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Understanding CBT and Counseling Techniques used for Better Mental Health

Posted in daily writings and musings of the psychologist, tagged , , , , , , , , , , , , , , , , , , , on April 11, 2022| Leave a Comment »

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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Autism Spectrum Disorder: Managing Behavioral Difficulties in ASD Children

Posted in daily writings and musings of the psychologist, tagged , , , , , , , , , , , , , , , , , , on December 10, 2021| Leave a Comment »

We regularly get queries from young parents asking for support to understand the behaviour of their wards suffering from Autism Spectrum Disorder and the behaviour difficulties faced by the affected children.

Children suffering from ASD have behaviour issues which are quite common. These issue relate to more about their communication, social interaction,working within the structured schedule and processing of the sensory information.However if parents are trained and equipped with the appropriate strategies , much of the stress and strain can be reduced bringing relief to the family and the child.They can often be managed through effective activity and behavior management.

There are many difficulties, ASD children face in their behaviour. These issues can be identified as difficulties in communication, issues of  sensory processing, social interaction, and physical balance issues that can make active play more difficult for these kids. Parents and caregivers need to understand that  such behaviours as appear inappropriate are in reality symptoms of the difficulties the child with ASD is facing in his her day to interaction and communicate with others .

Understanding the Causes of Inappropriate Behaviour

The main causes of behavioral difficulties are generally as follows:

Difficulties with communication: Children with ASD struggle with both verbal and expressive language, understanding what is being said to them, and comprehending non-verbal communication cues. This can, become quite frustrating for both the communicator and the child .The child may not be into problem behaviour but to the other person it would appear so ,which causes frustration at both ends.

Difficulties with social situations: The difficulties presented by social situations for a person with ASD are much more than mere communication; people with ASD struggle to understand others’ points of view and grasp the “unspoken rules” of social interaction that state when to, begin and when end a conversation. They are in no position to get the emotional nuances of social communication. Due to all of this, children with ASD may avoid social contact, and they are more likely to experience being harrassed and feel overwhelmed by unnecessary intervention by others in their life .

Difficulties with unstructured time: People with ASD have a hard time dealing with situations where there is no set schedule, as their brains have a hard time sequencing activities on their own out of the given timetable and schedule. Due to this some of the children with ASD are more likely to act out during the period which is not scheduled earlier eg.free period or suddenly declared break times, as they feel confused and frustrated.

Difficulties processing sensory information: Those with ASD often have over or under-sensitive senses, leading to a tendency to get overwhelmed or to seek attention to such a degree that it becomes embarrassing for the accompanying parent and the person interacting with the child.. ASD affected child may react strongly to an unwanted touch, be very selective and particular food eater, get largely disturbed and irritated by loud noises ( be it a noise coming from far off .The child feels unable to concentrate on account of background noise and reacts adversely.

Additionally, one should always remember that people with ASD do not easily adapt to change.Parents managing their ASD ward should be aware of the changes being brought about in their environment or schedule that can trigger problem behaviours.A sudden bout of Illness (especially seizures, which ASD individuals may be prone to) can also trigger adverse reactions as the child with ASD cannot give verbal expression to his or her pain. Doctors advise parents to use picture posters or diagrams to help children express where they are feeling pain.

Dealing with Problem Behaviour

It’s key to understand that the child is using these behaviours to try to communicate something to you, or to achieve some specific function. It’s vital to look under the surface of these behaviours so as to discover the unaddressed needs below. Try to asses what you child is trying to tell you, rather than reacting to the behaviour itself (resist “punishing”; few ASD children actually understand the cause and effect implied by it). It’s also advised to keep a “behaviour diary” or chart so that one can identify patterns in a child’s behaviour and from there, isolate what’s triggering the child’s episodes. One can then develop strategies to avoid or manage the triggers (be sure to introduce these slowly, as sudden changes in routine will do more harm than good). Likewise, expect the child to initially resist the change; stay patient and be consistent with it regardless, and make sure that other family members, teachers, and caregivers are also keeping consistent with it.

One should also develop supportive therapies to help the child shed his or her frustration; these typically include: exercise, brief time out periods in a quiet, darkened space, and relaxing activities. Set achievable treatment goals and don’t push too hard for rapid improvement, as people with ASD can struggle to integrate new knowledge and change behaviours.

To get the best out of a child with ASD, it’s often helpful to employ the following strategies:

  • Speak clearly and precisely (and use short sentences) in order to work around the difficulties that arise with complex verbal communication.
  • Use visual supports. Many children with ASD process visual information more easily than other forms of information. Timetables can be helpful to assist children in understanding schedules.
  • Create “social stories”. These are brief descriptions (using words and images) of situations, events, or activities that help tell a child with ASD what to expect during an upcoming social situation.
  • Help the child identify his or her emotions. This is often challenging to a child with ASD; use visual aids (such as “stress scales”) to help the child quantify what he or she is feeling and how intensely, and help the child learn via physical associations, such as showing him or her that anger connects to a reddening of the face, stomach pain, the urge to cry, etc.
  • Help them learn to relax. Children with ASD find it hard to relax, and can be very “intense” and obsessive in their interests. Try to work relaxing activities or some quiet “alone time” into his or her daily routine.
  • Make their environment more soothing. As children with ASD can become overwhelmed by sensory information, it’s important to ensure their environments are as free as possible of sensory irritants. Flickering lights, devices that give off background noise, scented candles, etc., should be removed.
  • Give praise, in the form your child likes best. Praise is as important to an ASD child’s learning as it is to most children’s learning, but depending on their unique needs, praise may have to be modified to suit the child. For example, some may not like hugs, some may not recognize verbal praise. Often visual cues like stickers on charts or time doing a favourite activity as a reward are effective forms of praise. Praise should be as immediate as possible so that the child can assess cause and effect.

Seeking Help

 If your child’s behaviour is placing him or herself at risk, or others at risk, you should seek professional help by a psychologist or psychiatrist, rather than trying to handle the situation on your own.

(more…)

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Stress Awareness:an insight into the same

Posted in daily writings and musings of the psychologist, tagged , , , , , , , , , , , , , , , , , , , , on June 22, 2021| Leave a Comment »

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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Mindful Perceptive Meditation and Talk Therapy can help Schizophrenia

Posted in daily writings and musings of the psychologist, tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on February 3, 2019| Leave a Comment »

pm2Ashu (name changed) could not do anything in life ever since he had been diagnosed of schizophrenia by the psychiatrist. He had been prescribed psychotic medicines by different psychiatrist doctors wherever his family had taken him to them .Yet nothing helped. His fears and phobias had worsened with time. The voices in his head continued disturbing him. His logical cognitive ability had been completely distorted and for him all the delusions had become the real images and characters.

meditation singleSimilarly Sheena (name changed) continued with the fear and phobia of persecution at the hands of a person who had long moved out of her life five years ago. Sheena had been diagnosed of delusional disorder (a psychotic disorder).Her life had become completely miserable as she would often get lost into her phobia and would not be able to conduct her normal day to day routine life.

Schizophrenia is a psychiatric disorder that disables and distorts the logical thinking and cognition of the individual affected by this chronic brain disorder involving “positive” and “negative” symptoms.

Positive symptoms relate to hallucinations (hearing voices or seeing visions that aren’t real), delusions (fixed false beliefs), and disorganized thinking or speech. People suffering from active positive symptoms often respond to those symptoms in ways that are obvious to others around them (e.g., agitation, disorganization).Ashu, mentioned above had suffered from imaginative voices in his head hearing that someone is out to prosecute him and that he would be sent to prison. While these thoughts were not visible to others but he often complained of hearing voices and attributed the voices to one of the persons he had been dealing with in his family business.

Negative symptoms relate to substantial decline in the affected person’s social interactions, communication, and motivation to conduct day to day affairs. Sheena had displayed negative systems when she had been referred to us for, a “split personality.” behavior, but Schizophrenia has nothing to do with split personality. She had been suffering from delusional disorder, a kind of schizophrenic psychotic disorder.

Ashu and Sheena both exhibited resistance to antipsychotic medications and their family members were definitely at a stage when nothing could help them. Ashu did sometimes show partial improvements only to go back to from where it had all started. We noticed that Sheena’s problem continued to be more chronic and affected all aspects of her life. She did not respond to any psychotic medications being administered by the psychiatrist.

But both Sheena and Ashu found it difficult to establish and maintain relationships within the family and externally. They were unable to carry on their day to day work on account of mood swings and delusions that would take a toll of their logical thinking. Both had virtually cut themselves off socially. Their disordered thought process prevented them to understand that they were not normal in their thinking faculty like other people in their lives. Their family too found it quite an uphill and expensive task   to follow the treatment handed out to them by the doctor every fortnight on account of heavy cost and also due to the patient’s refusal to take the medication.

We decided to make good use of Mindful Perceptive Meditation Therapy and Cognitive Behavior Therapy together to treat both Ashu and Sheena regularly on every alternate day basis in order to maintain regularity and without giving them a chance to revert to their pre conditioned schizophrenic way of thinking and cognition. Initially we found it difficult to communicate with the subjects as they would either not come for counseling or if they had come, they would not pay attention to what was being discussed. Gradually they started to respond to our instructions. We had begun the treatment with “Shwas Preksha ‘(Mindful Perceptive breathing exercise on the psychic centers) conducted under the watchful eye of the expert instructor. Soon we started noticing a significant improvement in both of our clients.

Thereafter we had begun with them the activities of “Mindful Perceptive Meditation” which involves both body and mind into deep meditation on the psychic centers, being fully aware of the moment and the breathe present in every living moment in its total intensity”. This continued along with the regular exercises of Kayotsarga to provide the much needed peaceful perception of the body through mind. Kayotsarga is a process of meditation that dissociates the physical body from the mind and it puts the muscles of the body to   complete rest progressively, somewhat similar to progressive muscle relaxation technique.

Peaceful-Mind-Remedies-South-Croydon-426x426Soon a very significant improvement could be noticed in certain negative symptoms, (e.g., negativity about self and family, sense of doom, lack of interest in surroundings and /lack of drive) started yielding to positive thoughts on all these issues .The clients did respond well as we noticed Ashu and Sheena both had begun looking at the positive aspects of their life. Their sense of appreciation for some aspects of their lives could be felt in their daily interaction with us. We could see their interest reviving in their day to day life too exhibiting positive symptoms.

These results had further been strengthened by the process of Mahaprana  Dhwani {greater inner sound effects  produced by the help of mouth and nose while exhaling  the breath by the patients }reformed  on all psychic centers during the process of deep perceptive breathing exercises and exhalation  undertaken by the patients.

Mindful Perceptive Meditation and CBT has been very effectively used by us in a variety of psychiatric/psychological disorders .We had used Mindful Perceptive Meditation and positive affirmative techniques to enable the affected person correct the functioning of endocrine glands producing negative steroids and emotions and subsequent faulty thought process .The practice of CBT generates critical cognition of actual position of the situation and helps analyze all kinds of thoughts with objectivity and factual back up. The Mindful Perceptive Meditation therapy supports written affirmative statements about the self and situations which would be given as homework exercises and are reviewed later with the clients. The whole process was focused on changing the negative perceptions about self and situations to positive emotions and thoughts.

Generally a patient requires 50 to 60 sessions over a period of three to four months. But in severe cases the sessions (each running for 45 minutes to one hour) can go up to 90 to 120 sessions over a period of 6 to 9 months’ time like it had been extended in these two cases for up to 6 months.

It gives us greater satisfaction and happiness that eventually after a hard work of six months , the patients had been cured of their problems to a large extent and with the help of their family and friends,  the process of rehabilitation  of both of  them into the family and society had been achieved.

We have   been making use of Mindful Perceptive Meditation and Cognitive Behavior Therapy successfully in many other cases of depression, anxiety, stress and many other psychotic disorders and many have been restored to their normal life.

Perceptive Meditation enables you live in and with your breath taking your mind away from your anxiety stress and worries of life .It empowers you to live in the moment with complete mindfulness of your soul ,body and mind “. Ramneek Kapoor.

If you have someone in the family suffering from any such disorder,Come and discuss with us how to proceed.

You take the first step today and  we help you  find the much needed happiness.

Call  on us @9179383554 or write to us @ mansikpramarsh@gmail.com

-Ramneek Kapoor – Family Therapist, Psychologist Counselor and Science of Living Expert.

 

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