Category Archives: Basic & General

Client Factsheet: Hypnotherapy / 客户须知:催眠治疗

Basic & General, Hypnosis & Hypnotherapy, , , , ,

The more you understand hypnotherapy, the more effective it is likely to be.  If there are any points below which you don’t agree with, or don’t understand, please discuss them with your therapist.

  • Hypnosis is a special way of using various naturally-occurring psychological and physiological states.  It’s a collaborative process in which you allow yourself to follow the guidance of the therapist by using your imagination to evoke positive emotions and rehearse behaviour change.
  • Everyone can, in principle, be hypnotised.  It has been shown to help if you relax, think positively, and imagine the things being suggested.
  • Hypnotic “trance”, so-called, is an increased ability to respond to positive suggestions, usually accompanied simply by relaxed attention to the ideas being suggested.
  • Hypnosis is definitely not a state of sleep or unconsciousness.  Roughly 90% of people report being aware of everything that happens, and relaxation helps but is not essential to hypnosis.
  • Hypnosis is definitely not a state of mind control.  You cannot be made to do anything against your will.  On the contrary, normally you must want to accept suggested ideas and actively imagine responding to experience their effects.
  • Hypnosis is completely safe when used in a responsible and professional manner.  Nobody has ever been “stuck” in hypnosis.
  • Comedy stage hypnosis has very little to do with clinical hypnotherapy and has been shown to foster misconceptions which can prevent people from benefiting from treatment.  Take what you see on television with a generous pinch of salt.
  • Hypnotic suggestion is a means of experiencing certain helpful ideas at a level profound enough to directly influence our emotions and behaviour.
  • Psychological and emotional problems can be seen as the result of negative thinking, whereas hypnotherapy aims to encourage (“suggest”) positive ideas which lead to improvement.
  • Hypnotherapy, except for smoking cessation, usually requires more than one session.  However, it is probably one of the briefest forms of psychological therapy, and in clinical studies the average number of sessions is around 4-6.
  • Hypnosis can help with an enormous range of different issues.  Research tends to provide most support for its use in,

1. Anxiety management.
2. Pain management.
3. Overcoming sleep disorders
4. Treating certain psychosomatic or stress-related illnesses.

However, hypnosis is also used to conquer habits such as nail-biting or smoking cigarettes, and for personal development in areas such as sports performance, public speaking, or creativity.

  • Thousands of positive experimental and clinical research studies on hypnosis have been published.  It was recognised as an effective treatment by the British Medical Association (BMA) and American Medical Association (AMA) in the 1950s and, more recently, by the American Psychological Association (for obesity) and NICE guidance (for IBS) used by the NHS.
  • Hypnosis is essentially a simple, down-to-earth, and common sense therapy.  For example, by relaxing, thinking positively, and picturing your goals, hypnosis can help you to progressively improve your habitual feelings and behaviour.

 

你越了解催眠治疗，它就越可能有效。如果以下有任何一点是你不同意或不明白的，请跟治疗师讨论。

  • 催眠是一种应用各种自然发生的心理和生理状态(naturally-occurring psychological and physiological states)的特殊方式。这是一个你与治疗师合作的过程 －你允许自己遵循治疗师的指导,使用想象力来唤起积极正面的情绪,并练习行为的改变。
  • 原则上，每个人都可以被催眠。它带来的好处已被验证，只要你放松，积极思考，并想象治疗师所说的暗示。
  • 所谓的催眠“恍惚状态”(trance)，是一种对正面暗示(positive suggestion)产生反应能力的增强，通常简单地伴随着对催眠建议的松散注意力(relaxed attention)。
  • 催眠绝对不是睡眠或昏迷状态。大致上90％的人都表示对过程里所发生的一切有意识;放松对催眠有帮助，但不是必须的。
  • 催眠绝对不是精神或思维的控制(mind control)。你不能被逼着做违背自己意愿的事。相反地，通常你必须愿意接受那些催眠暗示，积极地想象对这些体验产生的反应。
  • 在负责任和专业的使用下，催眠是完全安全的。从来没有人”被卡在催眠里出不来”。
  • 舞台催眠表演和临床催眠治疗没有什么直接的关系，舞台催眠表演已被证明是加深人们对催眠治疗的误解，妨碍了人们受益于催眠治疗。对于你在电视上看到的，要有所保留别尽信。
  • 催眠暗示(Hypnotic suggestion)是一种对有益想法的深刻体验，并使这些想法对我们的情绪和行为产生正面影响的一种方式。
  • 心理和情绪上的问题可以被看作是消极负面思维的结果，而催眠治疗的目的就是鼓励（“暗示” “suggest”）正面积极的思维，从而得到改善。
  • 除了戒烟课程，催眠治疗通常需要多于一次的疗程。然而，它很可能是最短形式的心理治疗之一，在临床研究显示平均疗程大约是4-6次。
  • 催眠对一系列不同的问题都有帮助。研究倾向于显示对下列治疗最有帮助 –

1.焦虑管理 (Anxiety management)

2.疼痛管理 (Pain management)

3.克服睡眠障碍 (Overcoming sleep disorders)

4.治疗一些身心或压力相关的疾病 (psychosomatic or stress-related illnesses)

然而，催眠也可以用来征服坏习惯，如咬指甲或吸烟，以及用在自我进步或个人发展领域中，诸如运动能力，公开演讲，或创意表现。

  • 成千上万的催眠实验和临床研究已被发表。它从1950年代开始就被英国医学协会(British Medical Association)和美国医学协会(American Medical Association)确认为一种有效的治疗，在近期也受美国心理学协会(American Psychological Association, 针对肥胖）和英国NHS的NICE指南（针对IBS 大腸激躁症）所认可 。
  • 催眠本质上是一种简单的治疗。例如，通过放松，积极思考，想象你的目标，催眠可以帮助你逐步改善你平时改变不了的情绪和行为问题。

References

AMA         (1958).  ‘Council on Mental Health: Medical use of Hypnosis’, JAMA, Sep 13, 1958: 186-189.

BMA         (1955).  ‘Medical use of Hypnotism: Report of a Subcommittee appointed by the Psychological Medicine Group Committee of the British Medical Association’, Supplement to the BMJ April 23, 1955: 190-193, Appendix X.

BPS.        (2001).  The Nature of Hypnosis.  Leicester: BPS.

APA         (1997), Update on Empirically Validated Treatments, The Clinical Psychologist, 1997

 

Adapted from the Client Factsheet: Hypnotherapy, by the UK College of hypnosis and hypnotherapy, translated by Hui Bee.

Learning Psychological Flexibility since Young

Basic & General, Issues & Debates, Treatment Approaches, , , ,

Our education taught us to work so hard to​ score 96 on maths, 95 on Chinese, 100 on moral, 90 on science etc. On top of that, it’s very common in Asian countries that children are​ sent to tuition classes, music, art​, martial art​ classes etc.

We’re a generation with blessings​(?)​, nothing much to worry about, parents,​ teachers, or the government will plan the route and do the worries for us, what’s better, problems are solved before we even​ realised it.

But what if we fall? Fall so badly​?​ ​Being in big trouble? Facing major life challenges?

​Sometimes we read in the news – A teenager of 17 years old committed suicide because “my girlfriend wants to breakup with me, life is meaningless”, the other one because she is one A short to make it a straight As in SPM. We see depression, mood swing, anxiety-related problems, OCD, insomnia in younger and younger age. We thought they are supposed to be having fun at that age​, but they don’t seem to be able to have fun?!

​Why never we learnt psychological flexibility since young? Why the environment was never created to learn that since young? Why English, Maths, Science, (even) Moral, Volley ball, etc, but never about how to bounce back, how to be emotionally resilient? ​Or in other words, how to stand up when we fall? Why for over 10 years we’ve been attending schools and universities, but the educational system never taught us this?

Prevention is better than cure, but we aren’t even preventing the happening of mental disorders, quite often people only start to learn about resilience after they suffer (like our patients who wished that they knew this and that long time ago).

How do we create that kind of environment for our next generations? Where (whether positive or negative) thoughts and feelings are taken lightly; where we understand negative and positive events, thoughts, feelings are just equally likely to happen as the positive ones, so we face them all and accept them all; where we allow children to explore their feelings and thoughts during difficult times; where even a young child understand what value is and changing or persisting his/her behaviour in serving of the values; where we are able to adapt to changing environmental and situational demands and get the balance in them?

Useless Psychotherapy?

Basic & General, Issues & Debates

For some people, I’d admit yes, psychotherapy can be quite pointless for them. For example, some therapists like to keep their clients coming to see them weekly for years, and yes I mean yearS, I don’t see the point. No matter how big the issue or problem a client has, it’s barely beneficial for the client to attend therapy sessions over 2-3 years. Sometimes it gets habitual, or some clients get attached to the therapist and literally can’t live without him/her.

Psychotherapy is supposed to let clients leave with confidence to sort their own problems and live their lives, with the necessary skills, motivation and direction. Well, supposed.

But recently, I came across some medical students who think talking to their mothers or friends equal to doing CBT (Cognitive Behavioural Therapy). I don’t know what people learn in their medical degrees, but really? That’s what the mother told me. He thinks he was already having psychotherapy session after a long talk with his mother regarding his obsession and anxiety issues.

Well, I do think mothers are one of the best healers on earth, whatever their backgrounds and educational levels, they seem to be so empowered and empowering. But really? Is that all you need to get out of your OCD and anxiety? So what do we psychotherapist / psychologist / therapist do then? Go home to find our mothers and look for solution?

My two cents, try to gain a bit more knowledge before you settle down with a solution or conclusion. Sometimes you may suffer through a difficult path for many years only realizing that it was your ignorance that causes all your suffer.

N.B. Sorry for the sarcasm. It’s only applicable to a very small number of people.

Related: Is psychotherapy for me? (it doesn’t tell you what psychotherapy is)

Is it Depression or Depressive State in Bipolar Disorder?

Basic & General, Bipolar Disorder, Depression

I’ve previously written about patients with Bipolar Disorder taking only anti-depressant medication (see here for Case 1 & Case 2). As presented in these cases, quite often hypomania and mania do not lead to doctor visits, whereas usually people in depressive state will seek help, which then means that anti-depressant medications will more likely to be considered and used initially. But after a period of treatment, just like the teacher in Case 2 who thought she had recovered but all the colleagues and headmistress found her so hyper, and the man in Case 1 who refused to stop anti-depressants as they made him feel so strong, empowering and elated, these drugs could go all wrong without proper follow ups and assessments.

Anti-depressants (SSRI, Selective Serotonin Reuptake Inhibitor) such as Prozac, Lexapro, Luvox, Zoloft are some commonly used medications for anti-depressant. Sometimes they also work for anti-anxiety and treatment for obsessive compulsive disorders. When bipolar is involved, an antidepressant taken without the protection of a mood stabilizer can potentially induce mania or hypomania, and worsen the course of the illness.

So if the family members or the patient suspects that the depression is actually part of a bipolar disorder (based on patient’s presentation and past experience), it’s very important to make aware to the psychiatrist or attending clinician, so that a mood stabiliser can be used first. Even if the mood stabiliser cannot control the depressive state, it can be used in conjunction with anti-depressants, as a “protective shield” from switching to manic stage (though still, no guarantee, only reducing the chance).

Also, it usually takes at least 2 to 3 weeks for mood stabilisers and anti-depressants to kick in, and a much longer period till it becomes fully effective, sometimes seeing no effects may suggest that you need to be patient and in a month or so you will feel very different, while other times it could also suggest that you are not taking the right dosage, and this is to be judged by psychiatric doctor.

N.B. This is written by a psychologist based on her experience working with patients in psychiatric clinic (and some research); if in doubt please consult your doctor. 

本文写的是抑郁症 (depression) 与躁郁症 (bipolar disorder or manic depressive disorder) 里的忧郁的区别. 大部分时候, 狂躁 (manic) 的人都不会寻求医疗帮助, 都是在抑郁的阶段 (depressive state) 去看医生, 这样一来, 医生很可能就会用抗抑郁药物 (anti-depressant). 可是就如 案例 1 里的男人吃了抗抑郁的药不肯停下来, 因为它让他觉得很强大兴奋和 案例 2 里的老师在接受抗抑郁药物一段时间后以为自己好了不再老是悲伤哭泣, 但身边的校长老师都觉得她情绪过度高昂近乎狂躁.

所以如果家人或者病人本身, 根据过去的经验与病人的表现, 怀疑病人目前的忧郁是狂躁的一部分而不是单纯的抑郁病, 就一定要和医生讨论, 可先用情绪稳定剂治疗 (mood stabiliser), 避免单纯的应用抗抑郁药物 (anti-depressants) 而把病人推向狂躁 (mania).

值得一提的是, 大部分抗抑郁药物 (antidepressants) 和情绪稳定剂 (mood stabilisers) 都至少需要两到三个星期才展现效果, 并需要更长时间才更完整地见效. 所以要是一开始完全不觉得情况有改善, 一是你需要更多耐心, 在大概一个月后你的感觉会改善许多, 二是病人的药物分量不够, 这则需要专科医生的判断.

备注: 本文的作者是一名心理学家 (psychologist), 内容是依据与精神科病人工作的经验与研究所写. 如有任何疑问请寻求专业医疗帮助.

Can you control your thoughts and feelings?

Basic & General, Treatment Approaches, , , , ,

Many of the self-help books out there teach people how to change their thoughts, physical sensations, feelings etc in order to feel better (including traditional CBT which targets automatic negative thoughts), if you’re one of those who have tried many of these techniques, how workable do you think they are? Do you think you really have so much control over your thoughts and feelings?

Try these:

(1) Try to recall something happened in the past week, anything — a dinner you had, a movie you went, a talk etc. [continue when you’ve got one] Now try to remove it completely from your memory, get rid of it so you will never think about it again in your life… Can you do it?

(2) Now, do not think about chocolate. As you read this, do not think about how a chocolate tastes, smells; do not think about its colour and texture; do not imagine how it feels when it melts in your mouth and how it feels when your tongue and teeth contact with it. Is it possible? Try again with honey maybe?

(3) Think about past experiences, whether when you have to give a public talks and feel very nervous; when a loved ones passes away and you feel really depressed; when your results doesn’t come out as good as expected and you feel disappointed etc etc. You hope you aren’t that nervous, depressed, disappointed, you try to get rid of these negative emotions as how they’re labelled, was the attempt successful? Did trying to control your emotions make it even stronger, ironically? So you’re more nervous trying not to be nervous?

So why ACT (Acceptance and Commitment Therapy)? Because in ACT, we understand in life negative emotions, thoughts, experience, sensations are all just as likely to happen as the positive ones, they are all part of our life, they are what make our lives meaningful, educational and contented. So in ACT, people learn to accept them, to live with them, instead of struggling with them, challenging them, changing them, getting rid of them.

Caregiver Education Course

Basic & General

The Malaysian Mental Health Association is running a Caregiver Education Course in April, which I think would be very useful and also a great opportunity for immediate family members and carers, especially for those taking care of people who suffer from chronic mental health problems. I believe they will also welcome anyone in the mental health profession to come to learn and share.

The course will cover a few mental disorders (e.g. schizophrenia, mood and anxiety disorders) and some modules like understanding the brain and psychiatric drugs, learning about handling crisis and communication skills etc.

What is even better is that the course is free of charge, and will be running on four consecutive Sundays in April starting on the 12th. So it shouldn’t affect those who work during the week. Though, participants should attend the entire course to get the full benefits. Also, this course will be provided in English, but the association is also looking to run more courses later this year, and hopefully some will be in Chinese.

For further information, please contact MMHA 03-7782 5499