Ways of Treating a Problem: Repair & Prevention

Body/Mind & Sensorimotor Methods

Body-mind therapy is a psychotherapeutic process that works on the relationship between the body and the emotional processes of the client, and is intended to address emotional concerns that are not as likely to be resolved through talk therapy alone. It is of great use for frontloaders or those with weak rear nets, but could be dangerous if you have wronguse in networks 1 or 5 (see tutorials).

Therapies are in alphabetical order.

Applied Relaxation Therapy

Teaches systematic approaches to relaxation, for example, progressive muscle relaxation, often combined with breathing techniques and/or meditation.

Aromatherapy

Is really a part of herbal therapy. Essential oils, ointments and sprays are (usually) plant-based preparations containing tiny aromatic molecules that are readily absorbed via the skin, and whilst breathing they enter the nose and lungs. They are used in several different ways:

Massage & bathing with essential oils is useful for aches & pains brought on by muscular tension. Some aromatics can act as rubefacients; drawing the circulation away from painful areas, others work as topical antibacterials (for example clove oil for a toothache). Their main use in NH is due to their ability to encourage the release of neurotransmitters and their role in memory adjustment.

Aromatic oil molecules come in different shapes & sizes, and the sensory detectors in the nose can differentiate between them. Each type triggers a different response in the brain. We can plot our own personal sensory association map and use this information for input control (see tutorials).

As with music, there will be a broad difference in the variety of individual odors that cause the desired response, but the broad categories of odor are universal (all humans like the smell of certain flowers and foods, and dislike the smell of vomit for example, although individually our favorite and least favorite smells will vary widely.)

Once you know which smells are most effective for you, you can employ them in input control.

You can easily make your own essential oils, the complicated way (using distillation) or the easy way -cold infusion: crush up the required herb or ingredient into a base oil such as olive oil, getting as much in as you can, in a clear glass container and leave it standing around in the sun or somewhere warm for three to six weeks, shaking daily. Then filter the liquid into a dark glass container and store in the dark. Don't use mineral oil as a base.

You can augment the effects of aromatherapy with herbal teas and dietary herbs.

Autogenic Training

Is often combined with relaxation methods to create a conditioned relaxation response to an internal stimulus, such as a word or phrase.

AT is a technique that teaches your body to respond to your verbal commands. These commands "tell" your body to relax and control breathing, blood pressure, heartbeat, and body temperature. The goal of AT is to achieve deep relaxation and reduce anxiety. After you learn the technique, you can use it whenever you need or want relief from symptoms of stress, or you can practice it regularly to enjoy the benefits of deep relaxation and prevent the effects of chronic stress.

It is a lot easier to learn this technique with biofeedback machines (see 'methods & tech part 2).

Breathwork

There are two hypotheses (called 'Central Ideas') behind Breath therapy. The first is this: In the average person, the breathing mechanism is functioning at only a fraction of its potential. The "normal" breathing system has been damaged, inhibited, due to a number of conditions and events, beginning at birth, and including family and cultural influences, as well as every physical and emotional trauma you have survived. The breathing system needs to be "healed," brought back up to the level that nature intended. The second is this: When full free breathing is restored, every system in the body begins to work better. We find that the breath itself naturally heals and renews the body, mind and spirit. "Conscious Breathing" becomes a very powerful self-directed healing process. The breath reveals itself to be an untapped natural resource, a therapeutic tool, for health, growth and change.

Eye movement desensitisation and reprocessing

(EMDR) is a form of imaginal exposure treatment for post-traumatic conditions where the traumatic event is recalled whilst the client makes specific voluntary eye movements.

Further reading: Tutorial 6

Light therapy

Offers drug-free relief from many specific conditions such as PMS, migraine, depression, hayfever, insomnia, Seasonal Affective Disorder, jaundice, wound-healing, sleep disorders, skin problems, coldsores and some psychiatric disorders. The method consists of exposure to daylight or to specific wavelengths of light using lasers, LEDs, fluorescent lights, dichroic lamps or full-spectrum light from a 'light box'. The light is administered for a prescribed amount of time and, in some cases, at a specific time of day.

Modern phototherapy lamps used in the treatment of seasonal affective disorder and sleep disorders either filter out or do not emit ultraviolet light and are considered safe and effective for the intended purpose, as long as photosensitizing drugs are not being taken at the same time and in the absence of any existing eye conditions. Light therapy is a mood altering treatment, and just as with drug treatments, there is a possibility of triggering a manic state from a depressive state, causing anxiety and other side effects, although these side-effects are usually controllable.

In some circumstances caution is required using light therapy. These include when a person has a condition that might render their eyes more vulnerable to phototoxicity, has a tendency toward mania, has a photosensitive skin condition, is taking a photosensitizing herb (such as St John's Wort) or medication (such as methotrextate or chloroquine; as there is a chance that these drugs could cause porphyria). It is also reported that bright light therapy may activate the production of reproductive hormones.

Music therapy

Helps improve your observable level of functioning and self-reported quality of life in various domains (e.g., cognitive functioning, motor skills, emotional and affective development, behavior and social skills) by using music experiences (e.g., singing, playing, composing, listening to and discussing music, moving to music) to achieve measurable changes in healing or developmental goals and objectives.

We all associate different types of music with different types of mood and experience, and it is the types of music (these are universal) that are important rather than the choice of individual performers (these are highly individual). Different music types can be used to stimulate release of different neurotransmitters, so they are an important tool for intelligence development and adjustment as well as healing and recovery.

Most online groups insist on 'music therapists', but music therapy is perhaps the best kind of DIY intervention. It's easy to learn and can be fine-tuned, if you'll excuse the pun, to suit your personal optimal needs. It's a powerful method of input control. We'll be exploring music therapy in future tutorials.

Sensorimotor Psychotherapy

Based on mindfulness and body awareness tied to the tenets of co-counselling, SP is a body therapy that involves a broad repertoire of postures and movements designed to help people improve their awareness of their bodies.

Sensorimotor Psychotherapy hypothesizes two general kinds of interrelated psychological issues: developmental and traumatic. Developmental issues result from disturbed early attachment relationships that lead to limiting beliefs about oneself and the world, while post-traumatic stress disorder results from overwhelming experience that remains unintegrated. When combined with unresolved trauma, early attachment disturbances can lead to a wide variety of adult relational problems (identical to the co-counselling hypothesis on emotional processing).

SP makes it possible to discover the habitual and automatic attitudes and behavior, both physical and psychological, by which we generate patterns of experience. It advocates following the inherently intelligent processes of body and mind to promote healing, and is particularly helpful in working with the effects of trauma and abuse, emotional pain, and limiting belief systems. Through the use of simple experiments, unconscious attitudes are brought to consciousness where they can be examined, understood, and changed.

The body is viewed as a living source of intelligence, information and change. The body, its sensations, and direct sensory experience are referenced throughout the therapy process. Sensorimotor Psychotherapy is based on and committed to principles of mindfulness, non-violence, organicity, unity, and mind/body holism. By proceeding slowly, gently, and non-violently, an atmosphere of safety is created in which our defences can be examined and willingly yielded, rather than confronted and overpowered and new resources, especially somatic resources, can be developed.

There are two problems with SP: One, it views all memory as somatic/emotional and can fail to address traumatic memories or aspects of experience that are not physically related; and two, it's not easy to do alone, as we need someone in the 'counsellor' role with whom to discuss the issues raised, and 'official' online groups cost money, but SP can be done like co counselling with a friend or small group, and books are available from libraries that explain the techniques. We'd recommend the Hakomi method:

http://www.hakomiinstitute.com/Resources/books.html

We'll discuss SP further in future tutorials.

Behavioral Methods

Work well allied to psychological methods for an integrated approach.

Lifestyle Changes & Input Control

At different stages of development we adjust to change for the better in different ways. Sometimes it is better to make a selection of small changes all at once, sometimes one large factor at a time, and sometimes a series of changes one step at a time. We have to get to know ourselves and what stage we are in to progress optimally in NH, and lifestyle observations help us to do that and to estimate roughly how long we may need to work on any particular area. It can also be useful for assessment, prediction and prevention.

An important rule for dealing with bad habits permanently is: never give anything up unless you replace it with something better. If you do, results are likely to be short-term or the bad habit will be replaced with an equally harmful one.

In almost all circumstances, acute fundamental changes (for example binge workouts, crash diets, sudden detox, emetics etc.) are dangerous.

Similar approaches:

Anger Management

The goal of anger management is not to create guilt about experiencing anger, but to use the experience as a signal that there is a harmful habitual response going on that needs to be addressed. Individuals learn how to recognize the signal and slow down their arousal when it happens, so that situations can be processed and interacted with in a proper way, forming healthier habits. To succeed, people need to learn what anger is, how to recognize anger triggers, how to become aware of their own unconscious responses and how to control and change them.

Most official 'classes' are sadly out of date with current neurology & psychology.

Authentic Movement Therapy

Arose as a conjunction between Jung's concept of active imagination and modern dance movement improvisation. It is used for creative and integrative movement exploration in the contexts of dance movement therapy, meditation and contemporary dance movement improvisation and, spiritually, as a journey of discovery. Movers improvise and explore spontaneous gestures and movements with their eyes closed, following inner impulses in the present moment. Some times called a movement meditation, Authentic Movement cultivates a contemplative frame of mind, clarity of perception and responsive movement and stillness of body and mind. Authentic Movement is practiced individually or in a group.

Behavior Therapy

Is a structured therapy originally derived from learning theory, which seeks to solve problems and relieve symptoms by changing behavior and the environmental factors which control behavior. Graded exposure to feared situations is one of the commonest behavioral treatment methods and is used in a range of anxiety disorders.

Conflict Resolution Therapy

Rests on the hypothesis that negative feelings mainly emerge in response to situations of conflict. If effective conflict resolution skills move the triggering conflict to resolution, well-being resumes. If conflict resolution skills are insufficient however, negative feelings continue to fester and grow.

This premise applies to conflicts within a person--conflicts for instance between someone’s desires and what they feel they should do. It applies similarly to conflicts between people--such as between a couple, spouses, a parent and child, or co-workers--and to conflicts between people and difficult circumstances--such as illness or economic difficulties. Conflict resolution therapy methods therefore are applicable to treatment with distraught individuals, couples, and/or families.

Conflict resolution treatment methods utilize visualization techniques for rapid exploration of family of origin sources of dysfunctional patterns. The treatment focuses primarily though on learning the communication and conflict resolution skills that enable couples to sustain a positive relationship (e.g., interaction), and using these skills to resolve the issues that have been divisive.

Unfortunately many groups are out of date when dealing with emotion-labelling. If sentiments like anxiety, depression, or anger have been problematic in the relationship, these also are addressed early on in treatment but are referred to as 'negative emotions'.

Continuum Concept

Particularly good for nonuse in network 2 (see tutorials).

Continuum aims to produce an extraordinary awakening to the fullness of what it means to be alive. Continuum has pioneered and revolutionized the role of somatics in health, relationships, physical fitness, creativity and spirituality... Continuum uses movement, the dexterity of breath, the resonance of sound and the value of meaning to amplify and refine interaction within ourselves, with others and with our world.

According to author Jean Liedloff, the continuum concept is the idea that in order to achieve optimal physical, mental and emotional development, human beings — especially babies — require the kind of experience to which our species adapted during the long process of our evolution. For an infant, these include such experiences as:

• constant physical contact with the mother (or another familiar caregiver as needed) from birth;

• sleeping in the parents' bed, in constant physical contact, until they leave of their own volition (often about two years);

• breastfeeding "on cue" — nursing in response to their own body's signals;

• being constantly carried in arms or otherwise in contact with someone, usually the mother, and allowed to observe (or nurse, or sleep) while the person carrying him goes about their business — until the infant begins creeping, then crawling on its own impulse, usually at six to eight months;

• having caregivers immediately respond to their signals (squirming, crying, etc.), without judgment, displeasure, or invalidation of their needs, yet showing no undue concern nor making them the constant center of attention;

• sensing (and fulfilling) their elders' expectations that they are innately friendly and cooperative and have strong self-preservation instincts, and that they are welcome and worthy.

Further Reading:

Wikipedia: http://en.wikipedia.org/wiki/Continuum_(theory)

Continuum Concept Website:  http://www.continuum-concept.org/cc_defined.html

Continuum Movement: http://www.continuummovement.com/cm-overview2.htm

Dance Therapy

Particularly good for those with nonuse in network 2 (see tutorials).

Physically, dance therapy can provide exercise, improve mobility and muscle coordination, and reduce muscle tension. Emotionally, dance therapy is reported to improve self-awareness, self-confidence, and interpersonal interaction, and is an outlet for communicating feelings. Some promoters claim that dance therapy may strengthen the immune system through muscular action and physiological processes and even help prevent disease, but this is true of any therapy (and method or practice) that reduces anxiety.

Based on working with body and mind as interrelated, dance/movement therapy is the psychotherapeutic use of movement as a process which furthers the emotional, cognitive and physical integration of the individual. It effects changes in feelings, cognition, physical functioning, and behavior.

Stress Inoculation Therapy

Is a type of behavior therapy that involves exposure to increasing levels of stress to practice coping more positively with stressful situations and preventing anxiety.

Chemical Methods

See: Drugs & chemicals section of the library, introduction

Methods Using Technology

See: “Methods & tech part 2: Tech” (in this section)

Psychological Methods

Psychological Therapies and Counselling; Evidence Based Guide

Types of Psychological Techniques

There are many types of psychological techniques and the range of different choices can be confusing. Whilst it is not practicable to give a full definition of every separate therapy, we have listed the main types of psychological therapies widely used. In addition, there are some therapies which, whilst not yet widely available, have been the subject of research, and these are also listed. Each of these can be practised with individuals, couples, families or groups, but most are impossible to do alone.

Treatment Length

A common therapy length is from eight to twenty sessions, although some therapies may need to be longer, for example, where there are complications of personality disorder or chronic relapsing depression. While there is little research evidence about the most effective pattern of delivery, there is some limited evidence of the benefit of extended follow up or ‘booster’ sessions for chronic disorders.

Therapies of fewer than eight sessions are unlikely to be optimally effective for most moderate to severe mental health problems. Often 16 sessions or more are required for symptomatic relief, and longer therapies may be required to achieve lasting change in social and personality functioning.

Specific phobias and uncomplicated panic disorder (without agoraphobic symptoms) can respond to brief interventions.

Eclectic Therapies

Many people formulate their program using more than one theoretical framework and choose a mix of techniques from more than one therapy approach. The resulting therapy is pragmatic, tailored to the individual. These generic therapies often emphasise important non-specific factors (such as building the therapeutic alliance and engendering confidence). By their nature, they are more idiosyncratic and difficult to standardise for the purposes of randomised controlled trials research to see how well they work, but this could be the most effective method of using therapies. There is an obvious split in therapy choice between front- and rearloaders (see tutorials); frontloaders emphasize cognitive solutions and rearloaders emphasize emotional/ or body-oriented healing. In reality both are important.

Integrative Therapy

Refers similarly to a formal theoretical and methodological integration of, for example, behavioral, cognitive, humanistic or psychodynamic approaches.

Supportive Psychotherapy

Refers to any psychotherapeutic approach that supports existing ways of coping with problems rather than challenges and attempts to change ways of thinking and responding.

Common Factors of All Successful Therapies

There are a handful of common denominators present in all forms of successful therapy. These elements are described below:

Unconditional Regard

Viewing a person with unconditional regard achieves two goals; first we treat the person (or ourselves) as greater than the problems. This is the hallmark of non-pathologizing therapy. It does not mean the problems do not exist, it means NOT viewing the problems as the whole person or the whole person as the problems. Working nonpathologically does not negate pathology, it depathologizes it. So for example, rather than labeling a person who's angry as an angry person, non-pathologizing therapy views one's anger as the malfunction of a system; not intrinsic to who the person is. We do justice to a person's true nature when we remember that behind the layers of anxiety-based protection, no matter how confused or indoctrinated or lost one has been, there is a loveable and intelligent person at the very core who is seeking help to get back out.

Second, this attitude empowers the person. Empowering therapists maintain the belief that people can continue to develop; to grow, heal, and transform. This belief is held no matter how intense someone's defenses and wounds are. People can heal if they want to and if they can contribute to their own growth by learning whatever is sufficient and necessary to that end.

It is a bad therapist who views a person as fundamentally flawed or incapable of change, because we now know that in those circumstances that person is more likely to feel and become flawed. We are far more likely to discover our true nature when therapy sees beyond wounds, problems and defenses and focuses on what we have in common -how the brain works.

Empathy

We are at our best when we give the intelligence that resides within each person (or ourselves) a chance to go to work. Good empathy can be established when a therapist or counsellor encourages a client to become the co-therapist or co-counsellor.

If you are working alone, empathy means 'knowing yourself'. Therapists who work collaboratively trust people to know themselves (or have the potential to learn about themselves) better than anyone else, to access their own intelligence, and to attend to their own problems. This orientation puts the 'client' in the driver's seat of therapy, and empathy-based therapies are known as 'collaberative therapy'. Collaboration is not directionless nor does it put the client at risk of further trauma.

The empathic relationship allows one to more fully and completely feel the presence of Self as your own intelligence while in the presence of another. A therapist or spiritual master who embodies intelligence as Self and feels unconditional positive regard in the face of whatever the client may be experiencing, nurtures the beneficial relationship. Without a beneficial relationship there is no benefit.

Genuineness

Being your natural responsive self is a state of being that a therapist can embody when with clients or that you can invoke in yourself. It's a state of calm, curiosity, friendliness, creativity, confidence, courage, connectedness, honesty and clarity. It is this state that allows a therapist to work collaboratively without pushing, without pathologizing, and without retraumatizing.

Glossary of Psychological Therapies in Alphabetical Order

Note: We only include therapies that have scientific proof or beneficial results. We do not insist on proof of background theory. In other words if a method shows clear evidence of working, we'll include it even if we don't know why.

Many therapies that work well have dodgy or out of date background 'theories', and we should always remember not to attribute results to unproven hypotheses. Some website might SAY that Aspirin kills pain because it is full of tiny warriors that attack pain goblins on horseback, so if you want to understand and get the best out of therapy you should learn as much about the brain as you can and make your OWN mind up why things work.

Adlerian Psychology

Particularly useful for those with nonuse in network 1 (see tutorials) because this approach focuses on people's efforts to compensate for their self-perceived inferiority to others. AP hypothesizes that these feelings of inferiority may derive from one's position in the family constellation, particularly if early experiences of humiliation occurred; a specific physical condition or defect existed; or a general lack of social feeling for others was present.

Consequently Adlerians are concerned with understanding the unique and private beliefs and strategies (one's life style) that each individual creates in childhood. This cognitive schema and life style serve as the individual's reference for attitudes, behaviors, and one's private view of self, others, and the world. AP claims that when we have looked at our early life experiences, examined the patterns of behavior that repeat themselves in our lives, and the methods by which we go about trying to gain significance and belonging, then healing, growth, and change can occur.

Art Therapy

Uses the creative process of art making to improve and enhance the physical, mental and emotional well-being of individuals. It is based on the hypothesis that the creative process involved in artistic self-expression helps people to resolve conflicts and problems, develop interpersonal skills, manage behavior, reduce anxiety, increase self-esteem and self-awareness, and achieve insight. Art therapy integrates the fields of human development, visual art (drawing, painting, sculpture, and other art forms), and the creative process with models of counseling and psychotherapy. It is used to assess and treat the following: anxiety, depression, and other mental and emotional problems and disorders; substance abuse and other addictions; family and relationship issues; abuse and domestic violence; social and emotional difficulties related to disability and illness; trauma and loss; physical, cognitive, and neurological problems; and psychosocial difficulties related to medical illness.

Counselling

Is a systematic process which gives individuals an opportunity to explore, discover and clarify ways of living more resourcefully, with a greater sense of well being. Counselling may be concerned with addressing and resolving specific problems, making decisions, coping with crises, working through conflict, or improving relationships with others. Counsellors therefore focus on client choices in their life circumstances, as a basis for their work. Counsellors may practice within any of the therapeutic approaches listed here, using psychodynamic counselling, cognitive behavioral counselling, systemic counselling and so on. However, most are currently influenced by humanistic, process-experiential and psychodynamic principles.

Co Counselling

Is a free interactional method of counselling done with a partner or group. Each participant takes equal time in the role of 'counsellor' and 'client'.

In the counsellor role we are expected to be attentive and to listen. In most cases there is no discussion and the counsellor gives no prompting; the aim is to support the person in the client role to work through their own issues in an autonomous, self-directed way.

Background theory:

The theory of co-counselling centers around what are called distress patterns. Distress patterns are patterns of behavior that tend to be repeated in a particular type of circumstance, that are irrational, unhelpful or compulsive. In other words they are harmful, either in themselves, or in the results they lead to, and usually both.

CC theory says these patterns are driven by the accumulated consequences in the mind of (currently unconscious) memories of past events in which the person was unable to express or discharge the emotion appropriate to the event. That means events and experiences in the past that we were unable to properly process at the time, that have left us with unsolved problems or issues we’re not comfortable with. It becomes a sort of a habit to run around these issues –often unconsciously-we get anxious and we get stuck.

Co-counselling enables release from these repetitive patterns by allowing "emotional discharge" of the past unresolved experiences. Methods of release used are called catharsis, and include things like crying, warm perspiration, trembling, yawning, laughing and relaxed, non-repetitive talking.

These are ways of processing an event that society represses, and it may be good for outward appearances not to cry in public but it’s not good for biology.

Co-counselling in general takes a positive view of the person (i.e. we are all essentially good), and considers the mind and body as an integrated whole (it is partly holistic. Fully holistic ontologies include the natural environment and all life).

While we do not recommend the 'official' co counselling institutions that apply restrictions and cost money, DIY co-counselling using Rogers' core conditions has the best results of any kind of counselling therapy.

Further reading:

“Interaction and core conditions: the basics” (Basics section of the library).

Intal tutorials

Drama Therapy

Is the intentional use of drama and/or theater processes to achieve therapeutic goals. Drama Therapy is active and experiential. This approach is good for those with nonuse in network 4 (see tutorials).

Drama therapy can provide the context for participants to tell their stories, set goals, and solve problems, express feelings, or achieve catharsis. Through drama, the depth and breadth of inner experience can be actively explored and interpersonal relationship (interactive) skills can be enhanced. Participants can expand their repertoire of dramatic roles to find that their own life roles have been strengthened. Behavior change, skill-building, emotional and physical integration, and personal growth can be achieved through drama therapy in prevention, intervention, and therapeutic settings.

Dreamwork & Dream Analysis

Is an area so contaminated with nonsense that it is difficult to find a practical method that makes sense. Ignoring dreamwork altogether would mean we miss out on a marvellous opportunity to develop unconscious awareness and sensitivity as well as coherent association skills, so we use dreamwork techniques in some later tutorials with interpretation based on the memory's own eidetic archetypes (themselves based on our biology), ignoring all other interpretation systems.

Emotional Transformation Therapy

(ETT). Useful for those with nonuse in network 3 (see tutorials); uses light & color therapy for input control to assist in the transformation of sentiment to healthy emotion, although it calls all feelings 'emotional states'. This means a thorough and rapid progression through an 'emotional state' that is likely to change a sentiment into a healthier, more functional and productive emotion. For example, hopelessness often transforms into empowerment, sadness into love, fear into confidence, anger into peace, etc. The strategy involves the person briefly facing the challenging sentiment in such a way that it facilitates a reduction of anxiety and then a new 'emotional state' (a genuine emotion) emerges. Before exploring this therapy it is useful to read: “Emotion and sentiment; the basics” in the basics section of the library.

Focal Psychodynamic Therapy

Identifies a central conflict arising from early experience that is being re-enacted in adult life producing mental health problems. It aims to resolve this through the vehicle of the relationship with the therapist giving new opportunities for emotional assimilation and insight. This form of therapy may be offered in a time-limited format, with anxiety aroused by the ending of therapy being used to illustrate how re-awakened feelings about earlier losses, separations and disappointments may be experienced differently.

Gestalt Therapy

Useful for those with nonuse in networks 1, 3 or 4 (see tutorials), Gestalt therapy hypothesizes two ideas. The first is that the proper focus of psychology is the experiential present moment. In contrast to approaches which look at the unknown and even unknowable, the perspective is the here and now of living. The second idea is that we are inextricably caught in a web of relationships and interaction with all things. It is only possible to truly know ourselves as we exist in relation to other things. These two ideas, here-and-now awareness and the interactive field, define the subject matter of Gestalt therapy. It provides a system of concepts describing the structure and organization of living in terms of aware relations.

Hakomi

See: sensorimotor psychotherapy (above)

Hypnotherapy, Hypnosis & Self-Hypnosis

Refers to any therapeutic approach using hypnosis as a main technique, for example, to promote imaginal re-exposure or relaxation.

Hypnosis is suggestion or self-suggestion.  The approaches discussed on this site are all based on proven psychological principles to give you what you need, quickly and comfortably.

You may have heard that some people can't be hypnotized. The ability to go into hypnosis is just that -an ability, and like all others it can be learned or improved.

If you couldn't go into hypnosis at all, you wouldn't be able to learn, to sleep, or to get yourself nervous by doing 'negative self hypnosis'. (You know when you imagine things going wrong and it makes you feel anxious? Well that's hypnosis!)

When well developed, hypnosis is a very powerful tool for improved performance and change.

At last, hypnosis is moving out of the realm of woo woo, magicians and stage performers and into the clear light of modern science - exactly where it belongs. Crazy news stories, stage hypnotists and gossip has led many people to believe that when you are in hypnosis, you are under someone else's control. Nothing could be further from the truth. When you are hypnotized, you are just really relaxed and focused - in fact, the most common comment is "Was I hypnotized?". It is a little like meditation –you may be aware of your state of mind changing but any time you want to, you can get up and walk away.

Hypnosis isn't like being asleep - you can be aware of everything around you, just like when you meditate. In hypnosis, you simply have a stronger focus internally, plus wonderful deep relaxation.

Further reading:

Hypnosis for beginners (methods & tech section of the library)

Tutorials

Image Therapy / Therapeutic Imagery

Therapeutic Imagery is a type of input control (see tutorials) that applies imagery; the eidetic language of unconscious memory, in overcoming conflicts or blocks in our behavioral motivation. Similarly, imagery can assist in healing the physical body by improving the immune system, leading to faster recovery and rehabilitation.

Through subtly inducing relaxation, therapeutic imagery enables us to bypass the conscious mind and begin accessing our feelings more quickly, working indirectly with hidden issues and distorted belief systems.

A problem with guided therapeutic imagery is that not all practitioners know what sort of imagery is therapeutic! The only methods with proof to support them use images of the natural world, and results are still not as good as those achieved by actually going outside in natural surroundings.

This is however a powerful method of input control, so if you have space to hang pictures or you'd like a pictorial desktop, why not choose images that have been proven to improve your health?

Interpersonal Therapy (IPT)

Not good if you have wronguse in networks 4 or 5 (see tutorials). A structured, supportive therapy linking recent interpersonal events to mood or other problems, paying systematic attention to current personal relationships, life transitions, role conflicts and losses.

Narrative Therapy

(NT) is particularly useful if you have nonuse in network 3 (see tutorials). It is used popularly as an approach to counseling and community work. It views people as the experts in their own lives and views problems as separate from people. Narrative therapy assumes that people have many skills, competencies, beliefs, values, commitments and abilities that will assist them to reduce the influence of problems in their lives.

It focuses on the stories of people’s lives and is based on the hypothesis that problems are manufactured in social, cultural and political contexts; each person producing the meaning of their life from the stories that are available in these contexts.

Narrative therapy is sadly behind the times but its efficacy is greatly improved when the stories or narratives it is using reflect the natural associations in memory; e.g., they are congruent. With this in mind we explore NT in future tutorials.

Problem-Solving Therapy

Good if you have nonuse in front networks, not good if you have wronguse in frontal nets (see tutorials). Systematically teaches generic skills in active problem-solving, helping individuals to clarify and formulate their life difficulties and apply principles of problem solving to reduce anxiety and enhance self-efficacy.

Psychoanalytic Psychotherapy

Is a long-term process (usually a year or more) of allowing unconscious conflicts opportunity to be re-enacted in the relationship with the therapist and, through interpretation, worked through in a developmental process.

Psychodynamic-Interpersonal Therapy (formerly known as the Conversational Model of Therapy)

Assumes that symptoms and problems arise from, or are exacerbated by, disturbances of significant personal relationships. It explores feelings using cue-based responses and metaphor; links distress to specific interpersonal problems and uses the therapeutic relationship to test out solutions in the ‘here and now’.

Rogerian or Person Centered Therapy

Currently has the most proof for overall beneficial results and coherent background theory. Best integrated with co counselling (see above).

Person-centered therapy moved psychology in general away from the idea that the therapist was the expert and towards a theory that trusted our intent ('innate tendency') towards entelechy or optimal function (known as the actualising tendency). It stresses the natural intent of all healthy human beings to strive towards fulfilment of their personal potentials.

Rogers stated that 'Individuals have within themselves vast resources for self-understanding and for altering their self-concepts, basic attitudes, and self-directed behavior; these resources can be tapped if a definable climate of facilitative psychological attitudes can be provided.' He pointed to three core conditions as providing a growth-promoting climate. These core conditions are: genuineness (congruence or congruity), unconditional positive regard and empathy. Evidence is mounting that when these core conditions are provided, development in a constructive, healthy direction will occur in the person receiving these conditions.

Further reading:

Biological psychology & personality theory: the basics (basics section)

Interaction & core conditions (basics section)

Tutorials

Wikipedia: http://en.wikipedia.org/wiki/Person_centered_counselling?new_sess=1

Social Skills Training

Is a form of behavior therapy in which people learn and practice skills in social and interpersonal relationships.

Systemic Therapy

Systemic therapy (whether treating individuals, couples or families) focuses on the relational context, addresses patterns of interaction and meaning, and aims to facilitate personal and interpersonal resources within a system as a whole. Therapeutic work may include consultation to wider networks such as other people or groups working with the individual or the family. Therapy aims to identify and explore patterns of belief and behavior in roles and relationships. Therapists actively intervene to enable people to decide where change would be desirable and to facilitate the process of establishing new, more fulfilling and useful patterns.

Therapeutic Community

Refers to a residential treatment in which people learn to understand their problems and to change through their interactions with other clients and staff throughout the 24 hours of community life.

Cognitive Methods

Useful for those with weak rear nets, not so useful if you have wronguse in networks 1 or 5 (see tutorials).

Cognitive Behavioral Therapy

In Cognitive Behavioral Therapy, problems are tackled head-on in a practical intellectual manner. CBT hypothesizes on the connection between thoughts and beliefs and their impact on behavior. How a person thinks about problems determines the way in which they respond to various issues. It's believed to be the manner of thinking about life's issues that steers the person's way of behaving, and discussing this is believed to facilitate change.

A good therapist will take as much time as is needed to truly, deeply, and respectfully understand and appreciate the source of a belief and will view you as the expert on yourself and your inner world of feelings. Bear this in mind, because CBT attracts more than its fair share of authoritarian characters.

Dialectical Behavior Therapy (DBT)

Is a longer term cognitive behavioral treatment devised for borderline personality disorder which teaches patients skills for regulating and accepting emotions and increasing interpersonal effectiveness.

Rational Emotive Therapy

Is a form of cognitive therapy that identifies underlying assumptions and patterns of thinking linked to negative unwanted emotions and challenges these.

Schema-Focused Cognitive Therapy

Is an integrative, long-term form of cognitive therapy, which addresses the deeply held, enduring beliefs (schemas) found in personality disorders.

NLP, Assertiveness Training, Self-Improvement

Neuro linguistic programming (NLP) has been called a hybrid of CBT, discourse analysis and self-suggestion. It was designed in the 70s by Richard Bandler and John Grinder, and is based on the belief in a connection between neurological processes ('neuro'), language ('linguistic') and behavioral patterns that have been learned through experience ('programming') and that can be organized to achieve specific goals in life.

NLP does not define causes but concentrates on treating problems, and unfortunately considers under- or overactive networks as 'normal', or 'different ways of thinking'. This limits its effectiveness in the long term and in those susceptible it can even make a problem worse. But NLP can be of great help if you have nonuse in networks 1, 3 or 5 (see tutorials).

Unfortunately, the method is easily adapted for (and too often openly recommended for) non-beneficial purposes; such as getting rich at others' expense or learning how to effectively coerce or control people, and this has given the method itself an undeserved bad name. In reality, almost ANY method can be abused or used for harmful purposes.

We quote from a typical site: “NLP teaches a series of linguistic and behavioral patterns that have proved highly effective in enabling people to change the beliefs and behaviors of other people”.

This blatantly opposes our principles of 'no coercion' and we do not recommend any practice that encourages it.

While we do not recommend the 'official' NLP institutions that approve of coercion and cost money, DIY NLP can be a beneficial technique for changing ourselves. We will cover this type of NLP in future tutorials, as it is not a technique that should be used until rear networks are in balance. You should not use NLP at all if you have wronguse in networks 1, 3 or 5 (see tutorials) because it could impede your progress.

Assertiveness Training

Has suffered in similar ways to NLP, but not so extensively. Assertiveness training can be a great help when it is directed at weak rear networks (see tutorials) but can hold back your progress if you have wronguse in network 5. If you find yourself doing things you don't want to do all the time because you feel you can't say 'no', assertiveness training is a really good option. Be very careful of sources though -some groups interpret assertiveness as aggression and arrogance, and merely train people how to be rude and inconsiderate in a variety of ways.

More sensible groups really do help the timid to build up confidence and improve communication. Consequently you can develop the ability to resist or sidestep being manuvered into doing something you really don't want to do, without being rude or in any way aggressive.

Most groups unfortunately go for the 'aggressive' approach, although this has been changing more recently. So take care to find a group with the right attitude. We explore assertiveness training in more depth in future tutorials.

Transactional Analysis

Do not use if you have wronguse in network 5 (see tutorials).

TA is a form of cognitive interactional analysis that uses the terms 'Parent, adult and child' for 'Authoritarian, mature and victim' (or 'action, interaction, reaction'). Those using the mental habits of authoritarian parents and those using the mental habits of timid children are taught how to move their state of mind into the 'adult' space of mature interaction.

Transactional analysis utilizes a 'contract' for specific changes desired and involves the "Adult" (mature intelligence) in both the client and the therapist to sort out behaviors, emotions and thoughts that are seen to prevent the development of full human potential.

Self-Help or Self-Improvement Groups

A complication about definitions is that the term 'self help' is at times used to refer to individual self-management of specific conditions, rather than mutual support among people who share common experiences - the latter meaning is used here.

The key characteristics of self-help groups as derived from a brief literature review are outlined below. Research suggests that the core values and principles of groups may be more important to their members than professional involvement in the group.

Research Study

The fieldwork was carried out over the winter and spring of 2005-2006, and included both qualitative and quantitative methods.

Questionnaire Surveys

Questionnaire data were gained from 20 current self-help group attenders, and these were amalgamated with data from previous surveys. Almost one third of group members had attended a prior group at some point, and nearly 90% reported some benefit, but only two per cent were still attending prior groups. The main reasons for leaving were recovery, closure of a group in their area, or the group's failure to meet their needs. Lack of confidence to attend meetings on their own was also a recurring theme. Suggestions for improvements included more structure and leadership, more suitable times and venues, and better publicity about the groups.

Most members attended a group for a year or less. They generally reported benefits from attendance, and rated most facilitators well. They also reported small improvements in their depression and their life problems. Aspects of the self-help groups that they found especially helpful included understanding better how they felt than most mental health professionals; being caring; helping them to think for themselves; understanding their problem without the need to explain, and reducing their isolation.

Online Help/Support Groups and the Role They Play

In recent times we have seen a significant rise in the number of individuals living with chronic illness turning to the Internet for information, advice and support. In particular, more and more people are joining online support groups to discuss their experience of their illness and seek information and advice from fellow sufferers.

Key factors associated with use of online support sites include availability of resources, convenience, access to good advice, and the lack of embarrassment when dealing with personal issues. Intensity of participation in online support activities is associated with improved quality of life, but not necessarily with improvements in specific conditions (lack of exercise, for example, will not be helped by sitting around chatting online).

A major problem with online support is that much of the information may be out of date, misleading or outright nonsense! Always check site owners or sources, because many health chat sites are set up by medical companies to promote their products, or other individuals seeking financial gain. Even sites run by charities may be sponsored by drug companies, so beware.

Bear this idea in mind: no intelligent person will ask for money from those who want to improve their intelligence. To do so would be as illogical as refusing free gold unless someone pays you to accept it.

Spiritual Methods

Contemplative Psychotherapy

Focuses on how you relate to yourself first and foremost, then moves on to how you relate to others keeping in mind your self awareness, strengths, needs and desires. Contemplative psychotherapy bases its methods on the philosophy and mindfulness/awareness practices of Buddhism that have clinically proven beneficial effects on mental well being.

It is an intensive practice that allows us to delve deep into the human experience of mind and stay present. This is important because Buddhist thought on suffering is that the individual creates distractions to avoid the full reality of our experience. In other words, we learn at an early age to filter out aspects of our authentic experience in order to conform to some sort of expected and imposed status quo. A contemplative therapist is trained in helping the client achieve a more accurate picture of their experience.

Meditation

There is plentiful scientific proof of the benefits of meditation, and it is gaining mainstream acceptance as a beneficial preventative health program. More and more doctors are recommending meditation as an effective anxiety buster and useful support for patients with many types of chronic and acute conditions. Some of the documented benefits of meditation are discussed below:

The effectiveness of meditation comes from the fact that you can achieve a state of deep relaxation in just a few minutes. When you settle down into the relaxation response, the body and mind can eliminate anxiety hormones, upgrade the immune system, and are refreshed and revitalized. This gives you many good effects that are both immediate and long lasting.

Research has clearly shown that meditation lowers levels of anxiety hormones. In particular, while meditating, your cortisol level drops and stays low for hours afterward. High quantities of cortisol produces unhealthy and unpleasant effects. Getting it out of your blood stream, in contrast, has beneficial and positive effects.

Meditation boosts the intensity of alpha and delta brainwaves – associated with quiet, receptive states. Practice leads to greater self-esteem, self-confidence and inner peace. You're able to concentrate more easily and and your ability to learn and remember improves.

Meditation helps you to feel less anxious about issues that previously caused you high (conscious or unconscious) anxiety, you become a better listener and exhibit greater empathy, which in turn leads to closer and more fulfilling relationships. Calmness brings with it the capacity for more accurate judgement and enhances problem-solving skills. Being calm results in having greater patience and tolerance and gives you the composure to act in considered and constructive ways.

Meditation produces definite comprehensive measurable improvements in mental health, enhancing positive features and reducing various forms of psychological distress. It is markedly more effective in reducing anxiety than most other techniques. It has also consistently been found to reduce depression, hostility, and emotional instability, indicating the growth of a more stable, balanced, and resilient personality.

Meditation has been proven to be effective in increasing self-actualization; an overall measure of positive mental health and personal development. It is exceptionally effective in developing three independent components of this dimension: emotional maturity, a resilient sense of self, and a positive, integrated perspective on ourselves and the real world. There is evidence that psychiatric hospital admissions are much less common amongst people practicing meditation than in the general population.

The Relaxation Response (basic meditation)

The “relaxation response” is the ‘fulfilment’ half of the brain’s pleasure system. It occurs when your brain chemistry changes in response to assimilation, success, satisfaction, fulfilment or understanding. During this response, heart rate and blood pressure slow, and cortisol (anxiety hormone) production is turned off. Natural opioids and serotonin are released in the brain, making us feel very comfortable and satisfied, yet still ready to interact.

During natural learning, this response occurs naturally. When there is too much cortisol present in the bloodstream, it can’t. Effectively the response is turned off. We have to hack in there, and turn it back on, because it reduces anxiety levels faster than anything else.

To keep cortisol levels healthy and under control, the body’s relaxation response should always be activated after the stress response occurs. You can learn the relaxation response with various techniques (see below), and you can learn control in order to keep your mind from habitually reacting with anxiety in the first place.  

The Relaxation Response is something some people find very easy and, unfairly, others may find really difficult! A lot will depend on where you’re starting from and what sort of methods you feel attracted to. The relaxation response is something that has to be experienced to be properly understood, and is often only understood in retrospect. Once you can make the response happen on purpose you will become more conscious of the change of mood and understand what it is doing to your body and mind.

 Here is one simple method: 

Lie down somewhere comfortable and relax. Turn off the phone, radio and/or TV. 

Close your eyes. Pay attention to any areas of your body that are tense. Breathe calmly and as you breathe naturally out, deliberately relax the tense areas, beginning at your feet and progressing up to your face.

Go over them all again and keep them relaxed.

Breathe through your nose if you can, unless it is blocked. Become aware of and listen to your breathing. Each time you breathe out, it may help you focus if you silently say the word, "ONE" to yourself.

Breathe easily and naturally.

Continue for 10 to 20 minutes. You may open your eyes to check the time, but do not use an alarm. Do not worry about whether you are successful in achieving a deep level of relaxation. Maintain a passive attitude and permit relaxation to occur at its own pace.

When distracting thoughts occur, try to ignore them by not dwelling upon them and return to repeating "ONE" silently to yourself.

When you finish, sit quietly for several minutes, at first with your eyes closed and later with your eyes opened. Do not stand up for a few minutes.

Shamanic Journeying / Psycho Shamanic

For thousands of years, Shamans have hypothesized that most of our problems can be solved by contacting one's “higher self” (intelligence). A trained Shaman can “move into parallel worlds” (view a situation from different worldviews) to achieve full understanding and empathy to help with specific problems and develop the mind. This may sound off the wall in our society. The key is: It's just another map for describing reality.

I should say maps, as there are as many different shamanic paths as there are languages. If you have spent much of your life living in or studying one particular culture, traditions relevant to the history of that culture will be relevant to you.

No genuine shaman will charge money for help or tuition, but it is traditional to take a gift or help with chores.

Guide to Using Therapies

Development of the Guideline we use in this section was led by the British Psychological Society Centre for Outcomes Research and Effectiveness, with the support and participation of the following organisations:

• British Association for Counselling and Psychotherapy
• British Confederation of Psychotherapists
• British Psychological Society
• Depression Alliance
• Mind
• Royal College of General Practitioners
• Royal College of Psychiatrists
• UK Advocacy Network
• UK Council for Psychotherapy

These guidelines are based on current evidence for who is likely to benefit from what kinds of psychological techniques, and which of the main therapies currently available is most appropriate for which situations. The recommendations are therefore an aid to your informed consent and decision-making. Psychological therapies have an important role to play in helping with mental health problems, and everyone should have access to effective therapy, both physical and psychological.

There is no doubt that these techniques can have demonstrable benefit, for example in reducing distress, symptoms, risk of harm to self or others, health related quality of life and interaction. However, everyone is different, and not all methods are effective for all people.

Terminology in this field can be confusing. Within the diversity of therapies, there are two main traditions, psychotherapy and counselling. The distinction between the two is blurred, as they lie on a continuum, such that for each type of psychological therapy there is a corresponding form of counselling (psychodynamic psychotherapy – psychodynamic counselling, cognitive behavior therapy – cognitive behavioral counselling, etc.). In essence, different forms of psychotherapy have evolved to offer remediation of mental health problems and symptoms by structured interventions. Different forms of counselling emphasise the individual’s resources rather than psychopathology, with a focus on a reflective, experiential process. Here the person’s concerns are rephrased and clarified in order that they may develop a greater sense of well being and cope with life difficulties differently. In the 21st century therapy places more emphasis on mental health promotion rather than ‘treating disorders’. The terminological confusion is exacerbated by the common practice of denoting all psychological therapy delivered in healthcare as ‘counselling’. In fact, a number of ‘counsellors’ employed in primary care are qualified psychotherapists.

Medication may be the most popular option for problems, but it should not be the only option considered. The value of a pharmacological treatment, whether as an alternative to, or additional to, psychological therapy, should be considered separately. (For medication options, see Drugs & chemicals section of the library).

The evidence on whether the combined effects of medication and psychological treatment are greater than singly is complex, but in general, drugs are not a contraindication to psychological therapy, or vice versa. 

Panellists were asked to make the following assumptions in rating the appropriateness of each form of therapy:

• a) there is equal access to all therapies, e.g. waiting time before treatment is not a factor.
• b) all therapies are delivered by competent persons to a reasonable standard for their level of experience.
• c) any medical management is optimal.

Anxiety Disorders

There is a wide evidence base from meta-analytic reviews supporting exposure-based behavioral treatments and cognitive behavior therapy, including panic control therapy. The demonstrated effectiveness of exposure based methods for a variety of anxiety disorders suggests they should be tried first for people who can tolerate them, and this was also the expert consensus. However, the lack of evidence on other therapies does not mean they are ineffective.

Anxiety disorders with marked symptomatic anxiety (panic disorder, agoraphobia, social

phobia, obsessive compulsive disorders, simple phobias and generalised anxiety disorders) are

likely to benefit from cognitive behavior therapy.

Depressive Disorders

Psychological therapy has been shown effective in the treatment of depression in general adult populations. The best evidence is for cognitive behavior therapy and interpersonal therapy. However, a number of other approaches have shown some evidence of effectiveness. These include behavioral therapy, problem-solving therapy, group therapy, systemic therapy, non-directive counselling in primary care, marital and family interventions and psychodynamic interpersonal therapy have all shown some evidence of efficacy.

This recommendation reflects a large body of research, considered in eight high quality reviews and two Cochrane reviews.

Eating Disorders

For the treatment of bulimia, a recent Cochrane review found most evidence for cognitive behavior therapy. Other evidence suggests that psychological therapy, interpersonal therapy and family therapy are effective, the latter particularly where the patient is under 18. The efficacy of cognitive/cognitive-behavioral therapy has been established; less research has been carried out on other forms of therapy, but there are indications that family therapy and interpersonal approaches may be effective. Focus on relationships in therapy has been associated with good outcome.

There was little evidence available from high-quality research reviews on the effectiveness of treatments for anorexia nervosa. In the absence of grade I evidence, best evidence for anorexia nervosa is for family therapy and broadly based individual therapy for patients with early onset and late onset of illness respectively

Generalised Anxiety Disorder

Cognitive and behavioral therapies are effective in treating GAD. Other psychotherapeutic approaches have not been systematically reviewed/evaluated.

Obsessive Compulsive Disorder

Behavior therapy (or exposure with response prevention) and cognitive therapy appear to be efficacious in the treatment of OCD (Ia), although there is disagreement over which is more effective according to the available evidence. These psychological treatments appear to produce results similar to those achieved by drug treatments. Behavioral treatment may be less effective in treating depressive symptoms than anxiety symptoms in OCD.

Panic Disorder and/or Agoraphobia

Exposure-based treatment and CBT have shown efficacy in the treatment of agoraphobia, although exposure may be less effective on measures of panic. Applied relaxation may also be effective.

Other psychotherapeutic approaches have not been systematically reviewed.

Personality Disorders

Mental health problems such as depression, anxiety, panic, eating disorders and self-harm often co-exist with severe difficulties in relationships and self-management. The latter problems sometimes begin in childhood and are severe and repetitive enough to meet diagnostic criteria for personality disorder. In such situations, recommended psychological therapies for common mental health problems such as depression may still be worthwhile. In particular, there is evidence that anxiety disorders can be treated successfully in this group. However, other evidence and a strong clinical consensus indicates that for many patients, therapy for common mental health problems in this group are likely to take longer and the outcome may be attenuated.

Psychological treatment of personality disorders themselves, rather than the co-existing mental health problems, has been the focus of intense development in recent years. A recent meta-analysis found that a number of therapy approaches, both individual, group and milieu show some success with personality disorders. Available therapies include dialectical behavior therapy, psycho-analytic day hospital programme, therapeutic communities, cognitive analytic therapy, schema-focused cognitive therapy and psychoanalytic therapy. We located controlled trial evidence to support the first three of these, and research is underway or planned in other approaches.

There is little comparative outcome research on the treatment of personality disorders with psychotherapy, and no high quality reviews were identified. One medium quality review suggested that behavior therapy in avoidant and borderline disorders and psychodynamic approaches in a variety of personality disorders may be useful. There are promising developments in psychotherapeutic treatment in this field, but most results are from cohort studies. Another review suggests the potential value of longer term, integrated, theoretically coherent approaches which focus on compliance and target problems in relationships.

Post-Traumatic Stress Disorder

Psychological treatment may have an impact on PTSD; review evidence suggests that this may be limited, and may reduce symptoms of depression and anxiety more than primary PTSD symptoms, with best evidence for cognitive behavioral methods, even in the absence of a complete cure. The differential effectiveness of different types of treatment has not been established, with best evidence for the benefit of systematic desensitisation (graded exposure) and related approaches (stress inoculation therapy, and eye movement desensitisation). Psychodynamic therapy and hypnotherapy have also shown benefit. Prolonged re-exposure (flooding) may exacerbate some symptoms (depression, anger alcohol use), and graded re-exposure is generally more acceptable to clients.

Self-Harm

A Cochrane review found some evidence of efficacy in reducing self-harm for problem-solving therapy, for the provision of an emergency card, and from a single study of dialectical behavior therapy. However, the authors concluded that there were too few studies to make firm recommendations. A trial of psychoanalytically informed partial hospitalisation compared with standard psychiatric care showed reduction in self harm and suicide attempts in patients with personality disorder after 6 months treatment, maintained until the end of treatment at 18 months.

Social Phobia

Exposure and cognitive therapy are effective for the treatment of social phobia . Other psychotherapeutic modalities have not been systematically reviewed/evaluated.

Somatic Complaints

General

 There is some evidence of the efficacy of family and marital therapies in the treatment of psychosomatic disorders and physical illness. Patients with functional somatic symptoms, in the initial acute phase may respond to individual therapy if they are willing to participate.

Chronic fatigue

 There is little high quality research on treatment of chronic fatigue syndrome. One Cochrane review indicates that CBT is more effective than controls in improving physical functioning and experience of fatigue. Other psychological treatments have not been reviewed. Randomised controlled trial evidence shows benefits of behavior therapy (including graded exercise therapy) and some evidence for cognitive therapy. Other modalities have not been subject to outcome research.

Chronic Pain

 Cognitive and behavioral therapies, hypnosis and bio- /neurofeedback show evidence of being effective in the treatment of chronic pain.