Wednesday, December 10, 2008

Cognitive Therapy (CBT) - reading for therapists

CBT is not just the "in vogue" therapy - its the one with the most evidence for its effectiveness and many recent advances.
If you are a therapist, unless you ar already a CBT therapist I'd suggest there is good reason to be be better informed about CBT.Why? Well, you may well decide that you do want to use CBT as your core method, or at least as one of your main set of methods - after all, we all want to use effective methods. Even if you are one of those that CBT is over-hyped, then finding out more will mean that you are speaking from a more informed position and not attacking a straw man.

So where do you start?
The book that I whole-heartedly recommend is
An Introduction to Cognitive Behaviour Therapy: Skills and Applications by David Westbrook, Helen Kennerley and Joan Kirk. It's modern, well-organised and makes a lot of sense - rather ike CBT itself. It includes sections on physical techniques as well as cognitive techniques and behavioural techniques - also useful sections on assessment, socratic method and depression and anxiety.
So that would be my number one recommendation - but below is my complete recommended reading list for therapists who want to find out more about CBT

Westbrook, D Kennerley, H and Kirk, J An introduction to CBT [particularly recommended]
Beck, J Cognitive Therapy: Basics and Beyond
Dryden, W (ed) Brief REBT (Wiley) (good on REBT)
Segal, Z, Williams, M. & Teasdale , J
Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing
A large number of CDs and DVDs are available from www.padesky.com and are excellent.

In a future post, I will share my reading list for clients and the general public who are curious about how CBT ideas and methods can help them

Monday, May 12, 2008

Happiness and its Causes conference in Sydney


A major Happiness and its Causes conference is happening in Sydney at the moment and has spawned interesting newspaper coverage. For example:

Happiness is not having children

THE belief that children and money will bring people happiness is one of life's abiding illusions, a Sydney conference attended by 2000 seekers of happiness was told yesterday.

The scientific evidence shows people are very bad at predicting what will make them happy, said Daniel Gilbert, a professor of psychology at Harvard University and the author of the book Stumbling On Happiness
Read more

Tim LeBon says: This research is important, but could it be that children impact more on meaning than happiness so the headline is rather misleading? Which isnt to say that people who dont have children can't lead very meaningful lives, but that for those who do have children, the benefit may be more in terms of meaning than happiness.


The Pursuit of Happiness


Stephen post ... cites a study, published by the US National Academy of Sciences, which monitored the brain activity of people asked to choose from a list of charities to which they would like to make a donation.

"This is in a laboratory environment, so they are not actually contributing, they're just thinking about contributing," he says.

The study found that when the subjects selected a charity from the list, the part of the brain dealing with joy, called the metholimbic pathway, was activated.

"So it suggests we are hardwired to feel a certain joy when we give," he says

Read more

Tim LeBon says: There is a lot of research into the benefits of altruism for the giver. However,  many people dont like the idea that we should be motivated by selfish reasons to be altruistic. Perhaps the way round this is to use this research to quiet any voice that says "why bother?" or "how about my new car?" when considering an altruistic voice - nearly everyone, I suspect, has this "selfish voice", and this research can be used to silence it.

Monday, May 05, 2008

Positive Psychology and Death

Anyone who thinks that Positive Psychology is just about smiley faces and being over-optimistic, read no further, unless you want to be disillusioned.
If you really want to find out more about positive psychology, I recommend subscribing to the Friends of Positive Psychology listserver which you can do by e-mailing FRIENDS-OF-PP-request@lists.apa.org
One of the things that has suprised me most since joining this mailing list is the number of posts on the subject of death.
Number one post on death in the positive psychology world concerns the free on-line lectures given by dying and wise 47-year-old professor Randy Pausch, especially his "Last Lecture", which you can view in long or short versions. He's just published a book called The Last Lecture.

In another vein, the poem variously called "If I had my life over" and "I would pick my daisies" and attributed to either Nadine Stair, aged 85 or Erma Bombeck after she found out she had a fatal illness ,has also been cited as an inspiration to live more authentically.
One version of it goes like this.


I'd dare to make more mistakes next time.
I'd relax. I would limber up.
I would be sillier than I have been this trip.
I would take fewer things seriously.
I would take more chances.
I would take more trips.
I would climb more mountains and swim more rivers.
I would eat more ice cream and less beans.

I would perhaps have more actual troubles but I'd
have fewer imaginary ones.

You see, I'm one of those people who live sensibly
and sanely hour after hour, day after day.

Oh, I've had my moments and if I had it to do over
again, I'd have more of them. In fact,
I'd try to have nothing else. Just moments.

One after another, instead of living so many
years ahead of each day.

I've been one of those people who never go anywhere
without a thermometer, a hot water bottle, a raincoat
and a parachute.

If I had my life to live over, I would start barefoot
earlier in the spring and stay that way later in the fall.

If I had it to do again, I would travel lighter next time.
I would go to more dances.
I would ride more merry-go-rounds.
I would pick more daisies.




In positive psychology jargon, thinking about death connects with "counting your blessings" as well as living more authentically. Eric Weiner in his Geography of Bliss also comments on stumbling on the importance of death in the search for happiness. I suspect that as positive psychology gets more and more mature, it will increasingly engage with death and its importance to life.

Life before Death exhibition

Recently I taught a ten week Personal Development Through Philosophy course, and, though we talked about many interesting things - wisdom, happiness, meaning, love, work - the topic that grabbed students attention most this time was death. I don't think that this was because the group was particularly negative or morbid - it wasn't - but because it's the one aspect of the human condition that is both inescapable and most frequently denied. Many live as if they believe they are guaranteed their full three-score and ten years - as if important things can wait.The truth is that even if we do not suffer an early death, time is our most important and non-renewable commodity. Whilst philosophers may associate a focus on death and time with existentialist philosophers like Martin Heidegger, other rather more populist thinkers have echoed similar sentiments. I particularly appreciate John Lennon's
"Life is what happens to you while you're busy making other plans." (from the song Beautiful Boy)

It's one thing to nod sagely at the above thoughts, another to let it affect one's life. If you are anywhere near Euston Station in the next couple of weeks, I recommend half an hour spent at the Life Before Death exhibition at the Wellcome Collection, 183 Euston Road.

The collection describes itself in this way

24 sets of photographs taken before and after death

Nothing teaches us more about life than death itself. Journalist Beate Lakotta and photographer Walter Schels asked 24 terminally ill people if they could accompany them during their last weeks and days. From these vigils came a series of insightful descriptions and photographic portraits taken before and after death.

Far from being gloomy, these intimate concerns of the dying reveal the preciousness and transience of life, and make us question what we often take for granted

You can view a slideshow of photos before and after death here.

The exhibition has received many positive reviews - see for example this five-star review. Even The Sun did a positive feature on it.

Personally, I found the exhibition moving and a further confirmation of the importance of facing the possibility of premature death head on.
One 68-year-old could scarcely believe the way death was cheating her out of her retirement. She had been working hard all her life to finally enjoy herself. "Can't death wait?" she pleaded. It could not - eight days later, she was dead.

Another of the condemned, aged 47, mused "It's absurd really. It's only now that I have cancer that for the first time, ever, I really want to live." Existential therapist Irvin Yalom has longobserved how impending death trivialises the trivial. Wouldn't it be good if we could do this without the sentence of imminent death hanging over us?

The exhibition is free and continues until 18th May.

Thursday, April 10, 2008

The Geography of Bliss by Eric Weiner (part I)

A funny book is one of life's great under-rated pleasures. An
instructive book is by no means t always pleasurable, but at least it's
good for the soul.
I've just started reading Eric Weiner's /Geography of Blis/s and it has
all the hallmarks of that rarest of breed, a funny /and /instructive book.

Wiener, a self-confessed grump and one-time foreign correspondent,
decided to spend a year in search of bliss. A journalist by trade, he
combined work
with pleasure, persuading his publishers to finance a year's travell to
the earth's spots most likely to provide clues about the nature of
happiness.
I'm up to chapter 5 so far, and his search has taken him to the
Netherlands, Switzerland, Bhutan and Qatar.

Sunday, February 24, 2008

Top Ten personal development classics

Whilst there are plenty of flakey self-help books out there, the very best personal development books contain wisdom delivered in language we can all understand. They can both be inspiring and insightful.

What is needed is a way to sort the wheat from the chaff. I've been a fan of the genre and been using them as part of my therapy and coaching work for quite some time. So which books have I and my clients found most helpful? Each year I update my personal top ten self-books - which books have I found most helpful in the last year.

The best self-help/personal development classics

My annual personal top ten (in brackets is position last year)

1. The Seven Habits of Highly effective People Stephen Covey (1)

2. Man's Search for Meaning Viktor Frankl (2)

3. The Feeling Good Handbook David Burns (8)

4. Overcoming Low Self-Esteem Melanie Fennell (5)

5. The Conquest of Happiness Bertrand Russell (4)

6. Don't Sweat the Small Stuff -and it's all small stuff Richard Carlson (3)

7. Emotional Intelligence Daniel Goleman (7)

8. The Art of Happiness Howard Cutler and the Dalai Lama (-)

9. How to Win Friends and Influence People Dale Carnegie (6)

10. The Consolations of Philosophy Alain de Botton (9)

What are your favourite self-help books?

Bertrand Russell's Conquest of Happiness - a personal development classic



Bertrand Russell’s Conquest of Happiness



Bertrand Russell’s books were described by Time magazine as a modern substitute for the Bible. If this is so, the The Conquest of Happiness must be at the very centre of his works.

Make no mistake, this is no abstract philosophical treatise – it is a recipe for good living, written for the likes of you and me. Russell’s work is based on two assumptions. First, happiness needs to be conquered. You can’t expect to waltz through life reaping happiness without putting in some thought and effort. But – and this is why The Conquest of Happiness is essentially an optimistic book– if you do make this effort, you can, given average fortune, attain happiness.

The conquest of happiness comes in three stages: first you need to learn about the principles that lead to happiness, next internalise them and, finally, put them into practice. Unless you had unusually wise parents, you must forget what you learnt on your parents’ knee; you must also put aside what teachers, friends and, especially, priests have told us. You must replace these ideas with ones that really will make you happy. One way to do this is to read The Conquest of Happiness, for what Russell has done here is describe fourteen characteristics of happy and unhappy people. This is the essential first stage, but it’s important to realise that Russell does not think that it is sufficient. Next, you have to really internalise these principles – it’s not enough to repeat them parrot fashion, you have to really feel them as you do your feeling of wanting to protect your own children. A superficial reading of the book might not pick up the point, yet Russell emphasises it several times.

“Let your conscious beliefs be so vivid and emphatic that they make an impression upon your unconscious and be strong enough to cope with the impressions made by your nurse or your mother when you were an infant.”.

The third stage – the transformation of your life - will happen automatically if the first two steps are carried out. For example, take a theme close to Russell’s heart – that you shouldn’t feel shameful about sex. The first step involves realising at a conscious level that, whatever the priest said, consensual sex is part of a happy life, not a sin. The second step is to fully internalise this belief, to feel it, not just to recite it; if you’ve really done this, then the pay-off will be that a sense of shame will no longer stop you leading a sexually fulfilling life.

If you can follow these three steps for each of the fourteen characteristics described by Russell you will give yourself the best chance of achieving not just happiness but also freedom from what the Enlightenment philosopher Spinoza called ‘human bondage’. You will no longer be flotsam and jetsam, acted on by the forces of society and the commands of your parents, but a self-determining human being. You will be happy and free.

This framework is given flesh by Russell’s analysis of the fourteen characteristics of happy and unhappy people. Each chapter consists of a justification of why the chosen characteristic is good or bad, nice distinctions between its various senses and a discussion of other writers’ views and Russell’s practical advice for attaining happiness. Sometimes Russell digresses to make some rather tangential remarks about society and education and other personal concerns. Since our concern is with how to be happy, rather than Russell’s other preoccupations – such as the difficulty of obtaining good housemaids in the 1920s – this will be our focus.

The Conquest of Happiness in a page

To CONQUER UNHAPPINESS

1. Don’t be taken in by melancholy

Melancholy is only a passing mood; don’t mistake it for wisdom.

2. Don’t get caught in the competitive treadmill

Feeling happy is the only true success.

3. Develop the right attitude to boredom and excitement

Excitement is best sought in small doses and in the right places.

A certain amount of boredom is to be expected.

4. Make your worries concrete, don’t suppress them

Get a sense of perspective; Ask yourself ‘what is the worst thing that could possibly happen?’

5. Don’t envy, admire!

Enjoy what you have for its own sake, don’t compare yourself with others

6. Fight back against guilt & shame

Look out for the superstitious voice of your early influences; reason with it and defeat it.

7. Don’t suffer from an exaggerated sense of injustice

Exaggerate neither your own good nor others’ interest in you!

8. Don’t care too much what others think

Respect public opinion only to avoid starvation and stay out of jail.

To CONQUER HAPPINESS

1. Cultivate zest

Get into the habit of taking a lively and friendly interest in everything

2. Be affectionate

Reach out to other people and give affection; accept, but never demand it, in return.

3. Be a good parent

Give your child time & user your parental your child’s good

4. Do interesting, varied and constructive work

Find work that is varied, builds on a skill and creates something.

5. Cultivate plenty of relaxing minor interests

Enjoy as many diversifying hobbies and pursuits as you can; make sure these provide variety from your day job.

6. Find the right balance between effort and resignation

Do your best and when you have done all you can leave the issue to fate

Saturday, February 23, 2008

BBC Programme on Self-Help Books

He came to mock, but ended up producing one of the best and balanced programmes on self-help books I've seen in a long time.

Alan Yentob, former Controller of BBC 1, gave us a glimpse of many of the self-help greats in The Secrets of Life, the latest programme in his Imagine series.

The programme begun with The Secret, a massive commercial success but an easy target for the sceptic. The "Law of Attraction" which underpins the book goes back a long way but is sufficiently New-Agey to get the "Are you Serious?" treatment from Yentob. "I can't help thinking that the easiest way to make money from self-help books seems to be to write one", he sneered.

Fortunately, though, Yentob wasn't the only voice we heard, and This Life writer Amy Jenkins
provided a balancing and very sane perspective in praise of self-help books. Just as some people like to go for a run in the morning, and others go down the gym, Jenkins likes to read a chapter of a self-help book to get her in the right frame of mind to face the coming day. And why not?
She agreed that The Secret was a bit OTT, but pointed out that it nevertheless contained some useful insights.

Yentob did not seem persuaded, and unsurprisingly neither Dale Carnegie's How to Win Friends and Influence People nor firewalking motivator Anthony Robbins, did anything to improve matters.

A turning point seemed to come when he interviewed Feel the Fear and Do it Anyway author Susan Jeffers. Her catch-phrases -"Feel the Fear and Do it Anyway" and "Whatever happens, I can deal with it" at first sight seem to exemplify the worst sort of trite positive thinking. Yentob wondered out loud whether some situations were too complex and too awful to benefit from such simple advice. "That's when you need it make", Jeffers replied, "for example, when I had breast cancer over 20 years ago." Yentob's expression became noticibly more respectful, and turned positively deferntial when he introduced us to holocaust survivor Viktor Frankl's Man's Search for Meaning. (A special treat was seeing rare footage of Frankl).

Things got even better when Yentob spoke to David Burns - apparently still wearing the same golfing jumper that features on the cover of The Feeling Good Handbook. Burns is one of the leading writers of self-help books helping people to practice CBT (Cognitive Behavioural Therapy). CBT is one of the most evidence-based therapies, and reading self-help books a crucial component. Burns told Yentob about a suicidal Latvian lady he counselled in his early days as a therapist. Rather than ask her to talk about her childhood, as a psychoanalyst might, he asked her think about some of the positive things that had happened in her life. In effect, he asked her to challenge her idea that she was a worthless person - and sure enough it turned out out that there was plenty of evidence to the contrary. Changing the way you think really can change the way you feel.

Yentob concluded his travels in France, going on a Buddhist meditation retreat led by Buddhist monk Thich Nhat Hanh , author of The Miracle of Mindfulness. The integrity and inner peace of the Buddhist monk contrasted starkly with the salesmanship and mania of some of the Californian-style gurus we had seen earlier. It was clear which impressed Yentob more.

Yentob seemed to have learnt something from giving self-help books a chance. Maybe we all can. To help, I've produced a list of my current top ten personal development books, and also a guide to one of my favourites not mentioned by Yentob, Bertrand Russell's Conquest of Happiness.

If you can access the BBC's I Player, there is at the time of writing still 3 days left to view the programme, and I thoroughly recommend doing so.

Monday, January 14, 2008

Why the good life question?

I sometimes use the "What is the good life?" as the focal point of a whole course. "What's so important about the good life question?", I hear you ask. After all, it's not a question you hear discussed on TV everyday, or in the pub, or - anywhere at all, actually. So here are my three good reasons to give the pub or TV a miss for once and think about this question

1. It can give you a direction is life. As the Roman Stoic philosopher Seneca suggested,

"If one does not know to which port one is sailing, no wind is favourable”.
Once you formulate your answer to the question, you will be better able to resist the winds of chance and peer pressure face dragging you off course.

2. It's the big question
Once you know what the good life is, other questions - such as "should I be in a relationship?" , "should I work more or enjoy myself more?" and "Should I have children" fall into place. As management guru Stephen Covey said,
"Many people climb the ladder of success only to find the ladder was leaning against the wrong wall."


3. You can improve your answer
In week 1 on my course I ask people to come up with a provisional answer to the question "What is the good life". Over 10 weeks, they then learn both philosophical methods and ideas of philosophers about the good life and refine their definition. The improvement in definitions is often startling.

I hope that's reason enough to think about the good life question. What would your answer be?

Saturday, January 05, 2008

New Year's Rules for Happiness

Regular readers may recall that in general I am not in favour of New Years Resolutions
(See last year's article New Years Resolutions? You must be nuts ...)
However, today's Times features a really interesting piece by none other than the Chief Rabbi,
Jonathan Sacks, entitled Count your blessings and begin to change your life
The apparent contradiction is resolved because Sacks isnt so much recommending unrealistic
resolutions as pretty
wise-looking rules for living well. You can read Sacks's whole article online, but here's a list of his 10 recommendations.(the bits in brackets are my gloss on what he says)

1. Give thank (be grateful, count your blessings)
2. Praise (other people)
3. Spend time with your family. (quality time)
4. Discover meaning. (purposes and main goals)
5. Live your values. (by developing habits, using rituals)
6. Forgive. (good for those who have upset you , better still for you)
7. Keep learning. (not just for the young)
8. Learn to listen. (really listen)
9. Create moments of silence in the soul. (if only for five minutes, prayer and meditation are two possible sources)
10. Transform suffering. (don't let yourself be a victim, look for what you can now do you wouldnt have done before

I can't say how many of these ideas are inspired by Sacks's religion.
Sacks attempts to make the connection with religion in the final paragraph of his article, where he says that "the great religions are our richest treasuries of wisdom when it comes to the question of how best to live a life." I can say that many of them are endorsed by recent positive psychology research on happiness. It looks like a good list of wise rules for living to me. I wouldn't argue with any of them, but here are 5 more wise rules for living I would add.
11. Socialise, and make friends a priority (a few good friends may be better than many not so good friends)
12. Find and enjoy meaningful work (a portfolio career may be the answer for some)
13. Look after your body - diet with regards to health as well as weight and exercise in whatever way you enjoy.
14. Use your strengths and manage your weaknesses (positive psychology tends to emphasize the first bit more)
15. Be aware of negative emotions rather than avoid them, and either use CBT-type techniques to reduce them or discover the existential messages in them and take appropriate action.

I'd be interested if other readers would like to suggest other wise rules for a happy and meaningful life, or comment on the link between religion and wisdom suggested by the Chief Rabbi.