Common Stressful Life Situations and Triggers
Many of our clients at Brisbane City Psychologists seek counselling from an experienced Clinical Psychologist to deal with stressful situations or changes in their lives, work and relationships. Common issues include:
- the end of a relationship and the after-effects of this;
- the loss of a job;
- an ongoing difficult work environment;
- an upcoming challenge;
- a traumatic life experience;
- or issues within the family.
Counselling at Brisbane City Psychologists
Often the effects of these situations on a person respond well to shorter-term evidence-based counselling therapies, such as Schema Therapy or Cognitive Behaviour Therapy (CBT). These types of counselling involve working with a clients’ style of thinking about situations, and the way they act to deal with them.
For instance, in preparing for an upcoming challenge such as a big presentation, our clinical psychologist will work with you to first understand the way you are processing the situation. It is common that you may be expecting the worst, such as judgment from others, and then focussing on how you are coming across in the presentation, rather than on the words and the audience.
You may cover up your anxiety with behaviours designed to mask it, such as rushing through the content, looking down, etc. All of these approaches then lead to worsened anxiety and self-consciousness. Through the exploration of this, experimenting with different thinking styles, role play and video feedback, and later exposure to a graduated series of public speaking tasks, counselling with a clinical psychologist will ready you to face that big presentation.
Other forms of evidence-based counselling therapies that have proven successful include EMDR, ACT and Mindfulness.
Evidence-Based Counselling Methods
Cognitive Behaviour Therapy (CBT)
CBT is an active and collaborative counselling treatment, where the client does not adopt a passive role but instead becomes an active partner in the treatment plan with the therapist.
In CBT, clients are taught about the vicious cycles of thinking, behaviour, emotions and physical reactions that maintain the disorder they are suffering from. Then counselling moves on to learning strategies such as relaxation, lifestyle changes, identifying and challenging ‘automatic’ thinking patterns, making gradual changes in unhelpful behaviours, such as avoidance of feared situations, and learning how to maintain treatment gains without relapsing.
In CBT, counselling continues outside the scheduled sessions, as research has shown the importance of clients practising strategies and attempting tasks in between sessions. CBT incorporates these ‘homework’ tasks.
Schemas are unhelpful beliefs and patterns of thinking, feeling and acting that were formed early in a person’s life, and have continued to the present day. These beliefs are so deeply held that they are just felt as ‘the way things are’.
An example of a schema might be the ‘mistrust/abuse’ schema, where the person believes that ‘others will just let you down, you can’t trust anyone’. Another example is the ‘unrelenting standards’ schema, where a person believes that one must always strive to be their absolute best and achieve, otherwise, they don’t feel good enough in themselves.
Schemas can become ways of seeing the world, oneself and other people, and then the person is driven to act in ways associated with the schema. The person who holds an unrelenting standards schema, for instance, may push themselves so hard at work and in other areas that they never have time to relax and have fun or procrastinate a lot to avoid all the tasks they feel overwhelmed by.
If your treating psychologist believes this approach will be useful for you, counselling will involve helping you understand the repeating patterns in your life and the origins of these, and then challenge them using discussion and ‘experiential’ techniques such as imagery and chair role-play, and behaviour change strategies, such as learning how to become more assertive, to set limits on work, or to change the way you approach relationships.
Our clients at Brisbane City Psychologists generally find this counselling approach very helpful.
Acceptance and Commitment Therapy
Acceptance and Commitment Therapy (ACT) incorporates two broad approaches to overcoming common psychological disorders. The acceptance approach means learning how to make room for painful emotions, thoughts and sensations, allowing them to be there without struggling against them. Commitment focuses on channelling your energies into living your life in a way that is most important to you, rather than waiting until you have controlled or overcome difficult emotions and thoughts first.
The ACT is a more recently developed therapy, and its research base is building. Research evidence exists to date showing ACT to be effective in the treatment of smoking cessation, depression, anxiety, chronic pain, diabetes management, addictions, workplace stress, weight management, epilepsy control, self-harm, body dissatisfaction, and eating disorders.
Eye Movement Desensitisation and Reprocessing (EMDR) Therapy
Eye Movement Desensitisation and Reprocessing Therapy, or EMDR, is used for individuals who have experienced severe trauma, enabling them to recover from the symptoms and emotional distress resulting from those traumatic life experiences.
EMDR has been proven through rigorous research to be one of the most effective treatment models for Posttraumatic Stress Disorder (PTSD). Trauma Focussed CBT and Exposure Therapy are also proven, effective therapeutic models. EMDR has been verified as an effective treatment for PTSD and meets criteria for evidence-based practice in the UK by the National Institute for Clinical Excellence (2005), in Australia by the Australian Centre for Posttraumatic Mental Health (2013).
EMDR therapy demonstrates that the mind can recover from psychological trauma much as the body heals from physical trauma. Following training on detailed EMDR protocols and procedures, a psychologist can help clients activate their natural healing processes, alleviate the symptoms of post-traumatic stress disorder (PTSD), and allow them to develop more adaptive coping mechanisms.
EMDR looks at emotions, physical sensations, thoughts and beliefs altogether. Following a structured eight-phase protocol, desensitisation begins with the individual’s attention being directed to the chosen target memory, negative beliefs, and body sensations while following the therapist fingers moving from side to side. Following a set of eye movements, the therapist asks the client to report what they notice now; they are then asked to either focus of what had emerged, on a body sensation or their level of distress. When distress has reduced to 0 or 1 (on a scale of 10), a preferred positive belief statement is installed with more sets of eye movements, until the positive statement is rated as highly believable. Any residual sensations are then desensitised with eye movements until there are no longer present.
During EMDR counselling sessions the individual is encouraged to “let whatever happens happen and just notice” so that freely-associated memories enter into the mind. It allows processing to take place allowing the memories to be consolidated and put into historical context. EMDR treatment encourages distancing effects that are considered effective processing of the memory; this means the memory is no longer as vivid and felt with such emotional and physical intensity.