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Friday, 10 February 2017

Tinnitus



As we finish up National Tinnitus Awareness Week, let’s take a look at a common problem that may affect around 18-20% of the UK population (McCormack et al 2014). We probably all know someone who suffers from it and may even have it ourselves, especially as we grow older but it can affect any age group (British Tinnitus Association).

Tinnitus itself consists of hearing unusual noises that are not coming from the external world but from within ourselves, experienced as ringing, buzzing, whistling even musical. These sounds can be loud or soft, in one or both ears, consistently or intermittently and have been experienced temporarily by most of in response to a loud noise. It can be caused by physiological problems like high blood pressure or nerve damage.

For some, the distress of the condition can lead to other symptoms such as anxiety or depression but for others it is something they learn to live with.
Depending on the cause it may disappear on its own, require medication to control the causes or other treatments. If it is caused by damage to the inner ear there may be no physical recovery but there is hope for addressing the psychological aspects of the condition.

Psychotherapy, such as Cognitive Behavioural Therapy, can be helpful in dealing with the secondary effects of the tinnitus as well as the symptom itself. Other approaches include techniques such as mindfulness which can help reduce stress as well as decrease contributory factors such as high blood pressure. Any therapy that can help the patient learn to accept the situation and deal with mental tension can be of benefit.

Hypnotherapy combines well with Cognitive Behavioural approaches to increase effective outcomes. In addition, therapeutic hypnosis is often a very relaxing experience in itself. Learning self hypnosis can be useful in calming the body’s stress response. Hypnotherapy can be applied in a similar way as with phobias, allowing the patient to build up tolerance to the noise and disturbing situations or even changing the perception of the noise and re-associating it with something more pleasant, like the sound of the sea or tuning it out like we do with noises around us that are not immediately relevant.

In any event, appropriate medical advice is essential before embarking on any therapeutic interventions for this condition but there are many ways that hypnosis may be helpful in managing the medium to long-term symptoms of tinnitus.

Kirsty Grant
www.kirstygrant.co.uk


McCormack, A., Edmondson-Jones, M., Fortnum, H., Dawes, P., Middleton, H., Munro, K. J., & Moore, D. R. (2014). The prevalence of tinnitus and the relationship with neuroticism in a middle-aged UK population. Journal of Psychosomatic Research, 76(1), 56-60.

Wednesday, 18 January 2017

The Dynamics of Gaslighting


Following on from my previous post on Gaslighting and Psychological Abuse, I thought it would be useful to highlight other gaslighting techniques that an abusive partner might use:

Withholding: the abusive partner deliberately pretends not to understand what their victim is saying, or refuses to listen to them. For example:

“You’re not making yourself clear. I don’t understand what you are saying”

“I don’t want to hear this again,”

“You’re trying to confuse me.”


Countering: the abusive partner questions the victim’s memory of events, especially when the victim presents an accurate recollection. For example:

“You’re wrong, you never remember things correctly.”

“You got that completely wrong. What actually happened was…”


Blocking/Diverting: the abusive partner changes the subject and/or questions the victim’s thoughts. For example:

“No. You’re wrong. No need to repeat yourself. Now, we promised that we would go for dinner with…”

“Is that another crazy idea you got from [friend/family member/work colleague]?”

“You’re imagining things.”


Trivialising: the abusive partner deliberately makes the victim’s feelings and/or needs seem unimportant. For example:

“Why are you getting angry over a trivial little thing like that?”

“Man up! You’re far too sensitive”

“You should act like an adult, not like a little child”


Forgetting/Denial: the abusive partner pretends to have forgotten the actual details of an event or denies out right promises and/or assurances made to the victim. For example:

“I don’t know what you’re talking about”

“I never said that at all. You always invent things”

“You’re just making things up”
  
 
A common form of emotional abuse is “I love you, but…” This is an insidious form of disguised criticism and, when you think about it, is also an implied threat. What it means is “I love you now, but if you don’t stop this or that, my love will be taken away from you.” It's a statement designed to strip away the victim’s sense of self and self-esteem. Unfortunately, the word “love” is a powerful weapon in the abuser’s arsenal as it becomes a word that effectively controls their victim. All the victim wants is love. The abuser knows this and uses it to control by offering the love they crave, with a concomitant threat to take it away. This can also come in the form of actions such as being nice, offering compliments, giving gifts etc. All designed to throw the victim into confusion whilst being an insidious way of seemingly erasing all their previous bad treatment. It is very rare for abusive relationships not to have these frequently intense moments of feeling good, accompanied by overly sincere apologies or other seemingly earnest attempts to make up for bad behaviour. The victim tenaciously clings to hope when these moments occur, hoping and believing that this means things have changed. The abuser knows this and therefore uses it to devastating effect.

Remember: the UK now has a new offence of emotional abuse and controlling behaviour that has been introduced by the government, and is now enshrined in law.

Peter Mabbutt FBSCH

www.lcch.co.uk 

Wednesday, 4 January 2017

Gaslighting and Emotional Abuse


People who know me well know that in addition to my passion for Doctor Who, I also have a passion for the radio soap opera The Archers.  For those not living in the UK, The Archers is the worlds longest running soap opera, having been broadcast since the mid 1950s. Its centred around the fictional village of Ambridge, situated in the Midlands.

No. I haven’t suddenly decided to change direction and make this a fan blog. The reason I am talking about this programme is that there has been a long running story line highlighting the increasingly abusive relationship between Helen Archer and Rob Titchner – spoiler alert – that ended up with Helen stabbing Rob. Listening to the drama unfold has been and continues to be (Rob didn’t die) an uncomfortable experience as the realism and superb acting do hit home in an almost visceral way. The script writers have done an excellent job, to the extent that the listener did doubt whether she or he is reading too much into Robs behaviour with Helen.

We are also confronted with abuse on a daily basis via the media who frequently report on abusive incidents with so-called celebrities and other popular cultural figure. We are shocked by, but get increasingly desensitised to images of people being hit or shoved, called degrading names or publicly cursed. However, these are overt examples of abuse.  It is a sad fact that abuse can very well be underhanded, very subtle, and covert, often going unnoticed by all except the victim - something that protects the abuser and, by its covert nature, creates a state of confusion in the person on the receiving end as they question whether they are being actually being abused.

Someone in such a relationship often feels as though they are constantly walking on egg shells all the time, censoring their actions and behaviours just in case there is subtle retribution.

Emotional or as it's also called, psychological abuse occurs when a person in a relationship tries to control information available to another person with intent to manipulate that person’s sense of reality or their view of what is acceptable and unacceptable. Psychological abuse often contains strong emotionally manipulative content and threats designed to force the victim to comply with the abuser’s wishes.

All abuse takes a severe toll on self-esteem. The scary fact is that this leaves wounds and scars that are unseen by others, yet painfully born by the victim. The abused person starts feeling helpless and possibly even hopeless. In addition, most mental abusers are adept at convincing the victim that the abuse is his/her fault. That somehow they are responsible for what happened.

Something that the relationship between Rob and Helen in The Archers has highlighted has been a more sophisticated form of psychological abuse that is often referred to as “gaslighting.”

This term comes from the 1938 stage play Gas Light, in which a husband attempts to drive his wife crazy by dimming the lights (which were powered by gas) in their home, and then he denies that the lights have changed when his wife points it out. It is an extremely effective form of emotional abuse that causes a victim to question their own feelings, instincts, and sanity, which gives the abusive partner a lot of power (and abuse is about power and control). Once an abusive partner has broken down the victim’s ability to trust their own perceptions, the victim is more likely to stay in the abusive relationship. Gas lighting is subtle and not obvious to others outside the relationship - something that goes a long way to protecting the abuser.

Examples may range simply from the abuser denying that previous abusive incidents ever occurred to staging bizarre events with the intention of confusing the victim. A typical example would be: “but darling, you must remember. I did tell you that yesterday” (said in the full knowledge that nothing I fact was said).

Luckily in the UK a new offence of emotional abuse and controlling behaviour has been introduced by the government and has entered in to law. The government has also updated its definition of domestic violence now recognises the impact of threatening behaviour and now protects in law. The government definition of domestic violence and abuse is now:
“any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over (below - child protection act) who are, or have been, intimate partners or family members regardless of gender or sexuality. The abuse can encompass, but is not limited to:
·       psychological
·       physical
·       sexual
·       financial
·       emotional
Controlling behaviour
Controlling behaviour is a range of acts designed to make a person subordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their everyday behaviour.

Coercive behaviour
Coercive behaviour is an act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim.”
 

This now means that for the first time people who control their partners through threats or by restricting their personal or financial freedom, could face prison in the same way they do if they are violent - and that could mean anything up to 5 years in prison.

Peter Mabbutt FBSCH

www.lcch.co.uk 

Wednesday, 28 December 2016

The 12 Days of Psychotherapy



In my random wanderings through the internet this holiday season, I came across this new take on classic popular Christmas carol written by By Tina Gilbertson, author of Constructive Wallowing: How to Beat Bad Feelings by Letting Yourself Have Them:

The 12 Days of Psychotherapy
A new Christmas carol for our time

Verse 1
On the first day of therapy, my therapist gave to me


some insight in-to my psyche.




Verse 2
On the second day of therapy, my therapist gave to me


Two cups of tea,



And some insight in-to my psyche.



Verse 3
On the third day of therapy, my therapist gave to me


Three mm-hm’s,


Two cups of tea,


And some insight in-to my psyche.


Verse 4
On the fourth day of therapy, my therapist gave to me

Four treatment goals,

Three mm-hm’s,

Two cups of tea,

And some insight in-to my psyche.


Verse 5
On the fifth day of therapy, my therapist gave to me


UNCONDITIONAL POSITIVE REGARD,

Four treatment goals,

Three mm-hm’s,

Two cups of tea,

And some insight in-to my psyche.



Verse 6
On the sixth day of therapy, my therapist gave to me

Six good reflections,

UNCONDITIONAL POSITIVE REGARD,

Four treatment goals,

Three mm-hm’s,

Two cups of tea,

And some insight in-to my psyche.



Verse 7
On the seventh day of therapy, my therapist gave to me


Seven short assessments,


Six good reflections,


UNCONDITIONAL POSITIVE REGARD,


Four treatment goals,


Three mm-hm’s,


Two cups of tea,


And some insight in-to my psyche.



Verse 8
On the eighth day of therapy, my therapist gave to me


Eight million Kleenex,


Seven short assessments,


Six good reflections,


UNCONDITIONAL POSITIVE REGARD,


Four treatment goals,


Three mm-hm’s,


Two cups of tea,


And some insight in-to my psyche.



Verse 9
On the ninth day of therapy, my therapist gave to me


Nine labeled feelings,


Eight million Kleenex,


Seven short assessments,


Six good reflections,


UNCONDITIONAL POSITIVE REGARD,


Four treatment goals,


Three mm-hm’s,


Two cups of tea,


And some insight in-to my psyche.



Verse 10
On the tenth day of therapy, my therapist gave to me


Ten new perspectives,


Nine labeled feelings,


Eight million Kleenex,


Seven short assessments,


Six good reflections,


UNCONDITIONAL POSITIVE REGARD,


Four treatment goals,


Three mm-hm’s,


Two cups of tea,


And some insight in-to my psyche.



Verse 11
On the eleventh day of therapy, my therapist gave to me


Eleven ways of coping,


Ten new perspectives,


Nine labelled feelings,


Eight million Kleenex,


Seven short assessments,


Six good reflections,


UNCONDITIONAL POSITIVE REGARD,


Four treatment goals,


Three mm-hm’s,


Two cups of tea,


And some insight in-to my psyche.



Verse 12
On the twelfth day of therapy, my therapist gave to me


Twelve probing questions,


Eleven ways of coping,


Ten new perspectives,


Nine labeled feelings,


Eight million Kleenex,


Seven short assessments,


Six good reflections,


UNCONDITIONAL POSITIVE REGARD,


Four treatment goals,


Three mm-hm’s,


Two cups of tea,


And some insight in-to my psyche.



Bonus verse
On the thirteenth day of Christmas, my therapist gave to me


an invoice for the preceding 12 sessions, with a polite request to remit payment upon receipt.




Peter Mabbutt FBSCH 

www.lcch.co.uk

Thursday, 8 December 2016

Getting Angry About the Numbers: Anger Stats and Beyond



As we come the end of of Anger Awareness Week, you may be wondering why we need an one. It’s a blessing for anyone who isn’t affected by anger, but where it exists – and it does exist widely around the world – it has a significant impact on people’s lives. From the simply irritating to abusive behaviour and murder, the extremes of anger should not be ignored. If left unchecked, even the simply irritating can escalate into something more concerning.

It is salutary to think that in the UK there are not many NHS funded anger management programmes that individuals can subscribe to. Where one is offered, there is usually a waiting list. The majority must therefore seek more immediate help through private individuals and organisations.

Do anger management programmes work? That is the question on many people’s lips. The simple answer is yes. The Mental Health Organisation published a report in 2008 called “Boiling Point” in which it reviewed 50 studies looking at anger management programmes in adults and 40 focussed on children and adolescents. It thankfully concluded that they are effective when applied to all age ranges.

So how widespread is anger? The report answered that question too and took a look at the prevalence of anger in the community, coming up with some salutary statistics:
  • 32% of people polled said they had a close friend or family member who had trouble controlling their anger.
  • 12% said that they had trouble controlling their own anger.
  • 28% said that they worried about how angry they sometimes felt.
  • 20% said that they had ended a relationship or friendship with someone because of how they behaved when they were angry. 
  • 64% felt that people in general are getting angrier.
  • 84% believed that people should be encouraged to seek help if they have problems with anger. 
  • However, 58% of people stated that they didn’t know where to seek help if they needed help with an anger problem.
  • The above might explain why only 13% of those who said they had trouble controlling their anger sought help for their anger problems.
  • There are striking generational differences. Older people had fewer friends or family members with anger-related problems than younger people.

The British Anger Management Association added to the statistics, showing that:
  • 45% of UK adults regularly lose their temper at work.
  • 33% of Britons are not on speaking terms with their neighbours.
  • 1 in 20 have had a fight with the person living next door.
  • UK airlines reported 1,486 significant or serious acts of air rage in a year a 59% increase over the previous year.
  • More than 80% of UK drivers say they have been involved in road rage incidents.
  • When facing computer problems, 50% of Britons have reacted by hitting their PC, hurling parts of it, screaming or abusing their colleagues.
Anger can be effectively managed. It takes time and effort, but it is worth it in the end. For more information on how you or your company can effectively manage anger, call us on 0800 999 8353, info@lcch.co.uk

Or to talk to someone in your area:

Scotland: +44 141 333 0878
Southwest England: +44 7761 773563
Midlands and Southeast England: +44 203 603 8535
Northern England: +44 7812 196 798
Southeast Asia: + 603 7960 6439
Portugal: +351 933 713 223

Wednesday, 7 December 2016

Stress and Anger



In times of great stress or adversity, it's always best to keep busy, to plow your anger and your energy into something positive.
Lee Iacocca

We have repeatedly been taught that ‘stress’ is a healthy emotion, and so is ‘anger’.  So, what then is the link between stress and anger?  And why do both these terms have negative connotations?

Studies suggest that there is increasing evidence of the rise in the levels of stress people experience – work, relationships and finances being the main contributors.  Other studies suggest that anger too is on the increase – road rage, trolley rage, schools, workplace and football pitches, being examples.

These two emotions are common for everyone, irrespective of gender, age, backgrounds, cultures, religions, etc.

It is common for anger to follow on from stress and for stress to result from being angry, but does this have to be the case, or can we be taught to distinguish the two emotions and be able to control them separately.  They need to be channeled for positive outcomes and results, as they can both be very destructive.

As stress and anger are or can be linked, emotionally and mentally, it is also true that the effects on the body are similar too, whether perceived or real.  The physiological responses, such as shallow breathing are common in both, e.g.
  • Increase in heart rate and blood pressure - this forces blood to areas of the body that need it during activity
  • Slowing down of digestion - blood is diverted to the brain and muscles
  •  Increase in respiration - more oxygen is delivered to the muscles
  • Increase perspiration - to cool the body
  • Increase in muscle tone - to prepare for action.
  • Increase in blood clotting - to prepare for injury.
  • Increase in levels of adrenaline, noradrenaline and cortisol - both adrenaline and noradrenaline will increase the heart rate, and cortisol prepares the body for physical activity
 
As human beings, we are programmed to cope with the demands that stress and anger can have on us physically and psychologically, however, the frequency and duration of these episodes can lead to more serious symptoms, e.g:
Short term effects:
Physical
  • headaches

  • gastrointestinal problems
  • aches and pains

  • trembling
  • sweating
  • insomnia
  • elevated blood pressure
  • compromised immune system

Psychological
  • panic attacks
  • anxiety
  • aggression
  • depression
  • poor concentration
  • feeling helpless
  • lack of confidence
  • withdrawal from social activities

Long term effects:
 Physical
  • stomach ulcers (due to elevated cortisol levels)
  • an increased risk of acquiring opportunistic infections (some authorities will include cancer)
  • hypertension

  • heart attack (myocardial infarction)
  • stroke (cerebrovascular incident)

Psychological
  • chronic depression
  • mental breakdown

As stress and anger are seen as healthy emotions, they can and need to be utilised productively to help us achieve beneficial and helpful results and outcomes, thereby preventing the negative effects on our minds and bodies. 



For more information on how you or your company can effectively manage anger, call us on 0800 999 8353, info@lcch.co.uk

Or to talk to someone in your area:

Scotland: +44 141 333 0878
Southwest England: +44 7761 773563
Midlands and Southeast England: +44 203 603 8535
Northern England: +44 7812 196 798
Southeast Asia: + 603 7960 6439
Portugal: +351 933 713 223


Feisal Umar FBSCH
Director of Studies, LCCH 

www.lcch.co.uk