Glossary

Attachment represents positive feelings and an emotional bond felt toward another human being. Our first attachments are with our parents, caregivers and other family members. These attachments are relationships that influence the way we relate with ourselves, other intimate relationships and even our children.

When a child is upset, hurt or scared it turns to the person they are attached to, expecting to be comforted.  The child’s distress is a signal to that person to do something that comforts the child. Like all mammals, we too are programmed to instinctively respond in these situations.

With time and the act of repetition, the child’s experiences of being cared for are internalised. What this means is:

• The child who has been cared for starts to feel comforted just by thinking of the person it is attached to.
• The child is comforted from within, almost like they carry that person with them.
• We learn to manage our emotional states for ourselves, in ways that shaped our early environment and relationships
• This allows us to calm or comfort ourselves as adults whenever we feel upset, hurt or scared.

Our relationships with our parents or caregivers, influence:

• Our attachment styles (these may vary and change over time).
• How we deal with close relationships.

This is often most evident in:

• Situations that cause us pain.
• When there is a danger or fear of being abandoned.

The way we regulate attachment relationships has a significant impact on our lives.

When an attachment is disrupted by abuse, neglect, significant inconsistency, cold indifferent parents, over-involved parents etc., termed as insecure or disorganised attachments, a child struggles to develop a sense of safety and identity.  Insecure and disorganised attachment affects the development of a fragmented sense of self, emotion regulation abilities, impulsivity and ability to inhibit behaviour, hyper-vigilance for threat, hypo-arousal of the emotion processing centres limiting recognition and understanding of others' emotional states (limiting empathy), limited understanding and defensive avoidance of taking other people’s perspectives (theory of mind).

A child then develops coping mechanisms or defences to survive in an environment. These defences continue to remain, often causing problems because they are no longer relevant to the person's life.  This can lead to psychological, emotional and relational distress.

Therapy for CPTSD and other attachment trauma-related problems often requires more complex and integrative therapy due to the complexity of the problems that can arise.  Such therapy will often involve skills development to reduce physical or mental symptoms of distress and a focus on emotions and relationships.

Cognitive Behavioural Therapy (CBT) is evidence-based psychotherapy. It is a structured approach that can help to address a range of psychological difficulties including depression and anxiety. The initial assessment for CBT requires information from the past but focuses on current concerns and what makes them persist, to develop therapeutic goals and plan treatment.   

CBT is a collaborative therapy that emphasizes working with your therapist to develop an understanding of the underlying patterns of thinking (automated negative thoughts), feeling and behaving that affect mood and functioning. By identifying these patterns, re-structuring, challenging and adapting the underlying thoughts and beliefs, you can be free to interact with your experiences in new and healthier ways.

CBT usually follows a 12-week structure. However, your therapist will help determine what is appropriate for you based on your needs. Often, your therapist may also give you a task to complete between sessions. Exercises may be focused either on a particular thought or thinking pattern or be more behavioural. 

While CBT provides an excellent evidence base for many presentations, it has also evolved from its initial inception into many therapies, known as “third-wave” cognitive behavioural therapies. These include Acceptance and Commitment Therapy, Dialectical Behavioural Therapy and Mindfulness-Based Cognitive Therapy. Your therapist may suggest one of these if found relevant to your concerns or needs.   

PTSD may be experienced by people who have been exposed to scary, dangerous or shocking events either directly or indirectly through people they are close to that are affected by such events or by being a first responder in such events.

A person with PTSD may experience some or all of the following:

• Frequent reminders of events through flashbacks, ruminative thoughts, and nightmares, often make the person feel like they are back in the same situation
• Tendency to avoid places, people, things or thoughts that might trigger memories of the event. Avoidance may take the form of suppression of feelings through addictive behaviours such as alcoholism.
• Increased anxiety
• Altered mood
• Some people with PTSD can struggle to continue living normal lives, while others may experience reduced enjoyment or performance in relationships and other activities. Eye Movement Desensitisation and Reprocessing (Link to EMDR) and other somatic-focused therapies can be very effective in treating PTSD. Trauma Focused CBT is also found to be effective. Therapy combined with things like yoga, acupuncture, meditation, dance and other movement-based activities has also proven to be effective.

Complex post-traumatic stress disorder (complex PTSD, sometimes abbreviated to c-PTSD or CPTSD) is a condition where you experience some symptoms of PTSD along with additional symptoms like difficulty controlling your emotions and feeling extreme anger or distrust towards the world.

Complex PTSD may be diagnosed in adults or children that have repeatedly experienced traumatic events, such as violence, neglect or abuse.

Complex PTSD is thought to be more severe if:

• Traumatic events happened early in life.
• The trauma was caused by a parent or caregiver.
• The trauma was experienced for a long time.
• The person was alone during the trauma
• There’s still contact with the person responsible for the trauma

As it may take years for the symptoms of complex PTSD to be recognised, a child's development, including their behaviour and self-confidence, can be altered as they get older.

Adults with complex PTSD may lose their trust in people and feel separated from others.

Dialectical Behaviour Therapy (DBT) is a modified version of cognitive behavioural therapy (CBT). Its goal is to teach people how to live in the moment, develop healthy ways of coping with stress, regulate their emotions, and improve their relationships with others.  It has mindfulness practice at its core and is primarily a skill-building approach to therapy.

DBT was originally used to treat Borderline Personality Disorder (BPD) but has been adapted over time to treat other mental health conditions. It can help people with difficulty in emotional regulation or those exhibiting self-destructive behaviours, such as anxiety, panic, eating disorders and substance use disorders. This type of therapy is also sometimes used to treat post-traumatic stress disorder (PTSD).

DBT has evolved into an evidence-based psychotherapy approach that is used to treat many conditions.

Different kinds of DBT include:

• Group therapy is where patients are taught behavioural skills in a group setting.
• Individual therapy with a trained professional is where a patient's behavioural skills are adapted to their life challenges.
• Phone coaching allows patients to call the therapist between sessions for guidance in coping with a difficult situation.

Some of the strategies and techniques that are used in DBT include:

• Mindfulness practice
• Distress Tolerance
• Emotion Regulation
• Interpersonal Effectiveness

Trained clinicians at The Free Spirit Collective provide DBT as individual therapy. Currently, we do not have any DBT group programs or coaching, though many of the skills and ideas are incorporated into other group therapy sessions.

Dialectical Behaviour Therapy (DBT) treatment is designed to help with extreme emotional instability, which clinicians term as Dysregulation, known as the inability to manage intense emotions, often leading to impulsive, self-destructive or self-harming behaviour. The goal of DBT is to teach adolescents techniques that help them understand their emotions without judgment — the mindfulness component — and to give them skills and techniques to manage those emotions and change behaviours in ways that will make their lives better. However, it is a process that requires a fair about of work and commitment.

DBT is an intensive and structured kind of therapy that can help kids and teens who have a lot of trouble handling strong emotions. DBT works by combining two sets of skills. The first, called mindfulness, helps kids understand and accept difficult feelings. The second, a treatment called CBT (cognitive behavioural therapy), teaches them how to change their feelings and behaviour.

DBT for adolescents includes one-on-one time with a therapist, group skills training as well as family therapy. Teens and their parents learn new skills together to help kids deal with hard feelings. In family therapy, parents and kids talk about home experiences, helping them relate to each other. 

DBT is used to treat everything from anxiety to depression, ADHD, bipolar disorder and eating disorders. It is often helpful for kids who have had trouble with other kinds of therapy.

Eye Movement Desensitization and Reprocessing (EMDR) is a fairly new, non-traditional type of psychotherapy. It's growing in popularity, particularly for treating Post-Traumatic Stress Disorder (PTSD). PTSD can often occur after experiences such as military combat, physical or sexual assault or car accidents.

We do know that when a person is very upset, their brain cannot process information as it normally does due to high levels of distress causing the pre-frontal cortex to shut down. A moment can be frozen in time which can make remembering a trauma feel as bad as going through it the first time, because the images, sounds, smells, and feelings associated with it haven’t changed. Such memories have a lasting negative effect on how a person sees the world and relates to other people.

EMDR seems to have a direct impact on the way that our brain processes information. It allows the prefrontal cortex to remain ‘online’ so our brain can resume processing information normally. Following a successful EMDR session, a person no longer relives the images, sounds and feelings associated with an event when they think of it. They still remember what happened, but it is less upsetting. Although many types of therapy have similar goals, EMDR appears to be similar to what occurs naturally during dreaming or REM (Rapid Eye Movement) sleep. Thus, EMDR can be thought of as a physiologically based therapy that helps a person see disturbing material in a new and less distressing way.

Holistic Coaching is an individualised and action-focused approach to physical, emotional, mental, social and spiritual flourishing. It does not focus on mental and emotional symptom reduction,  but rather on co-developing strategies and utilising healing techniques aimed at helping you grow and thrive.

Mentalizing is defined as implicitly and explicitly interpreting actions of oneself and others as meaningful, based on intentional mental states like desires, needs, feelings, beliefs, and reasons.  It is the process of understanding our own as well as other people’s thoughts.  We do this every day of our lives, like wondering why we feel the way we do about an event, or why our loved one or colleague appears to be in a bad mood or said a certain thing.  We often do this automatically and switch to controlled, effortful mentalizing when we need to. Some people can find it difficult to switch to controlled mentalizing and their automatic mentalizing leads them to assumptions and responses that cause more problems.  This can lead to a feeling that nobody understands you and that you don’t understand yourself.

MBT was developed as an outcome of working with people diagnosed with Borderline Personality Disorder. However, it has also been used successfully for many different problems and client groups. 

The main goals of MBT are: 

• Better behavioural control
• Increased affect regulation 
• More intimate and gratifying relationships 
• The ability to pursue life goals

These goals are believed to be accomplished by increasing the patient's capacity for mentalization to stabilize the sense of self and enhance stability in emotions and relationships.

Weekly group and individual sessions for MBT are held over 12-18 months.  MBT is also helpful in the form of individual therapy where clients experience difficulty with extreme emotions and in relating with others. The therapy works by building a safe attachment relationship with the therapist which provides a relational context in which the patient feels safe to explore the mind of the self and others. Developing this therapeutic relationship along with a persistent focus on mentalizing in therapy helps facilitate change by leaving people more open to learning outside of therapy, in the form of social interactions in their day-to-day lives.

Mentalization Based Treatment with Children (MBT-C) is a time-limited approach to working with children in middle childhood (ages 5-12) and their parents.  MBT-C is an integrative approach that combines psychodynamic principles with findings from attachment and affect-regulation theory, systemic family therapy and studies of mentalization. It is a flexible approach that can be used in clinical settings to address a range of childhood difficulties like emotional and behavioural problems, anxiety, depression, and relational difficulties.  

Mentalizing is the process of making sense of one’s own as well as other people’s mental states. It is the act of understanding what might be going on in someone's mind, beyond the behaviour that we see on the outside. Mentalizing is a uniquely human process and is something that we do in our daily lives, often without realizing it.

Mentalizing has been increasingly thought to be one of the core processes that most effective therapies have in common. Effective mentalizing supports well-being in several ways. It enables us to predict and understand our own as well as other people’s behaviour, understand social spaces in the world, regulate attention and emotion and help us develop a strong sense of self as well as good interpersonal relationships.

Mentalization-based treatments place mentalizing at the centre of the therapeutic process. They aim to promote mentalizing and resilience in children and young people, along with their families and carers, so they can learn how to make better use of supportive relationships and feel better equipped to tackle the problems that brought them to therapy.

A core part of all mentalizing approaches is the therapist’s mentalizing stance. The mentalizing stance is both an attitude and a skill. It is a ‘way-of-being-with’ that creates safety, trust and curiosity and facilitates mentalizing in the therapist and those seeking help.

Mindfulness is the ability to be fully present and connect with your awareness. It's the foundation on which the ability to flourish rests. Mindfulness allows you to take a wise and skilful stance when responding to life’s challenges.

Mindfulness helps us develop the habit of catching ourselves ‘in flight’ when we tend to drift too far into the ruminative mind in our attempts to control life. Through mindfulness meditation, we learn to simply see our mind and develop the ability to use it as the wonderful tool it is.

There have been many studies on how and why mindfulness training helps. In addition to modern evidence, there is the 5000-year evidence base supporting mindfulness meditation that comes from various wisdom traditions. 

Play is the natural language of children. It is a metaphor or symbolic expression of what is going on in their lives. Play is to children what verbalization is to adults. Early childhood experts agree that play is essential and facilitates:

• Expressive language
• Communication skills
• Emotional development
• Social skills
• Decision-making skills
• Cognitive development

Naturally, toys and other materials play an important role in the therapeutic process. If play is considered the language of children, toys are considered to be their words. Children in play therapy have an array of toys to choose from. They are given the power to decide which toys to play with and how to play with them over an extended duration. If a child decides to use a toy destructively, the play therapist will use limit-setting to help the child learn more effective and socially-appropriate ways of expression and develop self-control.

The relationship between a child and his or her play therapist is important to the therapeutic process as well as the outcome.  

Play therapists follow Virginia Axline’s eight guiding principles in their interactions with children:

1. The therapist is genuinely interested in the child and develops a warm, caring relationship.
2. The therapist experiences unqualified acceptance of the child and does not wish that the child were different in some way.
3. The therapist creates a feeling of permissiveness and safety in the relationship, so the child feels free to explore and express.
4. The therapist is always sensitive to the child’s feelings and gently reflects those feelings in such a manner that the child develops self-understanding.
5. The therapist believes deeply in the child’s capacity to act responsibly, respects the child’s ability to solve personal problems, and allows the child to do so.
6. The therapist trusts the child’s inner direction, allows the child to direct his or her play, and resists the urge to direct the child’s play or conversation.
7. The therapist appreciates the gradual nature of the therapeutic process and does not attempt to hurry the process.
8. The therapist establishes only those limits that help the child accept personal and appropriate relationship responsibility.

Schema Therapy was developed by Jeffrey Young in 1990 to work with clients that are diagnosed with personality disorders and other complex interpersonal difficulties, and who cannot be adequately helped by standard Cognitive Behavioural Therapy (CBT). Schema Therapy is integrative and combines aspects of cognitive, behavioural, psychodynamic, attachment and Gestalt models. It sees the cognitive and behavioural aspects as crucial for treatment but places an equal level of importance on emotional change, experiential techniques and the therapeutic relationship. Like CBT, it is structured, systematic and specific and follows a sequence of assessment and treatment procedures. The model outlines specific schemas, coping styles and modes. Most importantly, it normalises rather than pathologises personality disorders, assuming that everyone has schemas, coping styles and modes. However, the people we treat, are found to be more rigid and extreme. 

Schema Therapy places a great deal of emphasis on the origin of psychological problems during childhood.  Young defines Early Maladaptive Schemas (EMS) as self-defeating emotional and cognitive patterns that develop early in childhood and are strengthened and elaborated throughout life.  Maladaptive behaviours are thought to be driven by schemas. Schemas are dimensional, which means that they have different levels of severity and pervasiveness. The more entrenched the schema, the more number of situations that activate it, the more intense and negative its effect is and the longer it lasts.  Offending behaviour can be understood as an extreme consequence of schema activation.

Young identified 18 schemas, all of which are maladaptive, he hypothesises that a person develops coping strategies to cope with the emotional distress associated with the schema.  These coping styles take the form of Schema Surrender (giving in to the schema and accepting that the resulting negative consequences are unavoidable), Schema Avoidance (avoiding triggers internally and externally that may activate the schema) and Schema Overcompensation (acting as though the opposite was true) (Young, 1990).

Schema Therapy can be done as an individual or as a combination of group and individual therapy sessions.  At the Free Spirit Collective, we use schema therapy in individual therapy sessions, in cases where there are difficulties in relationships or relating to others, adversely impacting a person's day-to-day functioning.  To start with, the therapist works with you to identify what schemas are currently active and causing problems, moving on to helping you spot them in real-life situations.  Subsequently, cognitive and experiential techniques such as imagery are used to undermine and heal the schemas, reducing their impact.  Finally, new, healthy and adaptive behavioural responses are developed to help improve your current functioning.

Spiritual Psychology approaches challenges, interpersonal experiences and understanding of life from the perspective of the soul’sjourney. Taking the stance that life is happening for us, not to us, we go together on a journey of reintegration and self-discovery. Concepts from psychosynthesis, evolutionary astrology, archetypal systems, cultural mythologies and somatic experiencing are explored to enhance awareness & deepen connection to the essential self. 

Trauma can be associated with events such as accidents, violence, and different forms of abuse and with repetitions of such events over time. Trauma can also be in the form of repeated emotional and relational injuries such as bullying or a problematic attachment relationship with parents. Trauma can have a big impact on the lives of people who experience it, leading to difficulties associated with mental health, academics, society and relationships. People experiencing this can often lack a sense of safety, find it difficult to trust others or themselves, feel inferior or defective and feel extreme shame about themselves.

Working with Trauma 

At the Free Spirit Collective, we recognise that many people coming into therapy have experienced trauma in some form or the other, which may result in psychological, emotional and relational difficulties without them even realizing it. And so, we aim to create a safe space for clients to explore and heal their traumatic experiences and relationships. 

Wellbeing takes a slightly different approach to conventional psychology. Instead of focusing on the mentally unwell, it focuses on people at their best, exploring whether the ability to be at one's best can be taught. The answer is, yes. Through more than 20 years of research, we have proof that wellbeing is something that can be taught to people, providing them with the skills they need to be at their best more often. 

What wellbeing isn’t

A common misconception related to wellbeing is that one must be happy all the time. This can’t be further from the truth. We learn so much from suffering. Difficulties and uncomfortable emotions are as big a part of wellbeing as happiness. It is very difficult to build resilience without setbacks or failure. They are important components of life and therefore need to be included in wellbeing. To conclude, there is no place for toxic positivity, which means we are all allowed to be anxious, sad and angry.