What is Imagery Re-scripting and Reprocessing Therapy?

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MessageFrom the Clinical Director

Snooze your way to Fitness Tackling sleep from a panel of experts Page 3& 4

Diagnosis Corner - TraumaWhat do the doctors look for? Page 6

Testimonial of RecoveryYasmin on childhood trauma page 7

March 2012

MessageFrom the Clinical Director

Imagery and rescritpting therapy has a huge impact on childhood trauma memories and other types of trauma because it reduces distress whilst helping the person be stronger and enjoy life again. This type of therapy is part of the CBT tradition and research shows that it significantly reduces distressing memories whilst empowering the individual. Work by Smucker, Hackmann, Holmes, Grey, Lee & Kinnerley has shown and provided hope that you can survive trauma and indeed life can start again. Many live with the bad effects of trauma and make the necessary adjustments to help reduce the distress but unfortunately some of these adjustments include binge alcohol drinking, avoiding public places, avoiding social situations, drug takings and over eating. And so life reduces and as it shrinks then other problems creep in which in later life become so big and overwhelming that then help is sort with a visit to the GP. Top tip= don’t let life shrink and try to keep going with routines and get help. Difficulty comes when help is delayed and then overtime habits are formed which then become difficult to break but not impossible. The main focus of this March newsletter is Trauma which includes diagnosis corner, sleep and exercise and a testimony from Yasmin who has had problems with OCD, Body Dysmorhpia Disorder and Specific Phobia of Vomit which was routed in childhood trauma. If you enjoy any of the articles then please contact us via twitter or facebook • Website: www.cbtinthecity.com• Join Our Facebook Groups: CBT in the City - CBT in the City for Schools - Mindfulness and the City• Follow us on Twitter: CBTDaily  -  SchoolsCBT  -  MindfulnessCB

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2CBT in the City Ltd Registered company in UK:6709268. CBT in the City is a registered Trademark copyright 2010 and all work produced and published is the property of CBT in the City Ltd. Any reproduction is prohibited 2012

2CBT in the City Ltd Registered company in UK:6709268. CBT in the City is a registered Trademark copyright 2010 and all work produced and published is the property of CBT in the City Ltd. Any reproduction is prohibited 2012

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Failing to get sufficient sleep seems to be the common-cold of current times; work stresses, worries about our finances - all play a part. “Now approximately 10-15% of us, suffer with our sleep”, says Matt Broadway-Horner a Cognitive Behavioural Therapist from CBT In The City (www.cbtinthecity.com) , and what’s more this problem is more common in women than men. Matt says; “half of these sufferers report symptoms I’d consider severe.”

Well-being coach Dan Roberts (www.danroberts.com) says; “Insomnia is increasingly common in our over-stimulated, always-on, stressed-out modern world. But a lack of sleep can profoundly affect your mind function, decision-making and memory – all of which are crucial in fitness performance. A sleep deficit also has a powerful effect on your mood, so can be a key factor in stress, anxiety, depression or just feeling flat and uninspired.” These negative emotions will interfere with the commitment and energy that are required for working-out.

How much sleep?

The right amount of sleep varies from person to person, but the average is about seven hours. Dan says that consistency is key too; “there’s no point getting five hours a night on weekdays and catching up with a 10-hour sleepathon at weekends. Your body needs downtime to repair damage caused during the day, while your mind needs night-time inactivity to process the day’s events (which is why we dream).”

Exercise can help you sleep

Dan explains how powerful exercise can be when it comes to easing you into slumber; “taking regular cardio exercise like running, spin classes, cycling or tennis for instance can help you to get a better night’s sleep. So too can calming, meditative exercise like yoga or tai chi.

“With Cardio-Vascular exercise you can actually burn off stress and anxiety. CV makes you physically tired, in a good and healthy way. More calming exercise, like Yoga, deactivates your stress response and activates your relaxation response.” If you are struggling with getting to sleep though it’s advisable to not do your workout too close to bedtime as this may make you too warm and too energised to sleep.

Sleep your way to better performance

So exercise can help you sleep – but sleep can help your exercise? Personal Trainer, Gavin Walsh www.thebootcamp.co.uk believes that to reach your goals for physical fitness you need to be mentally fit too and that sleep is key, he explains; “Sleep is an often over-looked fitness tool.  However, it is highly important, and should not be ignored if you don’t want performance to suffer. You’re more likely to achieve a Personal Best if you’ve had 7 hours + sleep.” 

If we don’t sleep enough we just won’t be at our peak in terms of health and fitness levels. In fact sleep deprivation studies on mice have demonstrated that if you’re kept awake long enough, in time your immune system and overall well-being simply breaks down.

Snoozing Your Way to fitness overcoming a sleep problem

GWguest writer

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2CBT in the City Ltd Registered company in UK:6709268. CBT in the City is a registered Trademark copyright 2010 and all work produced and published is the property of CBT in the City Ltd. Any reproduction is prohibited 2012

2CBT in the City Ltd Registered company in UK:6709268. CBT in the City is a registered Trademark copyright 2010 and all work produced and published is the property of CBT in the City Ltd. Any reproduction is prohibited 2012

If we don’t sleep enough we just won’t be at our peak in terms of health and fitness levels. In fact sleep deprivation studies on mice have demonstrated that if you’re kept awake long enough, in time your immune system and overall well-being simply breaks down.

“Lots of studies show lack of sleep can lead to impaired reaction times and decreased endurance”, says Fitness expert Nick Critchley. He believes that performance suffers when sleep is lost; “sleep-time is when we replenish our neuro-transmitters as well as being a time for repair and regeneration of tissues used during intense exercise.” 

Sleep for focus

Gavin says research demonstrates that it can take up to 7-8 hours of sleep for our bodies to process the toxins we accumulate on a daily basis.  “These toxins can help reduce focus as they interfere with our mind-set. The toxins include processed foods, alcohol, air pollution and even poor quality water.  The accumulation of these toxins and sleep deficit can throw our hormones to play havoc.  For example, cortisol, a stress hormone increases with a lack of sleep which can further take-away from our focus on our sport or fitness activity”.

Sleep and Diet

Eating the wrong foods, putting on weight or just feeling more sluggish can have a hugely detrimental effect on our ability to exercise. Sleep, or lack thereof, can lead us into negative eating patterns, Dan explains; “If you struggle with food cravings or binge eating, one of the key triggers is being over-tired. When we are exhausted our strength is depleted and our willpower is low, so it’s much easier to succumb to cravings – especially for the kinds of sweet, sugary foods we crave during periods of low energy. You may also crave carbohydrates like crisps, pasta or rice or caffeinated drinks because your brain thinks you need quick, easily digested sources of energy. Getting the right amount of sleep will help keep these cravings at bay.”  

Sleep and Injury Risk

Gavin tell us that not getting enough sleep can increase the risk of getting injured because you won’t be paying enough attention to form; your stride and posture may suffer and this in turn can lead to twists and strains. He says, “If you’ve had a poor night’s sleep, then there is less chance that you’ll be working to your full strength during training.  This lack in power and focus will have a damaging effect on how you move and your posture. All of this is crucial when at the gym performing highly demanding technical lifts; your risk of injury will certainly be increased.” Gavin acknowledges that it’s not just down the gym that problems might arise; “when running or taking part in any sport, if you’re feeling tired you’re much more likely to end up with an injury, and this could see you out of action for months”.

Well-being CBT therapist Matt Broadway-Horner gives some tips for the perfect night’s sleep..

Do… • Develop good ‘sleep routine’. So make sure your bedroom is cool, quiet and dark (use a blackout blind if you have to - even a small amount of ambient light interferes with the body’s sleep-controlling mechanisms).

• Switch the TV off an hour before bed and read, listen to soothing music or take a long, hot bath.

GWguest writer

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How does PTSD start?PTSD can start after any traumatic event. A traumatic event is one where we can see that we are in danger, our life is threatened, or where we see other people dying or being injured. Some typical traumatic events would be:• Serious road accidents • Military combat • Violent personal assault (sexual assault, physical attack, abuse, robbery, mugging) • Being taken hostage • Terrorist attack • Being a prisoner-of-war • Natural or man-made disasters • Being diagnosed with a life-threatening illness

Even hearing about an unexpected injury or violent death of a family member or close friend can start PTSD

When does PTSD start?The symptoms of PTSD can start after a delay of weeks, or even months. They usually appear within 6 months of a traumatic event

What does PTSD feel like?Many people feel grief-stricken, depressed, anxious, guilty and angry after a traumatic experience. As well as these understandable emotional reactions, there are three main types of symptoms produced by such an experience:

1. Flashbacks & NightmaresYou find yourself re-living the event, again and again. This can happen both as a "flashback" in the day, and as nightmares when you are asleep. These can be so realistic that it feels as though you are living through the experience all over again. You see it in your mind, but may also feel the emotions and physical sensations of what happened - fear, sweating, smells, sounds, pain

Ordinary things can trigger off flashbacks. For instance, if you had a car crash in the rain, a rainy day might start a flashback

2. Avoidance & NumbingIt can be just too upsetting to re-live your experience over and over again. So you distract yourself. You keep your mind busy by losing yourself in a hobby, working very hard, or spending your time absorbed in crossword or jigsaw puzzles. You avoid places and people that remind you of the trauma, and try not to talk about it

You may deal with the pain of your feelings by trying to feel nothing at all - by becoming emotionally numb. You communicate less with other people, who then find it hard to live or work with you

3. Being "On Guard"You find that you stay alert all the time, as if you are looking out for danger. You can't relax. This is called "hyper vigilance". You feel anxious and find it hard to sleep. Other people will notice that you are jumpy and irritable

TraumaWhat do the doctors look for?

DCdiagnosis corner

6CBT in the City Ltd Registered company in UK:6709268. CBT in the City is a registered Trademark copyright 2010 and all work produced and published is the property of CBT in the City Ltd. Any reproduction is prohibited 2012

Other SymptomsEmotional reactions to stress are often accompanied by:• Muscle aches and pains • Diarrhoea • Irregular heartbeats • Headaches • Feelings of panic and fear • Depression • Drinking too much alcohol • Using drugs (including painkillers).

What makes PTSD worse?The more disturbing the experience, the more likely you are to develop PTSD. The most traumatic events:• Are sudden and unexpected • Go on for a long time • You are trapped and can't get away • Are man-made • Cause many deaths • Cause mutilation and loss of arms or legs • Involve children.

How can I tell if I have PTSD? Have you have experienced a traumatic event of the sort described at the start of this leaflet?If you have, do you:• Have vivid memories, flashbacks or nightmares? • Avoid things that remind you of the event? • Feel emotionally numb at times? • Feel irritable and constantly on edge but can't see why? • Eat more than usual, or use more drink or drugs than usual? • Feel out of control of your mood? • Find it more difficult to get on with other people? • Have to keep very busy to cope? • Feel depressed or exhausted?

If it is less that 6 weeks since the traumatic event and these experiences are slowly improving, they may be part of the normal process of adjustment

If it is more than 6 weeks since the event, and these experiences don't seem to be getting better, it is worth talking it over with your doctor

TraumaWhat do the doctors look for?

DCdiagnosis corner

6CBT in the City Ltd Registered company in UK:6709268. CBT in the City is a registered Trademark copyright 2010 and all work produced and published is the property of CBT in the City Ltd. Any reproduction is prohibited 2012

7CBT in the City Ltd Registered company in UK:6709268. CBT in the City is a registered Trademark copyright 2010 and all work produced and published is the property of CBT in the City Ltd. Any reproduction is prohibited 2012

cognitive behaviour therapy made a difference!....with my childhood trauma memoriesthe human conditionBy Yasmin

'No one can go back in time, but you can revisit things and view them in a different light. This was, I suppose the basic idea behind my therapy sessions with Matt when we started looking at my past. I was physically abused as a child. Fact – I can’t change that. What I can change however, is how I deal with the memories I have from that, and how I can view my future differently, more positively. Through using imagery and grounding skills in my sessions with Matt, I learnt how I could not change the past, but change the way it affects me in my day-to-day life. I no longer live in fear and my nightmares are history. I live a life I never thought I could and am happier than ever. So thank you Matt, for everything.

Testimonial of Recovery

TR

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