The Myth of Normal

We had a really good book group discussion yesterday about the Myth of Normal by Gabor Maté. Huge thanks to Andy Hill @behypnotherapy for hosting it.

We began by sharing our one-word reactions to the book which included: ‘unsettling’, ‘revealing’, ‘profound’ and ‘important’. Following our usual format, we discussed what we liked/disliked about the book, implications for clinical practice and for self-care as therapists.

There were many things we liked. We appreciated the compassion of the author as he talked about his family background, his client work and to his own limitations as a parent and physician. We felt the book achieved a good balance between scientific evidence, clinical practice and personal insight. In developing a holistic societal view of health Maté draws from a wide range of academic disciplines including: neuroscience, pharmacology, immunology, neurobiology, neurocardiology, epigenetics and socioeconomics.

The book offers new perspectives on disease, trauma and healing. Rather than seeing disease as a pathological entity invading the body it can be understood as an imbalance of the organism and a long-term dynamic process of interaction with the wider context. Using a petri-dish metaphor, the same set of cells would fare differently when placed into different solutions (benign and toxic). When we think about ‘Trauma’ we should also acknowledge ‘trauma’ to provide a more expansive understanding of those situations that inflict harm but also those situations which are marked by an absence of attention and attachment. He draws attention to the mechanisms through which stress and trauma can transmit intergenerationally. It is emphasised that healing and cure are not the same thing. ‘Healing’ can be understood as gaining new understanding, being active in the process of recovery and recovering self-compassion which is often lost through trauma.

We had few dislikes about the book although we agreed it was a tough and confronting read. Maté points to many pathological practices that have been normalised within society through political, economic and educational systems. I felt an unsettling response to the evidence presented in the book on the adverse physical effects of repressed or suppressed emotion. However, the author repeatedly emphasises that these insights should not invite blame of ourselves or our caregivers. It is an outlook that encourages compassionate understanding of and response to the social forces that condition us.

The following extract captures the essence of the book for me:
‘Everything within us, no matter how distressing, exists for a purpose; there is nothing that shouldn’t be there, troubling and even debilitating though it may be. The question shifts from “how do I get rid of this?” to “what is this for?”… we endeavour to get to know these irksome aspects of ourselves and then, a best we can, to turn them from foes into friends…. Healing does not require their disappearance, only their realignment – or perhaps their reassignment’. (pp 431-432)

We agreed that there were a lot of messages to take from the book both, in client work and personal life. As therapists, it encourages a heightened sensitivity and a compassionate trauma-informed perspective. As parents we all felt it was an important read. For self-care, the book is a reminder of how we all function as ‘shock-absorbers’ to each other in daily life and the value of noticing and responding to our own needs when feeling depleted.

What could he be thinking?

Recently, a client asked if I could hypnotise my dog as he has a habit of barking in an agitated way when people walk up the path. My intuitive answer was ‘no’ but it made me curious to go back to a chapter (‘Is a growling dog angry?’) in a book I read a while ago.

The question begins with trying to understand how my dog is feeling when people walk up the path. In the book ‘How emotions are made’, Professor Lisa Feldman-Barret suggests that emotions are shaped by language and culture much more than we used to think.
The book explains that emotions are formed initially through our interoceptive network. This is the system of neural pathways and circuits that provide information on the internal state of our body. Feldmann-Barrett acknowledges that dogs have a similar brain circuitry and nervous system to humans. However, for dogs to experience the emotion of anxiety (in the way we would perceive it) it would require: interoceptive awareness, the ability to learn emotional concepts and the capability to communicate these concepts in wider social groups. Based on the research evidence it is likely that dogs display the first two capabilities.

Rather than experiencing emotion, it might be more accurate to say that they experience ‘affect’. Research with macaque monkeys shows that they experience same bodily changes as humans do when watching positive and negative events. By tracking their eye movements and cardio-vascular responses researchers observed different responses when macaques observed video footage of monkeys foraging and grooming than when the other monkeys appeared distressed.

Animals use olfactory and visual cues, or ‘concepts’ (such as tail wagging) to identify friend or foe and Feldmann Barrett suggests animals can learn additional concepts if they are rewarded. When interacting with humans, dogs are attentive to gaze, tone of voice and some learned commands (‘sit’, ‘stay’, ‘heel’, ‘teddy’ etc). In this sense, animals show a capacity for understanding concrete objects and action-based concepts. However, humans have an additional capacity for goal-based concepts. For example, a dog may learn the concept ‘to climb’ in a literal and context-dependent sense whereas humans can perceive that different contexts of climbing (a tree, a staircase and rockface) share a similar mental goal.

We have a natural tendency to anthropomorphise animal behaviour and infer a ‘guilty look’ when our pet has guzzled a piece of food from the table. However, it seems that emotion is in the eye of the beholder. In one experiment the owner instructs the dog not to take the biscuit from the bowl and then leaves the room. In the next step, the experimenter enters room and either gives dog the biscuit or reinforces the command not to take the biscuit. When the owner comes back into the room the experimenter tells the owner either that the dog has or hasn’t taken the biscuit. They found that the scolded dog was perceived to display guilty behaviour regardless of whether the dog had taken the biscuit.

Feldmann Barrett stresses that it’s not a question of superior/inferior cognitive capacity. Humans and dogs are just well adapted to their environmental ‘niche’ and she encourages us to learn more about our animals on their own terms.
So, in response to the original question, my hunch is that hypnosis would not be an effective way of changing my dog’s behaviour. Hypnosis is an active mental state which enables clients to reconnect with a positive experience, disassociate from negative ones and visualise positive change. We use positive language, imagery and metaphor to help the client reframe problems and find solutions. Therefore, my dog might enjoy hypnosis in a limited way (such as the calming pace and soft tone of my voice!) but there would be limitations in our shared conceptual vocabulary to bring about the desired change.
He often lies on the floor outside my therapy room, and occasionally is invited into the session by some of my younger clients. But I will stay in my lane and consult the dog behaviour experts on this!

Why nostalgia is good for you

I was in Sheffield at the weekend, a city I lived in thirty years ago. Lots had changed but some things seemed the same. I met my husband there, and we went for a nostalgic drink in the pub where we first met (the Bath Hotel). So many good memories came flooding back.

The feeling of nostalgia is good for us. Researchers have found that nostalgic people are more optimistic and find greater meaning in their lives. Nostalgia feels like time travel. It can take us back to a mood, a feeling, an outlook. It can be evoked in many ways.

Professor Catherine Loveday researches the positive effects of musical nostalgia and finds the music we encounter during the ages of 10-30 has the most powerful impact. This is a formative period when we make a lot of life decisions and gain a clearer sense of who we are. I felt musical nostalgia when I went to see Pulp recently. By the end of the concert, I was bopping around like I was in my teens again.

The nostalgic state provides a valuable resource for wellbeing and a point of connection both with people we care about and with ourselves. And nostalgia can be practised rather than waiting for it to happen organically. Recent research* shows the positive impact of nostalgia-based therapy with people who are bereaved, displaced, or living with dementia. It was found to increase social connectedness and reduced intrusive thoughts.

Hypnotherapy clients often talk about how they want to feel (‘less anxious’, ‘more confident’, ‘more able to relax’). The solution focused approach encourages them to recall times these positive emotional states were present in their lives. This is not to be sentimental but to reconnect with positive inner states in a restorative way. Hypnosis helps to deepen this experience so that they can begin to make positive changes in their lives. Contact me to find out more.

*Tim Wildschut & Constantine Sedikides (2023) Benefits of nostalgia in vulnerable populations, European Review of Social Psychology, 34:1, 44-91, DOI: 10.1080/10463283.2022.2036005

#thebathhotelsheffield #nostalgia #nostalgiaisgoodforyou #hypnotherapy #manchester #renewal_hypnotherapy #didsbury #mentalhealthmatters

The Social Cure (why groups can be good for your health)

I read a great article yesterday by DJ/author Annie Mac about loneliness. She described how, in the ebb and flow of (post-pandemic) life, some friendship groups had splintered and a switch to homeworking had created an unfamiliar sense of loneliness.

Her story resonated with a book I have been reading recently. In the New Psychology of Health Catherine Haslam and colleagues explain the important psychological resources and sense of identity we draw from social groups. The book draws on research showing that being socially connected is associated with good physical and mental health. It is not social connectedness generally, but identifying positively with these groups that is associated with positive outcomes across a wide range of chronic health conditions (including stroke and heart disease) by providing people with more resources to cope with challenging life circumstances.

The benefits of group membership were previously thought by to be transactional in psychological terms: allowing for division of labour and providing safety in numbers. During the 1950-60s psychologists Milgram and Asch highlighted the negative social influence of groups on individual behaviour. In the 1970s Henri Tajfel (a holocaust survivor) began to show some of the positive influences of group membership on individual behaviour and identity. His research showed the minimal group conditions where people begin to identify with a group and show positive behaviour towards other group members.

Building on Tajfel’s social identity theory the book by Haslam and colleagues explains why people who are more socially connected have better physical and mental health. For example, a study of local football clubs in Australia showed that group membership (for players, supporters and volunteers) was associated with positive physical and mental health status, highlighting that it is psychological benefits of membership rather than the physical benefits alone.

Social identity theory helps to explain variations in how people experience stress. When we are socially connected, we appraise stressors differently. The question ‘can I cope with this?’ becomes ‘can we cope with this?’ and, at a physiological level, group belonging helps to regulate our nervous system, lower cortisol and reduce inflammation. The more groups a person belongs to the lower the risk of depression, whereas lack of social connections reduces our physical and mental resilience. A study of ‘frequent attenders’ of GP services showed that loneliness was a factor. These research findings are having an impact on health policy and there has been a rise in ‘social prescribing’. Nowadays GPs might prescribe joining a choir or a gardening allotment community as a way of managing health conditions such as chronic pain.

In her article, Annie Mac describes how she confronted her own sense of loneliness by gathering a group of friends for an in-person catch-up once a fortnight. In my therapy work clients often identify changes that have happened gradually (due to new working patterns or family commitments) that have eroded their social connections. The sessions help them identify ways to create new social connections and to benefit from the physical and mental wellbeing.

How exercise improves brain performance

“Spark: How exercise will improve the performance of your brain” by Professor John Ratey is an inspiring read.  I ‘skim read’ it a couple of years ago but read it again recently as we were discussing it at book group.  Andy Hill (@behypnotherapy) hosts the book group every couple of months and the discussions are fascinating as people bring so much expertise.  Hypnotherapy tends to be a second (or third) career for people, so we had early years specialists, nursing professionals, teachers, university lecturers and a professional athlete in the discussion.

One of the book’s key messages is that physical exercise alters our brain chemistry in a positive way.  We produce more dopamine, serotonin and norepinephrine through aerobic activity.  These neurochemicals reduce cortisol levels, improve signalling between brain cells and promote cell growth in the form of BDNF (a protein which builds and maintains cell circuitry).  Andy had a good metaphor for this. If we think of the synapses between brain neurones as the English Channel, then we are improving the travel routes from Dover to Calais but also improving the infrastructure of the ports so that more information can pass through.

Our brain structure and function are shaped by the way we are interact with our environment.  When we are stressed and anxious the amygdala (which is associated with emotional processing), becomes larger and denser.  When depressed, the hippocampus brain region (which is associated with context and memory) shrinks by approximately 15%. But these effects can be counteracted through exercise and Professor Ratey provides an inspiring chapter on the effects of exercise in reducing cognitive decline as we grow older.

In a way, exercise acts like a brain fertiliser by:

  • improving alertness and motivation
  • strengthening brain cells
  • increasing cognitive flexibility
  • acting as a circuit breaker (like a natural ‘beta blocker’)
  • activating the parasympathetic nervous system

Professor Ratey is well known for his books on Attention Deficit and Hyperactivity Disorder (and has ADHD himself). Research studies show the positive effects of exercise on improving attention, mental focus and regulating mood, particularly through exercise that is aerobic and includes complex motor skills (eg. tennis, taekwondo).

The key message in the book is that we should see exercise as a resource for improving mental fitness and resilience. Interestingly, everyone at the book group said they had increased their level of physical activity after reading ‘Spark’.  However, when chronically stressed or experiencing low mood it is not always easy to self-motivate and Hypnotherapy can be an effective method for overcoming subconscious mental blocks that can deter us from exercise.

Ratey, J (2009) Spark: how exercise will improve the performance of your brain.  Quercus.

Spark learning and creativity: SPARK by Dr. John Ratey – YouTube

Reading is good for your health!

Recently a client asked me for some book recommendations. This followed a conversation about how much they had enjoyed reading the novel ‘The Alchemist’ (Paul Coehlo) which I had read many years ago. We agreed that a good book can stir the emotions and provide lasting thoughts and insights on our own lives.

Recent research helps to explain how fiction can move us emotionally and affect our brain at a physical level. Research studies using EEG and fMRI brain scanning techniques show that we respond differently to narrative fiction than non-fiction due to the use of metaphor and imagery. Professor Philip Davies (University of Liverpool) has studied the effect of reading Shakespeare from a neuroscientific perspective. Brain imaging techniques helped to pinpoint the parts of Shakespeare’s writing that cause a gear shift (metaphorically) in the brain. The playwright’s use of ‘functional shifts’, the use of one part of speech to stand in for another such as when a noun is used in place of a verb – for example, ‘strong wines thick my thoughts’, produces a higher voltage in our brains.

The research shows that Shakespeare’s literary techniques activate not only the parts of the brain associated with routine language processing but also areas of the brain associated with emotion, empathy, creativity and search for meaning. His techniques, which were novel at the time, are now used by many other writers and have been found to activate the brain’s default mode network which is associated with autobiographical thinking and creativity. It seems that fictional stories push the brain beyond habit-based, literal thinking and stimulate the imagination. The evidence is growing that both reading (and listening to) fiction is a good way to enhance social skills and foster empathy which is great news for bookworms!

In solution focused hypnotherapy we use metaphor in various elements of the session which can help clients identify deeply-held personal narratives that can be negative and constraining and to reframe in more positive and constructive ways.

It took me a few days to mull over book recommendations for my client. It made me realise I have been reading more non-fiction lately and I now feel eager to get back to stories. Here is the list I sent my client of memorable books which have taken me through the full gamut of emotions over the years and found a lasting place in my thoughts:

A Fine Balance (Rohinton Mistry)
One Fine Day (David Nicholls)
The Art of Fielding (Chad Harbach)
Wolf Hall (Hilary Mantel)
The God of Small Things (Arundhati Roy)
100 Years of Solitude (Gabriel Garcia Marquez)
Number 9 Dream (David Mitchell)
Hamnett (Maggie O’Farrell)

*Source: Comer, C & Taggart, A (2021) Brain, mind and the narrative imagination. Bloomsbury

Future Tense:  Why anxiety is good for you (even though it feels bad) (Dennis-Tiwary, 2022)

Future Tense:  Why anxiety is good for you (even though it feels bad)

Tracy Dennis-Tiwary (Littlebrown, 2022)

This fascinating book by Tracy Dennis-Tiwary (Professor of Neuroscience and Psychology) traces the history of anxiety and identifies factors influencing the high rates we are seeing nowadays.  According to recent figures, in any given year 18% of teenagers in the USA will suffer from an anxiety disorder*.  This high prevalence is partly explained by the increasing medicalisation of anxiety, the ways anxiety is defined in current psychiatric classification models and the increased use of pharmaceutical treatments.

Dennis-Tiwary draws on wide-ranging evidence to challenge the medicalisation of anxiety.  This medical perspective can cause us to miss the constructive role anxiety can play in bringing about change in our lives and developing resilience.  Dennis-Tiwary draws attention to how anxiety can motivate and energise.  Studies show that we are more creative and innovative when ‘activated’ regardless of whether this is in a positive or negative way (ie. angry, anxious or joyful).  From this perspective, anxiety can be seen as an important communication which helps us to mobilise and take action.

There is a lot of criticism of the negative effects of social media as a contributor to anxiety.  Tiwary reports on a series of studies which shed light on this issue.  Negative effects appear to be reduced when we are using social media in active rather than passive ways (avoid the doom scrolling and endless social comparison!). Research also shows how our uses of social media for connection and social support are changing.  In an experimental study with teenager girls, access to text communications with a close family member while doing stressful tasks activated the social bonding hormone (oxytocin) which helped to reduce anxiety.

The pandemic provides further evidence of our resilience in dealing with anxiety. Surprisingly, anxiety levels for young people did not spiral upwards as anticipated.  Two large-scale international studies tracking anxiety rates in teenagers during the pandemic showed that rates of anxiety remained stable and 41% reported feeling happier during lockdown.  This is partly attributed to fewer stressors and social demands but also by the fact people were able to find practical ways to alleviate anxious feelings.

Tiwary encourages a re-conceptualisation and locates anxiety mid-way on a spectrum between optimism and pessimism. Anxiety animates us because we feel we can do something about the situation. She encourages us to see anxiety as the ‘secret sauce’ that can lead to constructive action. Her overriding message is not to fear anxiety but to see it as an important mind-body communication.  The question of how to eliminate anxiety is misguided.  It is more helpful to become curious about what is motivating anxiety and direct our attention to what we can do.

A client recently described to me how the relationship with his anxiety ‘completely changed’ after experiencing an episode of panic. When we feel this way about anxiety it can cause us to avoid more and more situations to try and prevent the feeling re-occurring.  The main focus of hypnotherapy is in helping clients develop techniques and strategies and to recognise how they can respond to anxious feelings in constructive ways.


The Joy of Living……

‘If you truly want to discover lasting peace and contentment you need to learn to rest your mind.’  (Yongey Mingyur Rinpoche)

I came across this wonderful book thanks to a chance conversation with someone at my choir (thanks Ian!).  Yongey Mingyur Rinpoche is a Tibetan Buddhist Master and his book offers a fascinating fusion of western and eastern thought. He brings neuroscientific understandings of the brain within a framework of Buddhist philosophy and shows that there is great deal of convergence.

For the past 20 years he has collaborated in a research project with neuroscientists at University of Wisconsin at Maddison to explore the effect of mindfulness and meditation practices on the brain. During meditation neural activity in the brain area associated with empathy and positive emotion increased 700-800 per cent for Yongey Mingyur.  For a control group, who were all new to meditation, the average increase was only 10%.  The research work is underpinned by mutual respect and a genuine dialogue between eastern philosophy and western medicine.  Neuroscientist Francisco Valera, co-founder of the Wisconsin’s Mind and Life Institute was a student of Buddhist practice under Yongey Mingur’s father.

In the book Yogey Mingyur Rinpoche shares his own story of the debilitating anxiety he suffered as a child and how he learned to overcome this anxiety through techniques of mindfulness and meditation.  He dispels many of the myths around meditation with a great deal of warmth and humour

The book offers a compassionate understanding of how the mind operates when stressed and in fear-based, survival mode. The author shares a powerful insights and techniques from Buddhist practice on how to relax the ego, reduce the fear response and foster compassion towards self and others.

I found this book fascinating and incredibly hopeful.  There are wonderful metaphors which I have incorporated into my practice as a therapist.  It shows how these fear-based responses can be over-ridden through focused attention and contemplation and the positive impact this can have at a physical level.





Can you see an angry face?

It’s been thought for a long time that there are some emotions we all experience no matter where we come from but recently that idea is starting to change.

The common research approach had been to show people photos of faces displaying emotion (like these pictures) but it seems that there are some biases in this way this research tool has been used.

Recent research described in Professor Lisa Feldman-Barrat’s fascinating book suggests that emotions are shaped by language and culture much more than we used to think.

The way we talk about an emotion like anger varies a lot. Russian speakers have two different words to refer to ‘anger at a person’ and ‘anger at a situation’. German speakers have three different words to describe the concept of anger and Mandarin speakers have five!

In Micronesia emotion is expressed not as an individual experience but as an interaction between people. The Himda tribe in New Guinea express emotion as a behaviour rather than a feeling. This diversity shows that we have can have more control over our emotions than we often think.

As a hypnotherapist I support many clients in understanding and regulating their emotions more effectively. Contact me to find out more.

Reference: Feldman-Barret, L (2018) ‘How emotions are made: the secret life of the brain’ (2018).

#angermanagement #stressrelief #emotionaregulation #mentalhealthmatters #solutionfocusedhypnotherapy #renewal_hypnotherapy #manchester

The Power of Positive Thinking?


These days we hear a lot about the power of positive thinking.  Magazines, adverts and self-help books encourage us to follow our dreams and ‘dream big’, implying that positive visualisation will energise us to fulfil our goals.

In 1991 Gabriele Oettingen published findings which challenged this assumption.   Her research with people enrolled on a weight loss programme explored how much they wanted to lose weight and how likely they felt they were to succeed. One half of the group were also asked to consider potential obstacles to achieving their goals.  Follow up 12 months later showed that focusing only on the goal hindered positive outcomes but focusing both on goals and obstacles increased the effectiveness of the programme.

The initial research findings have been replicated through experimental studies pain management, smoking cessation, career coaching and exam preparation and have drawn on innovative research techniques. In recent studies the research team have recorded systolic blood pressure readings to reveal how energised and motivated a person is before and after visualising a positive scenario.  It has been found that daydreaming results in reduced blood pressure, indicating that we can become less energised by our positive visualisations.

Oettingen suggests we can dream ourselves to a standstill as we can experience a short-term benefit from positive visualisation.  We relax and ‘fool ourselves’ into thinking we have achieved the goal (however briefly).  Her research over the following decades indicates that dreaming about the fulfilment of goals can have undesired effects. Rather than galvanising us for action, positive visualisation can reduce our motivation at a practical level.

The solution isn’t to do away with dreaming, according to Oettingen, but to bring a little bit of structure to the process.  ‘Mental contrasting’ describes a simple three-step process: visualising accomplishing a desired goal, anticipating obstacles which might interfere, and to forming a specific plan to deal with the obstacle.

Many approaches to behaviour change (eg. exercising more, eating better) rely on changing attitudes, values and beliefs.  The mental contrasting approach works differently by bringing together wishes and imagined obstacles.  The aim is to integrate goals and solutions, bring the future and present reality together and to draw on the subconscious mind.

Oettingen’s findings enhance understanding of human motivation and how to achieve change.  As a tool, mental contrasting can help in re-assessing and refining goals and in anticipating and overcoming specific obstacles.  As a self-help guide, Oettingen’s book offers practical exercises to apply this method in everyday life to short term and longer-term goals.  Therapeutically, the book offers a valuable framework for support.