Category Archives: Cognitive Behavioural Therapy

The Yoga and Mindfulness Path away from Depression and Emotional Distress – Moving Towards the Light – A Ten Week Course

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Hi Fellow Yogis,

You know when something keeps knocking at your door? A thought, a feeling, reminders or requests?

I always feel that we should respond to persistent nudges, which is why I am hoping to run a ten week course entitled “The Yoga and Mindfulness Path away from Depression and Emotional Distress – Moving Towards the Light”. This course will be an integration of my western Cognitive Behavioural Therapy (CBT) learnings and experience, with Eastern Wisdom gained through my yoga therapy training, yoga teaching, and almost thirty five years of personal yoga practice.
Together, we will find new ways to navigate difficult feelings and emotions. We will practice techniques and practices which will help students to move away from unwanted negative emotions and feelings, towards a more neutral perspective on challenging situations and experiences. We shall explore ways of filling our “happiness pot” and moving out of the shadows and in to the light.  

Students will be given a daily practice to take home with them and this practice will be changed and adapted each week to take account of new learnings and techniques/practices. Together, we will create a safe environment where we can build mutual trust and understanding, and students will be encouraged to positively support each other off their mats as well as on them.

The course will take place on a weekday during the day, venue to be decided. The cost of the full course will be £100, 50% of which will be due on registration and the other 50% before the course begins. Fees include 10 x 75 minute classes, 10 x daily home practice sheets (which will be updated and revised weekly) inclusion in the group support network and the opportunity to tackle emotional issues that are holding you back and preventing you from moving forward towards the sunshine!

There will be a maximum of ten places, and spaces will be allocated on a first come, first served basis.

The course can only happen if there is enough interest, so if you are interested in taking part, please email me at: [email protected]. I would also be grateful if you would share this with others who you feel might benefit.

Sending warm wishes.

Sarah Kemp

I – Into 2014

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A belated “Happy New Year” to you all! 

Whether you visited my site through an interest in Cognitive Behavioural Therapy, or Yoga Relaxation and Mindfulness, you are very welcome and I hope this site serves to encourage and inspire.

So how do you view January?  As a chilly month in the depths of winter, or as the opportunity to renew, replenish and refresh?

If you are thinking about CBT, then the chances are you are not feeling your happiest and so this month may well be the former. Winter has the effect of keeping us closed in, both in terms of where we are physically, and our emotional and psychological Selves as well. It is all too easy to become enmeshed in any negative feelings. This time of year encourages us to hibernate and take stock. When we are feeling positive and mentally strong, this is good for us.  However, if we are feeling down or dejected, having too much opportunity to contemplate our woes is rarely beneficial.

If you are interested in yoga, then your interpretation of January may be entirely different.  This is because, for a yogi, every day is a new beginning, bringing with it the opportunity to grow and develop all aspects of our Self. From respecting our physical body when we eat and drink healthily, exercise regularly and relax properly, to improving mental strength and focus through mindfulness, meditation and resilience, we yogis seek to improve and develop through every day of our lives.

So how do we move from viewing January as a depressing month, to seeing it as an opportunity to move forward and develop?

It is all a matter of perspective. Firstly consider what it is that is holding you back and causing you to feel whatever negative feelings you have. Then decide if you feel strong enough to tackle these issues on your own. Can you call on support from people around you?  Do you want to tackle your issues at all?  Or is fear of the unknown holding you back?  It takes a brave person to look their life squarely in the face and admit there is a problem!

For more help and advice around these areas, you can click on the links above, read previous blogs, or just email me or give me a call.

 

SO WHY NOT WORK ON ENABLING THIS NEW YEAR

TO BE THE ONE THAT YOU WANT IT TO BE!

I – I’m OK, You’re OK

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The expression ‘I’m ok, you’re ok’ was first used in a book of the same title, which was written by Thomas Anthony Harris MD, an american psychiatrist and author (born April 18, 1910, died May 4, 1995 in Sacramento, California). The book was a bestseller and its name became a cliché during the 1970s. ‘I’m ok you’re ok’ relates to the area of psychiatry/psychology/psychotherapy called ‘Transactional Analysis’ which integrates the theory of all three approaches in the examination of how we, as individuals, relate to each other. It is described as integrative because it has elements of psychoanalytic, humanist and cognitive approaches. Transactional analysis was first developed by Canadian born US psychiatrist Eric Berne (born May 10, 1910, died July 15, 1970), who wrote a famous book on the subject entitled ‘Games People Play’.

Transactional analysis sets out how people are psychologically structured by using a model known as the ego-state. The ego-state model mainains that we are always in one of three basic modes: Parent (a position of authority, not necessarily a parental relationship), Adult (a position of assertiveness, not necessarily a condition of age) and Child (a position of powerlessness – not necessarily a condition of age).  When we communicate with others, we will be in one of these modes (to a larger or lesser extent).  For example:

Parent to child: “You still haven’t cleaned your room!”

Parent to parent: “Children should keep their rooms tidy.”

Parent to adult: “My child keeps her room tidy.”

Child to parent: “Why do you always hassle me?”

Child to adult: “Alright, I’ll get it done now.”

Child to child: “God my parents get on my nerves!”

Adult to child: “Let’s get your room cleaned and then we can go out.”

Adult to parent: “I’ll get it done now.”

Adult to adult: “Let’s get this done so we can go out.”

By examining these differing states of interaction, we can see that the way in which we speak to others is very powerful in determining the sort of response we will get back.

To return to the statement ‘I’m ok, you’re ok’, there are four life positions that a person can hold, and our life will depend enormously on our own position.  These positions are:

  1. I’m OK and you are OK. This is the healthiest position about life and it means that I feel good about myself and that I feel good about others as, on the whole, I believe human nature, life in general and particularly my own situation, to be good.
  2. I’m OK and you are not OK. This is not usually a healthy position to take since I feel good about myself but I see others as damaged, impaired or inferior to me.
  3. I’m not OK and you are OK. In this position I see myself as inferior to others and will be the weak partner in relationships. If I hold this position I will unconsciously accept abuse as being OK.
  4. I’m not OK and you are not OK. This is the worst position to be in as it means that I believe that I am in a terrible state and the rest of the world is as bad. Consequently I will feel that there can be no hope at all.

The position that we hold in our life may sometimes have been carried with us into adulthood from childhood.  If, for example, we always felt powerless as a child, and were never encouraged to be assertive, then we may well remain in our child position of feeling powerless.  There are many complex ways in which we can be stuck in one or other of these positions, however the majority of healthy individuals will move from one position to another many times every day, depending upon who we are talking to. When we examine our most usual position(s) we can find out a lot about how we fit into our world and relate to it.

From a Transactional Analysis (and therefore CBT) perspective:

  • All people are OK, in that every person has validity, importance and deserves respect.
  • Positive reinforcement increases feelings of being ‘OK’
  • All people have a basic lovable core and a desire for positive growth (however well that may be hidden).
  • Everyone (with only few exceptions, such as the severely brain-damaged) has the capacity to think.
  • All of the many facets of an individual have a positive value for them in some way.
  • People decide their story and destiny, therefore these decisions can be changed.
  • All emotional difficulties are curable.

The aim of change, under Transactional Analysis, is to move towards: freedom from issues held on to from childhood, spontaneity, intimacy and problem solving, as opposed to avoiding or passively remaining in an unwanted situation. This is all done with a view to progressing and moving into a new, healthier position of ‘I’m ok, you’re ok.’

Further reading:  Eric Berne: Games People Play.

                              Thomas Harris: I’m OK, You’re OK’.

H – Happiness

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How do we define happiness? Is it getting just what we want out of life? Having lots of satisfying and supporting close relationships? Peace of mind? Not having to worry? Or maybe it is a combination of all these things?

According to Samuel Taylor Coleridge (1772-1834), an English poet, literary critic and philosopher – “The happiness of life … is made up of minute fractions – the little, soon-forgotten charities of a kiss, a smile, a kind look, a heartfelt compliment.” If that sounds too easy to be true then think about it for a moment:

Do you spend your time thinking about all the things you don’t have that you would like; all the people around you who annoy you; all the things you have to do that frustrate you? If you do, then I expect you’re feeling pretty fed up. If, however, you fill your day thinking about all the things you have that you can be grateful for (particularly the little things as suggested by Mr Coleridge); all the people around you who care; and all the choices in life that you have, then chances are, when you look back over your day, it will have been a good one (or at least not bad!).

Happiness and gratitude work hand in hand, so why not try spending an entire day being grateful: For the opportunities you are given – to hug somebody you love; the choices you have – cheese or tuna (at least I know I won’t go hungry); the actions you take – saying thank you, paying a compliment, making a difficult decision and trusting yourself that it will be ok.

Most importantly, be aware of your thoughts. If you notice a negative thought creeping in, then try to replace it with a neutral or positive one. For example: “I bet it’s going to rain again today” could become “It might rain today so I’ll take my brolly just in case” or even “who cares if it rains today, I’ll have my brolly!”

 

Think about what makes you happy and inject some happiness into your life everyday: 

  • Spend more time building positive, supportive relationships. 
  • Invest time and energy doing something that brings you happiness.
  • Take time out to be alone and be with yourself, just being you. 
  • Look after yourself: eat well, sleep well, exercise well, live well. 
  • Be in the here and now – make the most of every moment and see if you can enjoy it for what it is.

Free your thoughts, live your life

… and be happy!

 

H – Holistic

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H  – Holistic

Traditionally, one of the biggest differences between the eastern and the western approach to healing, was that here in the west, illness and disease were treated in isolation, whereas in the east, a holistic approach was taken.   My 35 years-old Pocket Oxford Dictionary doesn’t even contain the word holistic!  However, the concept is more popular now, so what does it actually mean?

The definition of holistic (according to the current Cambridge Dictionary) is “dealing with or treating the whole of something or someone and not just a part”.  When we talk of a holistic approach then, we mean that we are looking at, not just the physical whole of the individual but, the emotional, psychological, social and spiritual aspects as well. 

When a client or patient is treated using this approach, all parts of the individual are considered and takenHolistic Health into account.  When, for example, we are anxious, there is a distinct inter-play between the body and the mind: the body may be sweating, the heart will be beating faster than usual, the throat may close up and breathing becomes more shallow and speeds up. At the same time, our thoughts become more confused and begin to spiral out of control, leading to an emotional reaction, as feelings of panic, disorientation, lack of control, etc all combine with the physical symptoms causing feelings of being ‘out of sync’ and general distress.  So anxiety is neither just a physical condition, nor is it just psychological either.

It is now generally recognised that no part of the mind or body is separate from the Whole and so every aspect of an individual must be taken into account and treated accordingly.  When western medical practice is partnered with an eastern approach, it is felt that the individual is given the best possible treatment and the outcome is considered to be a great deal more favourable.

Guilt – (Part Two)

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In Guilt (part one) we looked at the definition of guilt, and the first two types of guilt.  So let’s have a look now at the  other three main types of guilt, and what to do about them.

Guilt for something you think you did:  Our thoughts are so powerful we often talk about our thoughts owning us rather than the reality of us owning our thoughts!  Because we can often believe the power of our thoughts without question, they can sometimes lead to irrational beliefs. For example, you wish ill to somebody through your thoughts: “I really hope their prize-winning roses die so that I may have a chance of winning the gardening competition”.  Then what happens? You get what you wished for and those flowers die.  We irrationally feel guilty, as if our thoughts alone have caused those flowers to die.  In some small, unheard, area of your mind, you know that you didn’t really cause those flowers to die – after all, you are not omnipotent – so why do you feel so guilty?  Remember that actions, not thoughts cause harm, and let the guilt go.

Guilt that you didn’t do enough to help someone:  If you, like many others, are kind hearted, conscientious and caring, then you are more prone to feeling this type of guilt. You may have given hours of your free time to help somebody who was maybe ill, or unhappy, lonely or Guilt 4struggling.  However, you may also find that however much you do, you still feel that it wasn’t enough when that person is still sad, lonely, or unwell. The guilt starts to get to you and you try desperately to carry on helping them, despite the toll it’s taking on you. This type of emotional and/or physical burnout is sometimes called ‘compassion fatigue’ and is usually used to describe a condition found amongst professional helpers. Adding to the overall emotional drain of the situation is the guilt you overlay on top of the fatigue because you think you should be doing more. What is most important in this situation is to separate your feelings around why you want to help.  Is it because you just want to be of help and support, or because you fear that the guilt will overwhelm you if you don’t?   Acting out of guilt can only drain you further and ultimately make you a less effective helper.

Guilt that you’re doing better than someone else: The term ‘survivor guilt’ is applied to those people who survive a traumatic event in which others do not survive, or are perceived to suffer more deeply than the survivor. This condition is recognised by professionals who work with those combat veterans who outlive their fellow troops.

Survivor guilt can also be felt by those who feel they have made a better life for themselves than their family or friends or even (if you are very compassionate) than those who are simply less fortunate.  This irrational form of guilt can deeply affect the quality of a person’s life as Gratitude 9he may well over-compensate financially, emotionally or in other ways. The only way you can effectively cure survivor guilt is to turn that guilt into gratitude. Remind yourself how grateful you are for your life and the opportunities you have had.  Also remember that others would derive no benefit should you fail (or not have survived a disaster), and so you may as well appreciate and enjoy your success.

You can’t live a completely guilt-free life however, by being consciously aware of, monitoring, your thoughts and converting guilt to remorse, you can keep it within manageable bounds. If there is a positive side to guilt, it is that it can help you to understand yourself better and to question your motives, your attitudes and your actions.  By recognising when you have done wrong, you can seek to recompense, let go of the destructive feelings of guilt and behave differently in the future.

Free Your Thoughts – Life Your Life!

G – Guilt (Part One)

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Guilt is an uncomfortable emotion that results from our thoughts telling us that we have been responsible for causing harm or misfortune to somebody or something.  It is a negative emotion that causes anxiety and sadness and often results in anger directed at the self along with internal confusion. People suffering from a condition called ‘chronic guilt’ find that they experience negative feelings of guilt due to their tendency to misinterpret what happens to them and not to question the logic of their conclusions. In CBT, treatment often involves teaching people to rid themselves of the ‘negative automatic thoughts’ they have which tell them that they’ve caused others to suffer. People constantly plagued by guilt are also taught to recognise their ‘dysfunctional attitudes’ so that they recognise when they’re going through such mental processes as catastrophising (making the very worst of a bad situation) or over-generalising (believing that if one bad thing happened, many more must have as well). As CBT enables a person to change their emotions by changing their thoughts, this kind of treatment is very powerful in eradicating chronic guilt and self-blame:  Once somebody can realise that they inaccurately see himself as causing others to suffer, he can readjust his mental set and more realistically figure out his role in whatever grief came their way.

According to Susan Krauss Whitbourne, 2012, the causes of guilt can be broken down into five basic types.

(See: http://www.psychologytoday.com /blog/fulfillment-any-age/201208/the-definitive-guide-guilt?page=1.)

Guilt for something you did: Maybe you hurt somebody by your actions. Or maybe you violated your personal principles by lying or stealing, or by breaking a promise to you or somebody else (such as smoking or drinking or cheating on your new, healthy diet). In this type of scenario, it is appropriate to feel guilty.  It is however, much more healthy to convert those feelings of guilt to ones of remorse.  Guilt is negative state: it is stagnant and can result in over-thinking about the situation, which, in turn, can  lead to negative automatic thoughts. In short, guilt does not serve a positive purpose as it does not manifest anything positive. On the other hand, remorse encourages positive action. Feelings of remorse encourage you to accept that you have behaved badly, apologise to whomever it may be that you have wronged and then look at ways of avoiding behaving the same way in the future. If you’ve violated your own personal standards (eg: through over-use of alcohol or cheating on your partner), you can best avoid straying in the future by seeking support from others who can help you rid yourself of this habit or help you to keep going when new patterns of behaviour become difficult to stick to> It is also worth bearing in mind that we are all egocentric. This means that we spend a lot of our time being caught up with how we are thinking, feeling and behaving.  It may well be that we are feeling incredibly guilty about something that, to somebody else, is of little importance.  That comment you made that you later realised may have sounded very insulting may not even have been noticed by the other person!

Guilt for something you didn’t do, but want to:  No matter how hard you try, your thoughts are filled with doing something that you know you shouldn’t. Having a sneaky cigarette, lying to your partner, in fact anything that you would normally consider to be dishonest, unfaithful, or illegal. This is a tough type of guilt to handle. It’s true that you haven’t actually done anything wrong and so technically you are ‘innocent’ however we all know that the very fact that you’re contemplating an act that violates your own standards can be as guilt-provoking as the act itself.

If you are struggling with these kinds of thoughts, you could choose to repress (plug up) or deny (push away) those thoughts and feelings or you could try an approach called ‘Acceptance and Commitment Therapy’ (ACT). ACT allows you to recognise that you have these illicit thoughts, accept them as part of who you are right now, and then, commit yourself to changing your behaviour so that you don’t follow through on them. Instead of trying to shove those illicit thoughts and feelings under the carpet, you can consciously embrace your illicit thoughts and desires and work on reducing them to something that your conscience finds acceptable.

To be continued …

G – Grief

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G – Grief

Grief comes to us all.  We all experience loss, whether it be the death of a loved one; the loss a family pet; a serious accident or the onset of ill-health; losing a friendship or a job that we love or suffering the breakdown of an intimate relationship.

How you deal with grief will depend very much upon:

(1)   Your life experiences so far since, ultimately our perceptions, attitudes and beliefs towards every experience in life is the result of the perceptions, attitudes and beliefs that we already hold due to the experiences we have already had! 

(2)   The value that you held for that which has been lost. 

(3)   The degree in which you have developed personal characteristics such as resilience, optimism, persistence and determination.

(4)   Your spiritual beliefs. If, for example, your belief system tells you that challenge makes you stronger, or that we learn through sadness, you will be better equipped to deal with grief in a more positive way. 

(5)   The amount of support you are offered and ask for.

Regardless of how we deal with grief, we find ourselves dealing with a pattern of human emotions and these are known as the Cycle of Grief.  Whilst the cycle is the same for most of us, we will all travel round it differently, due to the reasons given above.

Shock

When we experience an important loss, our first reaction is usually one of shock and complete disbelief. Shock affects people in different ways: everything can seem unreal; people can feel numb, withdrawn, detached; some people feel completely disorientated and don’t know what to do with themselves. For some it is a nightmare they cannot escape. Many people quickly experience complex and confused feelings – anger, guilt, despair, emptiness, helplessness and hopelessness.

Denial

When the shock begins to wear off, many people go through a stage of denial during which they cannot accept the reality of the loss. This often involves what counsellors call searching behaviour, an attempt at some level to try to deny that the loss has occurred. In the case of bereavement, people often find themselves thinking they have seen or heard the dead person and many people talk aloud to the person they have lost.

Anger And Guilt

It is common to experience anger, sometimes guilt and often both. Many people find themselves asking: “Why has this happened”? “Why me”? This is particularly so if the loss was sudden, unexpected or involved a tragic accident, Counsellors say that it is common to wish to find blame, either in ourselves, in others, or even with the person who has died, and this can lead to powerful feelings of anger and guilt.

Despair And Depression

In the first few weeks the whole situation may seem unbearable and in the months that follow, many people feel there is little purpose in life and nothing of interest in the outside world. People sometimes begin to question their own sanity and think that you are going mad.  This  is a common experience.

Acceptance

Eventually people pass through the period of depression and begin to accept the loss. This usually happens with the passage of time and, as the pain eases, we are able to think about our loss and recall the past without feelings of devastation. This can take up to a year or longer.  Eventually, however people start thinking of beginning their life again, maybe renewing old interests and taking up new pursuits. Many people take up a hobby as a therapy.   It is important to remember that the past is always a part of us and is not affected by enjoying the present, or planning for the future.

Finding Good Listeners

There is no automatic or quick answer to grief and it helps to express the feelings that well up inside us. Many people are afraid to talk to us when we experience a loss because they feel they will upset us. Most people do not realise that we want and need to talk about our loss. It is important to find good listeners. In the case of bereavement, there are organisations that can offer help and support during this vulnerable time. Please see below for links to useful organisations who provide professional help and counselling for the bereaved.

Remember, if you are grieving, whatever the reason:

(1)  Give yourself time and be kind to yourself.

(2)  Allow yourself to express your grief.

(3)  Understand that acceptance will come over time.

Useful Organisations

Cruse: http://www.crusebereavementcare.org.uk

Much Loved: http://www.muchloved.com/gateway/grief-support-organisations.htm

Winstons Wish – Have information and links specifically for children suffering from or anticipating bereavement:  http://www.winstonswish.org.uk

G – Generosity

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Throughout our day we will experience a whole gamut of emotions and feelings:  some negative: maybe frustration, displeasure, disappointment or sadness; others positive, for example happiness, gratitude, satisfaction or laughter.  When you look back over your day, what is it that makes you smile, or feel gratitude or pleasure?  In the normal routine of our daily lives, it is usually the small things that count because it is the small things that make up our general perspective of our lives.  Yes, holidays are fantastic experiences, yes salary increases are important financially and yes, good health is of extreme value to us.  However, it is the minutae of life that are equally important because they all add up.

The genuine smile from a stranger; the kindness of the person who let you into the traffic flow when you were running late for work; the thoughtful words of a friend when you need a caring ear; the compliment from a colleague when you’re feeling low; sharing a hug with a loved one … All of these things are important to us because they demonstrate a generosity of spirit. They are all given freely and authentically, with no expectation of anything in return. 

They are given for no other reason than because we can.

Cultivating a generosity of spirit is essentially good for all of us.  Isn’t it nice to smile at a stranger and have your smile reciprocated?  Or to listen to a friend’s problems, knowing that they are equally there for you when you need them. Being considerate to others helps us to feel integrated, it encourages acceptance and usually produces consideration in return.  When we are feeling good about life, it is easy to share those feelings around.  We whistle as we go through our day, we are a little ray of sunshine and everybody gets to bathe in the warmth of our happiness.  However when we are feeling down, we may distance ourselves and it can seem very difficult to raise even the most tentative smile. It is when we are feeling low, that generosity of spirit is most important.  If we turn our thoughts to others, and take the time to extend some consideration to our family, colleagues, peers, in fact anybody, we will reap positive benefits in return and that will help to lift our spirits and find a better perspective.

Some might call it Karma, some coincidence or luck, but whatever you want to call it, try it, it really works!

 

 

G – Gratitude

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What do you have to be grateful for?  Do you ever think about it?  Does it ever occur to you to be grateful?

Practising gratitude is inherent in many eastern philosophies. It is difficult to feel negative feelings such as regret, disappointment and sadness if we spend our time feeling grateful for all the good things we have in our life.  However low and desperate we may feel, for most of us, there is always a reason to be grateful.  Did you eat today?  Do you have a roof over your head?  Do you have at least one person in this world who cares about you?  Do you have children who love you?  Do you have hobbies and interests that absorb your attention?

Have you ever heard of a Gratitude Diary?  Every night, before going to sleep, simply write down five things from your day that you are grateful for.  They don’t have to be life-changing events, because, in life, it’s the little everyday things that really count.  Some examples from my diary are:  The book I’m reading; a smile from a passing stranger; hugging my daughters; yoga; the love of my parents; time spent with a close friend; a happy client; plain chocolate; a beautiful summer’s day; a trip to the beach; finding the ‘perfect’ clothes item; when everything just feels ‘right’; and finding a free parking space!

We are all individual and different things will please us and cause us to feel grateful. By keeping a diary, you will focus on all the positive aspects of your day, instead of the negative.  This will automatically improve your mood and encourage you to develop a positive outlook. If you practice gratitude on a regular basis, you are much more likely to look forward to your tomorrows, as you will find there is always something in your day to be thankful for. Try keeping your diary for a month and go to sleep feeling grateful for the day you have just spent, and looking forward to tomorrow.