Refining mental health

Mental Health today is a very expansive concept and there are a plethora of ways to work with the mind ranging from psychotherapy to mantra meditation to herbs to mindfulness ,pranayama and yoga to exercise to nutrition to hypnosis to entheogens to reiki  to quantum healing  to dance therapy to sound therapy etc etc etc…. the list goes on.

Its therefore no surprise if  we get overwhelmed and fall into something called decision fatigue where we don’t know the best way forward for us. Also within the list above there are many nuances and sub types of all the methods listed….for instance in therapy we have somatic therapy, dialectical behaviour therapy, psychoanalysis, Hakomi…under yoga we have power yoga, Ashtanga yoga, Iyengar yoga, the choices and types are ever growing . . .there are thousands of medicinal herbs and substances that are being marketed from açai berries to moringa powder as well as numerous schools and modalities of meditation  from Vipasana to Kala chakra empowerments . . . . so what’s the best thing for us?

Often taking care of the Self requires a multifactorial, holistic approach which stimulates us on a mental, emotional, physical and spiritual levels. So one would need to work with oneself in a balanced and disciplined way that is intelligible to one’s own psychophysiological constitution. What I mean is the right type of exercise, the right type of meditation, right type of food, right amount of rest etc. for oneself . .  Otherwise our efforts are counterproductive and we have limited results. As we say in Ayurveda that one can eat like a king, but digest like a beggar if one’s gut flora  or digestive fire, known as  Agni  is not working properly.  What is meant by this is that one can avail of the best groceries, trainers, yoga studios but if its the wrong type of practise for us in whatever field, we will not be able to contain it in our bodymind and will not receive the benefits from it. So if a very skinny person decided to do an intense cardiovascular work out then it would be extremely destructive for their nervous, endocrine and immune systems . . . similarly if someone who intellectualises and rationalises defensively undertook solely CBT they would not learn to recognise, feel and work with their emotions in the body. Hence it is extremely important to see what suits us . . . so this leads us to exploring our Prakriti or constitution. I now mandatorily conduct Prakriti analyses with my clients  in order to complement  their therapeutic process by giving them the sui generis  nutritional, lifestyle and self care advise that is customised coherently for their unique needs.


Managing Intense Emotions with DBT

Sometimes life feels very difficult, almost unbearable and we are left desolate and helpless. Dealing with the intensity of one’s emotions can be challenging and this might lead one to take extreme measures by over consuming alcohol and drugs, having a lot of sex, self harming, having suicidal ideation and loosing our boundaries with other people, to the point of one’s own self destruction. In such instances, we cannot handle the sensations and feeling that are coursing though the bodymind and we don’t want to feel them.  Our nervous system is fraught with arousal and we do not have the necessary psychological skills to self soothe and self regulate. We attempt to  drown out or change the feelings we experience be it anger, jealousy, sadness  or frustration, often with very unproductive and temporary methods.  Yet, while tragically these coping strategies bring us limited relief, the underlying problem continues to be with us, haunting us and goading us to continue in our self destruction.

Often cases of trauma constrain an individual’s  ability to tolerate distress and the  DSM V psychological disorders known as Borderline personality disorder, Bipolar disorder and other Mood disorders that show a constraint in managing  grief or rage effectively  have traumatic experiences underlying  them. In such instances, it is extremely important to get the right  psychotherapeutic support where the therapeutic work does not remain at the level of talk only. It is important to be able to tolerate emotions by feeling them in the body and being mindful of our experience where we can balance our emotions with our thoughts, our mind with our body, our internal world with the external world and ourselves in relation to others.  Dialectical Behaviour Therapy  (DBT) is a therapeutic modality to work with intense emotions and  low levels of affect tolerance to enhance mood management, prevent self harm and promote well being. DBT was founded by Marsha Linehan and is, at its a core, a set of self soothing and self regulating skills that help individuals gain their equilibrium in the most trying of circumstances. It is  noninvasive and medication free, premised on refining an individual’s self awareness, reframing thought processes and birthing new wholesome behaviours.

DBT is a progression from Cognitive Behaviour Therapy where the contemplative side of the individual is engaged through integrating a mindfulness practice along  with cognitive and behavioural therapeutic practices. In its essence,  DBT consists of 4 dominant skills- distress tolerance, mindfulness, emotional regulation and interpersonal effectiveness. It teaches one to live in the present moment while moving through very disturbing and difficult emotional states. DBT  primes individuals to draw on their higher minds and radically accept circumstances they cannot change while not feeling victimised by them. My clients who have persevered with DBT show remarkable progress in managing the stresses and contingencies of their life, it is not that they do not feel sad or angry or hurt anymore but they have the ability to make space for these emotions and utilise their energies in ways that are productive and beneficial as opposed to ways that are self destructive and malefic for themselves.


Psychotherapy and Counselling

I am often asked the difference between psychotherapy and counselling. While these words are used interchangeably, there is a difference between them and it is vital to be cognisant of the distinction. Counselling generally implies a short term,  very specific and targeted facilitation. There are many types of  counsellors and varied topic-centred types of counselling, such as: marital counselling, drug and alcohol counselling, career counselling, health counselling etc. The list can go on . .  what is important to know is that counselling designates a facilitation around very narrow criteria’s restricted to the theme the counselling is pivoted around.

So a marital counsellor will focus primarily on marital issues, and will have restricted therapeutic skills  in other areas of mental health, such as trauma work, attachment issues or chronic pain. Tangential issues that could come up in the context of a marriage, that go beyond the nominal marital issues, are out of the scope of the counsellor and counselling. For instance, if there are sexual problems in a relationship, due to one of the partners being a survivor of childhood sexual abuse,  it would be hard for a counsellor alone to tackle such a case since childhood sexual abuse elicits deep trauma work. Counsellors are restricted to mostly working on the communication styles of the partners and regulating the behaviours of each member of the couple  in the context of the marriage.

Psychotherapy or rather integral psychotherapy is a more expansive and  holistic method of therapeutic work which integrates a vast panoply of areas from developmental, social, spatial, temporal,   existential, behavioural and transpersonal vectors as they inform the subjectivity of the client. Here childhood misattunements with primary givers are given importance, as well as a range of other factors, some of which could be  medical conditions, cultural conditionings,  learning disabilities, traumas, stress reactions, dreams, fantasies, anxieties, memories, relational patterns, addictions, depression,  tics, phobias etc. that impact the individual. A psychotherapist is trained in one or more modalities that are oriented towards harmonising psyche and soma like integral somatic psychology,  psychoanalysis, analytical psychology, dialectical behaviour therapy, somatic experiencing, hakomi to name a few.

Like there are many different kinds of counselling, there are many divergent types of psychotherapies. It is good to inform oneself about the many kinds of psychotherapies available and then to choose what is most appropriate for oneself. If you are someone who is very into the imagination and has vivid dreams a Jungian analyst might be the right match, if you are oriented towards uncovering unconscious psychological roots of childhood experiences you might want a Freudian or a Kleinian, if you want group work a Bionian, for psychospiritual work a transpersonal psychotherapist, for somatic work a somatic therapist and so on . . .

It is best to know well  your own sui generis therapeutic needs and then to find a psychotherapist or counsellor that will be able to work within your ambit and with your very specific, tailor made  therapeutic goals.