Posts Tagged ‘cognitive behaviour therapy’

What actually happens during a therapy session?

May 12, 2016

MiaI’m excited about this referral because the money has been arranged by a health insurance company, so neither of us need worry about money. They have released money for 6 therapy session. She enters my room. I have no idea what I am going to hear, or what I am going to do. I begin in the same way that I always begin. I hear her story and watch her and help her feel comfortable in my presence. She is wringing her hands. She sits bolt upright. She is tense. I digest her story, process it, try to make sense of it, quickly enough to be able to feed back in that one session what I think might help her. As I listen, I mentally pick out her strengths, they will come in handy at some point (a technique from positive psychology and hypnosis). I teach her some calming and relaxation techniques, after helping her to understand why this is so important to do (when we are stressed, our thinking changes – it becomes narrower, more judgmental, more skewed, less rational, and things just seem much worse than they are. This is a change that is real, and has been demonstrated on brain scans). We record a relaxation session on her phone, tailored just for her. She told me she never relaxes, but in that five minutes, she did. She takes away the recording to listen to regularly (this activates the parasympathetic nervous system, triggering a calming response, helping her to think more clearly and calmly).

She comes in again the following week. She tells me that she has a major challenge on that week-end, so can we please help her cope with that. We do some cognitive work (challenging her negative beliefs about the stressful situation). We do some reframing (helping her to think of it differently). We do some behavioural strategy work (helping her to develop alternatives) and then we do some imaginary rehearsal (or rather, hypnosis, to get her to imagine herself actually acting out the coping behaviours. The brain needs to visualise to realise. Just talking isn’t enough).

We do some role play to cement the new cognitions (I give voice to the scary thoughts, and she answers them with the new ways of thinking). This bit is quite fun, and it gives me a really good idea of whether the work we have done so far has been understood by her. It has.

I then finish off the session with an NLP/hypnotic technique (neuro-linguistic programming technique) to cement at a deep level, the new behaviours. It’s called the Swish pattern technique, and I use it quite a lot. I can see in her face that it has worked supremely well (because she looks confused as she tries to bring up the old image of her previously anxious self. Her brain can no longer access it).

The next session, she comes in smiling. She relaxes onto my sofa. She tells me she is feeling good. She tells me she had a good week-end. It all went fine. It’s not that she coped with, or managed her anxiety, it’s that it wasn’t there in the first place. She tells me that it just didn’t really figure in any way. She doesn’t really know how it changed. I tell her that we had “reset the system” back to her old, relaxed happy self (that was the strengths that I had picked up on in the first session) but I don’t think she understands. This happens a lot. People get better, but they don’t know why or how. I do, but I don’t bother trying to explain it, as that would somehow take the magic out of it.

So, there’s no need to arrange a further session. She will call me if she gets any symptoms back again, and we will hypnotically release the past traumas that trigger her anxiety (using the Rewind technique). But we won’t do that now, because she chooses to just enjoy life and get on with it again (I did give her the choice).

So, the planned 6 sessions became 3. This happens all the time. Because when I introduced hypnosis and NLP into my cognitive behavioural model of working, change began to happen super-fast. And super easily. The adage “no pain no gain” is simply not true.  This super speed may not be good for my income ( I lost out on three sessions worth of pay), but it’s great for my work satisfaction.

Mia Scotland, Clinical Psychologist

www.miasscotland.co.uk