This blog is about exploring, evaluating and experimenting with different ideas, practices and activities … of ‘finding your own fit’.

My academic background and interests are broad although I strive to be as specific as possible when using tools, techniques and exercises. I value diverse perspectives as they contribute to the ‘whole’.

2024

1 January

A trivial example of trauma and avoidance. I was riding my bike the other day and ahead of me was a bend in the road which reminded me of a significant-in-my-life moment some years ago when I had a nasty accident and broke some bones. The brain’s automatic default response was to avoid riding the corner in any way resembling the way I rode it when I had the accident. It was a different moment in time, on a different road, on a different bend with different weather conditions and no oil on the tarmac as there was before. The angle of the bend was not the same and my mindset was different to when the accident happened.

But the primal brain does not care about such details. It remembered … and the memory flashes through my mind. It also remembered the slightly daring and confident feeling I had in the moment before I leant into and swang around the bend. It remembers the image and the feeling of the millisecond before the accident.

I take the corner slowly and differently and tell myself not to be daring or confident.

As counter intuitive as it may sound, this is not the best choice from a trauma perspective. I needed to remind myself that the accident was ‘then’ and not ‘now’ and push through the corner. That way I can begin to overwrite the traumatic memory in the module of my mind which applies itself to handling bends on a bike and create a new memory of riding similar corners. We get stuck in and bump into fragments of old memories when we avoid our fears and a moment from the past affects our behaviour in the ‘now’. It can be an intense and vivid experience which is scary. This is what trauma is.

The brain clings on to rules it creates to keep us safe, which can be limiting and lead to less openness to experience in different circumstances. This brings me to the unhelpful thinking habit I see the most: overgeneralisation. The primal brain loves to overgeneralise. Its job is to keep us safe so the species survives rather than add to our enjoyment of the moment. And in a way it has to do it. There is too much information in the world for the brain to be able to process it all. It struggles to comprehend that this bend is nothing like the one from the past and that I am in an entirely different moment to the one I was in then.

The brain needs quick rules, cognitive defaults, to make sense of the world. This is called ‘cognitive underspecification‘ and it leads to misattributions and the restrictive application of unhelpful behaviours and unnecessary rules in situations which are similar to the moment of the trauma. ‘Similar’ can be eons away from ‘same’ and that’s something which is helpful to remember if you find yourself avoiding something because of a fear from the past. EMDR and/or CBT for trauma helps with this.

2023

29 December

My psychological New Year gift would be this: The ability to turn off self criticism as one turns off a tap. How much good would that do. Just to be able to turn it off. Self criticism is the most consistently negative theme I notice. It is of no therapeutic value. Reflection, yes. ‘What could I do differently?’ ‘What did I learn from that?’ Then move on.

We tend to beat ourselves up with ‘shoulds’, ‘ought’s and high expectations and standards, comparing to others. It keeps us down and clogs us up. Whenever I ask someone if they would talk to a friend like they are talking to themselves they say: ‘No.’ The opposite of self criticism is self compassion. If we do this enough it rewires the negative representations in the mind. Cognitive psychology.

It’s been a busy 18 months without any posts so it was about time for one.

2022

10 February

I did some training on complex trauma and my main take-away was the importance of imagery work. Imagery is more powerful in terms of change than words and talking. Perhaps this is why EMDR works so well as it is so imagery based. We can talk about a traumatic incident in a session and not much is changing. Then, suddenly, there is a shift with imagery processing work. Why? Thinking about a negative event in images is 4 x worse than thinking about it in words; and vice versa. So thinking of positive images is also more powerful than talking. The brain can’t tell the difference between an imagined image and an actual image. There is no distinguishing between actual and perceived threat. Sports psychologists have been using this knowledge for years. Think of all those athletes who imagine how they want their race to go. The common objection is that it isn’t real if it didn’t happen. The key point is that even if we cannot change what did happen we can change how we feel about it, and that is what we want in therapy – to change how we feel. It doesn’t have to be real or possible. Therefore it is good to think about preferable outcomes to traumatic events. It is a pragmatic solution to reduce peak emotion. So if you work on trauma with me get ready to use your mind imaginatively to find new images. It will help.

7 January

Covid. How difficult a phenomenon this pandemic is for the whole world. In therapy I see three themes: (1) Fear of getting Covid (2) physical sensations leading to fear of having Covid prior to a diagnosis and (3) dealing with Long Covid if it happens.

Fear of getting Covid – this is about restrictions the fear causes, and reconciling the fear with the official guidance. We often cannot do the social/work and leisure activities which benefit our wellbeing. We need feelings of Achievement, Connection and Enjoyment/ Mastery and Pleasure to be in a healthy mood. Fear of getting Covid leads to avoidance, and avoidance is usually the enemy of healthy mental health. But the official guidance is, quite rightly, encouraging avoidance of all sorts of activities. It is when things go to an extreme that it could be time to reach out for help. This was the case with one person I worked with who had Covid, and was admitted to hospital. The experience was a traumatic one. When he recovered physically he, understandably, wanted to stay at home. We tackled the trauma with EMDR, and the avoidance and agoraphobia through graded exposure. Soon enough he was able to do activities he had been struggling with, using the tube to go to work, going for coffee again with friends, and to events where he could socially distance. Finding a proportionate response to risk is tricky and is something it can be helpful to talk about.

Physical sensations leading to fear of having Covid prior to a diagnosis is a Health Anxiety problem. Therapy is about learning how to interrupt and re-conceive the automatic/fast-acting cognitive (thought) or emotional (feeling) negative responses which come from a misinterpreted physical sensation ( e.g. a sore throat, a dizzy head, tiredness). This can be especially acute following a potential exposure to Covid.

Long Covid is unfortunately long term health condition/ACT territory as this condition is similar to Chronic Fatigue. The distress comes from the health consequence of Covid, the ongoing physical symptoms, and how we think about those symptoms, what they mean to us. For example, I worked with one person who could not reconcile the difference between past level of functioning with current level of functioning, ruminating on how things used to be, comparing self to others, and worrying if health would ever return to its previous state. He got depressed. Of course, this is a natural response, and it would be mine too. Some new perspectives and skills and activities to work on to cope with the new health situation proved helpful.

6 January

It’s that time of year when many of us have New Year resolutions. This reminds me of ‘goal setting’, which has been essential for so many people I have worked with over the years, and is fundamental to the CBT/ACT style of therapy, providing structure and focus and the motivation which comes with that.

I like to do goal setting in one of the early sessions and then check in on it regularly. Organising the goals well is important. Some of the tips I am likely to give you are to start small (no goal is too small) and to think about ‘chunking’ goals into short, medium and long-term categories, or see them in terms of ‘easy, moderately difficult or very difficult’.

Research into mood shows that feeling good entails getting a daily dose of feelings of Achievement, Connection and Enjoyment, or Mastery and Pleasure. So thinking of activities or practices which bring about these feelings in us provides a vehicle for progress. We are on target If these activities also link with our values and aspirations. The goals need to be specific and realistic, and being self compassionate with yourself as you go about trying to achieve them is key, avoiding self criticism if things do not go to plan. I talk about self compassion a lot.

13 December 2021

Physical movement, and how to move, is important. Any form of physical restriction tends to impact our mental health, which is especially relevant with chronic pain and long term health conditions. We want to do the activities we want to do as this gives us a sense of achievement and pleasure/mastery, feelings we need to experience regularly to be mentally well. As we age, the impact of the modern environment, injury and illness, often combines to restrict our movement and activities, impacting mood. It was not always like this. Our ancestors had less sedentary lives and may have stayed active and less restricted for longer. Getting back to ‘functional movement’ is healthy for the body and the mind.

For a deep dive: https://www.youtube.com/results?search_query=aaron+alexander. Longevity specialist Peter Attia has also done great work in this area: https://www.youtube.com/watch?v=FEK-vW8IQzA.