Psychotherapy and Counselling
   with Abigail Peters

Counselling and Psychotherapy in Harley Street and Paddington, Central London

There are many different types and schools of thought in regard to Counselling and Psychotherapy. You will find below information which will help to give you a better understanding of some of the ones already metioned.

COGNITIVE BEHAVIOURAL THERAPY (CBT)

Cognitive Behavior Therapy (CBT) is based on the idea that how we think (cognition), how we feel (emotion) and how we act (behavior) all interact together. Specifically, our thoughts determine our feelings and our behavior. Therefore, negative thoughts can cause us distress, stress, anxiety and result in problems such as: depression, phobia's, addictions etc.

One example could be someone who, after making a mistake, thinks "I'm useless and can't do anything right." This impacts negatively on mood, making the person feel depressed; the problem may be worsened if the individual reacts by avoiding activities. As a result, a successful experience becomes more unlikely, which reinforces the original thought of being "useless."

In therapy, the latter example could be identified as a self-fulfilling prophecy or "problem cycle," it may manifest in a specific phobia generated by automatic negative thoughts and/or dysfunctional assumptions/beliefs and the efforts of the psychotherapist and client would be directed at working together to change this. This is done by addressing the way the client thinks in response to similar situations and by developing more flexible thought patterns, along with reducing the avoidance of activities. If, as a result, the client escapes the negative thought pattern, the feelings of depression may be relieved. The client may then become more active, succeed more often, and further reduce feelings of depression.

If thoughts are the cause of emotions, stress, anxiety and/or trauma, the aim of therapy is to identify those irrational or maladaptive thoughts that lead to negative emotion and identify what it is about them that is irrational or just not helpful; this is done in an effort to reject the distorted thoughts and replace them with more realistic alternative thoughts.

Cognitive therapy is not an overnight process. Even after patients have learned to recognize when and where their thought processes go awry, it can take months of concerted effort to replace an irrational thought process or habit with a more reasonable, salutary one. With patience and a good psychotherapist, however, cognitive therapy can be a valuable tool in recovery.

SCHEMA THERAPY

Schema therapy builds on cognitive therapy by identfying Schemas which are cognitive structures in one’s mind that screen, code and evaluate incoming stimuli (information) from life that impinge/impact on a person. Schemas can be seen as deep core beliefs which affect the way we perceive the world. They are rigid and can be maladaptive causing individuals to live their lives through their belief systems which are maladaptive.

An example of a Maladaptive Schema in regard to disconnection and rejection might be mistrust/abuse: The expectation that others will hurt, abuse, humiliate, cheat, lie, manipulate, or take advantage. Usually this Schema involves the perception that the harm is intentional or the result of unjustified and extreme negligence. It may include the sense that one always ends up being cheated relative to others or ‘gets the short end of the stick.’

Schema therapy is divided into two phases: a) assessment and case conceptualization and b) Schema change.

These phases aim to identify presenting symptoms by obtaining a brief, focused life history. Educating the client about schemas, triggering schemas in the safe environment of the therapeutic sessions, confronting schema avoidance, identifying schema-driven behaviours, integrating the obtained information into a coherent conceptualization of the client, distinguishing between primary, secondary, and linked schemas before targeting one or two schemas for the change process.

Schema therapy aims to target schemas using cognitive, behavioural, experential and interpersonal techniques. Schemas can be resilient and rigid and so the process needs time and dedication from both psychotherapist and client.

NLP

NLP (neuro-linguistic programming) is a form of applied psychology and can be defined as “the study of excellence.” NLP undertakes to understand the ways in which we process information from our five senses through our brain and nervous system (Neuro). Linguistic relates to the use of language and how words, symbols and gestures impact on the way we code, organize and attribute meanings to our internal representations of the world and how we communicate them internally and externally. The programming part comes from information processing and relates to the way in which experience is stored, coded and transformed. By deleting, upgrading or installing our mental software, we can change how we think and how we experience life and, as a result how we act.

NLP was born when John Grinder, a linguist, and Richard Bandler, a mathematician, asked themselves a simple yet fascinating question: What is it that makes the difference between somebody who is merely competent at any given skill and somebody who ‘excels’ at the same skill. People typically answer that question in one of two ways. Either that some people have natural gifts or talents for a particular skill, or that practice and experience is what counts.

NLP side-steps these answers by focusing not on what has made the difference in the past between two people of different abilities, but on what can be done to turn the competent person’s performance into one of excellence.

NLP proposes that there are three elements to any skill or behaviour.

First, there is the external behaviour. That is, what the person actually does and says.

Second, there is the person’s internal computation. That is, what they think and the way in which they think. And, third, there is the person’s internal state. That is what and how they feel.

Each of these three elements can be examined in detail. A movement, for example, can be reduced to the level of micro-muscle movements. An internal image can be defined by size, position, colour, contrast and so on. An internal voice by the words themselves, tone of voice, volume, location and similar. A feeling can be described by position, intensity, temperature, direction of movement.

By following this process, it is possible to build up an extremely comprehensive model of excellent behaviour. NLP doesn’t insist that you change your beliefs about the world; merely that you be prepared to experiment with other approaches.

NLP adopts some useful presuppositions such as ‘the map is not the territory.’ In other words, the description of an experience is not the same as the experience itself. We live in a world in which we pay a good deal of attention to words. We often behave as if words were a direct and undeniably accurate description of experience. NLP invites us to make a distinction between the words, and the experience they describe. One other presuppositions is ‘there is no failure, only feedback.’ When things don’t work out the way we’d hoped they would, a common response is to consider that we ‘failed.’ NLP offers and alternative view. That what actually happened is neither good nor bad, but merely information. Think back to when you learnt to drive. You almost certainly crunched the gears at some point. That didn’t mean that you failed as a driver and would never be able to operate the gearbox: it simply meant that changing gear in that particular way didn’t produce the result you wanted. You then used that information to improve the way that you changed gears.

EMDR (Eye Movement Desentization and Reprogramming)

Eye Movement Desensitization and Reprocessing (EMDR) integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies. EMDR is an information processing therapy which uses an eight phase approach.

During EMDR the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. The client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session.

Eight Phases of Treatment

The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and psychotherapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.

During the second phase of treatment, the psychotherapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.

In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions. After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the psychotherapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Although eye movements are the most commonly used external stimulus, psychotherapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the psychotherapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The psychotherapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.

In phase seven, closure, the psychotherapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.

The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is to produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.

After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioural and personal change, which are further enhanced with standard EMDR procedures.

TRANSPERSONAL PSYCHOTHERAPY

In Transpersonal Psychotherapy personal change and crises are seen to have a useful purpose in that they:

A) Act as a warning signal, as well as
B) Indicate the way for us to change, grow and unfold.

Once the crisis, stress, anxiety, trauma is over and the mental condition is stabilized there is a chance to re-examine ourselves with a view to change and grow having made unconscious material (that not consciously known to us) conscious. This involves re-assessing our motivation, sense of purpose and meaning in life and our capabilities.

Transpersonal Psychotherapy believes that behind the masks, culturally conditioned beliefs and roles of each individual lies a deeper state of being that transcends individual identities, and that the individualised self or persona is only one manifestation of this deeper Self.

“When an individual becomes a person, the beauty hidden in the individual, which is divine, develops, and the development of beauty is personality” Hazrat Inayat Khan

POSITIVE PSYCHOLOGY

Positive Psychology is a new branch of psychology which focuses on the empirical study of such things as positive emotions, strengths-based character, and healthy institutions. Research has demonstrated that it is possible to be happier, to feel more satisfied, to be more engaged with life, find more meaning, have higher hopes, and probably even laugh and smile more, regardless of one’s circumstances. Positive psychology interventions can also lastingly decrease depression symptoms.

I offer Counselling and Psychotherapy from Harley Street and Paddington, Central London and West Acton.

To arrange an appointment or if you require further information please contact me on 07961 963610 or to send me an e-mail Click Here.


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