Attachment Centered Therapy Manchester, London and Guildford
I am Charley Shults and I have been practicing counselling and psychotherapy since 1987. I am offering Addiction Counselling in Manchester at Hampden House Psychotherapy Center, Relationship Counselling in Manchester, and Attachment Counselling in Manchester, as well as at 10 Harley Street in London.
Healing The Broken Bond:Is a book that I am working on and I will be posting regular excerpts from the book online. If you would like to read it, please do so at the bottom of this page. If you want to give me feedback or ask questions please do so using the email link. What is posted now is about REBT, Rational Emotive Behaviour Therapy, the grandaddy of all CBT, and in my opinion still the best. i hope it is useful to you.
Attachment Centered Therapy Manchester and London: I work with individuals, couples and families offering Attachment Centered Therapy in Manchester and London in order to help them heal difficulties related to their attachment relationships. I also find that this work has a global effect, so that those clients who do this work experience changes in all areas of their life's functioning.
Relationship Counselling Manchester and London: Over decades of working with clients, and training in many areas of specialization, I am convinced that the problems that most people present in therapy settings grow out of difficulties in their attachment relationships. These attachment experiences determine how we relate to other people in our lives, particularly those most close to us, and also how we deal with the difficulties that life presents us. I believe that by correcting these difficulties with attachment people are enabled to make the changes that they want to make and do the things that they know they need to do. My experience tells me that this is so.
Family Therapy Manchester and London: I also use an attachment based approach for working with families. Family work can be done with an entire family, or with different configurations of people from the family.
Addiction Counselling Manchester and London: I believe that most addictive disorders are due to attachment difficulties that result in unmet needs and feelings not being dealt with in an effective manner. The addictive disordered behavior develops because it is a vain attempt to meet unmet needs. While the addictive behavior provides the illusion of making things better by making the negative feelings that come from unmet needs go away, this is only temporary and so those unmet needs come back stronger than before, often leading to an escalation of the addictive behavior.
Attachment difficulties lead to other common problems, such as:
My practice for Attachment Centered Therapy, Addiction Counselling, and Relationship Counselling is in Manchester and London. My Manchester practice is within easy reach of Cheshire. I also have offices available in London, Harley Street.
Thank you for the work you are doing for me and for Isabella*. To my surprise she has told me about her "compulsive self reliance" and even read to me some data from the website you have kindly advised to look at.... I see this... as a big step forward in her life for which I am grateful to you. We are so lucky to have a professional person like you!
Sent from my iPad
Healing the Broken Bond: how attachment difficulties creates problems and what to do about it.
Rational Emotive Behaviour Therapy
REBT was one of the first therapies that I learned about. This was when I was a student in theatre performance and production at Birmingham-Southern College under Dr. Arnold Powell. But my mentor in regard to therapies was my friend and at that time associate professor as well, John Kitchens, as I mentioned earlier on. He introduced me to the idea of REBT, or RET as it was known at the time. This was a very exciting idea to me. It is really an age old proposition, that it’s not what happens to us but what we tell ourselves about what is happening – what we believe about the event – that creates our feelings and behaviour in response. So in this system, which uses the A, B, C mnemonic device, the A becomes the ‘Activating Event’: that is, the thing that happens; the B becomes the ‘Belief’ or what we tell ourselves: our opinion; the C becomes the ‘Consequence’ which is an emotional reaction to what we have told ourselves about the event. This consequence can be either a feeling state (fear), a behaviour (running away), or both, or a combination of the two as when a behavioural impulse is described as a feeling state (I feel like running away).
The trouble with a statement that uses a behavioural description to describe a feeling state is that it does not always elicit caregiving. For example, Racine, after she had broken up with Max, felt uncomfortable with being in his presence because he was being very punitive toward her. This discomfort was great, and she expressed it to her mother as ‘I want to leave that college. I don’t want to go there anymore.’ What she was really trying to express was her feeling of discomfort at having to be around Max. Her goal presumably, in expressing this to her mother, was to elicit comfort from her mother. Her mother, being a good performance oriented A4, was alarmed by her daughter’s apparent disregard for the importance of education above all else. This alarm then prevented mom from giving daughter the support and comfort that she needed, and it cut off the possibility that mom could use the emotional coaching approach advocated by Dr. John Gottman in his book, Raising an Emotionally Intelligent Child, which I recommend to any parent wanting to know how best to parent children, and I also recommend it to my adult clients as a way for them to self assess the type of parenting that they had.
It is worth saying at this point, for those who may wish to debate the point, that the proposition that the belief, opinion, or what one tells oneself, or the B part of the ABCs of emotions, comes before the C, or the consequence in feelings or behaviour, is not always entirely accurate. In fact, I am presenting a very cogent argument (well I think it’s cogent anyway) to the opposite effect. So since I will be contradicting myself I suppose it best to anticipate and address the contradiction now rather than later. First I want to emphasize that what I am interested in is results. One theme that is emerging from this book is that it is often what we believe that creates our reality. So what REBT does is help us to create our reality – a better reality – based on changing our beliefs. Whether it is strictly so that an emotion happens in relation to an event based on what we tell ourselves is not really important to me. What is important is that if we operate that way using this system then we can get a better result than if we don’t. We can make a strong argument that the reverse is also true: that an event occurs, we have an emotional reaction, and then we make up something to tell ourselves to explain the emotion. Again, neither way of looking at it is true all the time, and both are useful in their own way at different times.
REBT is simply a tool. One problem with CBT practitioners (see the blind men and the elephant) is that they confuse the tool with the job. You can teach someone how to use the tool without teaching them how to do the job, because there are usually many tools and techniques and materials that go into good workmanship, while driving nails with a hammer all day long doesn’t take much skill and perhaps produces nothing. So part of the concept of Attachment Centred Therapy is about what to use in a particular phase of the work. And I think knowing that is more of an art than a science.
But back to REBT strictly: here is an example of where the concept seems clearly to be useful and valid. Let’s say that there is a general election and the Tories win a clear majority. If I believe that the Tories are going to save the country from ruin then I am happy and I will have a drink or two to celebrate with friends. On the other hand if I believe that under the Tories we are going to hell in a hand basket then I am unhappy and I will have a drink or two to commiserate with friends. This is a clear example where the proposition behind REBT is almost certainly true: the event is exactly the same but the outcome in feelings is exactly opposite because the beliefs about the event are exactly the opposite. We will see this principle applied in a different way in the section about marriage and family therapy where we will encounter negative attributes of meaning versus positive attributions of meaning.
On the other hand, clever psychologists have shown that there are certain things that are intrinsically emotion producing. For example being alone in the dark is intrinsically fear inducing. Even as adults we experience this. Even more clever psychologists have shown that when we see fear on someone else’s face – even when it is so fleeting that we don’t consciously recognize it as fear – then we also feel fear in sympathy. These both seem to be biological adaptations that have been hard wired into our brains through genetics over millions of years of programming experience. Those who had the traits out-survived those who didn’t have them. But here is where the difference comes in: in those last experiments, when people who already had a high level of anxiety saw those faces, they became acutely aware of the innate feelings of fear and this further increased their anxiety. For those who already had a low level of anxiety, their mid-brains had been programmed to filter out the unconscious fear response, and so they never consciously felt a feeling of fear!
Now, in case you don’t already get it, despite the italics, this is a huge difference. What it means is something like this: if you and I go into a waiting area filled with people, and if I am already at a high level of anxiety even before I walk in, then the faces that show micro-expressions of fear (as most or many will when a new stranger enters the waiting area – they might be a threat!) then I will become acutely aware of my own feelings of anxiety and that will further reinforce my belief that I am a highly anxious person or that I am in a dangerous place. You on the other hand are at a low level of anxiety that you don’t really appreciate since you have no highly anxious state to compare it to, your unconscious mind will do the job that it was trained to do and eliminate the micro-expressions of fear from conscious awareness as they do not need any executive decision to be made, and so you will feel perfectly relaxed and comfortable sitting in the waiting room. Our subjective experience of entering the waiting room will then reinforce our predispositions. You will become more secure and confident as a result of your experience, and I will become more fearful and insecure. The rich get richer and the poor get poorer. So here we have what is more likely to be the case between the two propositions: does the belief produce the feeling or does the feeling produce the belief? It is most likely to be an interaction between the two processes of varying degrees one way or the other. Regardless, REBT is a very useful tool for dealing with the ‘C’ part of the equation: the consequences, emotional or behavioural.
After we find the belief, then we are ready to go on to the next step in the process, and that is to examine the belief to determine if it is a rational or irrational belief. This is where the R comes into REBT. Ellis’ belief was that rational beliefs produce healthy and helpful emotional responses, while irrational beliefs produce unhealthy and counterproductive emotional responses. To determine whether or not the belief is rational or irrational you ask three questions about the belief. The first question is whether or not the belief (and the consequent emotional response) is helpful in dealing with the situation in the long run? If not, then the belief is irrational because it isn’t long term helpful.
If yes, then we can go on to question number two: is the belief based on known facts and reality? This question is not so easily answered as it might appear at first blush. Often clients will answer ‘yes’ because they are answering it based on their own private story of known facts and reality. Unfortunately the GIGO principle applies here: garbage in, garbage out. If a person’s own experience has been distorted and warped by dysfunctional or worse damaging experience, then their own store of facts and reality is not going to be a useful base for comparison. We must utilize the known facts and reality of people in general in order to accurately answer this question. Thus the belief that ‘you can’t trust anyone’ might be more or less true in one person’s facts and reality, but fortunately for most of us we realize that most of us are trustworthy, at least to some extent or the other. Again if the answer is ‘no’ then we have an irrational belief.
If yes, then we go on to question number 3, is it logical? This question I find to be more difficult than the other two.
Some clients take to REBT readily and some never seem to like it or use it. The client who took to it most was a young woman who had enormous attachment issues, but when we tried to go into the attachment work, after the first AAI session, in which we dealt with her relationship with her mother, she came back the next week to say that she didn’t want to do anymore AAI work. The next day after our session she had been riding the bus, she said, and she began thinking about her mom and the work we had done the day before. She suddenly felt tremendously sad and started crying, and she told me that she never wanted to feel that way about her mom again so she didn’t want to do any more attachment work. She did however take to the REBT like a duck to water, and it was perfectly suited to her predicament, which was that when she knew her mother was planning to leave to go somewhere without her, whether it be for a week or a weekend, she felt tremendous anxiety, couldn’t sleep, catastrophized and produced somatic symptoms such that she would often have to be hospitalized.
Of course it was easy to identify the beliefs, the activating events, and the consequences in these recurring scenarios. Because these situations were fraught with difficulties there was often complicating intrigue around them, such as mom secretly making plans to go away that she didn’t share with her daughter, the client and also collusion with others to manage her daughter’s anxiety. Inevitably the client discovered her mother’s deception, and this unfortunately compounded the problem. Meanwhile the mother became more quietly desperate in her attempts to get away from her daughter’s neediness, and this in turn made the daughter more needy. And the client, who was very bright and training to be a helping professional herself, could quite easily see the irrationality of her beliefs when examined through the prism of the three questions. So this leads us to the last phase of the REBT process.
D and E, which follow logically after A, B, C, as most of us know by now, stand for D: Disputing the Irrational Belief; and E: Effective New Emotional Responses. In disputing the irrational belief you tell yourself something that meets the three question criteria discussed previously: 1. It is useful in dealing with the situation in the long run; 2. It is based on known facts and reality (of the human race, I should add); and 3. Is it logical?
Of course, simply telling oneself something one time on one day is not going to make much of a difference. So the REBT system has ‘zig-zag’ form for reinforcing new beliefs. In addition I recommend that they take the new belief and make it into an affirmation which they tape to the mirror so that they will see it each day, at least twice, and that they repeat it to themselves three times while looking at themselves in the mirror. This is most effective when the beliefs are about themselves and their own self-worth. So, for example, someone who has very low self-esteem and thinks they are unlovable and unworthy the affirmation might be, ‘I am a lovable, worthwhile person.’ Most people who try to do this find it a bit repugnant at the start because the UM will actively resist this discordant thought and will produce visceral and emotional reactions against it. In that case I recommend that they metaphorically take a step back and make the affirmation, ‘I would like to believe that I am a lovable and worthwhile person.’ I have never had this approach fail, though interestingly I have never come across it before in the affirmation books.
At any rate, after a while they find that they can tolerate giving themselves the unedited affirmation once again, and so proceed to change their beliefs about themselves.