CBT

Cognitive behaviour therapy, or CBT, is designed to help with a range of emotional problems. It is based on the premise that events do not result in distress in and of themselves, but it is the meaning that events have for us that result in emotional difficulties. For example, imagine walking down the street where you notice a friend that you haven’t seen for a while who doesn’t say hello. The meaning of this event, or the thoughts that go through your mind, can make a difference to how you might feel in this situation, and how you respond. For example, if you think that the friend ignored you, you might feel annoyed or hurt. But if you think that this friend didn’t say hi because he or she didn’t see you, your feelings might be different. The interesting point to note is that how you feel may depend on what you first think in this situation, however this may not be right.

Early life events, as well as more recent ones, can affect how we think of ourselves, others and the world. For example, life experiences involving actual or anticipated harm can result in a heightened sense of threat and that can lead to more frequent and heightened anxiety. Some who are more prone to perceive failure and rejection can be more susceptible to depression. These ways of thinking, beliefs and expectations that are borne out of one’s past experiences can become established and at times resistant to change. Ways of thinking formed in days gone by can remain dominant even though the circumstances that led to its formation changed long ago. Nevertheless, these thoughts that have become automatic, can continue to elicit powerful emotions.

At times we can behave in ways that are designed to help manage a difficult situation. However, this way of coping can inadvertently maintain thoughts that underlie emotional difficulties. For example, when seeing a friend who doesn’t say hello, we can avoid reaching out to him or her. In this case it is possible that avoiding contact with this person may maintain the assumption that they ignored you.

The aim of CBT is to identify unhelpful and persistent thoughts, sometimes called negative automatic thoughts that underlie distress and unhelpful behaviours that inadvertently keep it going. The process of therapy involves a collaborative process of guided discovery, whereby these thoughts can be identified and re-examined. CBT, is short-term and an effective form of therapy which can help to alleviate a range of emotional difficulties including anxiety disorders, depression, personality difficulties, eating disorders etc. It is recommended by the National Institute for Health & Care Excellence (NICE) as treatment of choice for many of these difficulties.

emdr

EMDR was initially developed for treating post-traumatic stress disorder (PTSD). However, it can also help with a range of mental health difficulties. EMDR stands for Eye Movement Desensitisation and Reprocessing. It is a therapy used to help people recover from distressing events and the problems these events have caused, like flashbacks, upsetting thoughts or images, depression, or anxiety.

EMDR is recognised by the National Institute for Health and Care Excellence (NICE) as a treatment for post-traumatic stress disorder (PTSD). When a person is involved in a traumatic event, they may feel overwhelmed, and their brain may be unable to fully process what is going on. The memory of the event seems to become “stuck” so that it remains very intense and vivid. Consequently, one can re-experience what they saw, heard, and smelt and the full force of the distress they felt whenever the memory comes to mind.

EMDR aims to help the brain “unstick” and reprocess the memory properly so that it is no longer so intense. It also helps to desensitise the person to the emotional impact of the memory, so that they can think about the event without experiencing such strong feelings.

EMDR achieves this by asking the person to recall the traumatic event while they also move their eyes from side-to-side, hear a sound in each ear alternately, or feel a tap on each hand alternately. These side-to-side sensations seem to effectively stimulate the “stuck” processing system in the brain so that it can reprocess the information more like an ordinary memory, reducing its intensity.

Some research suggests that EMDR is effective because concentrating on another task whilst processing a distressing memory gives the brain more work to do. When the brain is not giving its full attention to processing the memory, it starts to become less vivid, and the distress associated with the memory may become lessened. This allows the person to distance themselves from it and begin to remember the event in a more helpful and manageable way.