Metamorphosis issue4 winter2013 by Penny Ling

METAMORPHOSIS CHANGING IN A CHANGING WORLD - FREE

The case of the Westbury Cepholopod

Serotonin and depression linked or not linked - that is the question!

On your marks... Getting the best out of your sport Cortisol and why too much is bad for you Food glorious food

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CNHC

Complementary & Natural Healthcare Council

Thinking of trying

complementary therapy? ��

www.cnhc.org.uk

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For further information check: www.cnhc.org.uk call: 020 3178 2199 or email: info@cnhc.org.uk www.cnhc.org.uk 2 | Metamorphosis

WINTER 2013 | VOL. 1 | NO 4

elcome to this edition of Metamorphosis, the magazine published by the Association for Solution Focused Hypnotherapy. It’s our pleasure in sharing some of the fine work we do across the UK in helping people change problems into solutions.

e have a look at changing the way we feel about our deepest fears, how to get the best out of sport, brain and body chemistry and what it means for our physical as well as mental health and we finish on nutritious food.

ope you enjoy the magazine, any questions or queries please send to me at journal@afsfh.com

Penny Ling - Editor

METAMORPHOSIS

Publisher: the Association for Solution Focused Hypnotherapy. 8-10 Whiteladies Road Bristol BS8 1PD Editor: Penny Ling Email: journal@afsfh.com Design & Advertising: Redhed Design UK http://redheddesignuk. wordpress.com 07508 658934 Metamorphosis can be found on-line at issuu.com

The Association for Solution Focused Hypnotherapy established 2010 represents the practice of solution focused hypnotherapists as a distinct profession in its own right. Membership is open to those practitioners who have the appropriate qualiﬁcations and experience within the ﬁeld. The contents of this magazine are protected by copyright and nothing may be reprinted without prior permission. The publishers cannot accept liability for content of material in the magazine.

CONTENTS The Westbury cephalopod p4 ................................... Serotonin and depression p9 ................................... On your marks p13 ................................... The cortisol connection p16 ................................... Food glorious food p24 ...................................

Distribution is UK wide.

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“ The Case of the Westbury Cephalopod ” Roger Stennett’s on the case

Chapter 1 Of all the Therapist offices in all the world she had to walk into mine. It was one Monday in July. The kind of day when the rain splashed against the window panes and said “Welcome to British Summer time” I looked out of my office, down on to the mean streets of Westbury-on-Trym, and somewhere deep inside I guess I was challenging the Universe to throw me yet another curve ball. And it did. She came in wearing a uniform. Schoolgirl uniform. It took me all of two seconds to piece that one together. She was, in fact, a schoolgirl. She went to a swanky place. All Hockey sticks and Lacrosse before lunchtime. The kind of place that prepares a young woman for the world. But this ‘broad’ wasn’t prepared good enough. She may have known the square root of Peru, or how many beans made five, but she was scared. She was really, really scared. Now, when you’ve strayed down the

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wrong side of the mental tracks as often as I have, then you tend to take most things square on the manly chin. But I could see that there was a challenge ahead with this one. As she curled into the IKEA splendour of my consulting room chair she started to tell a tale of horror, and it was a tale that stretched way back to childhood and that day at the Zoo.

Chapter 2 She was just little, six maybe, seven tops. She and her friends were on an outing. Bristol Zoo was the place. It was fun. The kind of unquestioning fun a six year old had a right to expect. They’d seen lions and tigers and aardvarks. They’d drunk Cola and seen Koalas. So far so good. Not a cloud in the sky. Not a hint of the horror to come. Not a suggestion of the trauma that would rock her world and a decade later send her to me, sobbing out her story. It was The Aquarium. That was the scene. All fish and bubbles. Bright colours and crustaceans. The sort of place you would never expect to find terror. But that just goes to show. The roots of Phobia can hide in plain sight, and fear can be triggered in a heartbeat.

It was only a drawing. On the ceiling. Not even a real thing. But the moment she looked up and saw it, her eyes were captured and her heart chilled. She ran screaming from the home of the cuddly sea-horses, and for ten years could never bear to look at photographs, or even speak the name of that which had pierced her to the heart. In that one moment she had become Phobic. She had inherited terror. And the object of her aversion. The genesis of her cold sweat, rapid breathing and palpitations was a kids drawing of an ……. Octopus.

Chapter 3 As I hear all this a question was forming. While I could comprehend the visceral terror at the heart of a suckered cephalopod, and while I could appreciate the sensual challenge of its multi-armed embrace, it had been quite some time since I’d seen an Octopus or Squid or even a Manta Ray in Westbury-on-Trym High Street. Maybe

she could just “get over it” as my old mentor, David Newton, used to say. But No. There was more. And that more was a Cosmic Joke. For my schoolgirl was in the business of becoming a woman, and the passing out parade was to be a formal Black Tie Ball in two weeks time. A place where she and her ‘homies’ would strut their stuff, possibly even with boys who

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were busy becoming men. A place where she needed to look good, feel good and act good before she moved up and on to

And what do you think lived there …. You got it. Her worst nightmare.

Chapter 4 Take a breath. I’m taking over this story for a time to give my alter ego a chance to refresh his Cinema Noir. This was a challenge for anyone. Therapists have all probably worked with Phobias and irrational fears before. Anything could be the trigger. Anything could connect through from the outside world of stimulus to the irrational response of terror. It didn’t have to be a frightening object per se. I’ve known people who were Phobic of buttons, horse and carts and the underside of boats. All that matters is that a fear/flight connection is made, often innocently enough, and a person seems to be stuck with it. University and the world beyond. And where was this Rite of Passage taking place? The brand new state of the art Bristol ……. Aquarium.

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Now some fears are popular. They are in the Top Ten charts of cold sweat. Fear of Flying, fear of snakes or spiders, fear of heights. All good and all pretty work-able with.

But Octopus? We started off with some standard Anxiety reduction work combined with some Solution Focused Therapy initially in talking/listening mode, but also using trance. We tried to approach ‘the heart of darkness’ and its horror rationally, and gradually she was at least able to say the dreaded word ….. “Octopus”. At the same time we started to deconstruct the Octopus-ness of it all, and as part of the process we began to use humour. We started to ‘take the piss’ out of this fearsome wobbly-beast. We started to see it as a cartoon character, and even imagined what its voice would sound like if it could be bothered to speak. The challenge was to chunk it all down to something manageable, and something that could be seen in all its vulnerability. Dare I say it, something towards which my client could at least feel Compassion, if not Love. And it worked. Over a few sessions we began to cut her Fear down to size, so overwhelming Octopus became more bite-sized Calamari you might say. Added to that was the general wellbeing that results from anyone ‘feeling heard’ in a therapeutic space, and we were making progress, which was just as well since D-Day and the Formal Ball

was approaching fast.

Chapter 5 Sigmund Spade here. Back from my coffee break. So. Where was I? I’d done all the stuff above and my client was ‘cooking with gas’ as we say. But the proof of the pudding is in the eating, and I knew we needed a bit of ‘in vivo’, which isn’t a Pavarotti aria, but is trying a thing out in the real world to see if the wheels stay on. So, the day before the Ball I invited her to come with me and we’d visit the Aquarium. We’d pay a courtesy call on Mr Tentacle and see whether all that ‘shrink work’ had panned out. Now it’s a great place, and she and I loved feeling sorry for the Sea Urchins, and revelled in the seals and sharks and sardines, but every step took us closer to the tank where her ‘nemesis’ literally hung out, its multitude of suckers holding on to the glass. “Sigmund” I said to myself “It’s now or never. Make this work and it’ll be a gold star in your Big Book of Psychotherapeutic Intervention. Screw up and you might have to go back to writing plays for The Royal Shakespeare Company.” A lot was riding on this moment.

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And suddenly there it was. It was kinda waving with a ‘come hither’ look in its eye. At least I thought it was its eye, but it might well have been its anus. And before you knew it my ‘goirl’ was striding across to it and even putting her hand against the glass so they were finger to sucker. She even demanded photographic evidence for her mum, so I snapped away. I think I captured her good side. The jury is still out on the Octopus. It was a result, and we all smiled a lot. At least I think the Octopus smiled too, unless it was indeed its anus.

Chapter 6 It was a couple of months later that I got the letter. She was a University student now, and she was happy. Beating the Octopus cleared the way for her licking some of her other hang-ups, and she happily told me

how great The Ball had been, and how she made a point of introducing all her hockey playing chumettes to her new best friend, the Octopus. Job done. As I poured myself a glass of Vimto and looked out on to all human life on the street below I felt proud to be doing my job, and able to work the magic. I reflected on how well I’d been trained and how my old mentor would have smiled. Some days you just know you’re ‘in the zone’, and that with a bit of luck and a following wind you’ll manage to escape the clutches of The National Theatre, Andrew Lloyd Webber and the BBC for another day. And that feels good 

Roger Stennett is a writer, solution focused hypnotherapist and supervisor based in Bristol. roger.stennett@gmail.com www.rogerstennett.macmate.me

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Serotonin and depression Trevor Eddolls is convinced theyâ&#x20AC;&#x2122;re not linked

Trevor Eddolls is an IT expert and solution focused hypnotherapist in Chippenham Wiltshire http://ihypno.zxq.net

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Research shows that serotonin and depression are not directly linked. Everyone knows that low serotonin levels cause depression – in much the same way that everyone used to know that the Earth was flat! Everyone knows depression is caused by low serotonin levels – in the same way that everyone knows that headaches are caused by a lack of paracetamol or aspirin. The trouble is that many people believe there is a direct link between neurotransmitter serotonin levels and depression, and many hypnotherapists are saying this to their clients. According to Ben Goldacre in Bad Pharma: “The ‘serotonin hypothesis’ for depression, as it is known, was always shaky, and the evidence now is hugely contradictory”. Most drugs used for depression are SSRIs – selective serotonin reuptake inhibitors – yet Goldacre informs us that tianeptin is equally effective, and it is a selective The blood-brain barrier separates Brain ExtraCellular Fluid (BECF) from circulating blood. It consists of endothelial cells that restrict the diffusion of microscopic objects and large or hydrophilic molecules, but allow the diffusion of small hydrophobic molecules (O2, CO2, hormones). Glucose and specific proteins are actively transported across the barrier.

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serotonin reuptake ENHANCER. It should have quite the reverse effect, if the theory held water. Why is it so hard to prove this one way or another – either serotonin levels effect depression or they don’t. It’s hard because scientists would have to work on living brains, and not many people would agree to have part of their brain mashed up for science (and those darn ethics committees wouldn’t be very happy either!). The only way the science can be done is by measuring serotonin levels in blood. You can see the problem. Serotonin is a neurotransmitter, it exists in the synapses between neurons. There’s a blood-

It’s like that part in the television programme QI: the screen has gone black and is ﬂashing because Alan Davies has just said something that most people believe, and Stephen Fry is gloating over the error and showing his superior knowledge. We’ve all been Alan Davies, shortly (and without the gloating) we’ll become Stephen Fry! serotonin precursor.) And guess what? The subjects didn’t become depressed. Other scientists even came to the conclusion that too much serotonin causes depression – and suggested this as a reason for the side-effects of SSRIs.

brain barrier that stops large molecules diffusing in or out. And serotonin is made in other parts of the body too. It seems that about 90% of the serotonin in our bodies is in what are called enterochromaffin cells. These can be found in the gut and are used to regulate intestinal movements. Even allowing for these difficulties, scientists made an estimate of the serotonin levels in the brains of depressed people - and they found that they were pretty much the same as the rest of us. So, scientists tried another experiment. They took normal healthy people and reduced their serotonin levels. (It’s done by messing about with tryptophan, a

But there’s another issue here. Does a low (or high) serotonin level cause depression, or does depression cause a change in serotonin level? Let’s take a more detailed look at the arguments against serotonin causing depression. Firstly, how come it takes a month of taking SSRIs before there are any noticeable effects? Wouldn’t raising the serotonin level kick in pretty quickly if the theory was correct? Isn’t that what people argue as they tuck into a bar of chocolate. The evidence from medication would suggest that you should eat chocolate for a month before you felt happier!! Secondly, SSRIs would work on everyone in the same way. Yet the evidence suggests SSRIs work on only 60% of people.

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SSRIs obviously work – albeit slowly and on just over half the population – so how are they working? It looks like they also increase neurogenesis – the birth of new brain cells in the hippocampus. Experiments on animals (those ethics committees again) show the animals eat more tasty food and move around more when treated with antidepressants. And if you depress them, they do less of it – and neurogenesis is reduced as well. So, it looks like (it could well be that) increasing serotonin levels in the brain increases neurogenesis, which reduces depression. That would explain the three to four week delay before the effects of the SSRI medication can be felt. Or, of course, something else

it could entirely!

References:



ANTI-DEPRESSANT MEDICATIONS Selective Serotonin Reuptake Inhibitors (SSRIs): Fluoxetine (Prozac). Citalopram (Cipramil) Paroxetine (Seroxat) Sertraline (Lustral) Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) Duloxetine (Cymbalta and Yentreve) Venlafaxine (Efexor) TriCyclic Antidepressants (TCAs): Amitriptyline (Tryptizol) Clomipramine (Anafranil) Imipramine (Tofranil) Lofepramine (Gamanil) Nortriptyline (Allegron) MonoAmine Oxidase Inhibitors (MAOIs): Moclobemide (Manerix) Phenelzine (Nardil)

Bad Pharma: How drug companies mislead doctors and harm patients by Ben Goldacre; Publisher: Fourth Estate; ISBN-10: 0007350740 Hypnofacts by Trevor Eddolls; Publisher: iTech-Ed Hypnotherapy (30 September 2012); ISBN 9781291100822 http://www.newscientist.com/article/mg20727703.300-serotonin-cell-discoveries-mean-rethink-of-depression.html http://www.webmd.com/depression/features/serotonin http://www.guardian.co.uk/science/blog/2010/sep/28/depression-serotonin-neurogenesis http://www.psychologytoday.com/blog/charting-the-depths/201007/the-serotonin-theory-depression-is-collapsing http://en.wikipedia.org/wiki/Serotonin

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On your marks... Sports Psychology by Penny Ling

Sports psychology is the study of human behaviour in sport; it is the intersection between brain psychology – what we think – and brain physiology – what we can train the brain to do – through visualisation skills. Not only does a sports person strive to improve their physical bodies, they also need to manage their emotions and self talk.

deal with issues right across the board. It is better therefore to undertake some kind of psychological training right at the beginning before any set backs occur, rather than after an incident has taken its toll on performance. This helps keep motivation levels on track to reach your goals too. So you can deal easily and readily with any potential setbacks, which may arise.

So what motivates us to seek out When most people think about these challenges?

psychology, they think in terms of therapy. This implies a disability or something needs healing; but it is common to use these tools in order to prevent problems occurring in the first place. Often applying these methods of thinking and working improves mental ability and the way we

To start with, it may just be the challenge of finishing a race, or finding you have a natural aptitude for a particular sport. Then once a decision has been reached with its pursuit, it becomes a question of will, desire and motivation.

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Maintaining the motivation to continue the training can be very taxing and difficult to sustain. While it’s important to have the right equipment, clothing etc, it’s equally important to have the right frame of mind to effectively train on a daily basis, and it’s often the psychological aspects of training that tend to make the difference between success and failure.

Having effective goals Once your sports client has their goals in mind, you can help them work towards them, without dwelling on past performance – it is perhaps one of the most important aspects in long term training, goals must be achievable though. And of course they have to make sure they are physically fit and take into consideration possible long term physical problems which may occur, especially taking family history into consideration. You can also ask them a few questions to determine how serious they really are about the sport: 1) What is your previous experience of discipline? 2) How much training have you already done? 3) How much are you prepared to do? If someone is not physically prepared

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then it can lead to over training and injury and this will encourage mental setbacks. There is also realising your physical peak. After the Olympics there were a number of job fairs where employers were looking for athletes who wished to retire from the sport, but had that mental training and wanted to use it in other areas. Being aware of what they want to do after they become too old for the sport can help them prepare for the psychological ups and downs. Next to goal setting is planning. A friend of mine who runs marathons has an app on his phone that calculates how many miles he needs to run, in his plan for fitness before each race. He says it cuts out excuses such as the weather not being good so he’ll do it tomorrow. There’s no arguing with an app so he sticks to it. There’s also training outside versus the gym. I had a client come to see me who ran marathons. She’d broken her leg during a 10K race because she had only prepared over winter on a treadmill. This had not prepared her body for the pounding on the tarmac. Once her leg had healed she couldn’t face running again. I helped her, not only get over the incident but helped her clear room in her life to start planning a training regime, which was mostly outside. She was really impressed when she started to run in all weathers over the Christmas period and enjoyed it.

Penny Ling is a solution focused hypnotherapist in Oxfordshire and Berkshire. For more information go to: www.pennyling.co.uk Rest is just as important as the training as overdoing it can lead to all sorts of physical problems. When an athlete has set goals, created a programme of training that increases over time and allows for periods of rest then they are on track to develop the mental stamina too.

Using visualisation A great deal of research has been done in the States with the use of visualisation in sports. By using imagery it helps strengthens the pathways in the brain that deliver the shots or positions us just right, or scores the goals or conversions. It also helps prepare us for the unknown. Many cyclists for example will mentally rehearse a track before taking to their bikes. I used to do high jump and would mentally rehearse before each jump – by doing this you can also filter out all the cheering or jeering going around you and concentrate on the job in hand. Some athletes find visualising in first person difficult. If that’s so try them on third person as if they are watching it on TV. Using these skills you can plan every move in your body. Having been the person standing at the end of a Glenn Catley punch I can thank visualisation for the accuracy of that punch to stop only about 1cm from my nose – the movement of the air created by his fist was enough to ruffle my hair!

It may be an advantage for athletes to watch footage of their training so they can make adjustments to their manoeuvres, but make sure they do it in a positive light and not pick holes in it. This positive selftalk is important, so when they are feeling a bit wobbly they can use phrases such as “Focus” or “Come on”. Some people think Muhammad Ali was cocky, self opinionated and arrogant, but his self-belief spurred him on. Interviews with him later show his humour and humanity. An athlete has probably over done training if: a) They are more tired than usual and feel fed up b) The muscles have been over exerted despite adequate recovery time. c) Decreased performance d) Increased negative moods over positive ones e) Increased heart rate at lower levels of exercise f) Increased heart rate at resting. To monitor how an athlete is doing I scale their performance and help them paint a picture of how their performance will be when all the plans come together. Being able to focus on the final outcome is always important, as well as what went well 

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Cortisol

– and why too much is seriously bad for you

A comprehensive overview by Paul Concannon As a passionate Solution Focused Hypnotherapist, I sometimes have so much information at my disposal it can be rather difficult to take stock and remind myself of the fundamentals of what we are looking to achieve. I see one of my primary objectives as helping our clients to learn how to ‘chill out’. With the myriad pressures of modern life, it’s entirely possible for people to go week-in and week-out without ever really learning to relax. We can often equate sitting in front of the TV with our mind on overload, glass of wine in hand, with relaxation. Thus, we can miss out on

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the many profound benefits that deep relaxation can help us achieve. These include lowering blood pressure, fewer headaches and reduced chronic pain, decreased muscle tension, more energy, stronger immune systems, better sleep, improved attention spans, greater solution engendering abilities, efficiency and emotional balance. When creating positive trance states, we are helping clients elicit the relaxation response. The relaxation response is defined by Harvard Medical School as ‘A physical state of deep rest that changes

the physical and emotional responses to stress... and the opposite of the fight or flight response.’ The symptoms of the latter are well documented to us at this stage, and include increased blood pressure and heart rate, shallow breathing, muscle contraction, perspiration, stomach churning and an increase in stress hormones such as cortisol and adrenaline. In essence, the relaxation response assists the body from reacting badly when our stress levels increase. But why is that so important and how does it relate to overall wellbeing? The answer is far from simple and to find an articulate, medically based and accessible riposte, people should seek out the workings of Shawn Talbott, PhD, author of ‘The Cortisol Connection: Why Stress Makes You Fat and Ruins Your Health - and What You Can Do About It’. Talbott’s books are endorsed by The National Institute for the Clinical Application for Behavioural (sic) Medicine and provide a detailed, fascinating and a thoroughly absorbing account of the debilitating influences of stress on the body and mind, in particular the aforementioned production of cortisol, whose detrimental impacts have implications on everything from libido through to our ability to fight cancer. It’s impossible to do justice to Talbott’s

research and expertise in a relatively short article, but what follows is an outline of the effects of the potentially devastating consequences of excess cortisol. Hopefully this will allow the reader a deeper understanding of what it truly means for our clients when they are ‘stressed out’ and to help answer questions such as, ‘How does hypnotherapy help with disease?’ How

Stress

relates

Disease

Chronic stress, Talbott tells us, leads to raised cortisol and reduced testosterone levels. This kinship has consequences in a wide range of chronic diseases. “The medical literature tells us quite clearly that many of the negative conditions associated with a “modern” lifestyle—such as obesity, diabetes, hypertension, insomnia, headaches, ulcers, depression, anxiety, poor memory, and a lower resistance to infections—are all related to high stress levels,” says Talbott. Unsurprisingly, all these unchecked, stress related conditions have an enormous impact on economic conditions. Here in the UK for example, this is borne out some of the statistics from The Health and Safety Executive regarding the impact on industry.  Work-related stress caused workers in Great Britain to lose 10.8 million working days in 2010/11.  On average each person suffering from this condition took 27 days off work.

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 Stress is amongst the biggest problems in British work places, with the cost to the British economy being estimated at £3.7 billion per year. All this sickness of course means more trips to the doctor, as Talbott expresses in the context of his homeland, the USA. “Episodes of illness, doctor visits, and trips to hospital outpatient departments have been shown to double (at least) during high-stress periods when compared to lower-stress periods.” It’s not just workers who are impacted either; the list of those seeing the doctor includes highly stressed students and homemakers during periods of intense stress, such as exam deadlines and family issues. So why, one would think, does the human body need a hormone like cortisol? It should be noted that cortisol is vital in helping us deal with the stresses of modern life. The issue is that excess cortisol levels can lead to a host of “related metabolic disturbances” and “an increased risk for developing a variety of chronic conditions.” Essentially, this refers to the effect on our metabolism of elevated cortisol levels, meaning a disturbing list of causes and effects with a direct line to a series of chronic health conditions, a simple example being increased appetite (due to excess cortisol) and enhanced fat storage could lead to obesity. Other health conditions similarly impacted include heart disease,

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Alzheimer’s disease, depression, infections, anxiety, diabetes – all with links to cortisol induced metabolic issues. Insulin, diabetes, weight gain and overeating Insulin you will know about in relation to its affiliation with diabetes. Its function for the human body is to regulate blood sugar; it is sometimes thought of as a “storage” hormone because it helps the body put all these great sources of energy away in their respective places for use later. “The primary effects of stress in raising one’s risk of diabetes related to chronically elevated levels of glucose and insulin in the blood,” says Talbott. One of the first signals the body must send out (via cortisol) during periods of stress is a message, “No more energy storage!”—and that means shutting off the responsiveness of cells to the storage effects of insulin. “Telling the body’s cells to ignore insulin on a regular basis, as happens with chronic stress, can lead to a condition known as insulin resistance and predispose a person to the development of full-blown diabetes,” he continues.

Stress causes weight gain mainly because of an excessive secretion of cortisol, along with a reduced secretion of anabolic hormones, such as DHEA (Dehydroepia ndrosterone), testosterone, and growth hormone - a nasty combination which causes the body to store fat, lose muscle, slow metabolic rate, and increase appetite. Overall, stress makes us burn fewer calories and consume more food, especially carbohydrates – which as we know when not burnt, quickly convert into fat frequently in the abdominal area. For yo-yo dieters, there is more bad news here; people who have restrained their eating habits are likely to be more stressed, which of course, creates more cortisol – a cruel quirk of human psychophysiology. “Adding fat in the abdominal area (in response to stress) changes the body shape from that of an hourglass to more of a shot glass—and repeated diets only compound the problem,”Talbott explained. “Fat accumulation in the abdominal area is a condition that is closely associated with heart disease, diabetes, hypertension, and high cholesterol.” The hypothalamus is that bit of the brain

we tell clients about in our consultations which, “Regulates chemical responses in the body and mind.” Related to stress, it secretes corticotropin-releasing hormone which kills the appetite (we tend not to be thinking about lunch when under polar bear attack) conversely, CRH makes us feel like we’re having a panic attack, so nobody is recommending it as a diet supplement and these hunger suppressing effects only last for a matter of seconds in any case. Sadly, following on from the aforementioned stressor is an intense upswing in cortisol— which encourages our need to eat in the minutes to hours following the stressful event; comfort eaters can relate to this. “We’re rarely expending huge amounts of energy when dealing with our modern stressors (sitting in a traffic jam doesn’t burn very many calories), so the stimulated appetite makes us eat when we really don’t need the calories—and we get fat,” edifies Talbott. Many further details of the profound link between cortisol and metabolism, and the dangerous impacts on weight gain and insulin can be found in The Cortisol Connection series; examples include loss of muscle mass, breakdown of tendons, and ligaments, decreased protein synthesis (to conserve amino acids for conversion into glucose), increase in blood-sugar levels, increase in appetite and carbohydrate cravings to name but a few. “Are we destined to become fat as a result of our

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His work is packed to the rafters with scientific evidence taken from many high level studies, and as if to prove the old adage, ‘It’s all about balance’ we are further informed of the impact of overtraining and our levels of cortisol, “Over-trained cross-country skiers experience the very same adverse effects of elevated cortisol levels, such as mood disturbances, immune system suppression, and increased levels of body fat.”

stressful lives? Probably—unless we learn to control the adverse effects of cortisol,” argues Talbott.

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“Basically, they were exercising their brains out to get in better shape, but their elevated cortisol levels were hampering, and indeed outright preventing, their progress.” Thankfully, there’s plenty of good news there too, referring to a Swedish scientific study he explains: “A 13–14 percent reduction in cortisol levels is associated with a weight loss of more than twelve pounds. This means that despite the gloom and doom caused by the link between stress, cortisol, and obesity, we have some hope that by controlling cortisol levels we can make a positive impact on our body weight and level of body fat.” How often in our consulting rooms have we had clients reporting “low energy levels and fuzzy mental functioning”? Something called Syndrome X, says Talbott, could well be responsible: “If

you are starting to gain weight, feeling low on energy, seeing your cholesterol level and blood pressure creep up, and feeling as if your mind is not quite as sharp as it used to be, you are a likely candidate for developing (or you are already suffering from) syndrome X. Among the early signs of syndrome X are low energy levels and “fuzzy” mental functioning. Very often, these feelings strike following meals, due to the body’s difficulty handling carbohydrates.” And the root cause of syndrome X? You’ve guessed it – cortisol. It’s important to note, it serves as further clarity on stress and our role in helping clients to combat it. As therapists we can relate to cortisol’s role in fatigue and insomnia, two areas that depressed and anxious clients will report to us as a natural part of their symptomology. A better understanding of cortisol (that word again!) can help us communicate one of the key reasons why they are feeling so dreadful. Conversely, we are of course armed with the knowledge of how they can produce the feel good neurotransmitters such as dopamine, noradrenaline and good old serotonin; relaxation, positive thinking, interaction and enjoyable exercise. “Cortisol levels are elevated in response to stress, so any stressful events

encountered in the late afternoon to early evening will hamper a person’s ability to relax and fall asleep that night. If you’ll recall, one of the many effects of cortisol is to increase a person’s level of alertness— which is exactly what you want to avoid right before bedtime,” says Talbott. “But it’s not just that a lack of sleep leaves you feeling crappy; research shows that even mild sleep deprivation can actually destroy one’s long-term health and increase one’s risk of diabetes, obesity, and breast cancer.” So what we can see here is a complete picture developing of the importance of looking at the whole person. Cortisol and Sex Drive “You don’t need to read a book about the relationship between stress and disease to know that when we’re stressed out we also have problems in the ‘intimacy’ department,” writes Talbott. “Stress simply makes us lose interest in sex. In males, this is due primarily to a dramatic fall in testosterone levels during stressful times. In females, the stress-induced loss of sex drive is a bit more complicated, involving disruption in levels not only of testosterone, but also of oestrogen, progesterone, and prolactin.” This is a detailed area, and can be done with little integrity in the relatively short space available here.

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Here we can draw a simple conclusion; stress has a negative effect on our sex lives, and in our ability to procreate. Perhaps most ominously, there is disturbing evidence that what cortisol does to our immune function can curtail our ability to fight that most insidious and distressing of diseases, Cancer. “We know that cortisol has a direct effect on shrinking the thymus and inhibiting white blood cell production and activity,” explains Talbott. “Finally, and most remarkably, is the fact that cortisol can actually act as a signal to many immune system cells to simply shut off and stop working (that is, the cells die).” The message is chilling, stress causes cortisol and cortisol effects the production of the cells our body uses to fight cancer. There are complex processes at work here, however the link between cortisol and disease can be an incentive for people to be an active participant in the reduction of their stress levels, especially when they are able to understand their anxiety being through the roof at the same time as them being ill is more than just a nasty

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coincidence. It’s not only cancer which is impacted by excess cortisol – autoimmune diseases (wherein the immune system attacks the body’s own tissues) such as multiple sclerosis, lupus, fibromyalgia, and rheumatoid arthritis are on cortisol’s hit list. “Most of the world’s top immunologists and stress physiologists are baffled by the fact that stress increases immune system function on the one hand, but then turns around and dismantles one of our most important protective systems on the other.” It is fair to conclude at least part of the answer to the latter pertains to our modern lifestyles; running on empty at a hectic pace simply does not allow cortisol levels to return to normal. Now it is important to remember, here we are painting merely light brush strokes on this multifaceted subject, especially relating to the autoimmune aspect; cortisol is only one link in an intricate chain of events. Hearty truths response

about

the

stress

We will not be surprised to learn that all of this stress hormone surplus is going to be detrimental to our ticker. “Chronic activation of your stress response system increases your risk of blowing a gasket in your heart—otherwise known as heart disease,” said the writer. A few of the ‘lowlights’ include:  Our blood gets thicker because of the tendency of stress hormones to promote blood clotting  Feelings of sadness, anger, and control (and lack thereof ) are linked to causation of heart disease  Risk for coronary heart disease is three to five times greater in people with higher levels of anger, anxiety, and worry. He also reminds us of the part we have to play in impacting a healthy heart: “The dissipation of stress, through either meditation or exercise, helps to bring blood pressure back to normal levels.” And now for the good news It’s with a degree of trepidation that I once again bang on about the source, but it’s critical to remind ourselves here of the latter part of the title of the main book in question, and that is: ‘and What You Can Do About It’. There are practical tips aplenty within

the pages about how we can reduce stress and cortisol levels, in some instances relating directly to case studies. This is a medical book, a scientific book, but written for ease of access and intended for scholar and laymen alike. It’s no mere tome of doom, gloom and bleak news designed to have us leaking the very stuff it sets to educate us about. Rather it’s a highly practical source of information on how unchecked stress can impact us and what can be done about it, as Talbott concludes: “At first glance, many of us might view the close relationship between stress, cortisol, and the long list of chronic diseases as a hopeless disaster just waiting to happen— and for a great many people, it is. The good news, however, is that armed with the right information and the proper motivation, one can do a great deal to counteract these potential problems. The general idea is to control the stress response in such a way that cortisol levels are maintained within their optimal range—not too high and not too low—with long-term health and wellness as the outcome.” The message is simple; more balance and less stress helps us live longer, healthier, happier and more successful lives.  Susan Ritson is a Solution Focused Paul Concannon is a solution focused hypnotherapist working from Bristol. For more information go to: http://relaxationinaction.com/

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Food glorious Food

Susan Ritson sheds light to shed pounds Hypnotherapist who also has trained in nutrition. I wanted to interview her because we often see clients for weight loss, and her answers reveal some interesting facts. Q: When you are seeing potential clients at the initial consultation, what do you think is the most important point to emphasise? A: This rather depends on how the client presents themselves. Some clients present with obvious stress symptoms and therefore adding additional â&#x20AC;&#x2DC;homeworkâ&#x20AC;&#x2122; pressures, such as completing food diaries and following rules can be counterproductive in that initial consultation and to further therapy. So I tend to emphasise the importance of the brain/body connection ie when we are stressed the digestive system slows down; repeated patterns of behaviours etc. Really just sticking to the rules as we know them, but in addition reassuring the client that I will be asking them to complete a food diary and at a future date we will be

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examining that food diary in detail. If the client presents purely to address weight issues then I go through the appropriate elements of the usual initial consultation, placing more emphasis on possible health issues such as diabetes, colitis, IBS etc and the food element, so handing out a food diary for completion at the first session, and setting the ground rules for the therapy. The ground rules are as follows: 1. The client can eat anything they like, BUT; i. Anything that is eaten, and that includes snacks as well as meals is eaten at a table (a desk does not count as a table, nor does a car driving from one location to another count as a suitable location to eat lunch). ii. No distractions whilst eating ie no TV, radio, reading, PC, answering the telephone/mobile, texting etc. iii. Always leave something on the plate (even if it is just 1 pea!). iv. Always put knife/fork/spoon down between mouthfuls.

v. If feeling hungry have a drink of water as thirst can be mistaken for hunger. Then of course we navigate the ‘excuses’, the usual (in no particular order): 1.We don’t have a dining room table, or indeed any table, meals are eaten on laps in front of the TV. 2. I can’t leave my desk at lunchtime. 3. I don’t have time to sit down for breakfast I grab something on the way to work. 4. I use my lunchtime to drive between appointments so eat in the car. 5. I am a chef/cook and have to taste food. 6. I work shifts. 7. I have to answer the phone if it rings in case it is an emergency. 8. I don’t have time. Q: How many of them (percentage) have tried standard weight loss programmes such as weight watchers etc and have failed? A: This is an interesting question as around 98% of clients have tried some form of if not all forms of dietary / weight loss programmes. Most clients also inform me that for example: Weight Watchers or LighterLife or other ‘diet’ worked for them because they lost x stone, BUT, they put the weight back on again (usually more weight back on again). I always ask the client then how they define ‘works’ or ‘success’. Does works or success mean that losing 2 stone and putting on 3 stone after x period of time? Or, does success mean

changing their relationship with food and managing their weight. Do they want a quick fix or a longer term lifestyle change? Q: How many of them (percentage) know what food is required and which food is to be avoided? A: Without exception all clients tell me that they know what to do and what to eat. And, without exception I have never had a client presenting for weight management who has known how to eat correctly. If a client knew how to eat correctly and balance a daily diet then they would not have a weight problem. I never tell clients to avoid foods. This is diet speak and may cause anxiety, ie it’s deprivation. Balance is the key. Clients can eat anything they like – as long as they stick to the rules and they follow the nutritional guidelines, which I give them in the nutritional session. Q: What kind of details in their diet do you go through? Is this at the consultation or as you progress? A): I go through every nuance of their diet, each meal, snack, what they eat, drink and at what times of the day and when and how much exercise they do. My programme is usually (unless anxiety/ stress issues) as follows: Initial Consultation – hand out food diary for completion for Session 1 and set

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There is a very useful Food Pyramid available on the internet, which is visual (helpful for those who are dyslexic) and provides good all round advice (www.drweil.com). the goal (or stage 1 of the goal if they are very overweight). I reassure the client at this stage that I am here to help and not to judge. I want them to be honest. Session 1 – Quick review of food diary, make immediate suggestions (if anything obvious) in order that the client can start to make small changes before the next session. I also establish any foods they dislike. I will then continue the session with the Happiness Scale/Miracle Questions, trancework. Session 2 – Nutrition Session – complete and detailed review of the food diary. In between therapy sessions 1 and 2 I work on the food diary. This can take 2-3 hours per food diary. I work out the client’s BMI (Body Mass Index), BMR (Basal Metabolic Rate) and the calories they are eating now to maintain their current weight. To provide some further understanding for the client I calculate the calorific ratio for their goal weight. The nutrition session begins with a reassurance that the statistics and plans I have drawn up for them are to help them and are without judgement. This is highlighted in the Nutritional Plan that I give the client. We then review the plan ie each meal/day in detail, and I go through my suggestions and explain why I have suggested the changes to a more balanced eating plan.

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Why it is important to balance breakfast with lunch with dinner and even snacks where appropriate. The client can then ask questions and challenge the suggestions where they may be less practical, and we together find something that works to achieve the same result. I then generally see the client for a follow up 1 hour session in a couple of weeks, the client is expected to complete a food diary the week before the session. Either the penny has dropped and the client is happy to ‘go it alone’ or we meet again in a month’s time. Clients vary depending on their confidence levels, I let them decide. Q: Are there any techniques you have found consistently help, or is each person different? (ie eating from smaller plates etc)? A) Without exception, all my clients have to stick to the rules I mentioned in Q1. I guide and suggest, but never tell them what to eat, if they want to eat chocolate then they can eat chocolate, BUT they have to stick to the rules, even with chocolate, on a plate, at a table, with no distractions. I’ve never quite understood the logic in eating from a smaller plate. If the client isn’t balancing their food intake the size of the plate is irrelevant. Plus, when the client is eating from a plate they are usually, (although not every time granted), eating consciously. It is the subconscious eating

Susan Ritson is a Solution Focused Hypnotherapist and a nutritionist and can be found at: www. ritsonhypnotherapy.co.uk

we have to manage and that doesn’t usually involve a plate! Q: Do you talk about top ten foods which can help weight loss (ie soup lasts longer than solids so you don’t take so long to get hungry so quickly) etc? A: Top ten lists are for the quick fix dieters and this isn’t what nutrition is about. If you eat too much of any food it will make you fat! It is worth remembering that the human body has not changed since the Stone Age.To enable Stone Age humans to survive periods of food scarcity, the body was designed to store energy, which could be drawn on in times of famine. In 21st century Britain we do not have times of famine. However, the body hasn’t changed and stores surplus food as fat tissue. More important is how each individual processes food and that has to be examined with each person taking into account their lifestyle and likes and dislikes and general nutritional guidelines and health issues such as high blood pressure, diabetes, colitis, IBS etc. So to change your question to ‘guidelines for body fat loss and healthy weight management’ - the following guidelines should be applied:  Carbohydrates should make up 5560% of our daily calorie intake.  Fats 20-25% (of which only 10%

saturated fats)  Protein 18%  Fibre 18%  Fluids – general rule 1 litre per 1000 calories In general the body has to work harder to break down the fibre and complex carbohydrates (see table below) in whole grains and vegetables than it does in breaking down fibre-free refined flours or simple carbohydrates such as white pasta, breads, sugars, honey, maple syrup. So by ensuring wholemeal breads, pastas, oatmeal, brown rice etc are eaten and avoiding refined foods, sugar (including milk chocolate), pasta, breads, pastries, biscuits etc. will help the body to stay fuller for longer. We also have to take into account that the metabolism naturally slows down during the afternoon and evening, which means that food has less of a thermogenic effect when eaten later in the day. Therefore, if clients work shifts or have to eat late for whatever reason then a late meal should consist of lean protein and vegetables because pure protein has the most thermogenic effect of all foods (30% of its calories are used during the digestive process) and the fibre and complex carbohydrates in vegetables will helps to boost the metabolism (although not as much as it would if eaten earlier in the day).

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