Archive for Uncategorized

Taking care of yourself doesn’t mean me first, it means me too

Uncategorizedon May 15th, 2018No Comments

Mental Health Awareness Doesn’t Mean Me First – It Means Me Too

 

Clinical hypnosis may be career of the future

Uncategorizedon May 13th, 2017No Comments

Clinical hypnosis may be career of the future

April 14, 2017

Clinical hypnotherapists can help employees cope with the negative impact of stress and other psycho-social contributors that may lead to future depression.

COMMENT

depressBy Sheila Menon

Everyone can expect to suffer from depression at least once in their lifetimes. This global problem affects 20 million people in the US and an estimated 40% of Malaysians.

Even the Malaysian Employers Federation (MEF) concurs that there has been a visible increase in the number of work-related depression cases. The problem is growing and by 2030 depression is expected to become one of the most debilitating illnesses, causing loss of income, loss of workdays to the job industry and increased expenditure to healthcare providers and patients.

Depression is often contagious resulting in families and friends being dragged into feelings of misery, helplessness and low self-esteem.

There are two ways of tackling the problem. The first is by providing better education and coping skills so that people are more resilient or inoculated against the disease. The other is through effective psychotherapy, including clinical hypnotherapy to treat people with this illness.

There are three primary causes of depression; biological, psychological and social. Biological components may sometimes need medication. But increasingly, the therapeutic relationship between patient and therapist is considered important.

In fact talking therapies which include clinical hypnosis are considered a first treatment option for mild and moderate depression. Clinical hypnosis is an ideal rapport-based treatment, and research also indicates that hypnosis itself can specifically target the symptoms of depression and reverse their effect.

Clinical hypnosis to help employees cope with stress

This year the World Health Organisation launched a one-year awareness campaign and the London College of Clinical Hypnosis (LCCH Asia) has expanded its training to provide future therapists with the skills and tools to help both individuals and organisations deal with depression.

This stems from the growing belief that consultants will be required to provide specialist training to the industry. These consultants will help employees acquire the skills to cope with the negative impact of stress and other psycho-social contributors which may lead to future depression.

In short, clinical hypnosis just may be the career of the future, establishing a new group of professionals who are equipped to provide preventative training for groups as well as therapeutic treatment for patients.

Asian culture often avoids conversation about emotions, which means that Malaysians are sometimes reluctant about reporting depression. They may worry about being labeled as crazy, or considered weak or lazy.

People with depression can find it very hurtful to be told to snap out of it or buck up. The clinical hypnotherapist therefore has an important role to play and research shows that 90% of people can recover from depression with the right support and help.

Growing acceptance of clinical hypnotherapy in Malaysia

In Malaysia, the legislation governing Allied Healthcare and Complementary Medicine professionals means that more people are open to visiting clinical hypnotherapists.

In the Klang Valley alone, 40% of patients welcome the opportunity to see alternative therapists. An increased number of medical professionals offer clinical hypnosis as an adjunct to mainstream treatment and clinical hypnosis is also available in a growing number of hospitals.

One of the reasons for the popularity of clinical hypnosis is that it treats the biological, psychological and social aspects of the disease. This means it can provide relief for the associated symptoms of insomnia and physical discomfort as well as the mental anguish, intrusive negative thoughts and low self-esteem common to depression.

Clinical hypnotherapy has the additional benefit of combining well with all other forms of psychotherapy and is shown to enhance the efficacy of other therapy because clinical hypnosis works with both the conscious (analytical mind) and the unconscious (emotions).

Clinical hypnosis is part of a new approach to medicine and healthcare known as integrative medicine, which is expected to put the heart back into medicine.

Which Weight Loss Programs Work and The Brain Structures That Control Thirst and Hunger

Uncategorizedon August 16th, 2014No Comments

What brain structure(s) control thirst and hunger, and how is this done?

 

Hunger

From an anatomical point of view, the hypothalamus plays a central role in stimulating and processing feeding-related stimuli. Its activity may be modulated by the activity of other functional areas including the insula (which is involved in interoceptive monitoring) and the prefrontal cortex (which is responsible for cognitive control of impulses) (Carlson, 2012).

Neuroimaging studies have found that hunger is associated with the hypothalamus and insula, as well as additional areas involved in reward and motivation processing. These areas include the orbitofrontal cortex, the anterior cingulate, the parahippocampus and the hippocampus, the thalamus, caudate nucleus, precuneus, putamen and cerebellum.

In contrast, satiation relies on a neuroanatomical network that includes the ventromedial and dorsolateral prefrontal cortices, and the inferior parietal lobule.

Furthermore, research has found that insulin and free fatty acids may function as metabolic modulators of postprandial neuronal events in the brain (Tataranni et al., 1999).

Thirst

In generating the sensation of thirst, studies have shown that the anterior cingulate cortex plays a critical role (Denton et al., 1999). In addition, similarly to the sensation of hunger, the insula is also a critical component in the generation of thirst signals, and together with the anterior cingulate may act as cortical effector regions for thirst.

Furthermore, a major sensory site implicated in the generation of thirst is the lamina terminalis in the forebrain. Finally, signals are integrated in several intergrative sites across the brain, including the nucleus of the tractus solitarius, the lateral parabrachial nucleus, the raphe nuclei, the median preoptic nucleus, and the septum.

However, much of the pathway involved in the generation and processing of thirst remains to be elucidated (McKinley, Denton, Oldfield, De Oliveira, & Mathai, 2006).

Another interesting line of research suggests that the neuropeptide oxytocin can act as an anorexigenic signal in the central nervous control of food intake. In men, it has been found that oxytocin significantly reduced snack consumption, and specifically restraining the intake of chocolate cookies by 25%.

In addition, oxytocin attenuated adrenocorticotropic hormone and cortisol, and reduced the meal-related increase in plasma glucose. However, hunger-driven food intake was not affected, suggesting that oxytocin may regulate non-homeostatic, reward-related energy intake beyond its role in social bonding (Ott et al., 2013).

 

How do hunger and thirst interact?

 One of the main processes responsible for food intake is ghrelin, which acts in the hypothalamus to stimulate food intake. Ghrelin administration, however, also inhibits thirst.

Recently it has been proposed that decreased drinking behavior can be the cause of decreased food intake. One of the ways in which this happens is through obestatin, which is a posttranslational product of ghrelin preprohormone (Zhang et al., 2005).

However, thirst is also influenced by non-thirst related cues, in addition to those associated with food intake. Several such stimuli play a role, including nauseogenic stimuli, anxiety (e.g. psychogenic polydipsia), and ambient circulatory pressure. For example, changes in mean arterial pressure modulate pharmacologically driven water drinking.

Increased arterial pressure affects high- and low-pressure baroreceptive mechanisms, which in turn may not only reduce vasopressin suppression, but also the drive to consume fluid. In contrast, stimuli that are hypotensive, stimulate vasopressin release and water drinking, as well as increased autonomic outflow.

Elevations in mean arterial blood pressure can buffer drinking responses to thirst stimuli, most likely through baroreflex activation, and hypotension can also alter drinking behavior when the thirst centers in the brain are not alerted to the drop in pressure because of a compromised baroreflex (Yosten & Samson, 2014).

 

Which weight loss program works?

 A weight-loss program based on the mechanisms discussed above would need to take into account recent advances in our understanding of how ghrelin and oxytocin modulate appetitive stimuli and food intake.

It is also known that weight loss is promoted by reducing dietary energy density. A recent study found that diets that are low in energy density promote weight loss and weight loss maintenance by opposing increases in ghrelin, and promoting increases in peptide YY, which is a peptide that is produced in the brainstem and is thought to play an important role in reducing appetite (Hill, Rolls, Roe, De Souza, & Williams, 2013).

Ghrelin is currently the only known hormone with an appetite-stimulating role, and its role in increased appetite, food cravings and food intake have received extensive empirical attention in recent years.

Ghrelin levels rise before meals and decrease after meals; it induces short-term feeding and long-term body weight increase, by not only stimulating appetite but also decreasing fat utilization; it may also be involved in the rewarding nature of food, as it acts on the mesolimbic dopamine system.

While individuals who engage in caloric restriction diets show an increase in ghrelin levels after weight loss (potentially indicating stronger craving), individuals who lost weight after weight-loss surgery did not show the same reaction. Because weight-loss surgery is an extreme and very risky procedure for weight-loss, other weight-loss strategies have been proposed to reduce ghrelin or its impact (Adams, Greenway, & Brantley, 2011).

Research shows that ghrelin levels are directly correlated with stress hormones, and that stress management interventions such as exercise and sleep contribute to reducing ghrelin secretion and corresponding appetite.

Research studies show that while short- and long-term aerobic exercise does not appear to reduce ghrelin levels, resistance exercise (e.g. weight training) can decrease ghrelin. With regard to sleep, studies show that sleep deprivation stimulates ghrelin secretion, while improved sleep reduces ghrelin (Adams et al., 2011).

Thus, there is evidence to show that behavioral interventions that focus on stress reduction and involve exercise (resistance training) and improved sleep habits can contribute to weight-loss and maintaining weight-loss via a modulation of ghrelin secretion.

While weight-loss programs would need to focus on ghrelin levels and monitor these throughout the treatment, baseline levels of ghrelin have also been identified as an important indicator for treatment success.

Thus, obese individuals who have higher leptin levels and lower ghrelin levels at baseline seem to be more resistant to weight loss after a low caloric diet intervention due to metabolic adaptation (Labayen et al., 2011).

Finally, in addition to diet and exercise, recent research suggests that oxytocin can function as an appetite inhibitor in the brain, specifically in relation to cravings that are not hunger-driven (Ott et al., 2013).

Oxytocin is classically viewed as a peptide that is critical for the reproductive physiology of mammalian females (e.g., uterine contractions and delivery, milk ejection and maternal care), but is also plays a key role in complex pro-social behaviors (e.g. maternal behavior, infant attachment, emotional control, pair bonding, reward, moral judgment, selfless decision-making and interpersonal relationships) (Cai & Purkayastha, 2013).

Oxytocin and derived peptides are currently viewed as the next generation anti-obesity and anti-diabetic drug. In a recent clinical study, oxytocin was delivered via nasal spray (an established practice for improving neuropsychiatric symptoms) multiple times per day, and this successfully lowered body weight in obese patients compared to placebo.

Furthermore, the therapeutic effect amplified with the increase of treatment duration from 4 to 8 weeks, and the effect of weight loss was reflected by decreases in waist and hip circumferences of patients.

In addition, oxytocin treatment appears to also improve the lipid profile of patients by lowering serum low density lipoprotein and cholesterol levels, and improving postprandial blood glucose and insulin levels. Additionally, this effect was not found to be a result of weight-loss, but rather to be more directly influenced by oxytocin.

Also important to note is the fact that oxytocin showed these improvements without the any negative side effects on cardiovascular, liver or kidney functions (Cai & Purkayastha, 2013).

Thus, a weight-loss program, lasting between 8-12 weeks, focusing on low caloric intake coupled with changes in sleep and exercise patterns may prove beneficial. In addition, intranasal oxytocin administration may have an added benefit in reducing weight and maintaining weight-loss, however this is not yet an approved treatment for obesity.

References

 Adams, C. E., Greenway, F. L., & Brantley, P. J. (2011). Lifestyle factors and ghrelin: critical review and implications for weight loss maintenance: Lifestyle factors and ghrelin. Obesity Reviews, 12(5), e211–e218. doi:10.1111/j.1467-789X.2010.00776.x

Baron-Cohen, S. (2005). Sex Differences in the Brain: Implications for Explaining Autism. Science, 310(5749), 819–823. doi:10.1126/science.1115455

Cai, D., & Purkayastha, S. (2013). A new horizon: oxytocin as a novel therapeutic option for obesity and diabetes. Drug Discovery Today: Disease Mechanisms, 10(1-2), e63–e68. doi:10.1016/j.ddmec.2013.05.006

Carruth, L. L., Reisert, I., & Arnold, A. P. (2002). Sex chromosome genes directly affect brain sexual differentiation. Nature Neuroscience, 5(10), 933–934. doi:10.1038/nn922

Carlson, N. R. (2012). Physiology of Behavior 11th Edition: Pearson.

Denton, D., Shade, R., Zamarippa, F., Egan, G., Blair-West, J., McKinley, M., & Fox, P. (1999). Correlation of regional cerebral blood flow and change of plasma sodium concentration during genesis and satiation of thirst. Proceedings of the National Academy of Sciences, 96(5), 2532–2537. doi:10.1073/pnas.96.5.2532

Gross, J. J. (2013). Emotion regulation: Taking stock and moving forward. Emotion, 13(3), 359–365. doi:10.1037/a0032135

Gross, J. J., Sheppes, G., & Urry, H. L. (2011). Cognition and Emotion Lecture at the 2010 SPSP Emotion Preconference: Emotion generation and emotion regulation: A distinction we should make (carefully). Cognition & Emotion, 25(5), 765–781. doi:10.1080/02699931.2011.555753

Hill, B. R., Rolls, B. J., Roe, L. S., De Souza, M. J., & Williams, N. I. (2013). Ghrelin and peptide YY increase with weight loss during a 12-month intervention to reduce dietary energy density in obese women. Peptides, 49, 138–144. doi:10.1016/j.peptides.2013.09.009

Izard, C. E. (2009). Emotion Theory and Research: Highlights, Unanswered Questions, and Emerging Issues. Annual Review of Psychology, 60(1), 1–25. doi:10.1146/annurev.psych.60.110707.163539

Labayen, I., Ortega, F. B., Ruiz, J. R., Lasa, A., Simón, E., & Margareto, J. (2011). Role of Baseline Leptin and Ghrelin Levels on Body Weight and Fat Mass Changes after an Energy-Restricted Diet Intervention in Obese Women: Effects on Energy Metabolism. The Journal of Clinical Endocrinology & Metabolism, 96(6), E996–E1000. doi:10.1210/jc.2010-3006

Lentini, E., Kasahara, M., Arver, S., & Savic, I. (2013). Sex Differences in the Human Brain and the Impact of Sex Chromosomes and Sex Hormones. Cerebral Cortex, 23(10), 2322–2336. doi:10.1093/cercor/bhs222

McCarthy, M. M., Arnold, A. P., Ball, G. F., Blaustein, J. D., & De Vries, G. J. (2012). Sex Differences in the Brain: The Not So Inconvenient Truth. Journal of Neuroscience, 32(7), 2241–2247. doi:10.1523/JNEUROSCI.5372-11.2012

McKinley, M. J., Denton, D. A., Oldfield, B. J., De Oliveira, L. B., & Mathai, M. L. (2006). Water Intake and the Neural Correlates of the Consciousness of Thirst. Seminars in Nephrology, 26(3), 249–257. doi:10.1016/j.semnephrol.2006.02.001

Ngun, T. C., Ghahramani, N., Sánchez, F. J., Bocklandt, S., & Vilain, E. (2011). The genetics of sex differences in brain and behavior. Frontiers in Neuroendocrinology, 32(2), 227–246. doi:10.1016/j.yfrne.2010.10.001

Ott, V., Finlayson, G., Lehnert, H., Heitmann, B., Heinrichs, M., Born, J., & Hallschmid, M. (2013). Oxytocin Reduces Reward-Driven Food Intake in Humans. Diabetes, 62(10), 3418–3425. doi:10.2337/db13-0663

Parkinson, B., & Totterdell, P. (1999). Classifying Affect-regulation Strategies. Cognition & Emotion, 13(3), 277–303. doi:10.1080/026999399379285

Suls, J., & Bunde, J. (2005). Anger, Anxiety, and Depression as Risk Factors for Cardiovascular Disease: The Problems and Implications of Overlapping Affective Dispositions. Psychological Bulletin, 131(2), 260–300. doi:10.1037/0033-2909.131.2.260

Tataranni, P. A., Gautier, J.-F., Chen, K., Uecker, A., Bandy, D., Salbe, A. D., … Ravussin, E. (1999). Neuroanatomical correlates of hunger and satiation in humans using positron emission tomography. Proceedings of the National Academy of Sciences, 96(8), 4569–4574. doi:10.1073/pnas.96.8.4569

Yosten, G. L. C., & Samson, W. K. (2014). Separating Thirst from Hunger. In L. A. De Luca, J. V. Menani, & A. K. Johnson (Eds.), Neurobiology of Body Fluid Homeostasis: Transduction and Integration. Boca Raton (FL): CRC Press. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK200963/

Zhang, J. V., Ren, P.-G., Avsian-Kretchmer, O., Luo, C.-W., Rauch, R., Klein, C., & Hsueh, A. J. W. (2005). Obestatin, a peptide encoded by the ghrelin gene, opposes ghrelin’s effects on food intake. Science (New York, N.Y.), 310(5750), 996–999. doi:10.1126/science.1117255

Dealing with procrastination

Uncategorizedon June 24th, 2014No Comments

What is procrastination?

Consider the following scenario:

It is already late February and your best intentions to start exercising and eat healthy have been postponed since you made your new year’s resolution. You promised yourself every Saturday that on Monday you will start your new healthy lifestyle and exercise regime.

Monday arrives and you are very tired from the weekend, you feel as if you may be developing a sinus infection, or it is too cold to get up so early so you decide to start tomorrow. And “tomorrow” never comes. In the meantime you gained weight, became more lethargic and less enticed by the idea of exercise. This is a scenario most of us are familiar with in some way or another.

Procrastination is the voluntary delay of any action despite the knowledge that putting it off will likely result in a negative outcome (Sirois & Pychyl, 2013). People delay all types of activities both in their social and occupational lives. A stay at home mother may delay cleaniDeathtoStock_Wired3ng a particular room, or de-cluttering a cupboard while a corporate employee may delay preparing for a presentation or writing a report. A smoker may delay quitting smoking, while a runner may delay his training program.

Studies have indicated that prevalence of procrastination is around 20-25% of the population, while academic procrastination; the delay of studying or writing of term papers, is even higher and up to 70% of students will admit to procrastination (Klingsieck, 2013b).

Further research in the area of procrastination shows that procrastination rarely has good results and the definition of procrastination includes the fact that the action is delayed despite the knowledge that there is a negative outcome (Sirois & Pychyl, 2013). In fact, studies show that academic procrastination is generally associated with poor results, higher levels of anxiety and lower levels of self-efficacy (Klingsieck, 2013a).

In fact numerous studies agree that procrastination is associated with a variety of negative outcomes with a significant connection between self-reported procrastination and negative emotional experience such as lowered self-efficacy and performance (Krause & Freund, 2014).

In many cases, procrastination is also closely linked to an element of perfectionism. It has been suggested that procrastinating behaviour stems from excessively high standards and that perfectionism, anxiety and low self-confidence are often maintaining factors in the procrastinating behaviour (Rice, Richardson & Clark, 2012).

As a result, procrastination is not a pleasant experience and often results in more anxiety and emotional discomfort yet most people do not seek treatment for procrastination. Most people struggle alone to overcome procrastination.

Dealing with procrastinating

Many studies have suggested that procrastination is less likely to occur in personalities that have high levels of self-motivation, are self-determined and have an internal locus of control (Klingsieck, 2013b). In this sense, overcoming procrastination would then mean setting more realistic standards for behaviour and task performance, increasing self-confidence, increasing motivation levels and sense of mastery over tasks, as well as working with goal setting parameters.

In many cases fear of failure is what often leads to and maintains procrastinating (Krause & freund, 2014), so help for procrastinators would include goal setting work that assists the individual to set realistic goals with realistic expectations of performance as well as helping the individual deal with their fear of failure.

While many people wish to stop procrastinating, they simply find themselves in a vicious, anxiety provoking cycle where they feel stuck and are unable to make any real and lasting changes. Few people will seek professional assistance in treating procrastination and will attempt to make changes on their own. However, seeking help from a professional may be more effective in overcoming procrastination.

Hypnotherapy has been a popular adjunct to therapy in the past, particularly as an adjunct to cognitive behaviour therapy as it deepens the individual’s understanding of the concepts. Hypnotherapy, with its relaxed state of focused awareness, allows the individual to more readily accept suggestions aimed at reducing anxiety and fear of failure, as well as reinforcing the internal locus of control and self-confidence.

Such suggestions and positive changes may result in the individual overcoming procrastination by feeling more in control and more able to complete the task, rather than delaying it due to fear of failure or anxiety around the task. Hypnotherapy sessions will also focus on goal setting that is realistic and achievable and work on lessening perfectionism and excessively high standards if performance.

Again, this reduces the anxiety surrounding the task and, thus, reduces the need to procrastinate as a coping mechanism.

Conclusion

Procrastination is very much a maladaptive coping behaviour used to delay actions or tasks that cause anxiety due to fear of failure, unrealistic standards of performance, perfectionism and low self-confidence. Those individuals that feel in control, are self-motivated and confident are less likely to procrastinate than those that don’t.

As a result, treatment of procrastination should involve assisting the individual with increasing their level of self-confidence, teaching appropriate and realistic goal setting and dealing with the anxiety resulting from fear of failure or perfectionism.

Hypnotherapy is an especially useful tool in helping people cope with anxiety in general, as well as increasing self-confidence and motivation. Dealing with issues such as fear of failure and feeling out of control is another way in which hypnotherapy can help people to stop procrastinating.

References

Klingsieck, K. B. (2013). Procrastination in Different Life-Domains: Is Procrastination Domain Specific?. Current Psychology32(2), 175-185

Klingsieck, K. B. (2013). Procrastination: When good things don’t come to those who wait. European Psychologist18(1), 24-34

Krause, K., & Freund, A. M. (2014). How to beat procrastination: The role of goal focus. European Psychologist19(2), 132-144

Rice, K. G., Richardson, C. E., & Clark, D. (2012). Perfectionism, procrastination, and psychological distress. Journal Of Counseling Psychology59(2), 288-302

Sirois, F., & Pychyl, T. (2013). Procrastination and the Priority of Short-Term Mood Regulation: Consequences for Future Self. Social & Personality Psychology Compass7(2), 115-127

Resources

http://www.beyondblue.org.au/

Binge Eating and Overeating

Uncategorizedon June 9th, 2014No Comments

What is an eating disorder?

An eating disorder refers to an abnormal relationship with food and pattern of eating. Most people struggling with an eating disorder will fear gaining weight, with weight loss as a primary goal and will take on certain behaviours in order to lose weight and sustain weight loss. The two most common types of eating disorders categorized by the Diagnostic Statistical Manual of Mental illness (DSM) are anorexia nervosa and bulimia nervosa. Other eating disorders include binge eating disorder and eating disorder not otherwise specified (Sadock &Sadock, 2003).

Anorexia Nervosa is diagnosed when there is a strong refusal to maintain body weight at or above the minimally normal weight for the person’s age and height. The person is intensely afraid of gaining weight and has a disturbed self-perception of their body shape and size (Sadock & Sadock, 2003). Most people struggling with anorexia will restrict their intake of food and engage in excessive exercise or purging activities to reduce calorie intake.

Bulimia nervosa is diagnosed when there are recurrent episodes of binge eating (eating an amount of food that is much larger than they would normally eat and experiencing a lack of control while eating), and recurrent inappropriate behaviour to prevent weight gain suc
h as self induced vomiting and misuse of laxatives or enemas (Sadock & Sadock, 2003).

Binge eating disorders are diagnosed when the person does not suffer from anorexia nervosa as their body mass index is at or above the normal mark and they do not suffer from bulimia nervosa because they do not use inappropriate methods of weight control such as vomiting or laxative misuse (Telch & Agras, 1996). In this sense, it seems that binge eaters make use of food to regulate their moods and to manage difficult emotions, particularly anger, sadness and feelings of inadequacy (Telch & Agras, 1996).

Understanding compulsive eating disorder

Another way of understanding binge eating disorder is as a compulsive eating disorder. In this sense, the person who is struggling feels compelled to over eat and struggles to maintain control while eating. Compulsive eating, or binge eating is characterized by eating very rapidly until feeling over-full and uncomfortable, eating large amounts of food, mostly eating alone and then feeling disgusted with oneself and depressed about the overeating (Mantle, 2003).binge eating perth

Due to the large amounts of calories consumed during compulsive eating episodes, binge eaters normally gain weight quite rapidly. Remember that there is no attempt to regulate weight through excessive exercise or calorie restriction as in anorexia, or self-induced vomiting and laxative misuse as in bulimia. As such, the binge eater is likely to gain weight and can face serious health consequences such as diabetes, obesity, heart disease, high blood pressure and high cholesterol (Smith, Segal & Segal, 2014).

There are many theories around the maintaining factors of binge eating disorders, namely affect-driven models, which suggest that the binge eating episode induces a more manageable emotion (such as guilt) than the emotion preceding the binge (depression) (Stein, Kenardy, Wiseman, Dounchis, Arnow & Wilfley, 2007). Alternate affect driven theories posit that the binge eating focusses attention to the exclusion of all else and thereby offers an escape from uncomfortable feelings and moods, or theorize that negative emotions can now be blamed on the binge eating rather than require any self-awareness or insight (Stein et al., 2007).

Treating compulsive eating

There have been a range of treatments available for eating disorders ranging from Cognitive Behavioural therapy through to ego state therapy. The most important issue here is that binge eaters do not know how to stop eating. Therapy, therefore, often focusses on the emotional regulation aspect, teaching more effective coping skills and teaching problem solving so that the patient can learn how to stop eating. In the last 30 years or so there has been the addition and encouragement of the use of hypnotherapy in the treatment of binge eating and other eating disorders, although this is still a relatively new form of treatment and still in the trial and error phase (Vanderlinden & Vandereycken, 1988).

The most common difficulty in treating eating disorders is that most patients are in denial regarding their condition and are, therefore, treatment resistant. In this sense, hypnotherapy can be a useful treatment modality in using ideomotor signaling, age regression and ego-state therapy to identify the origins of the persons distorted cognitions and emotional difficulties that precipitate their eating disorder (Mantle, 2003). Learning how to stop eating is about identifying the triggers to the compulsive eating episodes and learning more effective coping skills to dealing with difficult emotions and moods. Hypnotherapy is also useful here to assist patients to gain control over their emotions, as well as their thoughts and behaviours. In fact using hypnosis to supplement weight control through the use of visualization (Mantle, 2003) to encourage healthy eating styles and the use of relaxation to learn more effective coping skills also assists binge eating patients to gain efficacy over their eating behaviours and emotional coping strategies.

There are different types of eating disorders including anorexia, bulimia and binge eating disorder. Compulsive eating occurs when the person loses control while eating and eats more than they usually would and to a point of feeling uncomfortably full. The person does not know how to stop eating and often uses the binge to cope with difficult emotions and thoughts. Binge eating can lead to serious health conditions and, as such, it is important to treat the condition. In recent years, hypnotherapy has become a recommended treatment approach in that it is effective, despite the patient’s resistance, in identifying the triggers to the binge eating episodes and helps to teach more effective coping skills in dealing with negative emotions and thoughts. Relaxation techniques are taught and visualization techniques assist in encourage more healthy eating patterns and teaching the patient how to stop their compulsive eating.

References

Mantle, F. (2003). Eating disorders: The role of hypnosis. (Cover story). Paediatric Nursing15(7), 42-45

Sadock, B. J. & Sadock, V. A. (2003): Synopsis of Psychiatry: Behavioral Sciences / Clinical Psychiatry. Philedelphia Lippincott Williams & Wilkins

Smith, M., Segal, R. &Segal, J. (2014, February): Binge Eating Disorder Symptoms, Causes, Treatment, and Help. Retrieved from http://www.helpguide.org/mental/binge_eating_disorder.htm

Stein, R. I., Kenardy, J., Wiseman, C. V., Dounchis, J., Arnow, B. A., & Wilfley, D. E. (2007). What’s driving the binge in binge eating disorder?: A prospective examination of precursors and consequences. International Journal Of Eating Disorders40(3), 195-203.

Telch C, Agras W (1996) Do emotional states influence binge eating in the obese? International Journal of Eating Disorders. 20, 271-280

Vanderlinden, J., & Vandereycken, W. (1988). The use of hypnotherapy in the treatment of eating disorders. International Journal of Eating Disorders7(5), 673-679.

About the effectiveness of Hypnosis in Couples / Relationship Counseling / Therapy

Couples Partners Hypnosis Hypnotherapy Counseling, Uncategorizedon April 8th, 2014No Comments

Profile Pictureby Jorg Thonnissen – Psychologist/Hypnotherapist

Keywords: Hypnosis – Hypnotherapy – Counseling – Relationships – Couples – Partners   

Relationships have the propensity to bring out insecurities that we may have been previously unaware of. There is the potential for so many misunderstandings between males and females or partners in general when it comes to communication and individual perception that it can feel like charting unknown waters in a vast and dangerous ocean. Make a mistake and you are sitting on the rocks of an unseen reef. Not knowing your way makes matters worse and so the ship might be sinking before you know it. The warm and fuzzy feelings that we once had for each other not so long ago are quickly spent replaced by frustration which build up just as fast leading us right into the arms of bitter resentment if issues are not addressed in time. Once that stage has been reached the ship is well and truly on its way to the bottom.

Ironically school and university provides us with all sorts of knowledge so we can be prepared for life – how to be a scientist, an accountant, a lawyer, a medical practitioner, etc… but when it comes to building better relationships with the opposite sex for example we are hard pressed to find anything that could have prepared us for a committed relationship . Thus we are condemned to find out how we fare using our ‘gut feeling’ and so it is not uncommon that we subconsciously apply the dysfunctional relationship models we have observed around us …

When two people are attracted and come together, they ‘feel’  they are made for each other.

But what does that actually mean? It usually happens that after a period of intense attraction during which we choose to ‘overlook’ any possible shortcoming in the other person there comes a time when the previously as sufficient perceived aspects of the partner are no longer satisfying our needs.

From my experience the problem comes first and foremost from a lack of self-knowledge and an inability to communicate effectively. I am technically talking about personality here. For example, if the introverted person needs space to recover some much needed energy expended during an extensive verbal interaction with the world around her/him and the extroverted partner wants to talk even more (as this is where s/he gets the energy for recovery) then we are potentially headed for conflict.

In addition to some very standard personality factors that are common within all of us there are of course also those factors that are based on sensitivities created through our experiences (traumas, neglect, rejection, fears, negative self-belief, … etc., etc…) that most definitely also play a major part in the way we perceive ourselves and our partner in a relationship.

We all know – there are better ways than having reckless arguments to get what we need, but… we jut can’t help digging in our heels and having a tit for tat argument which really isn’t going to advance the cause..

Thus, in the kind of couples therapy that I am providing can be summarized as follows:

Investigating by means of a broad based personality and other assessments what makes one ‘tick’ we can gather an incredible understanding of ourselves and if our partner is prepared to do the same we can possibly for the first time really understand where our strengths and weaknesses are and consequently come to know where our ‘hang ups’ typically appear. We thus have a framework that provides us with a communicational basis and invaluable relationship advancing tool. Once we are familiar with this concept it is actually quite easy to understand the needs of our partner and those of ourselves. No need to be constantly reminded of what needs to be done…once you’ve ‘got it’ (which really won’t take long) you will notice that your mind will automatically engage with the understanding and you will naturally feel that you can observe your actions and responses rather than feeling lost in it.

As you understand the beliefs you may hold and how these influence your relationship and the way you see yourself in general we may use cognitive behavioral therapy in conjunction with hypnosis/hypnotherapy to address unhelpful thoughts and feelings for the better.

I typically also give you a hypnosis CD of the session to take home with you so you can keep reinforcing the crucial aspects of what needs to be understood.

I am very confident that at this stage of the process you will find the effects actually quite impressive.

 

 

Principles Of Effective Couples Therapy

Uncategorizedon April 1st, 2014No Comments

 

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By Jorg Thonnissen – also published at Deep-Impact-Psychology.com

A number of key concepts for change need to be addressed for breakthroughs in relationships to occur. The basic tenants and theoretical underpinnings used during our couples therapy retreat can be summarized as follows – (primarily based on Solomon & Teagno, (2013)):

1. Intimate relationships provide challenges that bring out each partner’s weaknesses and vulnerabilities as it is based on one’s choice to be exclusively involved with each other.

2. The agreement of exclusivity to each other for ‘the rest of one’s life’ regardless of the changes in one’s personality or circumstances that inevitably takes place over a lifetime is likely to make this commitment challenging indeed.

3. Thus, individuals in relationships must learn how to successfully deal with the challenges that come as a consequence of the inevitable change if they want to succeed – i.e. have a satisfying relationship that encourages individual as well as the growth as a couple.

1415226_753623374. From a personality perspective we are attracted to each other because of our differences or similarities and this brings out not only our strengths but also our weaknesses or unresolved ‘issues’ that may stem from the models of the world we hold (experiences, beliefs, projections). When entering into a relationship, we are most probably unaware of these motives as they are likely to be unconscious processes hidden in the back of our minds.

5. This then means that we must be prepared to be committed to work on our own issues that affect the relationship we are in.

6. This also means that we need to be prepared and committed to understand that differences between partners will naturally and inevitably occur within the relationship – they will not reduce just by themselves over time, and we thus need to be committed to finding ways to incorporate these differences in perception and understanding in order for the relationship to succeed.

7. This requires the individual entering into a relationship to learn how to respect and appreciate that which is different in the other. (The Jungian Type assessor allows for a baseline understanding in relation to 4 dichotomous personality factors, as well as generically understanding the ‘stereotypical’ differences in thinking and communication style between male and female).

8. A shift or change in our partner however, will always bring some level of doubt and uncertainty, i.e. anxiety to the fore as it challenges our established expectations.

8. The internal dissonance or ‘battle’ resulting from this creates a polarity whereby one partner promotes the shift whereas the other is likely to resist.  This might well be on an unconscious level.

9. In psychological terms this is called differentiation (Solomon & Teagno, 2013) and signifies the recognition that there are differences between partners.  Differentiation however is a perfectly normal and essential part of the evolving relationship, yet more often than not it is difficult to accommodate as partners could feel rejected or threatened by the process.

Theoretical Underpinning

According to (Solomon & Teagno, 2013) there are three stages of couple development known

as: 1. Symbiosis, 2. Differentiation, and 3. Synergy

Stage 1: Symbiosis

Theory:

It is the stage we all know as infatuation or romantic love relationship. There is very little ‘I’ just a lot of merging into the one -‘WE’ – unconditional giving and receiving.

(Solomon & Teagno, 2013) believe that this merging into WE at that stage developed from our evolutionarily and instinctual need to enhance our chances of survival – thus the symbiotic bond maximizes that goal. This means we conveniently overlook our differences at that stage and only the good is emphasized – what we have found in our partner is the ‘missing link’. Nevertheless, this phase is bound to come to an end.

This phase of unconditional giving is necessary however to set the stage or foundation for solid relationship building beginning in stage 2. where the work starts.

Stage 2: Differentiation

Theory:

Eventually –sooner or later – the ‘I’ is reemerging and starts taking centre stage. The differences so well hidden during the symbiotic stage become apparent and we start seeing what we dislike or irritates us in our partner’s behavior. Arguments and disillusionment become more common and the relationship becomes more work. When we think that beyond the uniqueness of the individual, the Jungian typology of personality outlined by Myers Briggs (1980) for instance have identified 16 different personality profiles each one with their own intricate ways of perceiving the world, then it becomes clear that differentiation is a given, not a possibility.

This is the stage where many get stuck unless they find effective ways of resolving the ensuing conflicts and differences in perception or opinion. Once stuck, it is unlikely that things are getting better and the relationship is doomed to fail.

This is a very challenging and often painful time as conflicts start to occur.  Unless a couple engages healthy, effective ways of working (communicating) through these conflicts, the relationship will get stuck here and is likely to deteriorate to a point of no return.

However, rather than seeing differentiation as a negative roadblock to happiness we need to understand that it actually provides us with the opportunity to make us a fully evolved individual who is truly in touch with him or herself – and who is thus contributing to the relationship at the highest level. This level of achieved self-actualization allows for greater happiness which in turn can only be beneficial to our partner and the next generation that may results from the union.

Thus, the tension created when differences arise in this stage need to be exploited. Rather than reacting regressively to the conflict, partners need to see this as an opportunities of self-exploration with the goal of making their relationship as honest and truthful as they could possibly be about themselves treating each other with respect. The intimacy created this way will evolve the relationship exponentially. (Solomon & Teagno, 2013) call this conflict intimacy.

Even though it feels counterintuitive, conflict intimacy, is therefore an essential aim during the crucial stage of differentiation, and is achieved within 2 processes. The first one is called self-intimacy whereby each partner aims to be aware of thoughts, feelings and desires and the second process involves a form of communication that is not focused on the resolution of differences rather it aims to help the speaker to express what is on his or her mind to facilitate insight and self- learning.

In other words the listener is urged not to take the speakers words personally but as a reflection of the true self that is coming through.  It is important to one’s mental health to be aware of thoughts and feelings and that we take responsibility for getting in touch with our true self otherwise we will not be able to experience the fullness of our life nor the fullness of our relationship. Thus, we need to also allow our partner the same opportunity – and empathetically listen to what they have to say without making it a personal issue.

Of course, that isn’t an easy undertaking. Treating our feelings and desires as important does however not mean that we should be self-centred and egotistically only care for our own outcomes. We need to rather be observant and pay close attention so we are not in danger of being controlled by our thoughts and feelings that stem from our own insecurities. As mentioned earlier, it is not about us – it is about our partner – so, at times this requires that we need to put our own feelings and thoughts aside.

Be aware of tendency of wanting to revert back to symbiosis: 

During the differentiation stage we have a tendency  to revert back to the stage of symbiosis to eliminate the tension we are experiencing (Solomon & Teagno, 2013). This comes from the desire to merge into each other because we think that the original stage – the time where we ‘first met’, is the kind of experience that we want to maintain ‘forever’. Hence we aim to replace differences with similarities to avoid conflict. This might show itself through a variety of assumptions such as in compliance thinking i.e ‘if my partner truly loves me then … surely he or she will agree with me’. However, this just means that the partner will have to give up his or her independent thinking – the true self – the differentiation – just to show that he or she truly means it. Nevertheless, the opposite will be true. Partners will become more dissatisfied with the relationship, hence it is important to work through the stage of differentiation the way outlined earlier for the relationship to evolve – to get to the stage of ‘synergy’.

Stage 3: Synergy
Theory:

Once we feel accepted with for who we are – no matter what our strengths and weaknesses – and we have done so likewise when it comes to our partner, then the relationship enters into the synergy phase. We are safe and can be vulnerable without having to worry that we won’t be loved or respected. This makes the relationship a safe haven of support in all areas. The bond and intimacy between partners grows stronger and the relationship is deepening.   So, it needs to be remembered that conflict provides us as individuals the opportunity to grow – it causes the relationship to develop beyond what we initially thought possible.

True intimacy thus comes from two partners communicating maturely – verbally, physically and through their actions with each other. Communicating here again means the ability to speak and sincerely listen even if that may be directed against ourselves – i.e. the partner might say that they are no longer attracted to us or says something else that may be hard to hear, nevertheless, listening and trying to understand through questioning where our partner is coming from is the only way to really create the conflict intimacy that we need to make the relationship work. So our likely attempt to be defensive about what we are going to hear, attacking our partner or even avoiding to talk about difficult subjects all together or even making attempts to bring the focus back on ourselves is most definitely not going to do anything to deepen the relationship.  Only when we can communicate in that manner, are we able to achieve conflict intimacy. Of course it is not easy to achieve these outcomes when fear of rejection, anxiety or doubt hinders us from speaking our truth.

In fact, (Solomon & Teagno, 2013) point out that when facing conflict of that nature we are likely to regress into the same responses we have displayed during our childhood when faced with conflict. Then we may find ourselves reacting by pretending we are not hurt, shutting down emotionally, perhaps even trying to please our partner even more by making premature compromises or attack our partner either via passive or overtly aggressive means.

What needs to be understood here is that neither of these behaviors will create the closeness we are after – quite the contrary – we will grow more distant from our true self as well as our partner as a consequence. Thus, the most important aspect of therapy is to highlight how to use the conflict we are experiencing as an opportunity to find our true self as well as maximize the growth in your relationship.

Interestingly, from a more spiritual perspective, ancient Buddhist philosophy has pointed out that ‘differentiation’ – ‘distinction’ or ‘otherness’, creates the kind of tension that ultimately provides the drive for the growth of consciousness (Thonnissen, 2011). Psychology defines this kind of distinction as ‘cognitive dissonance’ (Festinger, 1962).

The strongest relationship one could achieve is based on two partners who not only love each other but who are individuated individuals who have achieved  healthy  affection intimacy through healthy  conflict intimacy.

These partners are able to maintain their individual self even when they are experiencing relationship tension as they have the ability to express their truth and at the same time empathtically ensuring that their partner can do so likewise.

This can be as simple as one partner making an observation about the other from a position of differentiation the way outlined earlier. This process is called mirroring (Solomon & Teagno, 2013) describe it like this “It is not telling your partner how you want him or her to change or how he or she “has to” change. It is one partner holding up the mirror to the other.  Then your partner looks at his or her image as reflected by you, and gives it honest consideration.  Most importantly, while looking in the mirror, your partner is holding on to his or her own sense of self. This can be one of the most positive processes in an intimate relationship, powerfully leading to self-growth” (Solomon & Teagno, 2013)

Types of personal limitations playing into relationship conflict:

Solomon & Teagno, (2013) talk about the three limitations that individual’s in committed
relationships are likely to encounter and which each partner needs to vigorously work on if the relationship is going to function effectively in the way outlined above (please note that these limitations are assessed in part 2 of the intake questionnaire). These are:

Self-imposed limitations, – fear of failure, thus not taking a risk or trying new behaviors. Low confidence and self-esteem/self-belief.

Trauma-imposed limitations, – fear of getting hurt due to experiences in the past – even very early experiences in childhood which are now projected onto the now and future. Fear of being vulnerable – instead ensuring safety through withdrawal or other defensive behaviors such as anger and incongruence controlling behaviors.

Genetically imposed limitations – physical and intellectual abilities, or lack thereof. Thinking that the partner is just not smart enough and thus of lesser worth for instance. Used as excuses to avoid intimacy for instance.

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Tips On Relationship Counseling North Perth

Uncategorizedon February 26th, 2014No Comments

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Personality in Couples Therapy by Jorg Thonnissen (also published at http://resolve-couples-retreats.weebly.com/ )

People often ask us, what type of personality makes the best partner for them when it comes to having a successful marriage or relationship?

There is no question that people with differing personality types can enter a successful relationship, however according to a number of Jungian type personality researcher some types work better than others and thus they may have to work harder to overcome their perceptional differences (Atkinson, 1993; Kong, 2010; Robertson, 2005).
Our personality is an aggregate collection of the decisions we have made throughout our life and the associated memory of the experiences to which these decisions led. In addition, our inherent genetic, as well as the multitude of environmental factors including our values, beliefs and expectations are all contributing factors to the development of what we term personality (Breger, 2009).

Thus, we are complex and unique beings who long to meet other complex and unique beings in order to form a relationship – and that needs some work. Applying the framework of personality theory to improve our relationships is a great start.

This means applying a 3 step process that will be asking you to complete a personality assessment, read and contemplate for yourself if what you read about yourself applies, then exchange what you have learned with your partner and vice versa.

The bottom line is, if you are in a relationship with someone whose type often conflicts with yours, you can have a happy relationship, but it might take a lot more work.

And if you are considering someone as a romantic partner, you’d do well to consider how your personalities will fit together. Whether you easily pair or not, you can improve your relationship by understanding where your partner is coming from, personality-wise.

In our experience, people taking the assessment report feeling somewhat liberated, even elated  from learning about their preferences, behaviors, and functions through understanding that they are ‘normal’ within their type instead of thinking that they are rather ‘odd’ or that others are ‘odd’.

Thus it is generally a validating experience. Furthermore learning about how your partner functions will increase your understanding and respect for him or her.

The next step in the process is to figure out how to work together. This can be done by analyzing of how partners work similarly or differently and seek practical suggestions for how they can work together better.

The bottom line is, if you are in a relationship with someone whose type often conflicts with yours, you can have a happy relationship, but it might take a lot more work. And if you are considering someone as a romantic partner, you’d do well to consider how your personalities will fit together.

Whether you easily pair or not, you can improve your relationship by understanding where your partner is coming from, personality-wise.

 

 

 

Applications Of Hypnotherapy For Claustrophobia North Perth

Uncategorizedon February 26th, 2013No Comments

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