Inside my Therapy Toolbox – What is BWRT?

Inside my Therapy Toolbox – What is BWRT?


What is BWRT? I wouldn’t be surprised if you haven’t heard of it before now. BWRT stands for ‘Brain Working Recursive Therapy’ – quite a mouthful! It’s a new model of psychotherapy and a relatively small number of therapists around the world are registered as Practitioners. However, it is getting rave reviews in some psychotherapy circles as clients report how long standing difficulties are dissolving quickly and easily in one or two sessions. Obviously this result is fantastic for those clients and is the main reason why I became interested in learning more about this new approach.

Often people want a quick fix and this is not something a therapist is always able to help them achieve. I won’t lie, I was very skeptical about BWRT when I first heard about it. How could long standing anxieties and phobias suddenly be resolved without you even having to disclose the details of distressing memories? All the BWRT Practitioner needs to know is the outline of the problem and what you would like to change.

My aim has always been to help people overcome their difficulties in the shortest time possible so I felt that if there was a successful way to help resolve particular issues more efficiently then I needed to offer it. I followed the development of BWRT at a distance for several months, still unsure about it’s efficacy. A few months ago my professional body, the British Psychological Society approved the BWRT training course as Continuous Professional Development for members and this endorsement reassured me that BWRT was robust enough to add to my therapy toolbox. I completed the course and passed my theory and practical Practitioner assessment last month. I am now a registered BWRT Practitioner with the BWRT Institute, one of the first 400 practitioners in the world to use this new therapy and the first to provide it in York, England.

So what is this new therapy all about?

BWRT is based on the latest discoveries in neuroscience that have allowed us to better understand how the brain works. During the BWRT process you are encouraged to overwrite old outdated automatic patterns that trigger your unwanted symptoms. Unlike other therapies, you don’t need to share anything you would rather not discuss. This is hugely appealing to people who do not want to disclose sensitive or intimate information and have been put off seeking any professional help for this reason. I only need to know how you feel in problematic situations and how you would prefer to feel instead.

BWRT allows you to choose and create a new response to previously difficult situations so that you feel, think or behave in the way you really want. Once the process is complete, the old symptoms are simply no longer triggered.

The mind boggling title ‘Brain Working Recursive Therapy’ describes the recursive looping process that the practitioner uses during a session to get you focussed on your symptoms and then to create and reinforce your new chosen response. The BWRT Institute reports that results from two years of worldwide testing experience have been encouraging and suggests that the changes made by clients are permanent. Furthermore they report no evidence of symptom substitution. All very interesting and amazing stuff!

Only Certified Practitioners have been trained to deliver BWRT and all have to adhere to a strict ethical code. Find out more at http://www.bwrt.org

You can read more about BWRT on my website at http://www.mindmakeoveruk.com/bwrt.html

I currently offer BWRT appointments at my clinic in York and I am exploring the best way to offer sessions via SKYPE. You can contact me via my website.

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Looking inside my Therapy Toolbox – What is EMDR?


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In my therapy practice I offer a range of different psychotherapeutic approaches and techniques so that I can use the most appropriate tool from my toolbox to help a client with their own individual issues. Good psychotherapists are committed to continuous professional development and undertake additional courses each year to keep their skills up to date and to stay abreast of new methods, models, techniques and research in the world of psychotherapy. Perhaps you have been seeking therapy or are just interested in what is available?

If you have ever checked out various therapist websites you are probably bewildered by the strange sounding therapies and techniques they offer. Whilst hypnotherapy is now very common, other evidence-based therapies such as EMDR are less well known. I trained in using this form of therapy a few years ago, when I felt I needed an extra tool in my toolbox for dealing with distress in a fast and effective way. In this blog I am talking about EMDR and how it can be invaluable in helping people overcome serious distress.

So what is EMDR?

EMDR stands for Eye Movement Desensitisation and Reprocessing. It is a powerful psychological treatment method that was first outlined in the 1980’s by Dr Francine Shapiro, a clinical psychologist. Shapiro developed the EMDR therapeutic approach based on specific principles, protocols and procedures with the goal of reducing distress in the shortest period of time.

Substantial research has demonstrated the benefits of EMDR in treating psychological trauma and (PTSD) Post Traumatic Stress Disorder. It is now commonly used to help the victims of large-scale catastrophes around the world including experiences of war and natural world disasters. However, it is also used to help people overcome the distress experienced from childhood abuse or neglect, assaults, surgical trauma, road traffic and workplace accidents. For example, train drivers who witness fatalities on the line are treated with EMDR as it can relieve their distress quickly and effectively. It can also be used to help people experiencing emotional distress with other issues including anxiety, phobias, grief, divorce, illness, performance anxiety, self esteem or any distress from the past, which is still impacting on day-to-day life.

So how does it work?

Being involved in a distressing event can feel overwhelming and the brain may be unable to process this information in the same way as it would an ordinary memory. The distressing memory seems to become frozen on a neurological level. Recalling the distressing memory, which can sometimes be triggered when you least expect it, can cause you to intensely re-experience whatever you could see, hear, smell, taste or feel at the time of the event. Sometimes the memory is so disturbing that you avoid thinking about it so you don’t have to experience the distress. In PTSD, people experience flashbacks and nightmares that are as intense as the actual incident that created the distress.

EMDR aims to identify and process dysfunctional and unhelpful behaviours, emotions, cognitions and memories arising from recent or past trauma and distressing life experiences. The theory behind the treatment proposes that unprocessed traumatic or distressing information produces dysfunctional reactions. These unprocessed memories are stored in separate unconnected memory networks in the brain. In EMDR, bilateral stimulation allows you to make connections between these neuro-networks causing spontaneous insight and change, resulting in learning and relief of emotional distress.

For example, let’s suppose someone was bullied at school and instead of the brain making sense of that experience and letting it go, the distress experienced is stored in a separate memory network along with all the emotion, beliefs and physical sensations that were there at the time. When something happens perhaps 20 years later that the brain interprets as being similar in nature (perhaps a boss at work makes a negative comment) the brain makes sense of it by linking to the old memory and all the associated feelings come flooding back. This person may not understand why the boss being negative triggers such a distressing reaction in them because it is happening automatically and is beyond their control. In EMDR, that old memory can be processed appropriately as you learn what you need from it and let the rest go. The original memory is transformed and stored in this reconsolidated form so the person can’t be triggered any more.

The treatment phase of the EMDR protocol can seem a little strange when you first encounter it. Alternating eye movements (or sometimes tapping or sounds) are used to stimulate the brain into reprocessing the frozen or blocked information that is being triggered and creating the distress. This bilateral stimulation allows you to re-process the distressing memories more appropriately, so they lose their intensity and can be stored in the same way as normal memories. The effect is believed to work in the same way as we naturally process ordinary memories during REM (Rapid Eye Movement) or dream sleep when your eyes move rapidly and repeatedly from side to side. After treatment, past memories no longer cause you distress, allowing you to respond adaptively in the present and in the future.

What happens during EMDR treatment?

In my therapy room, I start with a history taking session during which I assess your readiness for EMDR and develop a treatment plan. Working together, we identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance (triggers) and related historical incidents.

I always ensure that every client has adequate methods of handling emotional distress and good coping skills before any processing work takes place. Hypnotherapy techniques can be great for doing this effectively and the bonus is that you learn and practice some valuable skills that can be used in everyday stressful situations, as well as during or between sessions.

Once an initial target has been identified, it is processed using EMDR procedures. This usually involves you identifying a specific visual image related to the memory, beliefs about yourself in that situation, and the associated emotions and body sensations. There are other ways of using EMDR where you don’t have to openly share distressing information with the therapist, so before any processing starts we decide together which way of working would be most beneficial for you.

When the processing stage begins you are asked to focus on aspects of the memory whilst simultaneously moving your eyes back and forth following my fingers as they move across your field of vision for 20-30 seconds. You may be asked instead to listen to alternating tones or use a tapping device, which you hold in each hand to experience the bilateral stimulation, which enables the processing to take place. You are then asked to relate whatever thought, feeling, image, memory, or sensation comes to mind. This is repeated numerous times throughout the session. As the memory is adapted appropriately you will notice things changing and the associated distress subsiding until it disappears. Depending on the complexity and severity of the distress, it may take several sessions to process the old memories in a fully adaptive way.

After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Usually they cannot recall the old memory in the same distressing way again. Importantly, these emotional and cognitive changes generally result in spontaneous behavioural and personal change, which can be further enhanced.

When I first experienced EMDR I was blown away by it’s effectiveness. I have since used it very successfully for treating many clients including people suffering from the effects of phobias, anxiety, relationship distress, and road traffic accident traumas.

I have completed all 4 parts of an EMDR Association approved course and supervised practice in Eye Movement Desensitisation and Reprocessing. Training on an approved course is restricted to mental health professionals who hold current registration to provide psychotherapeutic services (such as British Psychological Society membership). I am pleased to be able to offer this service to my clients alongside my other services.

If you are interested in EMDR there is a link on my website to find out more: http://www.mindmakeoveruk.com/links.html

I am Susan Tibbett, a Chartered Psychologist and Hypnotherapist based in York. You can reach me at: http://www.mindmakeoveruk.com

Tips and Tricks for keeping your Stress under control


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Stress is your emotional and physical response to pressure and happens when you feel unable to cope. Many people lead demanding lives and stress can arise from life events, illness, living conditions, work, relationships, and money worries. in fact the list is endless because people have different ways of reacting to and coping with stress. A situation which is overwhelming for one person, may not concern someone else in the same way.  Even those events which you see as enjoyable can be stressful, such as holidays, moving house, starting a new job or course, pregnancy, parenthood, and family get togethers like Christmas.

When you are constantly under pressure, the stress hormones remain in your body, leading to the symptoms that let you know you feel stressed. It’s important to recognise these symptoms early and prevent serious health issues such as high blood pressure. Everyone gets stressed from time to time – it’s a natural reaction to a threat or danger or prolonged pressure, so it’s a biological part of all of us. However, what is important is how you choose to manage stress. Some people adopt unhealthy coping strategies such as comfort eating, drinking alcohol or smoking which take a further toll on health. There are simple things you can do to give yourself a sense of control and help you to cope in a healthy way.

The first step is to identify what makes you stressed:

  • Where am I when I’m feeling stressed? What am I doing? Who am I with?

Even if there is little you can do about some situations, making some small changes can make a big difference. In stressful situations remember to Pause, Take a breath, and Don’t just react automatically. Ask yourself:

  • What am I reacting to?
  • Is it helpful for me to think this way?
  • What is within my control?
  • Is there another way of looking at this?
  • How important is this really? How important will it be in 6 months time?
  • What is the most helpful way to respond for me and others?

I see many clients who are struggling with stress and anxiety in their lives. Common to all of them is the lack of knowledge or skills for controlling these feelings. There are lots of tips and tricks for helping you keep stress levels under control:

  • Deal with problems as they happen. Bottling up your feelings allows them to grow until they overflow
  • Slow down. You don’t have to do things at 100 miles an hour. Eat, walk and drive more slowly. If you don’t get as much done as you would like, there is always tomorrow. Act ‘as if’ you are relaxed: slow down your speech, relax your shoulders, and don’t fidget. This will also affect how other people will react to you
  • Do one thing at a time. If you have too much to do and can see no way to cope with it, see if you can divide it up and then tackle the bits one at a time. Prioritise and then do the worst thing first
  • The words ‘must’ and ‘should’ create pressure. Work out what you can realistically cope with and be content with this. You don’t have to be Superman/Wonder Woman
  • If people expect too much of you, you don’t have to accept their targets. Learn to be more assertive and say ‘No’
  • Stress can make you hard to live with and create problems with those close to you. Nurture strong, confident relationships which give you people to confide in and help you fight stress
  • Talk to someone – if you don’t have a supportive relationship or someone to confide in, there are lots of professional therapists who specialise in helping people with stress
  • Treat yourself as you would a good friend. What advice would you give?
  • Help others – people who help others become more resilient themselves. This can be as simple as doing someone a small favour that costs nothing
  • Shift your perspective by noticing what you have to be grateful for. Problems are often a question of perspective
  • Write down your thoughts and feelings – get them out of your head
  • Accept that there are things in life you can’t change – people get ill, people die, people lose jobs. Bad things happen and everyone has to learn to accept them as a part of life. Focus on the things you can control instead
  • Eat a healthy, balanced diet and cut down on high sugar foods such as cakes, biscuits and sweets which may fuel anxiety
  • Caffeine can make you feel alert but the effects of too much are the same as those of stress and anxiety. Caffeine is a stimulant that affects the brain and central nervous system. It can be found in: coffee, tea, Coke, Fanta, aspirin, cold remedies, headache tablets, energy tablets, drinks like Pro-Plus and Red Bull and even in chocolate at a low level
  • Stay hydrated by drinking more fresh, clean water
  • Some people believe that smoking helps them relax, but nicotine is a stimulant. The reported relaxation effect of smoking is nothing more than deep breathing when you inhale. Practice the breathing but lose the cigarettes
  • Make some time for relaxation, fun and enjoyment. If you think you don’t have time for this – you need it the most!
  • Learn Mindful Breathing (see my blog on ‘3 Quick Relaxation Exercises’)
  • Listen to music – sing and dance along to something upbeat, or relax to something calming and emotion-free
  • Physical exercise – get active even if you just go for a walk. Doing something physical completes the stress cycle and allows those stress hormones to dissipate, so you feel better
  • Get out in nature to feel uplifted – go to the park or for a walk in the countryside
  • Find a hobby or interest that gives you a sense of achievement – adult colouring books or doodling zentangles are great for feeling creative. Don’t know what they are? Look it up. Challenge yourself with something new
  • And finally….RELAX! Do some deep abdominal slow breathing or listen to my free 10 minutes Relaxation track on http://www.mindmakeoveruk.com to instantly feel a little better

I am Susan Tibbett, a Chartered Psychologist and Hypnotherapist based in York. I can be reached via my website at: http://www.mindmakeoveruk.com

3 Quick Relaxation Exercises


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Perhaps you’re feeling stressed or anxious and you know that you need to calm things down fast. Knowing that you need to calm things down to feel better, just makes you more anxious and more stressed because you don’t know how to do it. It can be difficult to change that state of emotional arousal when you don’t have a clue where to start. I see clients every week who have this dilemma. By sharing these quick relaxation tips, they soon learn how to get back in control of any anxious, stressful feelings and reduce the physical symptoms that can feel so distressing.

Did you know that your breathing plays an essential role in stress and anxiety? Breathing is a powerful determinant of physical state. When your breathing rate becomes elevated, a number of physiological changes begin to happen. Perhaps you’ve noticed this yourself when you’ve had a fright; you might suddenly gasp, feel a little breathless or lightheaded, or notice tingling sensations around your body. The way you breathe is a major factor in producing these and other sensations that are noticeable when you’re stressed or anxious.

One of the first things I teach my clients is the important role breathing plays in controlling the stress response, and how changing your breathing can be used to send a strong, positive message to your brain that everything is ok, you are safe at this moment and you can allow yourself to relax and calm down.

So if you are feeling stressed give this a try now. Find a place where you will be undisturbed for a few minutes. You can close your eyes or keep them open, whatever is comfortable for you. Sit with your feet flat on the floor and your hands resting lightly in your lap. If you wish you can lay down.

Exercise 1 – Breathing to release tension

  • Breathe in deeply (from your diaphragm) to the count of  7. Pause.
  • Breathe out to the count of 11. Pause.
  • Breathe in to the count of 7 and so on…

Just allow the oxygen to gently and slowly flow in and flow out. The numbers themselves aren’t important – it’s the lengthening of the out breath that does it. Sometimes people find it hard to breathe this slowly at first so adjust the numbers if you wish.

Once you have practised this breathing technique you can add the following:

  • As you breathe in, imagine that the air around you is a wonderful colour of calm. As you breathe in allow the colour to flow in and through your body like a wave of calmness, clearing any tension in your body or stresses in your mind
  • As you breathe out, imagine any tension or stress flowing out and away from you and disappearing into the air where it evaporates and disappears

Exercise 2 – Deep Breathing Technique

  • Breathe in so that your belly (not your chest) rises. This deep abdominal breathing (diaphragmatic breathing) is the correct way to breathe
  • You can check whether you are doing this correctly by placing your hands on your belly with your fingertips touching, on an out breath. As you breathe in, your fingertips should part

So why does changing my breathing help?

You might already know that you breathe in oxygen and breathe out carbon dioxide. For the body to run efficiently, there needs to be a balance between oxygen and carbon dioxide, and this balance is maintained by how fast and how deeply you breathe. Of course, the body needs different amounts of oxygen depending on your level of activity. When you exercise, there is an increase in both oxygen and carbon dioxide; in relaxation there is a decrease in both oxygen and carbon dioxide. In both cases the balance is maintained. However, when you are anxious, this balance is disrupted. You take in more oxygen than the body needs – in other words you overbreathe, or hyperventilate. When this balance is detected, the body responds with a number of chemical changes that produce those uncomfortable physical symptoms; dizziness, light-headedness, confusion, breathlessness, blurred vision, increasing heart rate, numbness and tingling in the extremities, cold clammy hands and muscle stiffness. The normal rate of breathing is 10 to 12 breaths per minute. What is your breathing rate and would you benefit from slowing down?

Exercise 3 – Mindfulness relaxation – it only takes a minute every day

This technique is simple yet very effective. Take a moment to practice it every day:

  • Close your eyes and focus your awareness on your body and become aware of any and all sensations there
  • Now focus your attention like a spotlight on any particular tightness or discomfort anywhere in the body. If there are none then just focus on the stillness in the body

You are not trying to judge any sensations or change them, but simply to become aware of them. If your mind wanders then gently escort it back to focusing on your breathing

  • You may find that any areas of tension begin to loosen and relax. You don’t need to try to do this, just be aware of any relaxation happening
  • You can stay like this for as long as you wish but even a minute is beneficial

Using these calming exercises, you can experience a minute of stillness, slow your breathing down and reduce your general level of anxiety. The key to gaining control really is practice, so set aside some time to do this every day. With enough practice, it will even help to reduce feelings of stress when you are in an anxious situation.

There are lots of breathing techniques out there so experiment with them and see what a difference this new habit can make.

I am Susan Tibbett, a Chartered Psychologist and Hypnotherapist and I work in York. I can be reached via my website at: http://www.mindmakeoveruk.com

Would you like a good night’s sleep? Here’s how


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Did you have a good night’s sleep last night? Did you wake up this morning feeling refreshed? Or was it a bad night?

If you had a rough night then you are not alone. Many people experience problems sleeping at some time in their lives. As babies, we can sleep for 16 hours a day. As adults we tend to benefit most from 7- 8 hours sleep on average. Over your lifetime you will develop your own sleep pattern, which may change as you age. You will probably notice changes in sleeping habits at significant times as a result of various issues. When I see clients seeking help for sleep problems it is helpful to define exactly what they are experiencing as there are different types of sleep disturbance:

  • Difficulty falling asleep
  • Sleeping lightly and restlessly, waking often, and lying awake in the night
  • Waking early and being unable to get back to sleep

We are probably all familiar with the tell-tale signs of a rough night’s sleep! Physical symptoms usually include feeling tired during the day, frequent headaches, irritability or lack of concentration, and feeling tired on waking rather than refreshed and re-energised. The main causes for sleep problems are:

  • State of mind – anxiety, depression, worry, anger, grief, or anticipating a difficult event
  • Menstrual cycle changes in women
  • Change – moving house, starting a new job or a course
  • Environment – noise, discomfort, time zone change
  • Pain
  • Medical conditions – heart, breathing, digestion, high blood pressure, arthritis, anorexia, tinnitus
  • Recreational drugs – nicotine, caffeine, heroin, cocaine, amphetamines, LSD, cannabis
  • Sleeping pills or tranquilisers – these substances can create sleep disturbance!
  • Other prescription drugs – some contraceptives, diuretics, slimming pills, beta-blockers, stimulants

It’s a long list so if you are having problems sleeping, it is important to work out whether there is an underlying cause for your disturbed nights, or any particular trigger. Here are some areas for you to consider:

  • Are you aware of any cause or trigger
  • Are you aware of any stressors
  • Is your bed comfortable – how old is your bed and does it need replacing
  • Is your bedroom dark enough – do you need thicker curtains or an eye mask
  • Any noise disturbance – neighbours/snoring partner. Earplugs may help
  • What is the temperature of the room and is it cool enough for sleeping
  • Diet – very rich foods and alcohol can interfere with sleep. Are you eating too late in the evening

It also helps to avoid these:

  • Naps during the day especially after 3pm and longer than 20 minutes
  • Going to bed when you are stressed or wound up or not ready
  • Having an argument at bedtime
  • Working, eating or phoning in bed
  • Using an electronic device in the evenings which emits blue light – including watching TV
  • Lying in bed awake for more than 30 minutes
  • Eating, drinking or smoking if you get up during the night
  • Falling asleep in front of the TV
  • Drinking too much liquid towards the end of the evening
  • Worrying about not sleeping or getting angry
  • Stimulants – coffee, tea, alcohol, nicotine, cola drinks, food additives, junk food, slimming pills or appetite suppressants

The good news is that there are many things you can do to change habits which may be interfering with the right quality and quantity of sleep, including:

  • Change or resolve things causing you stress where possible – see a therapist if you need help with this
  • Accept situations that you can’t change
  • Give yourself enough time to do things. Don’t take on too much and avoid unrealistic demands
  • Live in the present, rather than worrying about the past or fearing the future
  • Talk through any relationship problems with the person concerned
  • Do some relaxing activity just for pleasure
  • Get regular exercise, but not later than 2-3 hours before bedtime
  • Spend at least 30 minutes a day in natural sunlight. Daylight regulates your sleeping pattern
  • Some foods aid sleep such as a meal high in carbohydrates 2 hours before bedtime, a warm milky drink, a herbal tea such as chamomile, or hot water before bedtime
  • Establish a bedtime routine
  • If you are a late sleeper, get up earlier
  • Get up at the same time each day
  • Only go to bed when tired
  • Do one final security check
  • If you can’t sleep, get up and do something that is not too stimulating
  • Have a warm bath or take a light walk before bedtime
  • Replace negative thoughts with positive ones – “I will sleep”
  • Lavender scent on pillows can help to relax you
  • Don’t try too hard to sleep – instead just let go and allow it to happen
  • Give yourself some quiet time each day
  • Practice relaxation techniques or breathing exercises regularly
  • Keep your mind and body as relaxed as possible – self hypnosis, mindfulness and meditation is great for this

Various natural remedies claim to aid restful sleep such as valerian and cherry juice products. Research suggests that cherry juice increases melatonin levels – the hormone that regulates sleep and makes you feel naturally sleepy at night. As melatonin is released you feel increasingly drowsy. You naturally feel most tired between midnight and 7am. You may also feel mildly sleepy between 1pm and 4pm when another increase in melatonin occurs in your body.

Psychological interventions are very effective for dealing with sleep problems and can include relaxation training, stress management and hypnotherapy. I have helped many people suffering with insomnia using these techniques. For starters, why not listen to my free 10 minutes relaxation track before you go to sleep. If you find this approach helpful then there are lots of meditative recordings generally available which will help you to relax a busy mind and promote a good night’s sleep. My free recording is here: http://www.mindmakeoveruk.com. Alternatively, seek out a hypnotherapist who will work with you on a one-to-one basis.

Sleep well!