Positive Mental Training for Emotional Distress

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• Positive Mental Training for Emotional Distress
  Wellbeing
• Resilience Training
•  
• Friday 4th September 2009
• 12.30pm 5.00pm
• Scottish Health Service Centre, Crewe Road South,
  Edinburgh
• Dr Alastair Dobbin
• Sheila Ross, MSc

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Outline of the Afternoon Introduction/expectation
s What is Positive Mental Health The Philosophy
of Therapy Unconscious progressing Tea ( 3 pm
ish) Relaxation Positive Mental Training
Programme Patient videos Closing
exercise Discussion
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• What do you think
• positive mental health is
• and
• what do we need to have it?

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Theories of Emotion
James Lange now dominant theory better fit with
subsequent evidence
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Ventral Stream and Dorsal Stream
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• Rational thought does not drive what we do
• It interprets it
• (DB Video)

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• How can we use this to help people?
• Placebo suggestion
• Unconscious v conscious suggestion

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What is Hypnosis?

• State of relaxation and absorption
• Induced by focused attention
• - Eye closure, relaxation, suggestion
• Decreases sympathetic autonomic arousal effects

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Gruzelier, J. (1998). A working model of the
neurophysiology of hypnosis a review of the
evidence. Contemporary Hypnosis, 15, 3-21
Karl Friston Thomas Bayes
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Youre horrible I hate you Youre ugly Go
away Leave me alone
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Self Hypnosis - uses

• A trigger, conditioning -can be established in
  just one hypnotic session.
• Any stimulus for instance a word, movement,
  behaviour or situation, but also a thought
• When a stimulus has become a trigger it works
  even in those situations where the subject is
  unaware of the presence of the trigger. Such a
  trigger can not be changed by voluntary effort.

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Self Hypnosis

• A positive emotion such as the ideal performing
  feeling can be borrowed from a previous event and
  then conditioned to a future event.
• Lars Eric Unestahl 1973 Hypnosis and post
  hypnotic suggestions (PhD thesis Uppsala
  University) VEJE international Orebro, Sweden.

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• Short exercise
• Tea Break

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Relaxation Practice makes perfect
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• Using the Relaxed State

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Pavlovian Conditioning
CS UCS UCR
Sound (Tone)
Electric Shock
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RECALL TRIALhas 2 effects simultaneously
Trauma Recall
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CS2 - UCS CS1 CR2
(UCS)
Extinction
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CS2 UCS CR3
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Extinction
Avoidance Behaviour
1 2 3 4 5 6 No of
Trials minus Trauma
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Reappraisal in Self confidence

• You find you can never ever fail
• You will learn from your mistakes
• You will grow as a result of difficulties
• You will see problems as solutions
• You will see hindrances as challenges
• You have a right to be angry/sad

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• Positive Mental Training
• The Programme
• DVD How Positive Mental Training helps stress
  and depression
• Dr Alastair Dobbin Sheila Ross 14
  mins.
• CD1 The Foundations of Positive Mental Health
• CD2 Building Mental Skills for Success
• CD3 Building Personal Development for success
• Each CD has 4 tracks, each track 18 mins. long

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• Based on the Swedish model of Integrated Mental
  Training
• Developed for Peak Performance in Sport
• Used over the last 30 years

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CD 1

• Muscular Relaxation 1 2
• Jacobson relaxation with experiential self focus
• Notice the experience of relaxation and
  tension
• Encourages the observation of the body and
  breathing/Mindfulness
• Sets up a trigger
• Mental Relaxation 1 2
• Visualisation technique of a safe place
• Inner Mental Room
• Bolted onto physical relaxation

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• The Mental Room

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Positive Mental TrainingCDs 2 3

• Each begins with Relaxation introduction and use
  of trigger and mental room to recall experiential
  mindset and remove negative affect (3 minutes)
• Music
• Fixing Positive affect to enable problem solving1
  
• Further psychotherapeutic tools -
• reframing, accessing positive memories/states,
  visualisation, desensitisation.

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Its use in Primary Care

• Complies with NICE guidelines
• Fits with stepped care approach
• Library system
• Evidence for good patient preference compliance

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What is Positive Mental Training?

• A self help modular programme
• To listen to at home
• A DVD and 3 CDs
• Over 12 weeks one 18 min track a day
• Simple effective

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Comparison of Dobbin et al preference arms and
benchmarked studies randomised data with
Confidence Intervals
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Who for?

• Emotional distress
• Exclusions?
• Easily Accessible by socially excluded groups
  done at clients convenience no therapist
  present - so
• Single mothers
• Low income
• Young men

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• Patient Videos

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Resource

• This presentation on
• www.foundationforpositivementalhealth.com
• Contact us through this
• Certificates evaluation forms

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Advantages

• Immediate psychotherapeutic intervention
• Simple (requires no reading skills)
• Good compliance effectiveness
• Free patient access library system
• Retains GP/patient relationship
• Can be used by other Health Professionals
• Fits in with existing systems