Open questioning and closed questioning can be useful in therapy, particularly CBT, because it can give us facts about the client and allow the client to explore in more depth. Mostly open ended questions are used during formulation or assessment process in therapy to allow the therapist to collect as much detail as they can about the client while in the early stages. But sometimes a closed question is needed to find a clear answer. Closed questions are those that have short, often one word answers such as yes, no, last week, tomorrow, mother, father etc or maths type questions such as what is 2+2? Open questions allow the client or answerer to go into depth/detail about the information being sought. They can explore a memory or past event in their own words and give as many details as they like.

Below I have listed 15 questions I would most likely use in a formulation session with a client. They are mostly open ended questions to allow me to find out details about the clients past and experiences so that the client and I can build a clear and detailed picture of the issues bringing the client to therapy and the type of outcome the client would like.

1. What issues
   have caused you to seek therapy?
   
2. Have you
   had therapy before, what type was it and did you find it helpful?
3. When did you first notice this issue? Or How
   long have you felt like this?
4. Can you
   remember if that was the first time you felt like this? Can you describe the
   event you just recalled?
5. What
   events or actions cause you to feel like this?
6. How is
   this issue been impacting on your life?
7. How does
   this issue make you feel?
8. What do
   you do when you feel like this?
9. Why don’t
   you like that behaviour/feeling?
10. Where
    does this happen – work, home, friends, family, relationships, gym etc
11. What part
    of the behaviour/issue do you want to change?
12. How would
    you like to feel?
13. Do you
    have any specific goals you would like to achieve?
14. If you
    can wake up and the issue/problem had gone what would have changed?
15. Are there
    any other issues impacting on this issue?

Overall these are the main 15 question I would use during a formulation with a client, mostly they are open questions allowing the clients to explore and understand their life in detail and make links to actions and events. These will help me create a therapy plan with the client and use the correct therapeutic techniques to aid the client to the best of my therapeutic skills and abilities. So if your counsellor seems to ask a lot of questions in an initial assessment this could be why.

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

Endorphins

Endorphins are a peptide hormone produced by the body’s central nervous system in the pituitary gland and hypothalamus, they bind to the body’s opioid receptors and have an analgesic effect on the body. They are a not only natural painkiller released when we feel pain but can also be released in response to stress and depression as well as during pregnancy. They help us to function when we are injured but can also be released when we do certain other activities such as exercise, sex, dancing, eating, drinking, singing, art, or social activities, including laughing (they help us reinforce good social attachments). This means that when we are feeling low mood, stressed, anxious, depressed, aching, have sleep issues or self-esteem problems we can find relief by doing activities that create endorphins, sometimes however, the depression or stress causes us to be unable to do the endorphin releasing activity, it helps to have more than one way to release the natural opioid chemical. Endorphins are a very useful hormones to increase mood and social function and reduce pain or chronic illness.

Serotonin

Serotonin isn’t just found in brain cells and central nervous system but in the bowel/intestine/digestive system and blood platelets too; its sends signals between these areas. These signals can be about mood, sexual desire, appetite, sleep, memory, temperature or social behaviour. It is created by essential amino acid tryptophan a protein found in red meats, cheese and nuts. Serotonin can help us to be calmer, happier, more focused, less anxious and emotionally more stable.

Serotonin is a very varied chemical that is reported to have impact on various bodily functions such as: regulation of bowel movements, regulation of moods, impact feeling nauseous when our body wishes to push out a bad food, impact our cardiovascular system, our endocrine system, impact on blood clotting and wound healing by narrowing arteries and increasing blood platelets, it can also cause osteoporosis in bones if its levels are too high as well as having an impact on our sexual libido levels.

It is believed that serotonin regulates the many systems mentioned above, if we have too little serotonin in our systems we can have complications most commonly with depression, obsessive compulsive behaviour, panic, anxiety and insomnia. It is believed that depression could be caused by multiple factors including low production of serotonin in brain cells, lack of serotonin receptor sites (sometimes blocked by other chemicals), failure of the serotonin to reach the receptors, or a shortage of tryptophan. Lack of serotonin can also impact our libido, low serotonin usually has the result of increased libido or sexual desire. It could possibly impact on the condition known as irritable bowel syndrome giving a gut brain link that is currently being researched.

Low serotonin is often treated by chemicals most commonly known as anti-depressants – these are either SSRI’s selective serotonin reuptake inhibitors or SNRI’s serotonin and norepinephrine reuptake inhibitors (regulating which receptors and the number of receptors that bond with the serotonin, and how much can be used). It is also believed that sunlight (particularly for seasonal depressive disorder), exercise and diet can increase serotonin production and regulation. Low serotonin can have a negative impact on the body and the mind.

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

The A B C D E model of Cognitive Behaviour Therapy (CBT) was developed by Albert Ellis in the mid-20^th century. He based it on his Rational Emotive Behavioural Model of empirical based psychotherapy which believed that irrational beliefs are developed by people in response to perceived goals being achieved or failed. He understood that people construct ways of thinking based on their experiences in life including philosophy, language, belief systems, educational experiences and upbringing. Sometimes these rational (positive and useful) or irrational (negative and damaging) beliefs link to emotions and thus impact on our future thoughts, feelings and behaviours.

Ellis believe there different types of irrational beliefs. These he suggests are:

• Demanding – absolutism; very inflexible dogmatic
  and extreme terms used by individuals such as must, should, ought.
• Demanding – love or approval; the need to seek
  love form people they view as important (parents, partners, teachers, friends)
• Demanding – success; having to achieve or be
  best at what they do
• Demanding – comfort; struggle with any form of
  discomfort or distraction in their lives (working with noise, untidiness,
  cold/hot)
• Awfulsizing; events are categorised as the worst
  they could possibly be, rather than in context.
• Low Frustration tolerance; as above they believe
  they can’t cope with distraction rather than they actual can’t
• Depreciation of Self; global negatives all of
  them is bad because of one issue.

Ellis proposed the A B C D E solution to these issues. This is broken down as follows. It is often used by therapist to help clients understand themselves better and to make changes in previously help irrational beliefs and the subsequent behavioural responses.

A=Activating – this is the event, activity or adverse condition that causes the irrational thoughts to become a problem.

B=Beliefs – usually irrational, about the event

C=Consequences – the belief that develops has physical and emotional response or reaction

D=Disruption of beliefs – challenge and alter them. Argue against the irrational.

E=New Effect, or approach to emotions and irrational thoughts

An example I would offer is of a relationship where a fear of harm has developed.

A=partner has failed to arrive home with a reasonable time of when they were expected – the activating event.

B=thought process “oh dear what is they’ve been in an accident and they’re dead” irrational thoughts or beliefs. Can often develop from previous experiences – i.e. they may have had someone die in an accident or they may have learnt from a parent or traumatic event previously.

C=consequences can be mental, emotional and physical i.e. feeling sick, being sick, panicked, anxious, pacing, ringing people, hot/cold, headache etc.

D=disruption of these thoughts would be to use the question “what is here was an alternative?” then suggest answers – they may have had a meeting, there might be traffic, they may have gone to a friends, they’ve never had an accident before, they are often late, they may have got the time wrong.  It is about recognising the irrational thoughts and finding positive alternatives. About dislodging the old learnt behaviours and emotions.

E= Find a new emotion – I get to enjoy alone time, I trust them to drive safely, the worst doesn’t always happen, I would have been told by now if something was wrong, they came home late X times before and it was alright. Use a calming technique to find a new emotion to link to the situation.

This shows how Ellis believed thoughts and emotions can link together in a negative emotional way but that when challenge a new positive link can be created. Sometimes the stages overlap or aren’t clear cut but the therapist will work with the client using the ABCDE as a guide to their process of change.

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

This is a combination of Mindfulness and Meditation that can be helpful to those who find clearing their busy mind a difficult task. It is designed to help you be both calmer and more in control of your own thoughts.

I call it the 3 B’s – feel free to try it, remember adapt it to yourself – you are an individual.

Sit quietly or lie in bed, use mood lighting, scent or music (see previous blog posts for more information) if needed.

The Technique:

B 1 – Tense and relax your muscle groups from head to toe to ensure relaxed – bodyscan

B 2 – Breath in and out, counting slowly to 4 or 5 for each breath in or out. Recognise thoughts if they happen but refocus on your breathing

B 3 – When you start to notice thoughts are calmer create a bubble around you, give it form, colour and texture, be creative, really focus on it. Now create your world inside it, is it hot or cold, does it have a smell or colour? Is it a beach or a snowy mountain, use all your senses to create your world,. Give it as much detail as possible. The more you focus on your senses and the detail in the world the more control of your thoughts you will have and the calmer you will become. Try to focus on it for as long as you can – usually 5 minutes is a good time.

Remember if it doesn’t work for you or feels detrimental please stop using it.

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

Self-Care is well known as an important area of remaining functional and productive. This is not unique to the therapist’s world, self-care is good practice for everyone. To spend time finding out what recharges our batteries and then doing those activities is crucial to living a full, happy and productive life.

A lot of the time people say ‘oh you should try self-care’ or ‘have you done self-care today?’ but they fail to tell people what self-care is or their description is so vague people have no idea what is meant by self-care.

Self-care isn’t elusive, or known by a few, it is something you do have to put a little effort into finding out. So as children we are excellent at self-care, we know just when we want to nap, or play in the mud, or climb trees, or read, or take the video player apart, or make a Lego castle…. I could go on but I think you get the idea. As adults we get so busy with work, housework, children, etc that we forget the skill children have called ‘how to do what we feel we should be doing’. This is self-care, those little indulgences that make us smile or relax or feel happy. This is however, unique to everyone. For some people it is cleaning for others this would be a chore. For some it is building play scenery at the local theater for others it is being in a busy concert, for others it is reading a book by a stream. No answer is wrong if it is right for you and harms no one else in the process. You may need to experiment with things until you find ones that ‘feel’ right for you, these may differ based on your personality, mental health needs, physical health needs, circumstances, but everyone can find something.

I recently surveyed people and I will share the results with you in as helpful way as possible.

What people class as self-care

I asked for what people do as self-care to help give you a starting point of things to try, some of these are expensive, some are free, others are in between, remember be adaptive and be yourself. I have created a self-care bingo card using their answers. Have a go at making your own then when you are in need you can pick it up, choose an activity and hopefully feel revived. To download and use the full bingo document click on the word Bingo below

Self-care Bingo

Just click on the link above to download your PDF copy

Frequency of self-care

This all depends some activities require more time or money than others, or are only available at certain times, so it is always good to try and find a selection of items to put on self-care bingo to give you the best chance of finding one when you need to.

Out of 25 people who responded to my survey 15/25 (3/5) of them said they went out at least once a week (some said they went out to activities multiple times a week), 6/26 said they went out once a fortnight, 3/25 said they went out once a month and 1 said they went out less frequently than once a month. So the average answer here is that most people go out at least once a week.

Average Costs of Self-Care

I asked people how much they would spend on ‘going’ out or ‘treating themselves’. I published this in my last blog to show how therapy could cost the same as self care but just to remind you here are the results. This proves that self-care does not have to be expensive, especially if the average going out is at least once a week.

The average spend out of 22 participants was £60

The lowest spend was £15

The maximum spend was £120

If you need more than Self Help and would like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

I have recently been on a course about panic attacks, continuing professional development is an important part of being a good therapist. Here are some of the key points I learnt and some links for you.

The symptoms of panic attacks are:

• Palpitations
• Sweating
• Trembling
• Shortness of breath or shallow breathing
• Chocking
• Chest pain or discomfort
• Nausea or tummy ache
• Feeling dizzy or faint
• De-realisation
• Fear you’re dying
• Fear you’re losing control
• Numbness
• Hot or cold

Often panic attacks can be down to cognitive failure to understand the body’s responses to a stimulus and thus catastrophise it. For example out of breath while walking uphill, misinterpretation of the experience means body might think it is having a heart attack and cause panic symptoms. If these get repeated when you next feel out of breath your body might have a panic attack. People then stop doing the cause of the panic e.g. don’t go out walking which avoids the panic, bit creates a negative coping mechanism instead of altering the thought process that led to the panic originally. 

Cognitive Behavioural Therapy often helps as it changes thought processes, but equal so can Person Centres, and Mindful therapy.

At least 1 in 10 people have experienced a panic attack and up to 1 in 60 have a panic disorder. If you need to talk about panic please seek help, it is not unusual and help is available.

If you need more than Self Help and would like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

• Helplines:
  • No Panic – This website is a charity set up to help people with anxiety disorders including panic disorder. The website has lots of advice and support and a telephone helpline: https://www.nopanic.org.uk/ 
  • Mind – The mental health charity Mind’s website also has lots of advice and support plus an information helpline and webchat service. www.mind.org.uk  For specific link: https://www.mind.org.uk/ information-support/ types-of-mental-health-problems/ anxiety-and-panic-attacks/ panic-attacks/ #.XJ5HsdL7TIU 

• Information: The NHS has
  information on how to cope with panic attacks, e.g.:
  • https://www.nhs.uk/ conditions/ stress-anxiety-depression/ coping-with-panic-attacks/ 
  • https://www.moodjuice.scot.nhs.uk/ Panic.asp 

During my recent research I explored how much people would pay for a night out or for a hobby. My aims was to compare this to the cost of a therapy session in the hope of convincing you that therapy may be worth the cost.

The results of the research are as follows:

The average spend out of 22 participants was £60

The lowest spend was £15

The maximum spend was £120

Other research shows that activities such as:        

• a
  meal out can cost between £40-£60 on average
• having
  your hair done £30-£60
• a
  night out drinking/ pub quiz £20-£60
• having
  your nails done £20-£40
• a
  tanning session £20-£40
• Cinema
  £15-£30
• Wine
  for evenings £10-£70

These are activities that people do on a regular basis. Counselling is usually for a limited period typically between 6 – 20 weeks, with people returning at a later date if they wish to discuss other issues.

Therapy costs between £30 to £35 at Wright Minds. Would you consider spending £210 on 6 weeks of therapy a good bargain if it helped you feel better about yourself in the long term and enjoy your life more? Most clients find that therapy improves their life in some way.

When you next consider self-care consider therapy isn’t as expensive as you may think when compared to your other daily activities.

If you need more than Self Help and would like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

These are two books on my shelf that are written to the client to help them start their journey to good mental health. I found them very enlightening.

Remember, if you are journeying to better mental health and find that the books alone don’t work you can always contact a trained therapist or your Doctor for further help.

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

So I guess that sounds like a weird topic – Apps – but allow me to explain. I’m not talking about Apps that counsel you, but about Apps that can help you relax. I have downloaded and reviewed several Apps that are aimed to offer soothing or calming music. The three I’m going to share are free to download and I found easy to use.

The First is called Ambience – it allows you to choose and combine up to 3 sounds, such as city sounds, nature sounds, rain, water, fire burning, white noise, musical instruments and many more. You can create your perfect calm soundtrack and you can set it for how long you want it to run for, 10 minutes or 3 hours, its up to you.

The Second App I have found useful is Mindfulness, it has several guided Mindful Meditations that you can listen to or if you scroll through the menu it also include several tracks of music that you can use to help you relax such as Asian Spa Music, Deep Waters, Deep Space.

Third I suggest Sleep Sounds. Really easy to use, choose the main sound then add others, build them up your way, set the volume on each sound and even set a timer for when it stops

You could use these sounds or tracks to help you relax, de-stress, be mindful or meditate or even help you to fall asleep.

If you need more than Self Help and would like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304

images are screenshots from the mentioned apps

Easily available are mood lights, the one above is called a moon globe. They offer low, soft lighting to help you feel more relaxed while meditating, trying to relax or fall asleep, or make your office desk feel more calm. They can work really well in conjunction with meditation apps, as sleep aids, or even nightlights as often they are rechargeable rather than needing mains power.

If you’d like some face to face counselling in the Stoke-on-Trent, Newcastle-under-Lyme or Staffordshire area please do contact Wright Minds at laura@wrightminds.co.uk or on 07598810304