Exausted? Agoraphobia? Workaholic? Stress? Compulsive? anxiety?
Psychologist - anxiety - Agoraphobia - Couple´s problems.
Over the last ten years, our team of psychologists has specialized in adults, professionals and their associated disorders (anxiety, stress, phobias, agoraphobia, etc) including those produced by the phenomenon known as “social success”, and perhaps, in this sense, you find that you are becoming more and more limited.
Psychologists offer effective methods that help you to deal with problems associated with both your past or present lifestyle.
The therapies that identify and correct problems that have a major impact on or influence human behaviour in general have experienced a series of significant advances. For example, the handling of anxiety has effectively resolved phobias, obsessions, and other associated disorders. The control of automatic thoughts or irrational ideas is yet another major advance in depression, anxiety handling personality disorder therapy, etc.
Both anxiety and thoughts are associated with the control of human behaviour. As a therapeutic element, their control is considered as the nucleus of current psychotherapy practice.
Quality psychological services
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Psychologist, what is a psychologist?
The terms psychologist and psychiatrist are often used as if they were synonyms, leading to frequent misconceptions. Broadly speaking, a psychologist is a health expert specialising in psychological disorders that do not appear to be caused by alterations in the structure of the nervous system. A psychiatrist, however, is a doctor specialising in defects in the structure of the nervous system that result in alterations in psychological functioning. However, in the latter case, the psychologist can perform a role that complements psychiatric treatment in that whereas the psychiatrist treats organic alterations of the nervous system, the psychologist alleviates the psychological disorders deriving from these alterations.
What is the difference between a psychologist and a psychiatrist?
Psychologists and psychiatrists both provide treatment to individuals with emotional problems. Psychology is both a profession and an independent scientific discipline. Psychiatry is a specialization within the field of medicine.
There are many similarities in the treatment provided by psychologists and psychiatrists, and there are also many differences.
The coursework includes training in the science of psychology, with core courses covering the social, developmental, learning and biological bases for human behavior. This typically includes training in personality theory, normal growth and development, and the nature of psychological problems and psychopathology. Specialized training is also provided in diagnostic evaluation techniques, psychological testing, and psychotherapy and/or counseling methods. Psychologists also learn how stress, traumatic events, aging, and cultural background affect human behavior as well. Many courses have practicum requirements, which combine clinical experience and classroom knowledge.
Some psychologists have training at the Master’s level. This involves about two years of full time graduate training beyond the Bachelor’s degree, in the same subject areas used to train doctoral level psychologists.
Why Do People Seek The Help of a Psychologist?
Who Can Benefit from Psychological Services
Although it is now common practice to seek the services of a psychologist, there are still many people who do not know what a psychologist exists for or what kind of treatment they provide. There are also people who are unsure when or in what circumstances they ought to go. As a result of these and other misconceptions many people fail to benefit from techniques and methods that would help them restore or increase their physical, mental and social well-being, in other words, their health.
If you suffer any of the symptoms listed below, you ought to consult a psychologist:
Feelings of sadness, emptiness and depression.
The frequent desire to cry and feelings of hopelessness and dejection.
Loss of interest in or the desire for pleasure and enjoyment.
Feelings of worthlessness and an inability to fulfil a useful role in life.
Tiredness and apathy
Frequent headaches for no apparent reason.
Breathlessness, dizziness, irritability, excessive sweating, nausea or abdominal pain, trembling, etc.
Nervousness, tension, boredom, insecurity.
Inability to think clearly or concentrate. Memory loss.
Inability to take decisions or to focus on your work properly.
Fear of death, losing control or going insane.
Muddled or unusual thought patterns.
Family or relationship problems. Difficult relationships with your children.
The results of treatment and related problems
Cognitive-behavioural therapy is effective for between 65 and 75% of patients completing the treatment although a further 10 to 15% of people either give up or reject it. It has, however, proved more effective than other therapies such as medication.
The treatment involves presenting two types of problems that can be solved and which help improve its effectiveness. One of the problems patients face is their fear of fear, an inherent factor in panic attacks, but which is in some way common to all agoraphobias. Other problems concern the difficulty patients have in continuing with the gradual exposure agreed on even though they know and believe this to be the solution to the problem, having already made some progress. Additional techniques are therefore added to the treatment when necessary.
The fear of fear: exposure to interoceptive stimuli.
The training patients receive in acquiring techniques to cope with anxiety and which enable gradual and effective exposure includes physical techniques that teach them how to deal with the proprioceptive stimuli associated with anxiety.
It is now believed that training patients to control their breathing can help them greatly during exposure to situations.
Clinical experience shows that training in physical techniques, not just in breathing correctly, can play a significant and effective role in any treatment. In fact, patients with agoraphobia are very concerned with physical symptoms and in general with anything that may occur in their body. As a result, they continually look for signs of problems that may cause them to lose control or even die. In gaining greater control of their reactions and learning alternative ways of reacting to proprioceptive stimuli, patients find it easier to follow the necessary steps in exposing themselves to the situations they fear.
Physical techniques are of invaluable help in this kind of work, helping rapid progress to be made and improving the chances of success. They allow exposure to bodily sensations to be linked to techniques that are intrinsically relaxing, thereby making the exposure itself a technique that patients can use to cope with their anxiety.
Analysis and modification of underlying automatic thought processes
Another problem encountered in clinical practice is that patients find an excuse for not continuing with the plans agreed on even though they know they can and indeed have overcome situations with an acceptable level of anxiety. Such excuses are not based on objective obstacles, but on reasons that are not always explicit and which are triggered automatically in patients, preventing them from progressing. These reasons can essentially be interpreted as secondary benefits or advantages that result in the patient maintaining the disorder.
The social relationships of agoraphobia sufferers are greatly affected by their condition. As they are unable go out or venture unaccompanied to many places, the opportunities they have to be with other people are greatly reduced, restricting their social life significantly as a result. This inability to leave the safety of their own home unaccompanied also means they very often rely heavily on a close relative or friend. In response to this they develop special skills to attract company and control the people who love them.
In some cases they may even keep relationships going simply to avoid being alone, a situation that sometimes generates a huge dilemma for them: the very thought of breaking off the relationship is a source of great anxiety, but continuing it causes an equal amount of concern.
The origins of agoraphobia
It has been argued, perhaps because of the aforementioned deterioration in the relationships agoraphobia sufferers have with their partners, that the cause of the condition is possibly connected with the emergence of serious problems in these selfsame relationships. However, recent studies show that although highly stressful events may act as catalysts for the problem, relationship problems are not necessarily the most frequent cause, although they are relatively common. In fact, agoraphobia patients involved in steady relationships have a good chance of being treated successfully.
Stressful events triggering the condition may explain why the feelings sufferers experience when subjected to extreme stress (feelings they were once able to cope with) become much more unpleasant and why an increase in anxiety may lead to their tolerance threshold being exceeded, triggering alarms in the process. It is at this point that the struggle against the suffering begins, with patients attempting to control their feelings through physical reactions such as hyperventilation, tension, dissociation, etc. As these sensations cannot be controlled, the effort they expend increases anxiety levels significantly and may lead on to a panic attack. The search for security, staying at home and avoiding situations in which problems may be encountered are all indications that the disorder has taken hold and feelings of agoraphobia will only increase.
In many cases the condition manifests itself immediately after a stressful event but in others it may only appear months afterwards. When it does arise the sufferer becomes so anxious that even the mere thought of potential problems is enough to trigger an attack.
Anxiety is a universal human phenomenon. It afflicts all human beings in varying degrees, from an adaptive response to an incapacitating disorder.
In the majority of cases it requires no treatment whatsoever. Only when it becomes so intense that it constitutes a health problem, exceeds the adaptive capacity of the individual or interferes in their everyday life should treatment be contemplated.
In normal circumstances anxiety causes individuals to take action in threatening situations in order to combat, overcome or deal with them effectively. In some cases, depending on the defensive strategy adopted, anxiety may actually prevent the individual from acting.
Where anxiety arises, a particular relationship develops between individuals and their surroundings in which they identify a threat they are unable to deal with and which puts their well-being at risk. The critical processes in the relationship between individuals and their environment are cognitive evaluation and confrontation.
Something virtually all experts on the subject are agreed on is that anxiety is linked to the concept of threat, so much so that threat is seen as its most significant defining element.
Cognitive evaluation is a process of assessment that determines why and to what extent a certain relationship or a series of relationships between individuals and their surroundings is stressful or threatening.
Confrontation is the process through which individuals cope with the demands of the individual-environment relationship they see as stressful and the feelings this generates.
In order to understand the concept of threat in terms of the relationship between individuals and their environment the question must be posed as to how and why something is viewed as such, in other words, why a threat is perceived to be a threat.
Anxiety is linked to being, or rather, feeling at risk. When we suffer injury, a threat or a loss, it is our state of mind that is affected. Any lasting anxiety is linked to other areas in danger, some of them as a result of the threat manifesting itself.
Threat: Damage or loss that is yet to manifest itself but which is anticipated and which individuals believe to be too much for them to cope with.
Anticipation: A cognitive process evaluating an event that has yet to occur and in relation to which individuals assess possible risks, how they may arise and how to prevent or deal with them.
Biological activation: The internal overactivation and overstimulation of the body when faced with a situation considered to be threatening.
Confrontation: Cognitive and behavioural responses developed in order to deal with particular internal and external demands that are deemed to be threatening and beyond the capacity of the individual to cope with.
Results: The adaptive consequences or otherwise of confronting the threatening situation and which impact on the body’s affective, effective and physiological states/processes.
As we point out above, anxiety is not assimilable with any of the variables or any particular relationship between them but with the overall process.
Ineffective confrontation intensifies anxiety. As a particular project or achievement is undermined and physiological and psychological processes develop into a disorder, anxiety endangers, hinders or degrades (threatens, to put it simply) the continuity of other plans or plans connected to them that are, in principle, non-problematic. In the process it gives rise to a process of generalisation or a chain reaction that feeds the anxiety in a negative manner as individuals see their resources gradually being overcome and their well-being diminished.
The couple, couples therapy and social aspects
From society’s viewpoint the couple is an entity based on the relationship between two people. As a social entity the couple behaves as a single unit and is recognised as such by the people around it. It is within the couple as a social institution that dyadic relationships between its members occur. Laws, customs and habits mark out and define basic characteristics of the couple such as the commitment that binds its components, and endows them with a social function, impacting decisively on the form and content of the relationship between the couple.
Up until very recently, the vast majority of couples consisted of two people of different sex who, depending on any number of reasons decided to share their bodies and find mutual support for better, for worse, for richer, for poorer, till death did them part. The couple was married and its social function was to create a family, its intentions having legally been set out in a marriage contract.
The concept of the couple has broadened considerably since then and society today views neither of the aforementioned aspects as fundamental in the consideration of two people as a couple, with many couples having no intention of starting a family or of affirming their commitment through a legal contract.
The role of the couple and the family in society has gradually changed over the years and couples therapy has adapted to these changes. In the last two hundred years, the family has changed from being a production unit to a consumption unit. Each member of the family earns a separate income and the family shares consumer goods, food, a house, etc. The social existence of the couple means that in many respects it acts as a single, common unit and enjoys the single ownership and use of a series of goods, referring to itself in the first person plural with regard to its possessions and the activities it engages in.
It is now believed that the implicit objective of forming a couple is to make the other person’s life happier and more fulfilled and to receive the same treatment in return. The members of a couple therefore reciprocate behaviour and share, from a social viewpoint, a series of goods and activities. They do so as a priority, a priority that becomes a commitment of exclusivity.
They also make an economic commitment by which they agree to share their possessions. They usually have a house together although many couples now own different houses and choose to spend only short periods of time together such as weekends and holidays. Such couples are engaged in an ongoing courtship and have no plans to commit to each other or share anything else with each other.
The commitment to sharing economic goods is not necessarily formalised in law. In common-law couples, for example, there is no legal commitment to sharing possessions and neither, generally speaking, are the rules the couple observe explicitly agreed on.
Fatherhood/motherhood. This is one of the reasons why people decide to form a stable relationship. But even this aspect is changing. The proportion of children born to single women is gradually increasing and single mothers now outnumber their married counterparts in countries such as Iceland, Sweden and Norway.
There are other elements that are shared in some form such as social prestige or friends, but this does not occur exclusively and in this respect the variations between different couples can be considerable. For instance, the question of exclusivity when it comes to sharing free time has changed significantly. Although it has never been a determining factor for men, increasingly fewer demands are now being made with both members having greater freedom to enjoy their free time on their own. These aspects ought to be borne in mind as the issue of prioritising financial security in the case of women or social prestige in the case of men can lead to widely varying perceptions and conflict in the long term.
Whatever the circumstances, a workable basis for sharing has to be defined in couples therapy in order for the personal interests of each member to dovetail with each other.
The structure of the couple as a social entity and in its dyadic relationships is determined by the evolution and transformation of society, and differs in each individual, religious, financial or geographical context regardless of the process of globalisation we are currently immersed in. Knowledge of the structure of the couple in each social situation allows couples therapy to identify areas of action that can enhance its effectiveness and broaden its scope. By assessing the social and dyadic processes upon which a relationship is built we can define and outline the process therapy follows in the future.
Direct approaches to basic aspects of dyadic relationships, such as intimacy and validation or the analysis of ingrained behaviour patterns linked to strong emotions such as intense attachments, are now being put forward as a means of ensuring couples therapy can alter behaviour related to emotions and feelings, something that has only recently figured as a main objective of such therapy. Acting upon the component closest to love and passion involves taking into account the enhancement of the sexual relationship, not as the resolution of pathological problems but as an improvement and enhancement of the passion component in the relationship, thereby avoiding routine and boredom and preventing love and passion from being extinguished over the course of time.
The importance of strengthening commitment in the couple can be seen in the results. In becoming aware of the importance of commitment in achieving their own objectives, the members of the couple strive more effectively to resolve conflicts and to maintain the relationship without the need for intervention from third parties. In order to increase commitment it should be borne in mind that its creation involves conscious decisions to share possessions and behaviour with the other partner. It should also be remembered that commitment is inextricably linked to the social pressure surrounding the continued existence of the couple, and that we are living in a time in which the importance of commitment has been undermined along with the effort it involves.
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