Does CBT Work?

Over the last few decades, as the field of psychology has moved toward evidence-based practice, there has been more attention in the media about the increasing adoption of cognitive behavioral therapy (CBT) over other methods of treatment. Since there has been more importance placed on treatments with research support, there has been a flood of new research available to guide clinicians and patients to the most effective treatments for psychological problems. In study after study CBT stands out as the most effective treatment for numerous mental health issues. Furthermore, CBT treatments are usually of shorter duration, and the results are more enduring than those of other treatment methods (

CBT: Maybe not the Cure for all Ills?

An interesting article in The Guardian newspaper takes some of the shine off Cognitive Behavioural Therapy.  Copy and paste the link below to read:

Greeks vs. Germans: Politics or Psychology?

While the Euro and Grexit have been headline news for some time, a few comments have suggested that the Greeks have been behaving in a childlike way, for example, Leo Varadkar compared the Greek government to a students’ union.  There may be something to that view, because Sigmund Freud said that all boys must go through the Oedipal phase, which involves rebelling against the father, and attempting to dominate.  From Freud’s point of view, it is important that the child fail in this rebellious attempt and instead identify with his father.  In that way, society hands on the role of parent from one generation to another.  We know that sometimes when a boy’s father is absent from the home, he can go off the tracks for the want of a male authority figure in the house.

The Greeks’ attempt to take on the Germans and their resulting defeat by Angela Merkel seems to mirror that process very closely.  It there is any truth to this interpretation of events, we should find that the Greeks will ultimately become model EU citizens.  Watch this space!

Hobbies and Well Being

On RTÉ Radio 1, on Friday 11th October, 2013 you may listen into Morning Ireland for a article on the importance of hobbies and activities for good mental health. Cóilín will be among the guests interviewed by Cian Mac Cormac, and he will discuss the psychological underpinnings which explain the importance of pastimes for our minds.

Mindfulness Talk

I will a talk on Thursday October 10th, 2013 in the Temple Gate hotel, beginning at approximately 8pm. My talk will describe and explain what mindfulness is, how is can help with mental health, and I will guide the audience through a mindfulness meditative technique. The mindfulness piece is part of Mental Health Ireland Awareness week

Self-Identity: The Need for Clarity

Most of the time, we are happy enough with our lives and with who we are. A crisis can, however, can cause us to question what life is all about.  Who am I, really?  If fact, we all have an identity, which is usually based on a mixture of nationality, religion (or none), family values, and broader cultural values. Usually, out identity is taken on board gradually without any conscious effort on out part.  That is why it can be difficult to answer the question: ‘ Who am I?’  Go ahead, take out a sheet of paper and try it!

Not easy, is it?  The interesting thing about identity is that identity is constructed, that is, we make it up.  Identity is not a cut and dried fact; it is essentially a choice and if you want to change some aspects of your current beliefs and values, then you can.  As we journey across the lifespan, changes tend to occur anyway, because different stages of life have different goals and priorities attached.

You can, nonetheless, re-evaluate your life at any time and walk down a different road if you wish…..

Autobiography in 5 Verses

1) I walk down the street.
There is a deep hole in the footpath.
I fall in.
I am lost… I am hopeless.
It isn’t my fault.
It takes forever to find a way out.

2) I walk down the same street.
There is a deep hole in the footpath.
I pretend I don’t see it.
I fall in again.
I can’t believe I’m in the same place.
But it isn’t my fault.
It still takes a long time to get out.

3) I walk down the same street.
There is a deep hole in the footpath
I see it is there.
I still fall in… it’s a habit.
My eyes are open.
I know where I am.
It is my fault.
I get out immediately.

4) I walk down the same street.
There is a deep hole in the footpath.
I walk around it.

5) I walk down a different street.

Portia Nelson
From: Sogyal Rinpoche, The Tibetan Book of Living and Dyin


Anger Management

Unresolved anger is an increasingly common issue in my practice with clients attracted to the concept of ‘managing anger.’   However, should anger be managed as if it were an incurable illness of some kind?  Certainly, inappropriate outbursts of anger need to be contained, but in my view anger needs to be resolved more so than managed.

In theory, we only become angry if we feel threatened in some way.  Therefore, the pathway is;  threat > fear > anger.  In other words, we feel threatened in some way, then we become afraid, and finally anger follows as a means of defending against the perceived threat.  In primitive times, this system allowed to survive in a hostile environment.

In modern times, anger can be an over-reaction and threats are not necessarily physical.  Bullying is very threatening to a person’s self-esteem, even when the bullying consists of social exclusion, i.e., being left out.   Rumours about one’s reputation can be threatening.  In these cases excessive anger is not always helpful,  yet anger must be released somehow or other.

In counselling, you can learn to understand your susceptibility to anger more clearly, see if it links to past experiences, find safe appropriate ways to release your anger,  and learn how to cope with anger as it arises rather than let it build up.  Anger management is, as you can see, only one part of a long-term solution.

What Are Panic Attacks?

Panic or anxiety attacks are sudden unexplained bouts of fear, which cause the person to perspire, shake and want to escape the immediate environment.  There may also be heart palpitations and chest pain, which are symptoms that can be confused with a heart attack.  Consequently,  panic attacks (especially the first one) can be very frightening, and medical attention may be sought.

The cause of anxiety attacks can be difficult to ascertain, but Cognitive Behavioural Therapy (CBT) is an effective type of treatment, nonetheless.  CBT helps the client learn to manage anxiety and reduce the impact of an attack.  Early warning signs can by noticed and relaxation exercises can prevent the anxiety attack developing further.

It is also sometimes possible to determine the cause of panic attacks by noticing patterns in the antecedents to attacks.  That is, noticing what happened before the attacks.  Antecedents can give clues to possible underlying emotion issues.

What Causes Depression?

Sometimes depression is caused by an obvious trigger such as bereavement or a relationship break-up.  However, there is not always an apparent reason for becoming depressed.  Depression can be caused by bottling-up old emotional wounds and by avoiding emotional pain when it is appropriate and necessary to do so.

Perhaps, after a break-up you immediately enter another relationship to avoid feeling the loss of the old one?  If you re-bound several times over the years, a lot of emotional baggage may build-up, and eventually cause depression.

Another example is the person who has had a very unhappy childhood, but who put on a brave face and compensated by being very successful in life, only to find that life seems empty and pointless.  Depression can follow such a significant disappointment.  However, the link to the person’s past may not be obvious.

Counselling for depression involves exploring the past and making links between what happening now, and those past wounds that might have been triggered by the current situation.  Therapy for depression is usually very successful in treating depression of this kind.

What is Play Therapy?

A recent conference in Dublin hosted by the Children’s Therapy Centre underlined the growing awareness of the use of play in therapy for children. But what is play therapy exactly? Play therapy is a type of counselling designed specifically for children. It involves the child playing in a specially designed play room while the therapist pays close attention to the play and joins in, when invited. The child is fully in charge of the play, and the play therapist only intervenes if safety becomes an issue. The parent usually waits in an adjoining waiting room.

We use play therapy rather than ‘talk therapy,’ because in order to engage children in a manner which will be attractive to them, a methodology is required which does not involve long discussions as we do with adults. Instead, the most appropriate method likely to achieve these goals is non-directive play therapy.

The rationale underlying the use of play as psychotherapy is that; a) play is the most natural and spontaneous form of expression among children, and b) children openly use play as a tool toward developmental maturation. In other word, children can play and they like to play.

In the case of social, emotional or behavioural difficulties, play is used as a reparative technique by children in an unconscious manner. That is, the problem or developmental delay is repaired indirectly without your child having to talk about the issue.

Play therapy, therefore, facilitates change by allowing children, via symbolic activity, to attend to issues at a perceived distance. In that way, awareness may be directed towards the problem in a manner which does not increase anxiety. The use of play as therapy is, consequently, a respectful and non-invasive means of intervening to overcome developmental delays or resolve emotional disturbance.

An example of symbolic play is a child acting out a family scene with toy people or puppets. The activity, which seems to be a game, may also have some relevance to anxieties around change in the family at home.