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Posts Tagged ‘anxiety counsellor’

Cognitive Behavior Therapy is recommended to clients to get the necessary treatment for their negative thoughts to bring about the desired positive change .

The key principle behind CBT is that our thought patterns affect our emotional understanding of the events which, in turn, can affect behavior and subsequent interaction with the people we interact with .

CBT also is believed to make us aware of our own negative emotions influencing our thought patterns .CBT helps us analyse and understand others behaviour as elicited by our own emotional understanding of the situation.

CBT highlights how negative thoughts can bring about negative feelings and actions.Similarly how negative emotions can interpret a positive event ,in negative tones . But, if we reframe our thoughts in a more positive way, it can lead to more positive feelings and helpful behaviors.Or if we work on developing positive emotions about ourselves and situations the thoughts will become more accepting .

While conducting CBT the therapist trains the patient to recognise such negative reading by his mind and how to reinterpret the situation with a positive frame of mind. The patient can continue to use these skills so learnt, in all difficult situations and overcome depression,anxiety or other mood disorders .

Depending on the issue the patient is dealing with and the expected specific goals of the CBT , the therapist can make use of several ways to administer CBT. It will basically involve :

  • identifying specific problems or issues in the client’s day to day life.
  • Helping the client become aware of unproductive thought patterns and how they can impact his or her life
  • identifying negative thinking and reshaping it in a way that changes how he or she feels
  • learning new behaviors and putting them into practice

After speaking with the client and learning more about the issue the client wants help with, the therapist will decide on the best CBT strategies to use.

CBT involves making use of the appropriate combination of a few the following 9 strategies:

1. Cognitive restructuring or reframing

This involves taking a hard look at negative thought patterns. When we tend to over-generalize, and apprehend that the worst is about to happen , or tend to get into too much details for every thing we do we find it difficult to act. Our thoughts can prevent us from doing what we want to do and create havoc in our life.

The therapist in this situation will help us identify the negative patterns of our thoughts and inaction . He trains us as to how to reframe those thoughts so they’re more positive and productive and propel our action taking connative behaviour.

For example: “I am not valued in my office because I’m totally useless” can become “I may not be the best worker , but I’m as valuable an employee as can be and I contribute the same way as others do .”

2. Guided discovery

In guided discovery, the therapist will acquaint himself with our viewpoint. Then he will ask questions designed to challenge our beliefs and broaden our thinking.

The client might be asked to give evidence that supports clients assumptions, as well as evidence that does not.

In the process, the client will learn to see things from other perspectives, especially ones that he or she may not have considered before. This can help client choose a more helpful path.

3. Exposure therapy

Exposure therapy can be used to confront fears and phobias . The therapist will slowly expose you to the things that provoke fear or anxiety, while providing guidance on how to cope with them in the moment.This can be done in small increments. Eventually, exposure can make us feel less vulnerable and more confident in our coping abilities whenever the anxieties build up.

4. Journaling and thought records

Putting down your thoughts in writing is a very simple yet effective way of getting in touch with your emotions.One can list down repeated negative thoughts that occur frequently and disturb your homeostasis .It will certainly help to write down your positive thoughts also as would be the inclusion of new thoughts and new behavior for day to day interaction.

5. Activity scheduling and behavior activation

When you are in a negative frame of mind you tend to put off activities in fear or in anxiety.Writing schedules of such activities and visualising them before you begin practicing them can give you the confidence .With such a positive confidence it becomes easy to overcome negative emotions connected with such activities.

6. Behavioral experiments

Behavioral experiments are used for anxiety disorders that involve catastrophic imagining . The psychologist here asks you to express your apprehension as to what will happen if you perform the given task that you otherwise have been dreading to perform. Once you have (reluctantly ) completed the given task you are asked to talk about whether the apprehension came true. Over time, you may start believing that your apprehensive anxiety is not very valid as nothing that you expected to happen actually took place.

7. Meditation, Relaxation and stress reduction techniques.

Perceptive meditation, progressive muscle relaxation and positive imagery building exercises are undertaken to bring about a total positive control over mind ,body and soul to eliminate the phobias,fears anxieties and depression.

8. Role playing

Role playing can help us overcome negative thinking , apprehension and work through difficult relationship and situations. A role play out done with the help of therapist can lessen fear and can be used for:

  • improving problem solving skills
  • gaining familiarity and confidence in certain situations
  • practicing social skills
  • assertiveness training
  • improving communication skills

9. Successive approximation through small successes

This involves taking tasks that seem overwhelming and breaking them into smaller, more achievable steps. Each successive step builds upon the previous steps so you gain confidence as you go, bit by bit.

To know more about CBT and undertake the same ,please get in touch with us mansikpramarsh@gmail.com

917314263087

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We often think that our children have better resilience to their anxiety and they become normal once we have either given them positive strokes, bought them a chocolate, a gift or diverted their attention by permitting them to play video games. But it needs to be understood that anxiety doesn’t happen to the kids like the way we experience it happening to us adults. Anxiety in children can trigger, in panic attacks, in their tantrums, in their sudden rush of energy or it may occur in the untimely defiant behaviour. We as parent just push it aside by ascribing it to their misbehaving or being in the company of wrong friends. However, children may react differently depending on the immediate situation, past incidents or future anticipations.

As psychologists counsellors and family therapists we have to deal with couples, parents and other family members of our clients who always appear to be suffering from anxiety, In most such cases their children too suffer from similar anxiety or otherwise children from families where there is a good coordination amongst parents struggle with anxiety too.

Some parents would pretend and hide their issues of anxiety and other concerns from their children. Even when kids are understanding the parents would try to act as if everything was fine. These parents would do everything they deem fit or within their reach to calm their wards and reset their nervous system through various practices of calming. Children can pick up anxiety from their parents through the verbal communication, through the body language of their parents, through their mood disorders or the kids themselves can react to any general event in the family and develop a full or partial panic attack.

We have seen many a parents fighting and undermining each other when they come to us. They fail to realise that when they behave so their children too suffer mental agony and a fear of being abandoned by either or both of their parents. Children feel abused when their parents fight. They feel cheated by their parents. Children want to live in a typical family life environment irrespective of the riches or poverty. Any thought of living without a parent causes them much mental pain and that triggers anxiety. To them, their family is their safety nest. Their family enables them to play, to study, to make friends. It helps them grow. It is the reason of their being here in the world. To them family is the only reality, rest all is just make believe. Any iota of doubt on family’s continuity causes deep anxiety.

Parents should remember that their children would always pick up the stress and trauma that their parents experience and exhibit. The parents may think that their children are safe and that children have not been exposed to any kind of stress, physical, sexual, or emotional or personality abuse. They may believe that they are offering their children a great childhood compared to parents’ own childhood or other experiences that parents had to suffer. But actual truth is far from this. Children can become anxious for many reasons triggered by the parents’ obvious circumstances or not so obvious happenings within the family. Some of these reasons could be the actual and some could be as perceived by the children. To us adults many of those reasons might not be major, but to a child they become quite significant in triggering insecurities and anxiety thereof. Should the parents happen to be separated or divorced the self-blaming mind of the children would always be devastated by the memories of the times when the family was together. They would not understand the sudden blow of isolation and the non-availability of the parental umbrella. They struggle to be emotionally available to the single parent they now live with and at the same time add on a make believe relationship with the parent they have been separated from which they continue to believe was on their account. A two edged anxiety of this kind breaks them. It shreds the very fibre of their mental balance.

Children are often left heartbroken if there happens to be a fight in their family. They tend to believe that all tension is on account of their being a cause of distress to their parents. Often they are left with a broken trust. They feel guilty with their self-confidence devastated by the memories of parents shouting at each other. They are afraid of the sudden isolation caused by such disputes amongst their parents.

We always assume that our children are understanding. They adjust to the life as they grow. That they have stronger plasticity. This could be applicable in some way but it is not the complete truth. They are not as strongly fortified against anxiety as we tend to believe. Children do build up their defence mechanisms but these defence mechanisms may prove more damaging to their growing personality during adolescence and later on in their grown up relationships. We often come across young persons and old people alike who suffer from the traumas of their growing up years in anxiety.

We give hereunder some of the symptoms that we have witnessed in children while counselling the families .

1) Dissociation: Children have exhibited dissociation by completely cutting themselves off mentally from what is happening in their families. They form their own make believe world to hide the pain. Though parents may believe that the child is being creative, when the child speaks to and play with imaginary characters. Riya 6 years is one such case. Her parents do not see each other eye to eye. Their constant bickering causes much anxiety to the child. The child is seen talking to her doll most of the times and refuses to part with the doll when she goes to school or goes to bed. Her parents eventually brought her to the counsellor when her teacher noticed the child talking to the doll she had brought into her school bag to the classroom.

Monty’s (9 years) parents had been advised by the psychologist that their child suffers from ADHD because that’s the only way he can get their attention and evoke sympathy from them. His parents both working, hardly find time to spend with their child. Their occasional outbursts cause him such a deep distress. He exhibits his anxiety by getting irritated, by indulging into hyperactivity, impulsiveness and inattentive behaviour.

Depression was diagnosed in Deepa (10 years) as a mood disorder because the chronic emotional outbursts indulged in by her grandmother and mother in their interactions caused much disturbance to the child.

2)Gastrointestinal: Meenu’s (5 years) anxiety has been cropping up in her difficult behaviour to ease up herself. She holds up her anxiety in her abdominal area. In spite of her feeling pressure on the stomach she would refuse to sit on the pot to clear her stomach. She suffers from constipation. Her bowel training has been conducted a few times. But whenever she needs to clean her bowels, she holds on to her stool and often soils her clothes. A better approach would be to ensure the child is offered a better protective environment at home free from tension and stress. We noticed she catches on to her parents’ anxiety and expresses her own in the manner described.

3) Obsessive seeking of Validation: Divya (11 years) exhibits lack of self-confidence. She most of the times struggles to express herself confidently. She would often speak in almost inaudible tone She needs to be reassured that others are paying attention to her and she must speak louder with confidence. She always needs validation from her mother.

Children themselves may not be aware of their anxiety but parents and the teachers need to read the symptoms and signs that speak of anxiety in the children.

If you can be aware that a life experience has created anxiety in their lives, you can bring attention to it and help them cope with that anxiety. You must take your child to a psychologist for evaluation and necessary counselling wherever needed. The psychologist may have to counsel the parents too.

Just being aware that your child can suffer from your chronic circumstances and catch on to anxiety should be taken as an initial step to prevention. Take them to a psychologist whenever or if they exhibit symptoms of anxiety. Whenever possible speak to them about their fears, concerns and phobias whether implied or implicit. Children should be trained and encouraged by both parents to discuss, open up and ask questions from parents should there be any stressful occasion in the family. This will help them to understand that there can be differences of opinions, arguments and even conflicts within the family but that you will always protect them and be with them to take care of them.

Family is Everything
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We reproduce below the interview of our Ramneek Kapoor Psychologist and Family Therapist once again for the benefit of our readers and clients.

1 .What is ‘stress’

“I would refer to stress as “the mental, psychological, intellectual, emotional and physical unease to the personal situation and the expectation rose either by the self or by others to face/handle the situation “.

  1. Are all kinds of stress bad? How do we identify between good and bad stress?

“All kinds of stress is not bad, only the distress caused is bad. Eustress is a good stress that gives a high and stimulates the adrenaline. When you feel good about certain situation and event and feel you are able to handle it, you look forward to such a situational stress which results into a moral boost and good emotional physical feeling”.

  1. Do you think people are aware what stress does to their mind, body and soul? Do you think that once they realise how negative stress has adverse effects on them, they will be in a better position to manage it?

“Only a limited few numbers of people could be aware of the negative effects of the stress on their physical, mental, social, spiritual and emotional well being. Mere realisation that the stress is bad will not be enough. We need to also educate and inculcate in them the stress relieving self empowering meditation exercise routine on day to day basis. Preksha Meditation (perceptive meditation on the psychic centres) under the guidance of trained teacher will go a long way in relieving stress.

  1. In the world we are living in today, how important is it to spread awareness about stress? Are there any statistics that reveal how serious the problem of stress is one’s life?

“The very fact that more than 50 percent people suffer from the depression, anxiety and stress sometimes or the other in their life with no trained professional help to cope with this reflects the pitiable position of the awareness amongst common people. In fact no official statistics from any governmental source are available on the subject nor has any NGO worked on the subject authentically”.

  1. How do you think our previous generations managed stress better than today? Even with the state of the art technology and advance in medical sciences, why have we as humans not been able to cope/ deal with stress?

“It is a fashion to always refer to the better life of the previous generation. The fact is that the technological advancement has also brought with it the person related emotional, psychological and physical maladies in addition to making life easier. The state of art tech development has brought about personal isolation, in the midst of many. The person today is cut off and alienated from the self. He or she is always lost into an uncalled for competition with the others on the social media and into the realms of the imaginary virtual world.

  1. Do you think people today are ignorant about stress? Ignorance is bliss, but is this kind of bliss worth it?

“No they are not ignorant. They prefer living in the comfort of uncomfortable stress. The rat race takes its toll and the victims enjoy the bites of killing stress and anxiety and many other mental ailments. Eventually the person ends up with either cardiac problems or the chronic depression and anxiety will take toll on such persons “.

  1. Are there some observable and prominent symptoms a stressed individual will experience? Such as physical, mental, emotional, physiological etc.?

“Yes ;the breathing discomfort , sleeplessness , insomnia, loss of memory, eating disorder either binge eating or not getting hungry, social anxiety, irritation , unmanaged anger, repeated headache, psychosomatic pains , and weight gain/ weight loss are some of the prominent observable symptoms”.

  1. Who are the most stressed people according to you? What could be the causes for them being the most stressed?

“Adolescents, working women, housewives, company executives and even professionals with deadlines of times to meet are always under stress. But the large share of the stress cake goes to adolescents in the modern times. With the race to always look outwards and keep pace with the demands of peer aping the adolescents find it difficult to cope with the stress. This generation is neither amongst the younger generation nor are they amongst the adults. The social media, the rigid demands on their performances in academics and career aspirations’ of the parents for them, are some of the major reasons for this generation being most stressed

  1. What according to you triggers ‘stress? Do you think by being aware of the triggers we can be in a better position to manage stress?

Triggers of stress can be any event or situation that threatens the mental and physical equilibrium (homeostasis) of the body . The events can be either external or internal

. External can be the political, social, economic, competitive, family, academic, or work atmosphere. While internal triggers will relates to irresponsible behaviour, uncalled for self expectations, negative attitude towards life in general, and looking for perfectionism in self or others.

  1. What can be some of the long-term effects of stress? How does stress affect a person physically, mentally and emotionally?

The long term effects of chronic stress can be

  • Chronic sadness and depression. (2.) Chronic mental and physical fatigue. (3.) Chronic stress related illness (consistent headache, stomach ache, bowel problems, social anxiety) and other psycho somatic physical illness. (4) Isolating self, withdrawal, self destructive nihilistic thoughts .

Physical problems of the stress can be , sleep disorders, back, shoulder or neck pain, migraines , headaches, acidity, upset bowels, constipation, weight gain or loss, hair loss, loss of libido.

Emotionally the person can become nervous, edgy, depressed, moody, phobic, and not be able to focus and eventually suffering from Nervous breakdown.

  1. Please mention 5 useful tips for fighting/ managing stress? How can one follow these in his/her daily schedule and busy day?
    1. Accept life as it comes.
    2. Accept your self.
    3. Identify “ME” and try to become “ME” rather than becoming him, her ,they or she.
    4. Accept that perfectionism is a myth and utopia.
    5. Follow a healthy diet plan, an exercise and meditation routine to keep your heart health and positive.
  1. According to you, how can one prevent stress in everyday life? How do we know that the levels of stress have crossed the healthy limits? Until when can a person manage it on his/ her own?

“Stress is a natural occurrence but taking on too much can be avoided . Relax whenever you feel mentally, physically or emotionally exhausted before your stresses break you down”.

  1. Stress does not tend to only affect one person; its effects tend to spill over to the people around them. How do you think that we as a friend/ family member help a person dealing with stress?

“Stress is a personal problem but its manifestation can be felt and definitely seen in the family, friends and other areas of one’s life. The friends and family too should know that the life has to be lived in positive moments and as such the negativity should be eliminated from the life completely.

  1. What message would you like to give to our readers this Stress Awareness Month?

“Live life in positive emotions, the negatives are not meant for the living “.

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Meena had left her husband’s house a week ago and she didn’t want to go back.The little fight that they had , had been a routine .She felt she had been a little too hard on her husband. She wanted to atone for these bickerings by punishing herself.She wanted to stay away from her home and husband, always believing this would be her punishment .

Ravi always wanted to have some freedom and space in his busy life. He would travel to the hills once every three months. But he felt guilty of cheating on his wife,every time he did that .He did not know how to compensate his wife for this and the guilt always knawed upon his mind. He brought her number of gifts, believing that way he was paying for his neglect of her . Both the situations above indicate that,

We often take it too hard on ourselves and become compassion less for our own mind ,soul and body.We indulge into self denial ,self effacement and /or believe in self punishment .But how would such a step ever become a compensation to the other partner .Every harmful act that you think of doing to yourself either and or think that self punishment could be an act of compensation to the other partner would in fact be a compassionless act for both.

“You need to be more compassionate to yourself first before you think of developing the same for others. When you have learned compassion for yourself, compassion for others is automatic.”

What is Mindful Perceptive Compassion Focused Therapy (CFT)?

Compassion-focused therapy (CFT) aims to bring about a better mental health and emotional well-being by training and enabling people to develop a compassionate attitude toward themselves and other people in their lives .This helps the person get a better understanding of self and that of others’ intention, motivation and activities.

What does Mindful Perceptive CFT Involve ?

The therapeutic technique of CFT include five A exercises spelt out as Acceptance, Appreciation, Adjustment, Accomodation, Adoption or Adaptation.These extensive exercises, or activities emphasising the mental perception buildup of solid relationship, an individual can enjoy are undertaken during the Therapy on regular basis.

These exercises may include making a list of accepting person or things first at the face values irrespective of the likes or dislikes,Appreciation comes by taking time to savour the moment when something enjoyable is noticed, and other positive rewarding behaviours.Similarly mind then is trained to understand utilise and appreciate the concepts of other four A’s.

Mindful Perceptive Meditation is made use of in CFT is to develop a better sensory perceptive attention to the current moment in a manner that is free from any bias or prejudice. CFT makes use of Compassion-focused imagery exercises, or the use of guided memories to stimulate an appreciation of the environment .The objective of the guided imagery is the production and perception of a relational image that stimulates the calming system of the mind.

This can be achieved by perceptually imaging someone showing kindness and compassion to you and then mentally experience how that feels, with the intention that you learn how to show yourself kindness and compassion.

Disorders treated with Mindful Perceptive CFT

Mindful Perceptive CFT can be helpful to people who find it challenging to understand, feel, or express compassion in their social interaction and relationships .

Mindful Perceptive CFT can help to explore reasons ,events and past experiences that have brought about such a difficulty in developing compassion. Mindful Perceptive CFT explores methods of positive change.

This therapy can also be effective at helping people come out of their distressing thoughts, behaviours, and negative feelings of all kinds . Such MPCFT particularly is helpful when dealing with feelings associated with self condemnation,self effacement and self harm.

CFT can also help with, depression, Anxiety, shame based trauma, eating disorders, anger and self-harm.

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on the occasion of Doctors Day  we are releasing the second video by Dr. Ramneek Kapoor on youtube.

In this segment, Dr. Ramneek Kapoor, Psychologist, Family Therapist, Science of Living and Preksha meditation expert, talks about the need for self acceptance to deal effectively with depression, anxiety and stresses of life.

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