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1. How does emotional validation affect us?

   12th July 2023 3:42 pm Leave a Comment

   This article is part of our current series explaining what to expect from different forms of therapy that we deliver at JSA Psychotherapy.

    

   It’s sometimes tricky to understand what we can do with our emotional experiences or even whether there IS anything we can do with them. Emotions are often invisible, and we use a lot of abstract and theoretical ideas when talking about them. It can be helpful to think about a metaphor instead.

    

   

    

   Imagine you have a high energy dog that you have to take on a long car journey. In the past, this dog has chewed bits of furniture and made a mess of the car. The most effective thing we can do is take the dog on a walk before the journey, to burn off as much of its energy as possible.

   By exercising our dog, we can help it feel calm, rested, and relaxed. Of course, in order to exercise the dog, we need to notice that it’s full of energy, seeming excited or stressed. If we don’t notice, we can’t do anything about it.

    

   Now imagine instead of a dog, we’re talking about a child. If you want a child to sleep well or relax, one of the best ways to do this is to tire them out by doing activities or exercise to burn off all their excess energy. Again, in order to do this, we need to notice that it’s needed or that the child isn’t feeling themselves.

   Now, what if we noticed that the child is distressed so we decide to exercise them by taking them on a walk. All the way round, they keep complaining but we keep walking. At the end of the walk, they are still distressed and not relaxed or relieved. The best thing to do would have been to listen to what they were saying was distressing them.

    

   In several ways, our emotions are like that child in the previous example. In order to do what we need to do to be productive, we have to exercise those emotions. In order to know how to do that most effectively, we need to know what those emotions are telling us. In order to listen to them, we need to notice that they’re there.

   This process is called ‘self-validation’ and is something that you have an absolute right to.

    

   

    

   The difficulty is that, sometimes, people in our past didn’t notice our emotions and needs. Or if they did, they didn’t listen to what they were. Or if they did, they didn’t take them seriously and help us exercise them in a healthy way. This is called ‘invalidation’. If people do this enough, we think ‘oh that must be the way the world works, I’d better do that too’ and start to invalidate our own emotions.

   If we start to invalidate our own emotions, we may think that they are unacceptable, weak, overwhelming, bad, daft, too much for us to manage, over dramatic or something similar.

   IF THAT WERE TRUE, we would HAVE TO ignore, reject or downplay our emotions or even have a go at ourself if we do feel them.

   If we’re rejecting our feelings, we can’t notice, listen to or exercise them so we end up with a lot of high energy emotions inside of us which makes it harder to do what we need to.

   What if it wasn’t true though?

    

   In 1983, group of scientists including a man called McKay ran studies which found that every human on the plant has a set of emotional rights. These included the right to feel and express your emotions and pain.

   This means that we’re allowed to have emotions, allowed to notice them, allowed to listen to what they’re trying to say and allowed to exercise them.

    

   

    

   Of course, it’s worth asking, ‘what’s the most effective way of exercising our emotions?’ What’s the way that works best? In deciding this, we have to remember that everyone is different, so the details of this answer will be worked out together with your therapist. But as a principle, we can say that it can be useful to

   1. Do something to burn the energy that comes along with an emotion

   2. Express the things you discovered when listening to the emotion (if words aren’t your thing then finding music which expresses it, doing a drawing/painting or other creative options work just as well) and

   3. Doing this in a safe place without other people so you have the time and space to do what you’ve got to do.

   It is a good and healthy thing to exercise our emotions, much more sustainable than silencing them. In order to do this, we need to notice when they have become activated and listen to the messages they give us.

    

   Notice, Listen, Exercise

    

   If you would like to download an info sheet version of this article as a pdf for your own use, you can do so by clicking this link.

2. What happens when emotions hit?

   28th June 2023 7:56 pm Leave a Comment

   This article is part of our current series explaining what to expect from different forms of therapy that we deliver at JSA Psychotherapy.

    

   When we’re in the moment, it can be really difficult to remember how to respond productively to strong emotions. This sheet helps us keep track of what’s going on and reminds us of our various action points.

    

   Step 1: Something happens. We call this a trigger and it’s registered in the ‘recognition centre’ of the brain (called the thalamus).

    

   Step 2: Our recognition centre sends out two signals to other parts of our brain, our ‘fight/flight/freeze reaction centre’ (called the amygdala) and to our ‘logic centre’ (called the cortex).

   It’s a bit like this:

   

   Step 3: The path to the reaction centre is fastest and provokes a response first. This makes sense, if there really was a threat, we’d need to act quickly! The problem is, it’s also quite vague. It communicates that you feel threatened but not exactly what’s going on. That’s the job of step 4.

    

   Step 4: The pathway to the logic centre arrives. This pathway is a lot more detailed; it tells you what’s going on, who is there and what can be done about it. This information may highlight that there actually isn’t as much of a threat as you first thought. That can be a problem though, because you may have already acted on the first, faster, but less detailed pathway.

    

   Step 5: In a nutshell, we aim to pause after the first pathway kicks in and we have had our initial emotional reaction. As soon as you notice the strong emotions rising, try to pause. You can do lots of things to help you pause, whether that’s breathing or meditative exercises or asking for a five minute break. Importantly though, these methods don’t cause any actual change, they just buy us time.

    

   Step 6: Once both pathways have arrived, you have loads of information to make a productive decision.
   So this is where we’re up to:

   

   Step 7: At any point, we can buy into and agree with the message of threat. This can be when our first emotions kick in (step 3) or after we get a more detailed understanding (step 6). Either way, if we say ‘yes, you’re right, I’m in some kind of threat here’, it amplifies and boost the emotional reaction. This is like throwing petrol on a fire. Again, this isn’t always wrong. If we really are under threat, we need strong action to protect ourselves. However, what if we’re not? Buying into a threat which isn’t actually that serious is the main reason we have hurtful and damaging emotional reactions. These may hurt us or ones we love.
   It looks a bit like this:

   

   Step 8: Pausing before doing anything lets us act with the most possible information and make the most informed choice. If we realise and remind ourselves that there isn’t as much of a threat as we initially thought, we are then free to act productively. This can be any action which helps us problem solve and achieve our needs. You could act assertively, take a moment to show yourself some kindness or make a strategic decision.
   It looks a bit like this:

   

   Step 9: Making a specific statement to yourself about the threat level usually has a very rapid effect on our emotions, quickly reducing something which felt overwhelming only moments ago. Now we feel better and are acting productively.

    

   Result: We do something to buy us time while the second pathway kicks in and gives us a more complete picture of the situation. This evaluation of the current level of threat determines whether we’ll react with strong emotions or with calm productivity.

    

   If you would like to download an info sheet version of this article as a pdf for your own use, you can do so by clicking this link.

3. How do traumatic memories work?

   14th June 2023 3:25 pm Leave a Comment

   This article is part of our current series explaining what to expect from different forms of therapy that we deliver at JSA Psychotherapy.

    

   When an event happens, we receive information about that event through our senses. We see or hear something and our eyes or ears send that information up to our brain. This is done by a set of electronic messages which travel up our nerves. When these messages reach our brain they go to the relevant department, messages from the eyes to the visual department for example. Your brain ties all these individual messages together into a bigger message which summarises all that information.

    

   

    

   For example, if you see a dog moving its mouth and hear a barking noise, your brain puts those two together and understands that it’s that one dog that’s barking, instead of there being two separate dogs.
   

   Your brain takes all these summarising messages and tries to organise them into themes (eg. Memories about dogs) and tries to put them into the time period and location context (eg. I saw that dog last week/near my nan’s house).
   

   This means that the memory gives us some information about the theme (eg. What dogs are like), information about that time period (eg. Last week was stressful) and about the location (eg. My nan lives in an unsafe area). We call these beliefs. If we get lots of messages about the same topic, we’re more likely to have stronger beliefs on that topic.

    

   Because the messages aren’t summarised or put into the time/place context, the pain feels like it’s still happening now. We still feel uneasy because it feels like the situation we’re in now is still dangerous.

   The problem is that these ‘jagged’ messages don’t simply go away over time. They need to be summarised, put into their proper context and ‘filed away’ by the brain. Your brain keeps trying to do this which is why these feelings and memories may seem to keep coming to mind when you didn’t want them to. It’s just your brain trying to organise.

    

   

    

   Unfortunately, these messages are painful to experience so we avoid them. This leads to cycles of remember -> avoid -> remember -> avoid. Sometimes it gets difficult to avoid them, so people use other tools, distractions, substances etc. to numb them out.

   Another reason the memories may come to mind is that your brain makes links between similar messages, like with the summarising work mentioned earlier. That’s why, for example, you hear a song and your mind goes back to where you first heard it. Similarly, if you see someone who looks similar to the person who caused the trauma.

   For example, it may trigger a link in your brain to the painful trauma message. Normally another part of your brain would kick in and say ‘no, hang on, this is different because the other person you saw was a long time ago’ but remember, trauma memories aren’t put in their proper time/place context. This makes it feel like the trauma is happening again, right now.

    

   

    

   Everything we’ve described about the information from your senses from trauma experiences is also the same with information from your body. When we are scared, for example, we feel certain things in our body, maybe our stomach or chest. Again, in a trauma, these are intense messages and get ‘stuck’.

   This means that, just like seeing a person who looks similar, if we get a similar feeling in our stomach etc. to how we felt during the trauma, it may trigger a link to the painful trauma message. This makes it feel like it’s happening again, right now.

   This explains how we can literally carry trauma around with us in our bodies.

    

   How does therapy help?

    

   Therapy has two main approaches:

   The first is to work with the brain’s natural instinct to organise the memory. We teach activities to soothe the pain so you don’t have to avoid it and your brain has time to sort the memory.

   Secondly we use similar soothing methods to allow you to come into contact with the bodily feelings for long enough that you can learn that ‘I’m safe now, it’s not still going on. I can look after myself. I’m not overwhelmed’.

    

    

   If you would like to download an info sheet version of this article as a pdf for your own use, you can do so by clicking this link

4. What is long term stress?

   31st May 2023 3:00 pm Leave a Comment

   This article is part of our current series explaining what to expect from different forms of therapy that we deliver at JSA Psychotherapy.

    

   When we experience stress over a long period of time it can have a really damaging effect on our physical and mental health. In order to feel better we have to have a plan of action. This plan has two parts: Relaxation that works and dealing with the stress itself.

    

   

    

   What’s important with relaxation is that it leaves you feeling well afterwards. This could be satisfied, calmer, energised or something similar. See it as putting fuel in your emotional tank. You may not find the same things relaxing as other people do and that’s OK. The only rule is ‘would doing this long term have negative side effects or consequences?’ If so, it’s worth finding a different method, so you’re not storing up trouble for yourself down the line.

   
   When it comes to stress, relaxation is only half the battle. We also need to deal with the stress itself. This means working out where it comes from and then what we can do about it. There are three main sources of stress; ourselves, others and the situation.

   
   The difficulty is this, which of those sources do we have any meaningful control over? We cannot control other people and we all know that there are sadly large parts of life outside our control. We can only control ourselves, so we have to ask ‘what is my responsibility and in my control in this situation?’ If we try to manage things we have no control over we’ll just end up exhausted.

    

   

    

   Stress in situations

    

   We are not responsible for what happens to us, but we are responsible for how we deal with that.

   Try asking ‘what can I do something about right now?’ Try to think about specific steps that you can take, because if we try to do everything at once it’s really easy to get lost or overwhelmed. If you need to, think about who you can ask for help. It may be that you will end up having to accept that certain parts of the situation are true, no matter how much you wish they aren’t. Accepting this doesn’t mean you’re saying that it’s OK, only that you’re dealing with life how it is instead of how you wish it was. Then you can plan effectively. For example, if you break your leg it’s frustrating that recovery takes time. But, since that’s a fact, bearing it in mind when making plans will prevent further stress.

    

   Stress from others

    

   People can be a huge source of stress and this is often tricky to navigate. The best guidelines are to remember to communicate assertively instead of passively or aggressively. Remember you have a right to ask for your wishes to be respected and they have the right to say no. Remember not to make things personal, keep it progress focused. Remember to ask for help if needed. You might need to accept that some people just will not work with you right now. If so, you may need to be practical and minimise contact until both parties are showing willing to be productive.

    

   

    

   Stress from within

    

   This requires a lot of honesty about the things in your control and the unsustainable patterns of behaviour that come from this. One example is volunteering to take on extra work, another might be turning disagreements into a personal attack, another might be setting unrealistic expectations of yourself or others.

   
   Honest questions include; am I procrastinating? Am I being realistic about what can be achieved here? Am I asking for useful help? Do I want things to change? Will there need to be a compromise here? Am I on a guilt trip and is this causing me to discard positive evidence? Am I exhausted from putting my focus on things I can’t control? Do my responses have long term consequences that are coming round to bite me?

    

    

   These are all questions that, if we are honest with ourselves, everyone on Earth has done at some point or other, most of us do them pretty frequently. There’s no shame or judgement in having done so. We’re just asking how we can make the most progress possible.

    

   

    

   Stress is ultimately a good thing because it tells us that something is wrong. Once we notice this message, we have to do something about it by focusing on what is our responsibility and what is in our control.

   
   A lot of us experience guilt when we feel like we aren’t doing well at handling our situations. Whilst guilt is a huge topic which can be given the space it needs during therapy sessions, as a rule of thumb, we never deserve to receive personal attacks and we never deserve to be called harsh names. This applies to the things we call our self and means that things like ‘idiot’, ‘soft’, ‘weak’, ‘you’re such a screw up’ or ‘why would you do that’ are off the table. Commit to not calling yourself names or using personal attacks, while you work on the other parts of the stress plan.

    

   If you would like to download an info sheet version of this article as a pdf for your own use, you can do so by clicking this link.

5. Thoughts you can’t seem to get rid of

   17th May 2023 3:41 pm Leave a Comment

   This article is part of our current series explaining what to expect from different forms of therapy that we deliver at JSA Psychotherapy.

    

   We all have thoughts that we wish we could just push out of our minds. They might be thoughts that upset, scare, worry or annoy us. Either way, we wish they weren’t there. You may have tried all sorts of things to deal with them. This article looks at some of these methods and suggests a few alternatives

    

   Reason 1

    

   The vast majority of the thoughts that we try to put to the back of our mind seem painful. They may make us feel upset, desperate, angry, afraid or fearful. They may spark off other thoughts or memories or change our emotions. The fear of this pain is real and completely normal. Or maybe it’s not pain, we’re just unsure what they’ll bring up with them and that uncertainty is unbearable.

    

   

    

   Here’s the big idea though: anxiety and uncertainty acts as a bluffer. Imagine you’re sat at a poker table and ‘Mr Anxiety’ or ‘Mr Uncertainty’ is sat opposite you in one of those big, old school trench coats and a pair of dark sunglasses. He has his hand of cards and each card represents a thought or a feeling or a memory. And he sits opposite you, waving a card and saying, ‘this one will break you’. Mr Anxiety might make all kinds of threats, but the truth is that the reality is never as bad as you fear it will be. There may be discomfort or some pain, but it is never as bad as your anxiety makes you fear it will be.

   The problem is, the more dangerous something is, the stronger your reaction needs to be. Therefore, reacting strongly to thoughts makes your brain reason, ‘oh, there must actually be a danger here after all so I’d better deal with it’. This is one reason why pushing the thought away makes it come back, your brain wants to deal with the threat. Reacting to thoughts in a gentler way helps your brain understand that there is no threat after all and that there’s no need to fear.

    

   Reason 2

    

   You might have heard the phrase ‘the more you put in, the more you get out’ and this is normally true. You’d think this would mean that the more effort you use to combat unwanted thoughts, the more successful you’ll be. Unfortunately, our thoughts don’t follow this rule. You could summarise this as ‘the energy you use causes the strength of the return’.

    

   

    

   To visualise this, imagine an elastic band. If you loop one end of the band over your thumb, stretch the other end back as far as you can then let go, the energy you used to stretch the band back will make it fly forward really quickly and hit your thumb. It’ll probably hurt.

   Our thoughts work in the same way. The more effort and energy you use to push thoughts, feelings and memories away, the more force they’ll eventually come back with. This force may look like them coming back more often, being ‘stronger’ or being harder to shift next time. After a few times round the cycle, they seem overwhelming.

   This is why one of the major parts of therapy is changing the way we deal with out thoughts. Instead of fighting them off, we try to accept their presence then bring some balance.

    

   Now what?

    

   So these are the two reasons that thoughts seem to keep coming back. Pushing them away teaches us that the threat they’re warning about is real, so we HAVE to deal with them. Because they seem so threatening, we try to get rid of them with lots of force. This makes them spring back with an equal ferocity. So if we can’t push the thoughts away but we don’t want to be passive and let them run riot, what can we do?

   The goal here is balance. Anything you can do to acknowledge the thought and any emotions and memories it may link to then pivot into something else is helpful.

    

   

    

   For example:
   

   The simple phrase ‘Yes, sure, but…’ can be extremely powerful here. When a thought comes up, simply say to yourself, ‘Ok, sure, there’s X thought again but I also know that Y and Z are true’.

   In this example, Y and Z can be any fact which counters the difficult thought. This could be ‘sure but I know that I can cope better with my emotions now’ or ‘I know that I’m trying my best’. We acknowledge, then move into something more useful.

    

   Alternatively:

   The second method is focusing on the choice you now have. This could look like ‘OK, I could think about X. But it’ll probably feel better and be more useful to think about Y’.

   Importantly this is different from swapping a bad thought for a good one because we are acknowledging that we could think about the bad one if we wanted to. We just don’t want to right now. This takes the force out of the choice and removing that force is how things will change.

    

   If you would like to download an info sheet version of this article as a pdf for your own use, you can do so by clicking this link.

6. What is CBT?

   17th April 2023 4:31 pm Leave a Comment

   This article is part of our current series explaining what to expect from different forms of therapy that we deliver at JSA Psychotherapy.

    

   Aaron T Beck, an American psychiatrist, first developed CBT as a treatment for depression. After overwhelming evidence to support its success, it has become a recommended treatment for many other difficulties.

    

   What are the main concepts of CBT?

   
   1: We act on our beliefs
   

   If we believe something strongly enough, we will act as if this belief is a fact. For example, in ancient times, people used to believe that the Earth was flat. As a result of this, they didn’t sail too far away from land in case they fell off the edge. We all experience events throughout our lives that shape and mould our beliefs about ourselves, the world and others. When these beliefs are based on reality, they can be beneficial, either protecting us from harm or helping us get what we need. However, others, like the one described above, can limit our thinking and actions and have a negative effect on our lives. The only way to tell which beliefs are factual is to test them.
   

   Some of these beliefs are unconditional or ‘set in stone’, so to speak. These can be about our-self, the world or others. When these unconditional beliefs are activated, they spark off conditional beliefs which tell you how to act in line with your unconditional beliefs. This usually happens in the form of since…then…

   For example: Since the world is flat, then I’d better not sail too far or I’ll fall off the edge.

    

   2: We either think with logic or our emotions
   

   When life is going well and is reasonably calm we’re able to think logically about most situations. Imagine you’re down to your last quid and were debating whether or not to spend it on a lottery ticket. Logically you might think about the chances of winning, if you know anyone who’s won, how much profit they make etc. What might you do after these thoughts? However, if you wake up in the morning and feel in your gut like a winner and your emotions are running high then you may make a very different decision.

   It’s not unusual that when we experience psychological distress and difficulty, we process everything emotionally instead of logically. We can often live by the rule of ‘It feels this way so it must be true’. A big part of CBT is testing this rule.

    

   3: We can’t separate our thoughts from the rest of our experience
   

   We’ve already described how our thoughts and beliefs influence our actions. However, our thoughts also drive our emotions and bodily responses. For example, imagine you walk into a room full of people and they stop talking when you enter. Your first thought may well be ‘they were talking about me’. If this is a negative thought (‘they were talking about me because I’m annoying’), it’s likely to kick off a negative series of reactions. For example, you may feel upset or angry, your body may start shaking or sweating and you may take action by walking out. However, if it’s a positive thought (‘they were talking about me because it’s my birthday soon and they’re planning a surprise party’), you’re likely to feel happy or, at the very least, relieved. CBT is not about ‘thinking more positively’, however, it’s about thinking in line with the evidence. More on this later.

    

   4: Our reactions to events have a greater impact than the events themselves
   

   In the above scenario about walking into a room, the exact same situation occurred in both examples, but two very different responses were experienced. This is good news because it means that, if we can learn helpful and therapeutic reactions, we have control over how events impact our lives.

    

   5: We all have NATS
   

   Everyone experiences those situations and moments that just seem to guarantee the production of negative and hurtful thoughts. For some of us, they see to come more frequently than for other people, but they exist for all of us. These thoughts pop into our mind without us wanting them to be there or without us prompting them. Unsurprisingly, Beck referred to these as Negative Automatic Thoughts (or NATS). And just like real life (g)nats, they constantly buzz around us, causing bother and making life miserable. As described in point 3, these NATS can create, maintain or increase negative emotions and bodily feelings in us.

    

   

    

   6: CBT tests rules like an experiment
   

   If you look back at points 1 and 2, you may remember that we act according to our beliefs and their associated rules. When deciding whether to follow our rules, we can either think logically or emotionally. CBT is all about gathering and using evidence to test our beliefs and rules to see whether they’re helpful or not. We do these like a lab experiment, with a theory that we’re trying to investigate and an attitude of curiosity. For example, one of the first rules we test is:

   Rule 1: A thought is a fact
   

   Rule 2: A thought is an idea. It isn’t necessarily a fact

    

   7: We work on finding the most helpful way to act
   

   If our thoughts aren’t facts, then we have a choice whether to follow them or not. This is especially the case with our NATS since they make us feel negative and don’t help us do what we want to. In CBT we first of all test whether our NATS line up with reality. If they don’t then we come up with alternative, more realistic thoughts and act on them instead. This is different to ‘the power of positive thinking’ because a thought could be negative and helpful (protecting us from harm) or positive and harmful (thinking we’re invincible). Instead, we want to have the most factual and accurate thoughts, not the most positive ones.

   CBT is all about making choices based on evidence which we gather through assessing the basic facts of a situation.

    

   

    

   If you would like to download an info sheet version of this article as a pdf for your own use, you can do so by clicking this link.

7. What is EMDR?

   21st March 2023 4:51 pm Leave a Comment

   This article is part of our current series explaining what to expect from different forms of therapy that we deliver at JSA Psychotherapy.

    

   EMDR stands for Eye Movement Desensitisation Reprocessing. It was created by Dr Shapiro in the 90’s and since then there have been over 44 scientific studies supporting its use as a therapy. EMDR is recommended by the NHS for treating PTSD and it’s also recommended worldwide. It’s a safe and effective treatment for stress and trauma.

    

   How does EMDR work?

    

   Every time we experience something, we take in information about it. This comes to us through our senses and is based on what we are seeing/hearing etc at the time. EMDR is based on a framework which describes how we process this. The information travels from our eyes/ears etc up to our brain through our nervous system. Most of the time this information travels from these different places, is tied together in our brain and gets filed away neatly in our long term memory. It’s a bit like a jigsaw, our brain takes the pieces, creates the picture, and files it away. EMDR says that this system naturally creates healthy memories unless it’s disrupted. This is like our skin healing over when we get a cut unless there’s dirt in the wound.

   Our brain doesn’t store memories alphabetically, it stores them by association. This means that if one of the senses in one memory is similar to that sense in another memory, the brain will link them together. For example, if you heard a certain song at a school disco and then the same song at a house party, your brain would link those memories. Or if a family member wore a certain perfume and then you met someone who wore the same perfume, your brain would link those memories.

    

   

    

   When we go through something distressing, however, the information coming from our senses can be really intense. This makes it difficult for our brain to tie it all together and file it neatly away. But the information has entered our body and doesn’t just disappear. This means that it is still stored somewhere in our body. Because it hasn’t been filed away, this storage is unstable and can be activated easily in the form of a flashback.

   When triggered, these unstable memories influence our emotions, our bodily responses and the way we think about what’s going on right now.

    

   Why does it involve eye movement?

    

   Other activities can also be used like tapping or listening to a soundtrack and these work in a similar way. There are several theories about why they are important and it’s likely that the ‘true answer’ is a combination of these. Dr Jeffries writes that eye movements helps people stay aware of the here and now. This helps them not get overwhelmed by the memory that’s being processed. In essence, eye movements helps people keep one foot in the past and one foot in the present. Because therapy happens in a calm and safe environment, keeping one foot in the present helps people feel safe whilst processing distressing content.

   Professor van den Hout writes that eye movements takes up some of peoples attention span, stopping them getting overwhelmed. For most people, their attention span has 7 ‘slots’ available (some have a couple more, some a couple less). When a distressing memory is activated, it can fill up all 7 slots and feel overwhelming. If eye movements can fill up 3 or 4 of those slots, that prevents the memory from taking over and becoming overwhelming.

   Dr Perry also says that rhythm and eye movements are naturally calming, meaning that they can stop us getting overwhelmed when processing distressing content.

    

   

    

   As seen in all the above theories, the aim of eye movements is to help prevent people feeling overwhelmed while processing distressing memories. Remember that our processing system is geared towards creating a healthy memory and filing it away neatly unless it gets disrupted. The core of EMDR is that if we can help people not to feel overwhelmed, they naturally have the ability to process these memories and come to a healthy conclusion. Simply put, EMDR helps remove the things that block clients natural healing process.

    

   What will it involve?

    

   A course of EMDR will start by identifying the things in life that are currently difficult to manage. We will then identify the memories which are associated with these situations, including the earliest memory, as this is where our journey began. These memories will be processed using eye movements or similar activities. You will not be asked to re-live the memories or describe them in great detail to the therapist. We will then reprocess the current situations that we started with and then finish by planning for how we would like to manage these situations in the future.

    

   

    

   If you would like to download an info sheet version of this article as a pdf for your own use, you can do so by clicking this link.

8. What is DBT?

   13th March 2023 2:40 pm Leave a Comment

   This article is part of our current series explaining what to expect from different forms of therapy that we deliver at JSA Psychotherapy.

    

   Dialectical Behaviour Therapy (DBT) was created by Dr Marsha Linehan, who wanted to design a type of therapy to help people live a worthwhile life, even when things seem to keep getting in the way of achieving that. DBT involves finding new skills that can make it easier to build our Life Worth Living, while dealing with the obstacles that make it harder. One of the first things you will do in DBT is describe and flesh out your personal Life Worth Living. We’ll then come back to this throughout therapy to make sure we’re staying on target and use it as motivation to keep going when times are difficult.

    

   

    

   What does ‘DBT’ actually mean?

   
   Dialectic refers to the whole mindset of the therapy. A ‘dialectic’ is when two people work together to overcome a frustrating problem. Often it seems like there are two or more things in your mind which can’t both be true but somehow still are. A dialectical therapist will take your view seriously and won’t try to argue with you to make you change your mind. Instead, you’ll work together to find the outcome with the most upsides and the least downsides.

   Behavioural refers to the aim of working out which practical methods will most help build your Life Worth Living.

   Therapy refers to the partnership between you and your therapist as you work together to build this Life Worth Living. In DBT, the client and the therapist are both treated just as important as the other. After all, you’re the only person who can be the expert on your own life. The therapist takes that expertise and combines it with their knowledge of DBT methods.

    

   DBT is very useful for dealing with overwhelming emotions. Whether this is anger, sadness, fear, loneliness or something else entirely, these emotions can crash over us like a wave. Often one emotion can trigger another which means you can experience several waves, one after another. At the peak of the wave, when the emotion seems most intense, we do whatever it takes to manage and get it over with. The problem is, sometimes these methods have a bunch of side effects or downsides.

    

   Methods of managing the emotional waves

    

   DBT is split into 4 main sections, each designed to be a different way of making those emotional waves a bit easier to manage. DBT aims to develop strategies with less side effects, so that we have less things getting in the way of creating our Life Worth Living.

    

   Distress Tolerance is all about working out the practical things we can do when the wave seems at its most intense. In this module, we ask ourselves the questions;
   A. What am I feeling?
   B. What do I want to do to make that better? What are the pro’s and con’s of doing that?
   C. Is there something else I can do to get the same pro’s and less of the con’s?
   

   We then focus on working out what that ‘something else’ is.
   
   Emotional Regulation looks at the actual emotional wave itself to get a better understanding of how it works. This helps us make more effective decisions when trying to put our Distress Tolerance work into practice. This module focuses on identifying, understanding and experiencing emotions in a safe way, all with the aim of helping us get a handle on them. When we have a handle on something, it often seems less overwhelming.
   
   Mindfulness is the method of being ‘in the moment’. When we’re experiencing life in the moment, we notice how things come and go and naturally change on their own. This is also the case with our emotional waves. Mindfulness helps us not ‘grasp’ the wave, simply letting it role by. When we do this, we don’t feel the need to respond in a big way, meaning our actions will have less side effects and fewer downsides.
   
   Interpersonal Effectiveness

   Relationships are important, both for sharing parts of our life with people we care about and trust and for getting what you need in life. However, they can also be broken in a handful of moments. This module contains skills for navigating those moments in a calm, confident and assertive manner to make sure they have a stable place in your Life Worth Living.

    

   If you would like to download an info sheet version of this article as a pdf for your own use, you can do so by clicking this link

9. Developmental Trauma – Why it’s important to have a trauma-informed perspective

   15th February 2023 4:32 pm Leave a Comment

   If you have an interest in developmental psychology, or are involved in the care of children young people, it’s possible that you will have heard the term developmental trauma used recently. You might be aware of discussions around what it means to work from a trauma-informed perspective. In this article, we will be addressing the relevance of both terms in proffessional care involvement.

    

   What is developmental trauma?

    

   Developmental trauma can be a complicated term to fully explain without some important background context on how we understand the brains and nervous system to work, and how it develops in stages during childhood.

   Almost all of the learning and growth that happens for us as humans after we are born involves developing and practicing our higher thinking skills. These include thinking, problem solving and considering what might happen in the future or how other people might feel.

   These higher brain functions aren’t available when we’re emotionally overwhelmed and panicking. This is the brain’s way of protecting itself against extreme threats by resorting to emergency survival behaviours. These behaviours are often referred to as a fight or flight response, though sometimes a freeze or fawn response might be described as well. The behaviours themselves might vary, but they happen when we feel completely unsafe.

   This panic mode is important for protecting against danger, but it can be very harmful if it lasts for longer than a brief and occasional emergency. Running on adrenaline for days or weeks at a time is damaging enough for the body of a fully grown adult, but it causes even greater harm to the developing brain. If a child is kept in this state of high alert for frequent and extended periods of time during infancy, then they’re also prevented from using their higher brain functions.

   As a result, this means that they won’t be able to develop these skills with practice and experience in the same way that a safe, secure child will. Additionally, what opportunities they do have for brain development will typically be used for developing more complex survival skills first and foremost, before they’re able to learn and grow in any other areas. The brain is forced to develop differently, so that it can adapt to survive a traumatic infancy.

   These differences in development will have a further impact in later life as well. This impact is known as developmental trauma.

    

   What conditions are necessary to cause developmental trauma?

    

   When we, as adults, think about what it might mean for a baby, infant or child to be growing in a perpetually unsafe environment, it’s easy to imagine extremes of violence, conflict or disaster that put them at risk of literal bodily harm. However, newborns can’t distinguish between dangers like these and any sort of  threat. Every time a baby becomes overwhelmed because they feel frightened or uncomfortable, they will experience it as a matter of life or death.

   This is because they haven’t had enough previous experiences of caring support to learn yet, which would otherwise reassure them that they don’t need to be so upset. Unfortunately, the opposite is also true. A baby who doesn’t get these consistent reassuring experiences of safety and comfort to adjust to, won’t gain this perspective either. Having to go without comfort and affection won’t be any easier for that baby to calm down from than consistent exposure to physical danger.

   Therefore, a baby doesn’t need to spend the first months of its life in an active warzone to be kept on constant alert for threat. Prolonged periods of neglect will also deprive them of the safety they need to hit their earliest critical milestones of cognitive, emotional and relational development.

    

   

   How is this relevant when providing trauma-informed care?

    

   We talk about developmental trauma as a way to understand how being affected by traumatic deprivation in early life can result in more complicated issues with the development of cognitive, emotional and relational skills in later life. It’s a more comprehensive understanding of what is often recognised as behavioural difficulties or personality disorder, one that is informed by the circumstances of unmet needs which precede personality and behaviour.

   This context is important to recognise if we intend to meet those needs in the present, and the sustained fulfilment of a person’s unmet needs is essential for resuming their development towards the milestones which have been delayed. This is what’s known as a trauma-informed perspective.

   There are many professional roles in which it makes a critical difference to be working from a trauma-informed perspective, especially those that involve children in public care. This is because without that perspective, it’s possible to not recognise the real reasons why a person seems unable to engage in care and support. This can be frustrating and challenging at best, but can also result in further harm where these needs continue to go unmet, or even punished.

    

   What else is there to know?

    

   We have recently produced the first in an ongoing series of training courses on Udemy that explore the topics discussed in this article in much greater depth. This course has been written and delivered by Dr Margaret Bullock and contains 78 minutes of instructive video content with full captions and downloadable materials including handouts and audio only versions.

   The curriculum covers the theory behind developmental trauma and its scientific evidence base in much greater detail, with a focus on why this is relevant for those who are recovering from developmental trauma and how to provide support for this in a trauma-informed way.

   If you work in family law are a fostering or adoptive carer, or are otherwise involved in providing education or residential care for looked after children, then this is going to be particularly valuable training opportunity for you.

    

   

    

   Please take a look at our flyer to see if this course is likely to be for you, or follow this link to view the course directly. For any other queries, you can contact us on 01282 685345 or at office@jsapsychotherapy.com

10. National family caregivers month 2022 – Comparing settings of care

    9th November 2022 5:43 pm Leave a Comment

    Following from our series of miniature articles last month covering a number of awareness days taking place over October, this month we will also be covering a different awareness campaign which has some relevance to the work that we are engaged in on a regular basis. From this, we hope to offer some insight to enrich the discussions that are taking place around this important topic and potentially inspire further thoughts.

    Among other things, November is recognised as national family caregivers’ month. This year, the theme which has been chosen to be observed is caring around the clock. It’s easy to see why this was decided as an important area of focus, considering the varied challenges that are faced by those providing regular, extensive care for their family members.

     

    What are the challenges?

    By and large, the greatest challenge faced by family caregivers is an overwhelming amount of responsibility, paired with an untenable lack of support. A significant amount of this caregiving is performed on an ‘informal’, unpaid basis and even for those that do receive financial compensation, there remains a serious disparity of material wage support where this conflicts with other commitments and necessities outside of the care itself.

    Studies conducted by the NHS indicate that 80% of caregivers report that caring for someone living with a long-term condition has had a negative impact on their health. These issues are even more pronounced for those on either side of a typical working age.

    Carers Trust have found that 13,000 young caregivers under the age of 16 in the UK alone are working over 50 hours per week. Similarly, 65% of carers over the age of 60 have a long-term condition of their own that requires extensive care.

    There is a clear disparity in the balance, expectation and compensation for how essential daily care is provided.

     

    How does this compare to other caregiving roles?

    From our position of working closely with our sister company Life Change Care, there are several comparisons we are able to make between the caregiving role in a family setting and in residential care of looked after children. Though similar in some ways, many of these comparisons reveal a further depth to the disparities described above.

    Despite the obvious differences, there is a lot of theory behind the trauma-informed approach of our care model -the TIER system– which provides us with an important perspective on some of the more significant factors determinng whether a care setting is conducive to the ongoing wellbeing of those providing and receiving extensive care.

    Not all of the risks and challenges that are expected when working to support children and young people in recovery from developmental trauma are exclusive to LAC provision, by any means. Innumerable family carers are also in positions where they need to consider matters of physical and emotional safety, safeguarding, dynamic risk management, support of very complex mental health needs and more.

     

    Around the clock

    However, within a professional residential setting, these risks and pressures are approached within the context of a structured team and there is an inherent possibility for reprieve via rotating shifts, structured care plans, professional training, shared oversight and supervision from management.

    Additionally, in care setting operating from a similar model to Life Change Care, regular clinical supervision may be provided as well to ease the emotional strain of this role with the opportunity to debrief and offload.

    This support is mandated for accredited practitioners of counselling and psychotherapy, given their daily proximity to intense psychological distress in those they provide support for, but is uncommon in caregiving roles and much more so for informal caregivers.

     

    What is the impact?

    Without this kind of support in place, and especially if living together while providing care, it is exponentially more challenging to provide what we understand to be an essential factor in our care model – the facilitation of an integrated, continually grounding and emotionally safe domestic environment for the care to take place in.

    That’s not to suggest that a care environment that is deprived of this support is inherently improper or dangerous, but it does present unfortunate and unnecessary additional challenges to everyone involved if the emotional toll of caregiving becomes overwhelming.

    This is because there is likely to be little chance for those providing care to themselves be supported through a return to baseline and thus be enabled to pass on the emotional element of care in soothing and regulating the distress of those they look after.

     

    If you would like to know more about our models and approaches of providing professional care, or have a particular inquiry you would like to make, you can reach us in the office on 01282 685345 or at office@jsapsychotherapy.com