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Using the body to calm the mind

When we think about psychological difficulties, we often think of these as being purely in the mind.  In some of my other blogs I’ve spoken about the link between mind and body, and this is something I work with a lot in my therapy sessions with clients. 

This is particularly relevant with issues of anxiety; where the fight-flight-freeze system comes into play.  This ancient pathway in our brains allowed us to detect and respond to threats before we even had a conscious awareness of them.  Nowadays of course often the ‘threats’ are more likely to be psychological (fear about a situation for example) rather than a physical threat such as being attacked by a wild bear.  However, our bodies still react in the same way, by preparing our bodies to fight, run, or stand very still and hope the bear doesn’t notice us.  This is why stress and anxiety tends to lead to symptoms such as racing heart, tight muscles and increased breathing rate; all things that would help us to fight, run or stand very still.

We often might think of needing to use our minds (thoughts) to calm ourselves, and certainly in Cognitive Behavioural Therapy this is an important part of learning to manage anxiety.  However, we can also use our bodies to calm our minds.  As well as the messages coming from our brain to our body to say ‘quick, get ready to respond’ our bodies also send messages back to our brains.  So if we can do things with our bodies to calm, that in turn can send messages of calming back to our brains.  A good example of this is breathing:  In flight-fight-freeze mode our brains’ automatic response is to send a message to our bodies to make breathing shallower and faster in order to get oxygen to our muscles to prepare to run, fight or stand really still.  If, however, we over-ride this and purposefully slow our breathing to take deeper, slower breaths, that will send the message to our brain to say ‘it’s ok, we don’t need to be anxious’.  Some people find using a breathing square or star can be helpful.  If you imagine the shape and trace round it in your mind, breathing in as you trace along one side, and out as you trace along the next and so on.

Using progressive muscle relaxation (PMR) is another body based technique that can be really useful.  This involves working through the body from feet to head, tensing and then relaxing different parts in turn.  There are many scripts available online, or even YouTube videos which take you through a PMR exercise.  Again, this helps calm the mind by sending messages from the body back to the brain.  Even just going for a walk can be really useful when we are stressed or anxious.  At times of anxiety or high stress our bodies get flooded with hormones, including adrenaline.  This is what tells the body to prepare to run, fight or stand really still.  All the time high levels of adrenaline are present in our blood we will be in fight-flight-freeze mode.  Adrenaline is used up by our muscles, so doing activities that use our muscles will reduce the amount of adrenaline in our system.  So things like going for a walk are great for reducing adrenaline.

Most people anecdotally have probably found that when we are stressed or anxious going for a walk or taking 10 deep breaths can be useful.  As we can see there is a very real reason for why this can help; our bodies can be used to calm our minds.

Dr Emma Stevens, HCPC Registered, is an experienced Clinical Psychologist. She has an integrative approach drawing on Cognitive Behavioural, Systemic and Psychodynamic models, as well as Attachment Theory. Emma sees individuals primarily for sort-term work. Emma is available at our Lewes Practice.

 

Further reading by Dr Emma Stevens

Emotional Well-being

What is EMDR?

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The dangers of over medicalising

Earlier this month (October 2019) the government announced a new service for gaming addicts aged 13-25 at the Centre for Internet and Gaming Disorders.  According to the World Health Authority Gaming Disorder is a pattern of persistent or recurrent gaming behaviour so severe that it “takes precedence over other life interests”.  This description could equally be applied to any addiction be it an addiction to gaming, alcohol, dieting, exercise, drugs or sex to name a few.

New addictions and other mental health categories are being ‘discovered’ almost weekly.  The current version of The Diagnostic and Statistical Manual of Mental Disorders – DSM-5 published in 2013 contains 541 categories of mental disorders. This version replaced DSM-IV published in 1994 containing 383 disorders.  That’s an increase of 158 categories in 19 years – just over 8 new categories per year, a little more than 1 every couple of months.

GPs, psychiatrists and other mental health clinicians use the DSM to diagnose their patients.  Each category has a list of symptoms and as long as the patient presents with a required number of symptoms within the category a diagnosis is given.  Alongside a diagnosis there is a choice of treatment or treatments which will typically be a combination of medication and/or some form of psychotherapy to treat the symptoms.

So far so good, however with new diagnostic categories based on surface symptoms springing up so regularly the structural causes that lie beneath these symptoms are given less and less attention.  Two people may present with the same surface behaviour, for example, a pattern of persistent or recurrent gaming behaviour.  In both cases the person might describe significant impairment in important areas of functioning like work, relationships, their social life, education or occupation and so the label gaming addiction may be applied.  Dialogue however may show that for one the symptom is linked to how they wish to escape from feelings of anxiety and depression whereas for the other it is a consequence of the delusional belief that the gaming world they enter is in fact the real world and one in which they have a real place.  Similarly we might consider two people who are persistently restricting what they eat leading to weight loss or a failure to gain.  Again a discussion may show that for one person the reason they are dieting is because they imagine that the thinner they are, the more lovable they will be whilst another person may be refusing food because they believe it to be poisoned.

In this way the same symptom covers two very different causes and psychological structure.  In order for the symptoms to be reduced the underlying cause needs to be explored.  This is the work of long term psychotherapy where the person is treated as a whole and is encouraged to speak about themselves and their relationships both as they are now and also as they were in the past.  Personal history and family dynamics are thought about so that the meaning behind the symptoms can slowly emerge.

Anna Reynolds is a UKCP registered Psychoanalytic Psychotherapist qualified to work with a broad range of psychological issues as well as more complex mental health conditions in adults.  Anna works with individuals and couples.  Anna is available at our Lewes Practice.

 

Further reading by Anna Reynolds –

Attachment styles & how they affect relationships

The language of love: how couples communicate

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Death Anxiety

This blog follows on from my previous blogs – Existential Therapy and A consideration of some vital notions connected to Existential Therapies.  

In Existential Therapy reflecting on death anxiety would not be the same without a consideration of Heidegger. Heidegger (1927) regarded human beings as always ‘being towards death’. He asserted the significance of anticipating death as a vehicle to address the possibility of being itself.  Heidegger (1927) described the earnest recognition of our being towards death and its possibility in the following way:

“Impassioned freedom towards death – a freedom which has been released from the illusions of the ‘they’ and which is tactical, certain of itself, and anxious”

(p. 266) [1]

To me it seems Heidegger postulated that by confronting our finitude we can take responsibility for our existence and be released from the illusions surrounding a life of conformity.  However, this does not remove anxiety from living but reframes it as something inherent in being.

To a greater and lesser extent ‘death anxiety’ is considered by existential therapists as a central theme. One’s mortality is recognised as a continuing condition of human beings. It is perhaps the only thing that belongs to us,  and we can knowingly and unknowingly be living in the anticipation of its possibility and eventuality. This theme holds much uncertainty and reflects back to us the pervading uncertainty of life. It gives birth to the existential angst inherent in the human condition. This angst is generated by the fragility and unreliability of a life lived in this existence.

This does not have to be a pessimistic view. It is in fact allowing an exploration of the boundaries of life. By confronting our mortality, and in fact any pain and suffering experienced along our path, we have the opportunity to clarify our limits and identify that which is out of our reach rather than evading it. Simultaneously it can support us to become aware of our potential and the elements in our lives that it is possible to do something about. It can make us feel more adventurous and alive.

Existential Therapy frequently espouses the importance of facing up to our life and death and all that is experienced between the two poles of our existence, whether it be inevitable suffering or joy. We must find the capacity to confront our difficulties in living and permit the experience to feel it, without needing to linger for too long.

Equally we must see the good in our existence and recognise these times as they happen. Allow learning to ensue so that we can augment this in our lives, but without getting caught in the pursuit of unending happiness. Ultimately all aspects experienced, wherever they fall on the spectrum of suffering or joy, do not stand alone. They are all parts of the same indivisible perspective that each individual experiences as they travel within their existence.

So whether or not death anxiety is viable to consider, angst or anxiety is seen as an inevitable part of existence by Existential Therapists. Many will emphasise the significance of valuing, understanding and tolerating anxiety. Many recognise anxiety as a sign that something in our life needs our energy and attention rather than it being a threat or something to be eliminated. Perhaps it may be the very thing that unshackles us from conformity and seeking validation or permission from others. Perhaps it is the vehicle within which we may feel our aliveness, engagement,  and vital connection.

 

Susanna Petitpierre, BACP Registered, is an experienced psychotherapeutic counsellor, providing long and short term counselling. Her approach is primarily grounded in existential therapy and she works with individuals.  Susanna is available at our Brighton and Hove Practice and Lewes Practice.

 

Further reading by Susanna Petitpierre –

A consideration of some vital notions connected to Existential Therapies

Existential Therapy

Being embodied in Therapy: Feeling and listening to your body

 

Resources –

[1] Heidegger, M. (1927) Being and Time (transl. J. Macquarrie and E.s Robinson) Londo: Harper and Row, 1962 edn.  

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Post Natal Depression in Mothers & Fathers

In this blog, I want to write about post-natal depression, revisiting and summarising a classic paper by Lawrence Blum, an American Psychiatrist and Psychotherapist. The paper was written originally in relation to post natal depression in mothers, however, because it essentially explores the conflicts aroused in becoming a parent and caregiver, particularly in relation to our own experiences of caregiving.  I think it applies also to fathers and to same sex couples and heterosexual couples where the caring of the infant is more equally shared.

Blum’s paper, titled the, “Psychodynamics of Postpartum depression”, is available on the web.

The paper draws a distinction between baby blues which he defines as the hormonal induced depression resulting from pregnancy and childbirth, and post-natal depression, which has typical features of depression, – ‘sadness, crying, insomnia, or excessive sleep, low mood, low energy, loss of appetite, agitation and self-critical thinking.’ 

He describes the external factors that can contribute, such as prior anxieties and depressions, low external support, difficult relationships, difficulty conceiving, stressful life events, etc. He summarises the studies at the time into the results of different therapies and concludes that supportive counselling, CBT and Psychodynamic Psychotherapy were all superior to the control and that the Psychodynamic therapy had the biggest impact on depression, as defined by the DSM 111. 

The focus is then on the possible  ‘psychodynamics’ of the depression and these are what I shall briefly outline here as these are what can really be usefully explored and alleviated by Psychotherapy. Three principle emotional conflicts are outlined; Dependency conflicts, Anger conflicts and Parent conflicts. 

Dependency Conflicts

In order to care for a baby, there is a need to be utterly depended upon, this is tiring and emotional and benefits from support. If there is a conflict about receiving support, a self-denial of the caregivers own needs, they can seek to repress their own essential vulnerability and needs and get  depressed.

Often people manage this part by becoming carers and end up in caring roles, such as therapists (a good a reason as any why therapists need their own therapy!) This counter-dependent strategy can work until it doesn’t. Someone who seems to be managing everything well, suddenly finds the balance has tipped too far. A baby can stir up the caregivers previously unconscious or sleeping wishes to be cared for, hidden by a display of  independence.

Anger Conflicts

A conflict with feelings of anger, which can feel counter to the role of caregiver. Parents can feel they don’t have a right to be angry, feel guilty about it or frightened of it, yet may have experiences and histories, which have left them feeling angry. Anger can be felt towards the baby, either as a projection of past hurts, or for the very real things it has done to the parents lives; tuned them upside down, deprived them of sleep, money, jobs, sex, etc, while carrying on with its incessant demands obliviously. The danger apart from depression in all of this, is that these feelings are denied and controlled and ‘loss of control can follow from over control as internal pressure builds up”, and has to be released, either threatening the relationship with the baby or more commonly being displaced onto partners.

Feeling the anger, tolerating it, and judiciously putting it into words, easy for the clinician to say, is the difficult and essential task for the person who is looking after the baby.

Parenthood conflicts

Caring for baby can stir up unresolved and unprocessed feelings about the caregivers own experiences of being cared for, whether a mum or a dad by a mum or a dad. Although a negative experience of being cared for can positively inform the ways in which the caregiver feels they don’t want to be, it doesn’t necessarily translate into clear ideas of how or what to be. In addition the caregiver, giving the baby what it didn’t receive, can be gratifying but  can also stir up the wounds of what they, the caregiver, didn’t receive. 

I would like to finish with Donald Winnicott,’s, (a British paediatrician and Psychotherapist), funny but true reasons why a mother, (or father or caregiver), hates their baby, with the intention in which they were written, to provide relief from the day to day conflicts, that can be felt in the rewarding, important but by no means easy job of nurturing an infant:-

  1. The baby is not her own (mental) conception. 
  2. The baby is not the one of childhood play, father’s child, brother’s child, etc. 
  3. The baby is not magically produced. 
  4. The baby is a danger to her body in pregnancy and at birth. 
  5. The baby is an interference with her private life, a challenge to preoccupation. 
  6. To a greater or lesser extent a mother feels that her own mother demands a baby, so that her baby is produced to placate her mother. 
  7. The baby hurts her nipples even by suckling, which is at first a chewing activity. 
  8. He is ruthless, treats her as scum, an unpaid servant, a slave. 
  9. She has to love him, excretions and all, at any rate at the beginning, till he has doubts about himself. 
  10. He tries to hurt her, periodically bites her, all in love. 
  11. He shows disillusionment about her. 
  12. His excited love is cupboard love, so that having got what he wants he throws her away like orange peel. 
  13. The baby at first must dominate, he must be protected from coincidences, life must unfold at the baby’s rate and all this needs his mother’s continuous and detailed study. For instance, she must not be anxious when holding him, etc. 
  14. At first he does not know at all what she does or what she sacrifices for him. Especially he cannot allow for her hate. 
  15. He is suspicious, refuses her good food, and makes her doubt herself, but eats well with his aunt.
  16. After an awful morning with him she goes out, and he smiles at a stranger, who says: ‘Isn’t he sweet!’ 
  17. If she fails him at the start she knows he will pay her out for ever.
  18. He excites her but frustrates—she mustn’t eat him or trade in sex with him. 

Winnicott, D.W. (1949). Hate in the Counter-Transference. Int. J. Psycho-Anal., 30:69-74. 

 

Paul Salvage is Psychodynamic Psychotherapist trained to work with adolescents from 16-25 and adults across a wide range of specialisms including depression, anxiety, family issues, self awareness and relationship difficulties. He currently works with individuals in our private practice in Hove.

 

Further reading by Paul Salvage –

The Therapeutic Relationship and the Unconsious

A Nation Divided

Adolescence: the trials and tribulations

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A Dramatherapist at work in the sand tray

 

Dramatherapy is one of a group of therapies which are called Creative Arts Therapies, along with Music therapy and Art therapy. Today I am going to explore one aspect of Dramatherapy.

We usually come to therapy to talk.  Dramatherapy, has the capacity to go beyond the talking because it is creative.

Dramatherapy becomes useful in the therapy space when it is used as a way of illustrating  the talking which takes place between the client and therapist. This illustration provides another way (a container) for the client to find meaning in their experiences and in their sense of self.

How is this?

Mostly when we seek therapy we expect to be talking. As a dramatherapist I am always alert to opportunities within the talking,  opportunities to explore  those things for which there are no words-maybe those things that happened to us before we spoke,  or those painful experiences, things that we want to actively or unconsciously deny, or perhaps a dream, or an illness.  In other words those things that are not part of our everyday cognitive knowing.

And this is where creativity comes in. When we are creative we are tapping into the right side of our brain which is very different from the left side.  Simply speaking the right brain does not have the same rules of logical thought and sequential time. It receives and processes information and experience very differently. For us to be able to connect and communicate with the rich wisdom of the right brain we need to use a medium which represents (re-presents) our experience to us in a different way.

Sand tray is such a medium which can re-present a situation or experience. The placing of objects in the sandtray is intuitive, there is no right or wrong, only personal and individual interpretation.

In my work with a particular client who suffered from chronic anxiety, we explored her early pre-verbal experience as a way of understanding the roots of the anxiety.  She made sandtrays of her early years showing scenes of confinement, of heaviness, weight and pressure. Over the weeks she interpreted her created scenes to me, her witness. Through this witnessed process she was able to articulate her pain for the first time. As her feelings emerged and as she became more emotionally open her anxiety lessened.

In my experience this precious work continues outside of the therapy room, bringing a richness of new experience and self -understanding.  Through this work I see clients growing in self-confidence which I think is born from coming to know the self more fully and  profoundly.

If you are interested to know more about dramatherapy and how it may be of help to you, do contact me.

 

Magdalena Whitehouse is an experienced HCPC Registered Drama Therapist, working with individuals, couples and groups.

 

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