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One of the first challenges for therapists with a new client can be to provide some psychoeducation around the unconscious. Quite often clients can believe that if they are not aware of certain feelings, scripts, wounds, blueprints and beliefs then they assume that the content must not exist.

A person’s field of consciousness, or field of awareness, can be who they are aware of being. The material in such a field is what they present when they describe who they think they are and how they think they come across to others. It can be their sense of identity. It is this material that is often presented to the outside world. It can be seen as someone’s ‘front of house’; what is being presented to the outside world. Some schools of thought describe this as the survival personality, the version of self that needs to be presented to the world in order to feel accepted, welcomed and made to feel part of.

This language is similar to Freud’s ‘complexes’. Sub-personalities is another way of seeking to define this area, although sometimes I fear that such a term is outdated. The risk with viewing something as ‘sub’ is that a denied role could be undermined. The denied role could, for instance, be ‘super’ rather than necessarily being less than. That is why I prefer the terminology adopted by dialogical self theory with ideas about the personification and the multiple self.    Dialogical self theory conceptualises the self in terms of a dynamic multiplicity of relatively autonomous I-positions in the (extended) landscape of the mind. In this conception, the I has the possibility to move from one spatial position to another in accordance with changes in situation and time.

How does all this work in therapy?

We don’t need to go in search of unconscious material. It usually comes looking for us in the form of unconscious acting out. This can take the form of symptoms such as depression, anxiety, interpersonal conflicts, lethargy and the plethora of mood disorders that bring individuals into therapy.

It can be beneficial for the process of therapeutic movement to identify which parts of ourselves we are comfortable with and which we are not. The parts that we are comfortable with are usually the parts that we seek to present to the world. This is what can amount to the so-called ‘front of house’ material, that which we present about ourselves to the outside world.

The point at which people enter therapy can be when unconscious material starts to negatively impact on the field of conscious awareness. This can present as phobias, resentments, depression, anxiety and so on.

The therapist role is to expand the client’s field of awareness so that denied roles and ways of being can be better integrated within the psyche. In practice this means helping and facilitating the process whereby the client describes their narrative and brings insight to the parts of themselves that are troublesome. This is done by providing the space for the client to tell their story in as much detail as possible. This helps to shine a light on who and what bothers them and helps to keep the communication in the client’s language. It is possible to identify their acceptable and unacceptable parts of themselves as they outline their personal narrative about which people they like and who they don’t like, what their preferences are and how they describe their school days, family life, peer group experiences and so on. It is often the unacceptable parts of their psyche that have become troublesome and it is for this reason that they have sought help.

How to identify denied parts of self

  • List the qualities, behaviours, self-expression, ways of being that were disapproved of in your early life.
  • List the people that you are arguing with. Who do you have strong judgments about and why?
  • Which beliefs you hold about what is right and wrong and good and bad.
  • Which feelings and behaviours you would rather not have?
  • Which parts and aspects of yourself would you rather get rid of?
  • List people who you admire. Who would you like to be closer to?
  • Which qualities were approved of in your early life?
  • What was approved of and what was rewarded in your family network, in school, in peer groups and in work environments?

These lists will inform who you think you are. Qualities often operate in polarized pairs. Therefore, these qualities and behaviours will uncover a list of their exact opposites. For example, if being angry is not an acceptable way of being then the way of being that is acceptable might involve the role of the peace keeper. The peace keeper could be seen as the identified role in the field of awareness whereas being angry is defended against, repressed, hidden or denied. Being angry might mean going against historical family norms and values or longstanding ways of being. Being angry might be associated with shame in the contexts of the various rackets associated with home life. A whole host of mechanisms might be at play to prevent the presentation of anger such as guilt, dissociation, denial, splitting, projection and avoidance and so on.

Uncovering these mechanisms is part of the process of therapy and helping to abandon outdated toxic messaging systems can help you to manifest a more integrated way of being. It will be okay to be appropriately angry and not have the associated negative toxic messaging system. Being the peace keeper might be an adapted self position and therapy could be a process of uncovering your real self so that you can have a more fulfilling and happier life.

Seeking help

It is important that an impartial and professionally trained therapist with no vested interest is tasked with uncovering this material. They will be best placed to see your blind spots as part of the constancy of therapy. This is what it means to have good psychic boundaries. Can this be done by chatting with a good friend or confidant?  I think not. Friends invariably have a vested interest in the process and will want you to be a certain way, however well-intentioned they may be. A therapist should not have any such conflicts.

Helping to integrate polarities, rather than allowing them to wage a form of internal psychic war, is the task of the therapist. We must be aware of the parts that are being deemed unacceptable and killed off. Where are we shying away from conflict in our lives and why? The therapy session may represent a microcosm of somewhere’s life outside the room. Uncovering denied roles and learning to manifest positive qualities in the outside world is what makes therapy dynamic and exciting.

Noel Bell is a UKCP accredited psychotherapist based in Central London. He can be contacted on 07852407140.

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In spite of having had enough of the recent political shenanigans surrounding Westminster political decision-making I still switched on the BBC Politics Live show the other day. I was glad I did. On it, I heard Thomas L. Friedman discuss his latest book; Thank You For Being Late – An optimist’s guide to thriving in the age of accelerations. The theme of the book is that the world is getting faster and deals with how humans are coping with the change.

I heard Friedman say that when you press pause on a computer it stops, when you press the pause button on a human being it starts. For Friedman, we are in need of pressing pause right now as we are in the middle of seismic social change. We can overcome the multiple stresses of an age of accelerations, if we slow down, if we dare to be late and use the time to think differently about work, politics, and community.

Friedman says that to understand the twenty-first century, we need to take account of the planet’s three largest forces. For him these are what he calls Moore’s law (technology), the market (globalisation), and mother nature (climate change and biodiversity loss) which are accelerating all at once. Five key realms are being transformed as a result of these accelerations: the workplace, politics, geopolitics, ethics and community. It is argued by Friedman that these forces are not just changing our world but that they are actually reshaping it.

Friedman cites 2007 as a major inflection point in social and economic change which witnessed the release of the iPhone (in addition to advances in software development, silicon chips, increased storage, sensors and networking), all of which created a new technology platform. For Friedman this platform represented what he terms “the supernova”.  

I first began thinking of these ideas when reading Alvin Toffler’s The Third Wave, about the post-industrial society in the 1990s. It was Toffler’s thesis that since the late 1950s most countries have been transitioning from a Second Wave society into a Third Wave society. He coined many words to describe it and mentioned names invented by others, such as the Information Age (also known as the Computer Age, Digital Age, or New Media Age).

For Friedman, this new technology platform amounts to a massive release of energy that is redesigning how we lead our lives, from how we hail a taxi to international diplomacy and the fate of nations to our most intimate relationships. This new technology platform is creating vast new opportunities for individuals and small groups to save the world, or to destroy it.

So, what has all this got to do with counselling and psychotherapy, you may well ask?  I believe that awareness of wider health factors such as sleep patterns, quality of diet and levels of physical exercise are crucial in treating clients. It has been my experience that these wider health indicators can often be awarded less priority in counselling and psychotherapy assessments, compared to the emphasis on the internal states of an individual. It is also my view that for psychotherapy to be truly holistic and integrative we should be taking a 360 degrees view of a person’s life, including sociological, political and cultural influences, as Wilber outlined in his AQAL basic framework for integral theory. One’s relationship to technology should also form a part of this assessment given the gigantic changes taking place in how we lead our lives. There are big implications for how we view child development, mentalisation and mental well-being. Suicide prevention strategies also need to address the consequences of changes in the workplace and technological change.

So, what can be done on a personal level to help with pressing pause right now to better deal with the rate of technological change around us? I am not sure being late is the cure for having insufficient amounts of spare time for jogging or contemplating the nature of existence. Perhaps we need to step off the treadmill of this high speed digital world and take time out without being deliberately late. We could engage in more mindfulness practice, spend more time away from devices, spend more time outside, learn to play a musical instrument, these might be the better ways of slowing down.

Perhaps we also need a new system of governance. All national governments are currently paralysed by tribalism and partisanship, just witness the current Westminster logjam. Perhaps the healthy community will be the right governing unit and the way forward for the 21st century. The political challenge for government will be to accept responsibility and respond positively to the social and economic dimensions of health experience. Individuals and communities could be co-designers of health, using the concepts of health literacy and empowerment to become involved on their own behalf in health policy and service development.

Noel Bell is a UKCP Pyschotherapist based in London who can be contacted by telephone on 07852407140 or noel@noelbell.net

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Mindfulness can be a term commonly used in counselling and psychotherapy circles but often without any great explanation about what it actually means.  It is, therefore, important to understand what mindfulness is, and what it is not.

Simply put mindfulness is staying in the moment non judgmentally. That may sound simple enough, but do any of us achieve this state of being on a regular basis? Even individuals well versed in the practice of mindfulness will refer to great resistance when seeking to stay in the moment, including wanderings and distractions in the mind and avoidance seeking behaviour. Mindfulness means waking up to the sights, sounds, smells and tastes of the present moment, wherever we happen to be. Another important aspect of mindfulness is to keep awareness of our thoughts and feelings as they happen to the present moment.

We tend to operate on autopilot throughout the course of our everyday life. We don’t pay particular attention to what we eat, what sensations we are experiencing as we go for a walk or what we are thinking as we make decisions. That is probably for good reason. The brain, after all, processes billions of pieces of information every second. The average “clock speed” of neurons in the brain is a mere 200 firings per second. Just think of that gigantic set of statistics. Perhaps it is little wonder that the brain needs to form clusters and needs to operate a so-called ‘internal working model’. If it didn’t, we would feel exhausted throughout our day if we were to be conscious of these actions throughout our daily routines. The ‘internal working model’ in the brain ensures that we make decisions efficiently. We don’t, for instance, consciously think too much about doing something that is an everyday task, we tend to just do it.

The risks by operating as this autopilot are that we miss out on so much of the present moment. Mindfulness practice helps us to bring greater awareness to our conscious and unconscious processes.

To be mindful perhaps we need to be more like dogs

In the modern world we are consuming more and more attention every day. Most of us are walking around holding mobile devices so powerful, they have more processing power than the Apollo space mission control. We often walk in the park listening to headphones or looking at a phone whilst regurgitating yesterday’s events, or thinking about likely scenarios in the future.

We differ in so many ways to other species in the animal world. Dogs,for instance, are very mindful. When dogs walk in the park they can be truly in the present moment, taking in their total surroundings with all of their senses.  The olfactory sense (that part of the sensory system used for smelling) in dogs is massively more sensitive than ours. Dogs use smell to gather information about the world more than they use sound, and their attention filter has evolved to make it so.  To prove this point try calling your dog as they are smelling something interesting. It is very difficult to grab their attention with sound, as smell beats sound in the dog brain every time.

Becoming more mindful

It is important to realise that you don’t need to be anywhere especially peaceful in order to practice mindfulness. It can be practiced anywhere and under any set of circumstances. Taking notice of your thoughts, feelings, body sensations and the world around you, wherever you are, is the first step to mindfulness. This can be whilst you are on a busy commuter train, or attending a busy function, not necessarily in a quiet peaceful place.

Mindfulness practice is often abandoned because one’s mind is too chaotic. However, the aim is not to empty your mind of thoughts but to gradually bring more awareness to your thoughts. The point is to persevere even when the mind is scatty and chaotic and to try to stay focused on bringing attention to the present moment, even if that present moment feels chaotic and all over the place.

A useful exercise is to bring awareness to your breathing. Count slowly from 100 to 1 and bring awareness to your breathing as you observe your surroundings in the present moment. Notice when your mind begins to wander but just try to refocus on the present moment. Yoga and tai-chi can also help with developing awareness of your breathing.

Counselling and psychotherapy can incorporate a mindful approach in the actual sessions. This can be your opportunity to stop and take heed of what is occurring in your body. It is called talking therapy for a reason, you are there to tell your story, but you can also treat the safe and private space to explore what is happening within your somatic energies.  

Noel Bell is a UKCP Pyschotherapist based in London. He can be contacted by telephone on 07852407140 or noel@noelbell.net

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The ills of social media platforms are in the spotlight again with news that Instagram is to introduce “sensitive screens” that will aim to hide images until users actively seek to reveal them on screen. This followed increased political pressure after the recent tragic case of the suicide of Molly Russell whose parents believe took her own life after being exposed to graphic images of self-harm and suicide on apps such as Instagram and Pinterest.

The digital minister Margot James today accused social media companies of behaving as if they are above the law and creating an environment for bullying and abuse. The prospect of government regulation is now on the horizon as a voluntary code of conduct has been deemed to be unsuccessful and largely ineffective. There are even suggestions within government circles that tech platform bosses could be jailed if they don’t remove content deemed to be harmful to children. A white paper is due out later this year which will outline a range of options surrounding regulation.

Some are also speculating that social media apps are also the cause of the alarming rise in the suicide rate amongst 15-19 year olds, as revealed by the Sunday Times. The newspaper reported preliminary data from the Office for National Statistics (ONS), compiled in 2018 and not due to be fully reported until September, that showed that the suicide rate in children and young people aged 15-19 has increased, while it has dropped in older age groups. The figures will reveal suicides have risen to more than five in 100,000 teenagers in England, which is up from just over three in 100,000 in 2010.

I spoke about the news story on Sky News on Sunday.

Teenage suicide - YouTube

Noel Bell is a UKCP Pyschotherapist based in London. He can be contacted on 07852407140 or noel@noelbell.net

The painful truth is that troubled teenagers may have already passed a line by the time they are searching for information about suicide online. They could be seeking out social media as a coping mechanism for emotional regulation. Teenagers have anxieties about educational attainment and suffer from anxiety due to exam pressure, negative body image, social isolation and drug misuse in addition to undiagnosed mental health conditions. Their brains are still developing and their hormones are jumping all over the place and they are more susceptible to addiction and quick fixes. They are also struggling with life at a time when it is perhaps more difficult to be young dealing with technological advances, peer pressure and career options. Some teenagers suffer from lack of hope and austerity may have a role in helping to explain why some with emotional difficulties engage in self-harm, especially when mental health services have been under resourced.

Social media companies do, of course, have some responsibility for maintaining a duty of care to their users, especially their most vulnerable consumers. The tech companies clearly have the capacity to weed out inappropriate content, just look at their capacity to track and identify copyright content and child porn images. Some good work has been undertaken, such as the automatic notification on screens of the phone number for the Samaritans, for example, if their users trigger match criteria for suicide in searches. In spite of this there appears to be ongoing signposting to harmful and inappropriate content when users are searching for self-harm material across social media. I suspect that the tech platforms will seek to get their houses in order or be faced by increased regulation. However, that said, it is overly simplistic to solely blame social media platforms for the horrific rise in the teenage suicide rate.

See also

Is social media causing mental health problems

Call the Samaritans for confidential advice and support on 116 123, (lines are open 24 hours a day) or visit samaritans.org 

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More often than not the whole digital world of smartphone usage and social media interaction, particularly amongst young people, can be viewed within the broad health field largely from a negative bias. Smartphone usage and social media engagement is almost considered as bad for mental health as sugar can be on the impacts for physical health. Simon Stevens, the chief executive of NHS England, has recently called on social media companies to do much more to limit the amount of time young people spend using their platforms and has even called for a special tax for the tech companies to pay for treatment services.

A new phenomenon called ‘Snapchat dysmorphia’ has also appeared more recently shining even more light on the negative consequences of social media. The term was coined by Dr Tijion Esho, a cosmetic doctor based in London (yes, him from Channel 4/E4’s cosmetic doctor in residence on hit show Body Fixers). The term is intended to help explain where patients are seeking out surgery to help them appear like the filtered versions of themselves.

Can we say there is actual evidence to support such a contention that social media causes mental health problems?

Professional researchers such as Professor Andrew Przybylski, Director of Research, Oxford Internet Institute, would say,no, that there is not any actual evidence to say that social media apps actually cause mental health illnesses. Some studies would point to correlational factors, for sure, but that there is insufficient data to demonstrate hard evidence of strong casual data.

When researchers refer to a correlation between social media use and something like mental health well-being, it does not necessarily mean that A causes B or that B causes A. In many cases, A and B are actually both caused by X. There might be factors such as being male or female, socioeconomic status, educational attainment of parents and geographic location, such as whether or not kids can get out to play. When those factors systematically vary or are fixed over time, we see that as predictive of both lots of screen time and, maybe, more mental health deficits.

Recent research by University College London (UCL) claimed to show a correlation between use of social and depression and that teenage girls are twice as likely to show depressive symptoms linked to social media than their male counterparts, The UCL research, based on data from almost 11,000 young people, appears to add to a growing amount of information about links between social media and mental health. It found that 12 per cent of light social media users and 38 per cent of heavy social media users, defined as those who use it for five or more hours a day, showed signs of having more severe depression. But we need to be careful about causation with studies such as these. Who is to say that the participants were not already depressed? There are no longitudinal studies that have investigated the use of social media addiction and problematic social media use, particularly among teenagers and emerging adults.

To answer my own questions at the start of this post I would say the problem of emotional regulation resides ultimately with the individual rather than with the technology per se. It is the interaction with the technology rather than the apps themselves that might be causing the problems. That said, there are many groups, especially young female girls, who are particularly susceptible to the boosts to self-esteem that are on offer from the social approval strokes (such as the dopamine drip of ‘likes’ and new followers). Young females are more vulnerable given that they are often socialised to outsource their self-esteem to others and are, therefore, generally more tempted by the attraction of social media apps and filtered images. Boys are more likely to be attracted by gaming, gambling and porn.

Some social media some apps can be especially harmful for teens and especially those with BDD, and social media tech companies could be more pro-active with warnings to users on their platforms as well as displaying support advice to those who might appear to be in trouble. There has to be a balance drawn, however, surrounding privacy as users do not wish to be spied upon when using social media. It is also important that the providers of cosmetic surgery understand the implications of social media on body image to better treat and counsel their patients. An ethical practice would robustly assess the reasons someone is wanting corrective surgery before agreeing to go ahead with any procedures. Additionally, BDD awareness needs to be added to GP training to better identify the condition on initial presentation.

So, whats the technical diagnostic stuff about BDD?  The disorder has been classified as part of the obsessive-compulsive spectrum in the Diagnostic Statistical Manual (DSM), the psychiatric bible used by psychiatrists in order to make a diagnosis, currently in its fifth iteration (this is why it is often referred to as DSM5, or DSM-V if using Roman numerals). BDD is characterised by the obsessive idea that some aspect of one’s own body part or appearance is severely flawed and warrants exceptional measures to hide or fix their dysmorphic part on their person. In spite of greater awareness about BDD it is commonly misdiagnosed as social anxiety disorder, obsessive-compulsive disorder, major depressive disorder, or social phobia. 

For more information on accessing support services for symptoms of BDD see my article on accessing help

Noel Bell is a UKCP Pyschotherapist based in London. He can be contacted on 07852407140 or noel@noelbell.net

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Integrative psychotherapy spans a wide spectrum and I often wonder what I am personally drawn to, in terms of what I might integrate into my practice, from the many potential ways of working with clients.  I am sure, for instance, that my gender impacts on what I choose to integrate and what I choose not to integrate. I also speculate whether I could be more or less cognitively centred, or more or less somatic centred. As an aside, it would be a useful research exercise for someone to undertake, to actually go around and ask integrative practitioners what they integrate into their way of working, and why. So often I hear practitioners describe themselves as integrative without knowing what they themselves mean by the term. 

The two hour introductory group session was aimed at those who wished to experience an integrated somatic psychotherapy approach, and who wanted to find out more about CDP courses and/or personal development groups. Somatic experiencing aims to relieve the symptoms associated with past trauma and mental and physical trauma-related health problems by bringing the focus of the work on a client’s perceived body sensations. I viewed the event as an opportunity to potentially get out of my head and engage more with my body.

Last week I had the opportunity of engaging with a different way of working. I had pleasure of attending an embodied psychotherapy taster session, skillfully facilitated by Katarina Gadjanski and Tasha Colbert, which was intended as an introduction to a range of courses being offered by the Institute of Embodied Psychotherapy. Katarina and Tasha are both UKCP accredited psychotherapists based in West London. Together they set up the institute which aims to offer an integrative somatic approach that enhances healing and equips psychotherapists with the skills to work in a more embodied way with their clients.

The themes resonated with my own previous, and perhaps limited, experiential learning when exploring my own mind-body relationship through sensing, moving and reflecting. This can be a very subtle way of working and reminded me very much of aspects of the rich experiential work associated with my original training at CCPE, such as healing with breath and sound and creative imagination.  It also reminded me of the importance for participants at such events to be assessed or screened for their ability to sustain emotional resilience.  Participants should ideally be assessed for physical health, their social support system and any tendency to dissociate. 

What was different about this event last week was that a film crew were recording the proceedings for future marketing purposes, subject to participants having a final say on what is finally released. This may have put others off, and it did slightly inhibit me, knowing that camera operatives were hovering in the room. It did help, however, to know who the film crew were so I had no worries about their ethical ways of working. I also felt that as practitioners we need to step up, when appropriate, and become more visible in how we work, especially when working in creative ways, if the level of stigma about therapy and mental health recovery in society is to be reduced and made more normal.

Katarina and Tasha facilitated the workshop in a skillful and sensitive manner and participants were invited to draw upon techniques from body psychotherapy, dance movement psychotherapy, mindfulness meditation and the creative arts. The importance, for me, in accessing past emotional trauma is to firstly identify with it, hopefully within a safe containing space, and then to try to access an internal safe place, or what might be termed an internal calm place. This work, for me, involves getting out of my head and paying more attention to the energies in my body. When working with the body I often refer to a wise quote that says that the most important thing in communication is hearing what isn’t said. Sometimes, the body will reveal more in communication than the mind.

What was challenging for me with this event last week was that the group unexpectedly also contained one participant (is there ever any coincidences, you may well ask?) who had previously been inappropriately aggressive towards me in a professional setting. On the night I initially thought this individual’s presence in the group might jeopardise a sense of safe place for me to potentially engage with unconscious material, especially whilst being filmed.  There are, of course, risks associated with undertaking deep unconscious work with participants who you may have had prior history with. It would be worth checking with the appropriate people if there might be potential conflicts, although sometimes it might not be possible to know of such potential conflicts. 

Generally speaking, it is my view that one should be very careful with whom one should share their vulnerable material, in the same way that someone should be circumspect about who they share the contents of their dreams with. However, the fight/flight agitation I experienced at seeing this person in the group actually helped me to get in touch with gut level issues around safety, trust and how receptive I might be to letting go. I sought to overcome my weariness and embrace the ethos of the event in spite of having strong reservations. 

I enjoyed working with drawings and my images comprised of two scenarios, one of which was associated with fight/flight and emerged from gut feelings about survival and the other represented my perception of what a calm place might look like for me. I felt like I had accessed and processed some primal emotional material and this proved to be very fruitful. However, I then faced a fairly long complicated train journey home, involving multiple changes given signal problems on the railway network, having had parts of my psyche opened up.

Just like with deep therapy sessions I was reminded that it is important to have some quiet reflection following such work and to have an opportunity to stop and take stock within a calm and peaceful environment, if possible. It is not uncommon when potentially triggered by past emotional trauma to feel slightly scattered, broken or shattered. In such circumstances it is important to understand that your thoughts and nervousness may appear overwhelming.  Difficult memories could potentially make it feel like past emotional trauma is happening again in the present. In extreme cases individuals suffering with PTSD describe a brain that has essentially not detoxed the emotion from the trauma memory. Therefore, every time the memory is relieved (the flashback) so, too, is the emotion, which has not been effectively removed.

It is important to take responsibility for your own self-care if you are thinking of engaging in such potentially deep work at this training centre or any other. There are some basic but very effective techniques you can do with yourself at home or when out and about to anchor and calm your nervous system through body positioning. Creating an internal state of calm and relief through self-loving and self-compassionate exercises can be very grounding.  Knowing how to anchor and calm your nervous system in such circumstances through body positioning can prove to be immensely reassuring. Sometimes you might access some difficult feelings or past emotional trauma and this could prove to be unsettling especially if your social support structure is not robust.  

To find out more about courses offered by the Institute visit their website for more information. 

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There are many types of people but for relational purposes there are two main types which might be termed as either ‘energy zappers’ or ‘energy enhancers’. Energy zappers are people who don’t listen when in conversation. The exchange is usually one way. They will drone on about their own viewpoint, their own opinions or their own stresses. You don’t get a chance to speak, or when you do they will either wait for an opportunity to hijack the conservation so that the focus is back on them, or they will start to distract themselves by looking at their phone. These are the sort of people who leave you feeling drained after spending time with them. It is almost like they suck the energy from you. They are like narcissistic listeners, in that the focus of the conversation always has to be about them.

Not feeling heard by others can impact how we feel about ourselves, when others seemingly dominate our conversations. They may be fellow employees, higher up the so-called food chain (and exploiting a power dynamic) or on the same grade, but could also be friends, associates or family members, who always seem to turn the conversation, no matter the topic, back to them.

Not feeling heard can be debilitating on many levels. Our posture tends to droop when we feel that we have been defeated and are victims in a low status hierarchical structure. We tend to face the ground when we feel anxious, hurt and weak. Low levels of serotonin can mean lower levels of confidence and greater propensity to having feelings of depression. Self-esteem can, however, be boosted when we adapt a more commanding posture, when levels of serotonin flow more freely. Serotonin is a chemical and neurotransmitter which helps regulate mood and social behaviour.

Energy enhancers, on the other hand, are people who allow you to have a say in a conversation. There is a flow of energy backwards and forwards. It is a healthy two way exchange. You will be asked questions about your life and they will actually wait to listen for the answer. It won’t be all about them. These are the sort of people who help you to feel better about yourself after spending time with them. You leave feeling energised and reinvigorated.  They are happy to hear of your successes and any good fortune you might share, as they want the best for you. They are not jealous of your successes nor will seek to compete with you. They can listen with generosity of spirit.

Avoiding energy zappers in social settings

Energy zappers tend to read the unconscious signs that victims communicate in social situations. They will observe who they think they can dominate in conversations. Such victims tend to be people who are not confident in asserting themselves in social settings. Energy zappers will avoid people who they perceive as having healthy boundaries. They unconsciously know that people with strong boundaries will refuse to indulge their narcissism.

It may be that you are only becoming aware now about a long term friendship that is one way, where you don’t get your needs met. You may be wondering how you could change the way you operate in the world so that you can better assert yourself with such people. Self-esteem reflects your overall subjective emotional evaluation of your own worth. Self-esteem from an implicit source is deriving a healthy sense of self-worth from within. Self-esteem from an explicit source is seeking to gain a healthy sense of self from what others think of you. An explicit way of operating can lead to overly pleasing others in relationships to the detriment of your own well-being, which effectively entails giving your power away.

Seeking help for dealing with energy zappers and boosting low self-esteem

Therapy could be about understanding what is behind your need for seeking approval from others. One area that you might want to investigate is your role within your family. Remember that your family is your first experience of being in a group. Your mother and father’s relationship is the first role model of what a relationship looks like. Your mother is also a role model for how women should be in the world and your father likewise for men. How nourished you were in your family background, physically,emotionally and spiritually, can be a key determinant on how you learned to relate to others in later life. Your position in your family, either birth order or specific relationship to parents, and siblings, can also be hugely influential on your adult relational style. After all, families are very political institutions. You could explore who was the family mascot, who was the scapegoat, who was the martyr and so on. The tools and techniques of transactional analysis can be helpful for such work. You could also explore your own early attachment styles, and here attachment theory can be useful in uncovering what is informing present day relational styles. An Adlerian perspective on how you related to the dominance hierarchy in your family could also be a useful area of investigation.

Other areas to explore could be your experiences of peer development, early schooling and other relevant developmental factors. Uncovering any toxic messaging systems, which may have been incorporated into self-identity, could ultimately prove to be transformative.  Psychotherapy can be extremely dynamic when realising your true self and dispensing with concepts associated with an adaptive self. Boosting levels of serotonin can lead to more resilience, more happiness, less anxiety and less illness. You could ask yourself why energy zappers are in your life. You could work on what might be stopping you from setting boundaries with such people who dominate your conversations.  Are you the classic rescuer? You could also ask what it might be like to confront a friend and suggest a different way of relating with them, thereby transforming the power dynamic.  Another question might be what is stopping you from letting go of some people in your life.

Boosting self-esteem and your serotonin levels involves manifesting the qualities required to be more assertive especially with the negativity associated with energy zappers. A therapist can help you to uncover why you give your power away to others and where you might be victimising yourself. Feeling heard in therapy can be a rewarding experience with someone who is trained to listen and who, importantly, has no vested interest in your future decision-making. Just make sure that the therapist you contract with is not an energy zapper themselves.

Noel Bell is a UKCP accredited psychotherapist based in London and online and available for counselling and psychotherapy and can be contacted on 07852407140 or noel@noelbell.net

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The world of psychotherapy can represent a highly splintered profession. There are hundreds of different models of psychotherapeutic practices, all claiming to represent the truth when seeking to apply solutions to the great human sufferings. Perhaps it is due to genetics, as people tend to want to outdo each other in competitive rivalries and that might explain the professional splits that occur. Just take the historical split between Freud and Jung, for example, in quests to be the top dog of the emerging profession of psychoanalysis.

But there are often mini splits within splintered modalities. Within the transpersonal approach, there are a number of different views within a supposedly coherent school. Whats more, even within a subset of transpersonal, (such as psychosynthesis, for instance) there are further granular differences with opposing institutes claiming a particular truth within that approach.

It is probably little wonder that potential clients become confused when seeking help and when faced by a plethora of different type of practitioners, all claiming to be offering something unique and exclusive. Clients rarely know the difference between different approaches (why should they?), let alone know about the differences between the more substantive different disciplines such as clinical psychology and psychiatry.

Sometimes I wonder whether we, as practitioners, could better help clients by acknowledging the similarities of each approach rather than accentuating the differences. That is why I am drawn to the integrative approach since I believe that all approaches have potentially something to offer when assessing how to help someone in distress. I view consciousness as representing a spectrum and, therefore, it is perhaps necessary to be equipped with a broad range of theoretical knowledge in addition to a diverse set of tools and techniques to best help clients. This approach embraces mind, body and spirit in addition to keeping abreast of informed developments in such relevant fields as neuroscience, nutrition, sleep medicine and the benefits of physical exercise.

How one engages with clients, however, might be heavily informed by one’s own relational style and comfort zone. Someone who is inclined to think a lot might be attracted to a cognitive way of working whilst someone who is more in touch with their own feelings might be drawn to an embodied way of working embracing somatic energies in the therapy.  Either way I believe it is important to be aware of one’s personal biases and to be alert to possible blind spots that could potentially pop up in the consulting room. As a client myself I don’t like to feel subjected to standardised or formulaic treatment from a therapist.

Understanding internal states are not the prime driver for bringing about change in therapy

Whilst some modalities might focus on internal states I believe that a truly integrative and holistic approach is essential to fully understand why a person might be struggling in life. Internal states are, of course, vitally important and that is why one’s early object relations, early attachments and relationship conflict issues are a vital part of understanding current distress. That would, after all, be addressing the mind part of the holy trinity of mind,body and spirit.

To be really integrative and holistic I believe it is important to be addressing an individual’s nutrition, sleep, level of exercise in addition to emotional and psychological needs. To be comprehensively healthy it is important that all aspects of being are being addressed. Distress occurs when our basic nutritional needs are not being met, both emotional and physical needs, or when we have lost the capacity to control the direction of our lives (what we might term stress). It follows, therefore, that all aspects of an individual’s life need to be assessed when seeking to relieve the distressing symptoms that can present in counselling and psychotherapy consulting rooms.

Contextual issues are important in seeking to understand unconscious material in therapy

The importance of contextual issues are extremely important in seeking to understand unconscious material in therapy. A person’s upbringing and socialisation are important when themes of power, oppression and class, for instance, can be assessed to better understand how they operate in the world.  It can also be beneficial to adopt such an integral approach when dealing with issues relating to sexuality, race, social class, religious affiliation, national identity (especially with Brexit), gender and any other contextual issue that might be impacting an individual. Awareness of these contextual themes can be very useful in informing practical work with clients in taking a truly holistic view of the work, not just heart, mind and body but also potentially socioeconomic, cultural, political and genetic influences.

I like what Ken Wilber refers to in his AQAL view of psycho-spiritual development. Wilber, borrowing heavily from the truths of Buddhism, outlined a basic framework of Integral Theory; his use of a grid to categorise the perspectives of various theories and scholars is useful in applying not just psychological theory to understand a person’s interior but also sociological and political theory to understand a person’s external world.

Counselling and psychotherapy can offer a private and confidential space to help bring about greater awareness of and the impact of lifestyle choices. For the therapy to be successful it is important to be able to speak in a free and frank manner and to fearlessly address any self-limiting belief systems. Such negative reinforcing systems can often be the way the psyche protects itself against troublesome unconscious material. Such material might be manifesting in the form of defence mechanisms and learning to understand one’s own triggers to negative thinking can help to bring about personal transformation. Greater self knowledge and owning one’s own projections can lead to a freer and happier life as well as more harmonious relations with others.

Noel Bell can be contacted on 07852407140 or by email noel@noelbell.net 

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Smartphone devices are wonderful creations. They enrich the lives and learning of us all and offer a tremendous educative function, especially for young people. But by using these devices we are also enriching our eyes and brains with powerful blue light that has a damaging effect on sleep. Sleep is vitally important for brain health and provides a massive restorative function for a host of important physiological functions including memory retention.

Using LED devices at night negatively impacts our natural sleep rhythms, the quality of our sleep and how alert we feel during the day. Getting the right amount of sleep is even more pertinent for young people as they need sleep for their developing brains to flourish.

Modern living has massively impacted on our ability to adhere to otherwise instinctual sleep patterns. Longer commute times and “sleep procrastination” – as a result of late-night television and digital entertainment – have impacted on our sleep time.

Constant electric light as well as LED light, regularized temperature, caffeine, alcohol and a legacy of punching time cards are the side effects of the impact of modernity on sleep. It is these societally engineered forces that are responsible for the common mistaken belief that sleep problems are medical insomnia. Insomnia, also referred to as sleeplessness, is a sleep disorder and individuals have trouble sleeping. The difficulty could be in falling asleep, or staying asleep as long as desired. Insomnia is typically followed by sleepiness the next day, accompanied by low energy, irritability, and a depressed mood. A sleep medicine professional can diagnose whether you have medical insomnia or if your sleep has been compromised by poor sleep hygiene.

Neuroscience of sleep

Understanding brain functioning and specifically around sleep can prove to be valuable in boosting sleep quality. The suprachiasmatic nucleus is the master clock in the brain responsible for controlling circadian rhythms. It is located in the hypothalamus, situated directly above the optic chiasm, and co-ordinates the body clocks of vital organs (yes there are many body clocks). The suprachiasmatic nucleus contains neurons which display a circadian pattern of activity. It also serves to regulate melatonin secretion by the pineal gland in response to the environmental light/dark cycle. Melatonin is a hormone found naturally in the body. The production and release of melatonin in the brain is connected to time of day, increasing in darkness and decreasing when light.

Your internal clock can be wound back by two to three hours each evening by electric light. Electric light brought to an end a natural order of things – when appropriately scheduled tiredness, followed by sleep, would normally occur several hours after dusk.

The curse of blue light-emitting diodes

A new invention in the 1990s made matters worse for the healthy functioning of the suprachiasmatic nucleus. Professors Isamu Akasaki, Hiroshi Amano and Shuji Nakamura made the first blue LEDs in the early 1990s (and were honoured with the Nobel prize in physics in 2014). Blue light LEDs were less energy demanding and had a longer life span than incandescent lamps. That is the good bit. This enabled a new generation of bright, energy-efficient white lamps, as well as colour LED screens.

Although red and green LEDs had existed for many years, blue LEDs were a long-standing challenge for scientists in both academia and industry.  In their absence the three colours could not be mixed in order to produce the white light which we now see in LED-based computer and TV screens. In addition to this, the high-energy blue light could be used to excite phosphorus and directly produce white light – the basis of the next generation of light bulb. In its award citation, the Nobel committee declared: “Incandescent light bulbs lit the 20th Century; the 21st Century will be lit by LED lamps.”

However, the invention of blue light LEDs has been bad news for sleep as they have massively added to the delay in releasing melatonin. The light receptors in the eye that communicate “daytime” to the master clock in your brain (the suprachiasmatic nucleus) are highly sensitive to short wavelength light within the blue spectrum. This is exactly the sweet spot where blue LEDs are most powerful. So, what is the result of this? Well, evening blue light has twice the harmful impact on nighttime melatonin suppression than the warm, yellow light from old incandescent lamps (and this occurs even when the lux intensities are matched).

Admittedly, we may not stare into a LED lamp all evening but we do look at laptop and smartphone/Ipad screens for many hours with these blue light emissions very close to our eyes. Such usage can have a major impact on the release of melatonin and the ability to time the onset of sleep.

A vital question is to ask whether using a smartphone into the night actually changes quantity/quality above and beyond the timing of melatonin? Studies have shown that it did in the following concerning ways. Firstly, users ended up losing significant amounts of REM sleep following smartphone/laptop usage. Secondly, the research subjects said they felt less rested and more sleepier during the day following device time the night before. Thirdly, subjects reported a lingering aftereffect, with some saying that they experienced a 90 minute lag in their evening rising melatonin levels for several days after device use stopped. This reporting of a lingering aftereffect could be viewed as a digital hangover.

The solutions for fixing the negativity of artificial light

The solutions for restricting the effects of the omnipresent artificial light at night are not easy. You could, though, install software on devices that gradually de-saturate the harmful blue LED light as evening progresses. Some devices, especially the more modern ones, will have this function already installed in the control settings. You could also explore the options provided by yellow tinted glasses that helps to filter out the most harmful emissions from blue light that suppresses the release of melatonin. A less dramatic solution would be to rearrange your living room lighting to ensure dim lighting is fitted rather than employing powerful overhead lighting. Your bedroom should be completely dark and black-out curtains (or silver foil on the windows) could be used. Also, be aware that even basic reading lamps in the bedroom – even just 8 to 10 lux – have been shown to adversely affect the release of nighttime melatonin.

Do you think you need help with your sleep problems? The devices may be acting as a form of avoidance in not addressing difficult feelings. Therapy can help with imposing boundaries around devices and the use of technology in general including dealing with anxiety and any fear of missing out. Being able to better assert yourself and deal with stimulus control could prove to be transformative outcomes of therapy.

See also 

Counselling and psychotherapy for sleep problems

Noel Bell is available for counselling and psychotherapy and can be contacted on 07852407140 or noel@noelbell.net 

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So much of counselling and psychotherapy deals with thoughts, feelings and reasons for states of being from an internal perspective. However, the physical health of our brain is so important too. We know from neurogenesis (the process by which new neurons are formed in the brain) that a holy trinity of a balanced diet, physical exercise and sleep are vital for positive brain health.  However, sleep is the preeminent force in this health trinity but is so often neglected.

A huge contributing factor for good brain health is ensuring that we get sufficient levels of sleep. Our brains need restorative sleep. We sleep for a rich litany of functions. The guideline from Sleep Foundation in America is that we should be getting around 8 hours of sleep, although some of us will need more. Whilst the range is between 7 and 9 hours, it is important to pay attention to your own individual needs by assessing how you feel on different amounts of sleep. It is also important to note that one’s quality of life is a big determinant of whether one is getting sufficient sleep rather than a prescriptive set number of hours. Therefore, important questions surround sleep quality and how the quality of your sleep impacts on your functioning throughout your day as well as how your sleep impacts on your partner.

Seeking help for sleep problems

Specialist sleep disorders centres deal with the investigation and treatment of what might be termed the disorders of sleep. These might include apnoea, causes of excessive sleepiness such as narcolepsy and other neurological disorders, unusual behaviours during sleep such as sleepwalking and acting out dreams and disorders associated with your body clocks and circadian rhythm. Your GP should be the first point of contact if you have such concerns about your sleep. They could refer you to a specialist centre for further investigations, if appropriate.

Counselling and psychotherapy can offer the opportunity to examine and improve emotional regulation throughout the course of your day with a view to improving sleep quality. The perpetuating factors involved in sleep problems could be explored. Do you, for instance, find it difficult to set boundaries and to say ‘no’ to demands at work, at home or in your social life? Are you overly concerned with completing all tasks in daily to-do lists before sleep? Perhaps you have a very demanding job and a 24/7 culture at work. Are there difficult feelings being avoided and busyness becomes a form of avoidance? Or, it might be that you struggle with stimulus control before bedtime.

It is possible to explore such issues within a private and confidential space so that more positive life choices may be made. Improving sleep quality might not be an easy task but removing some of the more obvious barriers to better sleep will help. Journaling your waking thoughts, feelings, and concerns, has a proven mental health benefit and the same appears to be true for dreams.

Here are 5 suggestions for improving your sleep quality:

  1. Maintain a regular sleep routine

Try to set an anchor time. This is the time you get up each morning. Try to stick to this set time every day, even at the weekend.  This could be a way of understanding your sleep threshold and working out how much sleep you need by stretching the amount of time you aim to be asleep for. What is termed as ‘sleep efficiency’ is understanding the number of minutes you are in bed for and the number of minutes asleep. Sleep diaries are a way of working out your rate of sleep efficiency and can help to identify problem areas.

Setting a regular anchor time will, obviously, be very difficult if your working arrangements involve shift patterns or co-locating. This is where you might need specialist advice.

  1. Boost physical exercise

The increase and decrease in blood pressure within one 24 hour period due to physical and mental activity levels is largely influenced by the release of hormones, particularly cortisol and melatonin. Exposure to bright light is one proposed method of re-regulating what is called circadian rhythmicity (although there is no proper substitute for bright daylight). The use of physical exercise may also serve as a viable option for restoring dysregulated circadian rhythms.  Your circadian rhythms can influence hormone release, eating habits and digestion, sleep-wake cycles, body temperature in addition to other important bodily functions.

You may be pressed for time with a demanding job and home responsibilities but physical exercise can be incorporated into your daily life. Can you, for example, get off the train or bus one stop before home and walk the rest of the journey, if safe to do so? Or, can you take the stairs instead of the lift at work? You need not have to go to the gym in order to get physical exercise, although the higher the intensity of your exercise regime, the better for your sleep. The best time to exercise is late afternoon.

  1. Create a buffer zone before sleep

Are you winding down for sleep? Can you create a buffer zone (of at least one hour) where you actively engage in more mindful practices and avoid screen time interaction or overly stimulating activities. Could you think of implementing a relaxation period, possibly involving a yoga or meditation practice, where the emphasis is on deep relaxation?

The important aspect of a buffer zone is that you mindfully commit to a period of time to purposely slow down and to try to switch off. Aim to avoid stimulating your brain during this period. Ideally, you should not be working on to-to lists at this time or even thinking about the next day’s tasks.

Creating an effective buffer zone before sleep can be very difficult as so many factors are involved especially if you have to deal with incessant emails for work.  However, sometimes it can be a choice about what you prioritise and what you drop in your day.

  1. Assign the bedroom exclusively as a place of sleep

Your bedroom should be associated with the minimum number of tasks. It is, therefore, a good idea to review what you do in your bedroom. Do you go to your bedroom at times during the day or evening, for instance, to read, relax, rest on bed, to have privacy, to practice yoga, to use your laptop, to watch television, to use social media on your phone or to eat? Your brain might become confused when you retire at night if it has to choose between a multitude of tasks.

If your bedroom is confined to essential tasks such as sleep, engaging in intimacy and perhaps getting dressed, for example, then your brain has less options to consider when you retire at night. When you try to go to sleep at night your brain will more likely associate the bedroom with falling asleep, especially if your activities are aligned with your circadian rhythm.

Your bedroom should be dark and also enjoy a temperate temperature, (around 18 degrees celsius), and you should be sleeping on a comfortable mattress and pillows.

  1. See sleep within a 24 hour frame

Sleep should be seen across a 24 hour period. This might seem like an obvious statement. However, so often sleep is something which we consider only when we retire at the end of the day. It is important to consider the impact of activities in the earlier parts of our day on our sleep. Therefore, try to avoid naps during the day (or at least after 3pm) and stay away from caffeine from mid afternoon as caffeine blocks the receptors for the sleep fuel hormone adenosine. Also, try to restrict the amount of alcohol you consume two to three hours before sleep and try not to go to bed hungry.

Be mindful of stimulus control before sleep. Anxieties and stresses should ideally be dealt with over the course of the day rather than allowing them to build up when you are seeking to retire at night.

Sleep needs to be made a priority in your day. It should not be something you think about after everything else is done. Sleep, and preparation for sleep, should rather be your focus. So much of the stresses and anxieties from our day may seem unavoidable (such as having to deal with difficult people at work, for example) but a useful exercise in therapy could be to look at what stressor or trigger you can actually control. Sleep quality will improve when the stresses and worries being brought into the night are better dealt with during the course of the day.

Noel Bell is available for counselling and psychotherapy and can be contacted on 07852407140 or noel@noelbell.net

 

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