Daniel Mirea

If the gut and the brain are in constant and autonomous communication, and they make behavioural decisions for us all the time, then it is safe to assume that nutritional and other daily occupational habits, such as the proverbial rest, work, and play, could impact more significantly on our mental health, than ever anticipated (Mirea, 2023). We have always known this instinctively, but the bio-psycho-social processes operating in the background remain a mystery.
This article barely scratches the surface of an intricate world of internal highways of communication, hidden within the human infrastructure, which ultimately leads to behavioural and social decisions, every moment, of every single day. Decisions that ultimately, impact on our existence and quality of life. The article certainly raises more questions than answers, we do not seem to fully understand all the mechanisms that support gut’s constant communication with the brain.

If transference is nothing short of feelings triggered by associated thoughts, images or video reels, that can be traced back to early experiences and may result in questionable behaviours in the present-moment, I fail to see how this not exactly what CBT calls a contextual cognitive-behavioural conceptualisation, simply labelled differently in the psychoanalytic literature.

One of the problems we encounter in the field of evidence-based, applied psychology, is the firm and long-established reliance on the medical-disease model. In a nutshell, this means that we must diagnose first, and then treat. This is both a blessing and a curse, since indeed we have excellent disorder-focused approaches and CBT protocols, which treat specific psychiatric disorders with some predictable outcomes. On the other hand, not everything we observe in our clinics is diagnosable.

https://neuroaffectivecbt.com/2024/03/11/relationship-ocd-how-is-this-a-thing/

Research tends to indicate that approximately 25% of people who have experienced a significant trauma go on to develop post-traumatic stress disorder symptoms or PTSD, how do the up to 75% remaining deal with their symptoms post-trauma in order to, not develop chronic PTSD?

https://neuroaffectivecbt.com/2022/06/10/trauma-treatment-challenges/

In psychotherapy nobody seems to want to talk about physical training, or diet, or sleeping patterns, although it is crucial for emotional regulation. Sleep deprivation is the number one risk factor for a range of mental health problems. It may be useful to not only identify the challenging aspects of sleeping and eating well, but to also to identify some of the benefits that sleep or a healthy diet can provide when we get a chance to turn the tables around and we move in the direction of mental wellness.This leaflet introduces an efficient emotional regulation intervention that sits at the core of the Neuroafffective-CBT (NA-CBT), more details in the video link below: 

https://neuroaffectivecbt.com/2023/07/18/teds-your-best-friend/

Evidence indicates that the current self-isolation may be both a blessing and a curse, since it will clearly help us manage COVID-19 but at the same it might bring with it a series of challenges including, how to spend time at home in a way that improves our mood and does not increase feelings of fear, sadness, anger, isolation and lack of purpose.

CBT as a method maintains a focus on increasing self-efficacy and therefore it can provide a range of very well researched technology that could help people at home.

Several essential mechanisms underpin NA-CBT and each treatment module attracts a particular set of skills, none more relevant that the skill of building a therapeutic alliance. I coined the term empathic-mentalisation to highlight therapist’s skilful ability to connect with his client in a way that would allow the therapist to not just hear and understand at a pre-frontal level, patients’ vulnerabilities but instead to allow himself, to feel his client’s pain in a way which will help the client feel felt.

Most people would consider having high standards a good thing but at times this is just ‘part of the plot’ or in other words, part of a complex trap called ‘perfectionism‘. Striving for excellence might indicate that you have a solid work ethic, strength and ambition. But if and when achieving success (in any domain) is consistently associated with one’s value, self-worth and esteem, we risk falling into the trap of 'perfectionism'. High standards could indeed propel one towards the peak level of their potential. This is very common with professional athletes or musicians for example, who train long and hard to reach excellence in their respective sport or art. Clinical perfectionism could however develop when the individual believes that his/ her worth, value and appreciation by others, uniquely depends on achieving success all of the time and never failing a task. In parallel with that, standards are set so high that they often cannot be met, or are met with a great deal of difficulty.

It would be fair to describe the side-to-side eye movements or hands tapping as somewhat unorthodox exercises for the traditional psychotherapist, and therefore it should be no surprise that bilateral stimulation has been the target of many debates and studies. To make matters worse, the evidence hasn’t always been favourable.

One of the problems with anxiety and psychopathology in general is lack of psychological flexibility which translates without exception into poor attention training skills. When self-critical, self-blame thoughts, worry or shameful thoughts, enter our awareness, our attention is literally hijacked by these thoughts and we start engaging with them. For example, in the case of clinical perfectionism, when we are requested to produce an important business report we tend to worry about the language, typos, the format and so on, even after it has been completed. After we submit our work we might continue to worry about it or about the perceived negative feedback we could receive as a result of poor quality work. Of course, these are all false projections into the future or even catastrophical predictions (e.g. this is the end of me, I will lose my job this time 100%). When these negative thoughts (predictions and so on) enter our mind our attention is 100% directed towards the content of such thoughts, which triggers our sense of threat. This means that our brain (and body) starts to believe that we are under threat and it responds by triggering the Autonomic Nervous System (the sympathetic response), which manifests through a range of physiological symptoms of anxiety (heart racing, sweating, etc.). And thus, the 'perceived threats' start to 'feel' real. Over time and with lots of practice such negative thoughts begin to govern our existence and become more and more believable. In other words we become very good at getting anxious.

This article describes the process of assessment and case formulating  in CBT therapy. Formulations are essential for the CBT treatment and the principal role of the assessment process is to understand all the precipitating, perpetuating and predisposing mechanisms that maintain patients' presenting issues over time. Case formulations are also helping the therapist make many of the clinical decisions that are likely to unfold during the treatment and therefore treatment outcomes are directly linked with the ability of the therapist to assess and formulate.