Hope for Everyone

Kjetil Mellingen
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I am a very optimistic psychologist, but with reason. For 25 years I’ve been working with people who have had psychological problems in every conceivable area. Many psychologists have problems with burnout, especially early in their careers. For me, this has been very different. By using the treatment techniques that I do, I feel anti-burned out. It is so gratifying to see people get out of their serious problems, that I look forward to every day of clinical work.

The reason why many in the mental health field get burned out may be that they are not able to make changes in people’s lives as they had hoped.

I often get frustrated when patients come to me after a treatment career with four or five previous psychologists. The clients have been very close to giving up, but they often give it a last try, especially in the anxiety clinic where I work. Having failed in many therapies, having been made very pessimistic, I really admire them for not giving up completely.

Usually these patients have been to psychologists who are very concerned with childhood experiences. For years they have been talking to the psychologists about all kinds of bad things that have happened to them, in an attempt to find out what may have caused their psychological problems.

The problem is that even if we could reliably find exactly what caused the problems, this does not give us any direction about how to help cure the problem. The sad fact is that we cannot change people’s childhoods.

Another sad effect, is that doing psychotherapy that is not working may be very demotivating and give people the feeling that there is no hope for their condition.

What makes more sense, especially to clients, is to look at their everyday situation, and find out what problems they have within their daily lives. In technical terms, this is called formulation. Many British psychologists see this as a very useful alternative to diagnosis. The formulation would describe in everyday language what triggers your  problems, how you react, what  makes the problem worse or better, and eventually what may be done with this in the here and now.

By using such formulation, there is no need for diagnosis. I got a very nice experience the other day when one of my patients, who had been to many psychologists before, said that she liked to come to me because I told her of things that she could practice between sessions.

This attitude, of seeing all kinds of psychological problems, including psychosis, as mental habits that can be changed by psychological training, is very liberating, and very effective.

I got a very strong demonstration of this personally, when I was studying psychology. I had always been a worried person, but many of the worries went away by themselves. However, I had one problem it seemed impossible get rid of. Even when I was 23 years old, I was still extremely afraid of spider-like creatures with wings. These are creatures, the size of big spiders, which come into people’s bedrooms in the summer. I was totally scared by these, and had a very typical phobia.  I realized that they were not dangerous, but I just could not control my panic if they came into the room.

Phobias like this one may seem like details to people who don’t have them, but they can have very far-reaching effects on people lives. For me, the problem was that I was losing faith in psychology and, especially, in my own ability to help people, since I wasn’t able to help myself.  Then one day – out of curiosity – I picked up a colorful book where I found a very short article about how to treat a phobia in five minutes.

In my psychology studies, I have learned that anxiety could be very difficult to treat, and that we would have to be patient, maybe waiting several years for a cure. This article promised that phobias could be cured in five minutes. My immediate thought was that this was impossible.

However, I thought to myself, if this technique is so effective and it takes only five minutes to do, I would be very stupid to not try it. It was a very simple visualization technique, where I would imagine a picture of the insect right in front of me, and then very quickly send it away to the horizon. Then I would imagine a picture of myself being rid of the phobia, coming from the horizon and stopping right in front of me.

I did that visualization exercise as specified; out with the phobic image and in with the success image very quickly in one second, and then a break for 20 seconds. Then I repeated this five times as stated in the article. I felt a bit stupid doing this, but I said to myself – if it can make a big difference in my life, if this can help, I would be very stupid not to try it.

Then summer arrived and the insects started coming into my bedroom at night. I used to wake up my father in the middle of the night because of this fear, and I now noticed that I wasn’t afraid at all.

“Wow,” I thought to myself, “this is working, but it is probably very short-lived, since it was so easy.” Then after a few weeks I got the insect in my room again, and there was absolutely no anxiety. Another “wow,” and I started realizing that every time I saw this insect, I got a very positive feeling of mastery, and that this mastery was becoming attached to the insect.

So now instead of having anxiety, I had a feeling of mastery whenever I saw this insect. I have now had a 30-year anniversary for this fear-conquering experience.

Like all psychological techniques, it doesn’t work for everyone. However, it has been so reliable that when I have given courses for other mental health professionals I have used it as a live demonstration. It works every time. In a group of mental health professionals there will always be one or two with phobias. Usually it is either phobias of snakes, rats, elevators or heights. These are usually not debilitating, because people are usually able to avoid them. Just like with my phobia, the consequences in daily life may not be so great, but the consequences for self-image may be serious.

In the course, I do the treatment on a volunteer by promising that I will never really make them face their fear if they don’t want to themselves. They usually insist that they don’t believe that the technique is going to help, and that they will never take the elevator or touch the rubber snake. We do the procedure, it takes five minutes, and then I ask them if they’re willing to test out if they are cured. In every case they have been quite willing to try, and they have discovered that the fear is gone.

The first one I tested this on had phobia of heights, and she was so grateful when she saw that she was cured that she flung her arms around my neck and gave me a big hug.

Some may say that this is just a superficial technique that can be used just for very simple problems. However, psychological processes are very connected, which makes diagnosis in many cases relatively unnecessary. I worked for a while in a clinic for so-called psychotic and traumatized patients, and here I would see clients who had what are considered the worst symptoms in psychiatry: negative commanding hallucinations.

One woman was on five antipsychotics at the same time (which may have been part of the reason for her hallucinations), but according to the doctors everything had been tried with her to prevent hallucinations.

The voice, a very aggressive male voice, told her: “go and hang yourself you swine.” She was so devastated by this hallucination that she said: “maybe I should just do it so the voice goes away. Maybe I should just hang myself.”

There aren’t any easy solutions for this kind of problem in psychiatry, but she was suffering so much that I just had to use my imagination. The problem was that she wasn’t afraid of anything she could see.  She was afraid of a voice. So I thought that maybe the technique that had cured me could be used on voices. I told her: “try to imagine hearing the voice and then you quickly say “no, I’m going to live,” in a very optimistic voice. Then you take a break and repeat these two sentences, in sequence, 50 times, with 20 second breaks between each repetition. This will train your brain to go in the direction of the positive thoughts whenever you have the negative hallucination.

The patient did as I told her, and after three days the hallucinations were gone, and she finally got some hope maybe she could get better.

This was a woman who had had a lot of talk therapy and medication during 18 years of problems. I also treated her with very simple trauma techniques. This patient, who was seen as the worst of the worst, the most hopeless of the hopeless became quite functional, and started stepping down on all her medications gradually.

These simple and often extremely effective techniques are part of the reason why I look forward to every new patient and especially patients that have been given up on by other therapists.

Often, concrete psychological training methods – and reformulations of psychological problems as manageable faulty learning – have a very strong impact on patients. Luckily, with YouTube, I can now present these techniques in a very understandable way.

Conclusion: psychological problems, including schizophrenia, and serious trauma, PTSD, serious OCD, serious bipolar disorder, can be helped significantly through psychological retraining techniques. Some of these techniques are represented by CBT, Meta cognitive therapy, and many techniques from Neuro Linguistic Programming and energy psychology.

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35 COMMENTS

  1. Hi Kjetil,

    Thanks for this post. Like you, I’m a very optimistic therapist who never loses faith in the abilities of people to make important and sometimes dramatic changes in their lives. I trained in NLP in the ’90s and while it’s not an explicit part of the transdiagnostic cognitive therapy (Method of Levels; see https://www.youtube.com/watch?v=LQLnOHoko7U) I have developed, many of the questioning techniques have their basis in the NLP methods of investigating thought patterns and processes.

    Again, like you, I don’t see any reason why people can’t make lasting changes quickly. I’ve found in my clinical practice that people just take different amounts of time to change – some people change quickly and some people take more time. There’s no reason to believe, however, that quick changes are somehow inferior or more superficial than slower change. Often debilitating psychological distress can arise very quickly, sometimes after just one unfortunate event, so I don’t see any reason why it can’t disappear just as quickly.

    For me, being able to provide therapy is a tremendous privilege and I’m constantly in awe of people’s capacity to make new sense for themselves from a position sometimes of great distress.

    Thanks for your article. It’s great to read about someone who seems to have similar experiences to me with regard to therapy.

    Tim

  2. Thanks for a great article. Mindfulness was a major changing point in my life and doing a short gratitude exercise each morning as dramatically improved my resilience. Simple techniques that have greatly improved my mental health.
    I really do believe that psychologists should be clinically leading mental health services not psychiatrists. Formulation is far better than diagnosis and psychiatrists don’t know how to do this. And mental health teams should be filled with peer support workers and allied health. Peer support workers to walk alongside peoples journeys, OTs to help people find purpose and meaning, psychologists to improve how thinking etc, social workers to help with all those social issues. What role is there for a nurse other than jabbing someone in the bum.

  3. I have a niece, age 43, who is paranoid schizophrenic. Sadly, she lives on the west coast and I live in the mid-west. All I can really do is email suggestions to her mom and/or her of how to cope, particularly with the delusions. I have learned over the years that her brain does not recognize the “cause/effect” process……give a suggestion and she’s all for it, but soon it is gone. She has an obsession about having a significant other, to the point that she constantly hooks up with guys she’s met on the Internet, gives herself away, and naturally, they tire of her and she goes through a cycle of rejection, talks of suicide, and pretty soon it happens again. Shen says she hears voices. Your paragraphs about visualization: would this help her, do you think? Is there anything I can read about her particular obsession that might help her mom deal with it [her mom works all day, and at night, the worst time for my niece……must be a kind of sundowner symptom……my niece verbally abuses my sister.] I worry about how my niece will cope if my sister passes away. Any suggestions of reading material or any other ideas are welcome. Thank you.

    • yf444,

      My continued, and initially “coerced” psychiatric drug induced “delusion,” is that all people may be connected within our dreams, and the decent among us are working towards a better reality for all. And I, too, have a “man of my dreams.”

      Perhaps encouraging your niece that, in fact, her belief in a soul mate may be true, but patiently waiting for him to find her in real life, or looking for him in real life respectable and appropriate places, is the proper manner in which to meet him, is her best bet.

      But I’ll confess, psychotropic “antipsychotic” drugs cause one to be subjected to belief in altered states of reality, and cause a lot of long run physical health problems too, so slowly weaning your niece off the “schizophrenia” drugs will likely help her in the long run (but not likely in short run, due to neuroleptic withdraw induced super sensitivity psychosis) resume to a sense of realistic expectations and reality. She’ll need a lot of love and support in getting off neuroleptics, and most mainstream doctors will only provide the opposite of this.

      I’m glad, Kjetil, that you’re finding hope in your psychological assistance with those being grotesquely miss-medicated with psychotropic drugs, that cause “odd delusions.” I totally agree, confronting the “delusions” caused by psychotropic drugs or neurosis is beneficial. In my case, my drug induced “voices” were the same “voices” / real life people causing the trauma in my real life. According to my medical records, those who lied and defamed me to doctors to have me drugged up to cover up the sexual abuse of my child initially, were the drug induced “voices” in my head.

      But, in part because of this, I believe it’s possible that one’s psychiatric drug induced “psychosis” is possibly a way of working out difficult to deal with real life problems mentally, that the psychiatric industry is too lazy or unethical to want to deal with. And my subsequent pastor was kind enough to confess that historically psychiatrically stigmatizing / defaming people, and tranquilizing them, is the “dirty little secret” way the religions have always covered up their child abuse hobbies, and the mainstream medical community has covered up their easily recognized malpractice.

      Perhaps our society as a whole should move away from the Naziesque eugenics delusion that defaming and stigmatizing people, and torturing others (with psychiatric drugs), is the proper solution to the control of humanity by the unethical? And return to a humanistic, holistic, ethical, legal, and respectable manner in which we deal with all others? Including mainstream medical doctors who, due to paranoia, want to proactively prevent malpractice suits and cover up a “bad fix” on a broken bone and medical evidence of the sexual abuse of innocent children, due to their paranoia?

      Are the greed inspired bottom feeders of the medical community (those who have historically and still today covered up actually real life iatrogenic errors and child abuse of children), but have garnered control because of their power to defame and create “mental illnesses” in others with their drugs; the people we want as a society, in controls of dictating reality? I don’t think so.

    • “She has an obsession about having a significant other”
      It’s not obsession, it’s loneliness. It’s like saying that a hungry, undernourished person has an obsession for food. It’s a bit dismissive. And given how these man have treated her her paranoia is probably very justified as well… Unfortunately I don’t think that one has an easy solution unless you know how to make someone find mutual love… A problem as old as humanity.

  4. Thanks Kjetil
    ‘Hope for Everyone’ – is a fantastic title. Because thats what you’re offering.
    What so many people are up against is the idea of ‘no hope’ and long term uselessness.
    I was 23 and in a mental hospital when a psychologist told me that everyone in there could make complete recovery through the psychological process.

  5. Thanks Kjetil,

    Your article got me thinking about my extreme needle phobia. It is so bad that I didn’t get to say goodbye to my mother when she was dying in the hospital.

    One aspect of this phobia though is that if I did not have it I would be covered in tattoos and have a 600 dollar a day heroin problem. So I guess in that sense the phobia saved me from myself.

    Glad you can still be so positive after so many years because burnout is a very real problem in your profession.

    • I have a similar “phobia”. Although I don’t really think this one is so very irrational either. I am supersensitive to any pain stimuli and that’s why I freak out even when I expect something mildly painful to happen. It was also partly triggered by doctors in my childhood (which from what I’ve heard is very common in my generation when the paradigm was – if the kind’s hospital sick the parents are prevented from visiting in order not to create drama – in my case that was over 1month separation in a very early age – I hardly remember this save for a few events) and of coursed reinforced and blown up by the good professionals at the psych ward who not only didn’t care (I told them I had this phobia) but forcefully injected me with psych drugs and put a venflon in my vain. And then wrote up in their documents that my attempts to rip it off wee a clear sign of mental illness and self harm. I regret not stabbing them with it in the eye or sth.

  6. I think this is an interesting technique.

    However I also know someone who uses a conversational technique that is about acknowledging the past. He sees his technique as being about freeing people from childhood fears that are no longer necessary.

    I have found that relating the past to a confusing present can be reasurring – something akin to the concept of Normalising that you use. For example, I have a friend who has had lots of manic episodes. His father was also violent. He used to think he had Bipolar, but now, after some conversation he sees that his manic episodes were always shortly after he experienced violence, or the threat of violence. It reassured him that his experiences, although extreme, were understandable and that eventually they would be redundant as he learnt to deal with similar threats differently in the future.

    Evoking a fear may not be very good. Evoking a fear and then evoking courage to deal with it usually is.

  7. Yes of course there should be hope for everyone and there is value in the techniques you are discussing, which might be helpful for some people some of the time.

    However, promoting yourself, your approach and techniques in this way does not come across in a positive light. You, unlike others, do not suffer from burnout. You, unlike other psychologists, have the right techniques and approaches which can really bring about change for people. You are the one who knows what is best for the clients. These sorts of statements make me wonder whether you are open to learning from others, including your colleagues.

    Contrary to what you allege, many people are helped by approaches which focus on childhood adversity and not just on what is happening in the here and now. It is unhelpful to make an either/or black and white distinction here. Many people are helped by a combination of different kinds of approaches. As psychologists we need to be flexible, adapting our techniques and approaches to meet the needs of the different people we are working with, and seeking feedback as we proceed. A one-size-fits-all approach is not appropriate. How would you work with someone who stated they wished to discuss childhood trauma?

    Psychological therapies involve helping people to help themselves. Therefore, change, when and if it does take place, should not be attributed to the therapist alone, but to the collaborative therapeutic process. This has a lot to do with a person’s willingness, ability and commitment to engaging in a meaningful process of change.

    The therapeutic relationship is also important. I would not wish to work with someone who presented their techniques as the way forward, if that was not what was going to be helpful for me. Collaborative partnerships are important, as are choice and empowerment. We all have much to learn from one another. My way is the only and best way will never win the day!

  8. Your writings represent a very encouraging approach which I had considered myself for some time so feel validated by your work. I began wondering about the survival “benefits” of so-called mental illness years ago when I read much of Liz Greene’s astrological writings whereby she discusses how widespread depression is likely due to cultural and historical occurrences. Thereby, it is not so much personal, but a generational event.

    Since I am also interested in how behavioral traits and physical evolution usually occur to propagate the race, it seems logical that mental illness likewise might have survival benefits.

    Having a son who has been diagnosed with Borderline Personality Disorder, ADHD, and severe depression, we have sought many treatment approaches. His psychiatrist is very intelligent and compassionate, but constantly seeks a pill as the answer. I, on the other hand, search for natural means such as meditation and hypnosis. After chemical dependency treatment, we are going to try DBT so just knowing that there are others who believe change is possible and perhaps in a more timely fashion, is encouraging.

    The other night, a psychic told him that his crown chakra was wide open and stuck 🙂 This caused him to receive too much information from the universe and overwhelm him. As you can see, I am open to all ideas that may help him. At 21, he mostly placates me because he is truly a brilliant young man with a scientific bent. Honestly, after reading how Marsha Lineman (sp?) developed DBT, I would like to develop an approach that helps my son since most of what we have done in the past 2 years has not resulted in much improvement. Trying to support him wholeheartedly and unconditionally seems to have been the most help.

    Thanks for your article,

    • From one who rarely touts her own blog to onewhorarelcomments just thought you might enjoy reading my son’s and my adventures in the land of alternative healing. I have found that almost all alternatives (some of the best ones are truly “out there”) have brought my son further along the path to selfhood. Go to the About this Blog link, and you will find a list of stuff we have pursued which you can put into the search bar.
      http://www.holisticschizophrenia.blogspot.ch/

      My latest blog post is Kjetil Mellingen’s Hope for Everyone, because sustaining hope is so important for recovery.

  9. Ok, sorry but I’m going to have to be a bit critical here. You say in your article:

    “The problem is that even if we could reliably find exactly what caused the problems, this does not give us any direction about how to help cure the problem.”

    I find that this is a very incorrect statement. Many people here (and I’m aware that it’s not everyone, however) believe that trauma is a precursor to a lot of emotional/mental/spiritual distress (“mental illness”). Therefore, you need to address the trauma (what happened in the past).

    You are right about one thing is that sometimes too much emphasis is put on CHILDHOOD experience whereas the traumatic event/s could have happened at any point in the past. You are also right that some therapists just talk for the sake of talking which is unhelpful.

    However, for someone who has been traumatized in any way (physically or emotionally) dealing with the here and now is not always all there is to it. The pain of the trauma needs to be addressed for people to heal. For example (and this is a very straightforward example to keep things simple), you may have someone who was emotionally abused by their parents when younger and now as an adult finds themselves anxious in social situations. You can focus on the present day problem with helping them overcome their “social anxiety” and feel comfortable in social situations with their peers but that is not necessarily going to resolve the pain, anger and/or fear this person has in relation to their parents and carries inside them. It may help relieve those feelings but it’s not necessarily going to fully release them.

    Do you see what I mean?

    I am not saying your techniques are wrong or not useful but I have found that only addressing the problematic behaviours/reactions in the present only goes so far and to have deep healing the past needs to be addressed. This is trauma processing or trauma integration. The way that people process their trauma is different, and we all need to figure out how it is best done for us personally. For some it is just talking to someone about it (that’s why talk therapy is often helpful), for some they need to confront the person/people who played a part in the trauma, there are also body based techniques for trauma processing such as EMDR (requires a highly skilled therapist to do) or Trauma Release Exercises (which are gentle and can be done at home. Look up TRE David Berceli).

    I’m a bit worried because it sounds like you avoid talking about a person’s past and only go there if they bring it up. However, often people don’t even make the link between their present pain and suffering and past trauma.

    In saying that, I also do not agree with prolonged, drawn out conversations about the past that go nowhere and dredging up every single negative event. A talk therapist needs to have the skills to make sure that the talk is productive and not just talk for talk’s sake.

    • “You are right about one thing is that sometimes too much emphasis is put on CHILDHOOD experience whereas the traumatic event/s could have happened at any point in the past. ” That is certainly true. In fact in many cases it is happening right now and pretty much the only thing a person needs to heal is to have the abuse or stress removed from his/her life. Yet psychiatrists are not interested in dealing with some dirty little secrets of domestic abuse, sexual abuse, mobbing, psychological abuse, toxic relationships, poverty, racism, discrimination etc. Handing out pills is somewhat easier.

  10. “For years they have been talking to the psychologists about all kinds of bad things that have happened to them, in an attempt to find out what may have caused their psychological problems.”

    Exactly. And even worse – when they can’t find anything in the person’s childhood they try to invent something (happened to me, fortunately I was smart enough to decide that a person who’s forcing his ideas on me despite my opposition is a crappy psychologist and should never be having his job). Nothing better when the psychologist having found no trauma, neglect or anything at all wrong with your family (and he really tried, despite me telling him countless times I had great childhood) says “well, they were too good for you, that’s why you have these problems”. WTF? I wonder how many people fall for it and start blaming their families for things they would never have thought of as abusive or otherwise bad before. And there’s the false memories problem – if you use enough suggestion on an unsuspecting person who happens to trust you he/she can develop memories of events that never happened. The whole thing is wide open for abuse.