Counselling and Psychotherapy by Dr Elizabeth McCardell, M. Couns., PhD

March 2021

      In wondering what to write about in my monthly articles, I listen to what’s going on around me in order to identify what I sense is what needs to be said. For my article this month, I thought I’d get back to basics and examine what counselling and psychotherapy are as well as that they try to achieve.

     Counselling is recommended for specific issues and situations, such as addiction or grief, and takes place over weeks to several months. Psychotherapy, on the other hand, explores issues in greater depth and takes account of past issues and patterns of behaviour that might be contributing to present day problems. This level of therapy takes place over a much longer period. There are many cross overs between counselling and psychotherapy, so what I shall say here, describes them both.

     In my own practice, I am always curious about a client’s past, their family history and family dynamics, relationships past and present, and when they can identify particular difficulties arising and how they dealt with them. I also want to know how well they sleep, the how and when of feelings of anxiety, moodiness, sense of calm and contentment, excitement, and so on. These give me significant clues as to how to proceed.

     So, what is the main function of counselling/psychotherapy? It is to help clients come to know their own strengths, discover what is preventing them from using those strengths, and clarify the kind of person they want to be. They are encouraged to honestly examine  their behaviour and lifestyle as well as learn how to make decisions to modify the quality of their life.

     This is collaborative work, and there are no magic solutions. The pathway for successful counselling/psychotherapy arises from the quality of the therapeutic relationship that, when it is working well, offers support and warmth as well as challenge and confrontation. The latter is sometimes really necessary if old patterns have a chance of being released.

     Contrary to certain  popular ideas, the counsellor/psychotherapist works hard. It may look as though we are just sitting there having a chat with the client. We are, on the contrary, very focussed as we listen, and draw upon our extensive studies and experience of human dynamics and behaviour; ours is a knowledge that takes account of human development, abnormal psychology, social and individual behaviour, neurology, sociology, cultural ideas, and the like. Central to what we do together is the keeping in confidentiality of what is said to us. Those of us who are very experienced have practically heard it all (or so we generally think), so the client doesn’t need to withhold anything. The greater the sense of safety, the more the client feels they are able to speak, and the therapist do their work.

     Another tool that the counsellor/psychotherapist brings to the therapeutic situation is an ability to set aside their own assumptions and beliefs. This is called epoche. It means the therapist is present in a better state of clarity, with little agenda of their own, except to encourage a great easefulness for the client. It is in order to be able to practice our profession with this clarity that it is encouraged by most training institutions that therapists receive therapy of their own.  I began my therapeutic career in the 70s when I studied Jungian psychology (even though I didn’t practice as a therapist for many years) and began serious self reflection through psychotherapy. This continued for many many years. I wrote my Master of Counselling degree dissertation on the subject of therapists who receive therapy. There I noted that such a strategy not only gives insight into one’s self, our relationships, and our style of being in the world, but served as an apprenticeship into this field. All of which makes for good therapy.

     

     Probably the most effective tool in counselling/psychotherapy is the knowledge that the therapist will tailor their work according to the individual client. There is no one-size-fits-all approach. As Jung says, there are as many therapies as there are clients. We work together in the process of your healing and are thus, as therapists, a therapeutic person.

“Hearing” Others by Dr Elizabeth McCardell, M. Couns., PhD

 

February 2021

      I’m  intrigued by the way in which we  get a sense of unseen other people through the narrative of the people talking directly with us. In literary terms, this is known as narrative empathy and it may because my first degree was a major in English Literature, that the idea fascinates me on several levels.

      A while ago, I was listening to a man describing a few ex-girlfriends and I could barely get any real sense of the personhood of these women. It dawned on me that my feelings of disquiet had a lot to do with this man’s own lack of a sense of the “otherness” of the women. If they were characters in a novel, they would be like wraiths, with no substance. We speak, after all, much as we experience.

      We fill in, with our imaginations and felt sense, what we think is going on in another person’s mind when we listen to them speak or write or otherwise depict, the object of their interest. If a person’s focus is on outward appearances, as it was with the man described above, we get very little information on what these other people are actually like. It’s sort of like flicking through a Vogue magazine where women are objectified; nothing more, nothing less.

     This man, who did not have a real sense of the subjective nature of his ex-girlfriends’ experiences, could not understand the effect his actions had on them and the not knowing caused him and, presumably them, real distress. His lack of empathy seemed to be generated by an unawareness of the subjective presence of others. This, I think, was the result of being thrust into an adult world when he was still a child. We develop much of our capacity for empathy though peer contact in a casual environment where ideas of relationship are tried and tested and tried again, and he didn’t have much of this. He was forced to grow up too quickly.

     Getting a sense of how others are feeling is a sign of emotional intelligence and it is the capacity for empathy. Not “hearing” how others are feeling means that they don’t really get a sense of what they themselves are feeling. This is not to say they have no feelings, but rather can’t identify what’s going on within themselves and in the behaviour of others and have difficulty adjusting their behaviour to make space for others’ responses. There is a clinical word for this personality trait: Alexithymia, and being a  trait, it is possible to learn, to heighten, awareness of the feelings of self and others.

     When I was studying couples counselling in my Master of Counselling course we did a lot of practice runs working with people who were not “hearing” the perspectives of the other person they were in a relationship with. We had them do a bit of play acting whereby each had to pretend to be the other person, saying the words they’d heard the other say. This simple task quickly gave each person a felt sense of the other person and a bit of an awareness of other lives, other sensibilities, other perspectives.

     A study needs to be done to investigate how such a technique changes the quality of “voice” in a person’s narrative accounts of others. The quality of “voice” after all changes the capacity to “hear” another person, other people. When we speak of others, what we know of ourselves and how we perceive the other lives of the people we speak of, is reflected in the quality of our narratives. To speak of others without feeling something of what another is feeling is to speak as if “tone deaf”: there is sound, but not much content.  To “hear” another allows us to speak of them in a deeper, fuller way. The man I mentioned above, could well benefit from psychotherapy, if he ever should wish it. The purpose of therapy here would be to learn how to fill out a life with reciprocated relationships that feel good, by recognizing the felt being of others. That makes for a life among others rich and fulfilling.

 

 

Can Hypnosis Retrieve Memory? by Dr Elizabeth McCardell, M. Couns., PhD

 

January 2021

       Every now and again, I get requests from potential clients to help them remember something they’ve forgotten using hypnosis. I generally say I don’t do this sort of thing. There are three reasons for this, and I say so to these people. One is that memory isn’t a large, permanent and possibly accessible storehouse of information, nor is it a recording device; two, hypnosis isn’t a searchlight into such a storehouse;, and three, hypnosis wrongly done can plant false memories, and I’m uninterested in doing that.

     Memory is already a distortion of experience since it is an internal representation of an event and not the event itself. No amount of uncovering bits of information through hypnosis will get to an absolute truth. What hypnosis might do is allow a person to think about a situation or event differently, and this is useful therapeutically, but as a possibly inviolate forensic tool it is generally not admissible in the court of law, with few exceptions. It should be remembered that hypnosis isn’t a powerful tool to recover accurate memories under a variety of conditions including accurate memories as far back as birth or even past lives. You may get glimpses of ideas, but that’s about it.

     Digging into memory using hypnosis, it has been found through years of considerable research, is as susceptible to the problems of distortion and confabulation as any other method of trying to remember something. It would be unethical of me to use hypnosis to fulfill someone’s desire for memory recovery, and I won’t recommend any other practitioner who might claim to do this dubious thing.

     My interest as a clinical hypnotherapist, as opposed to a forensic hypnotist is the loosening up of rigid ideas about oneself. I use hypnotherapy as an adjunct to my psychotherapeutic practice, but only by client choice.  I am a psychotherapist first and foremost, and my participation in my clients’ healing is my actual interest in the field.

     I have helped some clients find missing objects, but not by directing them to that object. I know from personal experience that when something is missing I am more likely to find it when I’m not concentrating on looking for it. It’s when my attention is elsewhere that I can find pointers to the lost thing. When preparing for exams, I used to play difficult fugues on the piano and in this way solve the mathematical problems by approaching the issues from other directions. This, to me, is a far more interesting way of approaching difficulties.

     This loosened therapeutic direction, valuable as it is as I use it, actually also points to the inherent danger of trying to hypnotise someone in order to direct them to actual memory. A hypnotised person’s openness to suggestions, as well as an expectation that hypnosis will work, sets the stage for possible confabulation. Memory is easily contaminated by a whole range of things (just like a crime scene), including the very desire for hypnosis to uncover truth. If you believe something will work, you are most likely to believe the veracity of the something. In court cases where hypnosis is used to trigger memories (real or not), the person is likely to say they are more than one hundred percent sure that such and such is true. This is a red flag. Nobody can be so sure of anything. I note that I avoid such directiedness by saying something like, “Maybe you will find it; maybe you won’t, and that’s alright.” I try to avoid direct statements of any kind, as I do not wish to create stories for the other person.

     By avoiding direct statements during a hypnotherapeutic session, I also avoid client resistance, which is just more inflexibility to a much more fluid approach to life. Loosening anxiety around a problem has the capacity for releasing a person from the problem itself, and that matters enormously.

    So, hypnosis is an unreliable means for uncovering things unremembered, but it’s a wonderful tool for learning to think outside the box; it is a doorway to greater creativity and self confidence.

 

All the waters of the world by Dr Elizabeth McCardell, M. Couns, PhD

December 2020

     Most people who know me know that my passion is swimming, snorkelling, and diving. Just being in the water is bliss. These days, it feels to me that all the pools, ponds, lakes, rivers, seas and oceans I have ever swum in are gathered together in the singular swim of the day. It is as though all the waters of the world are present in the now of this swim.

     I have swum in the North Sea (Scotland, England, the Adriatic (off Italy),  the Andaman (off Thailand), the Indian and Southern Oceans (Western Australia), Fonty’s Pool, Manjimup (WA south-west),  in the Pacific, the Atlantic (Iceland) multiple rivers, streams, lakes (including Lake Zurich in Switzerland), the Silfra Fissure in Lake Thingvallavatn in Iceland (water temperature, 3-4 degrees Celsius); hotel and public pools (last year I was in Berlin swimming in their pool on top of a shopping centre, and Caracalla Spa in Baden-Baden), etc.,  etc. I actually dream of swimming across whole countrysides, and it feels fantastic. 

   One thing I love to do when diving, is swim upside down gazing at the underside of the shimmering water’s surface. I’ve had dive masters try to save me, thinking I’m drowning! This, I guess, is the legacy of nearly drowning when I was four years old. That time, I wasn’t yet a strong swimmer and couldn’t follow the group of swimmers who left me behind, so was going under. Far from being afraid, however, I was fascinated by the underside of the surface of the water with the light streaming through. It was magical. I was pretty cross on being saved and told to play on the beach like the other little kids. I guess the reason I didn’t drown was the children’s capacity for stilling the breath, something I consciously practice these days.

     I have a hankering to free dive the kelp forests off Tasmania, and plan on doing this in the next couple of months. I bought the useful extra long free diving fins and added them to my existing rather large fin collection (I’m the Imelda Marcos of swim fins).  My Octopus Teacher, that beautiful documentary made by Craig Foster on the way in which an octopus taught the man about octopus-life, has added fuel to this desire. The dance of waving kelp seduces me.

     So, what has this all to do with psychotherapy? Far from being a remotely connected idea, understanding what being in water requires and understanding what being in the presence of other people in the psychotherapeutic realm necessitates, gives a very clear pointer to how the one reflects the other. 

     Being in the water and working with clients requires in-the-moment attention; it requires focus, listening, awareness of everything around me, and all done while alert and yet relaxed. The nature of both and all the interconnections within is an imperative of the therapeutic communication. 

     It is no accident that water is often seen as the essence of communication, a word that shares its meaning with “communal”, or “togetherness”. Sound travels long distances in water. A microphone dropped beneath a boat captures whale song of those swimming many metres away.

     In astronomy, Sedna, the planetary body beyond Neptune, was named after the Inuit goddess of marine life. She, or it, in this romance, usefully could symbolize the coming of  consciousness from a backdrop of watery unconsciousness. This is our task in psychotherapy, and in life. It’s also what I endeavour to do while swimming, that is, swimming with awareness.

     Water is subtle in her currents, shifts in water temperature, clarity or murkiness, volume (it took awhile to perceive in my body depth perception), the delicate sense of water tension, and the strange way in which the swimmer can sometimes forget that there is a watery substance, but just the natural environment of the marine animal. Swimming the waters of the world is how I’m coming to know how interconnection, individuation and consciousness all roll into the doing of participation in the art, craft and process of psychotherapy. I swim for the enjoyment of coming to know my work, my life.

Smoking and Clinical Hypnotherapy by Dr Elizabeth McCardell, M. Couns., PhD

 November 2020

     People come to me for clinical hypnotherapy and counselling  in order to give up smoking and other issues (pain management, sleep issues, speech disorders, eating problems, confidence issues, etc.). Today I want only to talk about smoking and the efficacy of hypnotherapy in the treatment of that. What many people do not realize is that hypnosis cannot make you do anything against your will. If you have no actual intention of giving up smoking, the hypnosis won’t be effective. Hypnosis isn’t magic. It is only an altered state of consciousness where you are in a  trance state, much like the state you enter when you are absorbed into something, like reading, or running, or swimming, or watching a movie. The hypnotherapist is talking to your unconscious and giving you information about smoking that you already know: that it tastes horrible, it’s expensive and is terrible for your health, and that you don’t need to do it. If you really don’t want to smoke, giving up is well within your capacity. Hypnosis, in this case, acts as a trigger to change. No one is compelled to smoke; it is up to a point a choice, even though you may feel it is an addiction to nicotine or something to occupy your hands.

     I’ve known people who had smoked for 50 years and gave it away overnight. One man who told me about  his own experience in this, also said that he cried and cried during that night,  for his smoking had concealed a profound anxiety and depression. And this brings me to a fundamental point. Those who smoke heavily generally do so to deal with emotional and often relational issues that the smoking habit attempts to cover up. At this level, the problem is semi-conscious, that is, it is not something deliberately done, but comes about as a kind of self medication. I’ve be noticing this repeatedly ever since I first trained in this field and then began offering clinical hypnotherapy all those years ago, which is why I now want to emphasize that if you really want hypnotherapy to be successful, you need not only to actually want a given outcome, but to shake off the idea that hypnosis can deal with the problem without your emotional and intentional input and also I suggest that you commit to several sessions of counselling as well as hypnotherapy.

     During counselling you will be heard by someone interested in you.  Connecting to someone (me) about matters that are really important to you are the best ingredients for essential interior change. Hypnosis can beautifully set the landscape up for effective communication. It is relaxing and it feels very good and, with the suggestions presented to you under hypnosis, you have the settings for the beginning of enduring change.  This is not a quick fix, and it has substance.  

      I knew a hypnotherapist who had clients who gave up smoking for a year and then resumed this horrible practice. To my mind that’s not good enough and this is why I continue working for something far more effective.

     Of magic and such, some people expect change without their intention for change, as though with a wave of a wand and sparkles in the air, essential change can happen – whatever your mind set. Such an approach doesn’t work on stage, and it certainly doesn’t work in the clinical setting either.  Hypnosis isn’t magic and change usually cannot be achieved in a small number of sessions. Anyone who claims otherwise is delusional. You really will have to commit to several sessions and, with me, do the actual work to  shift  your relationship with nicotine.  

      Of smoking as an addiction. All the study, conversations and research I’ve done into addiction says the same thing: ‘the opposite of addiction isn’t sobriety, it’s connection’ (Johann Hari). When we start connecting through meaningful communication we start to heal. This is why I’m urging potential clients who want to be free of smoking, or anything else, to consider coming to see me and get down to the real work and not just a seek magical removal of symptoms.

 

 

 

Breaking free, with awareness by Dr Elizabeth McCardell, M. Couns., PhD

October 2020

     I was doing a hypnosis the other day and thinking, at the same time, about how much of what we do in daily life is as if in a trance. Driving (much of the time anyway), eating, drinking, smoking, reading, watching television/movies, walking, singing, writing - even, are mostly done in a semi-conscious state. It is no wonder, then, that the habits we have seem to run on their own steam and apparently drag us along for the ride. We forget that we, as a friend used to put it, are the drivers of our own life.

    The trance state, it should be noted, is a very useful space to be in, as long as we can emerge from it at will. The trance state   can be very creative, and full of possibilities. It is a relaxed,  yet focussed dreamy state for the job at hand. Most of us know how that feels. It is as though we are locked onto doing what we’re doing. Yes, we are aware of outside things: wind in the trees, a gecko chirp, water boiling, smells of dinner or the heavy scent of Jasmine in the afternoon, but it is in the doing of what we have chosen where our mind is at. In other words, it is in that quasi-awareness of outside things that we have the key to breaking free from being a slave to the trance state, if that’s what are interested in doing. There is, in here, a choicefulness in what is paid attention to in the gestalt of awareness (figure-ground, ground-figure), and, isn’t it interesting that we can be aware of both at the same time?

    The art of breaking free of doing something inherently bad for us: things that undermine our health and/or self confidence and/or a block to creativity (writer’s, painter’s, etc), can be learned in hypnosis. Hypnosis plays with the trance state, so that, coupled with expectation for change, the client experiences new internal statements as being part of the trance and also as part of ordinary life. In other words, the person’s preferred way of life is introduced in hypnosis as though it is just part of the ‘now’ of life, even if in fact, it hasn’t been part of ordinary life for a long time. A smoker who wants to give up smoking, experiences – in the hypnosis, and beyond – life without cigarettes and also a sense that smoking is now just a vague memory, without in any actual present interest.

     In hypnosis time is traversed freely backwards and forwards, now, in a year’s time, yesterday, tomorrow, at Christmas time, five years  time,  so  that what is learned in each hypnosis session (and three sessions is the minimum required for some people; more is usual) feels to the client as though that knowledge has always been there, and is felt to be preferable to what went on before. On top of that, there is a sense of a hidden observer, an agent of the self who can observe or witness our behaviour whenever we do those things we, until now, have habitually done. An observer that can step in whenever we drift off into unconscious habit activity and turn things around to doing what nourishes and heals us, instead of performing harmful things.

     Hypnosis is a tool where the hypnotic trance is introduced as a place of change, and not a place of just doing what we always do, outside awareness. Hypnosis is thus paradoxical where the awareness of the hidden observer is introduced, or enhanced, while in that lovely relaxed, focussed, dreamy state, and we become aware of our own capacity for change, we enter the path of choice, as opposed to feeling a slave to unhealthy being. The clinical practice of learning mindfulness also has that purpose. 

     Being hypnotised feels good because feeling relaxed feels good and the beautiful thing about the process is that you never lose control, but can step out of the trance whenever you like. You are comfortable in your relaxed, focussed state, and may thereby avail yourself of the freedom that awareness brings.

Talking to yourself by Dr Elizabeth McCardell, M. Couns., PhD

September 2020

     Silently talking to yourself in the third person, hearing voices alien to yourself, talking to yourself in the first person, and thinking in words are all things that many people do, but not all. Why we do/don’t do it is barely understood. There is quite a bit of research on hearing voices in schizophrenia and other psychopathological states, but very little done with people who are quite normal in other ways. A symptom of hearing voices in schizophrenia is an accepted diagnostic symptom, but it is possible to hear voices and not have schizophrenia. Hearing voices is a fact of life for people across many, if not all, cultures and in earlier times was viewed as hearing God’s voice or those of an angelic/or other realm. Most inner speech isn’t about hearing voices, however.

Inner speech, also called an internal monologue, self talk. inner discourse or internal discourse, is a person's inner voice which provides a running verbal monologue of thoughts while they are awake.   It is usually tied to a person's sense of self and is particularly important in planning, problem solving, self-reflection, self-image, critical thinking, emotions, and subvocalization (reading silently). It is thus relevant to a number of mental health issues like depression and anxiety, and bulimia nervosa, as well as certain psychotherapies, such as cognitive behavioural therapy and narrative therapy, where self talk is altered from negative self talk to positive.

     The ‘why’ of self talk has a number of theories. In the 1920s, Swiss developmental psychologist Jean Piaget  proposed the idea that private (or "egocentric") speech - speaking to yourself out loud - is the forerunner of social speech and that it dies out as children grow up, which it clearly doesn’t.  In the 1930s, Russian psychologist Lev Vygotsky proposed instead that private speech develops from social speech, and later becomes internalised as an internal monologue, rather than dying out. This interpretation has come to be the more widely accepted, and this supported by empirical research.

     Many of us engage in self talk, but what or who does this self talk sound like to us? In the last few decades researchers have examined this question in more depth. In one study, a  Polish psychologist, Malgorzata Puchalska-Wasyl, asked his subjects to describe the different kinds of inner voices they conversed with and came up with a list of four common internal interlocutors: the faithful friend; the ambivalent parent; the proud rival; and the helpless child. Each voice might pop up in different situations – an ambivalent parent-type might offer caring criticism, but a proud rival-type is more likely to be focussed on success rather than offering support. We might adopt these different roles to help ourselves get through situations like a difficult exam or sports game.

     Traumatic experiences also have a role in the quality of self talk. The inner critic seems to arise from early childhood experiences where the child feels they are not meeting the expectations of her/his parents and so their inner voice tells them to metaphorically ‘pull their socks up and do better.’

     Some people don’t have an internal voice at all.   Russell Hurlburt, an American psychologist currently working in the field, says that the thoughts running through our heads don’t often take the form of words, contrary to popular opinion. He believes that most people think in pictures, abstractions, symbols, algorithms, geometry, emotions, and other sensorial ways, and only 3% of people think in words. Whether this is true or not, it certainly gives one something to consider.  Hurlburt’s views are absolutely counter to the once fashionable idea that all thought is inner speech, but how and where we study the business of thinking naturally limits our conclusions. We can race down the rabbit hole of the question, ‘What is a thought’ because the explanations of this (that it is a representation or a map of something or a form of information) doesn’t help. What is useful, at least as I see it, is how we make sense of things and how we may avoid getting caught up in negative thinking through accusatory self talk. That’s what interests me.