Psychology and discriminating psychotherapy: The importance of finding an effective psychologist.

The importance of finding a solutions-focused psychologist.

One of my gurus, Michael Yapko, published a new book today called “The Discriminating Therapist” which is available as a download on Amazon.

Dr Yapko is a seasoned therapist, hypnotherapist and presenter. You can find his website and his new book at http://www.yapko.com/the-discriminating-therapist/

He came out to South Africa a few years ago and I was fortunate to be able to attend a hypnotherapy workshop that he presented in Pretoria. His approach to therapy is so practical and useful that I use his ideas and his strategies routinely in my therapy with clients, both in individual and in couple’s counselling.

Why is his approach so useful? Ironically, Dr Yapko would disagree with this question but would no doubt restate it it this way: how can the therapist be of help in enabling their clients to reach their stated goals? The client’s goals may involve achieving a desired state, such as becoming calm and content (if they suffer from depression or anxiety) or gaining mastery over some aspect of life, such as conquering procrastination or improving communication in their marriage.

Dr Yapko maintains that, in life, “how” questions are more useful that “why” questions.

Why does he say this? If you think about it, we can look for reasons for our behaviour until the cows come home! However, this doesn’t help us to identify, and change whatever behaviours (or patterns of behaviour), thinking patterns or thinking strategies that maintains our problems, such as depression or anxiety. Once the therapist has helped the client in this regard, positive change can be facilitated. 

This brings me to the topic of choosing a therapist that will be right for you. Dr Yapko would ask “How do you go about choosing an effective therapist”! 

I would ask a psychologist upfront whether or not you could have a short, free (15 minute) introductory session with him or her so that you can have an opportunity to assess whether or not his or her approach seems to be right for you in terms of how you relate to each other and also in terms of whether or not you are both on the same page regarding their focus, approach to therapy and envisaged time frame for the achievement of your desired goals for therapy.

Continue Reading No Comments

If you are feeling anxious, stressed or depressed for now apparent reason…..

perhaps you are “catching” these emotions from other people near to you!

A case example: Susan comes to see me in my psychology practice because she is about to write her final exams and is concerned that she is so “stressed out” that she fears that she will go blank when she is faced with her exam paper and will do badly as a result.

When I explore the factors that may be adding to her stress levels it turns out that she is in a small class at college, where her class-mates talk about themselves about how stressed they all are. They also commiserate with each other about how difficult the work is and how “impossible” it will be to do well in the exams.

In this way the stress levels of the group tend to increase as the exam date looms nearer and nearer.

Case 2: Tony is in his early twenties. He reports that he suffers from debilitating social anxiety which affects both his ability to interact socially and to find a fulfilling job. has grown up in a household where his father has always worried about everything. Tony’s father has conveyed the unconscious message to his children from the time they were small that the world is a dangerous and unpredictable place and that other people are generally not to be trusted. Tony comes to see me because he wants to become less anxious and more comfortable in social settings.

Case 3: Mary comes to see me because she is feeling “down” and unmotivated – that she has lost her enthusiasm for life. She is a homemaker and has many friends and hobbies but of late she has lost enthusiasm for the things she previously enjoyed. Her husband has been retired for a year and her children have left home. She reports that her husband tends to sit around the house all day, eating, drinking and watching TV. He tends to be demanding and would talk at length about how bad “things” had become.

 

Most clients who come to see me for counselling and psychotherapy tend to believe that their unpleasant psychological states are due to something they are feeling, doing or not doing – that they are the source of their problem (this is not the case with most couples I see, who usually blame each other, initially at any rate, for the problems in their relationship). I have often found though, on closer examination, that the social environment can play a big role in the our emotions states. Psychologists and social psychology researchers put this down to our ability to empathize with others. Those of us who are high in emotional empathy tend to “pick up” the emotions of others easily and will thus be more likely to be affected by the negative of other people. This influence is especially strong when there is a close emotional bond and a close and lengthy proximity with a stressed, anxious or depressed person or group.   Psychologists call this phenomenon “transference”.

This tendency to “catch” feelings from others and from our environment isn’t always a bad thing of course. We can also be affected by joy and happiness! 

In a following post I will suggest ways of counteracting the negative effects of this unconscious “force”.

 

 

 

Continue Reading No Comments

When it comes to anxiety, stress and depression: Are you unwittingly making things worse?

Our thinking patterns are crucial in determining how we feel! In my psychology practice, anxiety, depression and stress are the three major problems that cause many of my clients acute distress so I am always interested to read about research in these areas. A recent article in Psyblog mentioned three behavioural styles that are common in individuals who suffer from depression. These include rumination (preoccupation with cycles of negative throughts), a lack of adaptive coping ( failing to seek support and also not using positive approaches such as exercising and seeking out positive experiences) and self-blame. On the subject of stress – a large proportion of the stress we experience is as a result of daily hassles – recurrent, annoying things that happen on a daily basis such as hold-ups in the traffic, appliance malfunctions and call-centre queries. Our stress levels are dependent on the way in which we interpret and respond to these stressors and our health is directly affected by our characteristic way of responding to these hassles. The postive implication of this research is, of course, that it is possible to alter these patterns of behaviour. This is frequently the focus of my counselling and psychotherapy with my clients. Source

Continue Reading No Comments

Social phobia: Are you phobic when it comes to making presentations?

Here are some tips for mastering this very common problem.

 

Over the years I have had many clients in my psychology practice who have been plagued by social phobia causing anxiety, fear and dread when contemplating the idea of making presentations to large groups of people. Often their career success depends on being able to make impactful presentations and so there is invariably a great deal at stake.

 

If this is your particular issue, what can you do?

 

1. Mastering your anxiety is key. Don't allow yourself to go into "what-if" or catastrophising thinking – this will make your anxiety sky-rocket! Rather speak to yourself asif you were your own sports coach – use encouraging language, say things to yourself like "I will take things one at a time".

2. Remember to breathe deeply. Take a couple of deep breaths if you feel your anxiety start to build.

3. In the days before the presentation, take some time to close your eyes and to visualise yourself going through the presentation in a confident way, from start to finish.

4. Make sure you are well-prepared and know your subject matter backwards so that you hardly have to concentrate on bringing the material to mind during the presentation but can focus of making your talk interesting and checking your audience to see whether or not they are involved and interested in what you are saying.

5. If you are using audio-visual material such as a powerpoint presentation, make sure each slide is uncluttered and pleasing on the eye!

6. Just before the presentation, close your eyes and get into "the zone" where you access your "confident self" and go out there and act the part, even if it is an act initially.

7. When you are presented with your audience, focus on them and not on yourself!

8. And practise makes perfect! Practise on small groups of people initially, perhaps colleagues who are supportive and will give you helpful suggestions.

 

Best wishes!

 

 

 

 

 

Continue Reading No Comments

Couples and Singles: How high is your Couples’ EQ?

When it comes to relationships, are you any good at intimacy and emotional connection?

Valentine's Day again! Perhaps this is a good moment to refect on how you are doing relationship-wise! Not only in your intimate relationship(s) but also in your relationships with all the other people in your life.

According to an article in the most recent edition of "Psychotherapy Networker", there are two essential skill sets involved in keeping our relationships on track. These are distress tolerance and the ability to self-soothe in times of conflict, and emotional accessibility.

In my couple counselling practice I have found that being caught in a negative cycle of negativity and escalating conflict is one of the main characteristic of unhappy relationships. Couples who are at this stage of their relationship usually find it impossible to get out of this cycle without some type of professional help. John Gottmann calls this the "Roach Motel" phenomenon.

So what is involved in these two essential skills sets?

Distress tolerance and the ability to self-soothe concerns how well we are able to stay calm "under fire" – not to get angry and defensive in the face of anger and criticism from one's partner, but to stay in a receptive and empathic state. Of couse is is very difficult and requires a great deal of practise for most of us! 

Emotional Accessibility is about being able to stay emotionally engaged with one's partner, even when one is in the middle of an arguement. It is not easy to stay emotionally present in a conflict situation as we all know! (individuals characeristically either go into anger or withdrawal mode. Both styles only serve to intensify the conflict and will cause a relationship to deteriorate if the pattern continues over time).

 

According to research findings in neuroscience, once new, healthy relationship styles have been developed these have to be practised consistently over time in order to make the new pattern your "default" by rewiring the brain. 

 

The good news, though, is that effective relationship skills can be learned!

 

Happy Valentine's Day!

 

References: The Great Deception. Brent Atkinson in Psychotherapy Networker, January/February 2014.

John Gottmann and Nan Silver (2012). What Makes Love Last? How to build trust and avoid betrayal.

 

 

 

 

Continue Reading No Comments

Stress and Coping: Are you finding Life to be a rough ride at present?

If so, how do you keep your (metaphorical) tyres pumped up (in the wild ride through your life), especially at this time of year?

This morning I was speaking to a close friend who is currently under a lot of pressure – both at work and at home. Usually he is a full of bounce, with an ascerbic wit and a lighthearted and often irreverant take on Life. Today, however, I could tell that he was not his usual self – he sounded irritated and frustrated, with none of his usual sense of fun or enjoyment of life. What I noticed, too, was that when he was desribing his recent interactions with important people in his life, like his wife for instance, that he was not showing his usual levels of warmth, understanding and empathy. It was as though he was “running on empty”.

When I reflected upon this, what came to mind was an analogy of a driver taking part in a race through harsh terrain. At times the ride is fun, at times challenging and often also hard work – the obstacles can be daunting. The route can be tough, exhausting and at times the driver will also lose the way. But ultimately there is (hopefully) a sense of achievement that the perseverence involved was worth it and a lot has been learnt along the way.

If one’s vehicle is in good working order, the journey will be a great deal easier and the driver may even enjoy the whole experience, despite it being such a tough challenge.

Aren’t there strong parallel’s with Life? I felt strongly that in my friend’s case, the recent stressors he has been experiencing have mounted up. If we take the analogy of the car, each experience of stress (which is largely unconscious) is asif a certain amount of air is escaping from the tyres – too much will have the effect that each bump in the road jars the spine. Very soon the race is not enjoyable anymore, but becomes somewhat of an ordeal to be endured. Perspective is lost. too. No longer can one think about the race as a whole in relation to all the other races. Instead, attention is focused solely on “holding on”.

So what aspects of your life contribute to deflating your car tyres?

What serves to keep these tyres pumped up and your vehicle in good working order, ready for the challenges ahead?

And how can you lessen the impact of the stress in your life?

I will suggest some answers to these questions in my next post.

 

 

 

 

Continue Reading No Comments

Cape Town Psychologist reflects on: Comfort Zones – are the always bad?

I know I did say I was going to talk about couple counselling and in-laws in my next post, but then I got to thinking about comfort zones, so I decided to talk about this topic first.

Say you are in a really good place in your life at present – everything is going well, you may have even achieved most of the goals that were important to you. Your health is fine, you don't have any problems to speak of and can't even identify many (or any) items to tick off on your bucket list…..

You are happy and content with life!

But perhaps there is a nagging thought somewhere that this maybe isn't right – aren't you supposed to be contantly motivated to achieve new goals, and if this is not the case, is there something wrong? Is it perhaps undiagnosed depression?

I have had clients who present with this type of quandary, but of course many people who are in this type of mindspace do not come to see a psychologist as they are not motivated to do so!

 

So is this a problem?

 

In the Western World we are socialised from a very young age to believe that continual striving for excellence is the way to go. After all, no-one would be interested in competitive sports or in doing well at school if this wasn't the case and the human race would not produced such wonders as air travel and the ipad!

But, on an individual level, is it OK to get the point where your only goal is to not have any other goals?

 

I would appreciate your thoughts!

 

 

 

 

Continue Reading No Comments

From my psychologist’s chair: What happens when our best traits turn out to be bad (for us)?

 

How does this happen?

 

a) What are your best qualities?

and

b) What aspects of yourself do you hate?

If you say, for example, that you are loyal, responsible and/or exceptionally hardworking, you would probably put these under a).

These are stirling qualities and, if you possess them, could be seen in a highly positive light. After all, they contribute significantly to a happy, well-adjusted and successful life. 

However, under certain circumstances these qualities can cause an individual to experience significant problems, especially if they are extreme.

Sometimes traits that served us well in childhood are no longer so useful, or may even backfire on us as adults!

Take perfectionism for example. If you were perfectionistic and highly responsible as a child, probably everyone gave you a great deal of positive strokes, including parents and teachers, after all you were always obliging and gave no-one any trouble!

 

Over the years in my psychology practice I have seen many clients who are model citizens and do everything "right", but they complain that they are exhausted, stressed, burned-out and have no time for themselves. This is a difficult pattern to break, because of all the positive "pay-offs" that the behaviour pattern has for the individual (such as a sense of control and satisfaction that comes from ticking all the boxes, and ticking them well) and for the significant others in their lives who can often coast along comfortably because the perfectionist in their lives takes care of everything!

Sometimes the mere suggestion from the psychologist that they consider learning how to moderate their perfectionistic tendencies can bring on anxiety and even panic attacks, and is usually met with extreme (often unconscious) resistance.

If the burned-out individual can overcome this resistance and can make the necessary behaviour changes that can enable a more balanced life, this is not the end of the story unfortunately. Because the default tendency of the person is to be a perfectionist, there will be a need for a continuous high level of vigilance and commitment to maintaining the necessary boundaries and a "good-enough" approach to their numerous responsibilities in life in order to prevent backsliding.

 

However, I strongly believe that it is worth the effort!

 

Continue Reading No Comments

A Week in my Psychologist’s Chair

Reflections on all things Psychological in my Cape Town Psychology and Mediation Practice

 

I thought readers may be interested in getting  glimpse each week on the issues/problems that have been the focus of my attention in my psychology practice over the last week or so and my insight/suggestions/advice in this regard.

 

I will group these under various headings.

 

Couples/Relationships/Marriage

 

Most clients who come to see me are doing so because of relationship difficulties. They either come along alone (either because they elect to do so because they want to discuss their issues privately, or more commonly, their partner is resistant to coming for therapy).

 

The themes that have come out strongly this last week are:

  • To make a success of a marriage both your hearts should be fully on board.  Make sure you are committing to your relationship for the right reasons. For example, clients report that they decided to get married because a lease ran out on one of the partner's accommodation and another one agreed to tie the knot because his/her partner was about to leave the country. These reasons might be regarded as practical at the time, but are ultimately poor reasons for getting together. If both partners aren't equally psychologically and emotionally ready to enter into a permanent relationship, problems are likely to occur down the line.
  • Mutual trust is the glue that keeps healthy relationships strong. If trust breaks down, poor communication, conflict and a loss of intimacy are often the inevitable result. 
  • To improve your relationship you will need to spend mutually enjoyable one-on-one time together. During these times it is important to leave your problems behind and talk about "fun" topics, as if you are going out on "real"  date.

 

Stress and Burnout

 

I have become very aware this week of the "silent"  load that many individuals carry on a daily basis:  having too much on their plates at any one time –  feeling  overwhelmed by pressure to perform  both at home and at work. Often this can lead to extreme stress, causing insomnia, headaches and the like. When this situation goes on for quite some time, individuals often start to feel helpless to bring about any positive change and this can lead to high levels of anxiety and depression.

What can be done about this?

It is important to analyse the situation in terms of what and where changes can be made. Some things can't be changed and the challenge with these it to find ways to adapt by choosing to view the situation in a different way. However, sometimes we give up too soon when positive change is actually possible. It pays, therefore, to have someone who can provide objective guidance and support should you wish to change your life in a positive direction.

 

I would appreciate your comments!

 

 

 

 

 

 

Continue Reading No Comments

Cognitive-Behaviour (Behavior) Therapy: Very effective for stress and Anxiety!

If you are suffering from study pressure, exam stress, or general stress or anxiety….

Cognitive-behaviour (behavior) therapy, or CBT has been to be extremely effective. It is called an evidence-based treatment approach as large, well-controlled studies have proved its effectiveness – both here and overseas.

How does it work?

We all have a stream of thoughts going through our minds every moment of our waking lives. We are continuously having an internal dialogue with ourselves (some of us have this conversation out loud sometimes which can cause other people to look at us funny!).

These thoughts that we have are not necessarily reflecting the truth about things – they are merely our own “take” on life, and can be right, wrong, accurate or inaccurate.

Unfortunately, though, we tend to regard our thoughts as true, and as our thought affect our emotions, we can start to feel very bad – based only on our unreliable thoughts!

For example: if you always anticipate that awful things could happen in the future – your thoughts are often starting with “what  if”…you will undoubtedly feel anxious a great deal of the time!

People usually only dwell on the negative possibilities – like failing (if you are a student) or getting caught in a lift (if you are claustrophobic). Not many people have anxiety about winning the lottery!

CBT helps individuals recognise and alter unhelpful and innacurate thinking patterns so that they can begin to live happier and more mindful lives, free from debilitating anxiety and depression.

If you would like to experience CBT, please contact us!

Continue Reading 1 Comment