How to Sleep Well

 

Steps to a good sleep

Many people who experience anxiety and depression often also report a lack of sleep or insomnia.

Sleep is controlled by two body rhythms. The sleep/wake homeostasis and the circadian biological

clock.

When we have been awake for a long period of time the sleep/wake homeostasis tells us it is time

to sleep. This is about creating a balance of sleep and wakefulness in every 24 hour period. The

circadian body clock dips and rises at various times of day. For adults the strongest sleep drive

generally occurs between 2.00a.m. and 4.00 a.m. and between 1.00 pm and 3.00 pm. The

sleepiness we experience at these times will depend on whether or not we have had sufficient

sleep.

Teenagers need at least 8 hours but ideally a little more sleep than that yet the shift in their

circadian clock can make it hard for them to fall asleep before 11.00 p.m.. If teenagers are

consistently not getting enough sleep they will tend to extend their getting up time later and later

into the morning.

Apart from the peaks and troughs in wakefulness we also have a 90 minute circadian rhythm of

alertness. Going to bed at the right time is about catching the right place in this cycle. It can be

helpful to go to work back in units of 90 minutes from when you need to get up.

Sleep requirements vary but generally on average

3 years 12 hours

5-9 years 10.5 hours

10-13 years 10 hours

14 - 18 years 8.5 hours

19 - 45 years 7 hours approx.

45+ 5-7hours

We have different amounts and depths of REM and non REM sleep throughout the night. This too

depends on needs.

Sleep Hygiene

Bedrooms should be quiet dark and boring

Comfortable bed

Thick curtains or blinds

Not too hot or cold

No computers, phones, tv etc.

Other behaviours to support good quality sleep

Being physically and mentally active in the daytime

Be outside in the daylight as exposure to bright natural light can increase melatonin production

(melatonin is a hormone produced in the body which helps to regulate sleep)

Build a good routine of regular bed time and wake time (taking account of the 90 minute cycle)

Restrict fluids in the evenings

No big meals or strenuous exercise too close to bed time

Become a non smoker

Use the eye relaxation process to take your attention away from the busy head

If all the methods above fail to work you can use:-

Sleep restriction therapy

This method is used widely in sleep clinics

Firstly strict sleep therapists will say bedrooms are for sleep and nothing else.

If you can not get to sleep within 15 -20 minutes - get up and do something boring till you start to

yawn then go back to bed for 15- 20 minutes if you are still not asleep repeat the process until

eventually you sleep. No matter how tire d you are the next day satay awake till your normal

bedtime and you will normally sleep.

Do not expect to sleep 8 hours a night and nap in the day. If napping in the day works for you

deduct the nap time from the amount of night time sleep you would expect to get.

Another thing to do is to try to stay awake

How do you stay mentally well?

It is good that we are more aware of mental health but what worries me is the danger of more and more labelling and medicalising.  What I dream of is an acceptance of difference that does not have a cut off between mentally ill and mentally well but that we live in societies where all our needs are met in such a way as to keep us all well. 

I remember being on a course about psychopathology run by a psychiatrist.  The first thing he did was give us all an assessment to do and then grouped us according to the scores that put us into mental health categories as defined in DSM1V.  Believe me, especially in a group of psychotherapists, we all had at least one category that we scored in. He then said - OK so you have these traits and symptoms but none of you would say you were mentally ill.  So how do you stay well? For me that is the essence of mental health.  How do you stay well?  What do you need to stay well?  Some of it is out of our control but there are things that we can all do that would contribute to our wellbeing. This will be different for all of us.

I have recently, after 17 years as a psycotherapist, let go of my psychotherapy practice.  The financial cost of practicing became too great a burden for a small practice like mine but I am not done with supporting people as they strive to stay well. Helping them to stay on track and find ways to be the best version of themselves they can be. 

I got an invoice this morning and the royal mail had stamped “Supports Mental Health Awareness” on it.  Lets not let that be about a them and us but an us.  We are all different, our differences make us who we are.  Lets support one another to feel good about being who we are.

 

Just as we need to eat a balanced diet to stay physically well - we need to lead a balanced life to stay mentally well. You can take a moment to discover the things that are important for your mental wellbeing.  Can you make more space in your life for these things? What would life be like if you could? What help do you need to be able to do more of what keeps you well?

 

 

 

Setting Outcomes for 2018

As we settle into that belt loosening time zone it is easy to start to think about the resolutions we may set.  It is good to make a fresh start.  We can do that any moment in our lives. New years resolutions often do not work out as we hoped because we do not take time to set them correctly.

If I ask you not to think of a pink elephant of course a pink elephant is exactly what you do think of. Think about what you want in positive terms.  For example “I will give up alcohol” can be “I will enjoy the healthy feeling of sobriety”.  “I will lose weight” can  be “I will eat a healthy diet eating fresh and healthy food”.

If you write the answers to these questions they willI help you to achieve the outcomes that you want. You can set outcoems for all areas of your life.

What do you want? State this as a positive statement: remember the unconscious mind does not do negatives. If you achieve this goal what will it do for you? Check it will make life better in a significant way. 

What is the evidence that will let you know that you have achieved your outcome?  What will you be seeing, feeling and hearing?Is it realistic? When can you realistically acheive it? Can you make a start? Can you maintain the momentum?

What do you get out of your present behaviour that you would wish to preserve? Take a long time with this. To succeed requires that you find a way to meet the needs that your present behaviour meets.

Is the change worth the cost to you?  Is the outcome in keeping with your sense of self? 

You can begin to day dream about how life will be when you achieve your outcome.  Put yourself in that imagined picture looking through your own eyes. As you come back to the present notice all the changes that need to happen to achieve what you want.

Increasing Our Tolerance of Stress

We are able now to look at the workings of the brain and how it relates to the body in ways we have never been able to before. “Affect Regulation” is a term often spoken nowadays. Basically this is about how we regulate our emotions.  The problem is that keeping a lid on our emotions is not a healthy way to go forward. Although we do not need to get too hung up on the workings of the body and brain it an be useful to have some understanding. The aim is to be able to discharge emotions that arise appropriately by acting on our needs and feelings in a way that promotes our own wellbeing while, when appropriate, paying attention to the needs and feelings of those around us.

 

In situations of extreme stress adrenalin causes the autonomic nervous system to kick in.  Our ability to tolerate stress is reduced depending on a whole range of things past and present in our experience and in our genetic make up. 

 

One of the steps towards wellbeing is noticing. Reactions are normal and unusual reactions are normal in unusual situations.  Perhaps we can be curious about rather than judgemental of our responses to stress. 

 

Emotions are energy in motion if our defensive systems block expression or action on emotion then the body steps up the response and it is this that we can experience as anxiety.   Underneath the anxietythere are usually a range of emotions such as anger, sadness, fear, disgust, disappointment or even unexpressed joy. Anxiety is our body seeking to bring about resolution of the situation we are in.

 

Responses created in our body by the nervous system can be summarised and simplified as 5 Fs: Fight, Flight, Freeze,( Hyper arousal) orFlag or Faint ( Hypo arousal) .  Of course this is an oversimplification of complex reactions. 

 

We can also become stuck in a stressed state living as if it were still happening. Trauma or in the long term if this is not resolved in time PTSD.

 

When dealing with stressful situations it is helpful to hang on to whatever stability and safety we can. if we can involve others for support this is useful.

 

We can help process what is happening safely and slowly.  Working within the window of tolerance. Pacing ourselves and taking baby steps.

 

Self care is important as we manage to integrate any stress we have experienced.  Not expecting too much of ourselves, using appropriate support andways we can create a state of relaxation can help us to increase our window of tolerance. We can do this in whatever way works best for us. For example:- mIndfulness, yoga, physical exercise, fishing, running, walking, being in green space, listening to music, looking at or creating art, positive self talk, tapping, hypnotherapy, therapy, counselling etc. 

 

For further information you can read Siegel, D. (2007) The Mindful Brain, New York: Norton.

 

 

 

 

   

Anxiety

It is absolutely normal to be a bit anxious when we have an event of some kind coming up. It gives us energy and help us to focus but if we are too anxious we can feel overwhelmed. 

Our unconscious mind naturally sorts for what we focus on so the more we focus on things going wrong the more likely it is that will happen. Instead imagine the event turning out really well. Picture it, seeing it as if it is a video playing on a screen.  What will you see, hear, feel?  Imagine yourself stepping into the picture. How does it feel to have things turn out like this.  Adjust the experience till it feels just right then journey back to the present noticing what has to happen to achieve this. 

It can help if you write the outcome and all the steps down.

We naturally focus on an event coming up if it is one we want to go well so we might as well focus on the outcome that we want.

Understanding Others

Many years ago I worked in a personal development training centre.  We offered a variety of courses but one of these was off the job training for the youth opportunity trainees:

It was a cold wet Wednesday.  I awake with the chatter next door as my neighbour the grounds keeper shouted at the rabbits on the lawn. My early comfort at the familiar awakening subsiding. Remembering it was the dreaded Wednesday - a day when I had to wander for miles over the moors while allowing the group of 16 and 17 year olds in my charge to navigate using the map and compass skills the course leader had taught them the previous day. This day I was on a route I did not know. I hated these journeys because of suffering from a circulation condition meant I would lose the circulation to my fingers while out on the moors.

I gathered my group. The group had appointed a navigator and a leader.  The group were entrusted with the task of collecting the map (with the route marked on it) and navigating across the moors. Each group had been given a different route as it was very much a group cohesion task and not one where groups competed. We set of each group to a different starting point scattered many miles across the bleak, boggy, heather covered moors.  The navigator deciding at each stage where we were to go.  

In these pre mobile phone days we were equipped with maps and a silva compass. We all wore bright orange trousers and kagoules and carried food to cook at lunch time, a spirit stove, and a whistle. 

As we began to walk the navigator looked at the map on the map board, brushing rain off of the plastic coating and shouting with enthusiasm. He looked around him and then at the map and seemed to easily recognise the landmarks.  There is that farmhouse. Here is this hill - this way is north etc.  At lunch time we stopped in the shelter of a dyke.  As they nursed the stove into life to heat their meal I casually picked up the map. My heart sank as I realised that the map we had been following was for a completely different area the group had collected the wrong map. Somehow they had made the territory fit the map.

In case you should be worried - of course I had the right map safely stored in my back pack so we were able to find our way back to the correct route and completed the 13 mile trek before night fell.

Some time later I moved to Cleveland as a training officer and on my first day going around the workshops and familiarising myself with the tasks carried out in each I heard someone say someone say “I’ve forgotten my bait”.  I questioned how they were finding time to go fiishing in the lunch break. Once the laughter subsided I was informed that bait is what I would refer to as lunch or a ‘piece’.  These words have a meaning based on our experience

Just as the underground map is a symbol of the underground system, represented in graphic but not realistic form, so our language is symbolic.  Words are not the reality.  Although the words we use to describe an event are chosen to represent the event, the words themselves are not the actual event itself.  We create our own reality based on our past experiences, beliefs and memories.  NLP teaches us that we can expandthe map of the world that we have. 

Rhona and Karen are twins raised in a busy home.  At an early age these twins learned to escapefrom their cots and their parents had to use bits of an old cot to prevent escape anddanger.  Rhona in adulthood referred to this as an act of cruelty on the part of theirmother.  Surprised to hear her sister say this, Karen told how she rejoiced in the fresh puzzle they were presented with and enjoyed finding ways to escape. For one it was a cage and for the other a puzzle.

Think of times when you have been surprised to learn that others do not think in the same way as you? We can so easily use our maps to navigate, or at least to make sense of the lives of others.  Instead maybe we can take some time to understand the map first. 

The first presupposition of NLP states that the map is to the territory

Do you get bitten by the "should" monster ?

Do you find yourself doing things because there is a wee voice inside your head telling you that you should?  In NLP terms this a kind of linguistic generalisation that we call a "Modal Operator of Necessity".  That just means that we habitually put ourselves under pressure to behave in certain ways - usually to avoid some kind of consequence.

For example you might say, I "should" exercise more.  Now this is not a bad thing but it does not feel very inviting. It is what we call an "away from" statement. 

In the case of exercise there can be many possible reasons why you might want to do it.  Exercising might make you energised; it could take you outdoors; it will probably release endorphins in the body that make you feel good; it could help you to maintain wellbeing and fitness... I am sure that you can think of many reasons why you would want to exercise.

Next time the should monster bites you, perhaps you can stop and ask yourself "who says I should?  Do I really want to? What would it be like if I did? What would it be like if I did not?"

If you do something because you want to and you can see a positive reason for doing it then it becomes a possibility and not a necessity.

If I could change one thing in the world it would be the idea of failure

When we are babies we have no sense of failure.  When we learn to walk and fall over we may cry but we do not see ourselves as failed walkers.  We unconsciously adapt over time to learn what works.  Falling over is just feedback. It helps us to learn.

In learning it is by understanding our mistakes that learning deepens.  Yes of course it can be frustrating to make mistakes but if we express that frustration, then take a step back and think about the learning, we can tackle the task with restored vigour. One of the main principles of NLP is that there is no failure only feedback.

We live in a society where mistakes are not easily forgiven and yet look at the folk who do well at what they do they have learned to adapt and change and try again.

Lets start with ourselves.  When we get things wrong how about instead of beating ourselves up, making excuses or saying "it wisnae me!" we say:- I see now what did not work, I will do that differently next time.

Using technology is a hard thing for me.  I grew up in a world before computers. I am not a failed user of technology but I make a lot of mistakes and I am still learning.

What Kind of therapy is best

A huge amount of discussion goes into this subject but in actual fact two therapists approaching the same kind of therapy will do so very differently.  I think the best answer is given by Ian Gilchrist the author of "The master and his Emissary" which is a book about the divided brain. When interviewed for Psychotherapist Magazine. (The Psychotherapist Issue 65 Spring 2017, page 8)

"Number one, it is a relationship, it's not about a thing.  Therapy is not a thing that you do to somebody: it is something that goes on between the psychotherapist and the patient to which both contribute.  The spark of life between them.  It therefore does not have a universal direction. or application or measurability at all"

I find that I draw from all of the therapies that I have learned about and my a goal is to work with my clients in the way that is best for them with the resources that they have right now. ` Of course this changes and as we are all human beings we are never perfect in everything that we do.  So I get it wrong sometimes. 

Of course there are standard tools that can be used and techniques that can be taught to add resources to the process but they are far from the whole story. So in short I guess in answer to the question,  Which kind of therapy is best? I would have to say whatever works for you best at the time and with a therapist that you can relate to.