New combat stress helpline announced | BPS

New combat stress helpline announced | BPS

Problem solving for personality disorder

Mary McMurran and Stephen Coupe describe a promising approach to a distressing disorder

 

What is problem-solving therapy?

Problem-solving therapy has a solid evidence base for alleviating distress and improving social functioning in people with a range of psychological and health problems. This approach has considerable appeal for both therapists and clients, in that its basic principles are easy to understand, it does not pathologise individuals, and it empowers people to solve those problems that they prioritise. Applications of problem-solving therapy for people who are diagnosable with personality disorders have been pioneered by researchers and clinicians in the UK.

Social problem solving is the process by which individuals attempt to discover and apply adaptive means of coping with the wide variety of stressful problems encountered in the course of everyday living (D’Zurilla & Nezu, 2007). There is abundant evidence of an association between social problem-solving deficits and psychological distress, physical ill health, substance misuse, hostility and aggression, and mental health problems. Problem-solving therapy can help people to cope better with everyday problems and can lead to better mental and physical health. Problem-solving therapy teaches the skills required for effective social problem solving. These are the ability to recognise problems when they arise, define the problem clearly and accurately, set realistic goals for change, produce a diversity of possible solutions, anticipate outcomes, devise effective actions plans that have stepwise stages, and carry out those action plans to solve problems effectively. 

Click on the following link to read more about: Problem Solving Therapy

Coping with Suicidal Thoughts

There are times in life when we might feel totally, hopeless, helpless, overwhelmed with emotional pain. It can seem like there is no other way out of our problems, we've run out of ideas, possible solutions. Our problems seem unfixable. The pain feels like it will never end. We believe we've run out of options, and suicide is the only answer left.

Maybe the suicidal thoughts come to mind, and you might have mixed feelings about them. They can be frightening and confusing.

For some people, suicide may be a way of getting back at others, or showing them how much pain you're in. But after suicide, you won't be there to see that they feel guilty, or finally understand your pain.

Suicide is a permanent solution to a temporary problem.

Feelings will pass. Depression feels permanent, but it's transient. Things will change. Depression comes, and it goes. Depression and pain distort our thinking. It can seem like we're wearing very dark tinted 'gloomy specs'. Everything looks different to how it really is. Thoughts are thoughts - not necessarily how things are, although it certainly feels like the thoughts are true. Thoughts affect the way we feel, and thoughts and feelings affect the way we react, what we do.

Suicidal thoughts can result when we experience too much pain, without having enough resources to cope.

We therefore have two ways to get us through this horrible time:

1. Reduce the pain
2. Increase coping resources

REDUCE THE PAIN:

Self-soothing

Do something that will help you feel better, right now.

Perhaps collect items into an emergency bag or box that you can turn to.

Use all five senses to find things that will soothe you.

VISION – Focus your attention on looking at something nice, nature, a painting, watching a favourite programme or movie.

HEARING – Listen to a favourite piece of music, sound of nature, sing.

SMELL – Really notice smell – favourite soap, food, essential oil.

TASTE – Use sensation of taste to focus your attention. Eat mindfully -savouring each moment.

TOUCH – Wear soft comforting socks, stroke a pet, give yourself a hand massage.

Avoid drugs and alcohol

Whilst it seems like they help for a while, they will make your problems worse.

Ask yourself:

Are these thoughts facts or my opinion?

What has helped me feel better in the past?

What can I do right now that will help me feel better?

What gives my life meaning? What are my goals, dreams or life values? E.g. Family, friends, pets, helping others, faith, spirituality, community life, connecting with nature.

Tell yourself:

I've coped this far, I can get through the next .... (day, hour, 10 minutes)

Things will look better in time.

Depression is temporary - this will pass.

Suicide is a permanent solution to a temporary problem.

Depression is distorting my thinking - these thoughts are the voice of depression. They are not facts. I don't have to act on them.

The vast majority of people get better from depression. I will look back and be pleased that I chose to live.

Write things down

Safety Plan worksheet & Safety Plan Cards

INCREASE COPING RESOURCES – IMMEDIATE STEPS

Read and put your Safety Plan into action! 

Keep the Safety Plan where you can easily find it when you need it. Maybe make several copies – and keep them in several places (e.g. your room, your car, your purse).

Take one step at a time

Take things a little at a time. Set out to get through the next day, the next week or month, perhaps the next hour or even less. Tell yourself: "I've got through so far, I can get through the next hour".

Distraction

Do something else, and focus your attention fully on what you're doing (e.g. gardening, physical exercise, something creative, sudoku).

Talk to someone - now!

• A friend or family member
• A telephone helpline (E.g. Samaritans 08457 90 90 90)
• A health professional
• Go somewhere you'll feel safe - be with other people
• Go to the local Accident & Emergency department
• Call the local emergency number (E.g. 999, 112, 911)

Reference:

A huge thank you to Carol Vivyan who has put together an incredibly useful set of resources.

Vivyan, C. (2011), www.getselfhelp.co.uk

Mindfulness - what is it?

Mindfulness is an ancient Budhist practice which is very relevant for life today. It refers to a psychological quality that involves bringing one's complete attention to the present experience on a moment to moment basis. It could also be described as kind of non-judgemental, present-centered awareness in which each thought, feeling, or sensation that arises in the attentional field is acknowledged and accepted as it is.

Mindfulness is actually very simple concept. It is simply a practical way to notice thoughts, physical sensations, sights, sounds, smells – anything we might not normally notice. The actual skills might be simple, but because it is so different to how our minds normally behave, it takes a lot of practice. Mindfulness can simply be noticing what we don't normally notice, because our heads are too busy in the future or in the past - thinking about what we need to do, or going over what we have done.

For example, Carol Vivyan, explains how we are simply often set on auto-pilot in many activities of our life. In a car, we can sometimes drive for miles on automatic pilot, without really being aware of what we are doing. In the same way, we may not be really 'present' moment-by-moment, for much of our lives: We can often be 'miles away' without knowing it.On automatic pilot, we are more likely to have our "buttons pressed”: Events around us and thoughts, feelings and sensations in the mind (of which we may be only dimly aware) can trigger old habits of thinking that are often unhelpful and may lead to worsening mood.

By becoming more aware of our thoughts, feelings, and body sensations, from moment to moment, we give ourselves the possibMility of greater freedom and choice; we do not have to go into the same old “mental ruts” that may have caused problems in the past.

Mindfulness training has at least 5 broad beneficial effects, according to Felicia Huppert, Professor of Psychology of the University of Cambridge's Well-Being Institute. Specifically, mindfulness promotes:

• increased sensory awareness
• greater cognitive control
• enhanced regulation of emotions
• acceptance of transient thoughts and feelings
• the capacity to regulate attention

Mindful breathing

The primary focus in Mindfulness Meditation is the breathing. However, the primary goal is a calm, non-judging awareness, allowing thoughts and feelings to come and go without getting caught up in them. This creates calmness and acceptance. The following link takes you to the Mindful Breathing Script/Handout created by Carol Vivyan to help you started.

Mindul Breathing Script

Emotion regulation

Many of our intrusive thoughts come with an emotional flavour. Often these are negative – we suddenly remember a recent argument, which makes us angry, or the time we embarrassed ourselves in front of others. It is all to easy to get caught up by these intrusive emotional thoughts and to ruminate on them at length. Again, mindfulness encourages a more de-centred perspective on these feelings: they should be noted, and let pass. "Simply recognising your feelings gives you a choice in how you are going to respond, rather than reacting automatically in ways that lead to trouble", says Professor Huppert.

Using mindfulness to cope with negative experiences

As we become more practised at using mindfulness for breathing, body sensations and routine daily activities, so we can then learn to be mindful of our thoughts and feelings, to become observers, and subsequently more accepting. This results in less distressing feelings, and increases our level of functioning and ability to enjoy our lives.

Jon Kabat-Zinn uses the example of waves to help explain mindfulness. Think of your mind as the surface of a lake or an ocean. There are always waves on the water, sometimes big, sometimes small, sometimes almost imperceptible. The water's waves are churned up by winds, which come and go and vary in direction and intensity, just as do the winds of stress and change in our lives, which stir up waves in our mind. It's possible to find shelter from much of the wind that agitates the mind. Whatever we might do to prevent them, the winds of life and of the mind will blow, do what we may

"You can't stop the waves, but you can learn to surf" (Kabat-Zinn 2004).