“CUES” programme for ASD

Photo by Pixabay on Pexels.com

I consider myself very lucky to get a place on this course. It is a new programme with content which has been subject to considerable evaluation. It was developed by people with a solid background in practical clinical research and therapeutic approaches with people with ASD.

Its aim is to help parents with children who have ASD, so that they can cope better with uncertain situations. It has been well received by parents and appears to have considerable benefit for their children. I now have the training manual and presentation slides and am ready to go (almost).

I was keen to go on the course because of the gap in provision for people with ASD and severe anxiety, and I wanted to help them and their parents cope better. It will be difficult deciding on where to run the course: hospital, local charity, college, or school?

This is just one of the decisions to be made. Given I am one of the lucky ones to get a place on the training, I want to make sure that I make the best use of the opportunity I have been given.

Why train in empathy when you can read Dickens?



I do like Christmas especially when I can balance giving to others and allowing myself some pleasures – and not just intake of food and drink.
Of course, family life brings its own pleasures (and stresses) but also it is one of the only times when I can get my nose into a good book. So, what better books  at Christmas than Charles Dickens?
I had never read him before this summer when I read the magnificent David Copperfield. Charles Dickens must have had emotional intelligence by the barrowful to write something as emotionally moving as David Copperfield .  So my question is: who needs training in empathy when you can read and engage with the powerful writing of a master whose books remain as relevant as when they were first written.
Thus, encouraged by my reading of the first book, I am now tucking into the slimmer Great Expectations. Although not as enthusiastic about this classic nonetheless it has some marvellous characters and descriptions.  I don’t think I have ever been so saddened and yet so grateful to Dickens for capturing the possibility of unconditional love between people. It does, forgive the cliché, restore faith in humanity. Just a brief example from Great Expectations is that of the loss that Pip (the protagonist) predicts when separating from his adored brother-in-law (Joe) is on the cards.
“Joe laid his hand on my shoulder with the touch of a woman. I have often thought him since like the sledge-hammer, that can crush a man or pat an egg-shell, in his combination of strength and gentleness…… Oh dear good Joe, whom I was so ready to leave and so unthankful to, I see you again, with your muscular blacksmith’s arm before your eyes, and your broad chest heaving, and your voice dying away. Oh dear good faithful tender Joe. I feel the loving tremble of your hand upon my arm, as solemnly this day as if it had been the rustle of an angel’s wing!”
The classics can be relied on to capture and describe emotional experiences much better than the very best text books on emotion and emotional trauma. As good as Dickens, on description of complex emotion is D.H. Lawrence, who captures the defense of dissociation in the face of misery like no one before or since; the scene in the cowshed with his young infant is beautifully written.
There are some text books that are rich reading experiences, I have again picked up the late RF Hobson’s book “Forms of Feeling” and he masterfully uses literature (classic writing and poetry) to deepen our understanding of the privilege of working with people during difficult times. Such books, apart from being a joy to read, help shine a light on the importance of relationship and the value of striving to make a deep connection even when the other (or both) struggles with a process which they (and us) might find offers possibilities and joy and pain and loss. Training in empathy? Give me Charles Dickens everytime.

Mental Health Websites (Updated)

Mental Health Websites and apps

There are hundreds of websites out there for people to choose from. So its good that you can go on the NHS website who have the expertise to sift through the good, the bad and the damn right harmful. The first link takes you to the NHS website that recommends what to click on.

I have also collated those websites that have been recommended to me – mostly professional recommendations.

In addition, I have included other resources (some local) which can signpost people for help.

Very well mind is packed full of interesting mental health material:

They include some good resources on meditation like these guided meditations:

Side by side are help pages from Mind and include links to talk to people and support people and other information on mental health:

Website helping children who have had trauma:

Help for children who self harm with this useful app:

A good website to support parents with children who are having mental health difficulties:

Here is a local directory for the Bury area, helping people find support. Some of these here are also national helplines:

Catch it is a CBT based application that is currently being reviewed by the NHS

Words to beat ourselves up with

Photo by Leah Kelley on Pexels.com

As is often the case, the Journal of Behavioural and Cognitive Psychotherapy (May, 2020 just arrived ) has some great articles. One of which discusses chronic depression and its treatment with rumination focused CBT. Ed Watkins is best associated with it and his book on rumination was a revelation. It helped me understand the process of over-general memory and its links with unhelpful labels. This explains how people can describe themselves in unhelpful ways like “I’m lazy” “I’m useless” “I’m a failure” and why helping people to be more descriptive starts to break down such mood lowering short-cuts.

I am on a mission at the moment to encourage the effectiveness of clinical supervision by blending compassion focused work with techniques that encourage descriptive reflection with the hope of reducing rumination, blame and guilt and ultimately the mental health of nursing staff.

For far too long nurses have been dismissive of the restorative power of clinical supervision which is often viewed with suspicion and considered as just another task to tick off the long “To Do” list. Now is the time to at least plan to learn techniques that stabilise the nursing workforce through a frequently side-lined activity.

Clinical supervision has lost its credibility resulting in the proliferation of alternative support processes which frequently fail to take off for the same reasons – its another initiative, we haven’t got time, its another management tool to get management off the hook. I think it would be a safe bet, to say that the people who are currently accessing effective support are the ones in least need – sophisticated and psychologically minded and committed to trying the techniques that might help.

Try getting a busy staff nurse, who arrives home after a gruelling shift and to a family whose lives are on hold, to sit down, relax and reflect. Oh, and fit in some mindfulness exercises whilst you are at it.

Nurses do need support but they also need the time to access a process that needs to mature and that in need of enhancement of its restorative value through adding techniques that work. Wallbank (2016) makes a good case for the restorative aspects of clinical supervision as one that enhances self compassion and compassion for others, and that cant be a bad thing. The majority don’t need additional and new support mechanisms that seem alien and imported, so lets be grateful for what we already have.

Reading

Wallbank, S. 2016, “Restorative Supervision Implications for Nursing”. In: A Hewiston & Y Sawbridge (eds.) Compassion in Nursing: Theory, evidence and Practice. Palgrave, London.

Watkins, E. & Moulds, M. 2005, “Distinct Modes of Ruminative Self-Focus: Impact of Abstract Versus Concrete Rumination on Problem Solving in Depression”, Emotion, vol. 5, no. 3, pp. 319-328.

Watkins, E.R. 2009, “Depressive Rumination: Investigating Mechanisms to Improve Cognitive Behavioural Treatments”, Cognitive behaviour therapy, vol. 38, no. sup1, pp. 8-14.

Watkins, E.R. 2016, Rumination-Focused Cognitive-Behavioral Therapy for Depression, Guilford Publications Inc. M.U.A, New York

Learning to find joy in pain

I get this and I have experienced this myself – granted, not as painful as some people have had it. In this podcast, Meehan Krist eloquently describes living with uncertainty and her difficulty in deciding whether to bring a child into a world that is both “more terrible and more wonderful”.

Its a great listen that celebrates being human and a capacity to survive through learning, creativity, and embracing diversity.

For my part, my resilience lies in my love of learning and the joy and pain of helping young people who feel lost and anxious. More than this, I am currently helping others to help others through my teachings and supervision or by just sharing information including signposting uplifting podcasts that help us think differently.

https://www.bbc.co.uk/programmes/m000jp1y

Children our best enemy

Hi

I have been invited to do a talk about my work with children for BIG a mental health charity working in Bury, Manchester (thank you BIG staff).

The focus is on how through working with children it has helped me work with adults. It discusses the importance of containment when helping children with difficult, often embarrassing, emotions.

I have attached a podcast which previews the talk – I hope you enjoy the thick accent.

https://wordpress.com/media/audio/mood-coach.com

2020 visions

Photo by Johannes Plenio on Pexels.com

Extraordinary times see ordinary people doing extraordinary things. And so despite the pessimism, the constant examples of care in the community offer considerable optimism.

Small groups of people are springing up with offers of help to those who have needs or find themselves on their own. Thus dark clouds are transformed with silver linings and I cant help but feel joy and faith in the future.

We need to find better descriptions for human beings than those written albeit poetically by Shakespeare when he describes the acts of humans as folly and as quickly forgotten just as fast as they were done:

“Out, out, brief candle! Life’s but a walking shadow, a poor player that struts and frets his hour upon the stage and then is heard no more: it is a tale told by an idiot, full of sound and fury, signifying nothing (Macbeth Quote (Act II, Scene I).”.

We can console ourselves with other great works that have described apocalyptic events and found the best (and the worse) in human nature. I am reminded of Cormac McCarthy’s “The Road” – which people love and people hate. I love the description of parental love which oozes throughout the novel made more potent due to its backdrop: a worldwide calamity.

I have yet to do big events with big significance but have done many small events with small significance and for the moment I am satisfied with that. Learning to live with blame and responsibility, but quietly and without resorting to anger – that alone makes life significant.

We don’t know what the future brings – catastrophe and redemption sit alongside each other and we can all strive to performing small events which have great significance.

Positive – positive – positive ..

Photo by Johannes Plenio on Pexels.com

Difficult to find any positivity with all that’s going on but I am feeling positive about next week. Teaching new students, providing supervision to eager supervisees, and then holidays.

I am also feeling positive on the back of some of my reading. In a couple of weeks I will be teaching case formulation and in preparation looking at books on this. Ann Garland who wrote an excellent book on persistent depression has a chapter in a book on case formulation and she makes difficult material easy to understand.

People with depression find it hard to remember positives, through no fault of theirs. Ann Garland describes the research on the depressive process that leads to difficulties in accessing pleasurable memories.

Ed Watkins has more recently made a case for helping people describe in detail their past difficulties and how this can help people to achieve a more balanced memory of the past. This made me consider how person centred counselling may also facilitate this process.

Interestingly, Ann Garland points to difficulties in goal setting for people with low mood and makes me wonder whether this reinforces the importance of enabling people to specify in detail future goals to be achieved.

The speed of EMDR is scary

Photo by Leon Warnking on Pexels.com

I have just completed part one of my EMDR training.

Like many other participants on the training, it is hard to believe the speed and power of the process.

Within seconds quite difficult memories are surfaced, and without care it is easy to appreciate how re-traumatisation can happen. That is not to say that I don’t appreciate the need for past events to be processed rather than ignored. It is just that the pace is quite frightening and one that I wasn’t prepared for.

I was slightly disappointed by the unmet promise that EMDR offers a less confrontational approach to dealing with trauma – this wasn’t my experience on this training. I will need to do much more reading, training and supervision in order to explore a more gentle approach to the provision of EMDR.

I will use my early experience of CBT practice which was both “clunky” and awkward to stop me making that mistake with EMDR. Thus a gentle approach will be my special goal as I aim to work with people who have a history of “let downs” as well as traumatic events. People deserve nothing less than to work with a practitioner who is determined to offer an alternative experience to what they may have had in the past.