Working with Sufferers of Bulimia, part II

As mentioned in Working with Sufferers of Bulimia, part I the need for counsellors who work with sufferers of Anorexia, Bulimia, to enhance their understanding of these disorders in order to improve the quality of the therapy they provide is becoming more and more apparent as each new piece of research emerges. Furthermore, “Delineated treatment specifically tailored to the needs of each disorder” (Quinlan, 2013) as required for the treatment of eating disorders may be best accomplished by a full understanding of the differences in characteristics of these disorders.

Though there is no such thing as a typical patient or client, commonalities do emerge between sufferers of bulimia. It is often found that women who are engaged with the binge purge cycle, have been engaged with weight loss or have concerned with their weight and or a fear of being fat since their early teens (Beaumont, George and Smart, 1976). Additionally, further commonalities in personality traits have emerged among bulimic sufferers. Research into the personality traits of bulimic sufferers has show that they will often display more impulsive behaviours than those with Anorexia, (Garfinkel, Moldofsky and Gerner, 1980). These findings are confirmed by research carried out that showed a higher that average impulsivity often expressed by substance abuse (Pyle, Mitchell and Eckert 1981). In marked contrast to this, those sufferers of Anorexia are often “markedly obsessional, socially withdrawn” ( Bruch 1973). The rigid control of the anorexia patient is at variance with the more outgoing and extroverted style of behaviour of the bulimic patients. Bulimic patients however may alter their naturally outgoing social style as the binge purge cycle takes over their time and efforts, and they may become withdrawn and isolated. Add to this the on-going shame associated with bulimia and the sheer volume of time many bulimics give to their binge purge cycles and even though they may actually crave interaction, friendships and social encounters, they may find they withdraw and retreat into the comfort and familiarity of their food obsession rather than actively seek out and engage with others.

Once again given the propensity for sufferers of bulimia to maintain a fairly even weight, then identifying their eating disorder can be very difficult among their friends and family and so this eventual withdrawal can seem all the more difficult to explain and leave residual feelings of hurt or anger by those who cannot understand her behaviour.

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Coping with Child Sexual Abuse in Adult Relationships, Part III

The Role of Sensorimotor Psychotherapy in counselling adult survivors of Child Sexual Abuse (CSA) has been shown to facilitate clients in dealing with elements of Post-Traumatic Stress Disorder (PTSD) that commonly follow the survivors into adult relationships.

The primary function of Sensorimotor Psychotherapy is three fold; firstly to assist with calming and acting as safe guard as the brain responds in a ‘bottom up’ manner to the traumatic event ( Piaget 1952). That is to say the client is at the mercy of their somatic and kinaesthetic responses without cogent control over them and the role of the therapist is to harness and manage the clients experiences until such time as the client has re-established these differentiating lines; Secondly, to equip clients themselves with the necessary tools to deal with these abreactions and upsetting bodily responses and lastly to facilitate the reintegration of a ‘top down’ response, i.e. helping the client to retrain their responses to include a reasoned and logical response. (Pat Ogden and Kekuni Minton, 2000). Clients have also reported that through therapeutic relationship and the couple relationship sensorimotor psychotherapy helped them to limit the information they are processing at any one time;  giving them the opportunity to investigate the cognitive and emotional aspects of the  initial trauma without becoming so physically distressed as to prevent them from adequately doing so. As discussed in Coping with Child Sexual Abuse in Adult Relationships, Parts I and II, the role of the couple relationship is paramount in the rehabilitation of adult survivors of CSA, survivors of sexual abuse require safe and healing relationships from which recovery can most ably begin. (Courtois, Ford & Cloitre, 2009)

Sensorimotor Psychotherapy operates in a holistic way by attending to the physical, cognitive and emotional responses CSA provokes in its adult clients. By refocusing their attention away from the context and details of the original trauma and focusing instead of the bodily sensations in isolation form their context client have found they have been able to disassociate the physical reaction from the emotion and cognitive responses.

This gives rise to a feeling of safety that allows for the safe exploration of the cognitive and emotional impact of the abuse and furthermore may give rise to an increased feeling of safety as they begin to re-experience the trauma in a way that offers them the potential to physically protect themselves.  By adopting a sensorimotor psychotherapeutic approach and concentrating on the physical responses, we are directly dealing with the somatic effects on the body and this in turn helps enable emotional and cognitive assimilation of the traumatic experience

Coping with Child Sexual Abuse in Adult relationships. Part II

In the psychotherapeutic treatment of adult survivors of Child Sexual Abuse (CSA) therapists are often mistaken in treating the survivor in isolation and fail to include in their therapy, the role of the partner in their couple relationship. This is to limit and detract from the therapy on offer as “If, as we can all agree, healing takes place in moments of secure attachment (Solomon, 2003) then the opportunity provided for healing within the current couple relationship is a vital and dynamic opportunity that ought not be overlooked” (Quinlan, 2013).

In my practice at Midwest Counselling I too have found it common that adult survivors of CSA seek out and replicate the trauma of their abuse (Briere & Scott, 2006). Attachment theory, (Bowlby, 1988) may account for why in some cases the “normal” attachment processes formed in early childhood are replaced in adulthood by this re-enactment of disruptive relationships, and may even lead to re-enactment of traumatisation (Allen, 2001). Because of unresolved issues arising as a result of the CSA, such as fractured impressions of how adult sexual relationships are supposed to work, or errant self-images as a result of childhood programming, then often the adult generalised view is fractured and errant. For instance they may view all physical contact as frightening, painful or abusive, or that all men/women are inherently dangerous. It follows then that these views shadow them into their adult couple relationships.

Subsequently then in treating adult survivors of CSA, the circularity of systemic family therapy may also be helpful. As mentioned in Coping with Child Sexual Abuse in Adult relationships, Part I, in couple relationships, it is commonly found that the partner of the survivor of CSA is bringing with them their own problems of equal measure. Therefore, as the therapy investigates the paradigm that exists between the couple, a pattern of co-dependant coping strategies may emerge. This iterates the importance of treating the client in a holistic way, and of looking at more than just the trauma of the CSA but also at the extended influence this is having on their couple relationships. So too, the benefit to couples counselling is massive, it can help raise a number of questions that could facilitate to a great extent the investigation into the nature of the couple relationship that exists that is been brought to couple therapy for “fixing”.

Given the aforementioned propensity for adult survivors of CSA to seek out and form relationships that emulate patterns and elements of the original abuse, then the benefit of including the partner in therapy is inherent. By engaging with both partners the therapist can work on limiting the re-enactments and re-traumatisation of the client. Furthermore and equally as importantly by soliciting the participation of the clients partner, the therapist can encourage and facilitate the growth of understanding and respect, and the identification of mutually beneficial goals that may ultimately lead to a constructive and nourishing adult relationship.

January Blues???

It’s dark, cold and a very long way to pay day.

Is it any wonder that the third Monday in January has been awarded the dubious honour of being called Blue Monday – the most depressing day in the year?

The resolution to begin a lifestyle overhaul got postponed till all the Quality Street were finished, the exercise regime is impossible in the dark and wet… and sure you can’t quit smoking when it’s this gloomy out?? Hardly inspiring stuff, is it?

Putting a little balance back into our lives is really what these resolutions are about and are a big help in finding a bit of peace for 2013.

Take 10 mins and look at your life in terms of 8 different categories and try to (honestly) give each one a rating out of 10 – if you’re falling below 5 in any of the areas it may be time to take a look at it and see what can be done.

  • Health
  • Money
  • Social life
  • Partner/relationship
  • Work/career
  • Friends/family
  • Home
  • Personal growth/spirituality (religion, interests, hobbies,)

Set yourself reasonable and attainable goals and as always feel free to fail and start again.

Best of Luck and Happy New Year!

If you feel you many benefit from talking to someone,

please feel free to call me on 087 709 74 77 or

email me in confidence at midwestcounselling@gmail.com.

Stress, Depression and Christmas.

Although Christmas is meant to be a time of happiness and joy for many, depression, sleep problems and anxiety and stress are the more common features of the holiday season.

It may be the season to be jolly, but between mounting financial strain and the pressure of spending prolonged hours with our families and in laws, it’s easy to see why many of us would prefer to pull the duvet back over our heads and hope the whole thing will just pass us by.

Although this may seem a bit un-festive, in reality anxiety over strains of Christmas can negatively affect our health in many ways and with the “festive” period upon us there is often more opportunity to avail of unhealthy coping behaviors.
We are often more likely to try and cope by drinking, smoking, overeating or staying up alone late at night.

If you are feeling the strain and would like someone to talk to, feel free to call me on 087 709 7477 or to email me in confidence at midwestcounselling@gmail.com and perhaps we can try to put some of the yuletide glow back into the holiday season.

Understanding anxiety disorders

It’s normal to worry and feel tense or scared when under pressure or facing a stressful situation. Anxiety is the body’s natural response to danger, an automatic alarm that goes off when you feel threatened.
In moderation, anxiety isn’t always a bad thing. In fact, anxiety can help you stay alert and focused, spur you to action, and motivate you to solve problems. But when anxiety is constant, excessive or overwhelming, when it interferes with your relationships and activities, it stops being functional — that’s when you’ve crossed the line from ordinary, productive anxiety into the territory of anxiety disorders.

Do your symptoms indicate an anxiety disorder?

If you identify with several of the following signs and symptoms, and they just won’t go away, then it’s possible you may be suffering from an anxiety disorder.
• Are you constantly tense, worried, or on edge?
• Does your anxiety interfere with your work, school, or family responsibilities?
• Are you plagued by fears that you know are irrational, but can’t shake?
• Do you believe that something bad will happen if certain things aren’t done a certain way?
• Do you avoid everyday situations or activities because they cause you anxiety?
• Do you experience sudden, unexpected attacks of heart-pounding panic?
• Do you feel like danger and catastrophe are around every corner?

If you’re experiencing a lot of physical anxiety symptoms, consider getting a medical checkup. Your doctor can check to make sure that your anxiety isn’t caused by a medical condition, such as a thyroid problem, hypoglycemia, or asthma. Since certain drugs and supplements can cause anxiety, your doctor will also want to know about any prescriptions, over-the-counter medications, herbal remedies, and recreational drugs you’re taking.
If you can rule this out maybe you would benefit from speaking to a psychotherapist in your area. Anxiety disorders respond very well to psychotherapeutic treatment. The specific treatment approach depends on the type of anxiety disorder and its severity. But in general, most anxiety disorders are treated with behavioural therapy, medication, or some combination of the two. Sometimes complementary or alternative treatments may also be helpful.

Fell free to call me, in confidence, on 087 709 74 77 for an appointment.

Extract abridged from helpguide.org 22 July 2012

What is Depression?

What is Depression?

There is a difference between depression with a little‘d’ – which we all get – and depression with a big ‘D’. Depression with a little ‘d’ is a natural response to having a bad day or hearing sad news. Depression with a big ‘D’ is when your whole energy and concentration is down and you are struggling to focus. It is a mental health condition which affects a person’s thinking, energy, feelings and behaviour. It’s not just having a bad day!

Symptoms of Depression

Depression has eight main symptoms. If you experience five or more of these symptoms, lasting for a period of two weeks or more, you should speak to a GP or mental health professional. The symptoms of depression are:

• Feeling sad, anxious or bored

• Low energy, feeling tired or fatigued

• Under-sleeping or over-sleeping,waking frequently during the night

• Poor concentration, thinking slowed down

• Loss of interest in hobbies, family or social life

• Low self-esteem and feelings of guilt

• Aches and pains with no physical basis, e.g. chest, head or tummy pain  associated with anxiety or stress

• Loss of interest in living, thinking about death, suicidal thoughts

What causes it?

Depression has a number of possible causes. For some people, it happens because of a traumatic life event such as bereavement, relationship breakdown, financial difficulties or bullying. In other situations, the person may have an inherent tendency towards depression, and such genetic factors can be key in the case of bipolar disorder. This mood disorder involves not just periods of depression, but also periods of elation, where the person’s mood is significantly higher than normal. During these periods, a person may have excessive energy with little need for sleep, may have grandiose ideas and may engage in risk-taking behaviour.

What should I do if I think I am depressed?

The most important thing to do is to speak to a doctor or mental health professional in order to get a correct diagnosis. There are a number of treatments for depression, depending on the cause and severity of symptoms and a professional is best placed to decide which, if any, treatment is most appropriate. Accessing reliable information is also vital.

 Taken from Aware.ie 15th July 2012