Apps Which Help

mobilephone

Image courtesy of Stuart Miles at FreeDigitalPhotos.net

Since I can’t be with my clients 24/7, I usually suggest a few apps that they can put on their smart phones to use throughout the day. Here are a few of the ones that I suggest (unless otherwise stated, you can find them for both iPhone and Android):

1. Mindshift – an app which is useful for those suffering from anxiety issues. http://www.anxietybc.com/mobile-app (free)

2. Positive Discipline – for all your parenting needs. This app has a set of cards to help you think through possible parenting solutions.
http://www.positivediscipline.com/positive-discipline-iphone-app.html (not free)

3. Relax Melodies – great for when you need a bit of help falling asleep. You can set a timer for the soft sounds which is a bonus. (free)

4. Breathe2Relax – useful for learning to slow down your breathing
http://t2health.dcoe.mil/apps/breathe2relax (free)

5. Depression Check – helps you check the symptomology and whether they are getting better or worse. iPhone only.
https://itunes.apple.com/us/app/depressioncheck/id398170644?mt=8 (free)

6. Depression CBT Self-Help – an Android only app that gives you the CBT tools for depressive symptoms. Android only.
https://play.google.com/store/apps/details?id=com.excelatlife.depression&feature=search_result#?t=W251bGwsMSwxLDEsImNvbS5leGNlbGF0bGlmZS5kZXByZXNzaW9uIl0 (free)

7. Recovery Record – a useful app for those who are in recovery from an eating disorder or who are struggling with disordered eating/emotional eating. http://www.recoveryrecord.com (free)

When should you seek a therapist?

I was reading a blog post on Psych Central about when a person should seek a therapist.  It can be a difficult decision to make as I’ve found on some web boards where people ask about choosing therapy or whether or not to go.  People think that since they are shy or have a hard time talking to strangers that therapy won’t work.  As a therapist, I’d like to say that I won’t be a stranger to you for long – part of my job is to get to know you and to have an alliance between us.  Others worry about being judged.  This is not my job.  I’m not there to judge you.  What I am there to do is help you move in a healthier direction and we’re going to do it side by side in collaboration.  Others have been raise to just ‘buck up and get over it’.  I know that feeling.  Really.  In my family, we were raised to deal with physical illness that way (and I still fight it sometimes).  Sometimes you just need someone who will listen and work with you to find a new direction.  Someone who isn’t part of your personal life (like a friend or parent).

So, once you have figured out that you might possibly, maybe, think about going, when should you go?  I like the list that Psych Central came up with:

1.   The problem causes significant distress in your life.  Is it coming between you and your friends, your significant other?  Are you struggling to do work at school or in your job?  Have you stopped doing the things you love?  Yup, it’s time to seek help.

2. Nothing you’ve done seems to help.  I get it.  I try everything I can think of before I seek out my GP.  I don’t want to acknowledge that I can’t handle the pain.  But sometimes you have to acknowledge that the problem is bigger than you and someone else might be able to help.  Yup, it’s time to seek help.

3. Everyone in your life is sick of listening to you.  Are you becoming a broken moaning record?  Are people seemingly avoiding you because all you can talk about is your problem?  Can you focus on nothing but your problem?  While most people have friends or family who would love to help, sometimes a problem is too much for them to handle.  And that’s okay.  That’s what therapists are here for.  We won’t get sick of listening to you, and we’re trained to help.

4. You start using or abusing someone or something to alleviate your problems.  It’s tempting to have just one more drink.  It feels like it covers the pain.  But it doesn’t make it go away, and you may start to use that alcohol more and more.  Or you may feel anger.  And take it out on a significant other.  Yup, it’s time to seek out therapy.

5. People have noticed and said something to you.  It’s easy to discount what other people say…they don’t know your life.  But if you keep hearing it or you hear it from someone you have always trusted, then it’s time to look within and figure out if they are right.  What are they noticing that is so concerning?  Is it something from the above 4 reasons?  Perhaps, it’s time to find a professional to talk to.

This decision can be hard, but you can learn so much about yourself and the way you work.  There are so many possible therapists and therapies out there.  Talk to your GP, talk to a friend you know who’s seen a therapist in the past, check out the professional associations to see who is recommended.  But if you need therapy, find someone.  You don’t need to live with the pain.

Can cognitive behavioural therapy really change our brains?

The BBC website recently posted an article about the above title. It’s a good article about CBT so I thought I’d share it below.

What is cognitive behavioural therapy?
CBT is based on the idea that problems aren’t caused by situations themselves, but by how we interpret them in our thoughts. These can then affect our feelings and actions.

Situation affects thoughts, which then affect feelings and actions The way we think about a situation can affect how we feel and how we act
For example, if someone you know walks by without saying hello, what’s your reaction?

You might think that they ignored you because they don’t like you, which might make you feel rejected. So you might be tempted to avoid them the next time you meet. This could breed more bad feeling between you both and more “rejections”, until eventually you believe that you must be unlikeable. If this happened with enough people, you could start to withdraw socially.

But how well did you interpret the situation in the first place?

Common errors in thinking style
Emotional reasoning – e.g. I feel guilty so I must be guilty
Jumping to conclusions – e.g. if I go into work when I’m feeling low, I’ll only feel worse
All-or-nothing thinking – e.g. if I’ve not done it perfectly, then it’s absolutely useless
Mental filtering – e.g. noticing my failures more than my successes
Over generalising – e.g. nothing ever goes well in my life
Labelling – e.g. I’m a loser

CBT aims to break negative vicious cycles by identifying unhelpful ways of reacting that creep into our thinking.

“Emotional reasoning is a very common error in people’s thinking,” explains Dr Jennifer Wild, Consultant Clinical Psychologist from Kings College London. “That’s when you think something must be true because of how you feel.”

CBT tries to replace these negative thinking styles with more useful or realistic ones.

This can be a challenge for people with mental health disorders, as their thinking styles can be well-established.

How do we break negative thinking styles?
Some psychological theories suggest that we learn these negative thinking patterns through a process called negative reinforcement.

Spider Graded exposure can help people confront their phobias:
For example, if you have a fear of spiders, by avoiding them you learn that your anxiety levels can be reduced. So you’re rewarded in the short term with less anxiety but this reinforces the fear.

To unlearn these patterns, people with phobias and anxiety disorders often use a CBT technique called graded exposure. By gradually confronting what frightens them and observing that nothing bad actually happens, it’s possible to slowly retrain their brains to not fear it.

How does cognitive behavioural therapy work on the brain?
Primitive survival instincts like fear are processed in a part of the brain called the limbic system. This includes the amygdala, a region that processes emotion, and the hippocampus, a region involved in reliving traumatic memories.

“It seems that CBT really can change your brain and rewire it.”
Dr Paul Blenkiron, Consultant Psychiatrist

Brain scan studies have shown that overactivity in these two regions returns to normal after a course of CBT in people with phobias. What’s more, studies have found that CBT can also change the prefrontal cortex, the part of the brain responsible for higher-level thinking. So it seems that CBT might be able to make real, physical changes to both our “emotional brain” (instincts) and our “logical brain” (thoughts). Intriguingly, similar patterns of brain changes have been seen with CBT and with drug treatments, suggesting that psychotherapies and medications might work on the brain in parallel ways.

How effective is cognitive behavioural therapy?
Of all the talking therapies, CBT has the most clinical evidence to show that it works. Studies have shown that it is at least as effective as medication for many types of depression and anxiety disorders. But unlike many drugs, there are few side effects with CBT. After a relatively short course, people have often described long-lasting benefits.

“In the trials we’ve run with post-traumatic stress disorder [PTSD] and social anxiety disorder, we’ve seen that even when people stop the therapy, they continue improving because they have new tools in place and they’ve made behavioural and thinking style changes,” Dr Wild explains.

CBT may not be for everyone, however. Since the focus is on tackling the here and now, people with more complicated roots to their mental problems which could stem from their childhood, for example, may need another type of longer-term therapy to explore this. CBT also relies on commitment from the individual, including “homework” between therapy sessions. It can also involve confronting fears and anxieties, and this isn’t always easy to do. Ultimately, as with many types of treatment, some people will benefit from CBT more than others and psychologists and neuroscientists are beginning to unravel the reasons behind this.

Cognitive-Behavioural Therapy

I’m a member of the British Association for Behavioural and Cognitive Psychotherapies, and am hoping to eventually get accredited by them. So, what is CBT? According to the BABCP, CBT is a talking therapy. It has been proven to help treat a wide range of emotional and physical health conditions in adults, young people and children. CBT looks at how we think about a situation and how this affects the way we act. In turn our actions can affect how we think and feel. The therapist and client work together in changing the client’s behaviours, or their thinking patterns, or both of these.

CBT has been proven to help dramatically with depression, and I’ve used it in my own work with anxiety. There are a variety of other mental illnesses that respond well to CBT. So how does it work? CBT can be offered in individual sessions with a therapist or as part of a group. The number of CBT sessions you need depends on the difficulty you need help with. Often this will be between five and 20 weekly sessions lasting between 30 and 60 minutes each. CBT is mainly concerned with how you think and act now, instead of looking at and getting help with difficulties in your past.

You and your therapist will discuss your specific difficulties and set goals for you to achieve. CBT is not a quick fix. It involves hard work during and between sessions. Your therapist will not tell you what to do. Instead they will help you decide what difficulties you want to work on in order to help you improve your situation. Your therapist will be able to advise you on how to continue using CBT techniques in your daily life after your treatment ends.