Hypnotherapy centre opens in Burnham
Clacton and Frinton Gazette Jane Williams, 45, of Tillingham, has been working in the field of physical treatments for several years, training to become a qualified hypnotherapist this year. Hypnotherapy is a form of psychotherapy used to create subconscious changes in patients, ... and more » |
 Maldon and Burnham Standard |
Hypnotherapy centre opens in Burnham
Maldon and Burnham Standard Jane Williams, 45, of Tillingham, has been working in the field of physical treatments for several years, training to become a qualified hypnotherapist this year. Hypnotherapy is a form of psychotherapy used to create subconscious changes in patients, ... |
 Inverse |
Hypnosis Might Help Treat Anxiety | Inverse
Inverse Hypnosis brings up images of hokey magicians in capes, swinging pocket watches, and people clucking like chickens. But in real life, hypnotism doesn't turn ... The Secret of How Hypnosis Really Works | TIMETIME This is your brain under hypnosis | CosmosCosmos Study IDs Changes in Specific Brain Areas During Hypnosis | Psych ...PsychCentral.com (blog) all 4 news articles » |
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Telephone session with an anxious client,
using Nick Kemp’s Spinning Feelings and Tempo Shift methods,
with commentary by Steve Andreas
A colleague asked me for feedback on a 25-minute phone session that he did with a middle-level manager who was anxious about an imminent meeting with several upper managers, in which she expected to be criticized and attacked verbally. The session was very successful, as indicated by her report the next day, “Thanks for the check in, and THANK YOU for that fantastic work in the afternoon. I felt really great about how I conducted myself. I was able to provide the center even in the midst of yelling.”
Feedback seldom gets much better than that! However, despite the complete success of the session, I had a number of suggestions for how to make the process even more elegant and effective. Some of my comments are minor, perhaps even “picky”; others are more substantial. Many clients will be able follow instructions appropriately even when they are sloppily worded, but others will not. (And of course some clients will manage to misunderstand even the most carefully worded instruction.) The more specific and precise you are with your words, the easier it will be for the client to change. When I offer this kind of feedback, I also see it as an opportunity to learn as much as I can, in order to make my own language more precise. I’ve made my living as an editor—in one form or another—for some 45 years, so I have quite a lot of practice. With the coach’s permission I have made a transcript of the phone recording, and interspersed my suggestions, which I hope will also be of interest to others.
Verbatim Transcript
(Steve’s comments are in italics)
Coach: So, what would you like to have different?
Client: What would I like to have different? I would like to be less anxious, going to this meeting.
Coach: OK, so you’d like to be less anxious. Now that’s a negative so you want to be less of something. What would you like to have in its place?
(Eliciting a positive outcome is an important part of many interventions, but in the case of anxiety, it’s not required. My experience with the spinning feelings process is that it is unnecessary, because the result is automatically positive and appropriate, without needing to rely on the client’s conscious mind to decide what the new response will be.)
Client: Well, I would like to be a calm, non-anxious presence.
Coach: “Non-anxious” is also a negative.
Client: I would like to be astute. I would like to be a centering influence on the group; I’d like to be a calm influence on the group.
Coach: Calm influence. Actually the word that I like, is in comparison to being non-anxious is to be assured.
(“Assured” is content, which may or may not fit for the client. Content interventions can be useful, but it’s good to realize that they are different from process interventions.)
Client: Be assured?
Coach: Uh-huh.
Client: That’s good.
Coach: But anyway the idea of being able to be calm, which to me also is about being centered and grounded in who I am—
(“Centered” and “grounded” are additional content.)
Client: Totally.
Coach: —rather than being totally reactive to what other people are doing.
Client: Totally, Right, yes.
Coach: So with that in mind I’ve got a couple of things that I’d suggest we do, and the first thing is to respond to the anxiety, deal with the anxiety.
(“Respond to the anxiety,” and “deal with the anxiety” are not the same thing, so this introduces ambiguity and is a little confusing. I think what you mean is “work with the anxiety” or “resolve the anxiety.”)
(Before working with the anxiety it would be good to find out what the client says to herself that triggers the anxiety. The coach does this much later, after using the spinning feelings process. At that point, the feeling is resolved, making it awkward to find out what she says to herself.)
So take a moment and just be aware of,
(This is “putting the cart before the horse”; you need to elicit the context before being aware of something in it.)
imagine being in this meeting and how you probably imagine you will be.
(This sentence is also not as clear as it could be. “Probably imagining how you will be in the future,” elicits hypothetical, intellectual, possibility rather than present actuality. Compare with, “Imagine you are in the meeting, and notice what you feel,” which is more direct and succinct. You want to start with “imagine,” but after that presuppose in your language that the client is actually in the meeting.)
So just anxious, right?
(“Anxious” names the feeling, which is unnecessary, and may limit or distort the client’s experience of the feeling; using the word “feeling” is more open-ended, and can also be used for any other strong feeling. The outcome at this point is not to name the feeling, but to locate it.)
Client: Right, right.
Coach: So just take a moment and be aware of the anxiety.
(The previous sentence is unnecessary; the following one is fine.)
Now as you are aware of the anxiety tell me where it starts in your body and where it goes to.
Client: And where it goes?
Coach: Yeah. Anxiety is kind of an interesting experience. It has a huge physiologic component.
(The two previous chatty sentences are unnecessary, and irrelevant to the location.)
So where does it start in your body?
Client: It starts in my chest with very shallow breath.
Coach: Very shallow breath. It starts in your chest so it’s sort of your upper chest?
(I would delete the “sort of” which suggests her experience is uncertain. Nothing is added by saying “upper chest,” which may not be accurate.)
Client: It’s in my upper chest, and I’m truly having hot flashes. Of course it is about 100 degrees here today, but I’m still having hot flashes about this meeting, yeah.
Coach: So and so you also experience an increase in temperature. So now it starts in your chest. Where does that anxiety travel to? Where does it—?
(There is no advantage to naming it “anxiety.” “Feeling” or “it” is enough.)
Client: Well it goes down to my stomach, but it doesn’t go— How shall I say? It goes to my stomach, but my feet are not on the ground. It does not go— I know that I’m not grounded; I guess that’s how to say it.
(There is a curious jump in her attention from stomach to feet. I would have asked if the feeling goes anywhere after going to the stomach. Since she mentions that her feet are not on the ground, I suspect that the feeling goes all the way down through her legs to her feet. Even when I think I have the full path, I usually ask once or twice more, to be sure I have the complete path.)
Coach: Oh, OK. So the feeling now goes from your chest down to your stomach.
(The “now” implies a change; I would delete it.)
Client: Yep.
Coach: OK. So it’s traveling that path. Now notice, as it’s traveling that path what color is it?
Client: What color is it? Red.
Coach: It’s red. OK.
(A step of the protocol is missing here—asking about the shape, size, etc. of the path. It’s not essential, but it amplifies the visual representation of the feeling, establishing a detailed context for asking the next question.)
And watch it going down that red path,
(“As the feeling moves along this red path,” presupposes both the moving and the watching, so it’s a bit better for engaging unconscious processing.)
and tell me which direction is it spinning—clockwise or anti-clockwise?
(I prefer “notice” to “tell me,” since the client has to notice it before telling me, and the context already implies telling.)
Client: It’s spinning, uh, anti-clockwise.
Coach: Anti-clockwise, OK.
(The following conscious-mind selection of an outcome color interrupts the process, requiring a shift in attention, and back again to gathering information about the problem state afterward. It’s not part of the spinning feelings protocol, and seems to be unnecessary. However, selecting the outcome might be a useful addition for some clients.)
Now just set all that aside and come back to that sense of being grounded, with a sense of assurance in who you are, that sense of confidence and calm. When you think of that, what color is that experience?
(“When you think of that” is an invitation to intellectualize. “What color is that experience?” is more direct.)
Client: Grass green
Coach: Green, grass green
Client: Grass green, yep.
Coach: Cool. OK, so the first thing I want you to do is to take a moment—
(There is a big jump in attention here between the outcome specification and the problem state. More important, the problem context for the intervention is not elicited. Adding sparkles was omitted here; it’s not necessary, but it amplifies the visual experience in a pleasant way for most. Better to say, “Go back into that problem context and notice the very beginning of that feeling. As it begins to move along that path, spin it in the reverse direction, change it to a color you like better, and add sparkles to it, and just find out what happens.”)
—and spin that anxiety as it’s going down. It’s going anti-clockwise
(“It’s going anti-clockwise” is not useful because it elicits the problem state, which is not what you want here. Doing it this way links the reverse direction to the problem response rather than to the context. This can lead to feeling bad first before feeling better. You want to link the context directly to the reverse spinning.)
so I want you to spin it clockwise and as it’s spinning clockwise let it turn from red into that grass green color, and tell me when it’s spinning quite quickly in the opposite direction. So it will be spinning clockwise and you’ll begin to see as it spins quickly clockwise it will be turning from red into grass green, and tell me when it’s completely green.
(Again, mentioning “red” elicits the problem state, when you want the context to link directly to the new color. “Change the color to a color you like better.”)
Client: Right. It’s marbled. It’s a marbled red and green.
(This is the result of mentioning “red,” making it more difficult for the client to change it.)
Coach: Just center into yourself and just let it spin, and spin it quite quickly and tell me when it’s completely green.
(Nice “save,” presupposing that it will become all green.)
Client: Yeah, it’s completely green.
Coach: OK, and now as you watch it spinning and it’s completely green just let it add some sparkles to it, so that you’ve got green and little sparkles going inside of it.
(Much better to add the sparkles earlier along with reversing the direction of spin and change of color. Using several instructions together tends to overload the client’s conscious mind, eliciting unconscious change.)
Client: I saw my temperature coming down. My hot flash is subsiding.
Coach: Cool. So you got little sparkles in it as well?
Client: Yep.
Coach: Brilliant, brilliant. OK, now just take a moment and check to see whether your feet are now on the ground.
Client: They are.
Coach: Cool.
Client: It’s sort of amazing.
Coach: So now just see if you can get the anxiety back.
(This is imprecise. Better to say, “Go back into that meeting, and find out what happens,” to test and future-pace. If the process didn’t work, and the client still feels anxious, asking “see if you can get the anxiety back” would be a serious mismatch! Assuming the report is positive, then follow with a further challenge, “See if you can get the anxiety back.”)
Client: It’s interesting because now I can remember what red looks like but it’s hard to think about it. It’s actually harder than getting it to spin in the first place. The green is kind of overwhelming everything, which is good! Just the color, it’s a very common color to me.
Coach: Yeah. Cool.
Client: Yeah, amazing, amazing!
Coach: That really is quite amazing
Client: It’s so much better; I was out in my car searching, seeing if I could find a little happy pill to take. I don’t have any of those anymore, so there you go; I can’t take a happy pill—just do it the right way.
Coach: OK now so that’s the first thing so that sort of takes care of the physiologic part of the anxiety.
(The following elicitation of the voice that triggers the anxious feeling is a bit awkward now that the feeling has been changed. It would have been much easier and better to elicit the voice before changing the feeling.)
Now I want you to come back though and think about anxiety
(“Think about anxiety” is an invitation to intellectualize, rather than to notice.)
and to imagine I’ve never been anxious in my life. And so you are trying to teach me how to be anxious.
(“You are trying” implies effort that doesn’t succeed. Better to say something like, “Now I want you to imagine that I’ve never been anxious in my life, and your job is to teach me.”
And so the things that—particularly since you’re feeling anxious about a meeting that’s to come, so the meeting is not actually happening in the room with you at the moment, so it’s a future—
(That is a very confusing sentence. The focus has shifted from teaching the coach to the client’s experience. “You’re anxious about a meeting to come” would be much simpler and direct. But since she doesn’t get anxious any more, it’s hard for her to do. An explicit reorientation in time would be helpful here: “Go back 15 minutes to when you used to get anxious, and notice what you say to yourself just before the feeling.” In addition to gathering information, this sentence helps solidify the change that has been made.)
So you got to imagine the meeting right? Typically there are four things to pay attention to when we have an experience. And the four things are: what do we see with our eyes, what do we hear with our ears, and then what do we see on the inside, and what do we hear on the inside? And so I’m particularly interested in your experience of anxiety because it’s not happening at the moment.
Client: Right, right.
Coach: It’s just in your imagination that what do you have to see on the inside and what do you have to hear on the inside in order to get anxious?
(The foregoing would be fine as an introduction to a thorough elicitation. However, this is after putting the client into the situation, so it is requires a shift in attention, and is an invitation to pop out of the experience and intellectualize. For this process, the only thing you need is the voice and what it says.)
Client: Hmn, see on the inside, or hear on the inside. I need to see walls all around me like I’m in a tunnel.
Coach: OK, you need to see like you’re in a tunnel.
Client: Like I’m trapped.
Coach: So there’s a sense of being trapped. Now what do you have to hear?
Client: Actually what I have to hear is well inside of myself? Inside of myself I need to hear my voices, my mini-voices—
Coach: Yeah.
Client: —trying to figure things out.
Coach: And actually what you’ll find that in order to feel anxious there’s usually, well I call them, a negative mantra. It’s a little phrase that you repeat over and over and over again. It’s kind of in a loop like those old, old eight tracks.
(This may be true, but the client doesn’t need to know it, and it introduces content that may not fit for the client.)
Client: Right, right.
Coach: So this continuous loop and it’s doing, and it’s saying something. So just listen to the loop of all those voices and find the one that really elicits the anxiety.
(I would leave out “loop” and “all those voices” both of which may be a mismatch for the client.)
Client: Yeah, now I’ve got it, yeah.
Coach: And tell me what it is.
(“is” is vague, and confuses the client; “what it says” is more specific, and would avoid the confusion that follows.)
Client: You mean what it’s saying?
Coach: Yeah.
Client: It’s saying, “How can I get out of this?”
Coach: How can you get out of this?
Client: “How can I escape this?” Yeah, how can I? How can I? “I’ve got to flee.”
(Any of the above sentences will be in the fast voice tempo that elicits the feeling, so any will work to do the voice tempo shift.)
Coach: OK, now take a moment though. Why would—if you had to stay in this, why would that be a bad thing? ‘Cause getting out of this is an escape mechanism; you’re trying to escape some bad outcome.
(The foregoing is true but unnecessary. The voice is what used to trigger the anxiety. Asking about the precursors only confuses the client, as shown by what follows. )
Client: Yeah, why?
Coach: So what’s the bad outcome?
Client: Well, actually I think that when I’m trying to escape I’m trying to escape; I don’t even want to be part of it. But yeah, no on the level of—hmm—I’m not quite sure what you’re saying.
Coach: Well, it’s kind of like “I got to get out of this” and that may be the little negative mantra. Here’s what I often find though, is that underneath that is something like “They’re going to get me, I’m going to die.”
(“little negative mantra” and “underneath” may not be a good fit for the client.)
Client: Oh yeah, thank you, actually all day I’ve been saying I’m terrified.
Coach: “I’m terrified.”
Client: I’m terrified. I’m shaking. I’m peeing in my pants. I’m terrified.
(Being “terrified” describes the feeling elicited by the voice, not what the voice says that causes the feeling. This is where many people go wrong, mistakingly thinking that it’s the voice that causes the feeling.)
Coach: And so something—which tells me, something really bad, you’re imagining something really bad, like “They’re going to hate me, they’re going to fire me, they’re going to abandon me, or I’m going to be alone.”
(These are all content possibilities for what might cause the feeling.)
So take a moment, just take a breath, take a moment and listen and see if you can find what’s the sort of the darkest little mantra that’s way down underneath all of these?
(“The darkest little mantra that’s way down underneath all of these” introduces content that may not be a good fit for the client’s experience.)
Client: It’s really good. It’s very clear to me that if I stay in the thing I’m going to die.
Coach: “I’m going to die.” I’m just writing it down. “I’m going to die.”
(“I’m going to die” will also work. However, that meaning is carried by the voice tone in which she previously said, “How can I escape this?” etc. The words don’t matter that much. The fast tempo elicits the anxiety. If she said, “I’m going to the store” in that tempo that is will also make her anxious. It would be more efficient and equally effective to just use the first clear statement the client offered, “How can I get out of this? Or How can I escape this”)
(At this point in the protocol, the instruction is to ask, “When you have said this to yourself, do you say it in your normal conversational speaking voice, or is it said at a faster tempo? That’s all. Period. Compare this with the somewhat meandering instruction below, some of which is an invitation to think about her experience, in contrast to noticing it.)
So now let’s just take a moment and listen to “I’m going to die” and the first thing I want to do is figure out what do you have to do, and there’s usually two things but we’ll check both of them, to make the feeling of anxiety get worse? So I want to see what you need to do in order to get it worse. And the first thing is to change the volume of the, um—so for example, if we make the negative mantra “I’m going to die,” if we make it really loud does that make it worse?
(Although volume will have an impact, it is secondary. Asking about the volume is not in the tempo shift protocol, and unnecessary.)
Client: Yeah.
Coach: OK, loud. Now check also the pace of it. So if it speeds up, does that make it worse?
(“Does that make it worse?” is pretty clear in the context, but “Does that increase the feeling?” would be more precise.)
Client: Yes, yes, more than slow, fast, yes.
(The next step in the protocol is to ask the client to say it the way they have been, then to slow the tempo by one-third, and then to slow it much more.)
Coach: So fast and loud?
Client: Yep.
Coach: OK. So now what I invite you to do is you know when you watch TV on like CNN they have a “crawl” that’s going along the bottom of the screen?
(The above is not in the tempo shift protocol.)
Client: Yeah, yeah.
(What follows is essentially a variation of the phobia cure, with green and sparkles added in, rather than the anxiety protocol.)
Coach: OK, so I want you to imagine in your mind you’re seeing this whole situation and you’ve got a crawl going down the bottom of your visual field and the crawl is this “I’m going to die” and it’s just going, it’s an endless crawl. So you’re no longer hearing it, you’re now seeing it. So tell me when you see it. So you can see it?
Client: I see it. I got it.
Coach: OK, now the background of the crawl I invite you to make it that green with the little sparkles in it.
Client: So I’m like looking at the television set? Is that what I‘m imagining?
(This points out an earlier ambiguity. “Seeing this whole situation” didn’t specify seeing it on a TV.)
Coach: Yeah, or that sort of the visual field of what’s going on.
(A very confusing sentence! “Sort of” weakens the instruction. Better to say, “Yes, you’re seeing this whole situation on a TV.”)
In the bottom of it you’ve got this crawl and the background of the crawl, so like typically it’s usually like black writing on white or something like that.
Client: I think I don’t understand the word you’re saying, “call”?
Coach: Crawl. C-R-A-W-L.
Client: Oh crawl! Got it, got it. (both laugh)
Coach: So as you’re watching the crawl, make the background of the crawl that grass green color with the sparkles. And what we’re going to do is (slowly) slow the crawl down.
(At last, the tempo shift, visual variation, though modified significantly from the protocol.)
So it’s going, (very slowly) “I’m . . . going . . . to . . . die.” So it’s getting slower and slower. (client laughs.) Keep watching it as it’s going really slow, and get really curious and see which of the words is the first one to just get so slow that it gets bogged down and absorbed into the background so you can’t even see it anymore.
Client: Yeah, “going.”
Coach: “Going,” OK. And just keep watching and tell me what’s the next one that’s—?
Client: “I’m.”
Coach: And just keep watching and tell me when they’ve all gone.
(This is an instruction for amnesia. In general we never want to erase experience, only modify it.)
Client: Yeah, pretty much green, pretty much green. I can still see a little vestige of it, but pretty much green.
Coach: OK. And what’s the vestige?
Client: It’s more that if there was lighting there, the vestige is that it’s not perfectly green, I guess is a way to say it.
Coach: OK, so there’s a little reminder. And would it be OK if that reminder was a memory of how you used to be, which reminds you to be calm instead of that other way?
(The first part of this is a nice hypnotic invitation to categorize the “vestige’ as a “memory of how things used to be,” which puts the old way into the past, and consolidates the change. However, “instead of that other way” invites her to re-elicit the problem state again, so that’s not useful.
In the tempo shift protocol, all that is done is to slow down the tempo, and that is sufficient to elicit a new response.)
Client: Right, right, right, umhmn.
Coach: And assured. OK, so now as you think of this meeting, yeah as you think about the meeting, see if you can get the anxiety back.
(“Think about the meeting” is an invitation to intellectualize. “Imagine you are in the meeting” would be more specific. I prefer to first ask an open-ended question, “What do you experience?” which invites the client to respond with whatever they experience. If the process didn’t work, and she is still anxious, then asking “see if you can get the anxiety back” would be a serious mismatch of her experience.)
Client: It’s totally gone. I’m not anxious right now. My feet are on the ground literally—literally and figuratively.
Coach: So now take a moment and be grounded, and remember we used to talk about compassion being tender, fierce, mischievous, that sort of—
(The above seems to me to be totally irrelevant to the stated outcome of the session, introducing content that may not fit for the client. Likewise what follow seems to be a meandering way to future-pace. Since the purpose of the session was to resolve the client’s anxiety in a meeting, the simple and direct way to do this is to say, “Imagine being in that meeting, and tell me how you experience it now,” to confirm that the new response is immediate and spontaneous. That would get the job done, and make what follows unnecessary.)
Client: Yeah.
Coach: —think of your competence, the times when you have been grounded, that experience of you in your realm being responsive rather than reactive, with the full range of compassion.
(I think compassion is great, but I don’t see how it’s relevant here.)
Client: Right and I think that that’s— I’ve got that, and I think that it’s reminding me that my feet on the ground is important.
(The client returns to her own statement of the change she noticed, “my feet are on the ground” without mentioning the other things suggested, which adds to the likelihood that they are not particularly relevant to her.)
Coach: Grounded.
Client: Literally.
Coach: Now take a moment and just sort of internalize that experience
(“Sort of” weakens the outcome of internalizing the experience.)
of being really grounded, and now imagine having this meeting with these folks, being really grounded. And play that through like a movie, where you’re the lead character in the movie, not just watching yourself, but actually being yourself fully grounded.
(“Play it like a movie” suggests being separated from it rather than being in it; at best it’s ambiguous. And “not just watching yourself” is a negative command creating ambivalence. Better to say something positive like, “Imagine being in that situation now, seeing out of your own eyes, and find out how that scenario unfolds spontaneously.)
Client: Yeah, I mean I have a vision of myself being solid, you know—
(“A vision of myself” indicates seeing herself in the situation, rather than being in it, which is necessary for a dependable future-pace.)
Coach: And take a moment and imagine some other situation with some other people where you need to be this grounded and just imagine doing the same thing, playing a movie of you being grounded in the future.
(Again “playing a movie of you being grounded” is ambiguous at best, suggesting seeing herself. And since she is in “some other situation with some other people where you need to be this grounded,” “in the future” directs her attention to a future beyond that, which isn’t useful.)
Client: Right, I got that.
Coach: OK, cool. And now take a moment and go back in time to a situation where it would have been really good to have had this resource and just do the same thing, play it through like a movie as though you’re in the movie as the lead character but having this resource so we can use one of those past memories as a learning lab.
(This is fine, but out of order. Better to revise 1-3 past memories before doing a future-pace.)
Client: Yeah, I got that, and for me it’s a really good image because it’s like I’m taking up my space. I mean that in a really good way. I’m holding my space. My space is mine.
Coach: Yeah, and you’re fully inhabiting your body and your being.
(Nice reinforcement of the associated experience.)
Client: Yep.
Coach: And I should have done this a couple of moments ago,
(This is distracting, and not useful.)
but is there any situation that you could think of where this would not be appropriate?
(“This” is ambiguous, and “not be appropriate” is a negation, possibly causing the confusion that follows. Better to state this in the positive. “Can you think of any context in which you would want to have the old feeling, or some other response?”)
Client: Yes, I mean I think that this would not be appropriate in, um—you mean—
(The client is confused by the preceding ambiguities.)
Coach: Some kind of contextual limit and I don’t know—
(“Contextual limit” is unclear, and jargon.)
It may not be but I think of helping someone to be assertive and that we’re not actually doing that so much as we’re helping you to be grounded. It may not be the most beneficial to be assertive if you were in a 7-Eleven that was being robbed.
(The example of a robbery would be fine in a teaching context, but bringing in assertiveness is suggesting content that distracts from the simple question, “Can you think of any context in which you would want to have the old feeling?”
Client: Yeah, and I think I was actually thinking of the opposite if I had to, because it’s not about being grounded but it’s about being active, because what we’ve just done makes me feel calm and not inactive, but not a lot of frenetic energy. When we talked about the anxiety it was very frenetic and fast to me. So this seems very slow and deliberate, slow and deliberate. So I actually thought the only place that I can imagine—well no it’s not true. I was thinking if a building suddenly caught on fire I would still need to be deliberate. I might not need to be slow—I could be fast and deliberate.
Coach: Yeah, and just to sort of be aware that it seemed to be a pretty safe generalizable state
(What does it mean to “sort of be aware”? “A pretty safe generalizable state” is jargon. Better to say something like, “Being aware and grounded is a useful resource in almost any situation.”)
but there are times when maybe not like you said when you have to really— Well, I think there are times when there’s life and death where we need to act promptly, quickly, instantly if you like, and we can deal with the issues when we got people to a place of safety. Now so just take a moment and
(There have been quite a few times earlier when “take a moment” has been used without being particularly useful.)
with that in mind this seems to be a state that you would like to keep.
(“A state that you would like to keep” is somewhat dissociated and jargon. Better to say, “So you are fully satisfied with your new response.”)
Client: Yes, definitely, definitely.
Coach: Cool. Brilliant.
Client: Can you come to my meeting with me?
Coach: I don’t think you’ll need me, but here’s what I would— Just take a moment and thank yourself for your ability to learn and the resources that are within you to make these changes.
(This is a nice suggestion to view the change she made as a part of her identity, in contrast to just a change in behavior.)
Client: That’s a good reminder.
Coach: Ahah, Cool. Well I think we’re done.
Client: I think we’re done, too.
Coach: I look forward to hearing how it goes.
Client: Thank you very much. Thank you.
Coach: You’re welcome.
Client: Take care. See you next week.
Remember that despite all my comments, this session was very successful. Your clients want you to succeed with them, and they will often respond to what you mean, not what you say. Still, the middle word in NLP is “linguistic.” The words you say are important, especially in a phone session in which your gestures aren’t available to clarify the inevitable ambiguities in speech.
Furthermore, the as just words of sequence a sentence as in important is, the sequence of steps in leading a client through an effective intervention is just as important. Being precise makes it easier for your clients to change, and that makes your work with them easier and more satisfying for you as well.
Coach’s comments in response
Thanks Steve for the detailed review; it has been very helpful in several ways. Three things that I am really aware of:
Paying attention to 1 and 2 would make me more present with the client and my work with them more precise, efficient, and effective.
Once again thank you for refining my skills and the elegance of my work.
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The unexpected decisions depressed people make when regulating their emotions.
People who are depressed often do little to improve their mood, even when given the chance, a new study finds.
In fact, their choices often make them sadder, the research found.
Ms Yael Millgram, the study’s first author, said:
“Our findings show that, contrary to what we might expect, depressed people sometimes choose to behave in a manner that increases rather than decreases their sadness.
This is important because it suggests that depressed individuals may sometimes be unsuccessful in decreasing their sadness in daily life because, in some sense, they hold on to it.”
Managing and controlling your emotions is an important part of everyday life.
The researchers looked at the decisions both depressed and nondepressed people made in this regard.
In one trial people looked at happy, sad and neutral photos.
Participants were then given the choice of which photos to look at again.
Ironically, depressed people were more likely to look at the sad photos again.
In another trial, the researchers used happy, sad and neutral music.
Again, it was the sad music that was chosen by 62% of depressed people, as opposed to only 24% of nondepressed people.
Ms Millgram said:
“Depressed participants indicated that they would feel less sad if they listened to happy music and more sad if they listened to sad music, but they picked the sad music to listen to.
We were surprised that depressed participants made such choices although they were aware of how these types of music would make them feel.”
Why depressed people should chose to reinforce their depressed mood is not yet known.
Ms Millgram said:
“The most urgent task for us is to try to understand why depressed people regulate their emotions in a manner that increases rather than decreases sadness.”
The study was published in the journal Psychological Science (Milgram et al., 2015).
• Read on: Depression: 10 Fascinating Insights into a Misunderstood Condition
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“I’ve been struggling with depression for almost 35 years,” said Douglas Cootey, who pens the award-winning blog A Splintered Mind. “In that time, I have often felt hopeless, usually during times of suicidal ideation…Depression has a way of warping our outlook so that we only notice the bleakest parts of the world.”
The darkness stops feeling like a lens that distorts your reality, and starts to become your reality, said John A. Lundin, Psy.D, a psychologist who specializes in treating depression and anxiety in adults, teens and children in San Francisco and Oakland, Calif.
“Depression often robs you of the memory of joy or happiness, so it becomes difficult to draw on happy memories to give one hope for the future,” Lundin said. Depression even makes hope seem foolish, like an illusion, he said.
Many people with depression aren’t able to articulate that they feel hopeless. Because doing so requires putting “words to an experience that just feels as real and encompassing as the air they breathe.” Saying you feel hopeless, Lundin said, can actually be a positive step. “[I]t holds the implication that hope is something that is possible.”
“Depression can be overwhelming,” said Cootey, also author of Saying No to Suicide: Coping Strategies for People Dealing with Suicidism and for the Loved Ones Who Support Them. “All those negative emotions are suffocating. This makes it difficult to believe that things will get better.”
Most of Rebecca Rabe’s clients say they’ve lost hope because they feel alone. They feel like no one understands what they’re going through. They feel like they can’t talk to anyone.
Loss of hope also might represent a loss of belief that you matter or that you can be loved, Lundin said. (This is something he works on with clients, helping them understand why they don’t feel adequate or lovable.)
What can you do when hope feels unfamiliar or impossible? What can you do when you’re in the middle of the storm?
Cootey stressed the importance of using a wide variety of coping strategies. “When I use my coping strategies to overcome depression, the next day isn’t a prison of more of the same. It’s a brand new day free of the sadness.”
Colleen King, LMFT, a psychotherapist who specializes in mood disorders and also has bipolar disorder, stressed the importance of having a treatment team and support system. This might include a therapist, doctor and several friends and family. Ask them to help you remember the times when you’ve felt better, she said. Ask them to “encourage you to be in the moment when you do experience temporary joy, even if it’s for a few minutes.”
Both King and Lundin suggested participating in activities that feel nourishing to your soul, activities that you love to do when you’re not depressed. Do them even if you don’t feel like it, King said. “You will most likely alter your mood at least a little bit, and [the activity] may be a welcome distraction from depression.” Plus, it helps to “arouse glimmers of hope that you can feel whole and healthy, again.”
It often feels like depression will last forever, King said. Which is why she also suggested placing prompts at home and work to remind yourself “that you are having a depressive episode and that it’s not a permanent state of being.”
Don’t underestimate the power of small steps. Rabe, LMFT, who specializes in treating children, teens and young adults with depression, anxiety and trauma, shared this example: She worked with a woman who was struggling with depression and complained about “not being able to do anything.”
They worked on tracking small but significant accomplishments and setting small goals. “For example, she would strive to check 10 things off her list. Sometimes just getting to therapy got her these 10 checks.” After all, getting to therapy is anything but trivial. It involves getting up, showering, getting dressed, driving to the office, making the appointment on time, talking in session and driving home, among other tasks. Her client also started reaching out to supportive loved ones (instead of isolating herself); taking walks; and writing in her journal—all of which has helped to diminish her depression and create a more positive outlook.
“I’ve been through the worst my mind can throw at me. I’ve felt the pain of suicidal depression,” Cootey said. “I’ve wished and even planned for my own death, yet I learned an important truth: Depression lies to us.” This is another reason it’s helpful to surround yourself with support: These individuals can help you see through the lies, he said.
“You do have worth. You will overcome this. You won’t be sad forever.”
There is always hope for someone struggling with depression, Rabe said. “People are resilient human beings, and they can do so much more than they think they’re capable of.”
Also, remember that “how hopeless you feel does not correlate to whether you can feel better,” Lundin said. Depression is an illness that extinguishes hope. It’s the nature of the disorder.
Thankfully, therapy and medication can help. So can participating in support groups. “Some depression requires a short treatment to work, and other takes a long time. But I have never met a patient who didn’t see significant progress if they stuck with it.”
If your therapist or doctor doesn’t seem to be helping, seek out new providers, King said. “Having a trusting and caring treatment team greatly assists with creating confidence and hope for the future.”
For people who don’t respond to therapy and medication, other treatments are available, such as transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT), Lundin said.
With good treatment, effective and varied coping strategies and compassionate support, you can feel better. The heaviness gets lighter. The world becomes brighter.
So no matter how hopeless you feel right now, please don’t throw away your shot. Hope and relief are not some foolish illusion. They are real. They are possible.
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A new UK study suggests autism could be diagnosed by allowing children to play games on smart phones and tablets.
University of Strathclyde researchers believe the technology could offer an accessible and less intrusive way to diagnose the developmental disorder.
Dr Jonathan Delafield-Butt, of Strathclyde’s Faculty of Humanities and Social Sciences, and colleagues used fun iPad games to track players’ hand movements – gathering information that can help identify autism.
The study, appears in the Nature group journal Scientific Reports.
Dr Delafield-Butt, a Senior Lecturer in Child Development, said: “We have shown that children with autism can be identified by their gameplay patterns on an iPad.
“This is potentially a major breakthrough for early identification of autism, because no stressful and expensive tests by clinicians are needed. Early detection is important as this can allow parents and children to gain access to a range of services support.
“This new ‘serious game’ assessment offers a cheaper, faster, fun way of testing for autism. But more work is needed to confirm this finding, and to test for its limitations.
“This study is the first step toward a validated instrument. Interestingly, our study goes further in elucidating the origins of autism, because it turns out that movement is the most important differentiator in the gameplay data.
“In other words, it is not social, emotional, or cognitive aspects of the gameplay that identify autism. Rather, the key difference is in the way children with autism move their hands as they touch, swipe, and gesture with the iPad during the game.
“This unexpected finding adds new impetus to a growing scientific understanding that movement is fundamentally disrupted in autism, and may underpin the disorder.”
Anna Anzulewicz, Director of Research at Harimata, a company that develops mobile technology for improving early assessment of developmental disorders, said:
“Early assessment of autism allows timely therapeutic intervention, but professional diagnosis of the disorder is difficult and time-consuming.
“Our aim was to develop a test that would be intuitive, fast, fun and engaging for the children. iPad-based games seemed to be perfect, and they are embedded with powerful sensors, which allow for the precise measurement of the children’s play dynamics.”
In the study, researchers examined movement data gathered from 37 children with autism, aged three to six years. The children were asked to play games on smart tablet computers with touch-sensitive screens and embedded movement sensors.
Investigators discovered autistic kids displayed distinct play patterns including greater forces at contact and a different distribution of forces within a gesture. Gesture movements were also faster and larger, and used more space.
“These data support the notion disruption to movement is a core feature of autism, and demonstrate autism can be computationally assessed by fun, smart device gameplay.”
Autism spectrum disorder is a childhood neurodevelopmental disorder, and its global prevalence is estimated at one in 160 children.
Source: University of Strathclyde
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Following up a previous study that discovered adolescent bipolar disorder was linked to greater cigarette smoking and substance use disorder, a new study finds that risk of substance abuse was even greater five years later, particularly among those with persistent bipolar symptoms.
Researchers from Massachusetts General Hospital (MGH) investigators also found evidence that the presence of conduct disorder, in combination with bipolar disorder, may be the strongest influence on the risk of smoking and substance use disorder.
Study findings appear in the Journal of Clinical Psychiatry.
In the new study, researchers discovered ongoing bipolar symptoms appear to predict substance use issues.
“We also made another interesting finding — that those originally diagnosed with bipolar disorder who continued to have symptoms five years later were at an even higher risk for cigarette smoking and substance use disorder than those whose symptoms were reduced either because of remission from bipolar disorder or from treatment,” said Timothy Wilens, M.D., co-director of the MGH Center for Addiction Medicine, who led both studies.
“Both those with active symptoms and those whose symptoms had improved were at greater risk than our control group.”
The original study, published in the June 2008 issue of Drug and Alcohol Dependence, analyzed extensive data — including family histories, information from primary care physicians and the results of structured psychiatric interviews — on 105 early adolescents diagnosed with bipolar disorder and a control group of 98 with no mood disorders.
Among those participants, with an average age of 14, the rate of substance use disorder among those with bipolar disorder was 34 percent, while it was only 4 percent in controls. The risk for smoking was 22 percent for those with bipolar disorder and 4 percent for controls.
For the five-year follow up, structured psychiatric interviews were conducted for 68 of the original participants with bipolar disorder – 37 being lost to follow up – and 81 control group members.
Among those in the bipolar group, 23 no longer met criteria for the disorder, 36 still were experience active symptoms and 9 had symptoms that did not meet full criteria.
During the five years since the original study, more members of the bipolar group developed new cases of substance use disorder than did controls, leading to an overall incidence rate of 49 percent versus 26 percent.
In the new analysis, researchers found that controlling for conduct disorder caused the increased levels of substance use disorder to disappear.
That result suggests that co-occurring conduct disorder plays a significant role in the risk associated with bipolar disorder.
“We were surprised to find that conduct disorder, but not ADHD, played such a large role in mediating the increased risk of substance use disorder among those with bipolar disorder,” says Wilens, who is an associate professor of Psychiatry at Harvard Medical School.
“While this might be result of having only a few participants with bipolar disorder alone, it may be that it is the presence of conduct disorder that drives substance use disorder as adolescents with bipolar disorder become young adults.
Since symptoms of bipolar disorder usually appear before substance use disorder develops, clinicians following youth with bipolar disorder should carefully monitor for cigarette smoking and substance use, along with treating bipolar symptoms.”
Wilens and his colleagues are also analyzing a subgroup of study participants who received detailed brain imaging in an effort to understand the brain circuitry involved in these disorders and their interaction.
They also plan to investigate factors underlying the persistence of bipolar disorder and the impact of treatment on the incidence of smoking and substance use disorder.
Source: Massachusetts General Hospital (MGH)
For many decades, fearlessness has been considered the hallmark trait of psychopathy and has been blamed for the bold risk-taking behavior commonly found in the personality disorder. Now new research shows that psychopathic people may be capable of feeling fear, but they seem to have difficulty detecting and responding to a threat.
The study, published in the journal Psychological Bulletin, is the first to provide strong evidence that an individual’s conscious experience of fear as an emotion may be quite separate from his automatic ability to detect and respond to threats.
Researchers at Vrije Universiteit (VU) Amsterdam and Radboud University Nijmegen reviewed brain and behavioral data to look for any link between fear and psychopathy in adult individuals. Their definition of fear was based on state of the art knowledge of the neurobiological and cognitive underpinnings of this emotion.
Then they created a model that separated brain mechanisms involved in the conscious experience of fear as an emotion from those involved in automatic detection and response to threats.
Using this model as a reference, they first performed a conceptual analysis of the work of earlier theorists, going back as far as 1806. They found that only one theorist incorporated the construct of fear into a model of psychopathy.
The evidence for impairments in brain areas involved in the experience of fear was less consistent than is currently assumed, indicating that the experience of fear may not be completely impaired in psychopathy.
The researchers then demonstrated that psychopathic individuals may in fact feel fear but have trouble in the automatic detection and responsivity to threat, providing direct support for the claim that the conscious experience of fear may not be impaired in these individuals.
Another meta-analysis examining the five other basic emotions found that there may also be impairments in the experience of happiness and anger, but the lack of consistency in the current literature prevented making any strong claims.
“As a consequence of our research, some very influential theories that assign prominent roles to fearlessness in the aetiology of psychopathy will need to be reconsidered and made consistent with current neuroscientific evidence,” said researcher Sylco Hoppenbrouwers at VU Amsterdam.
“Such re-evaluations of key concepts will lead to increased precision in research and clinical practice which should ultimately pave the way toward more targeted and more effective treatment interventions.”
The findings are the first to provide strong evidence that the automatic and conscious processes may be separate in an individual. The proposed model not only applies to psychopathy, but can also be used to further increase conceptual precision and generate new hypotheses for research on mood and anxiety disorders, such as posttraumatic stress disorder.
“While psychopathic individuals may suffer from a dysfunctional threat system, people with posttraumatic stress disorder may have a hyperactive threat system, which later leads to them feeling fearful,” said Inti Brazil at Radboud University.
Source: Vrije Universiteit Amsterdam
As our everyday communication becomes more text driven, researchers worry that the ability to communicate emotions may become compromised.
For example, is “OMG I just LOVE pizza” a sarcastic statement or is it heartfelt?
On a more serious note, misreading the emotional content of a message can have damaging consequences — especially in our relationships.
In the new study, researchers explored if certain factors allow a person to better infer emotions from messages delivered over communication channels such as email or text.
Intuitively, if the receiver of the message is a friend, they should be able to understand the sender’s emotion better than a complete stranger.
Investigators at Chatham University, however, found that friends are no better at interpreting correct emotional intent in e-mails than complete strangers.
The finings from Monica A. Riordan and Lauren A. Trichtinger appear in the journal Human Communication Research.
For the investigation the researchers conducted three studies to find out the effect of contextual information on the confidence and accuracy of affective communication via e-mail.
In the first two studies, writers wrote two e-mails, indicating the presence or absence of eight different emotions in each e-mail. One e-mail was based on a predetermined scenario, and the other freely written. These e-mails were then read by strangers, who rated each e-mail for those same eight emotions.
The third study tweaked the procedure to test the effect of relationship. Writers wrote two e-mails (one based on a scenario, the other freely written) and indicated whether eight different emotions were present in each e-mail they wrote.
Writers then sent these two e-mails to both friends and strangers, each of whom rated the e-mail for the same eight emotions, then wrote response e-mails.
Saliently, although writers were confident their friends would interpret the emotions in their e-mails in a more accurate way than strangers, this was incorrect. Likewise, although readers believed they would be able to ‘read’ the emotions better in letters from friends than strangers, this was found to not be the case.
Therefore, although everyone was highly confident in their e-mail writing and reading abilities, the ability to detect emotions in textual messages is very difficult. This observation held true even when verbal and nonverbal cues, like emoticons, all caps, or repeated exclamation points were added to the message.
Past research has sought to determine how we communicate our emotions in environments from which facial expressions, vocal intonation, body language, and other cues are missing. But many of the studies have flaws in that they are based on artificial stimuli that third parties are asked to rate. It is difficult to determine whether nonverbal or verbal cues are substitutes for emotion without examining the communication as a whole.
“As e-mail, text messaging, and other forms of computer-mediated communication become more dominant forms of interaction, the communication of affect becomes more difficult, primarily because facial expressions, gestures, vocal intonation, and other forms of expressing emotion are lost,” said Riordan.
“It is clear from this study that readers can determine that we are angry, but cannot determine HOW angry. The loss of this subtlety could lead to consequences in many forms– especially in our relationships, where the difference between annoyance and rage can be vast, and a simple misinterpretation of an intended emotion can lead to a drastic alteration in that emotion.”
Source: International Communication Association/EurekAlert
Donald J. Trump will go down in American history as one of the most unusual politicians of all time. He is an enigma to everyone in the political establishment (and to much of America) as he continues his 2016 run for the American presidency.
What makes this Republican nominee tick? Why does Donald Trump speak the way he does, saying clearly outlandish things, then taking them back a day or two later? Let’s find out.
I’m not the first person who has had serious concerns about the mental health and stability of Donald Trump. Many others have commented on their concerns before me, especially about Trump’s apparent narcissism.
But I felt that these issues were best summarized in a short article to explain why these concerns exist in the first place. After all, when there’s a presidential election, a candidate’s mental health is usually not even a concern — much less the focus of the amount of media attention given to Trump during this presidential election season.
Therapists, researchers, psychologists, and experts in mental health appear pretty consistent in their belief that Trump suffers from narcissistic traits consistent with Narcissistic Personality Disorder:
“Textbook narcissistic personality disorder,” echoed clinical psychologist Ben Michaelis. “He’s so classic that I’m archiving video clips of him to use in workshops because there’s no better example of his characteristics,” said clinical psychologist George Simon, who conducts lectures and seminars on manipulative behavior. […] “Remarkably narcissistic,” said developmental psychologist Howard Gardner, a professor at Harvard Graduate School of Education.
Maria Konnivoka, writing over at the Big Think over a year ago nicely summarized the evidence for Trump’s personality symptoms. But for a reminder, let’s look at the symptoms for this disorder one by one.
Trump is a master of speaking indirectly to whoever his audience is. This is when he doesn’t come out and explicitly say something, but rather simply implies it. Psychologists call this indirect speech and Trump excels in it.
Here are a few examples of it:
“Russia, if you’re listening, I hope you’re able to find the 30,000 emails that are missing. I think you will probably be rewarded mightily by our press.”
The implication is that Trump was asking a foreign power to intervene in a national election through illegal activity. He later walked it back — as he does nearly all of his indirect speech comments — by claiming he was “only joking.”
“Only joking” or “don’t you get sarcasm when you hear it?” are rationalizations used by others when they want to say something, but don’t want to stand up for what they said. It is the type of speech that psychologists see regularly used by cowards and bullies, not usually politicians or distinguished statesmen.
“If [Hillary Clinton] gets to pick her judges, nothing you can do, folks… Although the Second Amendment people — maybe there is, I don’t know.”
Most people took this to mean that Trump was calling for the “Second Amendment people” to “do something” about it. Later, Trump claimed he was only encouraging those folks to use their voting power, but many people took this comment to mean something more nefarious. “[…] Literally using the Second Amendment as cover to encourage people to kill someone with whom they disagree,” commented Dan Gross, the president of the Brady Campaign to Prevent Gun Violence, after he heard Trump’s comments.
Indirect speech has many benefits. By not saying what you mean, you encourage every listener to form their own opinion about what you intended. That means his supporters will hear one thing, while his detractors hear something completely different. If anything he says is taken the “wrong way” by too many people, he can simply negate it: “You misunderstood,” “Only joking,” “That was sarcasm.” It’s a perfect linguistic and psychological trick that Trump exquisitely deploys to his benefit. It allows plausible deniability for anything he says. This makes it very hard to pin him down on anything he says, much like trying to nail jello to a wall.
He’s had to walk back so many of his comments, people have lost track of the count. Just last week he claimed that President Obama and former Secretary of State Hillary Clinton, Trump’s opponent in the presidential race, were literally the “founders of ISIS,” the Islamic terrorist group that has its roots during the time of the Bush presidency:
“No, I meant he’s the founder of ISIS… I do. He was the most valuable player. I give him the most valuable player award. I give her, too, by the way, Hillary Clinton. … He was the founder. His, the way he got out of Iraq was that that was the founding of ISIS, okay?”
The next day, typical of Trump’s behavior, he took the comments back, after it became clear everyone knows he was lying about Obama’s “founding” status in ISIS. (President Obama, of course, had nothing to do with the founding of this terrorist organization based in the Middle East.)
The other week, the Washington Post’s Fareed Zakaria had an insightful article about whether Trump’s constant lies are purposeful behavior in service of some ultimate goal, or are they simply symptoms of a “bullshit artist:”
[Princeton professor Harry] Frankfurt distinguishes crucially between lies and B.S.: “Telling a lie is an act with a sharp focus. It is designed to insert a particular falsehood at a specific point. . . . In order to invent a lie at all, [the teller of a lie] must think he knows what is true.”
But someone engaging in B.S., Frankfurt says, “is neither on the side of the true nor on the side of the false. His eye is not on the facts at all . . . except insofar as they may be pertinent to his interest in getting away with what he says.” Frankfurt writes that the B.S.-er’s “focus is panoramic rather than particular” and that he has “more spacious opportunities for improvisation, color, and imaginative play. This is less a matter of craft than of art. Hence the familiar notion of the ‘bullshit artist.’ ”
Trump — with his indirect speech patterns and ability to step back from any lie he tells — appears to be the consummate American bullshit artist.
And if he wins this presidential election, he will have shown that the American people will buy any line of B.S. it hears, as long as the person shelling it out is confident enough in the telling.
Reference
Lee, J. J., & Pinker, S. (2010). Rationales for indirect speech: the theory of the strategic speaker. Psychological Review, 117(3), 785.
