Posts Tagged ‘therapy madrid’

Behaviour link to lifelong health

Sunday, November 15th, 2009

People who behaved badly at school are more likely to suffer mental health and social difficulties as adults, a 40-year-study of Britons suggests. Canadian researchers writing in the Bristish Medical Journal examined data from 3,500 people from the age of 13 untill they reached their 40s or 50s. Those who had school behaviour problems were more likely to be depressed, divorced or have financial problems. The researchers from the University of Alberta wrote: “Given the long-term costs to society, and the distressing impact on the adolescents themselves, our results might have considerable implications for public health policy.” BBC. Source: Therapy Today – 2009
Counseling Madrid

British attitudes to emotional support

Monday, November 2nd, 2009

Although we are now relatively open to the idea that it is “good to talk”, most of our emotional support comes from informal sources rather than professionalsd in the “talk-based” therapies, according to the latest Bristish Social Attitudes report, published by NatCen.
The report finds a widespread view among the public that emotions are discussed more freely nowadays: 68 percent of people say it is important for them to be able to talk about their feelings. However, there is wariness about the idea of seeking psychotherapy or counselling: 43 percent would not want anyone to know if they had been to see a therapist, and 35 percent say they understand little about therapy.
There is also little evidence of reliabce on formal emotional support: four out of ten people have discussed their emotional lives at some point with a health professional. But the most common source of support is a GP: 31 percent of people have talked to their doctor about these issues, and 16 percent have used a professional “talk-based” therapist.People who have had serious mental health problems, or who have low levels of mental wellbeing, are particularly likely to have used formal emotional support. Poorer people, however, are likely to have used prescription medication at times of emotional difficulty.
Julie Brownlie, co-author of the report, comments:”Some have claimed that professional emotional support has come to occupy a dominant role in our lives. This appears premature. Informal social relationships continue to occupy a hugely important role in most people´s lives, while formal emotional support – and especially the use of talk-based therapies – remains relatively rare.”
NatCen. Source: Therapy Today

Counselling Madrid: dedicated to the expat community in Madrid, Spain.UK - culture

Poem: Good enough

Monday, August 31st, 2009

Body and mind
like birds and sky, intertwined
striving for the best
like horses on the racecourse, no time to rest!
Only the best seems good enough
although meeting high standards is tough
what else to expect from souls
living unknowingly, achieving third party goals.
Your body and your mind
isn´t it time to become more kind?
striving to be good enough
like wind touching trees, firmly sometimes, but not too tough.
You might be surprised to see the new responses coming in
when you are there you will be remembering
those days with relentless efforts pushing yourself
but here and now you uncovered a longer lasting verdict
good enough might just be perfect.

By Joseph Maussen – 2009

good enough often is good enough

good enough often is good enough

Relaxation techniques

Saturday, August 15th, 2009

This blog contribution by Joseph Maussen describes a way of helping with a common problem we are all likely to face – that of feeling tense or stressed. Sometimes this is related to difficulties in our personal lives or pressures at work or university, but, while the causes may be complex, it can be useful to think about how we carry tensions within ourselves and our bodies and how we can
actively develop ways of improving our sense of well being. Tension which continues over a long
period can end up affecting our health. How do we know if we are tense? Strangely, we can be so habitually tense that we accept our tense state as normal. (And it is true that a certain degree of tension can help motivate us to get on with a task.) The following are some of the symptoms which may identify undue tension:
● muscular tension, aches and pains
● difficulties with sleeping
● loss of appetite, stomach upsets
● persistent tiredness, exhaustion
● headaches, migraines
● hyperventilating, shallow breathing
● inability to concentrate or think straight
● a sense of things crowding in, feeling rushed and panicky.

To read more about relaxation techniques please visit www.counsellingmadrid.org/publications

Expat life & Counseling in Madrid

Monday, May 25th, 2009

At Counselling Madrid we welcome “blog contributions” from anyone wanting to share his/her experiences and views about life as an expat. Els Barkema-Sala has written an excellent article about the “ins and outs” and “ups and downs” while living the expat life.

(Els runs a private practice in The Netherlands helping expats with counselling, couple therapy and mediation.)

Article:
My life has been interesting with lots of traveling and living in different countries, including many years in Japan. Whenever I returned to Tokyo International Airport from a trip outside the country, the choice for lining up at passport control was always: ALIEN or NATIVE. It did not take long to absorb the fact that to Japanese this was a distinction of importance – not something to joke about. So I learnt to choose my place (as outsider, foreigner) and avoid hassle, but some other foreigners kept complaining about the airport signs.

Initially, life in a new country and culture can be a wonderful experience you just love to tell the folks back home about, but sooner or later the thrill gets mixed with frustration or anger, and you may miss home and all it stands for. This reaction is not so strange if we consider the definition of culture: ideas, customs and social behaviour of a particular people or society or the attitudes and behaviour characteristic of a particular social group that are
• based on learned human behaviour
• passed on from generation to generation
• a coherent, dynamic complex of norms, values and behavioural codes
• shared by a group of people.

When we try and settle in another country, we bring our own ways of being and thinking with us, and find they/we are different, which often comes across as ‘wrong’. Trouble is that when people from different cultural backgrounds interact, each takes things for granted that the other often finds unfamiliar (and sometimes appalling). The more that something is taken as ‘simply a fact of life’ by one, the harder it may be for the other to deal with it.

People miscommunicate for a number of reasons:
 It is hard to communicate in any language, more so in a second or third one. Little misunderstandings add up and stereotypical thinking or assumptions distort what is said or heard. Even body-language (non-verbal communication) differs subtly or majorly between cultures.
 How people use space differs: a good distance for one can be uncomfortably close to another. Private space is much more important in one culture than in another. Trouble is, there tend to be unspoken ‘rules’ about these things.
 How people regard time differs, for example: punctuality, dividing work and free time or private and family time. When people from different cultures live or work together, this can create chaos – consider for example what happens when a linear thinker (time is a line: one thing at a time) tries to interact with a person who likes to shift quickly from one thing to another or rather do several things at once…..
 Cultural values tell us what is seen as good, bad, important or trivial. They can differ hugely as to: how men/women/children should be treated, what food to eat, how to behave… Using your partner’s bathrobe may be a sign of pleasing intimacy to you, but to the other absolutely ‘not done’. Whenever people make judgements, values come into play. It needs awareness of one’s own values and a fairly strong sense of self to accept the fact that others have different values, without feeling threatened.
 Decisionmaking can vary from a high-context model (all opinions must be taken into account and ethics are situational) to low-context (strong demand for quick top-down decisions). Having to work things out with someone from another background can be much more difficult because of this difference in approach, however when you live anywhere long enough, there will be important decisions to make about: home, beliefs, lifestyle, childrearing, managing finances/ time/ vacations, family interaction, etcetera.
 Also the way in which information is shared, varies. An ‘outsider’ may be expected to know all about ‘the system’ (be it: social/ medical/ company/ family) without a need to explain. Trouble is, if someone expects you to know, but you don’t even know you ought to know, miscommunication is sure to happen.

People’s personality and character play a role too – in fact each individual carries her/his own culture, worldview and experiences from way-back that go beyond the mere fact of nationality and family of origin…… Even travelling to the other side of the world, we carry our own ‘bagage’ with us and that gives us that uniqueness, that can be fascinating as well as singularly difficult. Because wherever one lives, there is a need to create and maintain relationships and to find a niche to be comfortable in as an individual as well.

In close relationships, problems arise sometimes because there are too many unresolved issues (like family of origin or childhood difficulties). People think they get involved with a certain kind of person and then may find themselves plunged into situations they are unprepared for.
Having given up a career or satisfying job to be with this partner or spouse and thereby feeling fairly strongly dependent initially, this is bound to create difficult and painful situations. Another source of difficulties is that often signals are missed or misread as to: how a person feels, what is important or trivial, what really liked or disliked, what wanted or needed. How to communicate these things clearly? Too often we expect lover or friend to understand or be sensitive enough to know those things that are dearest/most personal to us.

People can behave differently when they are abroad as compared to back home in familiar settings, and this too can be confusing or upsetting – it may be useful to distinguish here between more group-based cultures (like many Asian, African or rural/traditional) and more urban, individualistic, Western societies. Interestingly though, intercultural interaction between people from a fairly similar background, that expect to have a lot in common, may actually be full of difficulties, probably because of those unspoken assumptions and high expectations. Of course our thinking about people and culture should not be rigid – sterotypes never promote understanding and neither do misconceptions, mistaken self-views or biases.

But if life in one’s own tried and trusted environment is hardly ever easy, international and intercultural living tends to be even more of a ‘mixed bag’. In fact, it can be said that living in another country is a life-altering experience, in ways that you never expected or could have foreseen. Of course, it makes a difference whether you chose to be there, or if fate has somehow thrown you there – and whether you plan to stay for a while only, or ‘for life’ because commitment or circumstances make leaving unlikely. When, for whatever reason, you feel you don’t have much choice, the experience is likely to be more stressful. Being part of a couple requires deeper commitment – when things do not go so well, there may be a greater sense of loss of ‘what was or could have been’. Short-term expatriates can take refuge in social interaction with people of their own nationality exclusively (a bit of Why bother?), but those who plan to stay feel a need to succeed, to get to know their new country and its people; there is likely to be more pressure to learn about and adapt to the culture and customs, and that may bring marvel or joy, but also frustration, irritation or tension. Support and understanding from partners or in-laws is not always there – it may be hard for them to be that empathic.

Occasionally things really go wrong. When you keep questioning yourself: What in the world am I doing here? and when you are feeling down all the time, you may be experiencing culture shock. That can be defined as: a condition of emotional upset and tension that becomes chronic for a period of varying duration and is experienced by persons who, exposed to life in an unfamiliar setting, react with anxiety, irritation and frustration. It can happen to anyone who has had to leave home, with its familiar and manageable routines and social patterns, and feels confronted with life in a different social setting with a language and mores/values that are unfamiliar (and that may be repugnant to the person with culture shock). No wonder this happens, because to feel lonely, isolated, uncertain about proper procedures, unable to control life, does give a lot of stress and wears a person down.
Culture shock has:
1. a honeymoon phase when all is terribly new, exciting, unknown but charming…
2. an angry, upset phase when you can’t help thinking Why don’t they do things properly?
3. a coping phase with more resignation, trying to adapt without losing your sense of self
4. a more integrated phase, when you are comfortable most of the time with where you are and how things are going.
Actually these phases may come and go and even after a long time any of those moods can become more dominant in certain circumstances. It helps to be aware of them, to know that what is happening is not uncommon, and to try and get help for the middle phases, such as an empathic listener, encouragement, good tips or support, if need be professional help. Don’t wait too long because getting timely professional help can save a lot of heartache!

Human beings are creatures of habit and maybe a nomadic existence is only good for those who can carry their ‘home’ with them, who feel at home whereever they are. That takes quite a bit of inner strength and considerable flexibility of mind. Those people have little trouble finding their feet in a new environment, they often have a talent for languages and a high degree of curiosity about other cultures or other ways of life. Experience learns though that even the most experienced expats can get some culture shock when they finally do go home and find it/themselves somehow changed, difficult to fit in again. It should be noted all of this goes for kids and especially adolescents as well – they may have been comfortable in a particular environment, but feel uprooted when they have to go and live in their ‘own’ country and feel ‘different’.

Of course in all of this there are many positives to consider, as the following statement expresses: The international and intercultural experience can be an unparallelled opportunity for learning and developing, for personal and professional growth and for sharing with others a sense of the uniqueness of the individual, whilst celebrating the diversity and similarity of human beings here, there and everywhere…..

About the author:
Els Barkema-Sala, MPhil, MBACP
www.counsellinginternational.com

Els, thanks again for your contribution!
Joseph Maussen
Head of Counselling
Counselling Madrid

The Differences between Counselling and Coaching

Monday, May 4th, 2009

As a Counsellor working in Madrid with the expat community I am often asked by clients about the differences between Counselling and Coaching. Although I have not researched this subject my explanation normally includes the argument that Counselling is for people who find themselves in a situation where they perform below what they consider to be their normal level of functioning. A Counselor is trained to assist clients getting back to their previous “normal” level of functioning. This explanation indirectly tells you what my view entails about Coaching: to get people, already functioning well, to perform even better.

From the above view you may deduct that some people receiving Coaching, actually might benefit more from Counselling. For example, when someone´s performance is temporarily affected by issues such as relationship problems or work related stress, Counselling seems a more approprioate way to get someone back on track again. I would add to this that Counsellors have more in-depth knowledge about the underlying triggers that lead to stress, and therefore are better equipped to look at the source of stress, rather then trying to make the symptoms go away through the use of relaxation techniques (also an important part of counselling). However, there are also people, currently receiving Counselling, that might actually benefit more from Coaching. Obviously there is no such thing as a clear line drawing the line between “will probably benefit most from Coaching” and “will probably benefit most from Counselling”.

Issues such as costs and availability also play a key role: the availability of one service – coaching or counselling – might increase the likelyhood of someone using one of the two services where actually the non-available service might benefit this client most. Let us also not forget the companies, schools and universities that are more or less inclined to be pro-active when it comes to offering Counselling and Coaching services to their most valued Human Capital: employees and students.

Therapists in Madrid, Spain

Sunday, April 5th, 2009

Counselling Madrid offers various types of therapy to clients in need of an English speaking therapist. In order to guide clients when making an informed choice, this week I wanted to write about the latest information released by NICE, The National Institute for Health and Clinical Excellence, based in the UK. (these guidelines have previously been published in the magazine for Counselling & Psychotherapy professionals “Therapy Today” – December 2008 issue). NICE have currently published 15 guidelines for the treatment of mental health and behavioural conditions. The following information is a brief summary of these guidelines.

Anxiety
Recommendations are made for both panic disorder and generalized anxiety disorder as follows:
Panic Disorder:
- CBT
- Self help in the form of bibliotherapy

Generalized Anxiety Disorder:
- CBT
- Self-help (bibliotherapy based on CBT principles

Attention deficit hyperactivity disorder (ADHD)
The ADHD guideline focuses on treatment for pre-schoolchildren, school-age children and adults:
- Group based parent-training/education programmes (CBT and/or social skills training)
- Individual based psrent training/education programmes
- Individual psychological interventions (CBT or social skills training)
- Group or individual CBT

Bipolar disorder
The guideline for bipolar disorder includes a number of recommendations for psychological therapies, including:
- Individual psychological therapy
- Structured psychological therapy
- Psychological treatment
- CBT
- Counselling (for women with unplanned pregnancy)
- Psychosocial intervention (psychoeducation and motivational enhancement)
- Self-help approaches (CCBT)
- Brief psychologival interventions
- Focused family interventions

Dementia
The guideline for dementia recommends:
- Psychological therapy (including CBT)
- Structured group cognitive stimulation programme
- Psychoeducation
- Genetic counselling

Depression
Psychological interventions feature in several of the key steps for the treatment of depression. Within step two, for the treatment of mild depression, the folowing treatments are recommended:
- Self-help based on CBT
- Brief psychological treatment – such as problem solving therapy, brief CBT and counselling.

In both mild and moderate depression, psychological treatment specifically focused on depression, such as problem-solving therapy, brief CBT and counselling, of six to eight sessions over ten to twelve weeks should be considered. Within step three, for moderate to severe depression, the folowing treatments are recommended:
- CBT (the guidelines states it should not be offered to patients with moderate or severe depression who do not take or who refuse antidepressant treatment)
- IPT if the patient expresses a preference for it or if, in the view of the healthcare professional, the patient may benefit from it. However, for moderate, severe and treatment-resistant depression, the treatment of coice is CBT
- Couple-focussed therapy for patients who have a regular partner and who have not benefited from a brief individual intervention
- Psychodynamic psychotherapy for the treatment of the complex comorbidities that may be present along with depression. In step four, CBT and mindfullness-based CBT are recommended.

Depression in children and young people

to be continued shortly

Note: looking for a therapist in Madrid? Counseling Madrid helps you choose the right therapy with the right therapist.

Counselling Madrid – Mindfulness, Meditation & Therapy

Saturday, February 28th, 2009

Mindfulness (often termed Right meditation) involves bringing one’s awareness into the present moment (from the past, the future, or some disconnected train of thought). By residing more frequently in the present moment, practitioners begin to see both inner and outer aspects of reality. Internally, one sees that the mind is continually chattering with commentary or judgement. By noticing that the mind is continually making commentary, one has the ability to carefully observe those thoughts, seeing them for what they are without aversion or judgment. Those practicing mindfulness realize that “thoughts are just thoughts.” One is free to release a thought (“let it go”) when one realizes that the thought may not be concrete reality or absolute truth. Thus, one is free to observe life without getting caught in the commentary. Many “voices” or messages may speak to one within the “vocal” (discursive) mind. It is important to be aware that the messages one hears during “thinking” may not be accurate or helpful, but rather may be translations of, or departures from truth. As one more closely observes inner reality, one finds that happiness is not exclusively a quality brought about by a change in outer circumstances, but rather that realizing happiness often starts with loosening and releasing attachment to thoughts, predispositions, and “scripts”; thereby releasing “automatic” reactions toward pleasant and unpleasant situations or feelings.

Meditation can be very helpful living a life more mindful. However, there are many misconceptions about meditation:

Misconception #1: Meditation is just a relaxation technique
The bugaboo here is the word ‘just’. Relaxation is a key component of meditation, but Vipassana-style meditation aims at a much loftier goal. Nevertheless, the statement is essentially true for many other systems of meditation. All meditation procedures stress concentration of the mind, bringing the mind to rest on one item or one area of thought. Do it strongly and thoroughly enough, and you achieve a deep and blissful relaxation which is called Jhana. It is a state of such supreme tranquility that it amounts to rapture. It is a form of pleasure which lies above and beyond anything that can be experienced in the normal state of consciousness. Most systems stop right there. That is the goal, and when you attain that, you simply repeat the experience for the rest of your life. Not so with Vipassana meditation. Vipassana seeks another goal–awareness. Concentration and relaxation are considered necessary concomitants to awareness. They are required precursors, handy tools, and beneficial byproducts. But they are not the goal. The goal is insight. Vipassana meditation is a profound religious practice aimed at nothing less that the purification and transformation of your everyday life.

Misconception #2: Meditation means going into a trance
Here again the statement could be applied accurately to certain systems of meditation, but not to Vipassana. Insight meditation is not a form of hypnosis. You are not trying to black out your mind so as to become unconscious. You are not trying to turn yourself into an emotionless vegetable. If anything, the reverse is true. You will become more and more attuned to your own emotional changes. You will learn to know yourself with ever- greater clarity and precision. In learning this technique, certain states do occur which may appear trance-like to the observer. But they are really quite the opposite. In hypnotic trance, the subject is susceptible to control by another party, whereas in deep concentration the meditator remains very much under his own control. The similarity is superficial, and in any case the occurrence of these phenomena is not the point of Vipassana. As we have said, the deep concentration of Jhana is a tool or stepping stone on the route to heightened awareness. Vipassana by definition is the cultivation of mindfulness or awareness. If you find that you are becoming unconscious in meditation, then you aren’t meditating, according to the definition of the word as used in the Vipassana system. It is that simple.

Misconception #3: Meditation is a mysterious practice which cannot be understood
Here again, this is almost true, but not quite. Meditation deals with levels of consciousness which lie deeper than symbolic thought. Therefore, some of the data about meditation just won’t fit into words. That does not mean, however, that it cannot be understood. There are deeper ways to understand things than words. You understand how to walk. You probably can’t describe the exact order in which your nerve fibers and your muscles contract during that process. But you can do it. Meditation needs to be understood that same way, by doing it. It is not something that you can learn in abstract terms. It is to be experienced. Meditation is not some mindless formula which gives automatic and predictable results. You can never really predict exactly what will come up in any particular session. It is an investigation and experiment and an adventure every time. In fact, this is so true that when you do reach a feeling of predictability and sameness in your practice, you use that as an indicator. It means that you have gotten off the track somewhere and you are headed for stagnation. Learning to look at each second as if it were the first and only second in the universe is most essential in Vipassana meditation.

Joseph Maussen: By demystifying meditation, clients can be motivated to start relaxing themselves. This is often a first and necessary step to become more aware, more mindful, of our thoughts and emotions and how these thoughts and emotions are the result of certain specific situations or events. Increased mindfulness opens the door to respond to situations instead of reacting or acting out. Clients often experience more freedom as a result and more fulfilling interactions with others, either at home or at work, with family members or friends.

Source: Mindfulness in Plain English, by Ven. Henepola Gunaratana
www.counsellingmadrid.org
Expats looking for a therapist in Madrid