CBT – Dave's Bankside Babble

Knowing that you could do with some help, and being able to access that support are sadly, but very often it would seem, two distinctly different ball-games. But is this situation the reality?

In an era where psychological solutions are becoming more scientifically and socially fashionable, rather than purely pharmacological interventions, it’s worrying if this type of resource is not available for those who need it.

Having the ability to successfully traverse the minefield of health bureaucracy is one thing, but actually getting the help you need is another. Thankfully and not before time, access to psychological support is, in reality, becoming far more easily available. Today, probably thanks to the power of social-media campaigns, we now have a better understanding of mental-health issues in our society.

The Availability of Therapy

Psychological therapy (good and bad) has been available for decades, particularly for those with sufficient cash. Well-healed ‘celebrities’ continually evidence the fact; anyone with the required moolah can buy a therapist. Which is possibly why so many of them do so, it’s fashionable and particularly in the USA.

A large percentage of our rich and ‘famous’ appear to have need of personal therapists. They need them on tap, to help manage the stress of any reduced social-media following or maybe, managing rumination about whether they need to invest in another Lamborghini. And if so, should they get it in electric green or yellow? Whatever, it’ll probably end up getting a gold or carbon wrap in any case. That’s all well and good commercially, and very fortunate for the business of independent therapists however; it’s not so good for anyone less able to pay for those services.

I wonder… Could some of these recent social-media awareness campaigns have been the marketing activities of therapists short on business? No, surely not?

Therapy UK

All cynicism aside, contemporary not philosophical; the availability of therapy (without payment) in the UK is improving. In addition to that fact, we should also be grateful to America. After all, a large proportion of today’s cognitive (or thinking) therapies and modern therapeutic methods were actually developed across the pond (see history). Despite having found their ancient roots in the Stoicism of Hellenistic philosophy.

In the UK, thanks to the NHS, we can now access various forms of talking therapy and counselling, or cognitive behavioural therapy (CBT). You don’t need a referral from your GP, you can refer yourself directly to psychological therapy services, as part of the Improving Access to Psychological Therapies (IAPT) service.

You can access self-help resources, online resources, smartphone apps and courses that are available to help you cope with stress, anxiety or depression. Or even those more simple but still emotionally challenging ups and downs of life, via the NHS Choices Moodzone.

Adjust Your Thinking to Fix Your Feelings

Regular visitors to my blog will previously have seen the quote shown below. It’s one I use on a regular basis; it also serves to simply and adequately explain why we tend to get our minds in an unhealthy mess.

We often get ourselves into a mental pickle about life events. We worry and ruminate about events and circumstances that we have no control over, to the extent that we can and do make ourselves mentally unwell sometimes.

Many of these events and occurrences are unpredictable, we may not be able to prevent them from happening, but what we think when they do is within our control. And once they have occurred, we need to understand that we may not be able to change any of the outcomes from that event. But again, we can control what we think about the situation. In simple terms; how you think now has an impact upon how you feel, during and after any event.

Life is Complicated by Humans

Rational Emotive Behaviour Therapy (REBT) is the original form of Cognitive Behaviour Therapy and one of the most successful types of psycho-therapeutic techniques available.

It was developed and first used by Dr Albert Ellis (American Psychologist – born 1913 died 2007) – to substitute irrational beliefs with more rational ones – by training a person to identify their irrational beliefs (e.g. “I must be perfect”) and subsequently, teach the person how to challenge those false (irrational) beliefs through reality testing (see Simple Psychology for more detail).

When Ellis established these techniques back in the 1958, he called it Rational Therapy. He did so because he wanted to stress that “emotional problems are based on irrational thinking” and if we are to address these issues effectively, we need to change such thinking to its more rational equivalent.

Addictions Recovery

The emotional strains of life events, and irrational thinking around those events, can lead people into the escapism of substance use disorders.

The desire or need to escape or mask and self-medicate past trauma can be powerful. As can the constant requirement for a crutch that supports us in dealing with difficult situations. Even those initial tests or the ongoing reward for our hedonistic party animal tendencies can become problematic, in time. And all often because of the way we think, long before any chemical or neurological hook we may experience. All the above are strong causation factors in people’s addictive behaviours.

REBT, along with aspects of Mindfulness and Motivational Interviewing, is the foundation of SMART Recovery; a popular and effective programme of self-help and mutual-aid. SMART is used extensively as a therapeutic intervention to support self-management and train people how they can recovery from substance addictions, problematic gambling and a diverse range of addictive behaviours.

Thinking Your Way to a Happier Life

But what is happiness? A subjective and relative elusive state, that’s what it is.

Philosophers, theologians, psychologists, and even the economists try to define it. Since the latter part of the previous millennium, positive psychology has dedicated all its efforts to corralling the concept of happiness and propagating the process.

Positive psychology is “the scientific study of what makes life most worth living”, or “the scientific study of positive human functioning and flourishing on multiple levels that include the biological, personal, relational, institutional, cultural, and global dimensions of life. (wikipedia.org)

Clinically and scientifically, happiness is about so much more than simply having a positive mood, it is a state of well-being that encompasses living a life that encompasses a sense of meaning and deep satisfaction.

Research suggests that happiness can improve your physical health. Feeling positive and being content can benefit cardiovascular health, the immune system, inflammation levels, and blood pressure, amongst other things. Happiness has even been linked to a longer lifespan, providing more years for you to continue striving for fulfilment.

Behaviour Change: Positive psychology, the science of happiness and well-being, advocates approaching change not from the perspective of difficulty, but rather from the perspective of capitalising on what we have, using our strengths and activating positive experiences. In that it uses well-researched interventions associated with flourishing and well-being. (positivepsychology.org.uk)

Attaining happiness is now a global pursuit. Researchers find that people from every corner of the world rate happiness as usually more important than any other desirable personal outcomes; like having a meaningful life, or becoming rich – contrary to what we are sold in social-media. Read more at Psychology Today) or perhaps you might like to have a go at The Happiness Test (20mins)?

My test response shows; “I’m generally the type of person who believes in the goodness of humankind.” Apparently I give nearly everyone the benefit of the doubt, at least until proven wrong, and I can accept what people say and do at face value. I tend not to assume ulterior motives. So there you have it… I’m an all round good guy – until you piss me off.

Read yourself Better

The book Mind Over Mood is designed to help you understand how to:

Learn proven, powerful, practical strategies to transform your life
Follow step-by-step plans to overcome depression, anxiety, anger, guilt, and shame.
Set doable personal goals and track your progress (you can photocopy the worksheets from the book or download and print additional copies).
Practice your new skills until they become second nature.

The book was cited as “The Most Influential Cognitive-Behavioural Therapy Publication” by the British Association for Behavioural and Cognitive Psychotherapies (BABCP) and has been included in the UK NHS Bibliotherapy program. You can find more books to help with common mental health problems, like anxiety and depression, on the Reading Well Books on Prescription website.

Single Session Therapy

One of the issues that often stands in the way of people seeking help, is the (mistaken) belief that therapy is something that must take place over a (long) period of time.

With the prevalence of a UK political direction for cuts in health-care funding, I can see how short-term interventions, with a drop-in capability, availability could well be in the ascendant. I’m all for it if it gives people what they need. For a little too long we have been a little too prescriptive in the help and support we provide to people asking for help.

According to Windy Dryden, a leading CBT practitioner and trainer, an Australian therapist (Jeff Young, 2018) examined research which challenged established longer-term approaches to psychological treatment;

The most common number of service contacts that clients attend, worldwide, is one, followed by two, followed by three. This is irrespective of diagnosis, complexity, or the severity of problem.
70-80 per cent of people who attend only one session, across a range of therapies, report that the single session was adequate given their current circumstance.
It is impossible to accurately predict who will attend only one session and who will attend more. Given this, why not approach the first session ‘as if’ it might be the last?

Dryden argues that Single-Session Therapy (SST) is a “time-efficient, cost-effective means of providing help according to people’s needs.”

There has been some reluctance to accept the ethos, possibly from those who are financially tied to the longer-term therapy business model (cynicism again, sorry).

What any detractors may not have noticed is; SST is not something applied in one session and then terminated. The idea is to provide a prompt intervention that allows the therapist and client to work together in a timely and expedient manner. And hopefully, get what they want from one session but if not, ensure more help is made available later.

The provision of a one-stop shop, or drop-in process, delivering expedient therapeutic support makes appears to make solid sense to me!

Who is Windy Dryden?

Windy Dryden is a leading Cognitive Behaviour Therapy (CBT) practitioner and trainer in the UK. He is Emeritus Professor of Psycho-therapeutic Studies at Goldsmiths University in London and has been working in the field of counselling and psychotherapy since 1975. He is best known for his work in Rational-Emotive Cognitive Behaviour Therapy (RECBT). He was one of the first people in Britain to be trained in CBT methods. (Please visit www.windydryden.com for more information)