The Importance of Structure, Routine and Meaningful Activity in Depression and Anxiety

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For many people with depression and anxiety, having a structure and routine can really help. Coping with these conditions can lead to great discomfort. What you need is a plan, a way of coping. Not only will you be dealing with the depression and anxiety using techniques and coping strategies, but you will also be dealing the vast expanse of time, that without structure can seem like an endless ocean of distress. When depressed and anxious life can seem a lonely place where you are at the mercy of your thoughts and negative ruminations. You also need to factor in meaningful activity.

Creating a routine has many benefits. Begin by dividing the week into days, dividing the days into halves, quarters even hourly segments. Look to building up four categories of support:

Addressing your physical needs.
Addressing your mental and emotional needs.
Addressing your spiritual needs.
Addressing the need for human contact.

Here are forty tips that you also may find helpful:

Learn a relaxation method.
Organise your day to include work (or meaningful activity), rest and leisure.
Plan your day to avoid worrying over uncertainties.
Eat small regular healthy meals, ovoid caffeine, sugary and junk foods.
Don’t go too long between meals.
Keep alcohol and smoking to a minimum
Avoid boredom or getting into a rut, this can increase stress and anxiety.
If you do not work, it is very important to find interest and purpose elsewhere.
Find out if there are any organisations, centres or clubs that need volunteers.
If you do work, it is important to have some “you” time.
Make sure that time for you is quality time.
Exercise daily – it will reduce anxiety and raise your mood.
Get some fresh air, even if you cannot get out, open windows.
Spoil yourself while you are not well.
Don’t accept put downs, try to be more assertive.
Learn to say “NO” when you need to. We can’t give all the time.
Let others help, but don’t lean on them.
Find friends you can relax with, rather than wind you up.
Set yourself small goals that you can succeed in, no matter how small.
Be positive!! Positive things happen to positive people.
Be yourself, remember your unique.
If your appetite is down, think nutrient dense.
Try to get plenty of sleep, avoid naps if sleep is difficult.
Sunshine is very good for depression and anxiety.
Humans are the only animals that don’t make their own vitamin C, eat an orange!
Make friends with nature, put out a bird feeder.
Do something creative, cut out pictures from magazines and make a collage.
If you anxious lower external stimuli, dim lights, turn down television volume.
Have a bath with soothing oils.
Cuddle a hot water bottle if your cold.
Keep a journal or diary of your thoughts and feelings.
Get yourself some flowers and put them where you will see them.
Break large tasks into many smaller ones.
Don’t expect too much from yourself.
Stop being a perfectionist.
Do not make major life decisions while you are depressed.
Make lists, they can really help.
Stop blaming yourself, stop saying, “it’s all my fault.”
Every morning, relax, breathe and chant an affirmation for 10 minutes
Keep a positive book and write down two positive things each day, however small.

For more tips check out my book, “50 Tips to beat depression,” available on Amazon.

Until next time, Steve.

We would be delighted if you visit our facebook sites:

www.facebook.com/yourmentalhealthmatters

www.facebook.com/bexhillmindfulnesscentre

www.facebook.com/mgbhillclimbchallenge

Steve Clifford                                                                                                                             Senior Accredited Integrative Psychotherapist.                                                                 Accredited Cognitive Behavioural Psychotherapist.

Image: http://commons.wikimedia.org/wiki/File%3AL059_-_depressed.jpg

References:

“How to Help Yourself get through Depression on a day-to-day basis” www.metanoia.org/help/helpyourself. htm [Accessed 29/05/13].

“Eight Ways to become an Optimist” by Vera Peiffer, Options, Feb 1993.

“20 Tips on Fighting Anxiety, Depression, and Fatigue Naturally.” www.kellythekitchenkop.com/2011/06/20-tips-on-fighting-anxiety-depression-and-ex... [Accessed 28/02/2014].

“Daily Survival Plan for Living in Hell,” Douglas Bloch. www.healingfromdepression.com/survival-plan.htm [Accessed 06/06/15].

Cooking to Cure; A Nutritional Approach to Anxiety and Depression

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Book Review

Cooking to Cure; A nutritional approach to anxiety and depression, is an inspiring, practical guide to nutrition and how a nutritional approach may help you eat your way towards better mental health. It represents an exciting cutting edge approach to health and is something researchers all over the world are looking into.

Could changes to our diet be as effective as pills? Could you take control of your dietary intake to improve your mental health? With depression and anxiety as one of the most common mental ailments in the western world, it is high time we sat up and looked at dietary factors.

This wonderful book explains in a very clear and understandable way how nutrients affect the brain and our moods. It details the nutritional contents of foods that are known to play a part in depression and anxiety, how much you need every day and even has a recipe section full of mouth watering meals.

As someone who has for many years appreciated the “truth” and power of nutrition as prevention and cure, Angela reflects on changes to eating habits over the years. She draws on scientific research to support the hypothesis that as our diets have become more and more depleted of essential nutrients, so too the incidence of depression and anxiety has rocketed. She tells us how replacing commercially processed food with “real” food (not faddy diets!) we can reclaim our health and well-being.

It is empowering and a must-read for all sufferers of depression and anxiety.

Available from: http://www.amazon.co.uk/Cooking-Cure-nutritional-approach-depression/dp/1508568146

Until next time, Steve.

We would be delighted if you visit our facebook sites:

www.facebook.com/yourmentalhealthmatters

www.facebook.com/bexhillmindfulnesscentre

www.facebook.com/mgbhillclimbchallenge

Steve Clifford                                                                                                                             Senior Accredited Integrative Psychotherapist.                                                                 Accredited Cognitive Behavioural Psychotherapist.

How to Let go of Worry and Anxiety

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The other night I woke and thought to myself, “What have I to worry about?” I realised then what I have always known; we are programmed to worry. I had nothing specific I needed to worry about, but realised that I nearly always have something competing for my attention and worry.

The following morning, whilst eating my breakfast, a thought entered my mind: “What if the card machine isn’t charged when I need it?” Able to catch myself, I was able to let go and come back to the present and my breakfast. This is typical of what happens to all of us every day.

Do you worry? Of course you do; we all do, as it is our natural default position.

When worrying gets out of control, it can lead to anxiety and panic. If excessive, it can cause illness. Worry, which could also be deemed “active problem solving,” is the result of the natural evolutionary response known as ‘fight or flight’, as you focus on “what ifs” or “what could happen.”

Persistent or chronic worrying is what doctors refer to as anxiety. It can impact on your daily life to the point that it interferes with work, relationships, sleep and appetite, and it diminishes your quality of life.

Many people who suffer from anxiety turn to smoking, drinking and drugs (over the counter or prescribed) in an attempt to get some relief from their emotions. Some people comfort eat, whilst others starve themselves. In some cases, when worrying and anxiety gets out of control, it can lead to depression and even suicidal thoughts.

What Causes Anxiety?

We humans are funny creatures, always looking outside ourselves for the answers. We look to external reasons for tension and anxiety.

All kinds of worries flit in and out of our minds: whether we will have enough food to eat, whether we will be able to find a partner so that we are not destined to spend our future alone, whether we will have a pay rise, lose a job, whether our car will break down or whether we will be able to afford a holiday. The list of worries is endless.

We look to “things” as the source of our worries. Often, we project our mind to the future and say to ourselves, “when this happens” or “when that happens, I will be happy and have no more worries!”

Look a little closer and you will see that these external things: job, money, relationships, etc, are not the true cause of the negative emotional states of worry and anxiety.

Worries do not come from outside and are not the result of “external circumstances,” they are the result of “internal circumstances”. Worry, stress, tension and anxiety are all the result of our thoughts.

 Accept Worry for What It Really Is. 

A worry is nothing more than a thought. Worry occurs when our mind is “future focused”. For example, if you were confronted by a lion or tiger your worry would not be about the fact there is a lion or tiger in front of you. Your worry would be that the lion or tiger might eat you! When you sit an exam your worry is not sitting the exam, but whether you will do well enough to pass! Worry is all about things going wrong, in other words, threats to our existence. Worry is simply a particular type of thought pattern, nothing more. Stress arises as a result of the internal stories we tell ourselves. Those with good imaginations make wonderful worriers!

By going over things in our minds we get stuck in a cycle of thinking, replaying events, projecting forward. As we ruminate over and over we become tense and experience stress. Many engage in what I call “stinking thinking!” that king of negative rumination that spirals into a very black place and which can ultimately result in clinical anxiety or depression.

Because your mind doesn’t know the difference between reality and your imaginings, the thoughts have the same results on the body no matter what. In other words, imagining an event happening causes the same physiological responses as if it were actually happening!

Those who worry experience ongoing irritability, muscle tension, concentration difficulties, indecision and agitation just as though they were actually experiencing the things they worry about. The result is a constant state of arousal, feeling “on edge,” and unable to relax. Often the mental stress will be accompanied by physical stress, headaches, neck ache, back ache, chest tightness and chest pain and so on.

When you learn to recognize worry and anxiety for what it really is, which is simply “thoughts”, it begins to lose its grip on you. With practice, it can become very simple to let go of worry.

Using Mindfulness to let go of Worry. 

To begin with, it is important to have a clear understanding of what mindfulness is:

“Paying attention to the present moment, experiencing the present moment non-judgementally, with kindness and compassion.” (Jon Kabat-Zinn)

The easiest way to do this is to use our breath as an anchor. Breathing in and out, paying attention to what is happening in our mind and body, becoming aware of our thoughts – the stories playing out in our minds – as well as the emotions and physical sensations as they are arising. You will soon discover that your mind has a life of its own, taking off into the future or dwelling on some past event. This is totally normal, and when you notice that your mind is no longer on the breath, notice what is on your mind at that moment. Whenever you find yourself worrying about something, note to yourself simply that you’re “just worrying.”

By doing this you begin to witness your thoughts, instead of being in your thoughts. You now have the power to choose to let them go. So notice what is on your mind at that moment and then gently let go, NOT by consciously pushing your thoughts away, but by recognising them and letting them be, as you gently turn your attention back to your breathing, paying attention to the present moment and what you’re doing. Every time you catch yourself worrying – no matter how often – you simply acknowledge, let go and return to your breathing.

Don’t Fight your Feelings

Eckhart Tolle, author of “The Power of Now,” reminds us, “Whatever you fight, you strengthen, and whatever you resist, persists.” The emphasis is always on what is happening, not why it’s happening. It is important not to fight your feelings, simply acknowledge in a non-judgemental way without criticism, without trying to push the thoughts away. You don’t need to spend energy fighting your thoughts, but you also no longer need to follow them and dwell on them. Simply acknowledge them, label them, put them down and move on. As soon as you struggle with the thoughts you give them power. Instead, try to observe your thoughts and worries objectively and with calmness. Simply make a mental note, without giving them any more importance or power than they deserve.

Know that you will face each situation as you come to it and deal with it then. Learn to deal with stress and difficulties more wisely, by responding rather than reacting. Learn to let go of the past and leave the future until tomorrow. Let your “future self” deal with tomorrow and let your “present self” deal with today!

Until next time, Steve.

We would be delighted if you visit our facebook sites:

www.facebook.com/yourmentalhealthmatters

www.facebook.com/bexhillmindfulnesscentre

Steve Clifford                                                                                                                             Senior Accredited Integrative Psychotherapist.                                                                 Accredited Cognitive Behavioural Psychotherapist.

Image: http://upload.wikimedia.org/wikipedia/commons/2/2c/Depressed_girl.png

References: 

This post was adapted from “How to Overcome Worry & Anxiety…For Good!”               http://mrsmindfulness.com/how-to-overcome-worry-anxiety-for-good/  [Accessed 14/04/15].

Black. A (2015) “The Little Pocket Book of Mindfulness”, CICO books: London, New York.

Tolle. E (2001) “The Power of Now” Hodder Paperbacks

“Mindfulness of the breath” a meditation by Jon Kabat-Zinn

How to Overcome Fear, Anxiety and Panic using Mindfulness Meditation.

 

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All of us will experience fear on occasions. It is a normal healthy biological reaction warning us of perceived threat or danger. However, some people experience fear more frequently, some even on a daily basis, perhaps manifesting as generalised anxiety or in the form of panic attacks.

Often people cope with fear by ignoring such feelings when they surface or by denying them. Many people try to push the feelings away, because they don’t like them and are not prepared to accept them, while others engage in wrestling and battling them as if they were the very threat itself, instead of the messenger.

What I am going to suggest, which might seem a little radical when all you want to do us get rid of these feelings, is to “make friends with your fear.” You see, the problem is, the more you try to battle, ignore or push these feelings away, the more they will surface. When you try to banish them to the deepest, darkest dungeon in your castle, no matter how hard you try, you will still hear them calling you. The harder you try to get rid of them, the more you will experience them. Why? Because you are focusing your energy on them and when you do this, rather like trying not to think about an annoying song or a tune that goes round and round in your head, it will simply magnify your experience.

The first thing I want you to know is that these symptoms cannot harm you. I will say it again, these symptoms cannot harm you. You will not have a heart attack, stop breathing, you will not faint and you will not lose control or lose your mind. Fear simply mobilises your body to be ready to fight off a real or imagined foe.

I will show you how, using a technique called mindfulness, you can achieve what you desire, that is, not to be overwhelmed by your fear and instead to bring about a new relationship with your fear. So, instead of viewing fear as something that should be suppressed or eliminated, we will be using mindfulness to bring about acceptance.

“The way of mindfulness,” says best selling author and mindfulness master Jon Kabat-Zinn,” is to accept ourselves right now, as we are, symptoms or no symptoms, pain or no pain, fear or no fear. Instead of rejecting our experience as undesirable, we ask, “What is the symptom saying, what is it telling me about my body and my mind right now?”

What he is suggesting is that we listen, take a closer look and get acquainted, instead of reaching for the diazepam, rescue remedy or whatever it is we grab in our  immediate desire to make it go away.

Using mindfulness and harnessing quiet gentle breathing we begin to make friends with our fear. As Jon Kabat-Zinn suggests, “We allow ourselves, for a moment at least, to go right into the full-blown feeling of the symptom. This takes a certain amount of courage…dip your toe in…and move a little closer for a clearer look.”

We begin to approach our symptoms “as we would a shy animal sunning itself  on a grassy bank.” Ever so gently, becoming aware of our feelings about the symptoms as they appear. Perhaps we feel anger, frustration, anxiety or despair. We may say to ourselves, “Why now, not again or oh no, I cannot bear this again.” The key is to look as dispassionately as possible, with a non-judging mind. We need to accept that whatever we are feeling, it is here now. It is already with us, already part of our experience in this moment. The key is to accept our feelings as they are, opening to the fear in a kindly way rather than continually trying to block it out and overcome it.

When you experience symptoms simply observe and watch as they unfold. Try not to react, responding as if the symptoms were a wild animal out to get you. Instead, calm, tame them by making friends. Observe your moment-by-moment experience and view it as a “process” instead of getting caught up in the “content.” As you do so, you will discover that there is a “flow” of changing sensations and responses. Allow yourself to be curious, interested in a dispassionate way in the quality of the sensations and your experience, rather than get caught up in the distorted imaginations you tell yourself. These fantasies about what may or may not happen simply fuel fear, anxiety and despair.

It won’t be easy, as resistance will re-emerge many times and your first response will be to block it out, but with practice you can learn to resist this habitual behaviour and you will learn to interrupt the cycle of tension, reaction and suffering and replace it with peace, awareness and kindness.

As you become intimately acquainted with the nuances of your experience you will gently tame that which you wish to banish. You will find that instead of visiting you regularly, stirring up terror and suffering, the occasions of fear will change, they will no longer be completely overwhelming; the intensity and duration will diminish, and you will be able to smile instead of tensing rigidly. You will begin to break free from that which bound you.

Here is a simple befriending mindfulness exercise:

Make yourself comfortable in your body. Spend a moment loosening or adjusting your posture. Whether you are standing, sitting or lying down.

Now place your attention on your breathing. Notice the in-breath, notice where the breath enters your body, the nostrils… Notice how at the end of the in-breath the breath naturally starts to subside; follow the breath. Try to find that momentary pause between the in and the out-breath, the out and the in-breath; a moment of stillness and space. Notice how without having to do anything, the breath rises and falls naturally.

Encourage a tender, gentle awareness to permeate the breath, so the breath softens any resistance and with full intention, breathe in kindness and compassion, breathe out tension and fear.

When we are aware that what we are feeling is fear, we make friends by saying:

“Breathing in – fear I know you are there.”

“Breathing out – I accept you, I will take care of you.”

Simply practise this over and over, remind yourself that  these feelings will soon pass. By developing a calm, mindful relationship with your body you will learn to let go of fear, anxiety and panic.

Until next time, Steve

We would be delighted if you visit our facebook sites:

www.facebook.com/yourmentalhealthmatters

www.facebook.com/bexhillmindfulnesscentre

Steve Clifford Senior Accredited Integrative Psychotherapist.                                           Accredited Cognitive Behavioural Psychotherapist.
References:

Burch, V. (2008). “Living well with pain & illness: The mindful way to free yourself from suffering,” Piatkus.

Kabat-Zinn, J. (2004). “Full catastrophe living: How to cope with stress, pain and illness using mindfulness meditation,” Piatkus.

Image: http://commons.wikimedia.org/wiki/File%3AScared_Girl.jpg

Should I see a therapist?

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Well, that really depends on why you want to see a therapist. If you are going to see them with the hope that they will solve your problems, then perhaps not. If, however, you are going to them with the hope that they will help you to solve your problems, then that’s another matter. You see, the job of a therapist is not to “fix,” but instead to help you to mobilise your resources. A good therapist does not solve your problems, but helps you to develop the capacity to solve your own problems.

People often look to have therapy when they have a major life crisis, such as a death, the end of a relationship or the loss of a job. Sometimes people feel empty or inadequate inside, or they may feel that life is not going right and they may feel unfulfilled.

It can take courage to go and see a therapist, after all, firstly the person has to admit they have needs and then they have to face them. Fear of facing painful feelings can prevent people seeking help and many turn to work, alcohol or other coping strategies to push thoughts and feelings out of their consciousness. Therapy does require a commitment from you, but it is worthwhile and talking about difficult emotions in a safe space can be very liberating. Expressing your thoughts and feelings in such a way as to clarify your own situation, come to terms with painful emotions and see your difficulties with greater objectivity can really be helpful.

It is the therapist job to provide you with a space where you can talk without fear of judgement. In other words, a confidential place where you can feel held, secure and safe. For many, the therapy room is a refuge, a sanctuary. I like to think of it as your room, your space within my world. A place where you can return to at any time in your life should you need.

A good therapist will make you feel at ease, they may even feel more like a friend than a professional therapist, someone with whom you may feel you can tell anything. Whilst friendship and friendliness may be an important ingredient, along with warmth, genuineness and congruence they can never be a friend as such. You are seeking their help as a professional not as a chum, buddy, lover or any other relationship.  It is precisely because of the uniqueness of this relationship where warmth and friendship in the therapy space combined with professional integrity come together in the service of your difficulties. Next time you are telling a friend something notice how they will often come back and try to tell you a worse story, or perhaps they will tell you what to do or simply rubbish what you say. A good therapist won’t do this. Of course, there may be a value in the therapist sharing or disclosing something of themselves, they will only do so really if it is deemed to be helpful and supports the therapeutic endeavour. You can be sure of one thing though, unlike a friend or acquaintance, a good therapist won’t dump their garbage on your shoulders!

The term psychotherapist is one that I really like. Not because it is a lovely grandiose title… but because of the original Greek meaning of the word. Here the word therapist literally means “attendant” and the word psyche literally means “spirit” or “soul.” So a psychotherapist is literally a “Soul Attendant.”

One of the problems when deciding that you want to take up therapy is to find the right type of therapy for you. The problem is that there are just so many different types of therapy to choose from. Therapies vary from analytical laying on the couch type therapy, to body therapy, cognitive behavioural, transpersonal to neurolinguistic programming. The list is seemingly endless. I suggest you go to a good bookshop and look for books on therapy in the psychology section, alternatively contact a few therapists and ask them to tell you more about their particular approach.

Probably the best way to find a therapist is through personal recommendation. This may be from your doctor or a friend. The key thing is that the therapists approach has to feel right for you.

These days a lot is spoken about a type of therapy know as cognitive behavioural therapy or CBT, which is my own speciality. This is an action-oriented as well as word-oriented therapy. It helps people understand what is happening and what they can do to change the way they feel and react. CBT looks at the way thoughts (cognitions) and beliefs affect our emotions and the meaning we give to events. This affects our emotions and our reactions (behaviours). Unlike some other approaches, CBT is a relatively short term psychotherapeutic approach. The length of therapy tends to depend on the complexity of the presenting problem. A block of sessions ( usually six) may often be enough for a noticeable difference to emerge. Improvement to “quality of life” is often the best measure of success. The goal of CBT could be said, to enable the client to learn ways to address problems and difficulties in order to become their own therapist.

If somebody asked me what do you do? I would reply that I do many things, but one of the most important things is”tilting the mirror.” In other words. Reflecting back in such a way as enable the client to glimpse a slightly different perspective. Helping the client gain insight and understanding. This may be helping the client to see how unhelpful thinking traits, such as catastrophizing mind reading, black and white thinking distort their view of reality. We may look at the meaning they give to events creates a huge emotional upheaval and how stepping back and distancing can help. Then together we look at the problem area and the way it impacts on the person’s life. We consider how life would be different if the problem was resolved. We look at what may need to happen or change, then we look at the emotions arising out of the event or situation and talk about them. Together we identify what needs to happen to bring about resolution of the problem area. Then we identify strategies and goals (or aspirations) to aim for. Working within a specific time frame, using measures and behavioural experiments to help us. Through the course of therapy the client and therapist walk “shoulder to shoulder,” addressing the difficulties In a collaborative way.

Some people say, “I felt worse after my first session,” for others, getting it out in the open can be a great relief. Problems rarely resolve themselves without action, and if they do so, it may not be in the way we desire. Having the opportunity to explore them with another person may help a great deal.

Don’t expect miracles, but don’t dismiss the possibility that resolution of difficulties can feel like a miracle. Therapists are not “miracle workers” and if they present themselves that way, don’t go anywhere near them! The therapist is there to guide you to achieve your goals, not to do the work for you or “make” you feel better. Every session you attend is one step closer to feeling better.

Until next time, Steve Clifford, Cognitive Behavioural Psychotherapist.

visit us @ www.stevecliffordcbt.com
Like us @ www.facebook.com/yourmentalhealthmatters                                                        tweet @ cbt4you

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Thought-Flipping

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All day long our minds are filled with constant chitter chatter. Most of it benign, some of it worry-some, and some of it down right troublesome.

Research suggests we have somewhere in the region of 65,000 thoughts every day and that on average our mental dialogue is in the region of 50 to 300 words per minute.

Much of this is self-talk, inwardly directed and a good deal of it is unhelpful. Because of the way it makes us feel, it is capable of raising our stress levels and bringing down our mood. In CBT circles we talk of NATs (Negative Automatic Thoughts) or ANTs (Automatic Negative Thoughts).

Such thoughts are:

AUTOMATIC              They just seem to come into your mind without any concious effort.

DISTORTED               They are not always supported by the things you know to be true.

UNHELPFUL             They are nearly always negative and make it difficult to change.

PLAUSIBLE               You accept them as facts without questioning them.

INVOLUNTARY         You do not choose to have them and they appear difficult to stop.

One of the problems is that we tend to be so identified with our thoughts that we often cannot see them for what they are…just thoughts. Instead, somehow we see them as us, and we feel we have no power over them. Often we give them power, believing them and that we are somehow at the mercy of them. Racing thoughts, obsessive ruminations and irrational fears take over.

How then can we learn to step back and take control? Well, let me introduce you to “thought flipping.”

I would like you to imagine that you are now going to install a “negative thought alarm.” As soon as a negative thought crosses your mind a silent alarm sounds. You then step in with absolute authority, grab hold of the thought and flip it on its head, by thinking the exact opposite.

Yes, expect a little battle at first, when your rational programmed mind tells you that such a practice is ridiculous and could not possibly be true. But like the Master you are, you use your authority and power to respond back in a direct and commanding way. The mind is reminded that it’s former thought was, at the very least, as lousy and ridiculous as the new flipped one. As you are the Master you will choose what is true.

Here is an example of thought flipping where we rewrite the negative mental script.
You find your mood dipping and you notice you are feeling angry with yourself. Your thoughts are as follows: “I am useless and have no sticking power, I missed an entire week at the gym.” By flipping the thought we create a different perspective and this can halt the negative mood slide. “I have been kind and listened
to my body and taken a break from the gym, so I am going to have a really good workout today, because I am truly committed to my goal of feeling good and honouring my mind and body.”

What you need to do is change the wording, in other words rewrite them. Which one do you want to be true? You choose?

It can be really helpful at first to get into the habit of writing down any serial negative thoughts that continue to pop into your mind. Do this when you notice the drain on your emotions and you start to feel down, depressed or anxious:

Write down your thoughts on paper and take a good look at it.

Do you know this thought is a fact, is it true?

Is this a helpful thought, does it serve you?

Write down a counter thought that opposes the negative thought

Change the wording of the thought to something more positive

Now each time the negative thought wants to dominate your thinking, assertively replace it with the new positive alternative.

So here we have it, thought flipping, tackling negative thoughts by re-creating positive alternatives with deliberate intent. Planting positive thoughts this way ensures that we take back control and create the reality we want.

Until next time, very best wishes, Steve.

 

You may wish to know that Steve is now offering therapy sessions via Skype                   Please contact us through our website @  www.stevecliffordcbt.com

Visit our facebook sites:

www.facebook.com/yourmentalhealthmatters

www.facebook.com/bexhillmindfulnesscentre

Steve Clifford                                                                                                                       Senior Accredited Integrative  Psychotherapist.                                                                 Accredited Cognitive Behavioural Psychotherapist.

 

Adapted from: “Thought-Flipping: A guide for Taking Charge of Your Mind-Stuff,” by Leigh Donovan, 30/06/12, Spirit-full, a personal transformational blog.

Ref: “Negative Automatic Thoughts,”  Central Manchester and Manchester Children’s University Hospitals NHS TRust, Clinical Psychology, 2002

Image ref: http://upload.wikimedia.org/wikipedia/commons/f/f9/Mr_Pipo_thoughts.svg

Eleven tips to boost self-esteem.

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Low self-esteem can really affect your emotional well-being and it can underpin some common mental health problems and lead to poor self-confidence and shyness.

What is self-esteem?

Self-esteem is the way that you think about yourself. If your self-esteem is low, the thoughts you have about yourself are likely to be negative and you are likely to focus on what you think are your weaknesses.

As a therapist I see many people with low-self esteem and this can often be at the root of problems such as eating disorders, depression, anxiety and phobias. While shyness and insecurity is often at the heart of low self-esteem, childhood factors such as bullying, abuse or neglect often leave the individual feeling less than good about themselves.

Having low self-esteem can affect a very area of life including work, personal relationships and your ability to socialise. Tackling low self-esteem and boosting positive thinking can really improve your sense of wellbeing and your mental health.

Here are some useful tips to help you boost your self-esteem.

1. Stop comparing yourself to others. You will nearly always home in on their strengths and that will make you feel worse about yourself.

2. Stop putting yourself down. Avoid self-deprecating comments such as, “you silly fool” or “your useless.” Every time you say something like this it erodes your self-esteem.

3. Listen out for compliments, learn to accept them and say “thank you.”

4. Find an affirmation, a statement such as, “I am confident and competent,” write it down and read it every day.

5. Read everything you can about self-esteem, devour books, blogs, websites, attend workshops and really make improving your self-esteem your mission in life.

6. Avoid people who are negative and put you down, instead mix with people who are positive, confident and supportive. Their positive self-esteem will rub off on you.

7. What do you like about yourself, however small. What qualities do you possess, for example, kindness, friendly, reliable, etc. note these down even if less than 100% perfect.

8. Make a list of your past successes, however small, like learning to ride a bicycle or play a musical instrument. Write these down.

9. What do other people value or compliment you on. Note these down too.

10. Try to do more of the things you love, rather than the things you think you ought to do.

11. Finally, be true to yourself. Respect yourself, live your life, not a life dictated to you by others.

Begin to make these positive changes today – Good luck.

Until next time, very best wishes, Steve.

 

You may wish to know that Steve is now offering therapy sessions via Skype                   Please contact us through our website @  www.stevecliffordcbt.com

Visit our facebook site @ www.facebook.com/yourmentalhealthmatters

Steve Clifford                                                                                                                       Senior Accredited Integrative  Psychotherapist.                                                                 Accredited Cognitive Behavioural Psychotherapist.

image: By 143peace (Own work) [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0)%5D, via Wikimedia Commons

Food and Mood

 

Most people reading this will recognise that our state of mind and food are inextricably linked. Just as devouring a whole packet of biscuits or demolishing a chocolate bar is something many people crave when feeling tired or fed up, so too, using food to express their mental anguish is a common phenomenon.

These days, thanks to global media coverage, the awareness of conditions like obesity and eating disorders such as anorexia and binge eating are much better understood. Having said that, neither condition is more accepted in our society; however, with the diet and food industry seemingly bombarding us with subliminal messages telling us to eat this, or cut out that, it is no wonder many opt simply for denial.

The food and diet industry have a lot to answer for. Many will remember the advice to avoid butter, eggs and animal protein in meat and dairy, with spreads and low fat alternatives on every supermarket shelf. Yet today, “going to work on an egg” is once again acceptable and many shun spreads and the harmful trans fats they contain in favour of butter once again. Saturated fats are no longer seen as enemy number one. The years of confusing messages have literally turned us all off. Perhaps, Granny was right all along…”a little of what you fancy does you good.”

Diets too have come to be seen as fads that do not work. Remember these: the grapefruit diet, the cabbage diet, the Beverley Hills diet, the Atkins diet, the F-plan? I could go on.  There are the substitutes, too, where liquid meal replacements, biscuits, bars and all manner of alternatives take the place of food.

No wonder we are all confused. Look at the way the supplements industry pedal vitamins, minerals, capsules and powders of every description. All being heralded for their great health benefits. Elixir of life or youth capsules, take your pick, hand over your money and the choice is yours. Who said that snake oil remedies do not exist!

Whichever way we look at it, one thing is certain and that is, eating problems are psychological. With the very rare exception of a metabolic disorder, perhaps;  obesity, anorexia and many other food related conditions have nothing to do with hunger and everything to do with meeting an emotional need. Food is used as a “medicine” to dull down emotional pain, to soothe or to mask an emotional discomfort. Food is a comfort and we all seek to push away discomfort. Food is used to fill up, cover up, and build up a protective barrier.

Quite literally, food (and alcohol) is to the adult, the surrogate breast or bottle. Smoking too, while technically more of an obvious drug than food per se,often serves the same purpose. Yes, food can become addictive as can the hormones released when starving, or the soothing pain felt by an anorexic when they seek to feel “in control.”

To get to the bottom of our emotional discomfort and the role food plays in this really is the domain of the psychological health professional. We need someone to hold up the mirror and tell us what is really going on. We need to understand why it is that our search for the “magic potion” and a “quick fix” will bring us nothing but more suffering. Furthermore, changing eating habits is not easy, after all, making changes means altering our comfort level and most people naturally balk at that.

If you have a food issue seek out a health professional with expertise on eating disorders who has no emotional ties to you. Someone who will hold the mirror up and help you see the real picture and help you to make changes to the way you eat and your relationship to food.

Until next time, best wishes Steve.

You may wish to know that Steve is now offering therapy sessions via Skype                   Please contact us through our website @  www.stevecliffordcbt.com

Visit our facebook site @ www.facebook.com/yourmentalhealthmatters

Steve Clifford                                                                                                                       Senior Accredited Integrative  Psychotherapist.                                                                 Accredited Cognitive Behavioural Psychotherapist.

Primary Ref: Sullivan, R (2009) “Reclaim your youth, growing younger after 40.” Montgomery Ewing Publishers.

Image: “Supreme pizza” by Scott Bauer – http://www.ars.usda.gov/is/graphics/photos/mar01/k7633-3.htm. Licensed under Public domain via Wikimedia Commons – http://commons.wikimedia.org/wiki/File:Supreme_pizza.jpg#mediaviewer/File:Supreme_pizza.jpg

Could there be an evolutionary explanation for depression?

File:Emmanuel Benner - Prehistoric Man Hunting Bears.jpg

Could there be an evolutionary explanation for mental health conditions such as anxiety and depression?

I have for a long time pondered over the hypothesis mooted by some that there may be an evolutionary explanation for both anxiety and depression. This explanation may also embrace seasonal affective disorder, and bipolar disorder.

Let’s start with anxiety. On the face of it, anxiety is fairly easy to categorise as an evolutionary response.

Imagine a tribe who live in mud huts next to a fast flowing river inhabited by crocodiles and surrounded by a dense jungle full of ferocious animals. This tribe have no fear whatsoever, and the children, just like their parents, take every opportunity to play in the fast flowing river and climb the trees in the jungle.

All, that is, but two people, a man and a woman who were born with this condition called anxiety. One by one the children and their parents get eaten either by the crocodiles or the ferocious animals inhabiting the forest. The couple with anxiety however, do not venture near the river or risk going into the jungle. Lo and behold they are saved because of their anxiety. In time they have children and so this condition us passed on and on through the generations.

Anxiety could be said to be one of the main motivating forces in much of human behaviour and provides a tremendous impetus to learning and adjusting throughout life. The earliest human remains that resemble us, is a female skeleton (Australopithecus) or should I say, several hundred bones known as AL- 288-1. She has been named Lucy” and she dates back some 3.2 million years and she is a hominid.

Lucy would not have fared very well when facing a huge wild beast; her nails could hardly be described as claws. Her hair, a little under her arms, between her legs and on her head could hardly be described as fur. Porcupines or their prehistoric equivalent had spikes that came up when they were scared. Lucy, on the other hand, had goose pimples and a few short hairs that stood up on end, hardly a match. She was not very strong and could not really outrun her enemies. So how then did she fare so well?

Well, she had two special gifts: a brain that could think and reason in a way that her enemies could not, and hands that had fingers and movement far more sophisticated than them. She soon learnt how to fashion weapons with her hands. This fantastic evolutionary condition called anxiety enabled her to identify threat.

If we were really being picky we might say that anxiety does not mean precisely the same as fear. Fear arises from threat, by some situation outside a person, that can be assessed and acted upon. Fear prompts us to either attack or run away. The sophisticated autonomic nervous system, ( the sympathetic and parasympathetic nervous system) in conjunction with the endocrine glands prepare the body for “fight or flight.”

There are several other states associated with fear and these include “freeze,” like a rabbit does when in a car headlight, and another we shall call “flop,”  – in this latter state, blood pressure, which is sky high when in the fight or flight state, literally drops in an instant causing us to faint. An example where this might come into play is where you are running away from your attacker and you are caught by a huge blow and a gaping wound prevents your escape. Unable to fight or flee, a message is sent to the brain in an instant and a rapid drop in blood pressure causes you to faint. Lying motionless, hopefully your pursuer just might think, ” ugh, dead meat, that’s it, I am not interested any more.” Another related state is known as “fawn,” – in this state, showing extreme affection and getting friendly with your attacker, you might be able to favourably influence your fate.

Coming back to anxiety, let us say that it is a feeling of unease or concern in relation to a perceived threat. This was the gift Lucy had. Her fairly small brain was programmed to look out for threat. That is why today we are fixated with the new bulletins and we gravitate towards news stories which have an element of shock and horror. Yes, Lucy could have been programmed to remember the kiss and cuddle she had with Freddie Flintstone, but no, she was programmed to look out for threat and danger. Today, we can be forgiven for being drawn towards gossip, after all it important for you to know if any dangerous predators are moving into our neighbourhood!

One could almost say that we are “over-engineered” to look out for danger; in other words, just like a car alarm that goes off with the slightest vibration from a lorry passing by, or a burglar alarm going off when a spider walks over it, we too are sensitive to all forms of imagined threat or danger. Hence we get “panic attacks” at the drop of a hat and our body kicks into “fight and flight.”

Depression too, could be viewed as a natural response to overwhelming odds or abnormal situations of stress. Imagine if you will, our prehistoric ancestors living in a   cave by a river, close to the plains populated by wild animals. The weather is particularly bad for a prolonged period, dark skies and rain cause the rivers to flood. As a consequence of the poor conditions the normally dry plains flood and the wild animals now are on the prowl for food.

Looking out for threat and danger, the dark oppressive skies signal to us that something is wrong and that we need to withdraw. Perhaps the modern day incidents of seasonal affective disorder hark back to this time? Chemical changes alert us that something is wrong. Could bipolar disorder signal to us to get hyperactive and gather what supplies we can before depression kicks in?

With danger imminent our body chemicals signal both brain and body to withdraw. With lowering of energy levels we do not feel like doing anything much, loss of libido means that we are no longer making babies, so no more extra mouths to feed! No need to go far to hunt as our appetite is diminished and our hastily gathered supplies will last us through this period of danger. With little energy to do anything, not even washing or dressing, we huddle up together under a pile of animal skins and hibernate, sleeping though until the spring and the nice weather arrives again. As it does, so the skies lighten, floods recede and the animals move back to the plains once again. Safety has returned and our mood is restored back to its former state.

Fanciful perhaps, but there may be a grain of truth in there somewhere, who knows?

Until next time, best wishes Steve.

 

You may wish to know that Steve is now offering therapy sessions via Skype                       Please contact us through our website @  www.stevecliffordcbt.com

Visit our facebook site @ www.facebook.com/yourmentalhealthmatters

Steve Clifford                                                                                                                             Senior Accredited Integrative  Psychotherapist.                                                                   Accredited Cognitive Behavioural Psychotherapist.                                                                                                                                                                                                                   Image ref: http://commons.wikimedia.org/wiki/File%3AEmmanuel_Benner_-_Prehistoric_Man_Hunting_Bears.jpg

 

 

Managing really upsetting thoughts and feelings

File:Glühwendel brennt durch.jpg

As a CBT practitioner I would be the first to point out that avoidance of upsetting thoughts and feelings only serves to perpetuate and strengthen the power they have over you. There are times however, when the sometimes overwhelming nature of these thoughts and feelings can simply be too much. Having intrusive and upsetting thoughts while your taking your child to school, or when faces around you become distorted, due to a painful flashbacks, is not to be recommended. I hope to give you a few tips to help you manage, so that you can go about your life with relative ease, until such time as you can address the causes of these upsetting thoughts and feelings safely in therapy.

The first technique I would like to share is adapted from the “Drop Anchor” exercise by Russ Harris (Harris, 2009).

This exercise will help you centre yourself and connect with the world around you.

1. Place your feet firmly on the ground.                                                                                   2. Now push them down firmly.                                                                                                 3. Become consciously aware of the floor beneath you, feel it supporting you.                       4.Notice the muscle tension in your legs as you push your feet down.                                 5. Become aware of your whole body, as if your whole body now is engaged in pushing.     6. NOw look around you, notice what you can see and hear.                                                  7. Notice where you are and what you are doing.                                                                     8. Breathe!

Grounding techniques

These are very helpful techniques to learn, particularly if you are prone to upsetting intrusive thoughts, memories and images. THey are also good to employ if you are feeling detached and unreal.  Rather like mindfulness, focusing all of your attention on sounds in the environment e.g. birds in the trees, waves on the beach or even the sound of your breathing can be very helpful.

There are many different grounding techniques and I have listed some of my favourite “sensory” grounding techniques below:

Visual: Select an object or perhaps a photo, picture or landscape to focus on.  Study it intently; describe what you see out loud or in your head.  You may choose to focus on something around you, like the wallpaper or even a spot on the carpet or ceiling. Really focus on the detail, shape, colour and pattern.  Counting the grain in wood or fabric will really heighten your “in the moment” awareness.  Use flashcards, with a message to yourself such as, “these dark days will pass” or “I can tolerate this.”

Touch: Carrying round a stone or crystal that you can get out of your pocket when you need to ground yourself is an easy way to bring yourself back to the present. Find yourself a special object to use at such times.Look at the colour, the shape, how solid it is, the temperature of the object and its texture, and whether it is rough or smooth.  You can even use foodstuff like a sultana, banana or mushroom.

Look to your environment, for example by feeling the grass under your feet or the bark of a tree. Take a shower and become aware of the stimulation of the water on your skin, or perhaps slap your hand on the surface of bathwater.  Pinging an elastic band on your wrist, rubbing a comb over your arm or an ice cube over your face can be helpful.  The latter are particularly helpful as an alternative to acts of self-harm.

Sound:  Use your voice, making different sounds and shapes with your mouth.  Select a piece of music, preferably something up-beat, and listen to the sound, in particular, paying attention to the beat, rhythm, the different instruments and vocal harmonies and become aware of any feelings evoked.  Listen to the sounds of birds, the ticking of a clock, or simply listen to the sounds around you, noticing how loud or soft they are.  Notice those in the foreground, mid-ground and distance – now categorise these into groups.

Scent: Scented candles, oil burners and incense are all good for grounding.  I burn incense before I see my first clients each day to help me to focus and put me in the “zone”, ready to attend to the issues they bring me.  It can be helpful to carry round a small bottle of perfume, or putting a dab on your wrist to smell.  A particular favourite of mine is the scent of patchouli, however, my Granny used to carry round a bottle of smelling salts to ward off the “vapours.”  I can only think that this latter, rather pungent scent would be good for managing panic attacks!

Taste: Take a glass of water (with or without ice cubes) and drink it very slowly, savouring the taste, imagining it cleansing and washing away your tension or distress.  A selection of herbal teas with different flavours can stimulate the taste buds.  Be aware, however, that herbal teas have certain therapeutic properties and so should be taken with this in mind.  If you want to find out about the beneficial effects of herbal teas consult your local health food store.

I hope you find these helpful.

Until next time, Steve Clifford, Cognitive Behavioural Psychotherapist.

Visit us @  www.steveclifford.com

Ask us your mental health questions anytime @ www.facebook.com/yourmentalhealthmatters

 

Image ref: http://commons.wikimedia.org/wiki/File%3AGl%C3%BChwendel_brennt_durch.jpg

Sources:

Russ Harris – “Simple Ways to Get Present” – 2009. www.actmadesimple.com 

Steve Clifford – “50 Tips to Beat Depression” – http://www.amazon.co.uk/Tips-Beat-Depression-Steve-Clifford-ebook/dp/B00ILV965A