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Self-care for Mental Health Professionals

As a psychotherapist how do you self regulate?

How do you keep yourself from getting burnt out?

When there are personal issues, because you’re human and you will have them, how do you balance personal and professional life?

If you’re triggered in a session, feel biased towards your client, have a sudden personal triggering memory pop up, feel agitated, suddenly feel unwell etc, how do you handle it mid-session?

Although we already have coping skills and knowledge about self regulation as psychotherapists, it’s really important to have quick tools that can help us self-regulate prior to, during and after a session as well as have a tapping self-care routine to prevent burnout. This form of regular self-care in turn helps your client. How?

By you being able to hold a safe space for your client during sessions. Being trauma informed means being able to hold a safe space for our clients and in order to do that we need to feel safe in our bodies as therapists, especially if we are working with clients with trauma history. And I believe mostly all clients have some form of trauma background.

Self-regulation also helps in your interactions with your client outside of sessions, for example, scheduling appointments, answering emails, handling conflicts with clients – all this requires you to be in a grounded and calm space.

Another essential aspect of therapy is to have empathy. However, consistently working with clients while being present and empathetic does take a toll on our minds and bodies, especially if we’re not careful and don’t engage in regular self-care practices. We need a form of self care that requires less time, is somatic and helps in processing feelings safely without analysis paralysis.

Let’s say you’re triggered right before a client session due to a personal issue. Now, what will you do? One of the quickest ways to feel calmer is to just tap for a few minutes. It helps in reducing your emotional intensity instantly and is even helpful during a session.

Consider learning foundational skills in EFT for quick reduction in stress and emotional distress.

While mechanical EFT ( which can be learnt just be reading a manual or attending a brief course) is helpful, for effective EFT application a solid base in foundational skills and experiential learning is necessary, otherwise you will not find significant improvements after EFT.

EFT is a research supported, evidence based, somatic-cognitive tool. Since trauma enters through the body and emotions are felt in the body, the best way for trauma and emotions to be processed is through the body and that’s where EFT comes in.

For a short video on this, click on the link below

https://youtu.be/eiJ_XXQ29io

Transforming memories: pros and cons

Do we need to Undo our past to Heal?

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Research shows that every time you remember a memory you basically edit it. “When you encounter a familiar experience, you are remembering the original memory at the same time, and the new experience somehow gets blended in…That is essentially what reconsolidation is” (Lee, n.d) It’s a known fact that memory is reconstructed over the years. When an event/incident takes place you think and feel in a certain way about it. It takes some time for the event to solidify in your brain. Once it solidifies and each time you retrieve the memory, meaning remember it, you basically alter it a little bit. However, it does not mean that the physical event did not take place. The way you think and feel about the event will change over the years – it would hurt less, you might not be as affected by it, but it does not become a false memory. It’s a reconsolidated and reconstructed memory.

Standard EFT and our memories

In standard EFT we neutralize the feelings towards the original event as the person remembers it. This helps as research indicates that “emotions are encoded along with memories in the brain, so connecting with the feeling, and healing it really helps change our perspective on what happened.”(N. Barron, 2013)

Movie technique/Tell the story technique or tearless trauma technique along with creative and gentle variations are used to tap on every aspect of that event, especially the emotional peaks, aka crescendos of the event. The significance of this process lies in the fact that whatever the person remembers, we tap on it. In this process of memory transformation, we don’t change the original story; we don’t substitute it with fantasy but work on the story as we remember it.

LeDoux (2005) says that the fewer times you use your memory, “the more pristine it is. The more you use it, the more you change it.” EFT requires re-telling the event while tapping on the various pieces/parts of that event. This leads to a decrease in the stress response tied with it and gradually we are able to nullify all the stressful feelings related to it. You can watch this video on a research where EFT led to reduction in the intensity of traumatic memories.

Example of using Standard EFT for memory transformation/neutralization of feelings: My client narrated in a session that when she was 8 years old, she was punched on her nose by her mother. She was in the back seat of her car and she said something and her mother punched her. When she recalled this event in the session, she could still feel the terror and shock of that moment. She had thought about it many times over the years and the memory was reconsolidated. She didn’t remember the exact details of the event; the date, where they were going, what she wore, what she had said etc, but she remembered being hit by her mother. With the help of EFT we worked on the aspects of ‘shock and terror’, by working primarily on what she remembered and gradually the feelings subsided, making her neutral towards the memory. We also used metaphors and inner child healing to release the pain and trauma from that memory.

EFT variations that end up disowning the story

Some variations of EFT use different ways of re-writing the story by “creating a happy ending” based on what you would have liked/wanted to happen (substituting the bad ending with a happy ending for a story). So if we worked on the “punching nose” event and used re-creation of the story, we would let the client choose a happy ending for her story and transform the memory into, for example, being touched gently on her cheeks by her mother – a fantasy. This will change how the client feels about the event but re-writing the story with a happy ending might make her uncomfortable as it is a lie, even though she has willingly re-created this childhood event in the session. She will have to say a lot of lies to herself to stick to the fantasy version of her story because the fact that she was physically abused throughout her childhood will not change and in order to change it, she might have to disown her story and re-create every memory that involved this abuse.

It’s true that we all perceive things in our own way but being punched by someone in the nose is a reality for that person and no matter how many different ways in which you want to see it, it remains the same. But yes, you can change how you feel about that memory. The memory of an event plays out in a certain way in the mind of the person. We tap on whatever we hold within ourselves. It’s our perspective, our understanding, our feelings about the event. But there are certain ‘unchangeable aspects’ of that memory that remain the same. For example, if someone’s relative died, then they died – it’s unchangeable. Similarly if someone is abused and would like to think that they were not, then it’s a lie. Suppose you were cut by a sharp knife and bleeding, re-creating this memory with a butter knife will not help at all! This distortion might help you in forgetting that you had a knife cut but you will be forgetting and losing out on what you can learn from it and get cut again by another knife.

Honoring Our Past

Our past guides us; we learn from our experiences. Our past can guide us in useful ways too. If we neutralise an upsetting traumatic memory, we can also learn or grow from it. We might learn that someone isn’t trustworthy, reliable and we need to set boundaries with that person, or create an emotional distance with that person. If we completely forget what happened by replacing all bad times with good endings, wouldn’t it be distorting our lived reality to the extent that we no longer know what happened? Someone with a history of psychotic episodes, using this kind of fantasy runs the risk of creating false memories that may have a deleterious long-term effects. We cannot undo what happened in our past. Physical reality and the psychological impact that happened cannot be undone and to heal we don’t need to undo it. We only need to process the memories, work through them, taking up each piece of the event and finally having left with a memory with no charge. The memory is there but it’s not upsetting you anymore.

We can honor our stories, learn from them, integrate them in our lives and heal.

Healing takes place when we accept whatever ending the story has without trying to convert it into an ending that suits us. “Disowning our story is not a healing move, being able to own it and accept it, while tough, is essential.”( N. Barron, 2013) Personally I prefer to work with changing ‘how I feelabout a memory, what I remember happening in that memory instead of changing ‘what actually happened’ in that memory.

As a practitioner, I don’t encourage or practice changing the memory into a fantasy memory or forcing positivity onto my clients. These ways of working with a client, especially those with trauma history , can retraumatise them. I stick with what the person remembers. So if someone was hit by a person , and they tapped on it, they might say – “Yes I was hit by so and so, but it doesn’t affect me anymore”. They wouldn’t have to lie to themselves saying that they weren’t hit.

Conclusion:

As Practitioners we need to tread carefully while working on memories and inform the clients about the process and the effect on memories. In my opinion, standard evidence-based EFT is a trauma informed approach and is a natural way of healing, not forced. Also, in advanced EFT, inner child healing and parts work is used to bring healing to our wounded parts and younger selves.

Using EFT we can simply neutralize the feelings towards an event rather than substituting it with a fantasy. It’s a far safer option in my opinion.

This article is an updated version of the original article that was published on 9th Nov, 2013, on my second blog. You can read the original article here.

References:

Barron, N. Personal Communication. Nov 08 2013 http://energyandintention.com/

LeDoux, J. (2005). Synaptic self: How our brains become who we are. New York, NY: Penguin.

Lee, J (n.d) In Discover Magazine: How much of your memory is true, retrieved November 1st, 2013 from http://discovermagazine.com/2009/jul-aug/03-how-much-of-your-memory-is-true

Using positive too soon in EFT doesn’t work

You would have noticed that tapping scripts and audios focus too soon on easing and releasing an issue. Instead of fully experiencing the reality of a particular situation and sitting with it while tapping, the focus is on easing it immediately. In EFT process when we evoke the issue in our mind, first the problem is activated as we are exposed to it and our emotional brain gets active. Then, when we tap on it, it sends deactivating signals to the amygdala and the problem (what you’re tuned in to) starts reducing in intensity.

However, if you don’t stay with the issue at hand, you don’t give a chance to yourself to fully process what is going on. Tapping on the positive may give you result but it won’t last. And more than that many a times you’ll experience resistance to tapping when you insert words like “ease” and “release” too soon into your tapping process.

In standard EFT, we encourage you to first tap on the reality of your situation, what you’re feeling, and only when the intensity subsides to do a positive round.

To know more, you can watch this short video here.

 

 

 

Procrastination

There’s always a choice point when we procrastinate. Although it may seem like it’s happening automatically and we might think we don’t have a choice, the fact is that we do. Either we act on the thought of wanting to do a task or give in to the urge to delay it. It’s at this critical juncture where thoughts play an important role. In that split second you’ve made a decision to delay the task and then your mind will give you umpteen justifications for your reasons to delay and that’ll become a habit.

Today when I was laying on the sofa watching Netflix and not feeling like getting up, I had a thought of sketching. I immediately went and picked up my drawing tools and sat down to draw. Hence the result is these two drawings. Now in that moment as I reflect, I had another thought, “let me watch one more episode”. That was the choice point – drawing or giving in to watching another episode and remaining in that place for the rest of the day.

I’ve had practise with catching my thoughts so I was able to quickly act on my action thought.

This may not be possible all the time. But over time if you practise you’ll be able to recognise your choice point – choosing whether to delay or act. Many a times, there are valid reasons for delaying like being burnt out, exhausted, needing rest, sleep etc. However many a times, what makes us procrastinate is not being aware of the choice point, and then we have these handy justifications that don’t help at all.

We have all these ‘ideal conditions’ that have to be met before we do a task. If any of these conditions aren’t met, we procrastinate. We think we need to do it perfectly and unless all the demands/conditions are met, we cannot do it. All conditions may be important but they aren’t necessary to do the task.

For example, if I think of drawing, I just need the drawing tools, hence even a pencil will do. All conditions like having a quiet corner for myself, being in the right mood aren’t necessary to draw. Also, we have this idealised and perfect image of tasks, like I might think I need the best markers to draw, I need to finish my laundry then draw, I need to do this and that and then… I procrastinate!

So try this. The next time you get a thought that prompts you to take an action, instead of ignoring it, act on it immediately. Once you act on it, you’ll gradually feel motivated to continue doing it. We cannot wait for the right feeling to come along to do something. You don’t need motivation to act, you just need to recognise the choice point and act despite the urge to delay. Also, become aware of the automatic thoughts that come up, the justifications that come up when you have the urge to delay.

Practise, telling yourself, I don’t need to meet all the conditions to do this task. All conditions don’t have to be met to complete this task or to start it. What I have is enough to do it right now.

Psychological reversals

Reversals or psychological reversals are a group of aspects that adversely affect the EFT process. They can come up when you are making progress. For example, you might feel fear or resistance when you’re on the verge of releasing a strong emotion, a physical symptom or condition. They can also come up right in the beginning as soon as you start addressing an issue for the first time.

They are conscious or unconscious resistance that we have towards healing something. They can show up as “conflicting parts and beliefs, secondary gains, protective parts”.

All of us have developed coping mechanisms to survive certain traumas and tough situations when we were younger and these coping mechanisms really helped. However, as we grew older these coping mechanisms became outdated , limiting and unhealthy.

These coping mechanisms can act as protective parts trying to hold on to what helped us survive. Gently addressing the fear and resistance around replacing old patterns and adopting healthier coping mechanisms can really help.

EFTi defines “Reversals as a specific group of Aspects that can negatively affect the EFT process. These can be conscious or subconscious and include secondary gains, resistance, conflicting beliefs or protective parts that stand in the way of progress. When EFT progress is slow or stalled (i.e. Intensity Levels are not dropping, emotional intensity is returning with frequency or presenting issues are not changing measurably), Reversals (i.e. hidden Aspects) are often present.” (EFTi glossary)

Thinking same thoughts?

Our present and future is always coloured by our past. As Joe Dispenza says and even neuroscience suggests, if you keep thinking the same thoughts, then the same neural patterns will get strengthened, the same neurons will fire and wire together. So when we keep reviving our past and the strong emotions associated with it, the body keeps getting into extended periods of stress. The body cannot differentiate between real and imagined event. Hence when we keep narrating or retelling the same stories in our head throughout the day, the body stays in that stressful mode.

Example, if you’ve been cheated by someone in the past, and very frequently you think about how bad that experience was, the body experiences the same emotions over and over again, the same neurons fire and wire. This becomes a habitual pattern where negative events will stick to us and positive ones will slide by easily.

That’s where EFT comes in. When you work on specific episodes with tapping, the narration is done in a structured manner where every crescendo of the story is tapped upon. This sends deactivating signals to the amygdala and the neural connections for that story are weakened. This changes how you feel about your past, which in turn creates a feedback loop and new thoughts and feelings are generated about the past that aren’t stressful to the body. Acceptance and being able to let go create a calmer physiology.

A short excerpt from Joe Dipenza’s interview.

“Become conscious of your negative thoughts.

People have a habit of clinging to the familiar and the known.  Most of the times we’re not even aware of what we’re thinking. Observe the thoughts. You will feel uncomfortable and will want to distract yourself. Any kind of change requires becoming uncomfortable to some degree.

Changing your thoughts consciously on a daily basis is needed.” You can see the full interview here https://youtu.be/ereahWKwNV8

Here are some tips and suggestions

  1. If you’re going through a tough time, take it slow. Choose a few methods that work for you and practice them regularly. Start with a practitioner or attend a workshop to understand the methods properly and then apply them on yourself.
  2. Always accept how you feel. Burying or acting upon feelings don’t help.
  3. Taming your thoughts takes time. Changing the critical inner voice to an encouraging one takes time – have compassion for yourself.
  4. Taking responsibility for what happened in the past doesn’t mean that you deliberately created that experience and you need to blame yourself for it. When you take responsibility, you operate from place of power instead of victimhood and that brings about changes. You stop blaming others for everything and decide to work on what you can do about the situation. All this becomes easier with EFT.

Growth & Survival

We have two very important survival mechanisms: GROWTH and PROTECTION

Dr Lipton did an experiemient in the laboratory on endothelian cells. When he introduced toxins into the culture dish, the cells retreated from toxins, just as humans move away from lions and tigers. These cells “gravitated” towards nutrients just like humans move towards nourishing food and love/connection.
Gravitating towards nutrients is a Growth response and Retreating from danger is a Protection response.

Now these two mechanisms cannot work efficiently at the same time!
So when we become protective – trying to protect ourselves from real or imaginery danger- we are operating from a protective mode. We go into fight or flight and the body channelizes the enegry to tissues and limbs to be ready for protection mode. Hence the growth is inhibited.
An excerpt from Dr Lipton’s book:
“Inhibiting growth processes is also debilitating in that growth is a process that not only expends energy but is also required to produce energy…the longer you stay in protection, the more you compromise your growth” (p. 116)

Most of the times we are not at a point where there is extreme danger to our survival and since humans are multicellular, not all of our cells have to be in growth or protection mode at the same time. Only depending on the severity of the treat, the cells engage in protection response.
While we can survive threats, chronic stress can inhibit growth mechanisms and can compromise your health.

Bottom line is that not only do we need to cope with stress in a healthy manner but also actively seek joy and move towards fulfilling loving lives where growth processes are stimulated (p. 117)

In order to move towards joy and lead more fulfilling lives we need to lessen our daily stress and also the stress from past experiences. What better way to do it than EFT! It can help you release negative experiences and reinforce positive ones.

Reference: Lipton, B. (2005). Biology of Belief. India, Hay House.

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Subconcious Programming

Our subconscious mind retains all of our early life’s data. It’s a storehouse of learned experiences and instincts. It’s basically a ‘repository of stimulus -response’ tapes from our childhood. (Lipton, 2005)

Subconscious mind is habitual. Think of the last time you lost it when someone did something. For example, I used to dislike it when I saw a piece of misplaced furniture. If a person sat on a chair and didn’t put the chair back in its place or position, I would get irritated. My dad is very organized and growing up I’ve observed and retained a lot of his habits around organization.
So in essence, my overreaction came from my subconscious mind which had stored all the observations about my dad’s organized behaviour. Of course, it also made me very good in organizing stuff which is a great skill but at the same time, it also made me inflexible and a perfectionist. After I realized that my overreactions were coming from my subconscious mind, I became more mindful and conscious of my reactions. Now, it doesn’t bother me much. Although I will still put the chair back in its place 😅, I do so without any irritation.

In his book, the Biology of Belief, Dr Bruce Lipton says that the subconscious mind is more powerful neurologically than conscious mind. Our conscious mind is the state in which we are aware, conscious, creative and attentive.

If you read his book, you will come to know about many fascinating facts. Did you know that the cell’s main brain is not the nucleus but the membrane? Bruce Lipton explains how this is tied to how the mind influences the body.

The membrane consists of receptor (awareness) and effector (action) proteins. “These protein complexes are the fundamental units of cellular intelligence” The cell membrane interacts with the environment to produce responses that help in sustaining life. The cell membrane is the brain of the cell. And our brain is the main unit in a human body and each cell of our body has to “acquiesce control to the brain..the brain controls the behavior of the body’s cells” (Lipton, p. 101)

The mind is a function of the physical brain.
What this means is that we can heal if we properly use our conscious mind. Our conscious mind has control over the cells of our body and the way we think and feel can affect our cells and thus lead to healing or aggravate ill health. That’s why working on our subconscious beliefs is so important for a healthy mind and body.

Our conscious mind is very powerful. It can choose how to behave in a situation, it can analyze the data coming from subconscious mind and so and so forth. Those of you who know EFT, know that with EFT, we engage the prefrontal cortex, the conscious mind, and that can override the subconscious mind’s default behaviors.
Work on your subconscious beliefs, remember to take up specific events to transform these beliefs.

Reference: Lipton, B. (2005). Biology of Belief. India, Hay House.

Learn about Genetic Deternimsm and Epigenetics here