CBT shows promise for people with low back pain

New research has found that CBT can help sufferers of low back pain and accompanying psychological distress manage their condition. Contextual Cognitive Behavioural Therapy (CCBT) is aimed at helping people to learn to live with and accept pain that cannot be cured.

The researchers compared CCBT with physiotherapy in 89 patients with low back pain. The CCBT group reported greater improvements in pain and disability than those who received physiotherapy. However, many who took part in the study thought the best treatment was a combination of CCBT and physiotherapy. Patients also expressed a preference for one-to-one therapy rather than in a group setting.

Until next time. 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

www.facebook.com/mgbhillclimbchallenge

Twitter @cbt4you

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

Ref: www.therapytoday.net/Therapy Today: July 2015

Talking therapy shows promise for people with low back pain: http://tinyurl.com/ntb96qp 

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Managing really upsetting thoughts and feelings

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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

 

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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

Medication for young people

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Here is a site that I will certainly be recommending. It is called “HeadMeds” and it has been launched by Young Minds (www.youngminds.org.uk), a website focusing on children and young people’s wellbeing and mental health (aged 13-25).

A survey was carried out in conjunction with the launch and it found that 49% of young people said they felt worried, 32% felt scared and 26% felt frightened when they were prescribed mental health medication. Half of those surveyed said that they wanted more information about side effects.

Headmeds is a funded by Comic Relief (www.comicrelief.com) and the Nominet Trust (www.nominettrust.org.uk) and the aim of the site is to provide information about potential side effects of medication and gives answers to questions that young people may have but not want to ask their G.P.

The website (www.headmeds.org.uk) is endorsed by the College of Mental Health Pharmacy as well as the Royal College of General Practitioners.

Until next time, with all good wishes,

Steve

Please feel free to email your blog posts for www.facebook.com/yourmentalhealthmatters to stevecliffordcbt@gmail.com                                                                                            

Visit us @ www.stevecliffordcbt.com 

Source

April 2014/www.therapytoday.net/Therapy Today

Get yourself a few rays of Sunshine – Beat #Depression

 50Tips

Tip 29 – Extract from “50 Tips to Beat Depression” available on Amazon

It is not just Morecombe and Wise who extol the benefits of sunshine.  Boosting the supply of vitamin D in the body serves to maintain optimum levels of serotonin to assist the activity of cells throughout the body, regulating mood, sleep and our ability to process information.  In the summer months go out for a few minutes every day, soak up the sun and ensure supplies of vitamin D are topped up.  Meet friends for a picnic, take a stroll before nightfall and watch the sunset.  In the winter, consider hiring or purchasing a light box, (see tip 40), as serotonin levels change with the seasons and are at their lowest in the winter months.

Until next time.

With best wishes, Steve.

Please feel free to email your blog posts for “Your Mental Health Matters” to stevecliffordcbt@gmail.com

Steve Clifford, Cognitive Behavioural Psychotherapist

Visit us @  www.steveclifford.com                                                                                      Ask us your mental health questions anytime @ www.facebook.com/yourmentalhealthmatters                                                                  Tweet us @ cbt4you

 

Remember the Positives – Beat #Depression

50Tips

Tip 6 – Extract from “50 Tips to Beat Depression” available on Amazon

It’s very easy when you are feeling down to lose sight of the positives.  One facet of depression is the way the depressed outlook shapes thinking.  The depressed person tends to ruminate on the negative things people say, and hears only critical comments. This is called “filtering out” and is a particular type of unhelpful thinking trait that often goes hand in hand with depression.  Instead of noticing things in a balanced way, we only notice things that “fit” our negative mind-set and we dismiss the positives. This in turn serves to reinforce low self-esteem and a negative outlook.

One way to turn this around is to create a positive book (see tip 25).  Buy a small exercise book, and if you are creative, cover it with a bright paper cover or positive images from magazines.  Use this book to jot down positive things that happen, positive things people say and positive things that you have achieved during the day.  Slowly you will begin to notice more and more positives as you learn to hear them and not dismiss them from your radar.

Consultant Psychologist Rick Norris, in his excellent book, “The Promised Land,” recommends compiling a list of 20 positive memories.  He acknowledges that this can be somewhat overwhelming, as depressed people get out of the habit of playing memories that make them happy, because their mental filter tends to screen these out of their conscious mind.  He suggests recalling three positive memories each day for a week. He tells us the benefit of doing this exercise last thing at night is because it can be a pleasant way to drop off to sleep and also that we tend to be more in tune with our sub-conscious mind during sleep, perhaps  leading to sweeter dreams!

With best wishes, Steve

Please feel free to email your blog posts for “Your Mental Health Matters” to stevecliffordcbt@gmail.com                                                                                               Steve Clifford, Cognitive Behavioural Psychotherapist

Visit us @  www.steveclifford.com                                                                                      Ask us your mental health questions anytime @ www.facebook.com/yourmentalhealthmatters                                                                  Tweet us @ cbt4you

Make a Comfort Box – Beat #Depression

50Tips 

Tip 3 – Extract from “50 Tips to Beat Depression” available on Amazon

It’s often hard to remember the good things in life when you are feeling low in mood.  At such times happiness and positive memories can seem far away.  Stimulating positive memories and associations can be invaluable in helping to keep us grounded in the real world and help lift the spirit.  Creating a “capsule” containing mementoes from the past can help to evoke feelings of comfort, warmth and personal security during difficult times.

A shoebox, biscuit tin or similar can be used to house objects to inspire hope.  I have a comfort box and mine includes a variety of objects: photographs and even “thank you cards” which I can use as “evidence” to support my being a worthwhile person.  I recommend any of the following:

CD, LP, MP3 of favourite music, chill-out, relaxation, etc.

DVD of favourite film with uplifting, or feel good theme, etc.

Photograph of a loved one or of something or somewhere of importance

Memento of a holiday, postcard, seashell, souvenir, foreign money, flight ticket stubs, booklet or programme from places visited

A note, card or letter from a loved one or write a letter to yourself when feeling well, offering encouragement and re-assurance that you will come through this difficult time

A favourite poem, statement, prayer or article that inspires hope

A favourite book, magazine or colourful picture

A favourite object, i.e. a small stone, crystal, lucky charm or something that is tactile

A sketchpad with crayons or watercolour paints

Aromatic oils for massage, scented candles, bath bombs or bath oils/salts

Herbal teas such as Chamomile, known for its calming properties

Favourite item of clothing, warm jumper or a blanket

A hot water bottle

Vouchers for a massage or beauty treatment

A list of telephone numbers, e-mail addresses of family or friends to whom you can turn for support (try to look for support from more than one person).

A list of national help lines e.g. Samaritans, Sane, MIND, etc. .

Any object associated with feeling happy and well.

With best wishes, Steve

Please feel free to email your blog posts for “Your Mental Health Matters” to stevecliffordcbt@gmail.com                                                                                                Steve Clifford, Cognitive Behavioural Psychotherapist

Visit us @  www.steveclifford.com                                                                                      Ask us your mental health questions anytime at: www.facebook.com/yourmentalhealthmatters                                                                  Tweet us @ cbt4you

It’s good to talk

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Sometimes life can seem very overwhelming,  especially if you’re suffering with a mental health problem. For years I have suffered with anxiety and depression. It has affected every aspect of my life from my relationships with partners, friends and family, to my work and even my physical health. My chronic low self esteem has led me to walk with my head down for so many years that my neck and back have slowly deformed and I now have a small hunch. It’s just one more thing to hate about myself, and another reason why I felt I couldn’t live anymore, why I felt I didn’t deserve life.
When I planned my suicide the first time I was at an all time low, but strangely I didn’t recognise that. I felt calm and in control. I made meticulous plans and took my time stockpiling prescription and over the counter drugs. I cheerfully strolled into the supermarket and purchased alcohol. The checkout girl could be forgiven for thinking I was having a party, because in my head I was. I was finally going to be free of all the agonising feelings, the torturous thoughts and the confused state my mind was in. I had been looking forward to this day for weeks and had all my affairs in order. I went home, made sure I left the door unlocked, fed my cat, put on my favourite album and poured myself a large glass.
When I woke up in hospital initially I was devastated, how could it have gone wrong? But as I looked around at the tear stained worried faces I began to realise that maybe people did care about me. Maybe their lack of warmth and comfort towards me was really lack of knowledge and understanding. The question I was continually asked was “why didn’t you tell us that you felt so bad?” Well I thought it was obvious! But apparently it’s not obvious.
When you suffer from depression for a long time you can get very good at keeping your brave face on in public and the inner turmoil you’re feeling may not show on the outside. It’s only once you express that turmoil that people can begin to understand and maybe even help.
Unfortunately this revelation was not the end of my depression and I did wake up in hospital on another 3 occasions. However it did start my journey onto talking, writing and expressing the pent up feelings I had inside of me, which helped other people understand more. I am still suffering with my mental health but I am on the road to recovery. Letting the thoughts and feelings out rather than keeping them hidden in my head has taken the weight off and I feel a little freer of my illness every day.

Thank you anonymous

With all good wishes

Steve

Please email your submission posts to stevecliffordcbt@gmail.com                                Steve Clifford, Cognitive Behavioural Psychotherapist

Visit us @  www.steveclifford.com                                                                                      Ask us your mental health questions anytime at: www.facebook.com/yourmentalhealthmatters                                                                        Tweet us @ cbt4you

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