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Mood & Mind

Is NOT talking the new therapy?

‘Hmmm, I see’ said my therapist, nodding.  ‘Then what happened?’  My first experience of counseling was at 16.  I had no problems I can remember but just after my parents broke up my GP became convinced I would benefit.

The therapist would sit there nodding, making me relive every last detail of events.  When my hour was up, he would say, ‘Okay, see you next week.’

After every session, I would go home and cry, feeling worse for days afterwards.

Since then I have been through a sudden redundancy and two emigrations. After well-meaning friends and family warned I could be affected later, I tried two more courses of therapy – one with a run-of-the-mill counselor for eight weeks and the other with a psychotherapist for six months.

But the only thing guaranteed to happen was that when I talked in detail about my negative feelings – whether formally or to friends or family – it often made me feel worse, somehow filled with my problems.

Now, if I am having a hard time say at work, I prefer to write things down in a journal then meet a hilarious friend who’ll make me laugh so hard I won’t care what a neurotic client said at 3pm that afternoon.

Forcing myself to be cheerful and positive is much more likely to get me out of a filthy mood than talking about it in dreary circles.

Recently, I had to stop seeing a particular friend after the fifth meet-up in which absolutely everything in her life was ruinous – her job, relationship, home and family.

Even her emails became toxic ‘poor me’ tirades in which I felt pressured to come up with advice on people and events I didn’t know.  After each night out with her I invariably came away miserable and tired, sucked listless of energy by her relentless whining and venting.

This might sound Polyanna-ish or like emotional constipation especially as ‘Let’s talk about it,’ is such a 21st century cure-all that the government has pledged £70 million on improving access talking therapies on the health service so more of us can have more therapy.

I am not alone in opting out of this indiscriminate emo-spillage in favour of a stiff upper lip.

Psychologists are now admitting that talking our negative feelings isn’t always be the panacea that Oprah-will-fix-it chat shows and Woody Allen films would have us believe.

In fact, a growing body of research argues that unless expressing your feelings comes naturally, holding it in – or using non-talking therapies to deal with it – could be better for you.

‘There’s no real evidence that talking about your feelings can be good for your recovery from traumatic events,’ says Professor Karin Coifman, assistant professor of psychology at Kent State University in the US.

Coifman’s research focused on people going through divorce, job loss and bereavement who avoided talking about their feelings, called ‘repressive coping’.

Previous research has shown that repressive copers could have long-term negative effects such as increased heart disease or blood pressure, says Coifmann.

‘But we looked at the health costs in people who didn’t share their feelings after a traumatic event and 18 months later the repressive copers had fewer health problems and could function better than those that had had counseling,’ she says.

‘That was a huge surprise as we have been led to believe people who repress their emotions would develop health problems,’ says Coifman.

Moreover, research from Tel Aviv University found that a repressive coping style could help people adjust to traumatic stress and to experience less anxiety, both in the short and longer term.

Indeed, forcing people to talk through their problems before they are ready could do more harm than good.

‘There is mounting scientific evidence that after somebody has been through something traumatic forcing them to talk about it– called ‘de-briefing’ – is anxiety provoking,’ says Dr Dennis Charney, author of Resilience: The Science of Mastering Life’s Greatest Challenges (Cambridge University Press £14.99) and Professor of Psychiatry at Mount Sinai School of Medicine.

‘If someone wants to talk about something they should,’ says Dr Charney,  ‘but if they’re not ready it’s important they have social support but it shouldn’t be forced out of them.’

After the experiences of victims of events such the London 7/7 bombings a shift has occurred in psychological thinking, say experts.

In the past, it was assumed the vast majority of people involved in traumatic events would suffer with Post Traumatic Stress Disorder (PTSD) symptoms such as irritability, insomnia, flashbacks, poor concentration and difficulty carrying out everyday tasks.

‘Forced de-briefing’ was seen as the psychological intervention that people needed after traumatic events, says Dr Collins.  ‘But groups who received therapy interventions actually recovered from the trauma less quickly than people who received no help at all.’

In fact, more recent research by leading psychologist George Bonnano found that up to half of people who experience a trauma will use repressive coping techniques and recover without any therapy or counseling while only 10-15 per cent would develop long-term symptoms of PTSD.

Now it’s believed talking about negative experiences can for some people interrupt the natural process of how the brain is dealing with it and almost imprint the trauma on that person’s psyche, Collins asserts.

‘It’s much more common in current practice to test people beforehand to see if they will benefit from therapy or counseling, not everyone will,’ says Dr Collins.

How can we know if we need help?  Coifman advises asking yourself: am I functioning?  ‘Being able to operate normally is the hallmark of whether a person is dealing with crisis, not whether they talk about it,’ she says.  ‘For some, not expressing it will be their way of coping,’ she says.

As an increasing legion of experts admit that talking about our negative feelings may not work for everyone, more options are available to help us feel and function better without it.

Non-talking therapy  Many people who suffer with anxiety or depression find talking unhelpful or too painful, says Beth Murphy of Mental health charity Mind.  Consequently, more non-talking therapies are becoming available.

‘Talking about your feelings can be a tall order for some people,’ says Murphy.  ‘Such people have told us that arts therapies encouraging them to work creatively with music, drama or dance, rather than talk about their problems help them find an outlet for difficult feelings or memories.’

Another non-talking therapy is ‘Mindfulness’, a type of non-religious meditation that focuses on being in the moment, whether that’s in a formal ‘sitting’ meditation, while washing the plates or eating a meal.

Mindfulness training teaches people to be in the moment, observe their negative thoughts and realize they are only thoughts that can’t hurt them, says Professor Mark Williams clinical psychologist at Oxford University and author of Mindfulness: A Practical Guide to Finding Peace in a Frantic World (£12.99 Little Brown).

Fans include Meg Ryan, Goldie Hawn and Ruby Wax and Mindfulness Based Stress Reduction (MBSR) is an eight week training course approved by National Institute of Clinical Evidence (NICE) for people with a anxiety or depression and now available on the NHS.

Spotting toxic talkers There’s an idea that talking to friends about our problems is always a good thing, says Professor Coifman.

‘But there’s a risk that you become too concerned with your problems by talking about them over and over again and this makes you preoccupied with them,’ she explains.

This process – called ‘rumination’ – is a significant risk factor in the development of psychological problems such as depression and anxiety, explains Dr Coifman.

‘There is a process that can happen between friends called ‘co-rumination’ where two people start to fixate and dwell on problems,’ she says.

Co-rumination might make two friends feel closer but the downside is that ruminating together on bad feelings makes both people feel worse, re-infecting them with the same negative emotions each time it’s discussed.

Diverting your attention by seeing friends and purposefully not talking about your negative feelings can help you out of this cycle, she says, as positive feelings can also be catchy.

Sleeping on arguments After years of arguing into the small hours in an attempt to abide by the old adage: never sleep on an argument, I now pull back, quieten down and head to bed.

Of course, when I’m tempted to throw a saucepan over my husband’s head, the thought of sleeping next to him is as welcome as a cold shower, but I force myself and while it might take an hour for my fuming to calm down (a good book helps) I now value sleep more than being right.

Being upset triggers a part of the brain called the amygdala that react when you feel under threat with a fight-or-flight response that causes surge of stress hormones in the body, literally pumping it for combat.

Sleeping on arguments gives all those fighting hormones time to dissipate which is why you often feel better in the morning.

‘I have a rule with my clients of not talking anything that could cause an argument after 9pm,’ says psychotherapist  and relationships counselor Christine Webber, author of Too Young to Get Old (Piatkus £9.99).

‘After that people are tired, stressed after a long day and may have had a drink so reasoning is impossible.’  She suggests training yourself to think, ‘I am annoyed but I will review this in the morning’.  ‘About two thirds of the time, it won’t be important come morning.’

If you’re still peeved the next day, Webber suggests the 20-minute rule.  ‘Set aside 20 minutes,’ she says.  ‘Each person takes five minutes to speak uninterrupted.’  Speech is about 180 words a minute so you can pack plenty into five minutes.

‘In the final ten minutes talk together about resolving the issue,’ says Webber.  ‘Then, stop.  If you don’t resolve it, set aside another 20 minutes to look at it again.

Afterward don’t talk about the issue again until the assigned time and do something together such as seeing a film to remind you both of what you like about one another.’

Pressing the pause button on anger  No one likes a scene and research from Duke University found a strong association between expressing anger repeatedly and an inflammatory marker of heart disease called C-reactive protein.

You can press the stop key, says Dr Marin Shirran, psychologist and author of recent book Pause Button Therapy (Hay House £12.99).  In PBT you learn to visualize the likely results of your actions as if you were watching a film, he explains.

‘People who don’t like talking therapy love the simplicity of PBT,’ says Shirran.  ‘You shut out the outside world for a few moments and consider the rights and wrongs, pluses and minuses of a choice you might make to act in a certain way.

‘Say you’re about to lose it with your children, you press Pause to give yourself some thinking time to consider a question such as ‘What will be the best outcome for my child?  Have I been habitually been reacting like this?  Is there a better way?’

PBT is being used in anger management successfully and being trialled in UK young offender institutions.  ‘It helps you see the consequences of your choices and you don’t have to talk to anyone, only have a virtual conversation with yourself.

Still, always holding in anger is associated with anxiety, chronic headaches, skin disorders and stomach upsets.

The answer is choosing your battles, explains Professor Paul Gilbert, professor of clinical psychology at the University of Derby and author of The Compassionate Mind (Constable £24.99).

‘Anger has three zones,’ says Gilbert.  ‘The first is the white zone where it’s a small irritation but it doesn’t really matter,’ he explains. He picks his toenails or leaves the loo seat up –   irritating but not exactly upsetting (and probably unlikely to change).

‘Expressing anger you feel in the white zone is not productive because it’s not something that really matters that much,’ says Gilbert.  During such times there is little point in saying anything, he says.

But the second level of anger is the pink zone where it is causing you some upset but you are still able to think.

‘Don’t be frightened of your rage and try and speak up in the pink zone when you are irritated but still able to hold a rational conversation,’ says Gilbert.

‘The final level is the red zone where you are no longer thinking clearly and lose your temper,’ says professor Gilbert.  ‘Letting your anger simmer from pink to red tends to make it progress’, he explains.

‘By the time you get to the red zone, often you only want to hurt the other person,’ he says.

‘Walk away and cool off,’ he suggests.  ‘Your brain has been aroused by adrenalin and you will need to wait about half an hour until this phase has passed and you’re thinking rationally again in the pink zone before discussing the issue’.

Resilience in the face of grief  According to Ruth Konigsberg, author of The Truth About Grief: The myth of its five stages and the new science of loss (Simon & Schuster £16.25), one of the myths associated with grief is that you have to express it or it will fester.

‘For some, repressing rather than expressing their grief can be helpful,’ she says. ‘The only people who studies show are helped by counselling or other bereavement interventions are those having serious difficulties, known as complicated grief.’

Konigsberg who looked at the experiences of bereaved mothers and widows as well as doing research into grief in the last 40 years and found many people surprised themselves by coping better than expected.

‘What you often don’t hear about is resilience,’ she says.  ‘This is about our innate coping skills for surviving hard losses,’ she says.  ‘You may already have everything you need to cope.

‘Don’t force yourself into counselling or therapy if it doesn’t feel right and be wary of prescriptions to express grief in a certain way that can stigmatize anyone that isn’t expressing it the way they are ‘supposed’ to.’

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