Chemsex partygoers and improving access to psychological services

I often wonder how the whole field of counselling and psychotherapy could help to better address the needs of those who are essentially most in need of psychological support. Men, for instance, who suffer from depression often present as angry individuals but the anger is often hiding the pain of depression. Depression in men is so often difficult to identify as it can be accompanied by displays of angry behaviour in social situations. Men, in effect, can more easily end up in prison than in a therapist’s room.

The stigma for men surrounding not only drug use but also gay sex can act as a barrier for individuals who really need help accessing psychological support services. The drug-fuelled party lifestyle associated with chemsex can destabilise the mental health of those already suffering from pre-existing mental health problems. These issues will be presenting more and more in the coming years in counselling rooms with the advances in mobile telephony and hookup apps. But a prevalent culture of silence, secrecy and stigma in the chemsex world can keep individuals isolated from accessing services. Chemsex users perhaps need to be reassured, more than any other client group, that they will be understood, and not judged, if they do end up presenting for help.

Therapy can offer people a vital place of safety to unravel their story so that greater insight can be obtained for problem behaviour. It can be common for attachment issues to get played out in all forms of addiction, as well as past traumas and previous psychological wounding.  Therapists need to be even more aware of their need to make personal connection with the presenting issues with such clients. An abstinence based approach might not always be appropriate for them, at least initially, as the thought of complete abstinence might make them run away. Harm reduction and psycho education could be useful areas to cover as well as the principles and ethos of motivational interviewing. These clients are often in a contemplative mode when assessing the options about their future intentions. Chemsex users are familiar with high adrenaline excitement as a means of mood regulation and will be easily frightened about slowing down and getting in touch with difficult personal material that might threaten their equilibrium.

Chemsex parties offer excitement and the apparent lure of social connection. However, for those vulnerable to psychological wounding the lifestyle can be a dangerous playground and chronic feelings of aloneness can persist. Addiction can be viewed as a search for emotional satisfaction, as a place of safety, balance and comfort. If the connection in the consulting room is robust the underlying psychological issues will get played out in a safe environment through projections and transferences.

To read more about chemsex and what is involved see my article: When the chemsex parties stop being fun

The drama triangle and asking for your needs

I believe that transformation in psychotherapy is when insight is achieved into one’s historical ways of operating in the world, that are not serving well, and personal qualities are harnessed to bring about change and a different way of behaving with other individuals. Therapists from different modalities will often seek to accuntuate the theoretical differences between each other and point to their own particular (and unique) training but ultimately, however, I believe we are all behaviourists. After all, we are all trying to help our clients to bring about changes in their behaviour so that they can enjoy more effective relationships – whether that is in their personal, family or business lives.

Stephen Karpman, a student of Berne’s Transactional Analysis, coined the term ‘drama triangle’ when he outlined the roles of persecutor, rescuer and victim. My latest article is on the drama triangle and asking for your needs so that you can avoid the victim role.

For more information and background on the drama triangle see this video below:

Men are at greater risk of physical illness from chronic anxiety

ecnpA major research study from the European College of Neuropsychopharmacology (ECNP) and the University of Cambridge reported on its findings earlier this week. The study involved tracking over 16000 Britons over a period of 15 years and found that men who suffered from anxiety were more at risk of dying from cancer as those men who don’t suffer from anxiety. It also found that the correlation held true regardless of other risk factors to cancer such as the levels of alcohol consumption, smoking and the rate of physical activity. There were a few standout points from the study. One of which was that the association was not shared by women.

Why are men more likely to suffer greater physical risk from chronic anxiety?

The results of this new study lend another piece of evidence that links chronic fretfulness to  sickness and death in males. However, the evidence still leave doubts over why this should be. An obvious, and perhaps lazy, explanation might be that men tend to smoke and drink more alcohol and don’t look after themselves as well as women. However, after researchers compensated for those factors, the strong association remained.

There are other studies that could add weight to the recent study to show the greater risk of physical illness from chronic anxiety (thanks to a Times2 article on the subject by John Naish).

A Finnish study in 2014, that tracked middle aged men for over 23 years, found that men who scored highly for anxiety were more vulnerable to the risk of death from all causes, not just from cancer.

A recent University of Edinburgh study found that those with ‘subclinical’ depression or anxiety had a 29 per cent increased risk of dying from heart disease and stroke over a decade than those who did not. ‘Subclinical’ is a term used to define a scenario whereby sufferers thought it unworthy of medical attention. It must be said that Dr Tom Russ, who led the study, is not saying that anxiety actually causes illness. His point is that the results of the study may show an association but the proof for causation might not be present. For instance, it could be that individuals with undiagnosed cancers suffer from pains that cause anxiety, although that doesn’t appear to explain it fully.

men-and-anxietyIt could be that chronic anxiety in men causes physical reactions that ignite the body’s defences, thereby sparking long-term inflammation that in turn may cause a wide range of illnesses such as cancer. For example, psychiatrists at the VU University Medical Center in Amsterdam reported that  men who develop anxiety disorders in adult life show significantly raised levels of inflammatory chemicals in their bloodstream, such as C-reactive protein (CRP), a phenomenon not occurring with women. CRP is not in itself necessarily harmful, as it can play a very useful role in the immune system such as protecting against the threat of infections, but can be dangerous if they persist at chronic levels. In particular, they are linked to a raised risk of developing cancers, heart disease and even diabetes. The production of CRP can also occur from sleep disturbance associated with anxiety.

Furthermore, psychiatrists at the Emory University School of Medicine reported that chronically raised levels of inflammatory chemicals can cause the brain’s centres, that initiate our fight-or-flight response, to become overactive (an area of our brain called the hypothalamus).

gut-fear“Gut fear”, that wrenching physical symptom of anxiety when your body is telling you to watch out because there is danger ahead, seems to have a physical affect on the brain. Evidence points to how inflamed stomachs damage our mental states, through neurological links such as the vagus nerve, which links our gut and brain, and by changing the balance of the billions of bacteria that thrive in our guts. For a full explanation on the physical symptoms of anxiety see the Anxiety UK website.

Scientists at the University of Exeter found that when people with depression, a common result of chronic anxiety, were given drugs to block the effect of their bodies’ inflammatory chemicals, their symptoms were mildly alleviated.

Such evidence clearly demonstrates the need for men to take seriously the deadly impact of anxiety.  Therapy can be a lifesaver for men but they invariably only attend when things are at a crisis point in their lives. We all need to address why men find it so difficult to reach out for support and there are no easy answers.

For more information on what works for the treatment of anxiety see my most recent article on Manxiety: The Importance of Men addressing their anxiety.

See also:

The acute mental health needs of men
Engage with the power of imagination to ease anxiety
Help your brain to reduce anxiety
Self discipline exercises that will ease your anxiety
Anxiety UK – for information on symptoms

Making better decisions

making better decisionsI always find it interesting when people not trained in psychology adopt tools, techniques and insights from the field and start to practice them in their particular area. Sports coaches are increasingly using psychological insights to improve elite performance in individual and teams sports.  Another area is the investment sector to boost one’s ability to improve upon their decision making. Michael J. Mauboussin, an investment strategist, has written a well researched book entitled ‘Think Twice – Harnessing the Power of Counter Intuition’ and has produced an interesting set of statistics, case studies and self-help tips to help improve the way we make decisions.

The power of intuition was an influential theme running through my psychotherapy training.  But, intriguingly, whilst Mauboussin encourages us to trust our intuition in the decision making process, he also cautions against overly relying upon it.

We all make poor decisions in all aspects of our lives from time to time. Even the people with the finest brainpower regularly make mistakes. The 2008 financial crisis is a classic example of that. Nobody embarks upon their day with the intent of making poor decisions. Poor decisions can emanate from cognitive biases and a failure to spot when we are acting from a blind spot. So, how might a person prevent new distortions from arising and bring more awareness to their distorted thinking?

The business of decision making can be highly complex. However, by instigating a few simple, yet counterintuitive habits, we can position ourselves to make better decisions.  See my article on Counselling Directory for some ideas to help improve your capacity to make better decisions more often.

To-do lists and how to help your brain run more efficiently

listsI have often wondered whether the compiling of to-do lists merely fuel our anxiety or help to ease our worry in an era of information overload. If you are anything like me you might fret about the unfinished tasks on a list rather than rejoice about the accomplishment of the tasks that you do manage to finish. There is no doubt that it feels good to tick a task as completed but what about the ones that get left as unfinished at the end of the day? It is interesting what Daniel Levitin, author of The Organized Mind, has been saying about how we can help our brains run more efficiently by devising categories within lists so that we are more productive. Apparently, our brains can only hold between four to seven pieces of information at any one time. This is when lists, containing categories of tasks, can help to offload a lot of the difficult work of the brain into the environment. Index cards, with short lists, can be very useful when making presentations or preparing for exams.

Andy Murray motivational speechThe current Wimbledon tennis champion Andy Murray was once a little bit wayward with the disclosure of his list in the form of motivational tips. A journalist at the Rotterdam Open in 2015 snapped a list of his motivational tips courtside (see picture, opposite) which contained some of the following:

  • be good to yourself
  • try your best
  • be proactive during points
  • focus on each point and the process
  • try to be the one dictating
  • stay low on passes and use your legs.

Sir Richard Branson once said “I live by to-do lists” but the key, for him, was to actually do them.  So, can lists help to make your brain run more efficiently for you and are you curious about the possibility of boosting your levels of productivity? Why not give it a try. What’s the worst that can happen?

Learning to cope with having unfinished tasks on your to-do list at the end of the day might be your biggest challenge. For more information on lists see my article: How to organise your brain more efficiently

Existentialism and integral studies

Existential thinkingIncorporating existential thinking into an integrative approach to psychotherapeutic practice has always been a huge influence for me.  An existential approach may have its limitations but there are a number of ideas within the approach, not that the approach is always coherent and uniform, that can be of enormous benefit when seeking to view the whole person in therapy. Take, for example, the ‘ultimate concerns’ or also known as the givens in life; inevitability of death, isolation/aloneness, freedom/responsibility and a search for meaning. It can be beneficial to view life struggles and associated psychological stress from the framework of how we relate to these concerns.  Do we, for example, engage in addictive behaviour as attempts at making connection and forging meaning in our lives? Do we stay in unhealthy relationships to avoid the fear of aloneness? Do we stay busy to avoid the anxiety associated with these concerns? Have we reconciled ourselves to the inevitability of our own physical demise?

Sometimes these questions are forced upon us, such as at times of great distress due to health matters, but it need not be that way. Once we begin to align ourselves to the challenges presented by the ultimate concerns we can achieve a new freedom in the present moment. New energy is found to live more meaningfully today. This is what it means to be truly present. An old sage once said that it is crucial to avoid the danger of getting to the day of your death only to realise that you have never lived.

See also my latest article on aligning to the four givens in life as a way of setting yourself free.

How to avoid the victim role and enjoy better relations

Karpman drama triangle

Steven B. Karpman, M.D. – 

Do you regularly find yourself blaming others for your plot in life? Do you often feel helpless and powerless in your dealings with other people? Do you struggle to make decisions and enjoy pleasurable experiences in life? If these questions resonate with you then you may be triggering the victim mentality when dealing with other people.

The “Karpman drama triangle” is a useful tool in bringing awareness to how humans relate to each other and can be attributed to Dr Stephen Karpman, a student of Eric Berne’s Transactional Analysis. Berne was a Canadian psychiatrist and was the author of The Games People Play. Karpman borrowed heavily from Berne and used triangles to map conflicted or drama-intense relationships and involves three people unconsciously playing out three roles that mirror their attitudes and behaviour. Whereas Berne used the parent/adult/child triangle Karpman used persecutor/victim/rescuer. Karpman referred to them as being the three aspects, or faces of drama.

Rescuers tend to find victims, as victims are seeking saviours. Co-dependent relationships involve one person enabling another’s laziness, addiction, recklessness, emotional immaturity or irresponsibility. Persecutors will blame the victims and criticise the enabling behaviour of rescuers.

A way of seeking to “escape” the Drama Triangle is to firstly bringing more awareness to how you operate in the world. The target is to function as an “adult” and not participate in the game. Once you gain greater  insight into the way you operate in the world you can free up negative psychic energy. There is a fresh flow of vitality and positive energy when you realise that that there are other, more positive, ways of behaving. The dynamic of your relationships can change for the better.

For more information see my article:  How to avoid the victim role and enjoy better relations

Better understand your attraction to the bad boy

Bad boy archetype

The term bad boy could be seen as a cultural archetype and in the movies James Dean’s 17-year-old character Jim Stark in Rebel Without a Cause would be a bad boy archetype.  A modern Jungian perspective would view an archetype as a primitive mental image inherited from our earliest human ancestors, and is present in the collective unconscious. For Jungians, the collective unconscious is a universal datum. Everyone is endowed with this psychic archetype from birth. It is innate and, therefore, cannot be acquired by conscious effort.

Think of an archetype as the best example of a specific category and Superman as the archetype of a superhero. To discover why you might be attracted to the bad boy read my latest article: better understand your attraction to the bad boy

Seven ways to adopt abundance theory in the office

Abundance theoryWhen dealing with toxic work colleagues it is important to try to stay focused on keeping your heart space open. Stressful work environments, particularly when they are toxic, have the potential to negatively impact on your worldwide. It can be tempting to see the world through cynical eyes when operating in a toxic organisation, that everybody is out for their own end and that you better grab what is on offer before the next person does. However,  just because you are witness to toxic behaviour it does not follow that you should become like them. The world is not actually full of takers. There are also generous and selfless people in the world too. It is possible to maintain your healthy boundaries in spite of having to deal with difficult individuals in an office environment.

We tend to manifest what we contribute to the universe. Generous people, both in material and spiritual terms, usually get rewarded with good karma. We suffer when we allow mean spirited people to cloud our optimistic view of the world. For suggestions on how to manifest abundance see my latest article: Seven ways to adopt abundance theory in the workplace.

Staying healthy with a demanding workload

workload management

Are you worried about your ability to cope with a demanding workload?  Do you believe that you are suffering symptoms of anxiety as a result of your ability to cope with deadlines and organisational objectives? Do you feel in need of support to devise a self care plan to maintain a healthy emotional state?  If these questions are resonating with you then take a look at my latest article on work-related stress and staying healthy with a demanding workload.

You may also benefit from reading an article on blanking which I contributed to and which appeared in the April edition of GQ magazine.  Follow this link to the GQ Article on Blanking here.