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Psychotherapy

May 20, 2009 by Leave a Comment

Psychotherapy is an intentional interpersonal relationship used by trained psychotherapists to aid a patient in problems of living. It aims to increase the individual’s sense of well-being and reduce their subjective sense of discomfort. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behaviour change and that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family). Psychotherapy may be performed by practitioners with a number of different qualifications, including psychologists, marriage and family therapists, licenced clinical social workers, counsellors, psychiatric nurses, and psychiatrists.

Most forms of psychotherapy use spoken conversation. Some also use various other forms of communication such as the written word, artwork, drama, narrative story or music. Psychotherapy occurs within a structured encounter between a trained therapist and client(s). Purposeful, theoretically based psychotherapy began in the 19th century with psychoanalysis; since then, scores of other approaches have been developed and continue to be created.

Therapy is generally employed in response to a variety of specific or non-specific manifestations of clinically diagnosable and/or existential crises. Treatment of everyday problems is more often referred to as councelling. However, the term counselling is sometimes used interchangeably with “psychotherapy”.

Whilst some psychotherapeutic interventions are designed to treat the patient employing the medical model, many psychotherapeutic approaches do not adhere to the symptom-based model of “illness/cure”. Some practitioners, such as humanistic therapists, see themselves more in a facilitative/helper role. As sensitive and deeply personal topics are often discussed during psychotherapy, therapists are expected, and usually legally bound, to respect client or patient confidentiality. The critical importance of confidentiality is enshrined in the regulatory psychotherapeutic organisations’ codes of ethical practice.

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Psychotherapy Models

May 20, 2009 by Leave a Comment

There are several main broad systems of psychotherapy:

  • Psychoanalysis – the first practice to be called a psychotherapy. It encourages the verbalisation of all the patient’s thoughts, including free associations, fantasies, and dreams, from which the analyst formulates the nature of the unconscious conflicts which are causing the patient’s symptoms and character problems.
  • Cognitive Behavioural – generally seeks by different methodologies to identify and transcend maladaptive cognitions, appraisal, beliefs and reactions with the aim of influencing destructive negative emotions and problematic dysfunctional behaviors.
  • Psychodynamic – is a form of depth psychology, the primary focus of which is to reveal the unconscious content of a client’s psyche in an effort to alleviate psychic tension. Although it has its roots in psychoanalysis, psychodynamic therapy tends to be briefer and less intensive than traditional psychoanalysis.
  • Existential – is based on the existential belief that human beings are alone in the world. This aloneness leads to feelings of meaninglessness which can be overcome only by creating one’s own values and meanings.
  • Humanistic – emerged in reaction to both behaviourism and psychoanalysis and is therefore known as the Third Force in the development of psychology. It is explicitly concerned with the human context of the development of the individual with an emphasis on subjective meaning, a rejection of determinism, and a concern for positive growth rather than pathology. It posits an inherent human capacity to maximise potential, ‘the self-actualing tendency’. The task of Humanistic therapy is to create a relational environment where this tendency might flourish.
  • Brief Therapy – is an umbrella term for a variety of approaches to psychotherapy. It differs from other schools of therapy in that it emphasizes (1) a focus on a specific problem and (2) direct intervention. It is solution-based rather than problem-oriented. It is less concerned with how a problem arose than with the current factors sustaining it and preventing change.
  • Systemic Therapy – seeks to address people not at an individual level, as is often the focus of other forms of therapy, but as people in relationship, dealing with the interactions of groups, their patterns and dynamics (includes family therapy and marriage counselling).
  • Transpersonal Therapy – addresses the client in the context of a spiritual understanding of consciousness.

There are hundreds of psychotherapeutic approaches or schools of thought. By 1980 there were more than 250. By 1996 there were more than 450. The development of new and hybrid approaches continues around the wide variety of theoretical backgrounds. Many practitioners use several approaches in their work and alter their approach based on client need.

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Exercise Addiction

May 20, 2009 by Leave a Comment

Some athletes suffer from a subtle form of eating disorder that results in excessive and addictive exercise in an attempt to control or lose weight. Addictive exercisers may use extreme training as one way to expend calories and maintain or lose body weight in the attempt to improve performance or achieve a desired body shape or weight, these problems can be solved through psychotherapy. They often justify their behaviour by believing a serious athlete can never work too hard or too long at their sport. Discomfort, pain or even injury will not keep an exercise addict from training.

When confronted about this excessive exercise, they may insist that if they didn’t work this hard, their performance would suffer. They also tend to cling to the false belief that even the smallest break from training will make them gain weight and unable to compete at the same level.

Many compulsive exercisers have behaviours similar to drug addicts. The athlete no longer finds pleasure in exercise, but feels it is necessary. It is no longer a choice; it has become an obligation. While exercise may provide a temporary feeling of well-being or euphoria, the athlete requires more and more exercise to reach this state. If he is forced to miss a workout, he will report overwhelming feelings of guilt and anxiety, similar to withdrawal symptoms.

While some researchers report that excessive exercise causes the body to produce endorphins (hormones secreted by the pituitary gland that block pain, decrease anxiety and create feelings of euphoria) there is still debate about whether one can become physiologically addicted to exercise. Endorphins are, however, chemically similar to the highly addictive drug morphine, so addiction to exercise is not beyond the realm of possibility. For many athletes, compulsive exercise appears to be psychologically addictive. Such athletes report that reducing their amount of exercise suddenly often results in bouts of severe depression.

Warning Signs of a Compulsive Exerciser

· You suffer symptoms of overtraining syndrome.

· You force yourself to exercise even if you don’t feel well.

· You almost never exercise for fun

· Every time you exercise, you go as fast or hard as you can.

· You experience severe stress and anxiety if you miss a workout.

· You miss family obligations because you have to exercise.

· You calculate how much to exercise based on how much you eat.

· You would rather exercise than get together with friends.

· You can’t relax because you think you’re not burning calories.

Compulsive exercise is as dangerous as food restriction, binging and purging, and the use of diet pills and laxatives. Compulsive exercise can quickly lead to more serious types of eating disorders including anorexia and bulimia as well as a number of serious physical dangers including kidney failure, heart attack and death.

Compulsive exercise is a serious health concern that often requires the intervention of someone close to the athlete such as a coach, teammate or family member who recognizes these warning signs and seeks professional help. If you suspect someone close to you is exercising compulsively you can help by learning more about this condition and talking openly with the athlete about getting appropriate professional help.

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Mental Health

May 20, 2009 by Leave a Comment

Mental health can be seen as a contunuum, where an individual’s mental health may have many different possible values. Mental wellness is generally viewed as a positive attribute, such that a person can reach enhanced levels of mental health, even if they do not have any diagnosable mental health condition. This definition of mental health highlights emotional well-being, the capacity to live a full and creative life, and the flexibility to deal with life’s inevitable challenges. Many therapeutic systems and self-help books offer methods and philosophies espousing strategies and techniques vaunted as effective for further improving the mental wellness of otherwise healthy people. Positive psychotherapy is increasingly prominent in mental health.

Mental health can also be defined as an absence of a major mental health condition (for example, one of the diagnoses in the Diagnostic and Statistical Manual, IV) though recent evidence stemming from positive psychology suggests mental health is more than the mere absence of a mental disorder or illness. Therefore the impact of social, cultural, physical and education can all affect someone’s mental health.

Mental health can be socially constructed and socially defined; that is, different professions, communities, societies and cultures have very different ways of conceptualizing its nature and causes, determining what is mentally healthy, and deciding what interventions are appropriate. Thus, different professionals will have different cultural and religious backgrounds and experiences, which may impact the methodology applied during treatment.

Many mental health professionals are beginning to, or already understand, the importance of competency in religious diversity and spirituality. A person is the sum of all his/her experiences as well as their biological inheritence. Therefore, psychotherapy should look at all these aspects of a persons life in order to understand the background to the issues that a patient presents.

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Couples Counselling

May 20, 2009 by Leave a Comment

Relationship counseling is the process of counselling the parties of a relationship in an effort to recognise and to better manage or reconcile troublesome differences and repeating patterns of distress. The relationship involved may be between members of a family or a couple, employees or employers in a workplace, or between a professional and a client.

Couples therapy is a related and different process which can help couples with relationship difficulties. It may differ from relationship counseling in duration. Short term counselling may be between 1 to 3 sessions whereas short term couples therapy may be between 12 and 24 sessions. An exception being ‘brief’ or ‘solution focussed’ couples therapy. In addition, counselling tends to be more ‘here and now’ and developing new coping strategies. Couples therapy is more about seemingly intractable problems with a relationship history, where emotions are the target and the agent of change.

Before the relationships between the individuals can begin to be understood, it is important for all to recognise and acknowledge that everyone involved has a unique personality, perception, set of values and history. Sometimes the individuals in the relationship adhere to different value systems. Institutional and societal variables (like the social, religious, group and other collective factors) which shape a person’s nature, and behaviour must be recognised.

Most relationships will get strained at some time, resulting in their not functioning optimally and producing self-reinforcing, maladaptive patterns. These patterns may be called negative interaction cycles. There are many possible reasons for this, including insecure attachment, ego, arrogance, jealousy, anger, greed, psychotherapy, poor communication/understanding or problem solving, ill health, third parties and so on.

Changes in situations like financial state, physical health, and the influence of other family members can have a profound influence on the conduct, responses and actions of the individuals in a relationship. Often it is an interaction between two or more factors, and frequently it is not just one of the people who are involved that exhibit such traits. Relationship influences are reciprocal, it takes each person involved to make and manage problems.

A viable solution to the problem and setting these relationships back on track may be to reorient the individuals’ perceptions and emotions, how one looks at or responds to situations and feels about them. Perceptions of and emotional responses to a relationship are contained in a mental map or a love maps. These can be explored collaboratively and discussed openly. The core values they comprise can then be understood and respected or changed when no longer appropriate. This implies that each person takes equal responsibility for awareness of the problem as it arises, awareness of their own contribution to the problem and making some fundamental changes in thought and feeling.

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Anorexia

May 20, 2009 by Leave a Comment

Anorexia nervosa is characterized by an irrational dread of becoming fat coupled with a relentless pursuit of thinness. People with the eating disorder anorexia go to extremes to reach and maintain a dangerously low body weight. But no matter how much weight is lost, no matter how emaciated they become, it’s never enough. The more the scale dips, the more obsessed they become with food, dieting, and weight loss. The key features of anorexia nervosa are:

• Refusal to sustain a minimally normal body weight

• Intense fear of gaining weight, despite being underweight

• Distorted view of one’s body or weight, or denial of the dangers of one’s low weight

There are two types of anorexia. In the restricting type, weight loss is achieved by restricting calories. Restricting anorexics follow drastic diets, go on fasts, and exercise to excess. In the purging type, people get rid of calories they’ve consumed by vomiting or using laxatives and diuretics.  Anorexia is most common in adolescent girls and young women, with a typical age of onset between the ages of 13 and 20.

The difference between dieting and anorexia

Many factors influence this destructive progression from healthy dieting to full-blown anorexia. For many anorexics, self-starvation is a way to feel in control. People with anorexia may feel powerless in their everyday lives, but they can control what they eat. Restricting food is a way to cope with painful feelings such as anger, shame, and self-loathing. Saying “no” to food, getting the best of hunger, and controlling the number on the scale make them feel strong and successful—at least for a short while.

Unfortunately, this boost to self-esteem is short-lived. Anorexics believe that their lives will be better—that they’ll finally feel good about themselves—if they lose more weight. But no amount of dieting or weight loss can repair the negative self-image at the heart of anorexia. In the end, anorexia only leads to greater emotional pain, isolation, and physical damage. Therapy helps explore the underlying feelings of low self esteem through psychotherapy, their origins and how the person perpetuates negative beliefs about them self.

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