Dealing with Anger issues


I’ve recently been dealing with a number of clients who have anger management issues and as a result have spent a lot of time trying to identify the most effective ways of defusing their anger.

Some people, of course, are just hardwired to have a short fuse, they are often very manipulative and turn violent if they don’t get their own way.  These are best left to proper psychiatric care.

For a lot of people though, anger is a natural emotional  response to events or issues which have shaken their world, creating issues which remain unresolved for years after the event and which gradually fester into a habitual sense of impatience and intolerance with the world around them.

Anger presents itself in sudden flare ups and inappropriate aggression towards to everyone from partners and children to shop staff and call centre operators.  Sufferers have an extremely low tolerance threshold of anything which requires them to deal with an issue, however trivial..  Those who are tolerant by nature suddenly become intolerant.  Those who have always had enormous patience suddenly start throwing things around in frustration or  threatening others with violence.  Frequently this violence is only verbal but sometimes it can go further.

By the time they reach my consulting room sufferers are usually at a cross-roads in their relationship – their partner has told them to get treatment or the relationship will be at an end. Sometimes, their partner has already found someone else, having been driven away by the frustration and fear induced by walking on eggshells every time Mr Angry is around.  At other times they might have been forced to seek treatment as a result of a restraining order or other court instruction.

When they sit down for their first consultation, sufferers are normally in a pretty poor state, feeling helpless and depressed, confused and fearful for their relationship, their family, the impact which their problems has had on their friends and colleagues at work –  their entire future in fact.  Some readily acknowledge their problem; other remain in denial that they have anything other than a low tolerance level for certain types of “provocation” or situation.

My job as a psychotherapist is to first establish the extent and intensity of the anger they experience and whether or not is hardwired or emotionally driven.   I then  identify the triggers which create the outbursts and the internal language which  it generates in the client, and the people who are most likely to be the targets.

From there I need to identify the type of fuel which is powering their anger.  Often it is quite apparent – the sudden death of a parent or very close friend or the loss of a child.  Redundancy is another common cause – it  can have a disastrous impact on someone’s sense of self-worth and identity.  Men in particular seem to have very fragile egos – they are often identified by their jobs – they are their jobs.  When those jobs are taken away, they become totally lost.  They seem like ghosts, with no idea of who they are or what they should be doing.  They become angry and frustrated at their ex-employers, their managers, the company and most importantly, at themselves for their seeming impotence, confusion and lack of direction and purpose.  These feelings then combine with all the unspent energy which would usually get used up during a busy working day to create a highly volatile cocktail of anger.

In addition, being let down by a trusted business partner, being ripped off by a crooked salesman resulting in the loss of income, house and the subsequent esteem of friends and family can make a normal loving father into a seething mass of anger – ready to erupt at the slightest provocation. This time the anger is fuelled not by loss of identity but at having the very roots of his masculinity challenged – he’s been duped, made to look a fool, lost respect amongst his family and peer.  His primitive instinct is to strike back, release the pent up rage in an orgy of physical violence against whoever caused him the hurt.  But he can’t do that; society doesn’t allow it.  And so he has to lock it up inside him where he tried to bury it, only for it to burst out in the  form of violent rage and anger.

Having got to this point of understand, both for myself and the client, I will usually use hypnosis to help the client release all this anger against an individual or situation in a safe way, by helping them to create scenarios and visualisations which allow them to burn off their anger, often in just a single session.  They can, in imagination, express their thoughts and feelings, rampage around, scream and yell, do whatever they feel they need to do to unlock their feelings, express them in their imagination and then emerge feeling cleansed and revitalised.

Having achieved this, they are they taught different ways of regaining control of themselves in difficult situations.  How to avoid indulging in knee-jerk responses to perceived provocation and learning how to take control of a situation before it gets out of hand.

And these sessions don’t need to go on for a long time.  I recently dealt with a case which was resolved in five one-and-a-half hour sessions.  The final session was held with his partner to help her understand how he had undergone such a transformation in  behaviour in such a short time, and to be reassured that without the fuel which drove his anger,  the  change she had observed was to all intents and purposes, permanent.

If you suffer from anger issues and would like to talk more please feel free to contact me via the blog or my website at www.keithjeffordhypnotherapy.co.uk

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AN INSPIRING & THOUGHT PROVOKING MOVIE


I watched a tremendous film called Temple Grandin last night on Sky.  It takes us into the world of someone with autism and the extraordinary talents they have.  Instead of the usual Hollywood slush it has a really uplifting hard-edged narrative taking us through her life and her remarkable achievements.  Wikipedia says about her…

Temple Grandin (born August 29, 1947) is an American doctor of animal science and professor at Colorado State University, bestselling author, and consultant to the livestock industry on animal behavior. As a person with high-functioning autism, Grandin is also noted for her work in autism advocacy and is the inventor of the squeeze machine designed to calm hypersensitive people.

Grandin is listed in the 2010 Time 100 list of the 100 most influential people in the world in the category “Heroes”.[1]

Look up the film. A very rewarding couple of hours.

The value of CNHC membership


Although this is a relatively narrow topic for a Blog, I’m writing it in response to a number of queries I’ve had from both fellow hypnotherapists and members of public who have asked “Why are you a member of the CNHC (Complementary & Natural Healthcare Council) Register?”

The short answer is because it is now the most important Register of professional competence open to practicing Clinical Hypnotherapists in the UK.

Many people are unaware that anyone can present themselves as a hypnotherapist.  There is no legal requirement for registration, licensing, training, supervision or insurance.

I have always considered this to be a completely unacceptable situation which has been brought about by the fragmented nature of the hypnotherapy fraternity in the UK and the  amount of political infighting which has resulted.   In 2000, a House of Lords Committee reviewed the whole issue of regulation of the complementary and natural health market and recommended that whilst legislation was not required, a Code of Voluntary Self Regulation should be implemented through an independent organisation.

Staggeringly, it has taken a decade for these recommendations to be implemented, accompanied by many thousands of man hours or discussion and debate.  Finally, however, in 2009, the CNHC Registered was launched.

The Department of Health now recommends that when seeking a hypnotherapist, NHS staff and members of the public should consult with someone who is CNHC registered.

To quote from the CNHC website…

CNHC registered complementary therapy practitioners using the CNHC quality mark demonstrate to members of the general public and other healthcare providers that they conform to national standards of practice in their work.

If a CNHC registered complementary therapist has the CNHC quality mark it means that they:

  • Have undertaken a programme of education and training which meets, as a minimum, the National Occupational Standards and the core curriculum for the complementary therapy/discipline concerned where a core curriculum has been agreed

or

  • Have achieved competency to the level of the National Occupational Standards for the therapy/discipline concerned by means of relevant experience of at least three years and /or relevant training and been assessed by their peers as having met those standards

and

  • Have provided an independent reference of their good character
  • Have confirmed that they do not hold a criminal record (including cautions), or notified CNHC of any such record for consideration by the Registrar prior to acceptance
  • Have confirmed that there are no health issues that impact on their ability to practice
  • Have confirmed that they have not been the subject of any disciplinary or civil proceedings against them in relation to their practice or have notified CNHC of any such proceedings for consideration by the Registrar prior to acceptance
  • Hold current professional indemnity insurance
  • Have agreed to abide by: The CNHC Code of Conduct, Performance and Ethics CNHC’s Continuing Professional Development (CPD) Policy CNHC’s Data Protection Policy Terms of use of the CNHC website.

Following it’s launch, the CNHC has made inroads to acceptance within the NHS and with charities, as evidenced by their latest Newsletter…

CNHC registration is key for mental health charities

As CNHC continues its work to raise awareness of CNHC registration across a range of sectors, they have been liaising with a number of organisations that represent people with mental health conditions. Here they outline the importance given to CNHC registration by Mind and Anxiety UK.

  •   Mental Health charity, Mind, supports CNHC registration. Mind provides a wide range of support and information to people with mental health conditions throughout the UK. Where people are seeking complementary therapies, Mind recommends they find someone who is CNHC registered.

Mind’s Head of Information, Beth Murphy commented: “Some people find complementary therapies help them to manage their mental health but it is vital that therapists are appropriately trained and regulated. Mind supports and promotes CNHC registration and the CNHC quality mark to help people find a therapist they can trust.”

  •  Anxiety UK is a national registered charity formed 40 years ago by a sufferer of agoraphobia for those affected by anxiety disorders. Today the organisation is still user-led, run by and for those with current or past experience of anxiety disorders. The charity is supported by a high-profile medical advisory panel as well as a number of celebrity patrons including cricketer, Marcus Trescothick and comedienne, Ruby Wax.  Anxiety UK works to relieve and support those living with anxiety disorders by providing services including counselling, clinical hypnotherapy and cognitive behavioural therapy (CBT). The charity also operates a national helpline, delivers online services and provides an innovative peer mentoring scheme. The charity uses robust screening processes for its therapy services to ensure the highest standards of governance are maintained both before and after appointment and CNHC registration is one of the criteria for its hypnotherapists.

Nicky Lidbetter, Chief Executive of Anxiety UK said: “It is of the utmost importance that our therapists are verified, validated and accredited by relevant and appropriate governing bodies to ensure the highest standards of clinical practice. As there are several governing bodies particularly in the field of hypnotherapy, it is most reassuring to know that the CNHC has made significant progress in defining and establishing a core standard in terms of qualifications, training and experience that hypnotherapists must have in order to be eligible for registration. Going forward, we will be requiring all of our hypnotherapists to be registered with the CNHC.”

To find out more about CNHC please visit http://www.cnhc.org.uk/pages/index.cfm

UNDERSTANDING TINNITUS – Part 1


This week is Tinnitus Awareness Week in the UK.  Coincidentally, I’ve spent much of January working on a CD to help tinnitus sufferers deal with the sometimes devastating impact of being aware of loud noises coming from inside their heads 24/7.  This blog is drawn from the introduction to the CD and is designed to help those suffering from its effects, or those with a friend or relative who suffers from the problem, to understand it causes.  

Having several friends who suffer from Tinnitus, I have made a particular study of how it works and how hypnotherapy might help sufferers accept it and reduce its impact on their day to day lives.

This blog divides into two parts – the first is a fairly detailed description of the mechanisms which drive Tinnitus.  I’ve found in my researches that it’s quite difficult to get a simple but comprehensive description of how Tinnitus sounds are generated and why they are so different for different people.  If you know about this already, please just skip down to the second part which deals with the ways in which hypnotherapy can help you live with Tinnitus more comfortably.

How Tinnitus Sounds Are Generated

When a sound reaches the human ear, it enters as a pressure wave of vibrating air. This wave is converted into mechanical vibration by the eardrum and then amplified by the hammer/anvil/stirrup structure of the Middle Ear. It then passes into the fluid filled space of the Inner Ear.

Inside this space lie the semi-circular canals which control our balance, together with the complex structure of the Cochlear. It is here that the mechanical vibration of the sound is converted into chemical and electrical energy by a part of the Cochlear called the Organ of Corti. This identifies the pitch of the vibrations passing through it and also, their volume.  This is then converted into a signal which is passed to the temporal lobe of the brain – the part which controls our hearing. Only at this point does our conscious mind becomes aware of the sound for the first time.

Tinnitus occurs because of  a mechanical malfunction inside the Organ of Corti.   Inside the organ is a highly specialised structure containing up to 20,000 receptors, each one with its own tiny hair cell attached.  Each hair is responsible for detecting sound at a set frequency and measuring its volume. This information is then passed directly to its parent nerve receptor (one of the 20,000 mentioned above) and then on to the brain.

These hairs are very sensitive to damage from aging, exposure to overly loud sounds or to certain ototoxic drugs and once they are damaged they do not regenerate.   However, the loss of particular hairs does not mean that we stop hearing sounds at those frequencies.  Instead, the nerve receptor which is attached to a dead hair switches to a default setting which amplifies the sound being sent to the brain.  So it doesn’t matter if the sound is soft or really loud in the real world; it will just be amplified to the one and only high level of volume that the nerve receptor can deliver to the brain.

As a consequence, as hair cells become damaged, certain  frequencies of noise will become unnaturally loud and the brain will become much more aware of them.

You probably already know that your body is not a silent place. You can sometimes hear your own heart beating when your head is resting on a pillow in a quiet room. Sometime you can hear rushing noises in your ears as a result of blood flow, or the movement of air in your ear canals. And it can become even more noticeable if you get anxious. As your heart rate increases, your blood pounds round your body faster and the sounds it produces become more noticeable. Even the hairs in the Organ of Corti itself produce noise as they move around.

This is why Tinnitus noise is a very individual experience. It can be heard in different parts of the head by different people and can range from a high pitched whine to loud thuddings and bangings or low groanings. And the same sounds persist day after day after day.

The Psychological Effects of Tinnitus

As a result of the above, Tinnitus can create strong psychological stress which is caused  by the way our brains evaluate and respond to sounds.  The ability to recognise sound is a vital primitive instinct – it helps us distinguish between the threatening growl of a tiger and the comforting purr of a cat. When we identify a sound, our body responds according to the level of threat the noise seems to represent.

The tiger’s growl behind us, for instance, triggers our “fight or flight” mechanism. It immediately prepares us to either fight the tiger or to run away from it. Consequently our Autonomic Nervous System (ANS) pours adrenalin and stimulating hormones into our bodies, dries up our digestive juices, dilates our pupils and opens the pores on our skin so that we can sweat and cool ourselves more easily as we run etc. In modern life, this response translates into high levels of stress and anxiety.

The kitten’s purr on the other hand, makes us smile and relax. So it does the reverse of the tiger’s growl. It triggers relaxation, and so the ANS pours pleasure-hormones into our body, calming us, slowing our heart rate and relaxing our muscles and minds.

So, every sound we hear get labelled and, if repeated often enough, creates a “conditioned reflex” according to the feelings we associate with it.   This reflex is very sensitive and sophisticated. For instance, even though a mother might sleep through a thunderstorm, she will wake up the moment her child begins to cry.

So, awake or asleep, our minds and bodies are conditioned to respond to the sounds we hear – consciously or unconsciously.

In addition, the way we think of a sound is as flexible as our response to it. For instance, loud music might be really enjoyable at a party, but a hellish din when heard through a thin wall at 2 o’clock in the morning. So the label we put on a particular sound depends on the context in which we hear it and the level of excitement/relaxation it causes.

Because Tinnitus sounds are inside the head, can’t be escaped and are more or less continuous, the mind’s response to the sounds is that they are unpleasant, threatening, unwanted and something to fear and feel angry and sad about – and who can blame it?

The problem it creates however, is that developing the habit of always being unhappy and distressed by the Tinnitus noise becomes a vicious circle. This learned response creates an ever-strengthening cycle of negative responses – starting with a feeling of annoyance and irritation and rapidly progressing to fear, anger and a desire to escape – all of which  makes the sensitisation to the Tinnitus sounds even greater.

In additon, to becoming a reflex response, Tinnitus also creates a self-reinforcing vocabulary of internal self-talk –  “I can’t stand it, it’s driving me mad, I can’t shut it out” etc – every time it’s heard.  This negative language once again alerts the ANS to something bad and so the unhappy feeling just get worse.

Finally, on top of all this, many GP’s will tell their patients that there is no cure for Tinnitus – which is medically correct, but leaves no hope of finding ways of alleviating the symptoms or learning to live in peace with the sounds.

How Hypnotherapy Can Help you Live with Tinnitus

We’ve seen from the discussion above that there are three elements involved in the experience of Tinnitus –  i)  the noise itself and the seeming inability to escape it  ii)  the emotions generated every time the noise is heard and iii)  the apparent lack of control and helplessness which sufferers feel.

As we’ve seen, it’s true that there is no literal way of escaping the noise of Tinnitus.  However, it is possible to change your response to the sound of Tinnitus, to  retrain your hearing to make the sound less intrusive ( a process called by audiologists Habituation) and in doing so, change your body’s emotional response to it.   Thus, by using a variety of techniques, it is possible to learn to live at relative peace with the noises – by learning to be less disturbed by them, to be able to forget about them for longer (if you think about, you probably do experience times during the day when the sounds are less troublesome or not even noticed) and to change your response to them when you do notice them.

Hypnotherapy can help you  learn to make the sound of Tinnitus less threatening, to make the use of masking sounds (Pink Noise) more effective and to help you extend the periods in which you don’t notice, or notice the sounds less  – in the way that sound of air conditioning will gradually fades from your consciousness the more time you spend with it.

Therapy for Tinnitus  begins with a thorough review of your own Tinnitus experience and the words you use to describe it.   At your first session you will be given a CD designed to help you relax your nervous system right down to a pleasant state of relaxation.  The CD will also train you to listen to Pink Noise, which will help mask your Tinnitus sounds and help retrain your auditory memory/awareness networks (the basics of Tinnitus Masking techniques).  It will also help you to ignore the sounds more easily and to be focussed instead on all those times when you just don’t remember hearing the noise. Finally it has a Pink Noise track which you can copy onto a mobile phone or mp3 player to use whenever you are out and about or in bed and want to supress your Tinnitus sounds.

Subsequent sessions  focus on your own particular issues, thoughts and feelings and are designed give you the means of putting you in control of your Tinnitus and help in creating a more positive and optimistic attitude towards your future.

If you or a relative suffer from Tinnitus and would lke to discuss how hypnotherapy can help,  please feel free to give me a call for a free, no obligation, consultation.  See my website www.keithjeffordhypnotherapy.co.uk  for more details.

Obesity, weight loss & why Gastric Bands fail


I am often asked if I offer hypnotic Gastric Band therapy and the answer is always “Yes, but…”.  The reason that I am loathe to offer an immediate gastric band fix is that it runs the risk of leaving the real underlying reason for weight problems unresolved and can therefore be doomed to failure.

Cummerspeck (literally grief bacon) is a German word which describes the mindless eating  which leads to weight problems and obesity in those with untreated emotional trauma.

GPs in the UK are often faced with patients who are desperate to become “normal” and demand quick-fix gastric band or bypass surgery to solve their problems.

Yet having a physical gastric band fitted means making major changes to diet (for instance having to avoid anything with oil or fat in it or else experience vomiting immediately after eating) and having to accept a death rate risk of 1 in 2,000 operations (the most common cause of death being pulmonary embolism) plus the risk of being one of the 1 in 10  patients who will need a further operation at some time due to slippage, erosion, leakage or infection involving the band.

But of more concern perhaps, is the fact that although the patient may lose weight and reduce the risk of heart and endocrine disorders there is mounting evidence that they may suffer ADDED psychological pressure due to loss of their mechanism for dealing with stress, leading to  issues of low self-esteem, relationship problems, dissatisfaction with  body image and ultimately, depression.

The same psychological problems can obviously attach themselves to use of a hypnotic gastric band.  As a result, I always insist that anyone wanting this therapy also does the first three sessions of my standard weight-loss course.  In this way, they have the opportunity to relearn the basic rules of good eating and to come forward with any underlying problems of grief, loss etc which might be driving their behaviour.  Having dealt with those things first and cleared or controlled psychological blockages, the chances of a hypnotic gastric band working are greatly enhanced.

In my view, hypnotherapy should provide support for overweight or obese clients in  a variety of ways:-

•   Firstly, by identifying and dealing with the underlying causes of their obesity – both emotional  (grief, fear, abuse etc) and practical (being unable to read/write, dyslexia, lack of social training etc) – thus providing a combination of therapy and practical help.
•   Secondly, by offering reinforcement – especially if they’ve already had advice from an NHS dietician.  New ways of eating and thinking about food can be reinforced through the creation of hypnotic suggestions based on an individuals eating plan and the breaking of addictions to unhealthy foods like chocolate, fried foods etc.  I find that teaching people to eat like thin people eat, often makes a major difference to their ability to lose weight.
•   Thirdly, through the creation of tailor-made CD’s – designed to reinforce therapy between sessions and provide constant reminders of what to eat, how to eat and all the benefits which weight loss brings, combined with ego-boosting suggestions and encouragement.
•   And finally, but very importantly – Resolution of problems arising –  providing an on-call resource for dealing with practical or emotional problems immediately they arise.

Five things that people regret on their deathbeds


Later on this year I plan to write a blog article on death, fear of it and coping with it.

However, for those of you who wonder what regrets you might have when your turn comes take a look at this brief article on the five greatest regrets express by people with only a few days of life left.

After reading the article, take a few moments to consider how, armed with that knowledge and insight, you might change your own life to avoid having the same regrets.

http://m.guardian.co.uk/lifeandstyle/2012/feb/01/top-five-regrets-of-the-dying?cat=lifeandstyle&type=article

Introducing Eye Movement Therapy (EMT)


Introduction to Eye Movement Therapies

As part of my regular Continuous Professional Development  I  attend weekend courses at the  ICH in London.  The latest course provided a fascinating introduction to the latest EMT  techniques.

Developed by Francine Shapiro PhD at the Mental Research Institute in  1987,   EMT has proved to be a highly effective way of engaging the brain’s innate memory processing system  to deal with memories of traumatic events.

It uses bi-lateral stimulation of the brain – either through eye movements or left hand/right hand tapping.

The constant shifting of attention from left to right through movement of the eyes or tapping of the hands, together with the client’s simultaneous, controlled replaying of  the memory and negative emotions it produces, provokes an increased flow of  neuronal activity between  right  and left brain memory centres via the corpus callosum.  This flow facilitates the dissociation of the  link between the trauma and the emotions which it engenders.  Thus, as the memory is processed, the negative emotions fall away, rendering the memory less and less painful.

While originally used for Trauma with a big “T” (PTSD, rape etc)  where it was found to eliminate 77-90% of civilian  single trauma PTSD  within three 90 minute sessions).  Variants of EMT are now used for dealing with a whole variety of issues including events from childhood which have resulted in feelings of self-blame or inadequacy, creation of fears and phobias, anger and relationship issues.  I recently used one of these variants, called WHEE, to break a client’s fixation with chocolate (to facilitate weight loss) in just a single session.