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false consensus effect

False Consensus Effect

False consensus effect

the false consensus effect is a cognitive bias that leads you to assume that other people think the same way that you do. It is natural, and inevitable, and leads to problems in therapy.

It is both good and bad. It is bad when extremists of any sort find confirmation of their own views in the general population. It is good when it allows you to feel more comfortable in a social group.

The self reinforcing effect

The false consensus effect causes you to overestimate the extent to which other people share your own beliefs, values, morals and behaviors. Once you believe this, you stop noticing evidence that doesn't support that, and you tend to reinforce your own view of the world.

You can test this quite easily. Simply ask someone to do something a bit strange, a bit out of the ordinary, something that you might think that would be socially unacceptable or potentially embarrassing. For example, ask your friend if they would dye their hair green. Note whether your friend says yes or no. People who say no, will say that the majority of people would also say no. People who say yes, will tell you that the majority of people would also say yes. They are projecting their own feelings onto the general population. Regardless of what the actual numbers are, people always overestimate in the direction that agrees with how they feel.

False consensus effect and therapy

What does this have to do with therapy? It is important because the way that you deal with your clients reflects your personal beliefs. Your personal beliefs about therapy were determined by how you were trained. How you were trained is determined by the beliefs of the trainer. So once you have these beliefs about how to do therapy, they tend to be reinforced by speaking to other therapist trained in the same therapy. You reinforce them, and they reinforce you.

The problem is that this process prevents you from being open to new ideas, to different modalities, to better ways of doing things. Unless you deliberately set out to challenge yourself, to talk to people from different backgrounds, two experiments with new techniques, you will tend to get stuck in a rut. You will tend to allow your techniques to fossilize, to become more and more embedded in your theory of psychology.

Avoiding the false consensus effect

This is one of the reasons why most therapy associations insist on annual professional development. Going to conferences gives you the opportunity to see a different view of the world. Getting trained in a different modality might well change your perspective on what you are doing, and why you are doing it.

It is something that we all need to be aware of, and something we should all try to avoid.

 

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caffeine addiction

Caffeine Addiction and Stress

Caffeine Addiction and Stress

I had a client today with a caffeine addiction. This man is driven, intense, and stressed out at work. He runs a cleaning business. He says he must be addicted because he can't stop drinking V, a strong caffeinated drink. Actually, he can give up V, but then he starts drinking Coke or Pepsi. But those don't give him the same satisfaction, so he always goes back to drinking V.

He drinks V when he is stressed. He gets stressed by work, by family matters, by staff problems, by irate customers.  It is a  a physical need to drink it. He does not get any mental distress about not having it. He has become a bit of a connoisseur of V. It has be V, it has to be cold, and freshly bottled, it has to have the right taste (apparently batches are different sometimes), it has to be from a bottle and not a can.

I could not find any mechanism causing this behavior. I was thinking of sending him home with no charge.

Caffeine Addiction is like smoking addiction

But it struck me that this was exactly how smokers behave when they can't give up. So I tested for depression. He had all symptoms. But when I discussed it, he was very reluctant to even consider the idea.

When he has to go to a cleaning job because one of the staff has failed to turn up, he has to motivate himself. He needs to  get over the feeling of frustration and annoyance with being let down. So even before he starts the job,  he is thinking of a cold bottle of V as his reward.

And this is the key to his problem. He has set up a problem-reward cycle where he can do anything provided he knows that he is getting his reward. But it has to be exactly right: cold, bottle, V brand only, correct taste. When he gets that, everything gets reset back to normal. But then the stress builds up again and he can't stand it until he has to have another V experience. The V is what motivates him.

Treat the stress and not the caffeine addiction 

When we went over the reasons for that it became obvious that his problem was black and white thinking. Once that was established it was clear that the right approach was to forget about the caffeine, and deal with the stress. Finally, he then revealed that his brother is bi-polar. He didn't want to hear about depression because he does not want to think he has a mental illness like his brother.

I spent some time outlining what depression is, and how he could manage it.  He left a much happier man.

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Smoking Diagnosis

Smoking Diagnosis and Treatment

Smoking Diagnosis

I had an email today from a client who wants a smoking diagnosis.

Good morning Dave!
I’ve just made an appointment with you for two weeks’ time, and wanted to check in with you about it ahead of time. 

I see that appointments are about an hour long. Does this session include a bit of a ‘diagnosis’? As you’ll know better than anyone does, people smoke for a variety of reasons and I want to make sure that my reasons to smoke would be taken into account. 

For example, I had a hypnosis session yesterday, but it didn’t work because it was about hypnosis to relax instead of smoking to relax, and I don’t smoke to relax anyway—so my real reasons to smoke were neglected. 

Does that make sense to you? I hope you can reassure me!

Smoking Diagnosis is essential

My reply was:

When I deal with smokers, to me the most important thing is to find out why they smoke. In fact I will not go forward with a hypnosis session until I am completely satisfied and I know why they smoke, and it's also obvious to the client why they smoke.

If I don't know why you smoke, then I really can't do anything much for you in hypnosis. Treating someone for relaxation is only going to work if relaxation is their problem. People smoke for thousands of reasons. I had one this morning who smokes on the anniversary of her daughters death. But this year, unlike other years, she wasn't able to give up as normal. So in that case I dealt with the cause of the stress that was keeping her going, and did some work to let her let go of her daughter.

Smoking is always complicated. Smoking is always about emotion. I believe that tobacco is not addictive. I believe it is the process of smoking that is addictive. Many hypnotists treat all smokers the same. I do not. I am constantly fascinated by people's behaviours and why they do things.

So yes, the first thing I would do is to explore with you why you smoke, and what you get from it. Only then can we have a reasonable chance of getting you to change your behavior. Every behavior is a positive purpose. My job is to find out what that purposes and redirect it.

I look forward to meeting you.
Dave

Client's view of Smoking Diagnosis

Hi Dave,
Thank you for your very thoughtful reply.
I’m so glad you think that tobacco is not addictive, and I’m frustrated that so many professionals believe that it is nicotine that causes smoking addiction. I know that’s not the case for me.
I feel reassured by your reply, and I’m looking forward to my session with you.
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sexual abuse by therapist

Sexual Abuse by Therapist

Sexual Abuse by Therapist

I had a client today who made me feel both depressed and angry. This young woman came in, and when she settled down in the chair, I  asked her "and what would you like to have happen?".

She said, "I just want to be happy". This wasn't really something I could work with, so I tried probing a bit more.

"So what is making you unhappy?" "I don't know."
Okay, not a great start. I decided to broaden the scope, and asked her "if you could change only one thing in your life what would that one thing be?".

She thought about it for a while, and then said "I don't really know".

We were getting nowhere. So I asked her "what is the most important thing in your life?"

She didn't answer. Instead, her face crumpled and she began weeping quietly.

Testing for depression

Anyone who sits in my chair crying, most likely has depression of some sort. So I did the standard test for depression and sure enough, she fitted into many of the categories. We discussed the symptoms, when this had started, and what she had done about it.

She said, "I went to see a couple of counsellors, I don't think they helped".

I asked, "and did the counsellors say about what was causing you to be unhappy?".

She looked away, and mumbled something. I said to her, "sorry I didn't hear that, what was it you said?".

Once again she spoke very quietly and the only word I could make out was 'interference".

Sexual abuse by therapist

So I said "Interference? Interference with what?"

She looked deeply embarrassed. I realized what she was trying to tell me. "Are we talking about sexual abuse here?"

She nodded, and look miserable. I asked her very gently "when did this happen?".

She said, "I don't know. I don't remember it."

I asked, "how do you know you were sexually abused if you don't remember it?".

He said, "I was so unhappy, I went to see a counsellor at the Sally Ann, and she couldn't find any reason why I was so unhappy. She said that if I was unhappy and didn't know why, that meant I had been sexually abused. I told her that I didn't think I had been sexually abused, but she insisted that I must've been. There was no other reason why would be so unhappy."

I asked, "and what happened next?".

She said, "I didn't feel comfortable with that first counsellor, so I went to the local office of Rape Crisis. The counsellor I saw there also told me that I had been sexually abused. But I have actually no memory of it. I didn't go back to her either. "

Phantom sexual abuse

After listening to her story I actually felt very annoyed. I felt quite incredulous that counsellors are still insisting to women that they must have been sexually abused when they can find no other reason for that woman feeling unhappy. The fact that she got the same story from two different counsellors almost made me feel depressed. I thought we had left behind the sexual abuse hysteria movement.

In the 1990s, there was a whole industry devoted to persuading women that they had been sexually abused by family members. There were books published on how to tell if you had been abused, even if you had absolutely no recollection of it, and no reason to suppose you might have been.

Families were broken up, lives were ruined, innocent men went to jail, the whole thing developed until it got to such a ridiculous level that the whole thing was seen for what it was. A type of mass hysteria. And here it is, alive and well in my area, years after I thought it had all been put away and forgotten about.

As far as I'm concerned, this is just another instance of sexual abuse by therapists. The damage they do to vulnerable women is just as bad as actual sexual abuse.

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indicators of trance

Indicators of Trance

Indicators of Trance

I help out in training people interested in hypnosis from time to time. It is often useful to think back on how I used to feel about going into hypnosis, and how strange it can be for people doing it for the first time. It helps if you can recognize the indicators of trance.

Indicators of trance: Increased heartbeat

One newbie said to me "I was listening to a hypnosis CD the other night. I often find it quite difficult to get into trance, and I wonder if I'm doing it right. With this recording, I found myself sinking into what I thought was a trance, and feeling very pleased about it, when I noticed a sudden increase in my heartbeat. I don't know if it was excitement or alarm, but whatever it was, it pulled me right out of trance again."

In fact, this is one of the quite common indicators of trance. When you feel that increase in heartbeat it means that you are actually going into trance.  It is quite normal, nothing to worry about. If you find it bothers you during other inductions, then add in slow breathing to the induction. That should fix it.

Indicator of trance: eyelids flickering

Another physical symptom that people often complain about is that "my eyes start flickering uncontrollably". This is another one of these indicators of trance. It is quite normal, and harmless, and usually passes after a few minutes.

Indicators of trance: giggling with embarrassment

"I get the giggles when going into trance". This is another physical reaction and an indicator of trance. This happens with people who are anxious or analytic. As the induction proceeds, their breathing slows down, the muscles begin to relax, and at that point they start entering trance. But for this type of person, relaxing equals losing control. As the start to feel themselves losing control, the feel embarrassed, uncomfortable, and the embarrassment comes out as giggling or laughing. It normally only happens once or twice. Once the person is comfortable with going into trance and realises that nothing bad happens, then they don't feel that same embarrassment and they don't get the giggles.

Indicators of trance: muscle jerk jerking

if you people find that when they feel themselves going into trance, and arm, or a leg, will start jerking. Sometimes quite violently. This is often enough to pull them out of trance completely. Some people just cannot get into trance because it happens every time.

What is happening is that as their body relaxes, their unconscious mind feels that it is losing control. This control is usually manifested as a tension in the muscles. As that tension releases, the muscle will spasm. This impediment to trance is actually quite difficult to get rid of. It normally means that the person has quite deep-seated anxieties. And of course the hypnotherapy is for getting rid of those anxieties. But those anxieties are stopping the person getting into trance. So you have a circular problem. All they can do is to go through a long, slow induction and give themselves time to relax every muscle completely.

But everyone can be hypnotised eventually. It is simply a matter of repetition and practice.

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millennial depression

Millennial Depression

Millennial Depression

It looks like therapists will not be running out of work any time soon. A recent large British survey has shown that people born since 1990 are more likely to suffer from depression than people born before that time. Depression has gone up nearly 15%, and self-harm has gone up by 14%. These findings are not just due to having better instruments to measure depression, or that they're using a new research method. The survey used identical questions to those used in the first study 10 years ago.

But at the same time, the findings show that alcohol abuse and antisocial behavior has gone down in this population.

Millennial Depression and general health

The researchers suggest that the increase in depression may be linked to the general health of the population. In the last 10 years the average body mass index has increased in the whole of Britain. 29% of those surveyed agreed that they were overweight. It is also possible that high levels of youth unemployment, decreasing social services and the declining economy are all causing anxiety. All of these are potential targets for intervention, but none of them will be quick or easy to fix.

People with depression and anxiety related disorders are likely to still have them in 20 or 30 years time. Even if employment picks up and economic conditions improve there will still be a larger proportion of the public needing social and psychological help.

Millennial Depression and economic instability

The years between 1990 and 2010, included the global financial crisis, and the era of economic austerity in the UK. The period has been compared with the social environment in wartime. The constant stress, uncertainty, and the bleak outlook all contribute to long-term ongoing psychological problems. The same may be true of the US.

All of this means that there will be a constant demand for psychotherapists, counselors, and hypnotherapists. I guess every cloud has a silver lining?

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CBT therapy

CBT therapy is older than you think

The origins of CBT therapy

I was reminded today that nothing is really new in therapy. Paul Dubois was a Swiss neurologist who worked in the late 19th century and the early 20th century.

He introduced what is known as "persuasion therapy". This was a forerunner of CBT and rational therapy. He developed a way of treating "nervous disorders" by using a Socratic method of questioning. He challenged his patients to justify why they were feeling the way they are. This used the patient's own intellect and logic to challenge and eliminate negative thoughts and feelings.

His method was based on getting his patient to realize that their thoughts were irrational and could therefore be dismissed. His method was very popular in the early 20th century. It competed head-on with Freud's psychoanalytical treatment at the time. Dubois was also one of the earliest people to write about the importance of "mind over matter". His work is almost forgotten today.

Psychotherapy in classical times

Dubois's approach to psychotherapy was largely a response to the failings of the other popular psychotherapy, hypnosis. In the early 20th century hypnosis was thoroughly discredited after the scandal of Jean-Martin Charcot (1825–1893) and his fakery of hysteria treatments. Dubois also regarded Freudian theory as of little value. (Incidentally, Freud learned hypnotism from Charcot in the early 1890's)

Dubois was familiar with the writings of classical Greek authors such as Socrates, Epictetus and Marcus Aurelius. He realised that that the advice that they were giving 2000 years ago in teaching philosophy was almost identical to what he was doing in current psychotherapy.

Stoic Philosophy

In particular, he admired the work of the Stoics. Modern readers think of the Stoics as philosophers. But they thought of themselves as offering a sort of medicine for the mind. The Stoics believed that everyone has to take responsibility for their own actions. And at the same time accept that things happen by chance, and have no personal meaning.

Rational Emotive Behavior Therapy

Albert Ellis developed Rational Emotive Behavior Therapy based largely on this ancient philosophy. One of his central ideas was that emotional disturbances and associated behavior are not caused by external events, but are caused by our own irrational beliefs about these events. “Men are disturbed not by things, but by the views which they take of them.” (Epictetus, 80 BCE) Ellis went on to influence Aaron Beck and the CBT movement started from there. But basically it all goes back more than 2000 years to the Stoic philosophers.

Maybe we should be encouraging our clients to read philosophy?

 

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