What is Psychosis?

Psychosis is when people lose some contact with reality. This might involve seeing or hearing things that other people cannot see or hear (hallucinations) and believing things that are not actually true (delusions). 

There are two main symptoms, Hallucinations, where a person hears, sees and, in some cases, feels, smells or tastes things that do not exist outside their mind but can feel very real to the person affected by them; a common hallucination is hearing voices. And Delusions, where a person has strong beliefs that are not shared by others; a common delusion is someone believing there's a conspiracy to harm them. The combination of hallucinations and delusional thinking can cause severe distress and a change in behaviour. Experiencing the symptoms of psychosis is often referred to as having a psychotic episode.

It's sometimes possible to identify the cause of psychosis as a specific mental health condition, schizophrenia, a condition that causes a range of psychological symptoms, including hallucinations and delusions, bipolar disorder, a mental health condition that affects mood, a person with bipolar disorder can have episodes of low mood and highs and Severe depression, some people with depression also have symptoms of psychosis when they're very depressed.

Psychosis can also be triggered. Trauma, Stress, anxiety, addictions and sometimes brain tumours can cause a psychotic episode. If we as Solution Focused Therapists witness a client who is experiencing a Psychotic episode, we should immediately seek assistance from the client’s medical practitioner.

If it is identified at the initial Consultation that a client is or has been diagnosed with a mental illness, whether currently taking medication or has previously taken it, then at these times we should contact their GP and our supervisor for advice. We should get clarification that what we can do for the client, will do no harm.

Talking therapies can help reduce anxiety levels in those who suffer, CBT is often prescribed alongside medications. If underlying anxiety can be reduced, this helps the medication be more effective in helping to prevent Psychotic episodes. Therefore, Solution Focused Hypnotherapy could assist in anxiety reduction and potentially reducing or stopping any addictions that the client may have.

I strongly believe that if the Solution Focused Hypnotherapist has even the slightest reservation regarding dealing with a client with a diagnosed Mental Illness, they should refer to a colleague with the experience to give the level of support the client needs. We should always work within our limits of experience to give the best possible care.

Analytical or Jungian therapy is a theory that emphasises the importance of wholeness. It was derived from the work of psychiatrist Carl Jung. It is believed that the unconscious mind is the most important aspect of each individual and that making as much of the unconscious mind as possible can help with healing and the attainment of wholeness. Dreams are thought to be a part of the unconscious and that dreams show ideas, beliefs, and feelings of which individuals are not readily aware. Jungian psychotherapy aims to align conscious and unconscious thoughts. It examines the motivations that lie deep within the client’s psyche and underneath client’s conscious awareness. Jungian therapy draws on dream analysis, word associations and creative activities such as painting, drama, dance and music. 

 

As a Solution Focused Hypnotherapist, it’s vital to understand and have a background knowledge of the differing approaches to therapy available today. Although I follow the SFH brief, there may be times when my methods would benefit from additional intervention, influenced by other forms of therapy.

It may be agreed with a client that a task is to be completed by the next session, this method is a favorite within CBT, where CBT would check that the task was completed, we would not mention it and allow the client to bring it up when we ask “what’s been good?” We discuss ways to make things better, we trust the clients to know how to solve their problems, but there may be times where we may indirectly suggest the better path to take. Tasks, goals and homework are set in CBT, elements we can choose to use if thought appropriate. A goal is key to any client and any therapist to allow us to work towards the clients’ best hopes

An area where we most definitely step outside of the usual SFH process is when it is evident that the clients progress would be encourage with the use of NLP. Rewind, Reframing and Swish are methods used very successfully when combined with SFH. In practice we may use the Swish method to allow clients to see their preferred outcome of a situation, or a preferred view of themselves. The joy with this method is that it can be done by the client whist at home at any time and doesn’t require Hypnosis. I have used this with clients who need help with weight loss and motivation at the gym. We use rewind to assist with Phobia and trauma. It is a non-threatening method which detaches the client from the emotional feelings attached to a memory or a trigger. I have used Rewind successfully on a number of Dog and spider phobia and most recently a fear of flying. We use reframe continually to allow clients to see things from a different perspective to the one that see now.

When discussing preferred futures with clients, we may from time to time think back and use the “My friend John” metaphor, used by Erickson, but as we don’t all have friends called John, we may suggest that “many clients have said that they have benefited from doing that” or using the powers of indirect suggestion to gently nudge the client in the right direction. 

We have to be continually looking to ensure we are providing the best level of support to our clients, they are all different, but our process is the same. So, careful use of language is vital to make the session unique to our individual. Some clients will not enjoy being told what to do, this is great if you have mastered indirect suggestion, some clients want to discuss the past, we do this, but it’s the positive past that we are interested in. Clients that want to give up smoking may feel they have a part of themselves that wants to keep smoking and dieters that want to subconsciously eat cake, we can help that using parts therapy. As long as the alternative methods we use are fundamentally positive, we should seek to use what ever we think is more appropriate.

Having the knowledge of many different aspects of other therapies, allows us to develop our techniques to allow choice as to the best possible solution for the client, which operating in the solution focused therapist brief. 

NLP uses perceptual, behavioural, and communication techniques to make it easier for people to change their thoughts and actions. It was developed by Richard Bandler and John Grinder, who believed it was possible to identify the patterns of thoughts and behaviours of successful individuals and to teach them to others. Effective communication is the key elements of neuro-linguistic programming. Some of the techniques used are anchoring, which turns sensory experiences into triggers for certain emotional states, Rapport, the therapist tunes into the client by matching their physical behaviours to improve communication and response through empathy, the Swish method, which changes patterns of behaviour or thoughts to wanted rather than unwanted outcome and visual/kinaestheticdissociation or Rewind, which removes negative thoughts and feelings associated with a past event.

In practice we may use the Swish method to allow clients to see their preferred outcome of a situation, or a preferred view of themselves. The joy with this method is that it can be done by the client whist at home at any time and doesn’t require Hypnosis. I have used this with clients who need help with weight loss and motivation at the gym.

We use rewind to assist with Phobia and trauma. It is a non-threatening method which detatches the client from the emotional feelings attached to a memory or a trigger. I have used Rewind successfully on a number of Dog and spider phobia and most recently a fear of flying. 

Therapy is therapy to many people. Understanding the different styles, what is available and what is appropriate for the patient can be a minefield. The NHS in the UK currently offers Seven types of talking therapy, Cognitive Behaviour therapy (CBT), Counselling, Behavioural activation, Interpersonal Therapy, Eye movement desensitisation and reprocessing, Mindfulness-based cognitive therapy and Psychodynamic psychotherapy (PP). All of which, in one way or another deal with depression, anxiety, panic disorders, phobias, obsessive compulsive disorder, post-traumatic stress disorder and bulimia etc. The lottery of different types of therapy for different problems, can be a difficult call for a GP, waiting times for referrals are currently running at 18 weeks and this is just to ascertain which of the seven is the best road to take, subject of course, to what specialists are available in the particular areas of the UK. Not great if your need is far greater than the waiting list.

We will compare below a selection of different therapy types, that deal with similar problems. These will be compared directly to the Solutions Focused Hypnotherapy (SFH) model and we will show how research has developed SFH it in the way it has.

Cognitive Behaviour therapy (CBT)

The aim of CBT is to explore change and how you think about your life.

Goals are set

Tasks are often used

Up to 20 sessions are often needed, sometimes longer.

Its highly structured to give consistency

Problems are broken down into parts and analysed.

It’s based on a theory, that thoughts, feelings, physical sensations and actions are all linked and that negative thoughts and feelings affect your mental wellbeing.

It’s recognised as a pragmatic therapy and doesn’t dwell on past problems, it’s very much in the now.

A very common therapy that is prescribed for most problems and extremely effective and is used to compliment medications also. It can be successful in a short period, but can take up a lot of the client’s time with extra work that could be asked for between sessions. It is focused solely on the client, rather than dealing with the wider issues going on in their lives.

Counselling

Counselling is a talking therapy

Problems are discussed in confidence with a counsellor

The expertise of the counsellor is vital to find solutions to offer to the clients.

Mainly used for depression, bereavement, anger, sexual orientation and to find reasons for the client’s unrest. It can be a long therapy. The client may have to discuss issues that they would rather forget and the past can be trawled over to find rational to why they are feeling that they are. But good for those that want to discuss and vent and to find those reasons.

Psychodynamic psychotherapy (PP)

This therapy looks at how childhood experiences and thoughts that the client is unaware of, effect feelings, relationships and behaviour.

The subconscious mind is assessed to provide reasoning for past problems that effect today.

Psychodynamic therapy focuses on the psychological roots of emotional suffering. Its hallmarks are self-reflection and self-examination, and the use of the relationship between therapist and patient as a window into problematic relationship patterns in the patient's life.

Hypnotherapy

Utilises guided relaxation to achieve a state of focused attention which enables the mind to find solutions

Used to treat conditions, such as anxiety, phobia, addictions, change habits, ease pain and increase confidence, to name a few.

Results are long lasting and success is usually in a short space of time.

Not currently prescribed on the NHS, but recognised by the British Medical Association as a valid medical treatment in 1955

Solution Focused Brief Therapy (SFBT)

Not currently prescribe on the NHS

Is future orientated to find solutions to problems

Is positive and builds on the strengths of the clients, with the understanding that they know what they need to do to move forward

Clients describe what they want, rather than what they do not want

The use of Scales is incorporated to monitor progress

It is goal directed

It finds exceptions to problems, investigating to find when the problem isn’t there

Does not rely on knowing what the problem is to be able to deal with it

Is structured and every problem, has the same process

Is a short therapy, 3-6 appointments us usually enough.

This method of therapy was devised to be brief and to allow clients to achieve their goals by positively questioning and encouraging success at every stage of the process. It relies on a team of people to watch the session with clients and is labour intensive, but has fast results.

What we have here is a SMALL selection of therapies available today and some of the similarities and differences, but not all. Before we compare this with the SFH model, let’s consider this - Knowledge is everything! having an understanding of how something works allows us to know when something isn’t working properly. Most appliances in the home come with operating instructions, so why don’t Humans?

Milton Erickson believed that everyone had sufficient wisdom and resourcefulness to be able to cope with life effectively, the subconscious part of the brain knew all the answers.

The cerebral cortex is a vast intellectual library, that is there for us all to access to find solutions. So how has Neuroscience influenced therapy? Well, there are too many contributors to mention, but let’s

consider a few, that have shaped the way that we work.

Jonathan Cohen, pioneered neuro-economics, he believed the forces that drive both rational and irrational forces are often at conflict with each other. He carried out a series of brain scans and identified that the more powerful the low roads activity (Amygdala), the less rational the reaction, the more active the high roads activity (prefrontal cortex) the more balanced the outcome. The low road was considered therefore a direct pathway designed to protect us without conscious thought.

Richard Davidson, proved that a positive state of mind can be trained, he carried out brain scans on monks who were thinking positively, then negatively and it showed that different parts of our minds are responsible for different feelings, so we can identify what part of the brain we are using and encourage positive thoughts.

John Ratey in his book, A users guide to the brain, saw the brain as an office, the Pre-frontal cortex was The Boss, who led the operation, the Amygdala was the Safety officer, always on the look out for danger and the Anterior cingulate was the Secretary, who let the boss know of any information he needed to know. In times of danger, the safety officer would take over instantly and the boss would be informed of his actions by the secretary, he could then make a rational decision about the situation, a great elaboration of Cohens discoveries. Ratey also proved we can alter the chemical balance in our brains in many ways to ensure we are “keeping the brain in balance to change your life”

Paul Elman discovered the Smile Advantage and discovered the brain is primed for positive feelings.

Marcus Raichle discovered that the brain showed large amounts of activity whilst resting or daydreaming and noticed that this activity stopped when the subject was given a task to complete. Asking the question, what was it doing during rest? the solution was reinforced by his colleague Gordon Shulman who saw on a sample of 134 brain scans that regardless of the task, areas of the brain that were active during rest, dimmed as soon as the subject was concentrating. They had discovered that the brain resorts to a default mode when unoccupied, which could be described as a trance like state and speculated that this may provide us with an inner rehearsal, considering future choices and outcomes.

Donald Hebb proved that neural networks were strengthened with repeated patterns of behaviour, by using rats to perform repeated tasks. Repetition strengthened areas in the brain, showing we can exercise our brains to and encourage growth.

Returning to the statement “knowledge is everything” why do most forms of therapy omit teaching the client how the mind works? We have years of scientific evidence to prove what is happening in our minds, surely an understanding of this is essential for our clients to be able to understand why they feel as they do.

Let’s finally look at Solution Focused Hypnotherapy and identify the similarities to other forms of Psychotherapy and the beneficial science-based additions that allow us to give a comprehensive service to our clients.

Solution Focused Hypnotherapy

A comprehensive presentation of the workings of the brain and mind is given to allow clients to see and understand how and why they are feeling like they do. Utilising research and scientific evidence from a multitude of professional bodies and researchers.

It is a talking Therapy (Counselling) (CBT) (SFBT) (PP) (Erickson)

Is future orientated, enabling the client to find solutions to problems (CBT) (SFBT)

It promotes positive change (CBT) (SFBT)

Its highly structured to give consistency (CBT) (SFBT)

It’s recognised as a pragmatic therapy and doesn’t dwell on past problems, it’s very much in the now. (CBT) (SFBT)

Is positive and builds on the strengths of the clients, with the understanding that they know what they need to do to move forward (CBT) (SFBT)

Clients describe what they want, rather than what they do not want (SFBT)

The use of Scales is incorporated to monitor progress (SFPT)

It is goal directed (CBT) (SFBT)

It finds exceptions to problems, investigating to find when the problem isn’t there (SFBT)

Does not rely on knowing what the problem is to be able to deal with it (SFBT)

Is structured and every problem, has the same process (SFBT)

Utilises guided relaxation to achieve a state of focused attention which enables the mind to find solutions (HYPNOTHERAPY) (Erickson)

Results are long lasting and success is usually in a short space of time (HYPNOTHERAPY)

Utilises repetition to build neural pathways in the brain (HEBB)

Puts the brain into a resting or trance state to activate the default mode and Inner rehearsal (Raichle/Shulman) (hypnotherapy) (Erickson)

 

As we can see, SFH is a combination of the best elements of many differing styles of therapy and its practice incorporates influences from esteemed therapists, scientists, researchers and the great Milton Erickson. Its solution focused approach allows clients to understand why they feel like they do and focusses on small positive changes to improve their mental health and wellbeing, allowing the mind to access its vast intellectual database to find solutions.  Such a collaboration of different therapies ensure that clients are given the best possible chance of living the lives that want to live, giving them the knowledge to make a change, because as we know, Knowledge is everything

For more info, email me This email address is being protected from spambots. You need JavaScript enabled to view it.

Milton H. Erickson invented the ‘my friend John’ induction, he was a master of indirect suggestion. Erickson was a man who seemed gifted in his ability to work almost, invisibly. It is even possible that even he didn’t know why some of his clients got better, he just knew that they would. He used many techniques, but much of his work was based around metaphor and story-telling. He combined these skills with Hypnosis to help his clients. Erickson believed that progress could be made whilst clients were out of trance as the unconscious mind is always listening, which these days could be replicated when we follow a solution focused brief.

He would set tasks for his clients to complete, some were considered abstract, for instance sending a married couple on different journeys over two days to see if they were still compatible, or making a client, who couldn’t sleep, to polish his floors. We may also set tasks, but we do so with indirect suggestion and certainly wouldn’t involve polishing floors, unless of course, the client choose this method !!.

Many of his metaphors are commonly used today

“Life will bring you pain all by itself. Your responsibility is to create joy." Milton Erickson”

“You can teach a child the importance of pain by your behaviour. You can also teach as child the importance of no pain by your behaviour.”
― Milton Erickson

“Life's difficulties are merely necessary roughage.”
― Milton Erickson

“Until you are willing to be confused about what you already know, what you know will never grow bigger, better, or more useful.”
― Milton Erickson & Rossi

 

Solution Focused therapy is future orientate, designed to find solutions to problems. It builds on the strengths of the clients, with the understanding that they know what they need to do to move forward

Clients describe what they want, rather than what they do not want to allow themselves to see their preferred future. The use of Scales is incorporated to monitor progress, in the same way as in Solutions Focused Hypnotherapy. It finds exceptions to problems, investigating to find when the problem isn’t there and building on the strength of the client to seek what they did differently at the time. It Is structured and every problem, has the same process, tailored for the individual client, I follow a similar process, but combine it with Neuro science and Hypnotherapy.

 

Our minds work in Metaphor, it’s a figure of speech in which a word or phrase literally denoting one kind of object or idea is used in place of another to suggest a likeness or analogy between them, which the intellectual brain processes and understands. Metaphors are used to describe things in our day to day lives, we may say “we feel Blue” to describe our feelings or “its cats and dogs out there!” we all understand what that means, we could have just said it’s raining!

They are similar to indirect suggestions, they guide people to think or feel something, without actually telling them, great with clients who respond badly to direct suggestion.

There are Metaphors used in Therapy. A famous example is the Ratey Metaphor used to describe the workings of the mind, in fact our Initial Consultation is a metaphor, the intellectual mind, the primitive mind, polar bears, stress buckets and depressed Cavemen are metaphors. They allow clients to understand easily and their minds are turned on to find meaning to what they are hearing.