Changes In Treatment Approaches For PTSD


Below is an article taken from the APA website that I find extremely interesting and reassuring that the military is not restricting themselves to CBT and EMDR in treating serving personnel struggling with PTSD.

A psychodynamic treatment for PTSD shows promise for soldiers
March 2012, Vol 43, No. 3
Print version: page 11

PTSD
While cognitive-behavioral therapy remains the most well-researched treatment for post-traumatic stress disorder, it doesn’t help all patients. That’s especially true for service members who have been perpetrators as well as victims of violence, says Russell B. Carr, MD, an Army psychiatrist.
“It’s a much more complicated experience, and they often feel a lot of shame in addition to the usual PTSD symptoms,” he says.

For the past six years, Carr has been working with soldiers who haven’t responded to cognitive-behavioral therapy, and he’s developed a new treatment rooted in intersubjective systems theory. This modern take on psychoanalysis pioneered by Robert Stolorow, PhD, posits that the heart of trauma is shame and isolation.
Carr’s therapy, described in the October 2011 issue of Psychoanalytic Psychology, has shown promise helping soldiers who haven’t responded to CBT by addressing the existential dread dredged up by trauma, and the feeling that their entire world has lost meaning. Though Carr’s goals are ambitious, his intervention is relatively short—requiring twice-weekly sessions for up to three months. As a result, the therapist must clearly define goals, keep conversations on track and quickly establish rapport with clients, Carr found.

Short-term therapy—which is typical of CBT, but less common with psychoanalytic approaches—is often the only option in military settings, he says.
“In the military, there is frequently the situation where a patient or therapist is leaving soon,” says Carr. “It’s a transient population, and it limits the length of time we have to work together.”

A key part of intersubjective therapy is helping clients put their feelings around traumatic experiences into words. These feelings aren’t always negative. One patient described in the article found he enjoyed the smell of burning human flesh, and was later horrified and ashamed of his initial reaction. By expressing empathy and not rejecting the soldier, Carr helped the soldier process the experience and reconnect with the civilian world.

Convincing soldiers that a therapist—as well as friends and family—can understand a little of what they are going through lessens their PTSD symptoms, Carr found. In some cases, soldiers even learn from the experience, he says. “Recognizing the fragility of life, you can refocus on what’s important to you, and not waste time on things that aren’t.”
—S. Dingfelder

Mind-Body Matters Series Video #3: How To Set Effective Goals To Set you Up For Success


Welcome to the third instalment in the Mind-Body Matter Series.This one does what it says on the tin, it’s all about how to set goals so that you can be more effective in the process and be more successful at what you want to achieve.

I have just updated a free ebook all about how to create effective goals that set you up to succeed, all you have to do is click on the link and download your free copy.

It has exercises in it that help you out the theory into practice and if you get stuck just drop me a message and we can arrange a time to chat through it and get you moving again.

How To Set Effective Goals To Set You Up For Success

Once you’ve worked your way through the workbook and completed all the exercises, drop me a message and let me know how you got on and if I can help you in any way.

Have fun with it.

Simon

 

Reframing Your Resolutions for Success


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Have you ever been your own worst critic, especially at this time of year when it comes to your new years resolution about losing that fat that’s crept up on you and got you in that immovable bear hug? How many times have you made that same resolution, made some progress then got distracted, injured, fed up, pissed of, bored, confused with all the hype and bullshit out there and then completely de-motivated?

Trying harder is often not the solution. Making resolutions from a place of mixed emotions such as guilt, shame etc, and from a state of confusion will always end in failure. The way to make a resolution that will actually work is to let all that negative shit go for a while and work on forgiving yourself for being where you are and accepting you for who you are right now. Once you reach this point you can dive back in to pursuing what you desire for yourself. But if you want to succeed, it has to come from a place of compassion.

I don’t like using the word goal these days, it’s far too corporate, clinical and not particularly motivating. I much prefer the word desire. When you focus in what you desire it generates very different emotions, feelings and thought processes and these are much more capable of developing the behaviours and habits that will get you tow what you desire.

Now I am very well aware that this may be a completely alien concept to you and that you may feel that this is easier said than done. Finding self-compassion can be quite a challenge at first, particularly if you are used to kicking your own arse when you don’t achieve what it is your set yourself, and the idea of forgiving yourself for being in the same situation time after time seems ridiculous. Yet while it might take a lot more self-reflection and exploration than counting calories and drinking green juices, compassion and forgiveness are the hidden keys to successful achievement in any area of your life. Here’s a few top tips.

1. Be compassionate towards yourself and find acceptance of where you’re at.
Begin by identifying the area where you’re stuck or dissatisfied in your life and approach it with compassion. This step can be difficult for people who feel sure that shame about their weight was the only thing standing in the way of gaining more weight.

It takes a lot of courage, patience, and self-reflection to release and reframe the belief that self-shaming is helping you stay in control. If you’re struggle with this, I strongly encourage you to honestly examine how that tactic has worked for you so far. Has it really helped you reach your desired result? If your answer is no, then are you ready to try something new?

2. Cut yourself some slack and forgive yourself.
Once you’re able to embrace compassion instead of shame, it’s time for the most important step: Explore ways that you can reframe your situation and forgive yourself for being where you are right now. While reframing looks different for everyone, it can sometimes be painful and anchored with emotional baggage. Be prepared to face your demons and don’t be afraid to reach out for support during this phase.

Reframing in this context requires two things: acceptance of the objective facts and willingness to subjectively reframe those facts in a more self-loving way. People often think they’re accepting the facts when they apply guilt and shame for where they’re at, but they’re not.

First of all be crystal clear about the actual facts. Separate your subjective stories (for instance, “I’m lazy and need to get in shape”) from the facts (“This is my body today”) and work to accept the literal truth of where you are. Don’t be surprised if your objective list is short: You are here, in this body, right now. Try looking in the mirror every morning and repeating to yourself, “This is what I look like today.”

You also need to reframe the subjective stories you tell yourself about how you got here, why you’re here, and what that means about who you are. The story you’ve believed so far is entirely subjective, it is just the reality that you’ve created to justify it to yourself, and must be rewritten to be kinder and more self-loving. It can be helpful to talk to people who love you. Tell them what you’re working on reframing and ask for their help.

3. Ask yourself, “What if this were a gift?”
I know this sounds completely mad, how could an extra 20 pounds be a gift? Bear with me here for a moment as you search for the gift in your struggle. You might be surprised to find that staying stuck has protected you from something you weren’t yet ready to handle, or that the change you’ve been trying to make actually goes against one of your highest values. Do you know what your core values are? Check out my free PDF that will take you step by step through the process of figuring them out.

How To Achieve Your Desired Goals

How to Feel Great Even When You’ve Gained Weight
After weeks of contemplation and journaling, a client of mine came to me one day with an answer to that question. She told me that the extra weight she carried protected her from unwanted male attention, and that she was absolutely terrified of what would happen if she lost it and became (in her words) “traditionally attractive.” She also said that other women saw her as non-threatening, because she wasn’t skinny. The weight had helped attract a great number of kind and supportive women into her life. In short, those 20 pounds truly were a gift, and her subconscious was reluctant to part with them.

This is how rewriting your personal story gives you the opportunity to forgive yourself. Mt client began to see that no matter how hard she tried to lose weight, she was always going to fail, because she valued safety and connection too highly.

No matter what your guilt ridden resolution might be, I assure you there is a very good reason you haven’t accomplished it, yet. There always is. Once you find that reason, you will also find compassion and forgiveness and be able to see what really needs to be done in order to move forward. For my client, that work meant learning to feel comfortable and safe in her own skin, healing from an old trauma that made her believe male attention was dangerous, and trusting that losing weight wouldn’t drive away the female connections she valued so deeply.

Compassion and forgiveness aren’t only useful for getting you unstuck; you can also use them to help you set goals from the get-go. Ask yourself what gift your habit has been and offer yourself a replacement before attempting your goal.

Take smoking as an example. If smoking offers you stress relief and common ground with friends, you’re going to need to adopt some new habits to fight stress and social awkwardness before your subconscious will let go of smoking.

By goal-setting from a place of compassion, forgiveness, acceptance and understanding, you’ll be armed with the right tools that you need to actually succeed and achieve what you desire.

If you’re still struggling with reframing then by all means get in touch with me and we can figure it out together, just drop me an email on simon@simonmaryan.com to arrange a time.

Simon

How We Encode Our Success or Failure with Our Thinking


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“You can map out a fight plan or a life plan, but when the action starts, it may not go the way you planned, and you’re down to your reflexes – that means your [preparation:]. That’s where your roadwork shows. If you cheated on that in the dark of the morning, well, you’re going to get found out now, under the bright lights.”

Joe Frazier

Today that quote is proving invaluable to me because today is proving to be a challenging day, and for no clear conscious reason as yet. I woke up in the middle of the night last night, not from a nightmare or any dream that I can remember but with an ominous feeling of what I can only describe as dread. I didn’t sleep much after that and lay there in bed with my heart racing until my alarm went off.

The day so far has been spent wrestling with my mind as the darkness that I lock away tries to overwhelm me and, I know that I will win this battle today.

Now why am I telling you this?

Well I know that there are many people out there who have had, and likely will have similar experiences to this, it’s a natural part of life.  I am a highly positive person and I am also very well aware as a psychologist what is happening. My life has been full of unusual experiences, some fun and some terrifying and exhilarating. This mixture of positive and negative experiences are all part of who I am and sometimes the negative takes over and leads me towards a path I do not want to tread because it is dark, threatening and dangerous. This path is virtually impossible to brighten as it seems to absorb all light like a black hole encompassing anything and everything.

I am grateful that I have learned to side-step off that path early on and use what I have learned and keep myself focused on what I do want; how I do want to think, how I do want to feel and remain focused on those things no matter how exhausting that can be at times like this.

It’s extremely difficult to explain to someone that has never had this kind of experience because it’s not something you can see, or touch or hear, it is a purely kinaesthetic experience. This is purely thoughts and feelings that create the mental state and this intangible element is hard for some to grasp.

There has been a huge amount of research over the years into how our mindset; our thoughts, feelings, language and behaviour, and how that affects our physical health as well as our mental health, and a field of science called Epigenetics grew from it and has shown that our beliefs can affect us at the cellular level.

One of the best-researched books about our language and responses to both positive and negative events in life is Learned Optimism by Dr. Martin Seligman. In a 25-year research study, Seligman proved that our mindset, manifested in our language and behavior, is a predictor of our success. In other words, what you think and say (your words and language) is proven to manifest in your life.

I continue to be baffled by individuals who wonder why their life is a mess when their entire mindset is defeatist and pessimistic. They are blind to their own undoing.

Seligman proved that how we respond (think, say, do) to our circumstances, both successes and failures, directly correlates to our accomplishments in life. Someone might argue that it can’t be that simple, but from Seligman’s research, it is.

To push your thinking limits even further, Dr. Bruce Lipton, author of The Biology of Belief, has confirmed that our thoughts can actually adjust our DNA, at minimum, how our DNA decides to respond to different stressors or events. Contrary to popular understanding, it is not your genes that predict your predisposition to your health condition, but rather your thoughts that act on your genes.

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Your thought life is highly influencing your condition in your life, including, but not limited to, your health, relationships, career, and achievements. Understand that regardless of your background, Personal Style, personality, or environment, you can learn optimism, measure it, and teach it to yourself and others.

If we are going to live our lives on purpose with passion, it is going to take resilience and mental strength and those who give up easily are generally pessimistic in their mindset. They get caught in a cycle of hopelessness, and can’t see their way out of their troubles or challenges. However, optimistic individuals face identical roadblocks and they overcome them to realise their own success and victory.

There are three principles or factors that comprise the primary work for Dr. Seligman’s optimist and pessimistic framework.

  1. Permanent vs. Temporary
  2. Specific vs. Universal
  3. Personalisation (internal vs. external) Elements

1. Optimistic Mindset Item One: Permanent vs. Temporary
Failure makes everyone at least momentarily helpless. However, those who are optimistic bounce back almost instantly. Those who are highly pessimistic remain helpless for days or perhaps months, even after very minor setbacks.

2. Optimistic Mindset Item Two: Specific vs. Universal
The optimist believes that bad events have specific causes, while good events enhance everything they do; the pessimist believes that bad events have universal causes and that good events are caused by specific factors.

3. Optimistic Mindset Item Three: Personalisation: Internal vs. External
When bad things happen, we can blame ourselves (internal), or we can transfer fault to circumstances (external). People who blame themselves when they fail have low self-esteem as a consequence. They think they are worthless, talent-less, and unlovable. People who blame external events when bad events happen do not lose self-esteem when negative events occur. Overall they like themselves better than those who blame themselves. The optimistic style of explaining good events is the opposite of explaining negative events. It is internal, rather than external. People who believe that they cause good things to happen tend to like themselves better than people who believe that good things come from other people or circumstances.

The Importance of Hope
Whether we have hope depends on two dimensions of our explanatory style (the words and responses we use): pervasiveness and permanence. Finding temporary and specific causes for misfortune is the art of hope – temporary causes limit helplessness in time, and specific causes limit helplessness to the original situation. On the other hand, permanent causes produce helplessness through all our endeavors. Finding permanent and universal causes for misfortune is the practice of despair. People who make permanent and universal explanations for their troubles tend to collapse under pressure, both for a long time and across situations. In Seligman’s work, no item is more important as your levels of hopelessness or hopefulness.

It’s important to remember the three principles of Dr. Seligmans’ optimistic and pessimistic mindsets; how they apply to your life, and why being conscious of them will help you avoid (and reverse) the cycle of despair and hopelessness. Living a life On Purpose, by definition, is a life full of HOPE. When life throws you a curve ball, where does your mind take you? Are you a glass half-empty or glass half-full kind of person? Your answer matters, To You.

“Each of us has two distinct choices to make about what we will do with our lives. The first choice we can make is to be less than we have the capacity to be. To earn less. To have less. To read less and think less. To try less and discipline ourselves less. These are the choices that lead to an empty life. These are the choices that, once made, lead to a life of constant apprehension instead of a life of wondrous anticipation.  And the second choice? To do it all! To become all that we can possibly be. To read every book that we possibly can. To earn as much as we possibly can. To give and share as much as we possibly can. To strive and produce and accomplish as much as we possibly can.”

Jim Rohn

If this post helps just one person today then it has done it’s job and if you feel you want or need to talk in more detail then please get in touch.

Here’s to your mental strength and success.

Simon

Life Design


For a long time I thought I was happy with my job, I was doing what I’d set to do in joining the Royal Marines. I worked with like-minded people, got paid to stay exceptionally fit, got fed four times a day and was provided with a roof over my head. The trade-off was that I was expected to do what I was told do whether I liked it or not and, some of the things I was asked to do I really didn’t like. However I was still happy living my dream.

Or so I thought.

Continue reading Life Design

The Language of Success


Now I realise that this may sound a little odd to some of you, but often, “trying harder” doesn’t always make things better or solve your problems. Sometimes you need to do something radically different to in order achieve your goals.When you find yourself stuck in one spot for too long you often need to break out of your comfort zone or pattern of behaviour in order to get to where you want to go.


This is the case with many things including work, relationships and also your physical fitness.

Whats really interesting (and encouraging) is that this does NOT always mean working harder.

Now don’t get me wrong, I’m not suggesting you don’t need to work hard to achieve your goals, in fact, if the goal/s set yourself are enough of a stretch then you will have to work hard for sure, you will also have to work smart too. I love the quote from Gary Player, the golfer renowned for being able to get himself out of trouble with consummate ease, when he overheard a guy in the crowd say, “he is so lucky” and Gary Player replied, “It’s funny, the more I practice the luckier I get.”

It’s just that sometimes working harder is not the right answer to being successful, sometimes we just need to work smarter.

Not everything can be fixed with a hammer, no matter how hard you swing, sometimes you need a different tool.

Over the past two decades I have worked with thousands of people both online and in person and along the way I have discovered little words/phrases that can pretty much predict a persons success or failure.

In fact, whenever I hear these words I can pretty much guarantee that the person saying them will not be successful.

These words are:

  • I’ll try to get the work done.
  • I’ll try to make healthy food choices.
  • I’ll try to start exercise or exercise more often.
  • I’ll try to get to bed earlier.
  • I hope so.
  • I hope I can do it.
  • I hope I can achieve that.
  • I hope I’ll make it.

Words and phrases like this tend to lead us to presuppose that we will fail and that we don’t really believe that we can achieve, so when we don’t we aren’t too disappointed. In essence we set ourselves up for failure.

If these are your answer to ANYTHING that you know you must do in order to achieve your goal, then I suggest you revisit just how important your goal is to you and listen to the kinds of words and phrases you use and write when talking about your goals.

Small changes in how you think, speak and write can make a huge difference to your ability to succeed.

I want you to succeed and I know that you can when you set your mind on the track from the beginning.

Here’s to your success.

There’s More to Maintaining Your Ideal Body than Just Input and Output


For some reason, even with all the science and information available out there, diet and exercise are still the main focus of attention when it comes to fat loss. The thing is as important a part as they do play in the process, it’s just not as simple as “burn more calories than you consume.” I still meet people on a regular basis who live by this misguided rule, now I’m not saying it doesn’t work, however, it generally only works in the short to medium term, not indefinitely. It’s an outdated model because there’s so much more to fat loss than just diet and exercise.

During my research and development for my book I discovered a number of things that, when factored into your fat loss and maintenance programme, make a huge difference in your ability to achieve and hold onto your desired outcome. So here I want to share with you four key elements that I drill into all my clients from day one to ensure that they continue to make progress.

Sleeping Baby

1. Quality Deep Restorative sleep. Sleep Like a Baby.
Now I know some of you may be thinking, what is he on about, sleep is sleep. Well there is a big difference and there is a common misunderstanding about sleep, and that is how much do we need and also that it should be constant sleep throughout the night. When we sleep we go through different depths during a 90 minute cycle called the ‘Ultradian Rhythm’. What this means is that we drift off into a light sleep, drop down into REM or Dream Sleep and then into Deep Restorative Sleep and this is where your brain and body recharge, repair and restore themselves. Without this quality deep restorative sleep we can wake up more tired than when we went to bed because we have been dreaming too much and never getting into that deep sleep. When we remain in that light sleep and REM sleep states we can be interrupted by our dreams and by outside noises that bring us up into conscious awareness and break that natural sleep pattern. I want you to understand that this is a normal part of the cycle and it is why we don’t have 7-8 hours of completely uninterrupted sleep, we wake up and go back to sleep a few times throughout the night. What is really important is that we go into the Deep Restorative Sleep state and recharge, repair and restore. This is why sleep is one of the first things I discuss with a new client, because it really is that important.

If you’re really serious about optimising your health and/or losing fat, then you really need to pay more attention to your sleep patterns and habits and make changes here first before doing anything else in order to get maximum benefit from your training and nutrition.

If my client’s fat loss stalls and/or they’re losing momentum and energy, I don’t start analysing their nutrition plan or increasing their exercise frequency or intensity. I look at their sleep quality and quantity, and their chronic stress level to see where we can make some changes.

As a society we are chronically sleep-deprived and over-stressed. Individually these elements can cause severe health problems and hinder fat loss. When you combine them they are disastrous for your overall health and your fat loss goals

Have you noticed that when you are exhausted you feel hungrier than usual? This is not your imagination. Not getting enough sleep affects leptin and ghrelin, which are  your hunger hormones.

A consistent lack of sleep will make you hungrier and much more impulsive, and you will have an almost insatiable craving for high-carbohydrate foods. This makes avoiding the muffins and cakes at the coffee shop or turning down the bacon rolls at the office a nearly impossible feat. Being chronically sleep-deprived also significantly elevates your cortisol levels  and insulin resistance and this affects your fat loss and your overall physical and mental health.

If this doesn’t make you want to go to bed a bit earlier, another reason is that adequate sleep is also crucial for cognitive function, maintaining a positive outlook, and having a steady supply of energy so that you can keep up with your kids, run around with your dog, lift heavier weights, run faster/longer and all the other active things you love to do.

Reflective Questions:
• Am I getting quality deep restorative sleep each night within an average of 7 hours sleep?
• If not, what am I prepared to change to ensure I get that quality sleep? (For example: Stop watching TV in bed. No phones, kindles, iPads etc in the bedroom at night to avoid the temptation to stay up interacting with social media)

Train Smart

2. Don’t Train Harder, Train Smarter. That Includes Variety.
When I was serving in the Royal Marines, particularly during basic training, I couldn’t eat enough because the amount of physical exercise was phenomenal. It was almost impossible to consume enough calories in a day to match my output. The same thing happened when I was racing in Triathlons, the problem was that it increased my appetite so much that all wanted I to do was eat and sometimes I simply didn’t have the time.

I finally understood a few years ago that high-intensity, steady-state exercise is not the best model for me, it turns me into a black hole for food. It was potentially far too easy for me to “out-eat” my training, which meant I was breaking even at best and running myself into the ground.

I recommend to my clients applying the Minimum Effective Dose Model to their training. Meaning, I totally understand that you love exercise and it’s important that you do just enough to elicit the desired results while keeping your hormones happy and your appetite in check.

For most people (who train regularly), this typically means two or three heavy strength-training days, one or two short-duration HIIT (high-intensity interval training) sessions, and no more than a couple of moderate-intensity, steady-state cardio sessions per week.
Getting too aggressive with exercise and doing an obscene amount of cardio, spending hours in the weight room each day, or doing two-a-day training sessions can lead to a voracious appetite, run down your immune system and lead to overtraining, which I’m guessing is probably not in line with your goals.

Reflective Questions:

  •  Is any type of exercise that I’m doing increasing my appetite to the point that it may be sabotaging, instead of supporting, my goals?
  •  What kind of exercise can I do instead to see how that makes me feel? (Example: Instead of running for 45 minutes, how about trying 15 minutes of intervals? Instead of that 60-minute Spin class, how about breaking it up into two 30-minute moderate-intensity cardio sessions throughout the week?)

Healthy eating

3. Eat Food That You Enjoy, Is Nutritious and Fills you Up.
When you think of fat loss, do you think it means eating the same boring foods, every day? Chicken breast, sweet potato, broccoli, egg whites, oats, and protein powder, day in and day out?

This absolutely can work because there’s nothing nutritionally wrong with it, in fact it’s full of great nutrients. What I can promise you is this. It won’t work for long, unless you actually love to eat like this and truly feel satisfied. Generally we can only tolerate so much bland, boring food that we don’t necessarily enjoy before we frantically wave the white flag and dive into a pile of junk food, never to return to it again…until the next time we want to lose fat!!

The key to making  your nutrition a sustainable part of your lifestyle is to ensure that you love what you’re eating. You have to enjoy your food in order to be satisfied and for me food is meant to be enjoyed. If you force down a meal that you hate because someone told you or you read somewhere that this is the way to lose fat, there is a high probability that you’ll be raiding your cupboards and fridge afterward for something to satisfy your palate.

Emjoy your meal

Fortunately on the Internet, there are millions of recipes right at your fingertips. While it may take you 20 minutes to bake a week’s worth of bland chicken breasts, it would only take you an additional few minutes to whip up a tasty sauce for them, try a new seasoning blend, or another way of cooking them. You can bake, broil, roast, slow cook, grill, steam, or sauté your food into an explosion of flavour with just a tiny bit more thought and effort. Trust me, it’s worth it.

Reflective Questions:

  • Am I currently eating foods I can’t stand but eat them anyway because I feel like I’m “supposed” to?
  • What can I do to those foods, or what can I substitute, to make eating an enjoyable experience again?
  • Can I spare an extra 20 minutes per day to improve the taste of my food? ( The answer is yes by the way.)

4. Choose the Right Form of and Amount of Cardio.
Cardio is a funny thing. For a while, it’s all many people wanted to do. Thankfully, times have changed and in particular, women have embraced the empowering feeling and advantages of strength training. The only downside to that is that cardio has started to get kicked to the curb to a degree. Cardio, like most forms of exercise, can be a wonderful tool when used correctly.
Is cardio necessary for everyone who wants to get leaner? Not really. But if you find that you’re a bit stuck, incorporating a couple of sessions per week could help.

Moderate-intensity, steady-state cardio is a way to burn calories, sure. More importantly, it improves work capacity, which can mean improved training. It can also aid in recovery from your strength workouts.

This is not a pass for a cardio free-for-all. Whatever form of cardio you choose, please make sure you’re doing the type that keeps stress low and your hunger under control.

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Reflective Questions:

  • What kind of cardio do I enjoy most? Walking, biking, cycling, swimming, rowing, running?
    Can I spare 20 minutes 2-3 times a week to incorporate some moderate-intensity cardio?
  • Am I prepared to do fasted cardio (train before eating to boost your fat burning capabilities) in the morning?
  • How did that cardio make me feel? Do I feel in control of my appetite? Do I feel energised? If the answer to those questions is yes, stick with it for a few weeks and see what changes you notice.

As you can see, when it comes to fat loss, there is more to the equation than simply restricting food intake and doing more exercise. If you find yourself stuck and not making any progress, take a look at these four things and see if making a few changes can help push you forwards and out of your rut.

As always, making changes in  your body begins with making changes in your brain in terms of how you think about and perceive all the different elements required to achieve your aim. Without starting with your brain and mind, you are almost certainly going to fail backwards at some point and have to start again and fall foul of the Yo-Yo process that millions of us get trapped in year after year.

One last but important note: Once you make a change, stick with it for at least four weeks, and then evaluate your progress before making any more changes.

For more advice and to find out about my Lifestyle Coaching Program that works your from the top down so that you make the changes in your brain/mind first setting you on the right path, with the right mindset right from the beginning, you can email me directly  at simon@simonmaryan.com

Have a fantastic weekend

Simon

Hypnosis and Cancer


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There is a huge body of research into the use of hypnosis with cancer patientsAs with many types of complementary therapy, one of the main reasons people with cancer use hypnotherapy is to help them relax and cope better with symptoms and treatment. Hypnotherapy can help people to feel more comfortable and in control of their situation.

People with cancer most often use hypnotherapy for sickness or pain. There is some evidence that hypnotherapy helps with these symptoms. It can also help with depression, anxiety and stress.

Some doctors and dentists have training in hypnotherapy. They may use this alongside conventional treatments such as chemotherapy or radiotherapy.

Research into Hypnotherapy in People With Cancer
Some reports show that hypnosis can help people to reduce their blood pressure, stress, anxiety, and pain. Hypnosis can create relaxing brain wave patterns. Some clinical trials have looked at how well hypnotherapy works for people with cancer.

Research has looked at the following areas:

Hypnosis and Cancer Pain
A report from the American National Institute for Health in 1996 stated that hypnosis can help to reduce some kinds of cancer pain. A large review in 2006 looked at using hypnotherapy to control distress and pain from medical procedures in children with cancer. The review found that hypnotherapy did seem to help to reduce the children’s pain and distress, but it recommended more research. You can look at this cancer pain review on the Research Council for Complementary medicine website.

In 2012, researchers in Spain again reviewed studies of children with cancer and found that hypnosis appeared to help reduce pain and distress from cancer or from medical procedures.

Hypnosis and Sickness
A large review in 2006 looked at research into hypnotherapy for feeling or being sick from chemotherapy. Most of the studies in this area have been in children. Overall, the studies did show that hypnotherapy might be able to help with chemotherapy sickness in children. There has only been 1 study looking at hypnotherapy for sickness after chemotherapy in adults, so we need more research into this. You can look at this cancer and sickness review on the Research Council for Complementary medicine website.

One study found that hypnosis can help to reduce anticipatory nausea and vomiting. Anticipatory nausea or vomiting happens when people have had nausea or vomiting due to cancer drugs and they then have nausea or vomiting just before their next dose.

Hypnosis and Hot Flushes
A clinical trial in America in 2008 found that women having breast cancer treatment who had hypnosis had fewer hot flushes and the flushes were less severe. The women also had less anxiety, depression, and interference with daily activities, and better sleep.

Hypnosis and Breast Cancer Surgery
A study in 2007 in America gave hypnotherapy to a group of women before breast surgery. The researchers found that hypnotherapy lowered the amount of pain, sickness, tiredness and upset that the women had after surgery. Another American study in 2006 found that hypnotherapy helped to lower anxiety and pain during a biopsy for suspected breast cancer.

Hypnotherapy for Symptom Control in Advanced Cancer
In 2005 researchers carried out a review of studies into hypnotherapy for treating symptoms in people with advanced cancer. There were 27 studies but all were small or of poor quality. So it is not possible to tell whether hypnotherapy can help people with advanced cancer. We need research to find this out and this research below goes a long way in helping medical science discover ways to treat and alleviate the symptoms of cancer.

 

Study 1: Cancer and Hypnosis – 2013 Overview

Hypnosis for cancer care: Over 200 years young
http://onlinelibrary.wiley.com/doi/10.3322/caac.21165/full

Notes: Hypnosis has been used to provide psychological and physical comfort to individuals diagnosed with cancer for nearly 200 years. The goals of this review are:

1) to describe hypnosis and its components and to dispel misconceptions

2) to provide an overview of hypnosis as a cancer prevention and control technique (covering its use in weight management, smoking cessation, as an adjunct to diagnostic and treatment procedures, survivorship, and metastatic disease)

3) to discuss future research directions. Overall, the literature supports the benefits of hypnosis for improving quality of life during the course of cancer and its treatment.

CA: A Cancer Journal for Clinicians, Volume 63, Issue 1, pages 31-44, January/February 2013
By: Guy H. Montgomery Ph.D., Director, Integrative Behavioral Medicine Program, Associate Professor, Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY

Julie B. Schnur Ph.D., Co-Director, Integrative Behavioral Medicine Program, Assistant Professor, Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY

Kate Kravits MA, RN, HNB-BC, LPC, NCC, ATR-BC, Senior Research Specialist, Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, CA

Study 2: Hypnosis for Cancer: Another Overview and Suggestions for Future Use and Research Hypnosis in Cancer Care.
http://bscw.rediris.es/pub/bscw.cgi/d4501369/Liossi-Hypnosis_cancer_care.pdf

Notes: Despite conclusive evidence for the efficacy of clinical hypnosis in the management of many cancer related symptoms and particularly acute and chronic pain, hypnosis is currently under-utilized in these applications. This paper gives a brief overview of the contemporary uses of hypnosis in pediatric and adult oncology and shows how hypnosis can be integrated into a total therapeutic process based on the needs and goals of the patient and the health care team treating them. The first section describes studies that have evaluated hypnosis in adult oncology. The second half consists of a review of the hypnosis literature in pediatric oncology. The paper concludes with suggestions for future research, and implications for clinical practice.

Contemp. Hypnosis 23(1): 47-57 (2006)
By: Christina Liossi, University of Southampton, UK

Study 3: Self-Hypnosis for Pain and Anxiety During Biopsy Outpatient Procedures
Adjunctive self-hypnotic relaxation for outpatient medical procedures: A prospective randomized trial with women undergoing large core breast biopsy
http://www.painjournalonline.com/article/S0304-3959(06)00393-9/abstract

Results: Women’s anxiety increased significantly in the standard group (logit slope=0.18, p<0.001), did not change in the empathy group (slope=-0.04, p=0.45), and decreased significantly in the hypnosis group (slope=-0.27, p<0.001). Pain increased significantly in all three groups (logit slopes: standard care=0.53, empathy=0.37, hypnosis=0.34; all p<0.001) though less steeply with hypnosis and empathy than standard care (p=0.024 and p=0.018, respectively). Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional professional: 46min/$161 for standard care, 43min/$163 for empathy, and 39min/$152 for hypnosis. We conclude that, while both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost and thus appears attractive for outpatient pain management.

Notes: Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. Two hundred and thirty-six women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n=82), or self-hypnotic relaxation (n=78) during their procedures. Patients’ self-ratings at 10min-intervals of pain and anxiety on 0-10 verbal analog scales with 0=no pain/anxiety at all, 10=worst pain/anxiety possible, were compared in an ordinal logistic regression model.

PAIN, Volume 126, Issue 1, Pages 155-164, 15 December 2006
By: Elvira V. Lang, Beth Israel Deaconess Medical Center/Harvard Medical School, Department of Radiology
Kevin S. Berbaum, Salomao Faintuch, Olga Hatsiopoulou, Noami Halsey, Xinyu Li, Michael L. Berbaum, Eleanor Laser, Janet Baum

Study 4: Pre-Surgery Hypnosis for Breast Biopsies – Post-Surgery Pain and Anxiety
Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients
http://www.tandfonline.com/doi/abs/10.1080/00207140208410088#preview

Results: Hypnosis reduced postsurgery pain and distress.

Notes: Each year, hundreds of thousands of women undergo excisional breast biopsies for definitive diagnosis. Not only do these patients experience pain associated with the procedure, but they also endure distress associated with the threat of cancer. To determine the impact of brief presurgical hypnosis on these patients’ postsurgery pain and distress and to explore possible mediating mechanisms of these effects, 20 excisional breast biopsy patients were randomly assigned to a hypnosis or control group (standard care).

Hypnosis reduced postsurgery pain and distress.
International Journal of Clinical and Experimental Hypnosis, Volume 50, Issue 1, 2002, pages 17-32
By: Guy H. Montgomerya, Christina R. Weltza, Megan Seltza, Dana H. Bovbjerga, Mount Sinai School of Medicine, New York

Study 5: Hypnosis to Reduce Presurgical Distress Regarding Breast Biopsies
Hypnosis decreases presurgical distress in excisional breast biopsy patients.
http://www.ncbi.nlm.nih.gov/pubmed/18227298

Results: Post intervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS emotional upset (16.5 vs 38.2, P < 0.0001, d = .85), VAS depressed mood (6.6 vs 19.9, P < 0.02, d = .67), and SV-POMS anxiety (10.0 vs 5.0, P < 0.0001, d = 0.85); and significantly higher levels for VAS relaxation (75.7 vs 54.2, P < 0.001, d = -0.76) than attention controls. The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical distress in women awaiting diagnostic breast cancer surgery.

Notes: Excisional breast biopsy is associated with presurgical psychological distress. Such distress is emotionally taxing, and may have negative implications for postsurgical side effects and satisfaction with anesthesia. We investigated the ability of a brief hypnosis session to reduce presurgical psychological distress in excisional breast biopsy patients. Ninety patients presenting for excisional breast biopsy were randomly assigned to receive either a 15-minute presurgery hypnosis session (n = 49, mean age: 46.4 (95% CI: 42.3-50.4)) or a 15-minute presurgery attention control session (n = 41, mean age: 45.0 (95% CI: 40.8-49.2)). The hypnosis session involved suggestions for increased relaxation and decreased distress. The attention control session involved nondirective empathic listening. Presurgery distress was measured using visual analog scales (VAS) and the short version of the Profile of Mood States (SV-POMS). Data were analyzed using analysis of variance and chi2 procedures.

Anesth Analg. 2008 Feb;106(2):440-4
By: J. B. Schnur, D. H. Bovbjerg, D. David, K. Tatrow, A. B. Goldfarb, J. H. Silverstein, C. R. Weltz, G. H. Montgomery, Department of Oncological Sciences, Box 1130, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York City, NY 10029-6574, USA

Study 6: Hypnosis to Alleviate Anxiety Related to Bone Marrow Aspirates and Biopsies
A Randomized Trial of Hypnosis for Relief of Pain and Anxiety in Adult Cancer Patients Undergoing Bone Marrow Procedures
http://www.tandfonline.com/doi/abs/10.1080/07347332.2012.664261#preview

Results: The hypnosis intervention reduced the anxiety associated with this procedure, but the difference in pain scores between the two groups was not statistically significant. The authors conclude that brief hypnosis concurrently administered reduces patient anxiety during bone marrow aspirates and biopsies but may not adequately control pain.

Notes: Pain and anxiety are closely associated with bone marrow aspirates and biopsies. To determine whether hypnosis administered concurrently with the procedure can ameliorate these morbidities, the authors randomly assigned 80 cancer patients undergoing bone marrow aspirates and biopsies to either hypnosis or standard of care.

Journal of Psychosocial Oncology, Volume 30, Issue 3, 2012, pages 281-293
By: Alison Snow LCSW-Ra, David Dorfman PhDb, Rachel Warbet LCSWa, Meredith Cammarata LCSWa, Stephanie Eisenman LCSWa, Felice Zilberfein PhDa, Luis Isola MDc & Shyamala Navada MDc

Author Affiliations:
a:  Department of Social Work Services, Mount Sinai Medical Center, New York, NY, USA
b:  Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA
c:  Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, USA)

Study 7: Hypnosis Versus Analgesic Cream (Local Anesthetic) to Relieve Lumbar Puncture Induced Pain and Anxiety in Cancer Patients Aged 6 to 16
Randomized clinical trial of local anesthetic versus a combination of local anesthetic with self-hypnosis in the management of pediatric procedure-related pain.
http://www.ncbi.nlm.nih.gov/pubmed/16719602

Results: Confirmed that patients in the local anesthetic plus hypnosis group reported less anticipatory anxiety and less procedure-related pain and anxiety and that they were rated as demonstrating less behavioral distress during the procedure. The level of hypnotizability was significantly associated with the magnitude of treatment benefit, and this benefit was maintained when patients used hypnosis independently.

Notes: A prospective controlled trial was conducted to compare the efficacy of an analgesic cream (eutectic mixture of local anesthetics, or EMLA) with a combination of EMLA with hypnosis in the relief of lumbar puncture-induced pain and anxiety in 45 pediatric cancer patients (age 6-16 years). The study also explored whether young patients can be taught and can use hypnosis independently as well as whether the therapeutic benefit depends on hypnotizability. Patients were randomized to 1 of 3 groups: local anesthetic, local anesthetic plus hypnosis, and local anesthetic plus attention.

Health Psychol. 2006 May;25(3):307-15
By: C. Liossi, P. White, P. Hatira, School of Psychology, University of Southampton, Southampton, United Kingdom

Study 8: Hypnosis for Colonoscopies: Anxiety and Pain (as well as decreasing Colonoscopy Recovery Time)
Hypnosis to Manage Anxiety and Pain Associated with Colonoscopy for Colorectal Cancer Screening: Case Studies and Possible Benefits
http://www.tandfonline.com/doi/abs/10.1080/00207140600856780#preview

Results: Results suggest that hypnosis appears to be a feasible method to manage anxiety and pain associated with colonoscopy, reduces the need for sedation, and may have other benefits such as reduced vasovagal events and recovery time.

Notes: This study explored using hypnosis for pain and anxiety management in 6 colonoscopy patients (5 men, 1 woman), who received a hypnotic induction and instruction in self-hypnosis on the day of their colonoscopy. Patients’ levels of anxiety were obtained before and after the hypnotic induction using Visual Analogue Scales (VAS). Following colonoscopy, VASs were used to assess anxiety and pain during colonoscopy, perceived effectiveness of hypnosis, and patient satisfaction with medical care. Hypnotizability was assessed at a separate appointment. The authors also obtained data (time for procedure, number of vasovagal events, and recovery time) for 10 consecutive patients who received standard care.

International Journal of Clinical and Experimental Hypnosis, Volume 54, Issue 4, 2006.
By: Gary Elkins, Joseph White, Parita Patel, Joel Marcus, Michelle M. Perfect und Guy H. Montgomery

Author Affiliations:
a:  Baylor University, Waco, Texas, USA
b:  Scott and White Memorial Hospital, Temple, Texas, USA
c:  Texas A & M University College of Medicine, College Station, Texas, USA
d:  Mount Sinai School of Medicine, New York, New York, USA)

Study 9: Hypnosis for Biopsy or Lumpectomy for Breast Cancer – Effect on Amount of Analgesics/Sedatives Required, Pain, Nausea, Fatigue, Discomfort, and Upset (as well as Reduced Surgical Time)
A Randomized Clinical Trial of a Brief Hypnosis Intervention to Control Side Effects in Breast Surgery Patients
http://jnci.oxfordjournals.org/content/99/17/1304.full.pdf+html

Results: Patients in the hypnosis group required less propofol (means = 64.01 versus 96.64 µg; difference = 32.63; 95% confidence interval [CI] = 3.95 to 61.30) and lidocaine (means = 24.23 versus 31.09 mL; difference = 6.86; 95% CI = 3.05 to 10.68) than patients in the control group. Patients in the hypnosis group also reported less pain intensity (means = 22.43 versus 47.83; difference = 25.40; 95% CI = 17.56 to 33.25), pain unpleasantness (means = 21.19 versus 39.05; difference = 17.86; 95% CI = 9.92 to 25.80), nausea (means = 6.57 versus 25.49; difference = 18.92; 95% CI = 12.98 to 24.87), fatigue (means = 29.47 versus 54.20; difference = 24.73; 95% CI = 16.64 to 32.83), discomfort (means = 23.01 versus 43.20; difference = 20.19; 95% CI = 12.36 to 28.02), and emotional upset (means = 8.67 versus 33.46; difference = 24.79; 95% CI = 18.56 to 31.03). Institutional costs for surgical breast cancer procedures were $8561 per patient at Mount Sinai School of Medicine. Patients in the hypnosis group cost the institution $772.71 less per patient than those in the control group (95% CI = 75.10 to 1469.89), mainly due to reduced surgical time.
Conclusions: Hypnosis was superior to attention control regarding propofol and lidocaine use; pain, nausea, fatigue, discomfort, and emotional upset at discharge; and institutional cost. Overall, the present data support the use of hypnosis with breast cancer surgery patients.

Notes: Breast cancer surgery is associated with side effects, including postsurgical pain, nausea, and fatigue. We carried out a randomized clinical trial to test the hypotheses that a brief presurgery hypnosis intervention would decrease intraoperative anesthesia and analgesic use and side effects associated with breast cancer surgery and that it would be cost effective. We randomly assigned 200 patients who were scheduled to undergo excisional breast biopsy or lumpectomy (mean age 48.5 years) to a 15-minute presurgery hypnosis session conducted by a psychologist or nondirective empathic listening (attention control).. Intraoperative anesthesia use (i.e., of the analgesics lidocaine and fentanyl and the sedatives propofol and midazolam) was assessed. Patient-reported pain and other side effects as measured on a visual analog scale (0-100) were assessed at discharge, as was use of analgesics in the recovery room. Institutional costs and time in the operating room were assessed via chart review.

JNCI J Natl Cancer Inst Volume 99, Issue 17Pp. 1304-1312
By: Guy H. Montgomery, Dana H. Bovbjerg, Julie B. Schnur, Daniel David, Alisan Goldfarb, Christina R. Weltz, Clyde Schechter, Joshua Graff-Zivin, Kristin Tatrow, Donald D. Price and Jeffrey H. Silverstein

Author Affiliations:

  1. Department of Oncological Sciences (GHM, DHB, JBS)
  2. Department of Surgery (AG, CRW), and Department of Anesthesiology Sciences (JHS), Mount Sinai School of Medicine, New York, NY
  3. Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania (DD)
  4. Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY (CS)
  5. Department of Health Policy and Management, Columbia University, New York, NY (JGZ)
  6. Department of Psychology, Good Shepherd Rehabilitation Hospital, Allentown, PA (KT)
  7. Departments of Oral and Maxillofacial Surgery and Neuroscience, University of Florida, Gainesville, FL (DDP)

Study 10: Self-Hypnosis for Percutaneous Tumor Treatment – Pain and Anxiety
Beneficial Effects of Hypnosis and Adverse Effects of Empathic Attention during Percutaneous Tumor Treatment: When Being Nice Does Not Suffice
http://www.jvir.org/article/S1051-0443(08)00180-2/abstract

Results: Patients treated with hypnosis experienced significantly less pain and anxiety than those in the standard care and empathy groups at several time intervals and received significantly fewer median drug units (mean, 2.0; interquartile range [IQR], 1-4) than patients in the standard (mean, 3.0; IQR, 1.5-5.0; P = .0147) and empathy groups (mean, 3.50; IQR, 2.0-5.9; P = .0026). Thirty-one of 65 patients (48%) in the empathy group had adverse events, which was significantly more than in the hypnosis group (eight of 66; 12%; P = .0001) and standard care group (18 of 70; 26%; P = .0118).

Notes: For their tumor embolization or radiofrequency ablation, 201 patients were randomized to receive standard care, empathic attention with defined behaviors displayed by an additional provider, or self-hypnotic relaxation including the defined empathic attention behaviors. All had local anesthesia and access to intravenous medication. Main outcome measures were pain and anxiety assessed every 15 minutes by patient self-report, medication use (with 50 µg fentanyl or 1 mg midazolam counted as one unit), and adverse events, defined as occurrences requiring extra medical attention, including systolic blood pressure fluctuations (=50 mm Hg change to >180 mm Hg or <105 mm Hg), vasovagal episodes, cardiac events, and respiratory impairment.

Journal of Vascular and Interventional Radiology, Volume 19, Issue 6, Pages 897-905, June 2008
Elvira V. Lang, MD, Kevin S. Berbaum, PhD, Stephen G. Pauker, MD, Salomao Faintuch, MD, Gloria M. Salazar, MD, Susan Lutgendorf, PhD, Eleanor Laser, PhD, Henrietta Logan, PhD, David Spiegel, MD (Department of Radiology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts 02215, USA

Study 11: Hypnosis for Venipuncture for Blood Sampling of Cancer Patients Aged 6 to 16 – Pain, Anxiety (and also Anxiety of Parents)
A randomized clinical trial of a brief hypnosis intervention to control venipuncture-related pain of pediatric cancer patients
http://www.painjournalonline.com/article/S0304-3959(09)00046-3/abstract

Results: Confirmed that patients in the local anesthetic plus hypnosis group reported less anticipatory anxiety, and less procedure-related pain and anxiety, and were rated as demonstrating less behavioral distress during the procedure than patients in the other two groups. Parents whose children were randomized to the local anesthetic plus hypnosis condition experienced less anxiety during their child’s procedure than parents whose children had been randomized to the other two conditions. The therapeutic benefit of the brief hypnotic intervention was maintained in the follow-up.

Notes: Venipuncture for blood sampling can be a distressing experience for a considerable number of children. A prospective controlled trial was conducted to compare the efficacy of a local anesthetic (EMLA) with a combination of EMLA with self-hypnosis in the relief of venipuncture-induced pain and anxiety in 45 pediatric cancer outpatients (age 6-16years). A secondary aim of the trial was to test whether the intervention will have a beneficial effect on parents’ anxiety levels during their child’s procedure. Patients were randomized to one of three groups: local anesthetic, local anesthetic plus hypnosis, and local anesthetic plus attention.

PAIN, Volume 142, Issue 3, Pages 255-263, April 2009
By: Christina Liossi, Paul White, Popi Hatira, School of Psychology, University of Southampton, Highfield, Southampton S017 1BJ, UK

Study 12: Hypnosis for Chemotherapy Related Nausea and Vomiting
Hypnosis for nausea and vomiting in cancer chemotherapy: a systematic review of the research evidence
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2354.2006.00736.x/abstract

Results: Studies report positive results including statistically significant reductions in anticipatory and “cancer chemotherapy-induced nausea and vomiting” (“CINV”). Meta-analysis revealed a large effect size of hypnotic treatment when compared with treatment as usual, and the effect was at least as large as that of cognitive-behavioral therapy. Meta-analysis has demonstrated that hypnosis could be a clinically valuable intervention for anticipatory and CINV in children with cancer.

Notes: To systematically review the research evidence on the effectiveness of hypnosis for cancer chemotherapy-induced nausea and vomiting (CINV). A comprehensive search of major biomedical databases including MEDLINE, EMBASE, ClNAHL, PsycINFO and the Cochrane Library was conducted. Specialist complementary and alternative medicine databases were searched and efforts were made to identify unpublished and ongoing research. Citations were included from the databases’ inception to March 2005. Randomized controlled trials (RCTs) were appraised and meta-analysis undertaken. Clinical commentaries were obtained. Six RCTs evaluating the effectiveness of hypnosis in CINV were found. In five of these studies the participants were children.

European Journal of Cancer Care, Volume 16, Issue 5, pages 402-412, September 2007
By: J. RICHARDSON bsc(hons), phd, rn, cpsychol, pgce, rnt, reader in nursing and health studies1,*, J.E. SMITH ba(hons), msc, former research assistant2, G. MCCALL dcr(t), msc, applied hypnosis, senior research radiographer & psychological support3, A. RICHARDSON bn(hons), msc, phd, rn, pgdiped, rnt, professor of cancer and palliative nursing care4, K. PILKINGTON bpharm(hons), dipinfsci, msc, pcme, mrpharms5, I. KIRSCH ba , ma , phd , professor of psychology 6

Author Information:

  1. Faculty of Health and Social Work, Portland Square, University of Plymouth, Drake Circus, Plymouth, Devon
  2. NHSP/CAMEO project, Research Council for Complementary Medicine, South-East London Cancer Centre, St Thomas’ Hospital, London
  3. The Florence Nightingale School of Nursing and Midwifery, King’s College London, Franklin Wilkins Building, London
  4. Project Manager/Senior Research Fellow, School of Integrated Health and Research Council for Complementary Medicine, University of Westminster, 115 New Cavendish Street, London
  5. School of Applied Psychosocial Studies, Portland Square, University of Plymouth, Drake Circus, Plymouth, Devon, UK

Study 13: Hypnosis and Survivorship (Life with Cancer Post Treatment) – Hot Flashes in Breast Cancer Survivors
Randomized Trial of a Hypnosis Intervention for Treatment of Hot Flashes Among Breast Cancer Survivors
http://jco.ascopubs.org/content/26/31/5022

Results: Fifty-one randomly assigned women completed the study. By the end of the treatment period, hot flash scores (frequency × average severity) decreased 68% from baseline to end point in the hypnosis arm (P < .001). Significant improvements in self-reported anxiety, depression, interference of hot flashes on daily activities, and sleep were observed for patients who received the hypnosis intervention (P < .005) in comparison to the no treatment control group.
Conclusion: Hypnosis appears to reduce perceived hot flashes in breast cancer survivors and may have additional benefits such as reduced anxiety and depression, and improved sleep.

Notes: Hot flashes are a significant problem for many breast cancer survivors. Hot flashes can cause discomfort, disrupted sleep, anxiety, and decreased quality of life. A well-tolerated and effective mind-body treatment for hot flashes would be of great value. On the basis of previous case studies, this study was developed to evaluate the effect of a hypnosis intervention for hot flashes. Sixty female breast cancer survivors with hot flashes were randomly assigned to receive hypnosis intervention (five weekly sessions) or no treatment. Eligible patients had to have a history of primary breast cancer without evidence of detectable disease and 14 or more weekly hot flashes for at least 1 month. The major outcome measure was a bivariate construct that represented hot flash frequency and hot flash score, which was analyzed by a classic sums and differences comparison. Secondary outcome measures were self-reports of interference of hot flashes on daily activities.

Journal of Clinical Oncology, JCO November 1, 2008 vol. 26 no. 31 5022-5026
By: Gary Elkins, Joel Marcus, Vered Stearns, Michelle Perfect, M. Hasan Rajab, Christopher Ruud, Lynne Palamara and Timothy Keith

Author Affiliations:

  1. From the Department of Psychology and Neuroscience, Baylor University, Waco
  2. Scott and White Memorial Hospital and Clinic, Department of Psychiatry and Behavioral Sciences, Temple
  3. Cancer Treatment and Research Center, San Antonio; and University of Texas at Austin, TX; University of Arizona, Tucson, AZ
  4. Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD

Study 14: Use of Hypnosis for Terminally Ill Hospice Cancer Patients – Insomnia, Itchiness, Bowel Issues, Pain, Chemotherapy Side Effects, Relaxation (and also suggests best time for Cancer Patients to start Hypnotherapy is right at time of diagnosis.)
Efficacy of Hypnotherapy as a supplement therapy in Cancer Intervention
http://bscw.rediris.es/pub/bscw.cgi/d4431493/Peynovska-Efficacy_hypnotherapy_supplement_therapy_cancer

Results: Of the 20 patients who completed the three sessions of hypnotherapy all reported varying degrees of anxiety. 5 patients wanted to have hypnotherapy for insomnia as a primary presenting complain, 1 for excessive itchiness during night time, 1 for excessively frequent bowel actions – 8 to 10 times a day for the last year, which invariably interfered with his social life and prevented him from going out, 8 wanted to have hypnotherapy for pain control, 3 patients opted for hypnotherapy to prevent the side effects of chemotherapy and 2 patients had it specifically for severe anxiety and panic attacks.
The 5 patients who had hypnotherapy for insomnia all reported improved sleeping patterns even after the first session. After the third session none of them complained of insomnia and this result was sustained till the followup, which was 3 to 4 months after the first session. They also reported increased energy levels, less tiredness and improved appetite. 2 of the patients with insomnia have been on Temazepam 10mg before bed, which they voluntarily stopped taking after the first session.

The patient with nighttime itchiness reported that their itchiness stopped after the first session and she continued with the remaining two hypnotherapy sessions working towards pain control.

The patient with frequent bowel action reported that he managed to half the number of times he went to the toilet after the second session.
Of the 8 patients who had hypnotherapy for pain control, all reported that the intensity of pain has significantly been reduced and as a result they have reduced heir dose of opiate analgesics taken daily.

The 3 patients, who took part in the study to prevent the side effects of chemotherapy, also reported very good results with no nausea, sickness and less loss of energy, which was in contrast with their previous experience with chemotherapy.

Most of the patients (19 out of 20) reported that after the first two hypnotherapy sessions they were able to relax for the first time in a very long period, felt less tired and more energetic, had more refreshing night sleep and as a result were able to cope better with their daily activities.

It appears that the best time for hypnotherapy to be offered to cancer patients is right at the time of diagnosis. In that way, patients will be able to develop better coping skills much earlier in the disease process, which will help them to possibly prevent severe anxiety, depression and panic attacks from developing. They will have better treatment compliance and generally will have a more positive psychological response to their illness, which has been suggested as a good prognostic factor with an influence on survival.

Notes: All the patients who took part in the trial were day hospice patients of Ann Delhom Centre, Wisdom Hospice, Rochester, UK. Patients were offered three hypnotherapy sessions and were assessed before the first session and after the third one together with a follow up after 3/4 months after the last session. On the first session all the patients were taught ”progressive muscle relaxation” and self- hypnosis. Short ego boosting was also incorporated at the end of the session. The second and third sessions were different for every patient depending on the expressed symptoms and because of that were always individually tailored. Most of the sessions included guided imagery and direct therapeutic suggestions.

2 European Journal of Clinical Hypnosis: 2005 Volume 6 – Issue 1
By: Dr Rumi Peynovska, Dr Jackie Fisher, Dr David Oliver, Prof V.M. MathewStone House Hospital, Dartford, West Kent NHS and Social Care Trust, Wisdom Hospice, Rochester, Medway NHS Trust
Dr Rumi Peynovska MD, MSc, FBAMH – Research Fellow, Stone House Hospital, Dartford, West Kent NHS Trust
Dr Jackie Fisher BSc, MRCGP – Consultant in Palliative Medicine, Wisdom Hospice, Rochester, Medway NHS Trust
Dr David Oliver BSc, FRCGP – Consultant and Medical Director, Wisdom Hospice, Rochester, Medway NHS Trust
Prof. V.M. Mathew MBBS, MPhil, MRCPsych – Clinical Director, Stone House Hospital, Dartford, West Kent NHS Trust

Life Design Enables Mastering of Self-renewal and Generativity


10 skills  required to change yourself …

Managing the change cycle is a self-renewing process. It empowers people to be self-confident and generative. Generativity is defined as a process whereby we learn to follow our deeper interests and longings and bring about change. It helps us to avoid the dangers of self-absorption and stagnation because we learn to live in new ways that expand our horizons. The following are 10 skills for managing the change cycle. Each skill has a time in the cycle when it performs a critical function, however, all 10 skills are important at all times because to some degree parts of our lives are simultaneously at various places in the cycle.

Visioning or Dreaming the Plan – The dream or vision is the driving force for the life structure, a source of passion and values. The plan is the plot for making the dream happen.

Launching – Launching puts the plan to action; it requires commitment and personal mission.

Plateauing – Plateauing is the art of sustaining a successful life structure…. It is knowing when and how to keep enriching the dream/plan for as long as it makes sense to do so.

Managing the Doldrums – This requires coming to terms with decline, negative emotions, and feeling trapped in an increasingly dysfunctional life structure.

Sorting Things Out – Choosing what to keep, what to eliminate or change, what to add, and how to proceed into a revitalised life structure is the task of this step of the change cycle.

Ending a Life Structure – This requires an ability to say farewell with gratitude and clarity, which frees you to consider your next options.

Restructuring – This mini-transition can be used if the life structure could be improved through some specific changes.

Cocooning – The transition into a new life structure requires turning inward to take stock, to identify your own basic values, and to disengage emotionally and mentally from the former life structure.

Self-Renewal – Following successful cocooning, this step involves a rebirth of self-esteem, a re-evaluation of core issues and beliefs, and the recovery of hope and purpose.

Experimenting – Creativity, learning, risk taking, and networking give one a sense of purpose and power in creating a new life structure.

SELF-RENEWAL FOR COACHING AND SELF-COACHING

Finding meaning in our work is critical if we are to avoid stagnation and boredom (Bergquist et al. 1993). It is the responsibility of each individual to effect the change necessary to reinvent work so that it has personal relevance. Many companies are now requiring that employees take responsibility for their own professional development.

Some critical strategies required when being coached:

  • Honest assessment of self and skills
  • Genuine motivation and drive to establish and pursue a goal
  • Understanding and knowledge of the strategic challenges of their position and business
  • Commitment to establishing an action plan that is built upon realistic expectations and that draws upon available resources, both within and outside the company
  • Being able to accomplish successful career/professional development transitions within an existing organisation/life structure
  • Creating a new organisation/life structure requires personal motivation.
  • Successful transition is linked with one’s sense of autonomy or internal locus of control, and manifested in a willingness to learn and a positive attitude. It is the force that propels individuals to take the initiative in directing their own lives and careers.

Many people find value in their work as a source of new learning and challenge. “They return to school, enter training programs, or enroll in workshops and seminars to keep up to date in their current jobs or strike out on their own” (Bergquist). Others, hampered by lack of drive, fear of failure, or reluctance to exit company retirement plans by terminating employment, stay in unsatisfying and/or stressful jobs. Bergquist et al. ask if the sacrifice is necessary or worthwhile. “When does the time come for us to cease deferring gratification for the future and begin actually living the fabled future?”. Whatever their age, adults must find meaning and community in their work if they want to be generative and alive. Therefore, they must look toward continued opportunities to reinvent work as a central part of reinventing themselves.

“Life Design” takes all these factors into account both personally and professionally and helps you make the right choices for your future.

Build Your Self Discipline and Increase your Success


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I regularly work with clients who say things to me like, “I can’t do that” or “I’ll never have/be/do that”, etc, etc. Now there are a load of things going on with these small statements that have to be addressed in order for these people to make a break through, things such as limiting beliefs, perception, mindset, attitude and a certain lack of motivation due to all of these things. This can have a hugely negative effect on a persons self discipline and motivation to actually succeed and to work towards success.

Personal success, achievement, or goal, can’t be realised without self-discipline. It is possibly the most important attribute needed to achieve any type of personal excellence, athletic excellence, virtuosity in the arts, or any form of outstanding performance, because without it, there is no consistency and continuity of effort towards achieving that goal.

What is Self-Discipline?

It is the ability to control emotions, thoughts, impulses, desires and behaviours. It is being able to say No, to immediate pleasure and instant gratification in favour of gaining the long-term satisfaction and fulfillment from achieving higher and more meaningful goals.

To possess self-discipline is to be able to make the decisions, take the actions, and execute your game plan regardless of the obstacles, discomfort, or difficulties, which may come your way.

Being disciplined does not mean living a limiting or a restrictive lifestyle, nor does it mean giving up everything you enjoy, or, to relinquish fun and relaxation. However, it does mean learning how to focus your mind and energies on your goals and persevere until they are accomplished.

It does means cultivating a mindset lead by your deliberate choices rather than by your negative emotions, bad habits, or the sway of others who do not have your necessarily have the same desires as you. Self-discipline allows you to reach your goals in a reasonable time frame and to live a more orderly and satisfying life.

How To Develop Self-Discipline
it’s best to start with small steps, because no new process takes place overnight. Just as it takes time to build muscle, so does it take time to develop self-discipline? The more you train and build it, the stronger you become. In exercise, if you try to do too much at once, you risk injuring yourself and setting yourself back. Likewise, take it one step at a time in building self-discipline, begin by making the decision to go forward and learning what it takes to get there.

Learn what motivates you and what your negative triggers are and this begins by learning about yourself! Sometimes it is very difficult to fight off urges and cravings, so identify the areas where your resistance is low and how to avoid those situations. If you know you can’t resist cake, fries, or other temptations – stay away from them, do not have them around to lure you into moments of weakness. If you also know that putting pressure on yourself does not work for you, then set yourself up in an environment that encourages the building of self-discipline rather than one that sabotages it. Remove the temptations and surround yourself with soothing and encouraging items such as motivating slogans and pictures of what you want to achieve.

Learn also what energises and motivates you. Your willpower can go up and down with your energy levels so play energetic music to perk you up, move around, and laugh. Train yourself to enjoy what you are doing by being energised as this will make it easier to implement desirable and appropriate behaviours into your daily routine – which is really what self-discipline is all about.

Make the right behaviours a routine. Once you have decided what’s important to you and which goals to strive for, establish a daily routine that will help you achieve them. For example, if you want to eat healthily or lose weight; resolve to eat several servings of lean protein and green vegetables each day and exercise for at least half an hour.

Make it part of your daily routine and part of your self-discipline building. Likewise, get rid of some of your bad, self-defeating habits, whatever they may be. They can put you in a negative frame of mind and hinder your self-discipline. A poor attitude is also a self destructive bad habit.

Practice Self-Denial

Learn to say no to some of your feelings, impulses and urges. Train yourself to do what you know to be right, even if you don’t feel like doing it. Skip dessert some evenings. Limit your TV watching. Resist the urge to yell at someone who has irritated you. Stop and think before you act. Think about the consequences. When you practice self-restraint it helps you develop the habit of keeping other things under control.

Engage in Sports or Other Physical Activities

Sports are an excellent way to enhance self- discipline. They train you to set goals, they focus your mental energy and exercises you emotional energies, enables you to become physically fit, and teaches you to get along well with others by working as part of a team. Participating in sports provides a situation where you learn to work hard and strive to do your best, which in turn, teaches you to integrate the same the thought processes and disciplines into your everyday life.

Learning to play a musical instrument can be another great way to practice self-discipline. The focus, repetition, and application required in learning to play an instrument is invaluable. Achieving self-discipline in any one area of your life re-programs your mind to choose what is right, rather than what is easy.

Create Your Mindset for Self-Discipline

Get inspiration from those you admire. There are so many inspirational people i the world today and from throughout history. read books by or about these people and draw inspiration from them. Sporting greats such as Muhammad Ali, Michael Jordan, Gary player. Great leaders throughout history; Alexander the Great, Winston Churchill. Philosophers such as Aristotle who said:

“We are what we repeatedly do. Excellence then is not an act, but a habit”.

Visualise the Rewards

There is nothing more gratifying than accomplishing your goals. Practice the technique that high achievers and top athletes do and practice projecting yourself in to the future with your imagination. Visualise your desired outcome. See how your life can be different, hear how differently you talk about your self and how others do, feel how rewarding it is and the countless benefits you will enjoy. Remind yourself what it takes to get there.

The Benefits
It helps build self-confidence.
You accomplish more, and are therefore more productive.
You are able to maintain a higher tolerance for frustration, obstacles and negative emotions.
Allows you to obtain better health, better finances and a good work ethic.
You are able to reach your most difficult goals more efficiently.
The more disciplined you become, the easier life gets.
If we are to be masters of our own destiny, we must develop self-discipline and self-control. By focusing on long-term benefits instead of short-term discomfort, we can encourage ourselves to develop of self-discipline. Ultimately our health and happiness depend on it.

If you would like to join my online goal setting workshop group then drop me an email on simon@simonmaryan.com and take advantage of a free 20 minute strategy session with me and find out how you can build your self discipline and achieve your goals.

Here’s to your increased success, health and happiness

Simon