Hysteria, where sufferers complain of a specific ailment with no discernible cause, is not an imaginary disorder, according to a group of Canadian researchers.

The team used brain imaging scans to detect evidence of cerebral dysfunction in three women suffering from the condition, more formally known as “sensory conversion disorder.”

The findings, published in the December 12 issue of the journal Neurology, will help to improve understanding of conversion disorder, a neurological disorder in which a person displays symptoms, but doctors are unable to determine a specific medical cause for the discomfort.

The three women involved in the study complained of numbness in their left hand or foot. The researchers used MRI machines to observe how the women’s brains responded to stimulation of the numb body parts.

In all three, stimulation of the numb body part failed to activate the part of the brain that responds to touch. However, the monitored brain area did respond when the researchers simultaneously stimulated both the numb appendage and the opposite one not affected by the disorder.

“The principal finding is that stimulation of the numb body part did not activate the somatosensory region of the brain, while stimulating both limbs did,” wrote study author Dr. Omar Ghaffar, of Sunnybrook Health Sciences Center in Toronto, in a prepared statement.

The researchers concluded that stimulating both the numb and normal-sensing limbs may act as distraction, shifting the patient’s focus, and thereby overcoming the inhibition.

“Future studies plan to build on these findings by scanning more subjects and health controls,” Ghaffar said. “In addition, a study examining the role of distraction in conversion disorder is underway.”

Anxiety manifests itself in a number of ways depending upon the severity of the disorder. It can begin by worrying about something happening to us or something that we will expect to happen to ourselves but ultimately the cause of the worry either passes or we learn how to deal with it. Unfortunately, not everyone has the capacity to cope well with what happens in their lives. In fact, there are people who spend almost their entire lives worrying and their worries are part of anxiety symptoms in a never ending cycle that can produce an anxiety disorder.

Anxiety symptoms can manifest themselves both physically and psychologically. Anxiety disorders happen when our brain warns us about a perceived danger that is about to occur. In this situation your body will ready itself for a fight or flight reaction. Your heart, lungs and other parts of your body will work faster and produce stress hormones and adrenaline to cope with that time period.

Depending on the perception of the danger, physical symptoms include abdominal discomfort, diarrhea, dry mouth, rapid heartbeat, palpitations, tightness and pain in the chest region, shortness of breath, dizziness, frequent urination and even difficulty swallowing. Such physical affects that anxiety disorders produce can become frightening and enhance the symptoms.

The psychological anxiety symptoms on the other hand include insomnia, irritability, anger, the inability to concentrate on various day to day tasks, a fear of madness, a fear of losing your mind and mental faculties, as well as the sense of being detached from reality and not having the ability to control your actions.

Besides the anxiety symptoms, people may experience emotional symptoms too, such as a constant feeling of unease that has nothing to do with your present situation. Others might experience anxiety due to being involved in a stressful situation like pressure at work or a relationship. Then anxiety symptoms may rear their heads due to being anxious about an illness, real or imagined. Then there is always your body’s reaction to perceived dangerous threats. All of these emotional stresses can and will increase the intensity of your anxiety symptoms dramatically.

These symptoms may be considered as anxiety symptoms if they are of a prolonged or severe state, or if the feelings of anxiety come into existence when there is nothing dangerous or stressful to bring them about. Then, if these anxiety symptoms start to interfere with your everyday life and activities like work or social events, you know for certain that you are suffering from anxiety disorder.

As the world knows anxiety is a normal response to danger. Everyone has felt anxious for something at some point in their lives. There is however times when anxiety turns into something else, this being a mental condition known as anxiety disorders. People who have anxiety disorders are sometimes afraid to get treatment for their anxiety as they seem to feel ashamed of having a mental condition. However anxiety treatments are valid medical remedies for a complaint that can affect your life. There is therefore nothing to be ashamed of having anxiety disorders or being treated for them.

Although you might suspect yourself to be suffering from anxiety symptoms it’s always a good idea to get your self-diagnosis confirmed by a qualified medical practitioner who can then start you on the proper course to cure you.

When you first experience anxiety your doctor must be able to diagnose your complaint. There are many types of anxiety treatments that you can try. Before you embark on such a step it’s a good idea to talk with a doctor or a psychiatrist who specializes in anxiety and panic disorders. As the treatments can be varied you will need to let your doctor know that you suspect that you are suffering from anxiety disorders so that your specific complaint can be identified. Once your anxiety is diagnosed then treatment may begin.

You might want to ask your doctor what the normal anxiety treatments are and their side effects and you should also find out what their effect will be on your lifestyle as well. Don't rule out alternative remedies - they may not be completely proven by medical science as anxiety treatments, but a number of people state that these alternative treatments can work at providing relief from anxiety symptoms.

The traditional anxiety treatments are prescription drugs like Selective Serotonin Reuptake Inhibitors, Buspirones, antidepressant medications and others. These drugs work to lower the chemicals that cause anxiety to surface. While many people have found relief from their anxiety symptoms, these tablets alone may not completely cure your anxiety disorders. It is like taking an aspirin to relieve a headache, that's all the aspirin does, it does not cure the headache but just reduces the symptoms so that they are bearable.

Alternate anxiety treatments include the age old methods of Acupuncture and Ayurveda. Both of these eastern anxiety treatments bring the symptoms of anxiety back into control by rebalancing your body’s internal energies. These treatments use a number of essential oils, poultices, herbal remedies and sterilized acupuncture needles to achieve that effect. These alternative anxiety treatments not only control the effects of anxiety in your body they also have the ability to completely cure your anxiety disorder symptoms.

Another alternative anxiety treatment is Gemstone therapy. Here it’s believed that gemstones have properties that can correct imbalances within your body. Each gemstone that is used in this treatment has healing properties and colors. The right balance can be achieved by placing a gemstone at a specific point on your body. Other anxiety treatments include Tai Chi, yoga, dance therapy, cognitive therapy, behavioral therapy and many others.

Whatever treatment is decided upon based on advice from your medical practitioner and adviser, by following a course of treatment that works best on your anxiety you stand a good chance of being in control of your life once more and truly in the end that’s all that matters.

I have a cycle that goes over a two week period. This week I paid $435 in bills and rent out of $500 in income allocated for me for the next two weeks. It is now three days later and I have $25.00 left and I look like I will need a miracle to get me through. But I know next week I will get and extra $30 and I am so used to living with no money I have a peace about me.

Many people with Bipolar go on a big spending spree every time they get paid. We just can’t help it. I spent forty five dollars on a movie and take away food and on coffees today. This would be better invested in other things like groceries, but I am Bipolar and stupid like that and I so enjoyed myself.

Sure I am on medication and taking it at the right time, but this spending habit is something that seems beyond my control. I enjoy four or five days and then I am lost and broke for the rest of the two weeks.

Then half way through the second week I start to get depressed. I promise myself I will save some money next fortnight and be silly and the next fortnight I spend it all in the first three days and am broke.

Seeing this is in the mental illness section you might not have read my other articles, but in some of my other articles I present as someone who is quite smart and intelligent but this bipolar spending is something that is out of control and makes me feel like a dummy.

Granted two of my bills were gas and electricity and only due once every few months, but I had a monthly phone bill of $160 and that is just way too much. That is just evidence of my elevated state in the last month as I have spent so much time on the phone ringing my interstate family.

I love my family but with a good Bible and a good relationship with God I should be able to get by with my faith, but no I spend hours on the phone ringing home and racking up a mammoth bill.

Journaling is a great way of putting stress in perspective. Putting your worries onto paper may help you see that you don't really have that much to worry about, or it may help you to be organized and manage your stress, rather than letting it manage you.

Why does journaling release stress?

Most stress you are aware of (and a lot of you unaware of) is emotional. Not the major upheavals in life, but the ordinary day to day stress.

Most of you may be saying, ‘but I don’t have stress’ and most of you would be wrong.

Stress is anything you expend energy on. Why? Because stress reduces your energy levels, internally and externally. Your internal energy is your ability to heal and recover as well as resist illness of all forms. Your external energy is your ability to run around all day long.

As most of you drive yourself to keep going, your external energy seems okay. What you are doing is driving your internal energy lower. This is why you see the following …

Dave has worked all his life, not a sick day off in 25 years, he retires and suddenly has a heart attack and dies. The most common words you will hear from his friends and family are …

‘But Dave was such a healthy person’.

You are not healthy if you die of a heart attack. That’s right, healthy people do not die of heart attacks. Dave may have thought he was healthy, but his internal energy was just getting lower and lower. With time this caused the worse type of health problem … an early death.

Most of you don’t know if you are healthy or not. You can have a full medical today which says you are 100% healthy and still die tomorrow. Health checks are checking for outward signs of disease, not inward signs.

So what can or should you do?

Reduce stress, eat well, exercise and do health promoting activities.

One of the easier and better stress relief techniques is journaling. You should use many others if you want to really reduce all your stress … physical, emotional, immune, and environmental and others.

Journaling does do one task very well.

It gets stress out of your head and onto paper. This is a simple mind trick you are playing, as the stress on paper is easier to look at and deal with. Stress also doesn’t seem that bad.

Just write down each day what is bugging you or any stress that has happened, events that are coming up they may cause stress, or just write whatever comes into your head.

You may have a whole page of swear words, after a day of stress. Journaling is good to do on a daily basis. You don’t need to spend hours each day journaling. Just jot down a few events at the end of the day, or as they happen.

Journaling the stress and at the end of the day write down a response. How you feel or felt, solutions to a problem or a bunch of swear words if it is just plain frustrating.

Journaling a response allows the attached stress to the event to be released and put on paper. You will be surprised with what you write at times. Small events can stress you out more than larger events at times.

It also is quite interesting to look back at in the future. You will be amazed, once you apply the solutions to problems how little the problem was. The stress you had last week doesn’t seem that large and you find you are able to use stress coping techniques better and faster.

You suddenly have ammunition for new stress as you have already planned how you can approach any new event. This gets better and easier each time you do it.

Stress once on paper never seems that bad. Start journaling, keep it with you and write in it often. Journaling is a simple and easy way to reduce stress when it happens and also giving you the ability to respond rather than react to stress.

So, you have ADD, right? Do you ever find yourself fidgeting? Like... foot tapping, your whole body might be moving, your fingers tapping--that kind of fidgeting? For ADD people, this probably indicates stress of some kind or sheer boredom.

In fact, if you have ADD, you're probably constantly moving around. Most of the time you may not even notice it. You can be shaking your leg a million miles an hour, not notice, and get mad at someone else for the same kind of repetitive motion.

The major point here is that you're externally communicating to the people in the room with you. Your ADD-related actions are driving everybody else in the room nuts because you're fidgeting around so much. You don’t always notice it. You may be communicating internally, but there’s an external aspect to that, too.

There’s no absolute line between internal and external communication, ADD or not. Both are very clearly related. At the end of the day, internal things are going on inside your body and external things are going on outside of your body, including when you're speaking to someone else.

The thing is we have all these micro-movements in our face and body that we’re not even aware of that other people, especially people who have studied this kind of stuff, will notice instantaneously. All of us, ADD or not, we’re always externally communicating. It’s just a question of if there’s someone else around that either knows what to look for or is, in fact, observing some of those things.

That’s an important point to make because you have to remember. You have control, not your ADD. You have choice over how you’re expressing certain things, certainly not your ADD. Sometimes, even if you’re all alone, you do both internal and external communication, you can cause yourself to become upset. You can cause yourself to have a miscommunication within yourself, and have a reaction. Very easily.

For instance, you may have gotten a call from your boss. He tells you that you did something wrong--minor, but wrong. Some people might go off on this tangent: "I'm going to be fired." You're actually miscommunicating inside yourself. The boss has no intention of firing you and probably forgets about the situation by the next day. It's all in the amount of control you exert over yourself, and that includes controlling your ADD.

Right now, sit down, slump over, start breathing shallowly, think about someone close to you that might have passed away in your life. Instantly you are not going to feel that good.

Now, stand up, take a deep breath, think about the best day of your life. Think about when you accomplished the most amazing thing, the weather was absolutely perfect – maybe it was really sunny out, or whatever you find to be the best weather in the world. You were in peak condition. Your mind and body were feeling absolutely as good as they possibly could have. Emotionally, you were feeling better than ever.

Now, how do you feel? If you think about those things, put your body into that same position, you start breathing as if you were really there. You immediately start feeling better. Right? That's one way to control your ADD.

It’s an example of self-communication or internal communication. You can change your body posture. You can change what’s running through your mind. You can change the words you’re saying to yourself. You can control your ADD.

For many people, their only contact with hypnosis is the stage performance, where the use of hypnotism is used to entertain and delight an audience. Stage performance can either be on tour, traveling throughout the country, or be on television shows, or both. This is obviously different from clinical hypnosis, where a hypnotherapist works one-on-one with a patient in an effort to solve a problem or seek a solution to an addiction

But the techniques are basically the same. Both attempt to induce an hypnotic trance, and bypass the conscious mind to reach the unconscious, and then plant a suggestion into the unconscious mind.

But that’s where the similarities end. The stage performer’s priority is to entertain, so his suggestions to his participants would have that as a goal, so he would suggest things such as quacking like a duck, talking with aliens, dancing like a ballerina, etc.. This would be unlike a clinical hypnotherapist whose chief aim would be more serious, for example, to root out an addiction or solve some ongoing problem for the patient.

Another difference would be the speed and depth of a trance performed by the stage hypnotist. He has a waiting audience to appease, so he can’t take too long to get his volunteers hypnotized. The stage performer would carefully look for signs with his volunteers to determine how open to suggestions they are, and who responds best to his suggestions. The need to find easily hypnotizable subjects is why the performer chooses more volunteers than he needs and that allows him to reject those he considers are not easily able to be hypnotized.

The clinical hypnotist,on the other hand, would take his time and ask his patient lots of questions, so he could determine the best and most effective way to induce an hypnotic trance.

A stage hypnotist has to be a good performer and have good stage presence. After all, he is putting on a show.

The clinical hypnotist works with his patients in trying to arrive at the best and most effective way to induce an hypnotic trance and reach a solution to the problem at hand.

A good stage hypnotist is no less skilled in trance induction and suggestion than a therapeutic hypnotist. In fact, a number of stage hypnotists have previously been clinical hypnotists; others may go on to became clinical hypnotists, and some do both at the same time.

A question that is frequently asked is about the use of free will. The generally accepted view among experts ad practitioners is that no person can be hypnotized to act against their will. They feel that there is always a part of the mind that is aware of what is happening, and the person would come out of the hypnotic trance if they would be given hypnotic suggestions to perform an action contrary to their belief.

In the late eighteenth century, stage performers would take part in elaborate stage shows in order to attract fee-paying clients. Hypnotism became a popular parlor game as the craze swept Europe and America. In the united States hypnotism stage performance really took off in the 1890’s and became a popular form of entertainment.

The dominant figure in the early part of the twentieth century was a man by the name of Ormond McGill, a great showman during his day, who first became interested in magic shows before he eventually changed to stage hypnosis. He was the author of several popular books on hypnotism and had a long and successful career both as a stage performer and in clinical hypnotism. In fact, he was an early pioneer in the use of television for his performances, and has served as an inspiration to many of today’s performers.

There are now thousands of stage performers throughout the world, performing before live audiences or on television. There are probably as many stage routines as there are performers. The basic pattern of each show may be similar; a group of volunteers are selected from the audience to come up on stage, put under an hypnotic trance, given suggestions and post-hypnotic suggestions, and then act out according to the suggestions, with the suggestions given only limited by the imagination of the performer.

Which brings me back to the original question: Does “Stage Hypnosis” give Clinical Hypnosis a bad name?

Critics say that the stage performances give clinical hypnosis a bad name because they trivialize the effectiveness of hypnosis in solving personal problems, and give the general public a warped idea of what hypnosis really is and how it can help in many aspects of life.

The counter argument is that the opposite occurs. By seeing hypnosis at work first hand, the public is more likely to believe in the therapeutic effects of it, and may even contact a clinical hypnotist for help with their particular problem.

Number ONE: Accept Yourself
Learn to love yourself. Sever dislike of yourself can lead to guilt, shame and depression. Believe in your own abilities and value your own uniqueness. Do this by:

* writing a list of your strengths
* working towards your aspirations
* writing poetry or songs dedicated to yourself
* pampering yourself
* having treats from time to time
* setting weekly or monthly achievable goals


Number TWO: Learn to Overcome and to Let Go
Everyone faces challenges and adversity. Being able to effectively cope with these challenges is crucial and each of us have our own techniques on how we do this. The best general advice for coping: Cope actively with situations that you have some degree of control over, and cope passively with situations that you dont have control over. Active coping means taking actions to improve the situation. Passive coping means to accept the situation and move on, making the best with what you’ve got.

Number THREE: Stay Connected and Nurture Relationships
Make time for social contacts. Feeling emotionally connected and supported is hugely important. We need relationships that we can count oh when the hard times come. We need people to trust and value us just as we trust and value them. Some hints to maintain good relationships include: Be forgiving, be tolerant, communicate honestly, express yourself, balance independence with dependence, act responsibly and nurture their values, desires and feelings and they are more likely to reciprocate. Talking to these people will help you to vent out and understand yourself and your difficulties better and this is crucial.

Number FOUR: Take Control
When we feel like the captain of our own ship, we’re more interested in life and more confident. Make steps to become more independent and organised in your own life, from balancing your current account, to keeping records on calendars, to not relying on others to do your own washing.

Number FIVE: Find your Purpose and Work Towards It
Feeling like life is meaningless is a hallmark of depression. Its crucial to have goals both short term ones and long term ones. Make daily, weekly, monthly, yearly and 10 yearly goals that aren’t too lofty. You’d be surprised how much effect this can have on your life!

Number SIX: Find Hope and Maintain Faith
You don’t have to be religious for this. When things seem dark, it really helps to have a sense of hope and optimism about the future and a belief that your goals will eventually be achieved. Being more positive thinking helps to override fear and keep us motivated.

Number SEVEN: Help Others
When we reach out to others in need we often can feel self satisfied and proud of ourselves. Helping others can also be useful experience in helping yourself if you ever came into the same predicament as the person you were helping.

Number EIGHT: Find Flow
Professional athletes are very big into this. Flow is the experience of feeling totally involved, engrossed and focused in an activity or experience. I once heard a piece of Buddhist wisdom: "If you are thinking about resting while sweeping the floor, you are not truly experiencing life as it exists. When you sweep, sweep. When you rest, rest".

Number NINE: Enjoy the Beautiful Things in Life
The ability to appreciate beauty is aesthetics. There is a lot of negativity and ugliness in the world with wars, disease etc. Being able to appreciate beauty when you see it is a saving grace and is very uplifting. Im lucky I live in the middle of the country side and I also find it uplifting. But beauty is in the eye of the beholder, it can be in reading poetry, a plastic bag caught in a breeze (like in American Beauty), photography, heroes, music, in the solitude and quietness of darkness, the moon or sun, walking in woodlands, children or even a well-executed football game.

Number TEN: Embrace Change and be Flexible
Sun Tzu (a famous Judo Master and strategist) once said that when we are rigid and inflexible we are more likely to experience resistance and strain ourselves in trying to maintain our posture; but when we are flexible and willing to change something that is not working for us we are more adaptable and better adjusted. Change takes courage but its vital for your well-being.

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If you are feeling down, need some one to listen to your problems or just need to chat one2one; then SpeakOut! is here for you. SpeakOut! is a caring community and we're here to help a broad range of people with a broad range of issues - including but not limited to depression, eating disorders, self injury, low self esteem, suicide, drug abuse, sexuality and relationships. SpeakOut's online community helps people get through the troubled times and celebrate the good times. You have the ability to post threads anonymously if you feel you have more discreet issues to deal with.

SpeakOut! is full of friendly and welcoming people that are here to help you - whether it is an official helper, a member, a forum moderator or an administrator. If you have a problem you feel that you need specific attention from SpeakOut! staff, you can open a help ticket in the one2one helpdesk and a SpeakOut! staff member will be there to help you, one2one to the best of their abilities.

Anxiety attacks and depression don't seem to be the same illness, yet many people who have one of these problems actually have both. Approximately one third of all depression sufferers experience anxiety problems to some degree.

Anxiety attacks and depression are both very common. Anxiety Disorders are one of the most common diseases in the world. Thousand of suffering people don't actually know that they're dealing with this disease, yet it controls most of their life.

People who don't have this problem sometime have a hard time sympathizing with you, because they don't understand what the problem is. Since it's never happened to them, many think and say things like "Oh, it's all in her head." What they don't realize is that when anxiety attacks keep happening, it's classified as a disease.

Anxiety attacks and depression are mostly the results of your mind and body reacting to a frustrating situation. In the mind of the sufferer, each attack seems to go on for an eternity, but in reality anxiety attacks don't last that long. It's difficult to understand why your mind and body react this way and I know from experience that it can be fixed.

In my opinion, fixing the symptoms of anxiety attacks and depression with pills can be comforting for awhile, but a better goal would be to cure your problem, so that it never happens again. Try to keep a journal and record significant events that you think might influence an attack. You might notice that eating junk food worsens symptoms or that even the slightest hint of stress will set you off.

Observe your findings and avoid the obvious triggers. This is an effective way to avoid attacks. When you do find yourself having an attack, you should focus all your attention and energy on taking deep breaths from your diaphragm. I find this lessens the duration and severity of anxiety attacks and depression problems.

Even though correcting your breathing patterns are great for helping with anxiety attacks and depression, there are methods that can cure your condition permanently. Real help can be found here.

Remember that you're not alone. Anxiety attacks and depression do not control your life. Avoid possible triggers and work on improving your total health. With a little work, you can be cured of these diseases and get your life back.

Making Progress

Therapy is a process of change. When it is working as it should, any description of the patient is a description of a person in transition. [Wachtel 1987]

There are no hard and fast rules for measuring progress in therapy, and in lengthy treatments evidence that it is happening at all can sometimes seem elusive. When we are dealing with something as complex as the mind we are not going to observe change taking place in a straightforward easily-measurable fashion.

Some of the most readily-identifiable signs of progress should come in the initial phase when we are making the transition from struggling to cope alone to having someone there to help, and if progress is seen at this stage it is a fair sign that, assuming the continued commitment of both parties, progress will continue into the more difficult times ahead when it may not be so easy to perceive.

When we first enter therapy our most pressing need will be for relief from symptoms and it is not unusual for a partial relief from symptoms to be experienced quite rapidly. But after the 'honeymoon' period deeper and more complicated processes start to take hold.

I was enthusiastic about therapy when I started and thought I was racing along making fantastic progress. Then after a while I seemed to lose momentum. Progress seemed to be slowing down and I began to wonder whether the treatment was working as it should.

I began to complain to my therapist that in spite of all the work I'd done and all the optimism I'd felt nothing much seemed to be happening. He replied, more times than I care to remember: "You have to bring your feelings into the session." Bringing feelings into the sessions makes a direct contribution to the development of transference, and getting us engaged in transference is the real aim of the early stages of therapy.

These are some of the phenomena which can take place as we progress:

Regression. The phenomenon of the mind returning to early stages of development is known as regression. During therapy sessions we can regress to any stage of our emotional development that is necessary, and over the course of time we are likely to move back and forth between various stages.

Dependence.

Often it is argued that the therapy should not serve as a 'crutch'. It should be noted, however, that crutches are not always employed as a permanent supportive device; often crutches are used as a temporary way of enabling a healing process to proceed in such a way that crutches will no longer be necessary. [Wachtel 1987]

When therapy, particularly intensive therapy, progresses as it should dependence will be an inevitable consequence of our interaction with the therapist. Lifelong patterns of feeling and behaviour have to break down and new patterns have to be established, and we cannot undertake such a delicate operation without a measure of dependence on the person who holds us together while we do it.

Internalising the therapist. An important sign of progress, particularly in intensive therapy, is when we can begin to feel that the therapist 'stays with us' when we leave the consulting room. We begin to not only understand and accept what the therapist has to offer us, but actually build it into ourselves at the unconscious level.

Every aspect of therapy takes place in the face of our resistance to it, and making progress can be seen in terms of overcoming resistance, or at least, of steadily pushing back its boundary. In some respects we may have to seem to get worse before we can get better. As our defenses break down the underlying problems are stirred up, and as they come to the surface we may well feel we are getting worse. But this is necessary in order for the problems to be worked through with the therapist, which should eventually bring relief from the problems altogether.

Transference as a corrective emotional experience

Transference begins the first time we meet the therapist, or even before, in what we imagine he or she is going to be like, but we will not be aware that it is happening until our therapy is well under way. Becoming aware of transference means becoming aware that the way we are perceiving the therapist is not so much a function the therapist him or her self as of characteristics we are projecting onto him or her.

Once we do become aware of what we are doing we understand the way we relate to others, and the relationship we had with our parents and the effect it had on us, much more clearly. We come to see just how much our adult lives are shaped by attitudes we adopted in early childhood as survival strategies, and once we begin to consciously experience this in the relationship with the therapist we find ourselves changing.

Those who cannot remember the past are condemned to repeat it

One of the reasons why the operation of transference is obscure until we learn to see it is that to a large extent the transference reproduces precisely those aspects of our emotional life of which we are not aware and whose origins we can't remember. If we could remember it there would be no need to repeat it in the transference. The saying: 'Those who cannot remember the past are condemned to repeat it' [Santayana 1905] is apropos in this context and mirrors Freud's conception of transference. We are condemned to repeat, not only in therapy but in the rest of our lives, those areas of our conditioning which we cannot recall and do not understand.

Without therapy it is difficult to recall the experiences of early childhood, especially those of the first year. But our earliest experiences can be reconstructed by working backwards from what happens in the transference and can be confirmed by the understanding of our parents' personalities which we will gain through therapy. In the manner that we found our relationship with our parents problematical we will experience our relationship with the therapist as problematical. The conditions which caused the original problem are recreated. In effect the therapist becomes a substitute parent and our unconscious experiences re-parenting in which pathological adaptation can be modified.

Transference feels real

Our unconscious creates the transference situation by perceiving in the therapist whatever it needs to find to work through its problems, but when it is happening we are no more aware that we are reacting to a situation we ourselves have created than we are when it happens in everyday life. We experience our feelings towards the therapist as genuine and justifiable, and this needs to be so for the therapeutic effect to work. If we cushion ourselves and the therapist from the full impact of our feelings by thinking to ourselves even as we speak 'this is transference' we are simply employing a defence. Real transference feels as real as, or more real than, anything else we experience:

The unconscious latches onto something the therapist actually does or says, or a characteristic he may have, as a hook for the transference, and feeling that we have a genuine grievance and tackling him in a direct personal manner is the process by which we work through our problems and eventually become free of them. We need insight to become aware that we unconsciously 'chose' to perceive the situation and react to it in that way for reasons which are inside us rather than because of the therapist's actual personality.

Positive and negative transference

Through transference the unconscious becomes entangled with the psychotherapist, and it is the struggle to free ourselves from the 'bad' aspects of this entanglement while assimilating the 'good' aspects that brings about change.

As well as the specific instances of transference in the sessions the transference can be viewed as a whole, and as having two aspects - the positive and the negative. The positive transference is made up of our good feelings about the therapist, and the negative of bad feelings. These sets of feelings can be seen as a replay of the ambivalent feelings all infants have about their parents, who on the one hand earn 'love' by giving protection and security, and on the other earn 'hate' by setting limits and imposing restrictions.

Neither the positive nor negative transference feelings will be appropriate to the actual person of the therapist, and because of their infantile origins both will be exaggerated and distorted, perhaps tending towards idealised images such as the saint and the devil. As we progress in therapy both extremes should diminish in intensity and be replaced by a perception of the therapist as an actual person with both good and bad qualities.

The negative transference is an accumulation of all the bad feelings we experienced in relation to our parents during childhood, both the way we actually experienced them, and our phantasies about them. The positive transference is an accumulation of good feelings, partly memories of the way we actually experienced them, but, also, partly phantasies about how we wished they had been, which is a reflection of what we needed from them but didn't get.

A baby who does not get satisfactory parenting grows up harbouring a deep longing for it and a wish that one day he might meet someone who will provide what he needed but never got. The wish can create an idealised phantasy, perhaps a saint or an angel, and this can become manifest in the positive transference.

The extent to which we will be aware that both positive and negative transference is taking place, and in particular the extent to which we can see that the two co-exist as two sides of the same coin will depend on the nature and seriousness of our problems.

Both aspects of the transference need to be worked through as we progress towards the goal of a mature, realistic, adult relationship with the therapist which will enable us to have mature, realistic, adult relationships with others. The negative aspect, the fears that the therapist is harmful and destructive need to be worked through so that we can deepen our trust in him or her, and the idealised positive aspects need to be worked through so that we can meet him / her as a real human being.

One way of viewing the difference between the state of mind in mental health and in mental illness is in terms of 'integration' and 'fragmentation'. The concepts give us an overview of our problems, and also describe dynamic processes of the mind. The terms refer to whether we function in a unified manner, or whether aspects of us are disunited and going in different directions. The more integrated we are the more emotionally healthy we are, and the more fragmented the more ill. (The saying 'united we stand, divided we fall' could be applied to each of us individually.)

With an integrated mind we can make a good adjustment to both external and internal reality. We are aware of ourselves as a whole, and the emotions we experience in the course of living can arise consciously as part of that whole. We are in touch with our past and can easily recall the stages we have been through in life and are aware of having been essentially the same person throughout.

When we are fragmented the past is distant, hazy, difficult to remember. We live from day to day with only partial awareness of the feelings going on inside us, an incomplete understanding of our own needs, and a tentative grasp on our own continuity. We are never completely sure who we are or what we feel or think. Our emotions, when they arise, take us by surprise and disrupt whatever sense of self we have. We are to an extent out of touch with our inner selves, or 'dissociated'. In effect we are going through life as a number of part-persons rather than one whole person. Different aspects of us emerge under different circumstances but they are disconnected from each other, and some parts never emerge at all.

The parts of ourselves with which we have lost touch in the fragmented state are aspects of our innate drives which cannot be accommodated by the person we have grown up to be. These clusters of feeling also embody part of our self-awareness. When we are angry, for example, we are in touch with the part of ourselves which can feel anger, and if we have had to cut off anger in childhood we also cut off that part of ourselves. In serious cases practically the whole personality can be lost to fragmentation, then we have an accumulation of defence mechanisms instead of a personality, and our personality is a ‘False Self’ [Winnicott 1960a].

Like all emotional problems fragmentation arises out of necessity, as a survival strategy. The problems begin when parents are unable to cope with aspects of their baby's emotional needs. They convey to the child that this aspect of him is unacceptable, and after repeated demonstrations of his unacceptability, which can be done by a failure to respond to the baby just as effectively as by an outward show of disapproval, the baby comes to internalise that belief, feeling that part of him to be unacceptable to himself. He is then in the impossible predicament of having needs which demand to be satisfied, yet are not allowed to exist.

So the fragmented state in which we find ourselves as adults is a legacy from the past, and might be conceived of as having taken place in two main stages; the first during early infancy and the second during the upheavals of adolescence. The faulty foundations are laid in infancy but the consequences may not become apparent until when, with all stresses and strains of trying to make the shift from childhood to adulthood, the cracks which have been there undetected throughout childhood get pushed apart. It is at this stage that the problems are likely to become manifest in the form of symptoms and/or pathological behaviour.

How psychotherapy brings about integration

Reintegration, or in some cases - integration for the first time, comes about through the experience of rediscovering those parts of ourselves that had been split off and finding that they are accepted by the psychotherapist as valid and important expressions of ourselves. This is a reversal of the original situation in which, as infants, we had to repress those aspects of ourselves because our parents could not cope with them.

Through finding that these feelings are understood and accepted by the therapist we are gradually able to understand and accept them ourselves, that is, to integrate them. Acceptance by the therapist has to be experienced repeatedly to counteract the repeated experience of being rejected and denied, and for the integration to gain strength and permanence. This is what is going on during the painstaking work of 'working through' which comprises the bulk of the work of psychotherapy.

The ability to make a mature, healthy, adult sexual relationship is one of the criteria by which emotional health can be judged, and if we enter psychotherapy unable to do this the progress we make towards being able to do it could be one of the ways we measure our progress in psychotherapy as a whole. Every aspect of our personality, our behaviour, our feelings about ourselves, and our whole orientation to life is bound up with the way we deal with our sex drive.

Sexual phantasy

We all carry within us the seeds of every sexual deviation. . . the study of sexual deviation is the study of sex without love. [Storr 1964]

If we continue in psychotherapy beyond the initial stages we are almost bound to have to deal with sexual phantasies, both conscious and unconscious, at some time, but any reluctance we may feel about doing so should be offset when we find out that as far as the psychotherapist is concerned, no matter what the particular nature of our phantasies, there is absolutely no need for guilt or shame, and there will always be a perfectly logical reason why we have such phantasies.

Deviant sexual behaviour

The comments made above about sexual phantasy are equally applicable to deviant sexual behaviour. If we are actually engaging in deviant sex rather than just phantasising about it we are said to be 'acting out' our phantasies, and this can make the treatment of the problem more difficult.

Incest phantasy

The closer one comes to the deeper disturbances of psycho-sexual development, the more unmistakably the importance of incestuous object-choice emerges. [Freud, S. 1905]

Whether we are talking about Oedipal conflicts in boys or corresponding conflicts in girls we are talking about conflicts that stem from deeply rooted human desires. There is no escaping it - incestuous desires are at the core of human psychology. [Forward; Buck 1981]

The subject of incestuous phantasy will, in some way, probably have to be touched on in all but the most superficial courses of psychotherapy. Neurosis is almost always found to have its roots in the Oedipal phase, which by definition takes place in the context of incestuous phantasies.

False Memory Syndrome

A special case of the emergence of sexual phantasy during psychotherapy which has caused bitter controversy [see for example Pendergrast 1996] is the 'False Memory Syndrome', where a patient uncovers repressed memories of having been sexually abused by his parents but the parents have no recollection of it ever taking place and vehemently deny that it ever happened. Both patient and parents are convinced that their memory is accurate and a situation of irreconcilable conflict is set up in which everyone, including the therapist, and the reputation of psychotherapy as a method of treatment, suffers.

While panic attacks can certainly be frightening, it is important to understand there are tips to prevent panic attacks which you can use to stop these vicious problems right in their tracks. There are a wide variety of tips that can be utilized; however, it must be pointed out that many of these tips require regular practice in order for them to be effective. Breathing and relaxation techniques are an excellent example of tips to prevent panic attacks that can be practiced and used on a regular basis. Ideally, these techniques should be practiced on a daily basis in order to see the most achievement from them. It is important to take the time to learn and practice these techniques when you are feeling calm and not at all panicked. Through this type of regular discipline you will learn how to control your breathing so that in the event you may begin to feel panicky again you can easily implement this technique and prevent an attack from actually occurring.

When seeking tips to prevent panic attacks it is also important to look at ways in which you can nurture yourself and reduce the amount of stress in your life. Stress can often lead to feelings of panic that can turn into panic attacks. Consider these options:

* Make sure you are getting enough sleep.
* Exercise on a regular basis to relieve tension and provide an outlet for stress
* Read a good book
* Eliminate or reduce caffeine, including cola, coffee and tea-caffeine serves as a stimulant and can make you feel even more anxious
* Take part in regular massage to relieve tension
* Eliminate or reduce intake of alcohol and tobacco
* Avoid use of recreational drugs
* Eat nutritious meals, including breakfast

Other tips to prevent panic attacks include looking at ways in which you can find time to do things you enjoy and get away from the stress of everyday life activities. Of course, this will vary from one person to the next depending on your preferences, but any activity that helps you to forget the stress of everyday life, calm you and focus on what is important is good. Excellent ideas include:

* Listen to music
* Perform volunteer work
* Start a hobby
* Meditate or pray
* Take a bubble bath
* Make a point to socialize with positive people
* Go for a walk

Many people often find that journaling can be an excellent way to put things into perspective, especially those things which concern them and could result in a panic attack. Journaling can also help to keep you organized, which can in turn reduce stress levels. You may consider keeping lists in your journal or simply describing how you feel about stressful situations in your life and then coming back later to evaluate your responses and determine whether they are appropriate to the situation.