Supportive Counseling & Therapy – When?
„When it becomes difficult to progress alone …“
Professional psychological support can significantly alleviate the distress and suffering resulting from difficult life situations or severe life events. Every individual has a unique perception of a “difficult situation”.
Following, some of the most prevalent psychological “disorders” and their corresponding basic treatment approaches will be outlined. The treatment approaches are explained in more detail under “Specific Treatments & Therapies”.
There are interdependencies between body and soul. Physical illnesses frequently result in psychological complaints or even illnesses, e.g. depression and anxiety disorders. Vice versa, prevailing psychological burdens often contribute to physical complaints or even illnesses, e.g. fatigue, dizziness, hypertension and gastro-intestinal illness.
Efficient psychological therapies provide alleviation and crucial support in terms of better coping strategies. With tailored psychological support individuals can learn efficient alternatives to deal in a more positive fashion with new challenges. Efficient intervention comprise psycho-education, treatments in the light of mindfulness-based cognitive behavior therapy and meditation- and relaxation techniques.
All of us are familiar with anxiety as a natural and precious protection mechanism in objectively dangerous situations. However, when fear and anxiety are out of proportion and occur in objectively not dangerous situation people might get into a vicious circle of “fear of fear”. The wide spread implications are avoidance, withdrawal and disengagement as an attempt not to get into such “dangerous” situations. Avoidance and social withdrawal in turn imply the inherent risk of increasing isolation and severe reduction of the quality of life,
The most prevalent anxiety disorders comprise Generalized Anxiety Disorder (free floating anxiety), Phobias (e.g. arachnophobia, agoraphobia, claustrophobia and social phobia), Panic Disorder (with sudden onsets of extreme anxiety) and Obsessive Compulsive Disorder (with unpleasant obsessive thoughts and/or compulsive behavior).
Psychological treatment focusses on evidence-based efficient techniques which strengthen the resources for alleviating and autonomy-enhancing coping strategies with the anxiety and, thus, contribute to happiness and (regained) quality of life.
Phobias predominantly result from dysfunctional learning processes, i.e. they are conditioned. With psychological therapy we can again “unlearn” such unpleasant responses to certain stimuli. To achieve this one has to confront oneself several times with the phobic, anxiety-inducing situations, objects or encounters. Systematic desensitization with subsequent exposure and confrontation represent highly effective and liberating techniques to “unlearn” such acquired phobic reactions.
Depression often co-occurs with anxiety disorders (with a comorbidity rates of around 60%). Psychological symptoms of depression comprise loss of former pleasant interests, feelings of worthlessness and social withdrawal. Somatic symptoms are sleeping difficulties, tension, loss or gain of appetite and loss of libido.
There has been a steady increase in prevalence and incidence rates of both anxiety and depressive disorders. On one hand we have become more sensitive with regards to both disorders, on the other hand the increase also reflects more pronounced adaptation demands in the professional and private domain – with rapidly changing professional and social structures and (perceived) insecurity and unpredictability.
Treatments within the mindfulness-based cognitive-behavior therapy have proven very efficient for the prevention, cure and relapse prevention of depressive episodes. The treatment approaches fosters identification and deliberate cessation of negative automatic thoughts and fruitless rumination. It activates the perception of positive stimuli, events and social encounters. In turn, this positive framing provides our thoughts, emotions and behavior with more positive and optimistic accentuations. Simplified and as Martin Seligman has put it, a transition from “learned helplessness” to “learned optimism” is possible – even within challenging life situations.
In addition to psychological therapy, exercise and sport are means to induce mood-enhancing effects. Physical activity increases the availability of neurotransmitters (such as serotonin, norephinephrine and dopamine) in the synaptic cleft and also the production of endorphins – as runners experience it by means of the “runners’ high”. Exercise in the company of others – such as team-sports and dancing – have also a positive social component.
In cases of severe depressive episodes, mania and bipolar disorders, the usage of psychoactive medication prescribed by psychiatrist has to be considered in addition to psychological therapies.
Substance abuse and potential dependency
“Sola dosa venenum facit” – only the dosage constitutes the poison. Alcohol consumed within health-compatible limits might have relaxing effects and foster sociability. For many stress-vulnerable people, however, alcohol implies the risk of health-detrimental „self-medication“, abuse and, moreover, potential addiction. If one can only relax by means of alcohol consumption, there is the severe risk of addiction with the result of increased anxiety and depression.
The Concept of Self-Control of potential Substance Abuse is based upon the concept of “Control of self-induced Substance Consumption” (“Kontrolle im selbstinduzierten Substanzkonsum” [KISS]), developed in the 1980s by Professor Dr. Joachim Körkel. The treatment approach here is, however, augmented by the implementation of Brief Therapy tools.
The Concept of Self-Control based on the method of Prof. Körkel can be applied to other substance-related and non-substance-related addictions. Examples for the latter ones ate behavioral addictions, e.g. mobile and internet addiction.
Life Events and Crises
We all experience difficult life events such as relationship split-ups, bereavements or the (risk of) redundancy. In addition, we might be subject to a severe accident or experience violence. People have different coping strategies to come to terms with it, to let go and to regain balance and stability.
Sometimes people struggle to overcome such life events and crises on our own – in this case psychological interventions can provide the required support – from supportive counseling to acute crisis support.
Rigid habits and compulsions
Habits are useful since they provide structure an orientation. Too rigid habits, however, potentially undermine adaptive change and progress. In extreme cases such rigidity can lead to Obsessive Compulsive Disorder (OCD) with obsessive thoughts and compulsions. However, the compulsive behavior – e.g. extreme hand washing – only results in brief states of anxiety reduction.
Psychological treatments provide aids and inputs to put liberating and adaptive changes in thinking, feeling and behaving into practice. Doing this step by step is a means to substitute rigid cognitive and behavioral patterns by flexible and functional paths. Severe cases of OCD necessitate cognitive preparation, subsequent exposure and reaction managements by experienced psychologists.