Cognitive-Behavioural Therapy

Depressive disorders come in different forms, just as is the case with other illnesses such as diabetes, cancer or heart disease. This article briefly describes three of the most common types of depressive disorders.
However, within these types there are also variations in the symptoms, their severity and duration. Major depression causes symptoms i.e. excessive fatigue, relentless pessimism, hopelessness etc. that interfere with your ability to work, study, sleep, eat, and enjoy activities that were once pleasurable.
This type of depression can be disabling and may occur once but more commonly occurs several times in a lifetime. A less severe type of depression, dysthymia, generates longer-term, chronic symptoms that do not disable, but prevent you from functioning optimally or feeling enthusiastic when you should.
Many also experience major depressive episodes sometime in their lives. Another form of depression is bipolar disorder.
This serious and often devastating disorder is characterized by mood changes that cycle in and out or on and off- severe highs (mania) and lows (depression). Occasionally, the mood switches are dramatic and rapid, but usually they are slower and gradual.
When in the depressed cycle, one can have any or all of the symptoms of depression. When in the manic cycle,however, you may be overactive, over-talkative and manifest too much energy.
Mania often affects your thinking, judgment, and social behavior in ways that cause serious problems, anger and embarrassment. For example, once in a manic phase you may feel elated and full of grand schemes that might range from unwise business decisions to romantic or promiscuous sprees.
Left untreated, this disorder can literally ruin your life and even cause a deterioration into psychosis. Medical treatments typically used, depending on the condition type and severity, include anti-depressant medications, anti-psychotics, psychotherapy and mood stabilizers.
The best psychotherapeutic treatment is cognitive-behavioral therapy which treats how your thinking processes affect your mood and behavior.
Unfortunately, sometimes patients inappropriately drop-out of medication therapy, rather than follow-through because of side effects which could have been ameliorated had they stayed in treatment.
Wonder if you are getting the correct treatment for your depression? The following recommendations are based on a review of the scientific literature regarding the use of psychotherapy, counseling and medication in treating depression.
Take heed:
1. The treatment of first choice for your depression should be cognitive behavioral or interpersonal psychotherapy. This is because of their superior long-term outcomes; they also pose fewer medical risks than using drugs or combined treatments. However, you should consider medications, combined treatment, or other types of psychotherapy if you do not respond appropriately.
2. You should not undergo insight-oriented psychotherapy by itself because studies suggest that it may produce poorer outcomes.
3. It is important that psychotherapy or counseling be included in your treatment program when anti-depressants are prescribed; you are at a higher risk for relapse if you use medication by itself.
Generally, the best results are achieved by the combined use of cognitive-behavioral therapy and medication.
4. Everything else being equal, when starting medication, a single medication administered with psychotherapy should be used.
5. Everything else being equal, when using an anti-depressant, you should use the lowest, safest therapeutic dose for the shortest possible duration. This minimizes the risk that you may experience any possible side effects, cardio-toxicity, potential suicidality or even drop-out of treatment prematurely.
6. If you are hospitalized, antidepressants should be only very cautiously prescribed, especially if you have cardiac vulnerabilities, because of the risk of sudden death.
7. If you have been suicidal, you should take antidepressants only if there is a vigilant monitoring plan in place to prevent over-dose.
8. Everything else being equal, you should be very reluctant to have ant-depressants prescribed for your children because there is no compelling evidence that they are effective for them and little is known about the health risks they pose for this population.
9. Caution should be used in prescribing antidepressants to elderly people because of possible hypotensive and side effect risks.
10. You should avoid taking regular minor tranquilizers alone for your depression because they have resulted in worse outcomes than no treatment at all.
11. It is crucial to hire the right professional for the right task. Clinical psychologists receive most of their training in psychology, counseling and psychotherapy.
Psychiatrists receive most of their training in medicine. Choose a psychologist for counseling and therapy; go to a psychiatrist for medication.

AbstractFeminist Therapy focuses on empowering women and helping them discover how to break the stereotypes and molds of some traditional roles that women play that may be blocking their development and growth. This type of therapy grew out of influences of the women’s movement of the late 1960’s. Feminist therapy tends to be more focused on strengthening women in areas such as assertiveness, communication, relationships, and self esteem. One of the main goals of feminist therapists is to develop equal mutual relationships of caring and support. The therapist believes that her client is the only “expert” in her own issues and will help her develop the tools needed to reach her potential as a unique and valuable individual. There are six main tenets of feminist therapy theory with five main principles. It is important to realize that feminist therapy is not just for women but men can benefit as well. Furthermore, there is a notion in feminist therapy that “personal is political”. This notion means that personal experiences are embedded in political situations, contexts, and realities.Feminist TherapyFeminist psychology grew from the influences of the women’s movement of the 1960’s. This movement was a grassroots one; therefore, no one particular theorist can be named the originator of feminist therapy. Feminists tried to keep elements of other psychological theories that worked but attempted to get rid of sexist aspects of the theories. They then tried to explain some of the common experiences and difficulties associated with the social roles that women endure that may be blocking their growth and development. The focus is mainly on helping women in areas such as assertiveness, communication, self-esteem, and relationships. Feminist therapy also focuses on empowering women by helping them see the impact of gender issues. The aim of therapy is change rather then adjustment. It is important to acknowledge sex roles, minority status and socialization in society as possible sources or causes of psychological difficulties. A core concept is equality; therefore, the therapist is seen as equal in the relationship with an outside perspective who provides guidance and new information but the client is seen as having the power to create his or her own desired outcome in themselves and their lives. Reclaiming personal power is a key concept. A task of the therapist is to help individuals explore and understand what is causing dysfunction and unhappiness and then to help develop strategies to overcome these difficulties…Feminist therapy is not just suitable for women, men can benefit from this therapeutic process as well. Men also deal with social and gender role constraints such as the demands of strength, autonomy, and competition. In addition, they are limited by the notion that they should not express vulnerability, sensitivity, and empathy. Both men and women are exploited by a patriarchal society and limited culture and gender stereotypes. Men can benefit from therapy by working on these issues and by learning new skills to help them understand and explore issues involved with emotions, intimacy, and self-disclosure. There are four main philosophies of feminists with differing goals in therapy including socialist, radical, cultural, and liberal. First, socialist feminists emphasize the need for change in institutional and social relationships. Next, radical feminists focus on the need for change in gender relations and societal institutions. In addition, they strive to increase women’s self awareness in regards to her sexuality and her desires and views for having children. Subsequently, cultural feminists emphasize the importance of the recognition that women are devalued in society and how detrimental this is. Finally, liberal feminists focus on the individual and the biases these people face in regards to self awareness, self-respect, esteem, and equality. Many ideas and views held by these philosophies overlap and are integrated with the main focus on equality. There are four major approaches that are unique to feminist therapy which include consciousness-raising, social and gender role analysis, resocialization, and social activism. Consciousness-raising is sometimes held in small groups in a leaderless manner involving the discussion of women’s individual and shared experiences. Women in these groups do not have to feel that they are alone and they could listen and support others. These individuals examine how oppression and socialization contributes to personal distress and dysfunction and they talk about ways in which solutions for creating individual and social changes can be made. Consciousness-raising helps women feel more powerful to take steps against oppression by participating in social action. Social and gender role analysis involves the evaluation of the client’s psychological distress and methods of coping. First clients will learn about the impact and affects of social and cultural norms and expectations and how negatively these issues affect society. This helps the client become aware and identify his or her own experiences in regards to social and gender role norms. The therapist helps the individual become aware of both implicit and explicit sex roles that the client may have experienced over his or her lifetime. This helps the client explore possible origins of psychological distress. Together the therapist and the client come up with ways to implement change and gain self knowledge.Resocialization follows social and gender role analysis and involves reorganizing the client’s belief system. They learn to view things differently and they develop new coping skills and strategies. Methods are taught that increase self esteem, assertiveness, and self views. A main goal of resocialization is an overall increase in well being.Social activism is rather controversial and not practiced by all therapists. It is embedded in the notion that “personal is political”, which is one of the basic tenets of feminist therapy. This means that there are underlying roots of client’s problems that stem from society and politics. Feminist therapy should not only help the individual but it should help all individuals. Social activism may involve participation by both the therapist and the client. This can be accomplished by speaking out, organized protests, and letter writing campaigns. Feminists agree that social change is crucial and advantageous to the mental health of all individuals.According to Gerald Corey, feminist therapy is based on five interrelated principles:1.The personal is political which implements social change.2.The counseling relationship is egalitarian which encourages equality between the therapist and the client. The client should be aware that she has the power to change and define herself and the therapist is only a tool with new insight and information.3.Women’s experiences are honored and they should get in touch with their personal experiences and intuition.4.Definitions of distress and mental illness are reformulated involving the internal as well as external factors of distress. Pain and resistance are viewed as a positive confirmation of the desire to live and overcome distress rather than being viewed as weak.5.Feminist therapists use an integrated analysis of oppression which means that they understand that both men and women are subjected to oppression and stereotypes and that these oppressive experiences have a profound affect on beliefs and perceptions. These core principles set the basis for feminist therapeutic practice and it is important to acknowledge that these principles contain overlap and interrelated common ground. Additionally, Lenore Walker indicates that there are six tenets of feminist therapy theory:1.Egalitarian relationships: this equal relationship between client and therapist models for women personal responsibility and assertiveness in other relationships.2.Power: women are taught to gain and use power in relationships and the possible consequences of their actions.3.Enhancement of women’s strengths: so much of traditional therapy focused on a woman’s shortcomings and weaknesses that feminist therapists teach women to look for their own strengths and use them effectively.4.Non-pathology oriented and non-victim blaming: the medical model is rejected and women’s problems are seen as coping mechanisms and viewed in their social context.5.Education: women are taught to recognize their cognitions that are detrimental and encouraged to educate themselves for the benefit of all women.6.Acceptance and validation of feelings: feminist therapists value self-disclosure and attempt to remove the we-they barrier of traditional therapeutic relationships. Feminist therapy is beneficial and needed for several reasons. The main goal is change, not just change within the individual but change in society. Gender issues need to be addressed because they can cause psychological distress and shape unwanted behavior. Our lives are affected and influenced by the stigmas and stereotypes associated with these internal and environmental pressures which can affect one’s identity. Feminist therapy recognizes this and implements these concerns in practice. Furthermore, women live in a world dominated by males and masculine patterns of thought and behavior. Until recently, psychological studies of human behavior were almost always conducted by men and on men. The results of these studies were generalized to apply to women equally. The results are biased for several reasons including the fact that men and women are not the same. They have developed differently from early childhood and they tend to view the world in different ways. The media gives young children strong gender biased messages. Boys are supposed to be independent, self sufficient, dominant, aggressive, and successful. Girls are sweet, well behaved, passive, submissive, overemotional, and attractive. There is a conflicting problem here because the same traits that are considered appropriate for little girls are considered negative and inappropriate as mature adults. Males tend to view the world in terms of competition and power, while females look at aspects of the world through relationships and connections to others. Therefore, these studies and techniques may not represent women very well.Women’s natural gifts of being nurturing and caring do not hold much power and value in society according to our social norms. These views and norms prevent women from feeling a sense of strength and power. These characteristics should not be viewed as weaknesses yet society sees it this way. Women should be commended for all he roles that they play. It is hard to juggle a family with children and a career, then come home and do housework and errands. As society becomes more of a dual income earning community some of these issues may turn in a more positive direction. Men do not have it easy either. If a man were to stay home and raise the children and tend to the household needs, society may call him lazy or worthless. Feminist therapists recognize how these factors and they understand how much relationships, connections, and nurturance plays a huge role in individual’s lives. They consider sex bias in a male dominated society and they honor women’s experiences and instincts as being valid. Feminist therapists specifically address issues such as family and marriage relations, reproduction, career concerns, physical and sexual abuse, body image disorders, and self esteem. One of the most important concerns of a feminist therapist is the empowerment of women in today’s world. Bohan (1992) states six guidelines for feminist practitioners to follow:1.Therapists are knowledgeable concerning gender role socialization and the impact these standards have on what it means to be a woman or a man.2.Therapists are aware of the impact of the distribution of power within the family and power differentials between men and women in terms of decision making, child rearing, career options, and division of labor.3.Therapists understand the sexist context of the social system and its impacts on both the individual and the family. 4.Therapists are committed to promoting roles for both women and men that are not limited by cultural or gender stereotypes.5.Therapists acquire intervention skills that assist clients in their gender role journey.6.Therapists are committed to work toward the elimination of gender role bias as a source of pathology in all societal institutions.These principles are based on a gender fair ideology for counseling which may be applied to family therapists as well.  These principles also apply to both individual and group therapy. The fact that many principles of feminist therapy can be incorporated into other therapies is a strength because it can broaden the theoretical base of other models and therapies. Feminist therapy aims at enriching and enlightening everyone’s lives by hopefully encouraging social activism in a positive direction. There are some criticisms and limitations to feminist therapy. Some therapists may be too feminist and militant in their views there by persuading clients. No therapist should persuade nor tell someone the “right” way to look at things. The therapist’s task is to offer support and information to challenge the client to examine for herself which road to take. Another criticism is the biased stance that feminists take. They are not neutral. They are all for a definite change in society and they should take caution not to be too pushy with their views on clients. It is also important that clients take responsibility for actions and experiences and not just blame society. They can be aware of society’s impacts but they also need to fess up and not avoid taking personal responsibility. Another criticism is the fact that feminism originated and was developed by, middle class, white, heterosexual women. Other races and cultures were not involved. This has been brought to attention and feminists have become much more inclusive.In summary, feminist therapy is beneficial and advantageous to today’s society. The human race will continue to evolve and new theories will also evolve to meet the needs of our unsustainable, plastic society. Feminist therapists will continue to break down the hierarchy of power by therapeutic approaches and interventions with the overall remaining goal as empowerment of the client and social positive change and transformation.References1.Walker, Lenore E.A. (1990). A Feminist Therapist Views the Case. In Dorthy W. Cantor (Ed.), Women as Therapists, (pp. 78-79). New York: Spring Publishing Company.2.Hecklinger, Fred J. (2003). Training for Life: A Practical Guide to Career and Life Planning. Dubuque, Iowa: Kendall Hunt Publishers.  3.Bohan, Janis S. (1992). Replacing Women in Psychology: readings Toward a More Inclusive History, (pp. 88-99). Dubuque, Iowa: Kendall Hunt Publishers.4.Swanson, Jane L. (1999). Career Theory and Practice: Learning Through Case Studies. Thousand oaks, CA: Sage Publications5.Benjafield, John G., (1996). A History of Psychology, (pp.321), Needham Heights, Massachusetts: Allyn and Bacon6.Corey, Gerald (2001). Theory and Practice of Counseling and Psychotherapy 6TH Edition, (pp. 341-375), Wadsworth: Brooks Cole, Thompson Learning.

If you consider that for hundreds, perhaps thousands of years man wanted to take to the skies like the birds, it seems strange that so many people have a fear or phobia about flying. Of course in today’s modern age we don’t strap on wings and take gracefully to the skies like our ancestors dreamt of doing, instead we climb aboard a giant machine of the air and place our safety and care into the hands of others. These others include pilots and air crew, air traffic controllers, mechanics and engineers, and many other individuals who make our flights through thousands of miles of sky possible. Fear of flying (or aerophobia) affects roughly 1 in 5 people, and can be a real nuisance. It might just mean that family holidays abroad are impossible, or it might make a desired career impossible if it involves flying during business trips. The effect that a fear of flying will have on a person can vary greatly. At one end of the scale, it might simply be anxiety during certain parts of a flight. At the other end, it might manifest itself as a full blown terror, which might even preclude them from just picking someone up from an airport. Statistically, of course, flying is one of the safest modes of transport … but to someone with a fear of flying, knowing this at a conscious level, is not enough, and they remain afraid, controlled by their fear of flying. To the sufferer, it’s their imagination that drives their fear, and no amount of ‘rationalisation’ can help this. Most nervous flyers simply avoid flying entirely if they can, and this avoidance serves to reinforce their fear of flying. Fear of flying, especially when an individual has flown before, perhaps many times, is often linked to a more serious level of anxiety disorder and sometimes panic-attacks are a part of the problem also. Fortunately all of the above can be very successfully dealt with by Hypnotherapy which may include Suggestion Therapy, Hypnoanalysis, Parts Therapy, Gestalt Therapy, Cognitive Behavioural Therapy, Neuro-Linguistic-Programming (NLP) and Kinesiology.

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Emotional stress is someth ing that we all experience when we have to cope with the many demands and responsibilities of home and work. Stress can be defined as an intense emotional and physiological reaction to a situation or the mental representation of a situation as a memory or anticipation. Chronic stress is produced when stress reactions do not resolve themselves and become habitual. The sustained physiological effects of chronic stress can have a serious effect on the body and lead to an increased risk of disease. The psychological effects of chronic stress produce fatigue, poor concentration and an impaired ability to perform tasks, which leads to more stress. Stress produces a general feeling of helplessness and negativity, both of which reinforce the stress reactions. This produces a lack of vitality, enthusiasm and creativity and many people describe chronic stress as a heavy blackness that covers everything and in its severe form, chronic stress leads to depression. Chronic stress can result in an increased chance of accidents as well as reducing work performance. Chronic stress also reduces our listening and learning skills and this reduces the quality of communication in our personal relationships and family.

It is well recognized that stress reactions are learned and originate from the influence of our own mental outlook and from belief patterns acquired from our parents, family and culture. Stress always contains both an objective component and a subjective component and in most situations, it is the habitual subjective emotional reactivity that generates the emotional tension and physiological characteristics of stress. There is pain and there is suffering. Pain is the objective component that is often inevitable or unavoidable, but suffering is a subjective reaction that we generate and add to the pain. The Buddha described this subjective suffering as dukkha and not surprisingly, mindfulness, which is one of the central teachings of the Buddha, was and continues to be very relevant for working with and resolving emotional stress.

The other major source of stress comes from unresolved traumas that result from physical injury, assault, domestic abuse and violence. In general this kind of trauma-related stress results from experiences and associated emotional reactions that we cannot process, because they are outside of our normal range of experience. These unresolved wounds become repressed and submerge into the subconscious mind where they continue to simmer and generate a generalized anxiety. This is described as post-traumatic stress disorder (PTSD). Occasionally, in severe cases of PTSD resulting from war or other intense situations, the stress reactions will erupt as nightmares and flashbacks in which the individual re-lives the trauma.

Whatever the source of the stress reactions, it is important to understand that each reaction has an internal structure in the form of negative thoughts and beliefs and associated emotional energy that gives power to these thoughts. It is often very helpful to examine these negative thoughts and try to change them. This is the approach taken in Cognitive Behavioral Therapy. Another approach is to change the emotional energy that empowers the thoughts and beliefs, because without this compulsive charge, the beliefs will have no power to generate stress. This is the approach taken in MMT. Through careful attention and investigation of the emotion through mindfulness, we can uncover the internal structure of the emotion and discover what needs to change. As the structure changes, so does the emotion. Resolve this and you will neutralize the stress reactions.

OVERCOMING STRESS REACTIONS: THE FOUR Rs

Stress is generated by habitual emotional reactions to external events and internal beliefs. These patterns of negative thinking can be changed by the application of the four Rs, which are the primary focus of MMT. These are: RECOGNITION, REFRAMING, RELATIONSHIP, RESOLUTION.

RECOGNITION

All habitual emotional reactions rely on two key elements: ignorance and emotional energy. The first task in MMT is to learn to recognize our stress reactions as they arise in stressful situations. We train ourselves to watch very carefully for any impulse to react. This counteracts the automatic and mechanical part of what makes reactions habitual. The maxim of MMT is that all change begins with mindfulness and mindful-recognition is the first and most important step. You know what pushes your buttons. It might be in your personal relationships with your partner or with your children or perhaps with your parents. One of the most important steps you can take on the path of self-transformation is to take the initiative to examine what stressors cause you to react and to learn to recognize your impulse to react. This is very empowering and changes your attitude from being a victim to being a warrior. For most of the time, most of us react out of habit and have no awareness of what is happening while it is happening. We are simply seduced into the same automatic patterns of reactive thinking over and over again. Clearly, the first step is to break this pattern of ignorance and know what is happening as it happens. This is the fundamental first part of mindfulness. Mindfulness means to be present for experience as it is unfolding.

REFRAMING

Now you are learning to recognize anger reactions, disappointment and frustration reactions, fear and anxiety reactions as they arise in real-time. This new awareness can be very transformational by itself by simply making you conscious of what you are doing. It is a truth that what you don’t see is what has the greatest power over you. Awakening to what is happening is therefore the first step to change.

The next step that paves the way for transformi ng the emotional energy that powers stress reactivity is to change your relationship to the emotion. Our usual response is to say I am angry or I am afraid or I am upset and we literally become the emotion. Contrast this to saying I notice anger/fear/upset in me. Now the emotion becomes reduced to an object, not me, that I can relate to with mindfulness. This simple reframing of how we perceive an emotional reaction – as me or as an object that has arisen in me is itself transformational.

RELATIONSHIP

However, what keeps a reaction alive is the associated emotional charge, without which the reaction would have no power to cause stress. MMT teaches us how to form a non-reactive relationship, the Mindfulness Based Relationship, with this underlying emotional energy that compels us to react. This is the RELATIONSHIP phase of MMT.

The mindfulness relationship is very important. This is where we allow ourselves to open our awareness and investigate the emotional energy, which is quite different to our usual reactions of ignorance, avoidance or aversion. We choose to be fully present with the inner feelings behind the stress reactions, rather than getting sucked into the content and story line. Just as in personal relationships, it is the quality of our PRESENCE, our ability to listen with an open mind and heart that is most important. Now we are learning to cultivate this same presence for our inner emotional stress. The nature of the mind is such that if you allow things to change, they inevitably will. If you allow things to change and unfold into this safe spaciousness of the mindfulness-based relationship, things will change in a beneficial direction that will transform and resolve the inner conflict and pain. It is the habitual reactivity that stops this natural healing and as we learn to disengage from the patterns of reactivity we create the right conditions in which emotional tension will resolve itself.

RESOLUTION

Mindfulness creates a therapeutic space that allows the emotion to unfold and undergo transformation. If you give it space it will change. This is one of the great discoveries made by the Buddha, 2500 years ago and which we are rediscovering today. It is not what we do that matters as much as how we relate to our emotional stress. When this relationship is based on the receptivity and openness of mindfulness, then we create the best possible conditions in which emotional tension can resolve itself.

Resolution can be understood as the process in which a stress producing emotion like anger or anxiety or disappointment undergoes a process of unfolding and differentiation. When we investigate anger with mindfulness, we begin to see that the anger is actually an assembly of more subtle content – the inner structure – in the form of feelings, memories, sensations and often some form of inner imagery that pulls all these parts together into the form of an emotion. The anger differentiates into feelings of sadness, emptiness, fear. With intense stress reactions resulting from trauma, we will likely notice vivid inner imagery. It is by uncovering the internal structure of the emotions and associated imagery that change becomes possible and mindfulness provides one of the best ways of cultivating a safe relationship with painful content by teaching you how to stay present and avoid becoming reactive to what you are uncovering.

Through becoming conscious of the inner structure of the emotions that power our stress reactions, the emotional energy will change and resolve. Without this emotional power, there is nothing to sustain the emotional reactions and life-long patterns of stress producing reactivity begin to dissolve, leaving you free from their compulsive grip. Like the petals of a lotus bud that were previously held and constrained so tightly, the mind begins to explore a new freedom with all its possibilities and choices. This is the freedom that the Buddha talked about and that is possible for all of us to discover through the practice of mindfulness. MMT teaches you how to apply mindfulness to resolve your patterns of habitual reactivity so that you can realize your full potential and enjoy your life and relationships to the full.

Peter Strong, PhD is a scientist and Buddhist psychotherapist who specializes in the study of mindfulness and its application in Mindfulness Meditation Therapy. Peter teaches mindfulness meditation (vipassana) and works with individuals and couples using Mindfulness Meditation Therapy for resolving difficult emotional problems including anxiety, depression, phobias, grief and trauma and the management of anger and stress. Besides face-to-face work, Peter also works with individuals and couples online via email and web conferencing. To learn more visit http://www.mindfulnessmeditationtherapy.com/

Email enquiries welcome.

Having a phobia of walking outside your own home and being in a wide open public space can be debilitating and wreck any chance of a normal happy life. Even the thought of this situation can send a sufferer into a terrible panic attack with feelings of anxiety that could soon develop into depression. One of the best things a sufferer can do is to have psychotherapy and give themselves a shot at living again.
The term ‘agoraphobia’ is literally a fear of open spaces and comes from the Greek words meaning “fear of the marketplace”. The phobia is most common in women and occurs in a high number of people aged 25-35. Agoraphobia can also apply to people who find it difficult to be in crowds or struggle with travelling on their own. It’s usual for people to continue with their day-to-day lives when suffering with agoraphobia but it makes for an uncomfortable existence. Others can be completely housebound by it.
The most common symptom of agoraphobia is a panic attack. These attacks can take the form of shaking, sweating, palpitations and chest pain. The sufferer can also develop a headache from tension and have tingling sensations around the body. They will also feel a sense of terror and seek to flee from the situation. If this applies to you when in a public space or social situation, you may well be suffering with agoraphobia.
As with many phobias, the causes are believed to be chemical and also a result of physical and environmental factors. An imbalance in our chemical make-up can disrupt neurotransmitters in the brain that may bring about attacks. Also, emotional factors from past experiences can affect the way we perceive certain situations and therefore we try to avoid placing ourselves in a similar situation again. When these factors cause us to avoid situations for fear of them, it can impair our social, professional and personal life and we should seek help.
Your GP should make a diagnosis of your condition and then recommend a course of treatment. Many doctors choose to treat the condition with medications such as antidepressants, serotonin inhibitors or tranquilizers but psychotherapy is now the non-drug way of overcoming the phobia and your GP can refer you to a trained psychotherapist.
Psychotherapy will use what is known as cognitive behavioural therapy to help agoraphobics overcome their fear. Many psychotherapists use a technique called ‘desensitisation’. They will slowly expose a patient to the situations that cause them anxiety to purposely trigger their fear. When this happens, the psychotherapist will help calm the patient with breathing exercises and relaxation methods and gradually the patient will learn to cope. By breaking the connection the mind makes with the feared situation and the feelings associated with it, the phobia can ease and eventually disappear altogether.
Another technique a psychotherapist may employ is a psychodynamic therapy that tackles the underlying causes of the phobia. By discussing any emotional conflicts a sufferer has, the patient can learn to overcome their fear. Often the causes of agoraphobia are not apparent until the patient starts to talk about them.
Psychotherapy has a high success rate with agoraphobics and by working with a trained psychotherapist you can begin to understand why you are suffering with agoraphobia and start to develop coping strategies to overcome it. Before long you could be enjoying a happy and active social life again.

Get Paid to Submit Article like “Can Psychotherapy Really Help?”Therapy in this case means behaviour change or at least behaviour modification, which can be achieved in a number of ways. Psychotherapy all started with Freudian psychoanalysis, but protracted therapy sessions with an analysis slowly grew less popular as people looked for quicker ways to solve their problems.

More recently CBT or Cognitive Behaviour Therapy which has evolved from behaviour Modification Therapy has become increasingly more popular. It is now in common usage as a treatment option and is widely accepted as an empirically based and cost effective treatment alternative by the medical establishment. Thus it is used to address many disorders and psychological problems. If for instance somebody is suffering from an anxiety state such as the fear of flying the person will set up a number of protective behaviours that will guard them from the belief that flying is inherently dangerous. Overall they will probably avoid flying in an aeroplane at all. If forced some people will travel by air but in great discomfort and under a lot of stress. In some cases anti-anxiety drugs may alleviate this. However, if the individual avoids flying altogether they will find that the behaviour inhibits them in many avenues of life. For instance it will be difficult to travel on overseas holidays which might result in family pressures. More likely the real crunch will come when the person is required to travel abroad for work reasons. A refusal or inability to fly could have huge repercussions on work prospects and could lead to the loss of a job. However, we all have feelings about flying which can range on one hand to an exhilarating adventure and to the other to something that is dreaded, I think all will agree it would be nice to have a choice in the matter. CBT is able to help in situations like this by getting the subject to examine the beliefs that came into being that designated flying as something dangerous. Frequently the cause events go back to childhood. However, CBT is unable to deal with a problem like fear of flying quickly. It will take several months to come to a place where the subject is able to take a plane and travel to a destination with acceptably reduced stress levels. Unfortunately people in need of this treatment to offset the fear of flying usually do not have the luxury of this elongated time frame. Very often business executives are notified of overseas business trips just a few short weeks before departure date. Moreover treatment requires severall therapy sessions and this can work out costly. However, it must be said that treatment techniques like CBT are considerably better than those that preceded them, so it seems we are on a gradually improving learning curve.

However, when we go outside the empirically proven techniques that fit within the belief structures of the scientific principals favoured by the medical profession we do come to therapies that are quick and effective, Hypnosis or more precisely hypnotherapy has gained favour over the years because it can be effective and it can be quick. Some people are afraid because there are so many misconceptions about hypnosis. Many people think that a cloaked Svengali figure will take possession of their minds whilst waving a pocket watch in front of their eyes. This is nonsensical but stereotyped images like this get in the way of the true effectiveness of hypnosis.More recently the Meridian Energy Therapies have gained some popularity. The best known of these therapies is EFT or Emotional Freedom Technique. There is no hypnosis involved merely the tapping of the end points of the acupuncture meridians in a form of acupressure. EFT has had some amazing results from ridding people of life long phobias in a matter of minutes to curing Dengue Fever! It can be effective and is worth checking out because psychotherapy in the expert hands of a capable practitioner can result in truly amazing long-term benefits.

A lady was once referred for treatment for emotional distress. This distress had resulted from unpleasant memories of having undergone sexual abuse. In her case cognitive therapy had been unhelpful, Her own opinion was that cognitive therapy did not address the anger and fear that she was feeling strongly .

There are many approaches in therapy that are available for anyone who wants this service. Cognitive Behaviour Therapy (CBT)is the most well known, because it is the most researched form of therapy. CBT is the product of the West, where people are encouraged to think and discouraged to feel emotions. CBT is based on the premise that our thinking can change our feelings.

This is not always true. When people undergo abuse or torture, no amount of thinking is going to sort out the feeling of rage that underlies such experiences. The rage that one feels about such experiences overwhelms the thinking ability of an individual and the person still ends up acting out the emotion. In all such cases CBT fails to get any results. Yet because it has been written about widely, mental health practitioners erroneously believe that it is the only suitable form of therapy in almost all forms of psychological conditions.

A middle aged man, enraged by an ex-employee’s deception wanted to harm the ex-employee physically. Overwhelmed by anger, he felt that the only way the person would realize how they felt was by conferring physical pain. No amount of reason or logic was useful. According to him, ‘action had to be taken’. The best solution in this case was to reduce the anger by releasing it. When it was done in a few minutes, he thanked me for helping him out of the situation. The perception had changed. The thoughts were non-aggressive. Needless to say, he did not act out the rage.

When our inner drives are strong, they overwhelm our thinking. At such times reason or logic is governed by the drives. Anger is one such emotion. When it takes the form of rage, the person may lash out physically. The solution does not lie in reasoning with the person, but to help the person reduce the drive. In other situations when the anger is in the form of annoyance, reason can still be used to ‘distract’ the person away from the issue. But the feeling stays. To distinguish between times when behaviour can be changed by thinking and when it cannot be changed by thinking requires wisdom.