercise, and certain medications sometimes do, in fact, cause panic attacks. One of the most frustrating things for the panic sufferer is never knowing how to isolate the different triggers of an attack. That's why the right therapy for panic disorder focuses on all aspects -- physical, psychological, and physiological -- of the disorder.
Can People with Panic Disorder lead normal lives?
The answer to this is a resounding YES -- if they receive treatment.
Panic disorder is highly treatable, with a variety of available therapies. These treatments are extremely effective, and most people who have successfully completed treatment can continue to experience situational avoidance or anxiety, and further treatment might be necessary in those cases. Once treated, panic disorder doesn't lead to any permanent complications.
Side Effects of Panic Disorder
Without treatment, panic disorder can have very serious consequences.
The immediate danger with panic disorder is that it can often lead to a phobia. That's because once you've suffered a panic attack, you may start to avoid situations like the one you were in when the attack occurred.
Many people with panic disorder show 'situational avoidance' associated with their panic attacks. For example, you might have an attack while driving, and start to avoid driving until you develop an actual phobia towards it. In worst case scenarios, people with panic disorder develop agoraphobia -- fear of going outdoors -- because they believe that by staying inside, they can avoid all situations that might provoke an attack, or where they might not be able to get help. The fear of an attack is so debilitating, they prefer to spend their lives locked inside their homes.
Even if you don't develop these extreme phobias, your quality of life can be severely damaged by untreated panic disorder. A recent study showed that people who suffer from panic disorder:
are more prone to alcohol and other drug abuse
have greater risk of attempting suicide
spend more time in hospital emergency rooms
spend less time on hobbies, sports and other satisfying activities
tend to be financially dependent on others
report feeling emotionally and physically less healthy than non-sufferers.
are afraid of driving more than a few miles away from home
None of this needs to happen. Panic disorder can be treated successfully, and sufferers can go on to lead full and satisfying lives.
How Can Panic Disorder Be Treated?
Most specialists agree that a combination of cognitive and behavioral therapies are the best treatment for panic disorder. Medication might also be appropriate in some cases.
The first part of therapy is largely informational; many people are greatly helped by simply understanding exactly what panic disorder is, and how many others suffer from it. Many people who suffer from panic disorder are worried that their panic attacks mean they're 'going crazy' or that the panic might induce a heart attack. 'Cognitive restructuring' (changing one's way of thinking) helps people replace those thoughts with more realistic, positive ways of viewing the attacks.
Cognitive therapy can help the patient identify possible triggers for the attacks. The trigger in an individual case could be something like a thought, a situation, or something as subtle as a slight change in heartbeat. Once the patient understands that the panic attack is separate and independent of the trigger, that trigger begins to lose some of its power to induce an attack.
The behavioral components of the therapy can consist of what one group of clinicians has termed 'interoceptive exposure.' This is similar to the systematic desensitization used to cure phobias, but what it focuses on is exposure to he actual physical sensations that someone experiences during a panic attack.
People with panic disorder are more afraid of the actual attack than they are of specific objects or events; for instance, their 'fear of flying' is not that the planes will crash but that they will have a panic attack in a place, like a plane, where they can't get to help. Others won't drink coffee or go to an overheated room because they're afraid that these might trigger the physical symptoms of a panic attack.
Interoceptive exposure can help them go through the symptoms of an attack (elevated heart rate, hot flashes, sweating, and so on) in a controlled setting, and teach them that these symptoms need not develop into a full-blown attack. Behavioral therapy is also used to deal with the situational avoidance associated with panic attacks. One very effective treatment for phobias is in vivo exposure, which is in its simplest terms means breaking a fearful situation down into small manageable steps and doing them one at a time until the most difficult level is mastered.
Relaxation techniques can further help someone 'flow through' an attack. These techniques include breathing retraining and positive visualization. Some experts have found that people with panic disorder tend to have slightly higher than average breathing rates, learning to slow this can help someone deal with a panic attack and can also prevent future attacks.
In some cases, medications may also be needed. Anti-anxiety medications may be prescribed, as well as antidepressants, and sometimes even heart medications (such as beta blockers) that are used to control irregular heartbeats.
Finally, a support group with others who suffer from panic disorder can be very helpful to some people. It can't take the place of therapy, but it can be a useful adjunct.
If you suffer from panic disorder, these therapies can help you. But you can't do them on your own; all of these treatments must be outlined and prescribed by a psychologist or psychiatrist.
How Long Does Treatment Take?
Much of the success of treatment depends on your willingness to carefully follow the outlined treatment plan. This is often multifaceted, and it won't work overnight, but if you stick with it, you should start to have noticeable improvement within about 10 to 20 weekly sessions. If you continue to follow the program, within one year you will notice a tremendous improvement.
If you are suffering from panic disorder, you should be able to find help in your area. You need to find a licensed psychologist or other mental health professional who specializes in panic or anxiety disorders. There may even be a clinic nearby that specializes in these disorders.
When you speak with a therapist, specify that you think you have panic disorder, and ask about his or her experience treating this disorder.
Keep in mind, though, that panic disorder, like any other emotional disorder, isn't something you can either diagnose or cure by yourself. An experience clinical psychologist or psychiatrist is the most qualified person to make this diagnosis, just as he or she is the most qualified to treat this disorder.
This Article is designed to answer your basic questions about panic disorder; a qualified mental health professional will be able to give you more complete information.
Panic disorder does not need to disrupt your life in any way, you are not alone and there are both those who can help and those who understand. Contact me for information on a No Panic Service offered both in Ireland and the UK
Psychotherapy the Basics
Wikipedia
Psychotherapy is a set of techniques intended to improve mental health, emotional or behavioral issues in individuals, who are often called "clients". These issues often make it hard for people to manage their lives and achieve their goals. Psychotherapy is aimed at these problems, and solves them via a number of different approaches and techniques; commonly psychotherapy involves a therapist and client(s), who discuss their issues in an effort to discover what they are and how they can manage them. Because sensitive topics are often discussed during psychotherapy, therapists are expected, and usually legally bound, to respect patient privacy and client confidentiality.
General description
Given that psychotherapy is a kind of treatment restricted mostly to verbal exchanges, practitioners do not have to be medically qualified. In most countries, however, psychotherapists must be trained, certified and licensed with a range of different licensing schemes and qualification requirements in place around the world. Psychotherapists may be psychologists, social workers, trained nurses, psychiatrists, psychoanalysts, or professionals of other mental health disciplines. Psychiatrists' training focuses on the prescription of medicines, with some training in psychotherapy. Psychologists have special training in mental health assessment and research in addition to psychotherapy. Social workers have special training in mental health assessment and treatment as well as linking patients to community and institutional resources.
Recent trends in drug development to treat chemical imbalances have led to a more wide spread use of pharmaceuticals in conjunction with psychotherapy by medically qualified mental health nurse practitioners, psychiatrists, and in some states prescribing psychologists . While having benefits for patients with ailments such as bipolar disorder, impulse problems, schizophrenia and obsessive compulsive disorder, drugs of late have begun to be used as a 'quick fix' and are gaining less favor in the therapeutic community.
Psychoanalysis
Psychotherapy is a set of techniques intended to improve mental health, emotional or behavioral issues in individuals, who are often called "clients". These issues often make it hard for people to manage their lives and achieve their goals. Psychotherapy is aimed at these problems, and solves them via a number of different approaches and techniques; commonly psychotherapy involves a therapist and client(s), who discuss their issues in an effort to discover what they are and how they can manage them. Because sensitive topics are often discussed during psychotherapy, therapists are expected, and usually legally bound, to respect patient privacy and client confidentiality.
General description
Given that psychotherapy is a kind of treatment restricted mostly to verbal exchanges, practitioners do not have to be medically qualified. In most countries, however, psychotherapists must be trained, certified and licensed with a range of different licensing schemes and qualification requirements in place around the world. Psychotherapists may be psychologists, social workers, trained nurses, psychiatrists, psychoanalysts, or professionals of other mental health disciplines. Psychiatrists' training focuses on the prescription of medicines, with some training in psychotherapy. Psychologists have special training in mental health assessment and research in addition to psychotherapy. Social workers have special training in mental health assessment and treatment as well as linking patients to community and institutional resources.
Recent trends in drug development to treat chemical imbalances have led to a more wide spread use of pharmaceuticals in conjunction with psychotherapy by medically qualified mental health nurse practitioners, psychiatrists, and in some states prescribing psychologists . While having benefits for patients with ailments such as bipolar disorder, impulse problems, schizophrenia and obsessive compulsive disorder, drugs of late have begun to be used as a 'quick fix' and are gaining less favor in the therapeutic community.
There are at least five main systems of psychotherapy:
psychodynamic,
cognitive
humanistic/supportive
behaviorism
Brief counseling
History
Psychoanalysis
Although there are some bodies of thought in psychology without Sigmund Freud in their legacy, most can be traced back to his work starting in the 1880s in Vienna. Trained as a neurologist, Freud began noticing neurological problems in patients that had no biological basis. Seeing blindness, paralysis and anorexia with no apparent physical cause, he looked towards the mind for answers. Finding some evidence that those who were mentally ill could exhibit physical symptoms, he discovered colleagues and teachers who were equally perplexed and interested in such matters like Josef Breuer and Jean-Martin Charcot.
Freud opened up a private practice in 1886 until 1896 that mostly treated women who showed symptoms of hysteria (which, at that time, was very loosely defined). Using such techniques as dream interpretation, free association, transference and analysis of the id, ego and superego, his colleagues developed a system of psychotherapy termed 'psychoanalysis'. Students and colleagues of his such as Alfred Adler, Otto Rank and Carl Jung became psychoanalysts themselves, and formed their own differentiating systems of psychotherapy. These were all later termed under a more broad label of 'psychodynamic', meaning anything that involved the psyche's conscious/unconscious influence on external relationships and the self. Psychodynamic psychotherapy and psychoanalysis are considered to be particularly effective at treating certain mental disorders, such as personality disorders and mood disorders.
Current psychodynamic approaches continue to develop and change. Contemporary Freudian approaches usually retain Freud's emphasis on sexuality, aggression, and mental conflict, and often prefer insight-oriented, uncovering psychotherapy to more supportive techniques. Contemporary Freudians, for the most part, continue to believe that psychotherapy is most effective when it leads to increased self-knowledge on the part of the patient. Other current psychodynamic approaches -such as object-relational and self-psychological approaches- prefer techniques designed to change the patient's habitual patterns of living by building an especially authentic or supportive relationship with the analyst that is believed to help the patient learn new ways of relating to others and to life in general.
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Help
Know the Signs of Trauma
People often wonder, “If most trauma reactions are normal and will pass by themselves in time, how do I know when I should seek professional help?”
That’s a good question. On one hand, the reactions you are experiencing may subside by themselves during the days and weeks after an event if you:
Recognize that the trauma reactions seem to be normal responses to abnormal events.
Take some time to care for yourself.
Have supportive people around you.
On the other hand, just like it’s sensible to check in with a doctor when you’ve got a severe case of the flu, talking to a trained counselor after a traumatic event can be very helpful. There are also some trauma reactions that require you to seek help from a mental health professional. To continue with the medical analogy, these severe trauma symptoms suggest that your case of the flu may have been complicated by pneumonia. If you catch pneumonia, you need to see a doctor. And if you experience any of the following severe trauma reactions, you should contact a mental health professional. Likewise, if you observe these signs in someone else who has experienced a traumatic event, you should strongly encourage them to contact a mental health professional.
The following may be signs of a severe trauma reaction:
Suicidal thoughts
Feeling as if you might be a danger to yourself or others
Heart palpitations, chest pain, trouble breathing or other potentially serious physical symptoms (contact a physician immediately)
Severe psychological symptoms, including:
Flashbacks
Amnesia
Enduring feelings of unreality and “disconnection from the world”
Feeling completely overwhelmed or paralyzed
Feeling that you cannot handle the intense thoughts, feelings, and bodily sensations alone
A history of mental illness and psychiatric treatment
Substance abuse (e.g., consistently using alcohol or sleeping medication to help you sleep)
Feeling that your emotions are not “falling into place” over time and experiencing chronic tension, confusion, emptiness, and exhaustion
Noticing that your relationships are suffering and/or sexual problems are developing
Driving yourself to stay active all the time to avoid your feelings
How do I find professional help?
Many humanitarian workers live and work in places where contacting a mental health professional is difficult. Begin by contacting the Human Resources department of your employer. They may be able to refer you to an appropriate person or resource.
That’s a good question. On one hand, the reactions you are experiencing may subside by themselves during the days and weeks after an event if you:
Recognize that the trauma reactions seem to be normal responses to abnormal events.
Take some time to care for yourself.
Have supportive people around you.
On the other hand, just like it’s sensible to check in with a doctor when you’ve got a severe case of the flu, talking to a trained counselor after a traumatic event can be very helpful. There are also some trauma reactions that require you to seek help from a mental health professional. To continue with the medical analogy, these severe trauma symptoms suggest that your case of the flu may have been complicated by pneumonia. If you catch pneumonia, you need to see a doctor. And if you experience any of the following severe trauma reactions, you should contact a mental health professional. Likewise, if you observe these signs in someone else who has experienced a traumatic event, you should strongly encourage them to contact a mental health professional.
The following may be signs of a severe trauma reaction:
Suicidal thoughts
Feeling as if you might be a danger to yourself or others
Heart palpitations, chest pain, trouble breathing or other potentially serious physical symptoms (contact a physician immediately)
Severe psychological symptoms, including:
Flashbacks
Amnesia
Enduring feelings of unreality and “disconnection from the world”
Feeling completely overwhelmed or paralyzed
Feeling that you cannot handle the intense thoughts, feelings, and bodily sensations alone
A history of mental illness and psychiatric treatment
Substance abuse (e.g., consistently using alcohol or sleeping medication to help you sleep)
Feeling that your emotions are not “falling into place” over time and experiencing chronic tension, confusion, emptiness, and exhaustion
Noticing that your relationships are suffering and/or sexual problems are developing
Driving yourself to stay active all the time to avoid your feelings
How do I find professional help?
Many humanitarian workers live and work in places where contacting a mental health professional is difficult. Begin by contacting the Human Resources department of your employer. They may be able to refer you to an appropriate person or resource.
Trauma and Negative Emotion
Perceived Threat and Negative Emotions During Trauma
The exceptionally threatening character of traumatic events has been highlighted in the diagnostic criteria for PTSD (American Psychiatric Association, 1980; World Health Organization, 1992). Perceived threat to life during trauma showed consistent correlations with PTSD severity in a recent meta-analysis (Ozer, Best, Lipsey, & Weiss, 2003), with an average weighted correlation of .26. For perpetrators of violence, the perceived threat to their social status may be an important additional source of threat (Beck, 1999). It was therefore included as a possible predictor in the present study.
Emotional reactions during trauma are also highlighted in the diagnostic criteria for PTSD, in particular fear, helplessness, or horror (American Psychiatric Association, 1994). In Ozer et al.'s (2003) meta-analysis, the intensity of such negative emotions showed an average weighted correlation of .26 with PTSD severity. Other negative emotions that have been shown to predict PTSD include anger and shame (Andrews, Brewin, Rose, & Kirk, 2000).
Cognitive Processing and Disorganized Trauma Memories
Theories of PTSD suggest that information processing is compromised during trauma and that compromised information processing explains PTSD symptom severity over and above what is explained by high arousal and negative emotions (e.g., Brewin et al., 1996; Ehlers & Clark, 2000). The most widely investigated indicator of such compromised processing is dissociation, which was the best predictor of PTSD in Ozer et al.'s (2003) meta-analysis, with an average weighted correlation of .35.
Dissociation is a complex concept, and it is unclear how it relates to other forms of cognitive processing that have been shown to influence memory (Roediger, 1990; Wheeler, 1997, 2000). Ehlers and Clark (2000) suggested that two further cognitive processing dimensions, data-driven processing (i.e., the predominant processing of sensory as opposed to conceptual information) and lack of self-referent processing (i.e., failure to encode new information as related to the self and other autobiographical information), predict whether people develop reexperiencing symptoms after trauma. These processes are thought to overlap in part with aspects of dissociation. Preliminary empirical support for a role of data-driven processing and lack of self-referent processing in intrusive trauma memories was found in studies of trauma survivors and volunteers exposed to distressing films (Murray, Ehlers, & Mayou, 2002; Rosario, Williams, & Ehlers, 2006).
Compromised cognitive processing is thought to lead to deficits in the autobiographical memory for the traumatic event. There are different hypotheses about the nature of this deficit, including a deficit in memory representations that facilitate intentional recall (Brewin et al., 1996), highly fragmented memories (e.g., Foa & Riggs, 1993; Herman, 1992), and poorly elaborated memories that are inadequately incorporated into their context of other autobiographical memories (e.g., Ehlers & Clark, 2000). Poor elaboration is thought to lead to poor inhibition of unintentional triggering of aspects of the trauma memory by matching cues. Ehlers, Hackmann, and Michael (2004) further suggested that the poor elaboration should be most pronounced for those parts of the trauma that are later reexperienced.
The mechanisms involved with the formation of trauma memories and deficits in recall specified in the different PTSD models are difficult to measure (Ehlers et al., 2004; McNally, 2003). One way is to code narratives of the traumatic event for indicators of the hypothesized mechanism. Common to the fragmentation and poor elaboration models is the hypothesis that intentional recall of trauma memories should be disorganized. Several studies have shown preliminary support for more disorganized trauma narratives in patients with PTSD versus those without PTSD (Foa, Molnar, & Cashman, 1995; Halligan, Michael, Clark, & Ehlers, 2003; Murray et al., 2002) and in volunteers exposed to a highly unpleasant film who developed intrusive memories than those without subsequent intrusions (Halligan, Clark, & Ehlers, 2002).
Appraisals of the Trauma and Its Aftermath
PTSD has been found to be associated with excessively negative appraisals of traumatic events (Ehlers & Clark, 2000; Foa & Riggs, 1993; Resick & Schnicke, 1993). For example, trauma survivors who blame themselves for the event or those who appraise a traumatic event as a sign of a negative (e.g., incompetent, unworthy, inadequate) self have more persistent PTSD symptoms than those who do not (Andrews et al., 2000; Dunmore, Clark, & Ehlers, 1997, 1999, 2001; Ehlers, Maercker, & Boos, 2000; Foa, Tolin, Ehlers, Clark, & Orsillo, 1999).
Although it is common for people to experience temporary unwanted memories following trauma, only a subgroup suffer from persisting intrusive memories (e.g., Baum & Hall, 1993). Ehlers and Steil (1995) suggested that negative interpretations of intrusions and other PTSD symptoms contribute to the maintenance of intrusive memories because they motivate the survivor to engage in behaviors that prevent processing of the trauma and may even increase intrusion frequency (e.g., rumination, thought suppression, use of alcohol and drugs). Several studies have supported the role of negative interpretations of intrusions in maintaining intrusions and PTSD (e.g., Dunmore et al., 1999, 2001; Ehlers, Mayou, & Bryant, 1998). Other trauma sequelae may also be interpreted in a negative way, contributing to the maintenance of PTSD (Ehlers & Clark, 2000). A common example is that trauma survivors interpret the trauma and its consequences as meaning that they have permanently changed for the worse as a person. Perceived permanent change has been shown to predict chronic PTSD (Dunmore et al., 1999, 2001; Ehlers et al., 2000).
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The exceptionally threatening character of traumatic events has been highlighted in the diagnostic criteria for PTSD (American Psychiatric Association, 1980; World Health Organization, 1992). Perceived threat to life during trauma showed consistent correlations with PTSD severity in a recent meta-analysis (Ozer, Best, Lipsey, & Weiss, 2003), with an average weighted correlation of .26. For perpetrators of violence, the perceived threat to their social status may be an important additional source of threat (Beck, 1999). It was therefore included as a possible predictor in the present study.
Emotional reactions during trauma are also highlighted in the diagnostic criteria for PTSD, in particular fear, helplessness, or horror (American Psychiatric Association, 1994). In Ozer et al.'s (2003) meta-analysis, the intensity of such negative emotions showed an average weighted correlation of .26 with PTSD severity. Other negative emotions that have been shown to predict PTSD include anger and shame (Andrews, Brewin, Rose, & Kirk, 2000).
Cognitive Processing and Disorganized Trauma Memories
Theories of PTSD suggest that information processing is compromised during trauma and that compromised information processing explains PTSD symptom severity over and above what is explained by high arousal and negative emotions (e.g., Brewin et al., 1996; Ehlers & Clark, 2000). The most widely investigated indicator of such compromised processing is dissociation, which was the best predictor of PTSD in Ozer et al.'s (2003) meta-analysis, with an average weighted correlation of .35.
Dissociation is a complex concept, and it is unclear how it relates to other forms of cognitive processing that have been shown to influence memory (Roediger, 1990; Wheeler, 1997, 2000). Ehlers and Clark (2000) suggested that two further cognitive processing dimensions, data-driven processing (i.e., the predominant processing of sensory as opposed to conceptual information) and lack of self-referent processing (i.e., failure to encode new information as related to the self and other autobiographical information), predict whether people develop reexperiencing symptoms after trauma. These processes are thought to overlap in part with aspects of dissociation. Preliminary empirical support for a role of data-driven processing and lack of self-referent processing in intrusive trauma memories was found in studies of trauma survivors and volunteers exposed to distressing films (Murray, Ehlers, & Mayou, 2002; Rosario, Williams, & Ehlers, 2006).
Compromised cognitive processing is thought to lead to deficits in the autobiographical memory for the traumatic event. There are different hypotheses about the nature of this deficit, including a deficit in memory representations that facilitate intentional recall (Brewin et al., 1996), highly fragmented memories (e.g., Foa & Riggs, 1993; Herman, 1992), and poorly elaborated memories that are inadequately incorporated into their context of other autobiographical memories (e.g., Ehlers & Clark, 2000). Poor elaboration is thought to lead to poor inhibition of unintentional triggering of aspects of the trauma memory by matching cues. Ehlers, Hackmann, and Michael (2004) further suggested that the poor elaboration should be most pronounced for those parts of the trauma that are later reexperienced.
The mechanisms involved with the formation of trauma memories and deficits in recall specified in the different PTSD models are difficult to measure (Ehlers et al., 2004; McNally, 2003). One way is to code narratives of the traumatic event for indicators of the hypothesized mechanism. Common to the fragmentation and poor elaboration models is the hypothesis that intentional recall of trauma memories should be disorganized. Several studies have shown preliminary support for more disorganized trauma narratives in patients with PTSD versus those without PTSD (Foa, Molnar, & Cashman, 1995; Halligan, Michael, Clark, & Ehlers, 2003; Murray et al., 2002) and in volunteers exposed to a highly unpleasant film who developed intrusive memories than those without subsequent intrusions (Halligan, Clark, & Ehlers, 2002).
Appraisals of the Trauma and Its Aftermath
PTSD has been found to be associated with excessively negative appraisals of traumatic events (Ehlers & Clark, 2000; Foa & Riggs, 1993; Resick & Schnicke, 1993). For example, trauma survivors who blame themselves for the event or those who appraise a traumatic event as a sign of a negative (e.g., incompetent, unworthy, inadequate) self have more persistent PTSD symptoms than those who do not (Andrews et al., 2000; Dunmore, Clark, & Ehlers, 1997, 1999, 2001; Ehlers, Maercker, & Boos, 2000; Foa, Tolin, Ehlers, Clark, & Orsillo, 1999).
Although it is common for people to experience temporary unwanted memories following trauma, only a subgroup suffer from persisting intrusive memories (e.g., Baum & Hall, 1993). Ehlers and Steil (1995) suggested that negative interpretations of intrusions and other PTSD symptoms contribute to the maintenance of intrusive memories because they motivate the survivor to engage in behaviors that prevent processing of the trauma and may even increase intrusion frequency (e.g., rumination, thought suppression, use of alcohol and drugs). Several studies have supported the role of negative interpretations of intrusions in maintaining intrusions and PTSD (e.g., Dunmore et al., 1999, 2001; Ehlers, Mayou, & Bryant, 1998). Other trauma sequelae may also be interpreted in a negative way, contributing to the maintenance of PTSD (Ehlers & Clark, 2000). A common example is that trauma survivors interpret the trauma and its consequences as meaning that they have permanently changed for the worse as a person. Perceived permanent change has been shown to predict chronic PTSD (Dunmore et al., 1999, 2001; Ehlers et al., 2000).
http://web.ebscohost.com/ehost/detail?vid=6&hid=116&sid=698b07e7-4ecd-4fa6-baed-a4a154ccb9c0%40sessionmgr102
Please See the related link for the full article and related articles on PTSD and PTSD in the Emergency Services.
Help
What Is Depression
Depression is a common disorder affecting at least 10% of the population directly at some stage or other in their lives. In addition to the marked impact it may have on many facets of the patient's life and that of the family, mood disorders in their many subtle guises have had a major influence on the artistic, political, religious and financial spheres of most cultures. These brief introductory notes outline the different types of depression and how they are treated. If you would like to know more about the subject you can obtain a recommended reading list from Aware.
What is Depression?
The word depression has many different meanings but in a psychiatric context it is used in two specific ways. It is frequently used by patients to describe their feelings of emotional distress and in this sense it is regarded as a symptom. Depression is also a diagnosis which a doctor might make when a patient complains of several symptoms such as feelings of sadness and fatigue, having a disturbed sleep, poor appetite and lack of interest. Though there are many different symptoms present when a depressive disorder is diagnosed the symptom "depression" is just one of these. Sometimes, however, when a diagnosis of depression is made the patient may not actually feel depressed. In many cases a person who is depressed may not realise the nature of the problem and they may need a doctor to tell them that their excessive fatigue or anxiety is actually depression. Everybody gets feelings of sadness or depression and for most these are short-lived and tolerable. Such feelings, or "normal depressions ", occur most frequently in response to the disappointments of everyday life and to a lesser extent our mood fluctuates with the seasons and in response to hormonal factors. Depression which is particularly severe or prolonged and is more than the person is able to cope with is considered an "abnormal depression" or a depressive disorder.
To Read The Full Article Please Click HERE
What is Depression?
The word depression has many different meanings but in a psychiatric context it is used in two specific ways. It is frequently used by patients to describe their feelings of emotional distress and in this sense it is regarded as a symptom. Depression is also a diagnosis which a doctor might make when a patient complains of several symptoms such as feelings of sadness and fatigue, having a disturbed sleep, poor appetite and lack of interest. Though there are many different symptoms present when a depressive disorder is diagnosed the symptom "depression" is just one of these. Sometimes, however, when a diagnosis of depression is made the patient may not actually feel depressed. In many cases a person who is depressed may not realise the nature of the problem and they may need a doctor to tell them that their excessive fatigue or anxiety is actually depression. Everybody gets feelings of sadness or depression and for most these are short-lived and tolerable. Such feelings, or "normal depressions ", occur most frequently in response to the disappointments of everyday life and to a lesser extent our mood fluctuates with the seasons and in response to hormonal factors. Depression which is particularly severe or prolonged and is more than the person is able to cope with is considered an "abnormal depression" or a depressive disorder.
To Read The Full Article Please Click HERE
REBT- Rational Emotive Behavioural Therapy
WHAT IS REBT ?
REBT is a practical, action-oriented approach to coping with problems and enhancing personal growth. REBT places a good deal of its focus on the present: on currently-held attitudes, painful emotions and maladaptive behaviors that can sabotage a fuller experience of life. REBT also provides people with an individualized set of proven techniques for helping them to solve problems.
REBT practitioners work closely with people, seeking to help uncover their individual set of beliefs (attitudes, expectations and personal rules) that frequently lead to emotional distress.
REBT then provides a variety of methods to help people reformulate their dysfunctional beliefs into more sensible, realistic and helpful ones by employing the powerful REBT technique called "disputing." Ultimately, REBT helps people to develop a philosophy and approach to living that can increase their effectiveness and happiness at work, in living successfully with others, in parenting and educational settings, in making our community and environment healthier, and in enhancing their own health and personal welfare.
But don't you need to uncover the past in order to really understand people's problems?
Contrary to what some people erroneously believe, REBT does recognize that we may be strongly influenced by events in early life. Much of our philosophy of life—what we think about ourselves and our values—is learned from past experiences. But the past is with us in the form of beliefs that we carry in our head in the present. REBT homes in on the beliefs that are harmful in our current emotional life and behavior—whether those beliefs arose in the distant reaches of our youth or within the past few weeks.
REBT believes that the "nuttiness" of our past exerts its influence in our current-day thinking patterns and beliefs. Although we cannot change the past, we can change how we let the past influence the way we are today and the way we want to be tomorrow. In this sense, REBT is an optimistic approach to living and to solving problems.
I've heard that REBT tries to do away with negative emotions altogether by making people think logically and objectively. Is that true?
This is a fundamental misconception of REBT. Perhaps more so than any other approach, REBT emphasizes the involvement of emotions in just about every aspect of our thinking and actions. REBT proposes that when our negative emotions become too intense (e.g., rage, panic, or depression), not only do we feel very unhappy, but our ability to manage our lives begins to deteriorate. At these times, the quality of our thinking changes and we begin to take things over-personally, blow things out of perspective, condemn others for their transgressions and generally become less tolerant of life's hassles and hardships. REBT helps restore the emotional balance in an individual's life by providing methods for thinking more realistically and level-headedly about ourselves, other people, and the world.
But aren't feelings such as anger and anxiety normal and appropriate?
Of course! But it is the quality of feelings that is important. Experiencing intense irritation and displeasure when things go wrong can motivate you to change frustrating conditions. Feelings of rage, on the other hand, often land you in a smoldering stew, where you're likely not to take any action at all, or to act in ways that are impulsive and self-defeating. A bit of anxiety or some degree of concern about facing the boss can add an edge of excitement that sharpens performance; excessive anxiety, however, can interfere with thinking and action. While REBT tries to minimize debilitating emotions, that does not mean that it's unhealthy to experience keen feelings of sorrow or displeasure when you experience misfortune.
With REBT's emphasis on reducing emotional upsets in the face of unfairness or misfortune, doesn't it encourage the preservation of the status quo? (Not to mention take away energy to make things better?)
One of REBT's favorite maxims (first expressed by Reinhold Neibuhr) is: "Grant me the courage to change the things I can change, the serenity to accept those that I cannot change, and the wisdom to know the difference." REBT seeks to empower individuals both by helping them more effectively handle their own painful emotions, and by enabling them to change their own behavior and improve their world where possible. When you get too upset, it is much more difficult to behave in constructive ways. By gaining better control over upsetting emotions, you become far more able to act assertively to change bad outside circumstances.
With all this emphasis on "me," doesn't REBT encourage selfishness?
Don't we already have too much selfishness in this world?
A very good question. Yes, many people are too selfish for their own and others' good. REBT provides people with the skills and attitudes to become less selfish. Selfishness is often motivated by ego-gratification. Many selfish people tend to be very needy and demanding and are intent on getting what they want at any cost in order to feel good about themselves. REBT helps people to reduce their own neediness and specifically their need to prove themselves to others. To discourage selfishness, REBT teaches what Albert Ellis calls the value of rational self-acceptance. According to Ellis, healthy people are usually glad to be alive and accept themselves just because they are alive and have some capacity to enjoy themselves. They refuse to measure their intrinsic worth by their extrinsic accomplishments, materialistic possessions and by what others think of them. They frankly choose to accept themselves unconditionally; and then try to completely avoid globally rating themselves—meaning their totality or their "essence." They attempt to enjoy rather than prove themselves. Thus, rather than acting out of selfishness, they learn to operate from responsible self-interest.
Isn't REBT just about intellectual disputing?
REBT does help people by teaching them to recognize and change those aspects of their thinking which are not sensible, accurate or useful. This is probably what is meant by intellectual disputing. However, it also uses a host of other emotional and behavioral methods designed to reduce upset feelings and increase personal effectiveness. These include rational-emotive imagery; assertiveness, self nurturance, risk-taking, and other behavioral homework assignments; communication skill training; and "shame-attacking" exercises.
I've heard that REBT is only really useful with very intelligent people.
REBT can work very well with very bright people. Good brain power can help certain people analyze more quickly the ways in which their thinking is illogical when they are upset. However, just because you have the potential to quickly see the irrational qualities of your thinking, doesn't mean you will use your potential to help yourself. Many very bright people are more motivated to argue the "rightness" of their beliefs than to consider they might be wrong.
Over the years, REBT methods have been adopted for children as young as five or six years old, and even for the learning-impaired. Rational emotive behavior therapists are trained to tailor REBT to meet the wide variety of intellectual, cognitive-developmental and other personal characteristics of clients.I've heard that REBT therapists do a lot of confronting. This doesn't sound very empathic or supportive.
REBT practitioners are very concerned about establishing a helpful, supportive, and facilitative alliance with people. They realize that not all people come to therapy ready for action and change, and that some people—because of their personalities and problems—require a great deal of support and empathy before they are ready to change. At the same time, REBT practitioners tend to take an active role with their clients. They help provide people as quickly as possible with the tools to help them change their beliefs leading to disturbing emotions, thus freeing them to confront their everyday problems with all their resources.
By being so active, aren't REBT therapists "controlling" the client?
REBT practitioners have excellent insight into the nature of problems in living and how to help clients free themselves from their emotional misery about them. They are conscious that many clients find it difficult to address the main problems in their lives and their own inner obstacles to happiness. Rational emotive behavior therapists work collaboratively with clients to clarify existing problems, and to identify important general problems to work on together. And yes, REBT practitioners are active in teaching clients new methods for changing their thinking, feelings and behavior. However, REBT does not control the client. Rather, it empowers people to manage their own emotional problems more effectively and to take control of their own behavior in order to try to obtain more of what they want in life.
Does REBT force its own beliefs about what's rational on people?
REBT defines rational beliefs as those which help people live satisfying, healthy, and fulfilled lives. Over the years, Albert Ellis has identified a set of rational beliefs or values which abet a person's happiness and survival. For example, rational self-acceptance—which involves people giving up the self-rating game—seems to help people significantly reduce anxiety and increase feelings of self-acceptance.
High frustration tolerance, which encourages people to accept (not like) life's hardships and other people's imperfections, leads to greater perseverance, patience, and the ability to get along with others. REBT practitioners are careful, however, not to impose "rational" beliefs. REBT accepts that there are also other "non-rational" belief systems that can help people achieve happiness. REBT accepts the value system of the client and works within that framework to facilitate the client's goals.By emphasizing the individual's beliefs and values and eliminating "shoulds," isn't REBT incompatible with religious values?
REBT has discovered that when people impose rigid expectations on themselves, other people, and the world they are likely to experience unnecessary emotional distress.
In REBT, these expectations are expressed as absolutistic "shoulds," "oughts," and "musts." For example, "I should be successful in important things I do at work" can get you into emotional hot water when you make mistakes or fail. REBT affirms the value of achievement, but helps clients give up their demandingness for total success at all times. REBT advocates instead a more preferential system of values: one which encourages people to work toward their professional goals, but never to condemn and damn themselves when they fail to achieve them. In a similar way, REBT is useful in helping people from diverse religious backgrounds to be more self-accepting, as well as more accepting of other people who may not share their particular values.
REBT makes sense, but I can't seem to apply it to myself—I understand it "intellectually," but not "emotionally."
When you think about it, what REBT sets out to accomplish sounds pretty ambitious: its goal is no less than changing core irrational beliefs that you've spent your whole life rehearsing, living, and "feeling." For many people, it takes some time before the emotional "gut" follows what their head already "knows." Learning new ways of thinking and new beliefs can be compared to a horse-driven carriage which has had the same driver and horse for years. The horse knows where to go without having to be told by the driver. Once you change the driver (new ways of thinking), the horse still goes in the same direction (old emotions and behaviors), but the driver has to strain at the reins to produce a change in direction (new emotions and behaviors). The positive aspect of the strain you may experience in using REBT is that it shows you are learning new ways of feeling and behaving and that you are taking charge of your own direction in life.
REBT is a practical, action-oriented approach to coping with problems and enhancing personal growth. REBT places a good deal of its focus on the present: on currently-held attitudes, painful emotions and maladaptive behaviors that can sabotage a fuller experience of life. REBT also provides people with an individualized set of proven techniques for helping them to solve problems.
REBT practitioners work closely with people, seeking to help uncover their individual set of beliefs (attitudes, expectations and personal rules) that frequently lead to emotional distress.
REBT then provides a variety of methods to help people reformulate their dysfunctional beliefs into more sensible, realistic and helpful ones by employing the powerful REBT technique called "disputing." Ultimately, REBT helps people to develop a philosophy and approach to living that can increase their effectiveness and happiness at work, in living successfully with others, in parenting and educational settings, in making our community and environment healthier, and in enhancing their own health and personal welfare.
But don't you need to uncover the past in order to really understand people's problems?
Contrary to what some people erroneously believe, REBT does recognize that we may be strongly influenced by events in early life. Much of our philosophy of life—what we think about ourselves and our values—is learned from past experiences. But the past is with us in the form of beliefs that we carry in our head in the present. REBT homes in on the beliefs that are harmful in our current emotional life and behavior—whether those beliefs arose in the distant reaches of our youth or within the past few weeks.
REBT believes that the "nuttiness" of our past exerts its influence in our current-day thinking patterns and beliefs. Although we cannot change the past, we can change how we let the past influence the way we are today and the way we want to be tomorrow. In this sense, REBT is an optimistic approach to living and to solving problems.
I've heard that REBT tries to do away with negative emotions altogether by making people think logically and objectively. Is that true?
This is a fundamental misconception of REBT. Perhaps more so than any other approach, REBT emphasizes the involvement of emotions in just about every aspect of our thinking and actions. REBT proposes that when our negative emotions become too intense (e.g., rage, panic, or depression), not only do we feel very unhappy, but our ability to manage our lives begins to deteriorate. At these times, the quality of our thinking changes and we begin to take things over-personally, blow things out of perspective, condemn others for their transgressions and generally become less tolerant of life's hassles and hardships. REBT helps restore the emotional balance in an individual's life by providing methods for thinking more realistically and level-headedly about ourselves, other people, and the world.
But aren't feelings such as anger and anxiety normal and appropriate?
Of course! But it is the quality of feelings that is important. Experiencing intense irritation and displeasure when things go wrong can motivate you to change frustrating conditions. Feelings of rage, on the other hand, often land you in a smoldering stew, where you're likely not to take any action at all, or to act in ways that are impulsive and self-defeating. A bit of anxiety or some degree of concern about facing the boss can add an edge of excitement that sharpens performance; excessive anxiety, however, can interfere with thinking and action. While REBT tries to minimize debilitating emotions, that does not mean that it's unhealthy to experience keen feelings of sorrow or displeasure when you experience misfortune.
With REBT's emphasis on reducing emotional upsets in the face of unfairness or misfortune, doesn't it encourage the preservation of the status quo? (Not to mention take away energy to make things better?)
One of REBT's favorite maxims (first expressed by Reinhold Neibuhr) is: "Grant me the courage to change the things I can change, the serenity to accept those that I cannot change, and the wisdom to know the difference." REBT seeks to empower individuals both by helping them more effectively handle their own painful emotions, and by enabling them to change their own behavior and improve their world where possible. When you get too upset, it is much more difficult to behave in constructive ways. By gaining better control over upsetting emotions, you become far more able to act assertively to change bad outside circumstances.
With all this emphasis on "me," doesn't REBT encourage selfishness?
Don't we already have too much selfishness in this world?
A very good question. Yes, many people are too selfish for their own and others' good. REBT provides people with the skills and attitudes to become less selfish. Selfishness is often motivated by ego-gratification. Many selfish people tend to be very needy and demanding and are intent on getting what they want at any cost in order to feel good about themselves. REBT helps people to reduce their own neediness and specifically their need to prove themselves to others. To discourage selfishness, REBT teaches what Albert Ellis calls the value of rational self-acceptance. According to Ellis, healthy people are usually glad to be alive and accept themselves just because they are alive and have some capacity to enjoy themselves. They refuse to measure their intrinsic worth by their extrinsic accomplishments, materialistic possessions and by what others think of them. They frankly choose to accept themselves unconditionally; and then try to completely avoid globally rating themselves—meaning their totality or their "essence." They attempt to enjoy rather than prove themselves. Thus, rather than acting out of selfishness, they learn to operate from responsible self-interest.
Isn't REBT just about intellectual disputing?
REBT does help people by teaching them to recognize and change those aspects of their thinking which are not sensible, accurate or useful. This is probably what is meant by intellectual disputing. However, it also uses a host of other emotional and behavioral methods designed to reduce upset feelings and increase personal effectiveness. These include rational-emotive imagery; assertiveness, self nurturance, risk-taking, and other behavioral homework assignments; communication skill training; and "shame-attacking" exercises.
I've heard that REBT is only really useful with very intelligent people.
REBT can work very well with very bright people. Good brain power can help certain people analyze more quickly the ways in which their thinking is illogical when they are upset. However, just because you have the potential to quickly see the irrational qualities of your thinking, doesn't mean you will use your potential to help yourself. Many very bright people are more motivated to argue the "rightness" of their beliefs than to consider they might be wrong.
Over the years, REBT methods have been adopted for children as young as five or six years old, and even for the learning-impaired. Rational emotive behavior therapists are trained to tailor REBT to meet the wide variety of intellectual, cognitive-developmental and other personal characteristics of clients.I've heard that REBT therapists do a lot of confronting. This doesn't sound very empathic or supportive.
REBT practitioners are very concerned about establishing a helpful, supportive, and facilitative alliance with people. They realize that not all people come to therapy ready for action and change, and that some people—because of their personalities and problems—require a great deal of support and empathy before they are ready to change. At the same time, REBT practitioners tend to take an active role with their clients. They help provide people as quickly as possible with the tools to help them change their beliefs leading to disturbing emotions, thus freeing them to confront their everyday problems with all their resources.
By being so active, aren't REBT therapists "controlling" the client?
REBT practitioners have excellent insight into the nature of problems in living and how to help clients free themselves from their emotional misery about them. They are conscious that many clients find it difficult to address the main problems in their lives and their own inner obstacles to happiness. Rational emotive behavior therapists work collaboratively with clients to clarify existing problems, and to identify important general problems to work on together. And yes, REBT practitioners are active in teaching clients new methods for changing their thinking, feelings and behavior. However, REBT does not control the client. Rather, it empowers people to manage their own emotional problems more effectively and to take control of their own behavior in order to try to obtain more of what they want in life.
Does REBT force its own beliefs about what's rational on people?
REBT defines rational beliefs as those which help people live satisfying, healthy, and fulfilled lives. Over the years, Albert Ellis has identified a set of rational beliefs or values which abet a person's happiness and survival. For example, rational self-acceptance—which involves people giving up the self-rating game—seems to help people significantly reduce anxiety and increase feelings of self-acceptance.
High frustration tolerance, which encourages people to accept (not like) life's hardships and other people's imperfections, leads to greater perseverance, patience, and the ability to get along with others. REBT practitioners are careful, however, not to impose "rational" beliefs. REBT accepts that there are also other "non-rational" belief systems that can help people achieve happiness. REBT accepts the value system of the client and works within that framework to facilitate the client's goals.By emphasizing the individual's beliefs and values and eliminating "shoulds," isn't REBT incompatible with religious values?
REBT has discovered that when people impose rigid expectations on themselves, other people, and the world they are likely to experience unnecessary emotional distress.
In REBT, these expectations are expressed as absolutistic "shoulds," "oughts," and "musts." For example, "I should be successful in important things I do at work" can get you into emotional hot water when you make mistakes or fail. REBT affirms the value of achievement, but helps clients give up their demandingness for total success at all times. REBT advocates instead a more preferential system of values: one which encourages people to work toward their professional goals, but never to condemn and damn themselves when they fail to achieve them. In a similar way, REBT is useful in helping people from diverse religious backgrounds to be more self-accepting, as well as more accepting of other people who may not share their particular values.
REBT makes sense, but I can't seem to apply it to myself—I understand it "intellectually," but not "emotionally."
When you think about it, what REBT sets out to accomplish sounds pretty ambitious: its goal is no less than changing core irrational beliefs that you've spent your whole life rehearsing, living, and "feeling." For many people, it takes some time before the emotional "gut" follows what their head already "knows." Learning new ways of thinking and new beliefs can be compared to a horse-driven carriage which has had the same driver and horse for years. The horse knows where to go without having to be told by the driver. Once you change the driver (new ways of thinking), the horse still goes in the same direction (old emotions and behaviors), but the driver has to strain at the reins to produce a change in direction (new emotions and behaviors). The positive aspect of the strain you may experience in using REBT is that it shows you are learning new ways of feeling and behaving and that you are taking charge of your own direction in life.
Brief Therapy
Brief therapy is an umbrella term for a variety of approaches to psychotherapy. It differs from other schools of therapy in that it emphasises
(1) a focus on a specific problem and
(2) direct intervention. In brief therapy, the therapist takes responsibility for working more pro-actively with the client in order to treat clinical and subjective conditions faster. It also emphasizes precise observation, utilization of natural resources, and temporary suspension of disbelief to consider new perspectives and multiple viewpoints.
Rather than the formal analysis of historical causes of distress, the primary approach of brief therapy is to help the client to view the present from a wider context and to utilize more functional understandings (not necessarily at a conscious level). By becoming aware of these new understandings, successful clients will de facto undergo spontaneous and generative change.
Brief therapy is often highly strategic, exploratory, and solution-based rather than problem-oriented. It is less concerned with how a problem arose than with the current factors sustaining it and preventing change. Brief therapists do not adhere to one "correct" approach, but rather accept that there being many paths, any of which may or may not in combination turn out to be ultimately beneficial.
(1) a focus on a specific problem and
(2) direct intervention. In brief therapy, the therapist takes responsibility for working more pro-actively with the client in order to treat clinical and subjective conditions faster. It also emphasizes precise observation, utilization of natural resources, and temporary suspension of disbelief to consider new perspectives and multiple viewpoints.
Rather than the formal analysis of historical causes of distress, the primary approach of brief therapy is to help the client to view the present from a wider context and to utilize more functional understandings (not necessarily at a conscious level). By becoming aware of these new understandings, successful clients will de facto undergo spontaneous and generative change.
Brief therapy is often highly strategic, exploratory, and solution-based rather than problem-oriented. It is less concerned with how a problem arose than with the current factors sustaining it and preventing change. Brief therapists do not adhere to one "correct" approach, but rather accept that there being many paths, any of which may or may not in combination turn out to be ultimately beneficial.
Psychodynamic Therapy
What is it?
Psychodynamic therapy (or Psychoanalytic Psychotherapy as it is sometimes called) is a general name for therapeutic approaches which try to get the patient to bring to the surface their true feelings, so that they can experience them and understand them.
Like Psychoanalysis, Psychodynamic Psychotherapy uses the basic assumption that everyone has an unconscious mind (this is sometimes called the subconscious), and that feelings held in the unconscious mind are often too painful to be faced. Thus we come up with defences to protect us knowing about these painful feelings. An example of one of these defences is called denial - which you may have already come across.
Psychodynamic therapy assumes that these defences have gone wrong and are causing more harm than good, that is why you have needed to seek help. It tries to unravel them, as once again, it is assumed that once you are aware of what is really going on in your mind the feelings will not be as painful.
How long does it last?
This can vary quite a lot. The length of treatment can vary anywhere from 8 weekly sessions, to therapy going on three times a week for a number of years.
In the UK, psychodynamic therapy on the NHS is relatively rare, and tends to be performed mainly by Clinical Psychologists. This tends to be of the shorter variety.
What's the difference between Psychodynamic Therapy and Psychoanalysis?
Although similar to Psychoanalysis, in fact it was derived from a similar background!, it tends to differ in two obvious ways. Firstly it is shorter (usually!), and secondly there tends to be a more specific aim to psychodynamic therapy. For example, sorting out a phobia. Whereas, Psychoanalysis will tend to look to affect a lot more of your personality.
How does the Therapist work?
The therapist normally takes an attitude of unconditional acceptance. This basically means that the therapist holds you in high regard because you are a person, no matter what your problem is.
The therapist tries to develop a relationship with you, to help you discover what is going on in your unconscious mind. They do this partly by theoretical knowledge (academic stuff!), partly by experience, and partly through their knowledge of themselves.
We know the last part must seem quite weired, but actually it is critical. The therapist often uses how they feel in the room with you, as a guide to how you are feeling. They are, for lack of a better way of putting it, testing the relationship with you to discover more about you than you are aware of. The therapist uses interpretations, which are a way of making sense to you about what is going on, in order to help you become aware of your unconscious feelings.
So, in every session, the therapist is trying to judge, how much you are in touch with your own feelings, what feelings you are not aware of, how close are you to knowing the unconscious feelings, how painful these feelings are to you, and how well you can tolerate the pain that becoming aware of these feelings will bring.
How the therapist works is actually more complicated than we have presented here, but we hope this gives you a rough idea.
Does it Work?
Sometimes, but not always.
Psychodynamic therapy has got a scientific record of its effectiveness for certain conditions (e.g. depression). However, because of the way it is carried out it is really hard to judge just how well it does work. The experts tend to argue amongst themselves whether it works, but we think the best judge of the issue are the patients themselves. A lot of patients have reported that it has helped them enormously, and indeed some go on to full psychoanalysis. However, equally a lot of patients, really disliked it. These people tended to drop out of therapy quite quickly.
Psychodynamic therapy is one of the few mainstream therapies that focusses on aspects of your personality, and although it is used to treat a wide variety of conditions, it seems to us particularly suited for problems to do with personalities, and past and present relationships.
Therefore, the advice that we offer to you is that if this type of therapy appeals to you, then find out a bit more, and give it a go. There are a lot of people that are glad they did. However, be prepared to be open and honest, and be prepared to find the going difficult, especially at first. Even, if it doesn't seem appealing now, you may find someway down the line, that you would like to give it a go.
Like in all therapies, there are no guarantees
Psychodynamic therapy (or Psychoanalytic Psychotherapy as it is sometimes called) is a general name for therapeutic approaches which try to get the patient to bring to the surface their true feelings, so that they can experience them and understand them.
Like Psychoanalysis, Psychodynamic Psychotherapy uses the basic assumption that everyone has an unconscious mind (this is sometimes called the subconscious), and that feelings held in the unconscious mind are often too painful to be faced. Thus we come up with defences to protect us knowing about these painful feelings. An example of one of these defences is called denial - which you may have already come across.
Psychodynamic therapy assumes that these defences have gone wrong and are causing more harm than good, that is why you have needed to seek help. It tries to unravel them, as once again, it is assumed that once you are aware of what is really going on in your mind the feelings will not be as painful.
How long does it last?
This can vary quite a lot. The length of treatment can vary anywhere from 8 weekly sessions, to therapy going on three times a week for a number of years.
In the UK, psychodynamic therapy on the NHS is relatively rare, and tends to be performed mainly by Clinical Psychologists. This tends to be of the shorter variety.
What's the difference between Psychodynamic Therapy and Psychoanalysis?
Although similar to Psychoanalysis, in fact it was derived from a similar background!, it tends to differ in two obvious ways. Firstly it is shorter (usually!), and secondly there tends to be a more specific aim to psychodynamic therapy. For example, sorting out a phobia. Whereas, Psychoanalysis will tend to look to affect a lot more of your personality.
How does the Therapist work?
The therapist normally takes an attitude of unconditional acceptance. This basically means that the therapist holds you in high regard because you are a person, no matter what your problem is.
The therapist tries to develop a relationship with you, to help you discover what is going on in your unconscious mind. They do this partly by theoretical knowledge (academic stuff!), partly by experience, and partly through their knowledge of themselves.
We know the last part must seem quite weired, but actually it is critical. The therapist often uses how they feel in the room with you, as a guide to how you are feeling. They are, for lack of a better way of putting it, testing the relationship with you to discover more about you than you are aware of. The therapist uses interpretations, which are a way of making sense to you about what is going on, in order to help you become aware of your unconscious feelings.
So, in every session, the therapist is trying to judge, how much you are in touch with your own feelings, what feelings you are not aware of, how close are you to knowing the unconscious feelings, how painful these feelings are to you, and how well you can tolerate the pain that becoming aware of these feelings will bring.
How the therapist works is actually more complicated than we have presented here, but we hope this gives you a rough idea.
Does it Work?
Sometimes, but not always.
Psychodynamic therapy has got a scientific record of its effectiveness for certain conditions (e.g. depression). However, because of the way it is carried out it is really hard to judge just how well it does work. The experts tend to argue amongst themselves whether it works, but we think the best judge of the issue are the patients themselves. A lot of patients have reported that it has helped them enormously, and indeed some go on to full psychoanalysis. However, equally a lot of patients, really disliked it. These people tended to drop out of therapy quite quickly.
Psychodynamic therapy is one of the few mainstream therapies that focusses on aspects of your personality, and although it is used to treat a wide variety of conditions, it seems to us particularly suited for problems to do with personalities, and past and present relationships.
Therefore, the advice that we offer to you is that if this type of therapy appeals to you, then find out a bit more, and give it a go. There are a lot of people that are glad they did. However, be prepared to be open and honest, and be prepared to find the going difficult, especially at first. Even, if it doesn't seem appealing now, you may find someway down the line, that you would like to give it a go.
Like in all therapies, there are no guarantees
Stress Management for All
Stress can be thought of as resulting from an “imbalance between demands and resources” or as occurring when “pressure exceeds ones perceived ability to cope”. Stress management is premised on the idea that stress is not a direct response to a stressor, ones resources and ones ability to cope mediate the stress response and are amenable to change, thus allowing stress to be controllable.
In order to develop an effective stess management programme it is first necessary to identify the factors stress theory suggests are central to controlling stress, and to identify the intervention methods which effectively target these factors. Interpretation of stress focuses on the transaction between people and their external environment. This transactional model potentially empowers the individual on which stressors act by conceptualising stress as a result of how the stressor is appraised initially and how the individual appraises his/her resources to cope with the potential stressor. This model breaks the stressor-stress link by proposing that if stressors are perceived as positive or challenging rather than a threat, and if one is confident that s/he possesses adequate rather than deficient coping strategies, stress may not necessarily follow the presence of a stressor.
This model proposes that helping stressed individuals change their perceptions of stressors, and providing them with strategies which help them cope with stressors and feel confident in their ability to do so, will reduce their stress.
Need for stress management
It is now an accepted fact in the medical community; according to recent research, that stress is one of the major causes of all illnesses. Stress can cause migraines, stroke, eczema, a weak immune system, and many other diseases. Stress is also known to cause medical complications during pregnancy for both the mother and the child. Hence, there is a growing need for stress management.
Techniques of stress management include
In order to develop an effective stess management programme it is first necessary to identify the factors stress theory suggests are central to controlling stress, and to identify the intervention methods which effectively target these factors. Interpretation of stress focuses on the transaction between people and their external environment. This transactional model potentially empowers the individual on which stressors act by conceptualising stress as a result of how the stressor is appraised initially and how the individual appraises his/her resources to cope with the potential stressor. This model breaks the stressor-stress link by proposing that if stressors are perceived as positive or challenging rather than a threat, and if one is confident that s/he possesses adequate rather than deficient coping strategies, stress may not necessarily follow the presence of a stressor.
This model proposes that helping stressed individuals change their perceptions of stressors, and providing them with strategies which help them cope with stressors and feel confident in their ability to do so, will reduce their stress.
Need for stress management
It is now an accepted fact in the medical community; according to recent research, that stress is one of the major causes of all illnesses. Stress can cause migraines, stroke, eczema, a weak immune system, and many other diseases. Stress is also known to cause medical complications during pregnancy for both the mother and the child. Hence, there is a growing need for stress management.
Techniques of stress management include
- self-understanding (e.g. self-identification as a Type A or as a Type B personality
- cognitive therapy
- self-management (e.g. becoming better-organized)
- conflict resolution
- positive attitude
- self-talk
- autogenic training
- breathing
- progressive relaxation
- meditation
- exercise
- diet
- rest
- stress balls
- therapeutic massage
- laughter
Some techniques of time management may help a person to control stress. For example:
becoming more organized and reducing the generation of clutter
setting priorities can help reduce anxiety.
Using a "to do" list of tasks that a person needs to complete can give a person a sense of control and accomplishment
Effective stress management involves learning to set limits and to say "No" to some demands that others make.
PLEASE VIST THE RELATED LINKS AND ARTICLES ON THIS PAGE FOR MORE INFORMATION
HELP
Generalized Anxiety Disorder (GAD)
The Causes of Generalized Anxiety Disorder (GAD)
You may wonder why you are anxious. Is it something that you have done (or not done)? Are you at fault? Although you may feel your worries are all psychological, in fact an underlying biological condition may be triggering these feelings. Research indicates there are genetic and biological reasons that may explain why you experience feelings of anxiety. You may have inherited a brain neurotransmitter imbalance or a misguided adrenaline trigger. These are simply chemical imbalances in the body that can be safely and easily controlled with medications.
Women are at higher risk for anxiety disorders, and at least two-thirds of people with anxiety disorders are women. The reason anxiety disorders affect women more often than men is because women experience hormonal fluctuations throughout their lives, including menstruation, pregnancy, and menopause. These hormonal fluctuations are thought to trigger imbalances in other neurotransmitter systems, often provoking conditions such as anxiety and depression.
There also are environmental factors that may contribute to anxiety. People with anxiety disorders often report having parents who were overprotective or controlling. Childhood separation anxiety, shyness, and limited social interaction also are associated with anxiety. Stressful events such as the death of or separation from a loved one, the loss of your home or business (such as in a fire or natural disaster), illness, and marital conflict may precipitate the onset of anxiety disorders.
Common stimulants such as nicotine, caffeine, some nonprescription (over-the-counter) decongestants, and appetite suppressants may trigger your feelings of anxiety. For some people, even a minimal amount of caffeine or nicotine can increase anxiety levels.
http://www.nehb.ie/menshealth/directory2.htm
Fortunately, there are very effective treatments available, including psychological, medicinal, and self-care methods, for anxiety disorders. The first step is to learn more about anxiety and to identify if you have GAD.
You may wonder why you are anxious. Is it something that you have done (or not done)? Are you at fault? Although you may feel your worries are all psychological, in fact an underlying biological condition may be triggering these feelings. Research indicates there are genetic and biological reasons that may explain why you experience feelings of anxiety. You may have inherited a brain neurotransmitter imbalance or a misguided adrenaline trigger. These are simply chemical imbalances in the body that can be safely and easily controlled with medications.
Women are at higher risk for anxiety disorders, and at least two-thirds of people with anxiety disorders are women. The reason anxiety disorders affect women more often than men is because women experience hormonal fluctuations throughout their lives, including menstruation, pregnancy, and menopause. These hormonal fluctuations are thought to trigger imbalances in other neurotransmitter systems, often provoking conditions such as anxiety and depression.
There also are environmental factors that may contribute to anxiety. People with anxiety disorders often report having parents who were overprotective or controlling. Childhood separation anxiety, shyness, and limited social interaction also are associated with anxiety. Stressful events such as the death of or separation from a loved one, the loss of your home or business (such as in a fire or natural disaster), illness, and marital conflict may precipitate the onset of anxiety disorders.
Common stimulants such as nicotine, caffeine, some nonprescription (over-the-counter) decongestants, and appetite suppressants may trigger your feelings of anxiety. For some people, even a minimal amount of caffeine or nicotine can increase anxiety levels.
http://www.nehb.ie/menshealth/directory2.htm
Fortunately, there are very effective treatments available, including psychological, medicinal, and self-care methods, for anxiety disorders. The first step is to learn more about anxiety and to identify if you have GAD.
HELP
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