Are you suffering from PTSD?

When people see the term Post Traumatic Stress Disorder (PTSD), many associate this with the armed forces or war veterans. PTSD was indeed first recognised in soldiers returning from war, but today the condition can be diagnosed in anyone who has experienced trauma.

When someone experiences a traumatic event in their lives, such as a sudden death in the family, or while witnessing a serious accident, they will often feel numb or they may find disruption to their sleep patterns. These symptoms are usually referred to as ‘acute stress reaction’. Most people will find these symptoms disappear after several weeks. However, when symptoms last longer than a month, PTSD could be the problem.

GPs often categorise PTSD as mild, moderate or severe, depending on the symptoms and how they are impacting a person’s life. Regardless of the category of PTSD, it is important to recognise when someone is suffering from the condition, so that they can seek help.

It is really important to remember that any traumatic event can cause PTSD. Different people will react differently when faced with trauma in their lives. Some people have very high thresholds while others will experience symptoms soon after the event.

Typical events that trigger PTSD

Traumatic events in life are unfortunately all too common. The sudden death of a family member or a close friend can be extremely disturbing. However, so too can other events that come along. A car accident for example can sometimes bring on delayed reactions, called delayed-onset PTSD. Witnessing a serious accident or a crime can also be a trigger.

One of my recent clients worked for a construction company. He was at work one day, working at height with a colleague on a scaffold. His colleague reached over the handrail, which failed, and he fell 40ft to the ground. My client rushed down to help his chum, who had suffered serious head injuries. My client came to see me four months after the accident because he was experiencing flashbacks and nightmares. He definitely had PTSD.

Witnessing a crime can also be traumatic for many people. In fact, it doesn’t necessarily have to be witnessed to become a problem. Many people who have their property broken into and personal items stolen suffer PTSD symptoms. Fear of living in the property or, in very serious cases, fear of going outside are often experienced by victims of crime.

Common symptoms

One of the most common symptoms of PTSD is when someone relives aspects of the event. Flashbacks and the feeling that the event is happening again can be very disturbing. Nausea and trembling while recalling the event are important signs that something is wrong.

Feeling on edge is another symptom that should not be ignored, especially when there are feelings of panic when reminded of the event. Hypervigilence is common too, which is often described as a ‘constant state of alertness’. This is often accompanied by being jumpy or easily startled.

Another serious symptom that can follow traumatic events is the feeling of being unsafe. Many people think they can’t trust anyone anymore, while others feel that the world has become unsafe or unhealthy. Blaming themselves for what happened is another very common symptom, which, if left untreated, can be very harmful.

Complex PTSD

If someone experiences PTSD symptoms while also suffering from associated issues, such as anxiety, depression or self-harm, their condition may be classed as ‘complex’. Although not a definitive list, complex PTSD can be caused by; ongoing domestic violence or abuse, childhood abuse, being a prisoner of war, repeatedly witnessing trauma or violence, neglect or abandonment.

People who suffer trauma at an early age can sometimes experience complex PTSD in later life, particularly if the trauma lasted over a long period of time or if the child was harmed by someone close to them.

Complex PTSD needs careful and planned treatment and therapy, possibly for many months and even years.

Therapies for PTSD

Trauma-focussed cognitive behavioural therapy (TF-CBT) is a very important treatment for PTSD. Adapted from CBT, this type of therapy was developed 25 years ago to help children recover from early trauma. Essentially, the technique aims to help those who have suffered from trauma to learn to recognise their symptoms and to learn coping strategies.

There are three distinct phases of treatment with TF-CBT. The first phase, known as stabilisation, involves teaching the client about trauma; what it is and how it affects us. Relaxation techniques is an important part of this phase too.

The second phase is to recreate the trauma, through a trauma narrative. This is done while allowing the client to explore their feelings and emotions during the recreation. Many think this is a negative thing but recalling the event while thinking about emotions can be extremely positive. Talking through the event is a really powerful way to help a person.

Finally, phase three consolidates the lessons learned from the first two phases, while continuing to build coping skills.

A short questionnaire to help diagnose PTSD

Proper diagnosis of PTSD can only be carried out by a trained and experienced therapist or doctor. However, there is a useful set of questions to help assess whether PTSD might be an issue.

Take the simple test to find out if you are suffering from the symptoms of PTSD.

I would love to hear if anyone has tried trauma-focussed CBT as a therapy.

 

 

 

How to build mental health resilience in the workplace

Public awareness of mental health and wellbeing has never been greater. On television, in newspapers and online, there are daily references to mental health and its impact on people, employers and on society.

This is great news, because talking about mental health is an important step towards really helping people. The more we talk about the subject, the less taboo it will become. However, we still have an awful long way to go.

Business leaders are taking this seriously too. Almost weekly, I get a call from a company asking what they need to do to put in place a mental health and wellbeing strategy. This is really good news, because it shows that the message is getting through to employers.

In this post, I don’t want to reel off statistics and data, suffice to say mental ill-health is now at the top of the list when it comes to time lost at work. Instead, I would like to spend a little time discussing the main things a company should do to help their employees.

I believe there is a six-stage approach to building mental health resilience in the workplace. Put simply, the six stages are:

  • Identify the risk: the baseline
  • Pledge support: the commitment
  • Develop a plan: the journey
  • Champion the cause: the support
  • Coach leadership: the change
  • Providing support: the counsellor

Identifying the risk: the baseline

The first thing that employers need to do is to identify whether or not they have a problem. A company may have perfectly happy employees, who are all fulfilled at work and who thrive on their daily challenges.

At the other end of the spectrum, a company may have a very negative culture, with high absenteeism, and with some of their employees on the brink of collapse.

The first step is to identify the risk. Is your company at one end of the spectrum or somewhere in the middle? You need to know where you are so that you can plan your journey for improvement.

There are many ways to identify the risk. The simple approach is to ask employees to complete a mental health and wellbeing questionnaire. There are some very good off-the-shelf questionnaires that will help categorise where the risk lies. However, I don’t think questionnaires on their own are effective. I much prefer a combination approach; completing questionnaires and one-to-one sampling of the workforce. A properly trained interviewer (usually a counsellor or psychotherapist) can glean a huge amount of information during a ten-minute one-to-one session with an employee.

The output from the questionnaire and from the sampling will provide an accurate picture of the level of risk within the company. More importantly, it will show which areas are weak.

Pledge support: the commitment

Next comes the pledge. Let’s hear it from the boss. It is incredibly important for top management to address mental health in a proactive manner. They need to pledge support and they need to commit to a policy. I find a one-page policy on wellbeing works nicely. It is something that can be published across the company for all employees to see. The pledge needs to be signed by the top dog.

A policy and pledge should clearly show that mental wellbeing is high on the company’s agenda. It should show commitment from the boss, and it should include something about early intervention and securing appropriate funds to finance wellbeing initiatives. The policy should challenge the stigma of mental ill-health by committing to raising awareness across the company.

Develop a plan: the journey

The third stage is to plan. Armed with information from the baseline survey, the journey for improvement needs to be planned and documented. The journey starts here.

It is a great idea to set up a consultation group to help develop the plan. The consultation group should consist of volunteers from across the company and should include representatives from senior management, from line supervision, representatives from each department and from trade unions too.

I have a few corporate clients where I chair their consultation group. We meet every quarter to discuss progress against the plan. It is a wonderfully positive meeting, full of enthusiasm and support. It always amazes me how innovative people can be. A few months ago, I sat and listened to a group discussing how to promote life-work balance. Suddenly, someone exclaimed: “We could use the WELL concept.” All eyes turned to the lady as she described her idea. She suggested putting together a company-wide initiative, using a themed approach, around the concept of Work, Engage, Learn, Live. Amazingly simple, but they have now embraced the WELL concept and everywhere you go across the company’s sites you can see posters that explain how to work, engage, learn and live.

Champion the cause: the support

The phrase ‘mental health first aid’ is doing the rounds at the moment. I think this is a wonderful thing. If an employee cuts their finger while at work, they would pop along to the first-aid station to get a plaster and a bit of TLC from the local first-aider. However, if an employee is close to emotional breaking point, who do they turn to?

Training mental health first aiders is an essential stage in building workplace resilience. Properly trained people, who can offer support to employees, can be invaluable.

Every company should have at least one Mental Health Champion. I advise the 1:50 ratio; there should be one properly trained champion for every 50 employees. Mental health and wellbeing champions are there to advise management and to offer emotional support to employees when needed.

I conduct a lot of training courses but my favourite course is the Mental Health Champion course. Delegates on the three-day course are enthusiastic and motivated, and it is a complete joy to be helping them to discover the huge rewards from being a mental health champion.

Most people don’t know what to do if a colleague is on the brink of emotional crisis. These courses teach how to recognise when a person is in need of support and how best to support them. Active listening is a key skill when dealing with emotional wellbeing and these courses teach this important skill that can be used in and out of work.

Coach leadership: the change

Who ‘controls’ the workplace? Is it the man or woman at the top of the tree?

Undoubtedly, the person who controls the company is the Managing Director or the Chief Operating Officer, but do they really influence attitudes and behaviours at the coal-face?

A few weeks ago, I was involved in carrying out a baseline mental health survey of a large international manufacturing company. I asked one of the shop floor workers, “when did she last talk with the COO?” To my surprise, she told me she had no idea who that person was, let alone having ever met them. I interviewed the COO a few days later and asked him why the majority of people in his company had no idea who he was. His reply was simple. He said: “I crunch numbers, I secure funding, and I make sure we have enough money in the bank to pay salaries at the end of each month. I employ supervisors to run the business and to manage people, so nobody needs to know me.” Interesting point, I said.

Now, whether you agree or disagree with that COO’s idea of running a business is clearly open to debate. But, he did make an interesting point. How can he possibly know 6,800 people? Supervisors and line managers know more about their teams than anyone else in the company. It is their job to look after the wellbeing of their teams. Ironically, these are the very people who can cause most damage to a person’s mental wellbeing. Poor management and poor leadership skills can wreak havoc with a person’s mental state of mind.

How many supervisors come up through the ranks, from shop floor to management positions? Most of them. But how many of them have been trained in the people-skills that are so important in today’s world? Not many.

I worked with a company last year where I got to know most of the supervisors quite well. One guy had been an electrician in the company for 20 years. He knew more about the electrical systems in that firm that anyone else. He was a very skilled tradesman. Then he was promoted to supervisor! Disaster.

That poor electrician quickly went from a position of expert to a position of incompetence. His management skills, or lack of, had a huge effect on his team. His staff were stressed out, absenteeism in his department was the highest across the company and the team’s reputation went spiralling out of control. Why? Because senior management had promoted someone on the merit of his skill and not on his management abilities. He was completely oblivious to the damage that he was causing. He became depressed and was prescribed medication from his GP.

All levels of supervision and management need to be trained in ‘managing people’. Getting the best from your staff, in a safe and healthy way, is a skill that cannot be achieved without proper training and coaching. That is why this stage in the wellbeing journey is so important.

Providing support: the counsellor

Sometimes, all the proactive stuff just isn’t enough. Sure, it is always better to fix the cage before the tiger escapes, but sometimes the lock on the cage door is just too rusty and it is a matter of time before escape is inevitable. When the tiger gets out, we need to have contingencies to find it and to return it safely to its enclosure (with a new lock on the door). Okay, enough of the tiger analogy. The important thing here is for employers to recognise that sometimes being reactive is okay.

Employees should be provided with the opportunity to get help when they need it. Every employer should set up an employee support system, so that employees can discuss their personal issues with a trained counsellor or psychotherapist. This is an absolutely essential aspect of building resilience in the workplace.

And so, that is it. The six-stage approach to building mental health resilience in the workplace. It is important for employers to start their journey by identifying the level of risk. They need to pledge support and they need to set out a detailed plan for improvement. Training mental health champions and first aiders is vitally important, and so too is the need for leadership training and coaching. Finally, access to a counselling service for staff needs to be in place. If a company were to put all of these things in place, they will be well on the way to keeping their workforce safe and healthy.

If anyone has experience of building mental health and wellbeing resilience in the workplace, I would love to hear from you. Let me know what worked, what didn’t work, and the challenges along the way.

For more information on the things discussed in this post, please visit our website.

 

 

 

 

 

Can you beat stress with a wellbeing device?

I must admit, I am a gadget junkie. I love smartphones, ipads, fitbits and anything else I can get my hands on. But I had never really thought much about stress-relieving gadgets, until one of my clients started to wax lyrical about her ‘stress balancing bracelet’. I couldn’t resist, so I bought one to try out.

We all know that stress can affect our quality of life. But sometimes, it can be difficult to see exactly where stress is coming from. Does it peak during our daily commute to work, is it something to do with an irritating work colleague, or perhaps it is something related to home life? More often than not, it is a combination of many factors.

Wouldn’t it be nice if we could track our stress levels as the day, weeks and months go by? Maybe that way we could see what, where and when our stress levels peak. Well, this is all possible with one of the many stress monitors that are on the market.

But first, a word of caution. I am a psychotherapist and, as such, would never advocate substituting professionals counselling for a device that is worn on the wrist, or on any other part of the body. Having said that, I do think these devices have their place.

Stress monitor

The Wellbe Stress Balancing Bracelet is a Bluetooth-enabled unit that integrates with a smartphone app. Basically, it uses a proprietary algorithm based on your heart rate and variable heart rate to identify stress levels, and calmness, throughout the day.

The bracelet comes in various colours; cork effect, silver and black. It is lightweight to wear and the strap comes in small, medium or large. The unit charges via a USB cable, which is provided in the kit.

Setup through the Wellbe app was fairly straightforward. Downloading the app and device pairing went smoothly. Their website is quite informative and provides a couple of good videos to get you started. The videos aren’t really necessary but they provide interesting background to the device.

Finally, after setting up the  basics, you will need to take baseline measurements, but the app and the device provide step-by-step instructions.

The smartphone app

When wearing the bracelet, measurements are taken automatically every hour, and the app updates the data quickly. Based on your heart rate and variable heart rate your stress level is measured on a 100-point scale, from ‘calm’ to ‘high’ stress.

wellbe2

You can see real-time information on the app. The really nice thing about this device is the correlation between stress levels and time/location. For example, if your stress level peaks at, say 10.30 in the morning, you will be able to see where you were at that time. Over a period of several days and weeks, and even months, you will be able to analyse when and where you are experiencing the most stress.

Another great thing about the device is the ‘alert’ function. It will notify you if you are getting close to ‘high’ levels of stress. It will even suggest relaxation exercises. I tried the ‘ambient music’ exercise and it worked really well. According to the bracelet, I lowered my stress level from high to calm in just under ten minutes while listening to the music. Ambient music is only one of many different exercises the app will suggest for you.

In addition to the exercise suggestions, there are many podcasts to download and listen to. The bracelet will prompt you when it ‘thinks’ you need a podcast! According to the Wellbe website, there are over 30 hours of content available via their app. There is the option to subscribe to a larger collection but it is not really necessary. Thankfully, the app doesn’t bombard you with prompts to pay for a subscription and there are no in-app purchases, which is good.

Disadvantage

One of the annoying things about the bracelet, which I also find with my fitbit, is the intermittent readings. I like to wear the strap quite loose around my wrist and often the data link gets lost.  If the strap is not positioned correctly it is easy to lose data.

As always, battery technology hasn’t quite kept up. The device will only last two days before needing a charge. It is not really a problem because I put it on charge everyday when in the shower in the morning.

In conclusion, I thought the bracelet was wonderful. It is more than a toy, it can give you a really good indication about stress levels and how they vary over time. The app, in my opinion, is excellent and the vast variety of content to help alleviate stress is very good too.

The main disadvantage for me was the short battery life and the data loss. However, I think the latter is more to do with how I like to wear watches and bracelets.

Overall, a nice piece of kit. Not too expensive either; it retails in the UK for about £115. Well worth the money and I would certainly recommend it.

Take a look at the Wellbe website or Amazon for availability.

Let me know if anyone has tried a stress balancing bracelet.

 

Breathe your way to greater health

When stressed or irritated by someone or something, everyone knows to take a deep breath and count to ten. That would seem to suggest that a deep breath is somehow good at calming the brain. Well, latest research has found exactly that.

For over 2,000 years, Buddhists and yoga gurus have promoted the benefits of breath-focused meditation. Modern meditation practice usually starts with focusing on inhalation and exhalation. But it was generally considered that ‘clearing the mind’ of all thoughts was the aim of meditation and that focusing on breathing was a way to help us to clear the mind. However, latest research, carried out at Trinity College Dublin, has found an interesting connection between focused breathing and brain health.

Firstly, lets deal with the science bit. Noradrenaline is an important brain chemical, which is released when we are challenged and emotionally aroused. This chemical is the brain fertilizer because it helps to promote growth of neurons and it helps our brains to form new neuro-networks.

Although noradrenaline is an essential chemical, an incorrect balance in the brain can cause us some harm. For example, too little can result in lethargy, lack of concentration and even depression.

Now comes the interesting bit. The research carried out in Dublin found a connection between the amount of noradrenaline produced, our concentration levels and our breathing.

The team at Trinity College measured breathing, reaction time and brain activity in the brainstem (the area where noradrenaline is produced). They found that levels of noradrenaline increase slightly when the subjects focused on their breathing. In turn, concentration levels and reaction times improved when noradrenaline levels increased.

It would appear that focusing on our breath can stimulate the brainstem to produce exactly the right levels of noradrenaline, which improves our attention and concentration.

By focusing on our breathing for a few minutes each day, levels of brain chemicals can get regulated and optimised, leading to an overall improvement in concentration and the ability to focus longer and deeper on tasks.

Meditation has long-term benefits too

Our brains usually lose mass as we age. However, brain mass in long-term meditators doesn’t lose as much mass when compared to brains of non-meditators. More ‘youthful’ brains are less likely to suffer from dementia and memory loss, possibly because neuro-networks stay strong and healthy.

Meditation or mindfulness is often taught to people who have suffered brain injury and the results can be very encouraging. Neurons can be stimulated to form new connections and thus achieve partial repair.

So, there really is a connection between meditation and brain health. Yogis have been advocating this for many many years and the latest research would suggest they are correct. The team at Trinity have provided a deeper understanding of the neurophysiological benefits of this ancient concept.

Perhaps the secret to a healthy brain is indeed to practice regular breath-focused meditation.

For more on meditation, take a look at my podcasts.

 

 

 

 

 

 

 

 

 

The benefits of forest bathing

What is the main similarity between sushi and forest bathing?

They are both imports from Japan!

When sushi first arrived on the shores of the UK there was much scepticism about the food. But look at how it has taken off. Perhaps forest bathing will go the same way.

What is forest bathing?

Many people might think forest bathing is something to do with swimming in a river that flows through a forest. In fact, it has nothing to do with swimming, nor bathing. Instead, it is all about using your senses to soak up the atmosphere of a forest.

Japan is one of the most densely populated countries in the world. Surprisingly, it is also one of the most heavily forested countries too. In the 1980s, The Japanese government, concerned about high stress levels, carried out research that found a two-hour forest-bathing session reduced blood pressure and lowered cortisol levels. Cortisol spikes during periods of stress and although we need this steroid, continual high levels can be detrimental to our wellbeing.

Trees release phytoncides, which are antimicrobials. These help to protect them from insects and bacteria. The research in Japan concluded that phytoncides could have an anti-microbial effect on humans. In Japan, forest bathing, known as shinrin-yoku, was introduced as a national health programme.

More recently, the Center for Environment, Health and Field Sciences at Japan’s Chiba University, measured physiological effects of 280 people. Blood pressure, cortisol levels and pulse rates were measured during a day in the city and then compared with the same biometrics taken during an hour in a forest. The study found that forest environments promote lower concentrations of cortisol and greater parasympathetic nerve activity, which is associated with stress reduction.

Scepticism

Yes, I was definitely sceptical when I first read all this stuff about tree-hugging. And then I thought, why not give it a go. I started researching shinrin-yoku a few years ago and I am now fully hooked on the concept. I have always enjoyed walks in the forest, but I have found a whole new dimension to time amongst the trees.

Forest bathing is not simply ‘walking in the forest’. Instead, it is about allowing all your senses to experience mindfulness in nature. It is a form of meditation.

I often take small groups into the forest for art and photography therapy. One of the first things I do now is to get my group to sit down and close their eyes. I ask them to concentrate and to ‘feel’ the ground beneath their feet. After a few minutes, I ask them to concentrate on their breathing and to enjoy inhaling the scent of pine trees. Next comes sound. Concentrating on the different sounds of the forest can reveal amazing things that might otherwise be missed. Finally, after about 15 minutes, I get my group to open their eyes and look up into the canopy. I challenge everyone to find at least twenty different things. Usually they spot many more than this.

Mindfulness in nature can really help to reduce stress, and to bring about a feeling of happiness and contentment.

I would highly recommend spending some time in a forest. But don’t just walk amongst the trees, instead enjoy all they have to offer the senses. You could even end your forest bathing session with a Japanese tea ceremony, which involves taking tea infused with foraged nettles, pine needles or blackberries. The first cup is traditionally offered to the forest, as a thank you.

Let me know if you have tried forest bathing and mindfulness in nature.

 

 

 

 

 

Get rid of the toxic people from your life

How many times do you get to work in a really positive mood, thinking the world is at your fingertips, only to find that your enthusiasm and energy is sucked out of you before you’ve had your first cafe latte of the day?

I worked with a woman who spent the first 20 minutes each morning ‘offloading’. I would get to work about an hour before Wendy (not her real name), and I would often sit at my desk really pleased with life and enthusiastic about the day ahead. I would dream about my successes and I would enjoy being me. Then Wendy would come in!

Wendy saved up all her troubles from the day before so that she could offload each morning. She wouldn’t talk to me or with me, no, she would talk AT me. Wendy would rant about other people and how they were stupid, incompetent and how they were making her life miserable. I would eagerly wait for Wendy to shut up. Left deflated, I would rush out for a double espresso in a full fat latte – with a triple chocolate muffin on the side.

Wendy sucked the energy from me. Wendy was a toxic person.

Interestingly, I had a psychotherapy session with a client a few weeks ago. She is desperately trying to succeed in her job and she is very ambitious. However, every day she seems to burn out quickly; her energy and enthusiasm dissipates by mid-morning. Thinking she was ill, she visited her GP but thankfully there was nothing physically wrong with her. During our session it became obvious what the problem was; she worked with a Wendy! The toxicity from her colleague was sucking the energy from her and was causing her great anxiety.

I thought it might be a nice idea to reflect on my session with my client and put some thoughts together about toxic people. They really can cause harm.

If you work in an office, especially an open plan office, take a few minutes to listen to people around you. How many of them, while on the phone or talking to a colleague, are negative? How many people criticize others, complain about other people and generally rant about how hard their lives are being make by other people? They are all toxic!

How many toxic people are sucking your enthusiasm?

It is not the person that is toxic – it is their behaviour

If you want to succeed in life it is important that you remain enthusiastic and motivated. It is equally important that you recognise things that might be negatively affecting your enthusiasm. It is important to recognise toxic people in your life. Sometimes you can’t get rid of them completely and rarely will you be able to change them, but it is important that you recognise them and recognise their impact on you.

Whenever I have a life coach session with one of my clients we talk about ‘developmental blockers’. These are things that are blocking you from achieving your goals. Developmental blockers can often be people – toxic people in particular.

It is not the person that is toxic, it is their behaviour. Sometimes people offload onto others because they haven’t been able to accept their particular situation, therefore everything and everyone else is to blame. They cherish the opportunity to rant to another person about their crisis. They are usually in much need of therapy but they haven’t recognised this in themselves. So, they offload onto others.

Most toxic people are indeed in crisis. They create dramas in their lives so that they can become the center of attention, thereby manipulating others. They try to get their needs met through criticism of others and through bemoaning their bad fortune. Just think about some people you work with or people you know.

Often, toxic people will leave you drained of energy, sometimes you might compromise your own values when talking to them. It is really important, for your own survival and success, to recognise your role in the interaction with toxic people, so that you can acquire defence mechanisms.

Typical traits of toxics

Do you know a toxic person? Think about people in your life who might show some, or all, of the following.

Toxic people are manipulative. They want to use other people to accomplish their own goals and objectives. Nothing is equal in their relationships though, it is all about them and their terms.

Toxic people are highly judgemental. They will be the first to criticise others while never accepting their own faults. They never apologise.

Taking responsibility for your own feelings is a wonderful trait to have. However, toxics will never do this. They will blame others for their own feelings. They are always the victim and they will use their victim status to seek sympathy from others.

One of the most interesting aspects of a toxic person’s behaviour is their ‘divide and conquer’ attitude. They will almost always want to make you chose them over someone else.

Have you ever had the feeling that you need to defend yourself and your actions when talking to a colleague at work? Well, that is not surprising because toxic people will shoot your ideas down quickly, and they will seldom be interested in your point of view.

Whenever I talk with my clients about relationships they have with other people some key phrases come up time and time again. My clients often say things life “I feel emotionally wiped out after speaking to her” and “I am left frustrated and unfulfilled”. These are common feelings when working with toxic people. They can drain your enthusiasm, leaving you feeling inadequate and unworthy.

Surviving toxic behaviour

Researchers in Germany, from the Department of Biological and Clinical Psychology, found that exposure to negative stimuli caused their subjects’ brains to show massive stress responses. They concluded that whenever we are subjected to something negative our brains treat this as a stress. Electrical energy in our brains change, which affects our short-term mood. So, unbeknown to us, these toxic people are actually having a biological effect on us.

We can’t avoid toxics, they are everywhere. But we can develop strategies to neutralize their effect on us. Here are a few suggestions.

If you were to sit next to someone who blew cigarette smoke in your face, would you continue to sit and take it? No, of course not. Yet, you might be willing to sit and listen to a negative person while they wallow in their problems. It can seem rude to stop them but there is a fine line between being helpful by listening and getting the life drained out of you. Ask them, very directly, how they are going to fix their problem. See what happens when you do this. Toxics don’t like to come up with solutions, so asking them how they are going to solve their problem can have a dramatic effect.

I often suggest to my clients that they think of themselves as a counsellor. When listening to a toxic rant, imagine yourself as their therapist. You listen intently and try to put yourself into their world. At the end of the session, think about how different (and good) your world is compared to their one. This technique is called distancing and it helps to put a barrier between their life and your own.

Recognition of your own emotions is critical. Think about your own emotions. Are you getting wound up by the person’s rant, or are you near to breaking point? Are you praying that the floor opens up so that you can get a break from the barrage of negativity. Recognition of your own feelings while listening to others can work wonders for your own sanity. It actually puts you on a higher plane than your speaker. This is another form of distancing.

Where you focus your attention will determine your emotional state. If you think negatively, your brain’s neurons will make connections that store those negative thoughts. This is why cognitive behavioural therapy is a wonderful tool, because it changes your thought process – more on this later. You can use a similar technique while listening to a toxic. While they moan and groan in their negativity, you need to turn those thoughts into positives. For example, while they go on about a colleague, in your own mind you should picture the colleague and think about positive things about her, things that you like and admire about her. You could reflect these back to the toxic to see how she reacts. Distancing yourself and your world from the toxic’s world is a crucial element of maintaining your sanity.

Toxic folk can be good for us

You know, I actually learned a lot from working with Wendy. I certainly learned how to distance myself so that her world was kept very separate from my (nice) world.

I need to catch up with my client to see how she is getting on with her colleague.

I would love to hear your tales about toxic people you might know.

 

 

 

 

 

 

 

 

Migraines are a real pain – can hypnotherapy help?

Most people have suffered from a headache at some time in their lives. Usually, the pain is mild and a couple of painkillers is often enough to block out the pain so that normal life can resume. However, migraine headaches are quite different. Sufferers quite often have to stop what they are doing and hide away in a darkened room until the worst of the episode passes.

The pain from a migraine can feel like the temples are going to explode. some people say the pain is like a garden rake scraping over their eyes and head. Some have said that their head feels like a balloon that is overfilled with air and is about to burst.

Many migraine sufferers get a feeling of being washed out and drained of energy after an attack, looking pale and feeling tired for a day or two after an episode.

Migraine has been recognised as a medical condition for centuries. Unfortunately, it is a complex disorder and medical science is not able to offer definitive reasons why some people suffer from the condition. We know that as many as 20% of the population are affected, with women three times more likely to experience migraine than men.

Thankfully, migraine attacks are not life threatening, although to many sufferers the condition can seem like the end of the world. One of the biggest problems with migraine is that you can never really predict when an attack will occur. A person could be driving, going off on holiday, about to pick up the kids from school or about to go our for a meal with friends when the dreaded migraine strikes.

The sequence of events

Research has helped us to understand what happens during a typical migraine. Some people notice that they yawn a lot more in the hours leading up to an episode while others say they have lots of energy. Some crave certain foods. These unusual signs may be experienced a few hours before a migraine comes on, or they can be experienced a day before.

Migraine headaches can be classed in two different ways; with aura and without aura. The ‘classic’ migraine usually starts with some sort of visual disturbance, referred to as an ‘aura’. About 25% of sufferers know that a migraine is starting because they notice a disturbance in their vision. Many of my patients say their ‘eyes go funny and out of focus’ or they see ‘zig-zag lines’ that move across their eyes. Some people say they have blind spots in their vision.

The aura stage of migraine can last from a few minutes to an hour or more. This stage is usually followed by the first signs of pain in the head.

The ‘common migraine’ is when there is no aura. The attack starts with a headache, which quickly develops into a thumping pain in the right or left side of the head.

Most people experience other symptoms during the early stages of a migraine. Speech many be affected, with difficulty forming words. Some people have a tingling sensation in their fingertips, which often spreads up their arms. Many people experience tingling in their tongue.

One of my patients told me that he suffers from about five migraines each year and they all follow exactly the same pattern. They start with a visual disturbance that lasts about 20 minutes, followed by difficulty speaking. He gets tingling in his fingers and tongue and then the headache starts, mild at first but it quickly develops into a thumping pain in either his left or right temple. He feels completely drained for the next 24 hours.

Similar symptoms to a stroke

Some of the symptoms of migraine can be frightening, particularly the speech problem. Often referred to as ‘migraine babble’, this part of the migraine cycle is one of the most noticeable signs that a person is experiencing something untoward. Speech problems, or transient aphasia, probably occurs when blood vessels over-dilate, which is thought to be the main cause of migraines. Different parts of the brain are affected by over-dilation, which partly explains why many people get these unusual symptoms.

Understandably, some people are afraid that their migraine is a symptom of a stroke. The good news is that there is little evidence to suggest that a stroke is more likely to occur during a migraine. A stroke is when a blood vessel in the brain in either blocked so that oxygen is prevented from getting to brain tissue, or that a blood vessel bursts inside the brain. Migraine is neither of these two things.

Trigeminovascular theory of migraine

So what causes a migraine?

The answer to this question is not an easy one. For many years, it was believed that over-dilation of blood vessels in the brain caused migraine pain. However, over-dilation doesn’t quite explain why the attack occurs.

Research has shown that electrical changes that go across the brain are linked to the early stages of migraine, particularly the aura effect. This wave of electrical activity is quickly followed by what is called ‘spreading cortical depression’ and it is during this phase that constriction of blood vessels occurs. Studies have shown that as the waves of spreading depression pass over the brain there is a drop in oxygenation of that segment of the brain. Thankfully, the drop in oxygen levels doesn’t last long, only until the wave of electrical energy passes over. This could explain why some of the symptoms that migraine sufferers experience are similar to those of a stroke victim.

There is also evidence of brainstem activation at the beginning of a migraine, and there is strong evidence that migraine is linked with abnormally excitable neurons in the trigeminal nerve. In summary, something may trigger abnormally excitable neurons to fire, which causes a wave of electrical energy to pass over the brain, resulting in constriction of blood vessels and a drop in oxygenation.

What excites the neurons?

So, what causes the over-excitement of these neurons? Various things can do this, including low magnesium, abnormal calcium channels or inherited brain chemical abnormalities.

Regardless of the scientific pathology, it is generally accepted that migraines are started by ‘triggers’. Some people are more susceptible to certain triggers than others. But the story about triggers is complex too. A person exposed to one of their known triggers might not be enough to start a migraine. For example, red wine is thought to be a common trigger. A person who is susceptible to red wine may drink a glass every day for a year and never have a migraine. We know that more than one trigger is usually needed.

I often talk about ‘tipping the balance’. Imagine if red wine is one of your triggers. You might drink a glass with no effect. However, if you had a glass of red wine on an empty stomach after driving a long journey following a few days of lack of sleep or sleep disturbance, you may have tipped the balance and, hey presto, a migraine is triggered.

All of those things mentioned above can be triggers. I classify triggers in nine categories: lack of food, specific foods, sleep disturbance, stress and anxiety, exercise (not enough or sudden bursts), long travel journeys, changes in the environment (lighting, noise), neck pain, and hormonal changes in women.

Three or four of the above occurring together may be the root cause of a person’s migraine. That is why it is such a good idea to keep a migraine diary. Whenever I have a patient who needs treatment for migraine, I always ask them to keep a diary so that we can discuss their habits and lifestyle at their first appointment.

Can migraine be treated?

Some people are prescribed preventative medication by their GPs. These can have varying degrees of success. Beta-blokers, serotonin antagonists and tricyclic antidepressants are common drugs that are known to help migraine sufferers. However, they can take more than three months to start working and they often have unwanted side effects.

A popular relief medication that is available over the counter are tablets that contain sumatriptan. Taken as early as possible whenever a migraine is noticed, this medication can help reduce the effects of an attack and, in some people, they can shorten the episode.

But medication is not the cure, it is merely a sticking plaster to help relieve the symptoms. To get to the root cause of migraine another approach is needed. One very successful therapy is hypnosis. Treating and preventing chronic migraine headaches with hypnosis is a cost-effective alternative to drugs. Hypnotherapy doesn’t just help relieve the acute symptoms such as pain, it can also help stop migraines completely, by looking at the underlying reasons why migraines are occurring.

Two uses of hypnotherapy to treat migraine

There are two uses of hypnotherapy in the treatment of migraine. Firstly, self-hypnosis is a technique to help patients deal with the pain when an attack does occur. Teaching self-hypnosis can be a wonderful alternative to using painkillers. Patients are taught how to induce a deep state of relaxation whenever a painful headache comes on. Some of my patients say that 20 minutes in a self-hypnotic state usually takes the pain away completely.

Secondly, and more importantly, is the use of hypnotherapy as a way to treat the underlying cause of migraine. Stress and anxiety are two of the most common triggers of migraine and so it is important to treat these properly. A migraine is the body’s way of telling us something is wrong. It is something abnormal. However, the conscious mind might not be able to understand exactly what is wrong. I will talk about the conscious and subconscious mind in later posts.

Hypnotherapy is a gentle and powerful way to reach into the subconscious mind to understand why migraines are being triggered. There is a reason why people have migraines. Neuroscience can help explain the ‘what’ but it cannot fully explain the ‘why’. The subconscious mind has most of the answers but it is only accessible through deep relaxation and through hypnotherapy. By discovering the underlying reasons for migraine, the patient can be helped to eliminate them completely.

I hope you enjoyed this brief insight into migraine headaches. I would love to hear your stories about migraine and how you manage to cope with this debilitating condition.

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