WHO’S WHO IN THE MENTAL HEALTH SERVICE

GPs, PSYCHIATRISTS, PSYCHOLOGISTS, CPNs AND ALLIED THERAPISTS

By Karen Hastings

When a person is experiencing psychological or emotional difficulties, they may well attend their GP. The GP will interview them and based on the nature and severity of the persons symptoms may either recommend treatment himself or refer the person on to a specialist. There can seem a bewildering array of such specialists, all with rather similar titles, and one can wonder as to why they’ve been referred to one specialist rather than another. In this article I give an outline of the qualifications, roles and typical working styles of these specialists. This may be of interest to anyone who is about to, or already seeing, these specialists.

The General Practitioner

Although not a mental health specialist, the GP is a common first contact for those with mental health problems. A GP is a doctor who possesses a medical degree (usually a five-year course) and has completed a one-year “pre-registration” period in a general hospital (six-months on a surgical ward and six-months on a medical ward as a “junior house officer”). Following this a GP has completed a number of six-month placements in various hospital-based specialities – typical choices include obstetrics and gynaecology, paediatrics, psychiatry and/or general medicine. Finally, a year is spent in general practice as a “GP registrar” under the supervision of a senior GP. During this period, most doctors will take examinations to obtain the professional qualification of the Royal College of General Practitioners (“Member of the Royal College of General Practitioners”, or MRCGP). Others qualifications, such as diplomas in child health, may also be obtained.

The GP is thus a doctor with a wide range of skills and experience, able to recognise and treat a multitude of conditions. Of course the necessity of this wide range of experience places limits on the depth of knowledge and skills that they can acquire. Therefore, if a patient’s condition is rare or, complicated, or particularly severe and requiring hospital-based treatment, then they will refer that patient on to a specialist.

Focusing on mental health problems it will be noted that whilst the majority of GP’s have completed a six-month placement in psychiatry, such a placement is not compulsory for GP’s. However, mental health problems are a common reason for attending the GP and, subsequently, GP’s tend to acquire a lot of experience “on the job”.

Most GP’s feel able to diagnose and treat the common mental health problems such as depression and anxiety. The treatments will typically consist of prescribing medication (such as antidepressants or anxiolytics) in the first instance. If these are ineffective, alternative medication may be tried, or they may refer the patient to a specialist. GP’s are more likely to refer a patient to a specialist immediately if their condition is severe, or they are suicidal, or they are experiencing “psychotic” symptoms such as hallucinations and delusions.

The Psychiatrist

This is a fully qualified doctor (possessing a medical degree plus one year pre-registration year in general hospital) who has specialised in the diagnosis and treatment of mental health problems. Most psychiatrists commence their psychiatric training immediately following their pre-registration year and so have limited experience in other areas of physical illness (although some have trained as GP’s and then switched to psychiatry at a later date). Psychiatric training typically consists of a three-year “basic” training followed by a three year “specialist training”. During basic training, the doctor (as a “Senior House Officer” or SHO) undertakes six-month placements in a variety of psychiatric specialities taken from a list such as; General Adult Psychiatry, Old Age Psychiatry (Psychogeriatrics), Child and Family Psychiatry, Forensic Psychiatry (the diagnosis and treatment of mentally ill offenders), Learning Disabilities and the Psychiatry of Addictions. During basic training, the doctor takes examinations to obtain the professional qualification of the Royal College of Psychiatrists (“Member of the Royal College of Psychiatrists” or MRCPsych).

After obtaining this qualification, the doctor undertakes a further three-year specialist-training placement as a “Specialist Registrar” or SpR. At this point the doctor chooses which area of psychiatry to specialise in – General Adult Psychiatry, Old Age Psychiatry etc – and his placements are selected appropriately. There are no further examinations, and following successful completion of this three-year period, the doctor receives a “Certificate of Completion of Specialist Training” or CCST. He can now be appointed as a Consultant Psychiatrist.

The above is a typical career path for a psychiatrist. However, there are an increasing number of job titles out with the SHO-SpR-Consultant rubric. These include such titles as “Staff Grade Psychiatrist” and “Associate Specialist in Psychiatry”. The doctors with these titles have varying qualifications and degrees of experience. Some may possess the MRCPsych but not the CCST (typically, these are the Associate Specialists); others may possess neither or only part of the MRCPsych (many Staff Grades).  Psychiatrists of any level or job title will have significant experience in the diagnosis and treatment of people with mental health difficulties, and all (unless themselves a consultant) will be supervised by a consultant.

Psychiatrists have particular skill in the diagnosis of mental health problems, and will generally be able to provide a more detailed diagnosis (i.e. what the condition is) and prognosis (i.e. how the condition changes over time and responds to treatment) than a GP. The psychiatrist is also in a better position to access other mental health specialists (such as Psychologists and Community Psychiatric Nurses or CPNs) when needed. They also have access to inpatient and day patient services for those with severe mental health problems.     

The mainstay of treatment by a psychiatrist is, like with GP’s, medication. However, they will be more experienced and confident in prescribing from the entire range of psychiatric medications – some medications (such as the antipsychotic Clozapine) are only available under psychiatric supervision and others (such as the mood-stabiliser Lithium) are rarely prescribed by GP’s without consulting a psychiatrist first.

A psychiatrist, as a rule, does not offer “talking treatments” such as psychotherapy, cognitive therapy or counselling. The latter may be available “in-house” at the GP surgery – some surgeries employ a counsellor to whom they can refer directly.

Psychologists and allied mental health staff typically provide the more intensive talking therapies. Some senior mental health nurses and CPNs will have been trained in specific talking therapies. It is to a Psychologist or a trained nurse that a psychiatrist will refer a patient for talking therapy. These therapies are suitable for certain conditions and not for others – generally, conditions such as Schizophrenia and psychosis are less appropriate for these therapies than the less severe and more common conditions such as depression, anxiety, post-traumatic stress disorder, phobia(s) and addictions. In many cases, a patient will be prescribed both medication and a talking therapy – thus they may be seen by both a therapist and a psychiatrist over the course of their treatment.

The Psychologist

A qualified clinical psychologist is educated and trained to high degree. In addition to a basic degree in Psychology (a three year course) they will also have completed a PhD (“Doctor of Philosophy” or “Doctorate”) – a further three-year course involving innovative and independent research in some aspect of psychology. They will also be formally trained in the assessment and treatment of psychological conditions, although with a more “psychological” slant than that of psychiatrists. Psychologists do not prescribe medication. They are able to offer a wide range of talking therapies to patients, although they typically specialise and become expert in one particular style of therapy. The therapies a particular psychologist will offer may vary from a colleague, but will usually be classifiable under the title of Psychotherapy (e.g. Analytic Psychotherapy, Transactional Analysis, Emotive therapy, Narrative therapy etc) or Cognitive Therapy (e.g. Cognitive Behavioural Therapy (CBT) or Neuro-Linguistic Programming (NLP) etc).

The Community Psychiatric Nurse (CPN)

These are mental health trained nurses that work in the community. They will have completed a two or three year training programme in mental health nursing – this leads to either a diploma or a degree, depending on the specific course. They are not usually “general trained”, meaning their experience of physical illness will be limited. Following completion of the course they will have spent a variable amount of time in placements on an inpatient psychiatric unit – this time can range from twelve months to several years. They can then apply to be a CPN – they are required to show a good knowledge and significant experience of mental health problems before being appointed.

CPNs are attached to Community Mental Health Teams and work closely with psychiatrists, psychologists and other staff. They offer support, advice and monitoring of patients in the community, usually visiting them at home. They can liaise with other mental health staff on behalf of the patient and investigate other support networks available (such as the mental health charities).  Some CPNs will be formally trained in one or more “talking therapies”, usually a cognitive therapy such as CBT (see “Allied Therapists” below).

“Allied” Therapists

Many “talking therapies” are offered by non-psychologists – for example, mental health nurses and mental health occupational therapists can undertake a training course in a cognitive therapy like CBT. After successful completion of the course, the nurse will be qualified and able to offer CBT to patients. The length and intensity of these courses can vary dramatically, depending on the type of therapy and the establishment providing the course. Some are intensive, full-time one or two week courses; others are part-time and can extend over months and years. Perhaps a typical course will be one or two days a week for two to three months. Formal educational qualifications are not necessary to undertake these courses, and they are open to “lay” people with little or no experience of the NHS mental health services. Of course this is not necessarily a problem - it may even be considered a positive point!

Some of those therapists thus qualified will offer their skills as part of their work in the NHS – for instance, a nurse, CPN,  or occupational therapist, may offer cognitive therapy to a patient that has been referred by a psychiatrist. Unfortunately this is relatively rare at the moment, presumably due to the reluctance of the NHS to pay for such training for their staff. As a result these therapies are more accessible on a private basis.

Summary

An individual with psychological difficulties will normally attend their GP in the first instance. The GP will usually have encountered similar problems with other patients and can offer a diagnosis and appropriate treatment. If the condition is unusual or particularly severe, the GP can refer the patient to a psychiatrist. The psychiatrist is able to access a wider range of treatments (medications and hospital care) and can, if necessary, recruit other mental health professionals to help the patient. This system perhaps works best with the severely mentally ill such as those with psychotic symptoms or who are suicidal.

The Mental Health Services in the NHS are generally less well suited to those with psychological problems of a less severe nature – the moderately depressed, the anxious, the phobic etc. The availability of “talking therapies” is limited in the NHS, with long waiting lists or even no provision at all in some areas. This appears to be due both to the cost of training staff appropriately and the time-intensive nature of these therapies.

For those with such conditions, the main option is to seek help outside the NHS. There are some voluntary organisations that offer free counselling for specific problems such as bereavement or marital/relationship difficulties, but more intensive therapies (such as CBT or NLP) are typically fee based. Your GP or local Community Mental Health Team may be able to recommend a local private therapist.

Misunderstandings About Hypnosis

By Karen Hastings

Hypnosis refers to being in a trance like state, the kind of states that people experience naturally all the time in daily life.  If you have ever been driving somewhere and have suddenly realised you have reached your destination, whilst being absorbed in thoughts about other things, if you have ever been so engrossed in a good book or movie, that you have been unaware of time or distractions, if you have ever daydreamed, then you have experienced trance. 

Hypnotherapist’s use hypnotic techniques in order to induce a trance like state in the individual.  Whilst the individual is in trance, the therapist makes suggestions towards the client’s goal.  Hypnotherapy is based on the belief that when a person is in a trance state, conscious criticism and analysis is switched off, allowing therapy to be directed at the unconscious mind.  It is also understood that the unconscious mind has access to areas of yourself that your conscious mind doesn’t.  For example, people have used self-hypnosis to control pain, control physiological functions such as heart rate and solve problems, which they are unable to do consciously.

 As an Occupational Therapist, therapist who often uses hypnotic techniques, at my NLP and Hypnotherapy practice, Edinburgh for therapeutic benefits, I am aware that many people have inaccurate beliefs about hypnosis.    For example, a friend asked me if I could work with her husband to make him give up smoking and pick up his socks!  Two activities which he had no intention of stopping! In fact hypnotherapists cannot make people do anything they do not want to do and this will be explained along with other common misconceptions.

1. Hypnotherapists can make you do things against your will – This is not the case.  During hypnosis you will be in a relaxed state and choose to follow the therapists voice and listen to the suggestions.  The session relies on 100% commitment from the client, as all the work is carried out by the client in their imagination.  The therapist can guide but cannot control what goes on inside your head.  Therefore, if the therapist ever made any suggestions, which did not fit with your values or which you did not agree with, then you would immediately come out of your relaxed trance state.  Since the success of hypnotherapy relies so much on the motivation and commitment of the client, a hypnotherapist cannot get rid of a ‘problem’ that your not that bothered about solving.

2. Hypnosis is like being in a deep sleep – Unlike sleep, during hypnosis you will actually be highly aware of your surroundings and your senses will be switched on as you concentrate and focus on the therapists voice.

3. Some people can’t be hypnotised – Most people can go into relaxed trance states, as it’s a normal experience that we have in life.  A person who is particularly nervous about hypnotherapy, perhaps due to misconceptions about it, could resist going into trance if they really didn’t want too.  A good hypnotherapist is able to guide a nervous client into relaxation, this can be done at the clients own pace over a few sessions.

4. Hypnosis is therapy – There is a big difference between a stage hypnotist and an experienced hypnotherapist.  Hypnosis is a technique. Hypnotherapy is the therapy that is carried out during trance.  A hypnotherapist must have a good understanding of clinical conditions and disorders in order to assess and treat appropriately.  For this reason it’s important to ascertain what experience your hypnotherapist has.

5.  I’ve had hypnotherapy and I didn’t go under! – The first time I had hypnotherapy, I had the experience of being unsure of whether I had been ‘successfully’ hypnotised.  The reason is that some people expect hypnosis to feel unique in some way, when it is a familiar feeling of being relaxed and highly focused, like during day-dreaming. It’s not like being anaesthetised!

How Does Counseling Differ From Cognitive Therapies Such as NLP or CBT?

By Karen Hastings

If you are considering having some form of therapy it can sometimes be difficult to decide which therapy is best suited to meet your needs.  Most people are aware of what counseling is, but nowadays there are other options such as Cognitive Behavioural Therapy (CBT) and Neuro Linguistic programming (NLP).   I am a cognitive therapist providing NLP and CBT therapy, in Edinburgh.  Often people contact me to discuss how CBT and NLP, Edinburgh differs from counseling therapy. This article will introduce you to how these therapies differ from traditional counseling approaches.

Counseling involves meeting with a counselor and having the opportunity to explore via talking, difficulties you may be having or distress you may be experiencing.  The counselors role is to listen attentively to what you are telling them in order to begin to form an understanding of your perspective of the difficulties you may be experiencing.  Counseling does not involve giving advice or guiding a client to take a particular course of action.  Through the process of being listened to by a counselor, who is trained to reflect and help you to clarify your problem, counseling can be a way of enabling change, more choices or of helping you release strong emotion and feeling, which you have kept bottled up or have felt unable to share with family or friends.

During counseling you are able to explore and talk freely about any aspect of your life, be it past, present or in the future, in a setting which is confidential.  Counselors accept and respect their clients and provide a safe environment for the client to explore their life, relationships and themselves.  Counseling can be very useful for helping people to deal with distressing emotions associated with bereavement and loss.  Counseling can be very useful for you if you feel you would benefit from being listened to or feel burdened by troubles.

Cognitive approaches such as CBT and NLP are both approaches used to promote positive change in individuals.  Like counseling, the therapist will treat you with respect and provide a confidential environment for you to work through your problems.  Cognitive approaches are effective at alleviating emotional distress and behavioural problems. Unlike counseling, cognitive techniques can be practised by the individual and are based on the philosophy that the content of our thoughts have a major influence on our emotions and behaviour. Through cognitive therapy, it is possible to learn ways to eradicate or manage the types of thoughts you have, which means that the state of mind they sustain, such as anxiety, can be resolved. CBT and NLP are solution-focused techniques that focus on the ‘here and now’. Unlike other talking treatments, such as counseling, the focus is not on trying to find the cause of your distress (the therapist will take a full history and discuss your past but practical strategies to promote well-being in the present is the main focus) rather you will learn to improve your state of mind right now.  This involves learning which factors maintain your distress or problem and learning strategies to overcome your problem which you will practice in your own time.

NLP is an intimidating name for what is a common sense, practical and effective therapy. ‘Neuro’ means brain, ‘linguistic’ relates to how we use language both to communicate with others,  and within our own brain and ‘programming’ relates to how we create and use patterns of behaviour in everyday life in order to get results. We know that we experience the world through our senses and that this information is translated into thoughts. How you use this internal language in your own brain directly affects your physiology, emotions and behaviour. People tend to develop habits and patterns of using internal language that have positive or negative effects on their emotions and behaviour. NLP therapy, Hert encourages new perspectives and options in thinking, giving you more choices about your behavior and emotions, enhancing your communication and relationships and generating lasting life skills.

Cognitive Behavioural Therapy focuses on how you think about a problem (cognitive) and what you do about it (behaviour). CBT can teach you how to recognise and change faulty thinking patterns. This doesn’t mean that you will always think positive thoughts. It is a way to gain control over racing repetitive thoughts, which feed anxiety and depression. CBT can help you make sense of overwhelming problems by breaking them down into achievable parts.

Both these therapy approaches are practical and focused on problem solving in order to meet your therapy goals.  This means that unlike counseling, sessions are more structured and less free flowing as you move towards change with the support of your therapist.  Often people will seek cognitive therapy such as CBT, Edinburgh or NLP, Edinburgh, when they want solutions to their problem or to move on from limiting thinking, feelings or behaviour.

How can Occupational Therapy Help Me?  

By Karen Hastings

Occupational therapy is an allied health profession.  This term is used to refer to the wide range of professional groups that work in mainstream health care. Other examples of allied health professionals include physiotherapists, radiographers, speech and language therapists, and podiatrists.  Occupational therapists are required to train at degree level and register with the Health Profession Council, which was set up by the government to ensure the safety of the public and continuing professional development of its members.

Occupational therapists are concerned with human occupation in its widest sense.  They believe that people have an intrinsic drive to be active and express themselves via occupations and activities.  Occupational therapists understand that occupations contribute to a person’s sense of identity and place in society.  Take a moment to have a think about all the roles and occupations that make up your life, you may be a parent, or partner, you may be studying at college or working your way up the career ladder, you may be into exercising and keeping fit or you may be leading a hippy lifestyle! 

Whatever, your life choices, it is likely that these roles and occupations give your life direction.  For example, think about the range of activities that you do in any week, you will find that most of what you do, is related to your life roles and choice of occupations.  This is because we do what is meaningful to us and what is necessary (ironing is likely to fall into the latter category!). 

The body and the mind require activity in order to maintain functioning.  Through the activities that you do, you develop skills and get to practice them, interact with other people, learn to adapt, meet basic human needs and convey whom you are.  Activities are the things that you do in order to work towards your goals.

It is understood that if your routines are disrupted or you are deprived of occupation because of illness, stress or other problems your health and well-being will suffer.  Occupational therapists help people whose usual and important routines are disrupted because of illness, stress or social problems. Their aim is to enable people to achieve as much as they can for themselves, so they get the most out of life. Occupational therapists work on any occupational difficulties and in this way are experienced life coaches.  When people cannot do things which are important to them - such as getting dressed, giving a presentation at work, having a shower, working, socializing, feeling confident to go out into the community or undertaking a favorite hobby - an occupational therapist can help them in many ways, based on each individual person’s needs and lifestyle.

Occupational therapy can help you to maintain a personally satisfying routine of activities.  Occupational therapy, life coaching is available privately in Aldbury in Edinburgh.  I am an NHS experienced occupational therapist and have worked with people with mental-health difficulties of all types, using a range of mental health therapy techniques.  Occupational therapists are skilled at empowering individuals with depression, anxiety and stress to become re-engaged with life and to feel confident again. Life-coaching in Edinburgh will involve a combination of occupational therapy, NLP, hypnotherapy, and CBT techniques. 

NLP and Hypnotherapy:  Unscrambling The Link

By Karen Hastings

NLP and Hypnotherapy are very closely related and could be considered to come from the same ‘family’ of therapeutic approaches.  In fact, if you are considering having hypnotherapy and are currently searching for a therapist, you will probably find that many hypnotherapists now-days, practice NLP to some level and conversely that most NLP practitioners who have completed certified training courses, will also be familiar with using hypnotic techniques during therapy sessions.

How are these therapies similar?

Hypnotherapy utilises hypnotic techniques in order to bring about therapeutic change.  Hypnotherapy enables a person to solve personal problems by bringing about a deeply relaxing state of mind.  When the person is deeply relaxed this allows the unconscious part of the mind to use its resources to find solutions. It also allows the person to focus their attention completely on the therapists voice in order to follow the positive suggestions and guidance the therapist is making.   In hypnotherapy this relaxed state is called trance.  All people experience trance states on a daily basis.  Trance simply refers to the experience of being really relaxed.  It also involves focusing your attention so that it is highly selective.  Reading a really good book and being completely absorbed in it, is an example. 

Have you had the experience of being totally immersed in the characters of the book, being able to vividly imagine what they are like, whilst at the same time being able to ignore other noises and distractions going on around you?  If so, you have experienced trance.  Using your imagination and day-dreaming are other examples.   Any time that you ‘go inside’ your own head you are in a light trance.  If you’ve ever had the experience of having a problem that is constantly with you, so that it feels like all you have or all you are, is this problem, then you will know what it is like to experience a bad trance.

Richard Bandler (a computer scientist) and John Grinder (an associate professor in linguistics) developed NLP in the 1970’s. NLP was created after they spent time studying and modelling therapists who were considered to be extremely effective at getting good results.  One of these therapist’s, was the Psychiatrist Milton Erickson.  He was also an extremely talented hypnotherapist.  Eriksson’s style of indirect hypnotic suggestion and skilled use of ambiguous and vague language patterns, has become known as Ericksonian hypnosis.  Since NLP was developed after modelling Erickson, many NLP techniques involve Ericksonian hypnotic approaches.   Like more traditional hypnotherapy, NLP works with the unconscious part of the mind in order to find solutions to problems.  NLP therapists are also trained in using Milton Model language patterns in order to induce light trance states in clients. This is very useful at getting a problem moving when a person is stuck in a bad trance.  Other hypnotic techniques that are common to NLP include metaphorical story telling and utilising the client’s imagination in order to bring about a highly focused state of attention during change techniques – a trance state.

How do NLP and Hypnotherapy Differ

You will find that they are more similar then they are different.  During hypnotherapy you are much more likely to be seated in a comfy chair, perhaps reclining with your eyes closed!  During NLP you often get more involved with the techniques on a practical level, so you may be standing, or be required to do or say certain things related to overcoming your problem.  You may still get to close you eyes and you will certainly get to use your imagination.  NLP techniques utilise hypnotic elements but usually in a more subtle way, the NLP therapist will empower you to draw on resources you already have in order to bring about new options in thinking.

When you see an NLP therapist you will find they often use more traditional hypnotherapy techniques as well.  At the end of your NLP session, after all the hard work, you will often get to recline back in your chair and experience relaxation so that you leave the therapists office feeling positive and ready to go on with your day.

Magic Pills Do Not Exist – Even NLP Ones!

By Karen Hastings

As an NLP master practitioner who runs an NLP practice in Edinburgh, I am one of the first to sing the praises of NLP as a therapy tool, as I believe it can be a really effective instrument for change work, when used in the hands of a good NLP practitioner. 

However, as an occupational therapist, and having worked in mainstream NHS mental-healthcare, I also believe that NLP at times sends out a misleading vibe, which cannot be said of some of the more traditional therapies.  By this I mean that NLP can give the impression  of being this magical therapy that will cure people in minutes, when years of psychotherapy, counselling, cognitive behavioural therapy etc. has had little or no effect.

The result of this misconception about NLP, is that clients can turn up for a consultation at NLP Edinburgh, expecting the therapist to wave her magic wand, with little or no effort on their part.  Like all therapies, NLP relies heavily on the client’s commitment and motivation to want to change.

A good therapist or NLP practitioner will want evidence of this commitment, in terms of the client being willing to engage fully in the process, particularly spending initial therapy sessions learning the fundamental principles of NLP such as the major frames, the communication model and presuppositions.

It is crucial for the client to ‘buy into’ these principles such as the frame ‘being at cause’ and to fully understand the impact of the way they filter life experiences on their state and behaviour, before any of the ‘magic’ can begin.

Unlike other therapies, NLP does have specific techniques such as the Fast Phobia Cure, Swish, Change Personal History and Parts Integration that are rather glamorous.  In my opinion, these techniques do work very well, only always when they are supplemented by the more mundane psycho-educational work. 

I recently had a highly agitated client turn up for a therapy consultation expecting that I could ‘do something’ immediately to help him feel better.  This client had experience of other more traditional therapies and my hunch is that he would not of expected the same of his psychotherapist!

NLP is not about a therapist doing a technique on a client that will solve all their problems in an instant.  It is a highly effective therapy that can lead to new options in thinking and behaviour when the client works alongside the therapist.  Like other therapies such as CBT, NLP strategies and any new positive behavioural and emotional habits require practice and hard work by the client.

So, if your looking for a quick fix, NLP isn’t it!  And any practitioner that tells you otherwise is probably after your money.  Don’t let this put you off seeking NLP.  It is very effective and if you want change in your life and are prepared to work towards it with the therapists support, you will have change.  NLP is available at NLP Edinburgh.

The NLP communication model- a good starting point for therapy

 By Karen Hastings

NLP is an art and a science. It is based on the idea that the sensory information around us is translated into thoughts and ideas, which affect our state, physiology and behaviour and therefore our results. Our words also affect our experience and the experience of others. NLP teaches us how to use communication more effectively. NLP also tells us that we code or represent information to ourselves in certain ways.  How we do code information varies between events we perceive as positive and negative.  NLP teaches specific strategies and techniques that we can learn in order to represent this information differently to produce better results.  These strategies are used at my NLP, CBT  and Hypnotherapy practice in Edinburgh.

The NLP communication model explains clearly how we process and use information and how this affects our state, physiology and behaviour.  This is why it is a good starting point for therapy and I will always explain it to clients attending their first session of CBT, NLP or Hypnotherapy, in Edinburgh.  It is really important for clients to understand this model in order to be able to make changes to how they view their world. 

 What we know is that every second we are bombarded by sensory feedback (an estimated 2 million bits of information every second) from our 5 senses Visual (sight), Auditory (hearing), Kinaesthetic (feeling & touch), Olfactory (smelling) and Gustatory (tasting).  In any given moment we are selective as to what information we pay attention to because of course we cannot possibly hope to process all of the information.  Memory theorists suggest we can handle or remember about 7 new bits of information at once.

This means that we filter the 2 million bits of information into about 7 bits.  The way we do this is by deleting, distorting or generalizing. Deletion means we do not attend to information that is not relevant in the moment, distortion means we adapt the information to make it fit with what we believe or are on the look-out for, generalization helps us to relate new information to what we already know.  These three processes are crucial, as they prevent us from being overloaded with information and allow us to function.

 However, what this also means is that we do not have the full picture because we have ignored or changed information during the filtering process. Using the 7 bits of information that have filtered we recreate the outside event inside our mind. This is called an internal representation. This mean that what we represent to ourselves inside our minds is never true to what is actually happening in the event

Our internal representations are a re-presentation of the original information after filtering.  Because the information we take in is via our 5 senses, our internal representations are made up of thoughts, feelings, sounds, pictures, smell and tastes. Importantly, the way we represent or code information in our internal representation affects how we feel, which in turn affects our physiology and behavior.  What we know is that happy people tend to filter and represent information differently to depressed or anxious people.  More importantly via cognitive therapy such as NLP or hypnotherapy, Edinburgh, people experiencing mental distress can learn to filter in a way that allows refreshed perspectives and a different emotional experience.