Adding back the body to the counselling client!
The nature of counselling
According to Professor John McLeod, one of the leading advocates and teachers of counselling and psychotherapy in the UK, over a period of several decades: Counselling is a wonderful twentieth century invention; and, when individuals find it difficult to manage some aspect of their lives, especially their emotional lives, by using their normal coping strategies, then “Counselling is a really useful option at these moments.”
However, counselling does not just illuminate issues for the client; or clarify their blind spots; or help them to clarify their goals. It actually changes their brains. This has been verified by brain scans before and after therapy.
This raises a very interesting issue: The emotional centre of a counselling client is in the core of the brain – the limbic system - but emotional experience is also encoded into muscle tension and skeletal posture, etc. And now, increasingly, we are learning of a link between the guts and the brain, which directly affects emotions like depression, anxiety and even schizophrenia. For example, in her Appendix on Diet and Emotions, in Byrne (2016), Renata Taylor-Byrne wrote this: “What we eat has a very powerful effect on our bodies and minds. And knowing and understanding how our bodies react to the substances we feed ourselves, is a crucial part of self-care.”
Renata cites a range of expert sources in defence of her conclusion, including: Julia Ross, The Mood Cure. Kris Carr on eating healthily to overcome anxiety and depression; Robert Redfern on nutrition and mental health; Patrick Holford on nutrition for the mind; David Perlmutter on the link between gut bacteria and brain functioning; Kelly Brogan on diet, supplements and depression; and S. J. Schoenthaler on diet and anger. Which I have listed for you below.
We also know that for the brain to rewire itself, it needs the right kinds of ‘building materials’. Omega-3 fatty acids are one essential for rebuilding brain cells. And trans fats (found in junk food) ‘rot the brain’, or stiffen the cell walls; (Sources: Dr Joseph Mercola and Laurie Barclay)
The implications being that some years ago, in 2011, while I was writing an updated version of my book on stress management, I found it necessary to include all of the following subjects, in order to comprehensively (or fairly comprehensively) help the reader to get control over their feelings of anxiety, anger, and depression when under excessive pressure:
Chapter 6. A range of techniques to reduce your stress level
6.1: Develop your awareness
6.2: Exercise regularly
6.3: Learn a good system of time management
6.4: Practice self-empowering visualisation
6.5: Personal reflection on sections 6.1 to 6.4
6.6: Learn and practice a relaxation system
6.7: Learn to be compassionate towards yourself
6.8: Learn to think “rationally”; and use Rational Emotive Imagery (REI)
6.9: Learn how to ‘reframe’ your stress problems, using four of the frames from the Six Windows model
6.10: Learn daytime relaxation using ‘power napping’
6.11: Personal reflection on sections 6.6 to 6.10
6.12: Learn to be assertive
6.13: Try to operate from love, rather than hatred and fear
6.14: Eat a balanced diet
6.15: Self-reflection on sections 6.12 to 6.14
6.16: Build timeslots into your day for recreation or play
6.17: Learn to meditate
6.18: Listen to relaxing music rather than TV news
6.19: Personal reflection on sections 6.16 to 6.18
6.20: Include lots of comedy and humour in your life
6.21: Distinguish what you can control from what you cannot control
6.22: See a recommended stress counsellor
6.23: Personal reflection on sections 6.20 to 6.22
From that point onwards, (paradoxically), I continued to think of myself as “a Rational-Emotive therapist, engaging in philosophical counselling”, but I somehow worked into that practice the teaching of some elements of my stress management approach: including physical exercise, relaxation, and elements of diet. (It has been argued that counsellors do not normally practice what they say they practice, but are quite unconscious of their deviations from their ‘official school’ – and this example from my practice seems to confirm that claim).
What I have found, and been guided by, is this insight: Sometimes the client’s problem has a decidedly physical basis, as opposed to a cerebral/limbic/ideational one.
An example of this is Candida Albicans.
I personally have had to grapple, for more than 35 years, with a problem of intestinal Candida overgrowth, which is a fungal infestation, often precipitated by a course of antibiotics, which kills off all of the friendly bacteria in our guts. Some of the main side-effects of this condition – which is thought of as “an overgrowth of unfriendly (as opposed to friendly) bacteria in the gut”, are: physical exhaustion and low mood, and sometimes anxiety. These side-effects can be avoided by keeping the condition in check with the use of anti fungal supplements and live acidophilus.
The relevance of this self-revelation? Within a couple of years of beginning to work as a counsellor, I came across an occasional male client who had symptoms of depression or anxiety, but no obvious psychological causation. In those cases, I have suggested that they treat their condition as an overgrowth of intestinal Candida Albicans, and see if their emotional problem quietened down (I would refer them to a suitable nutritionist for advice on supplements). And, lo and behold, that is normally what we found.
From that point onwards, I could not restrict myself to merely dealing with the client’s story; or their goals; or their need for a secure base; or reflective listening; or empathy. Very often, in at least twenty percent of my cases, I have to consider that dietary changes, and/or physical exercise, could be a big part of the ‘cure’ that a particular client needs. And sometimes I recommend reading material on diet and exercise, etc., and sometimes I recommend a suitable alternative health practitioner.
Recent research results evidence a strong link between food and emotions is building up daily. For a recent example of a randomized controlled trial, let’s take a look at an Australian study which published its results in January 2017[13]. This is how the study was described by Bonnie Kaplan and Julia Rucklidge in the webzine Mad in America.
“This study, called SMILES (Supporting the Modification of Lifestyle Interventions in Lowered Emotional States), was carried out in Australia over 12 weeks. Participants were randomized to receive either Dietary Support (DS) or Social Support (SS). To participate, they had to meet criteria for having had a Major Depressive Episode. And they also had to report on the Dietary Screening Tool that they had low intake of dietary fibre, lean protein, fruits, and vegetables; as well as a high intake of sweets, processed meats, and salty snacks.”
Kaplan and Rucklidge go on to explain that:
“Each participant randomized to DS (dietary support) received 7 hours of sessions with a dietician. Those assigned to SS (social support) received a similar amount of time in a ‘befriending’ arrangement. There were 31 people who completed DS and 25 who completed SS.”
The results were dramatic.
“On the primary outcome measure of depression (the MADRS), the DS (dietary support) group improved significantly more than the SS (social support) group, with a large effect size. And the changes in depression scores were significantly correlated with changes in diet; in other words, the people who improved their diets the most were the ones who experienced the most improvement in mood.”
In their concluding comments, Kaplan and Rucklidge state that “poor diet is an extremely important cause of mental disorders”.
Surely, this kind of result – whereby teaching depressed individuals about nutrition reduces their depression - must cause most counsellors, who are made aware of these emerging results, to rethink their approach to counselling depressed clients.
In conclusion, out of my journey of enquiry and discovery, accompanied by my wife as fellow researcher, I have continued to build a system of counselling and therapy which seeks to be as holistic as possible: including a consideration of the body-brain-mind-environment of the client; and not just their ‘mind’.
Last year, my wife and I collaborated on a project in which she wrote two long documents: one on diet, and the other on exercise, and their impact on human emotions. I wrote several chapters on how those dietary and exercise elements can be integrated with a range of models of the body-brain-mind-environment of the client. And this resulted in our book: Holistic Counselling in Practice, which is described on our website.
I hope my insights prove helpful for counsellors who often find themselves wondering if their client is indeed a free-floating mind, or actually a body-brain-mind, with physical and emotional components to their lived experience.
View Dr Jim Byrnes and Renata Taylor-Byrnes site here for information on their many books.
Authors Bio
Dr Jim Byrne earned his Professional Doctorate in Counselling from the School of Education, at the University of Manchester (2003-2009). He was originally trained as a Rational Emotive Behaviour Therapist, but now practises his own form of Holistic Counselling and Lifestyle Coaching, in Hebden Bridge, West Yorkshire; where he has been in private practice, ABC Counselling for more than eighteen years. You can view his website or contact him
He also serves as Executive Director of the
Footnotes
John McLeod, An Introduction to Counselling, 2003.
Jeff Victoroff MD (2002) Saving Your Brain. Page 92. “Good psychotherapy does not just boost self-esteem – it changes brains. PET scan studies clearly show improved cerebral blood flow after therapy for depression. Insight-oriented psychotherapy may literally rewire the brain, boosting the synaptic connections that are adaptive and damping the maladaptive ones. …” This can protect your brain: “For example, psychological counselling has been shown to prevent second heart attacks in patients with depression”.
And:
Doidge: ‘There is no longer any doubt’, writes Kandel, ‘that psychotherapy can result in detectable changes in the brain’. Recent brain scans done before and after psychotherapy show both that the brain plastically reorganizes itself in treatment and that the more successful the treatment the greater the change”. Page 233.
Quotation from: Doidge, N. (2008) The Brain that Changes Itself: Stories of personal triumph from the frontiers of brain science. London: Penguin.
Ross, J. (2002) The Mood Cure: Take charge of your emotions in 24 hours using food and supplements. London: Thorsons.
Kris Carr; cited in: Pinnock, D. (2015) Anxiety and Depression: Eat your way to better health. London: Quadrille Publishing.
Redfern, Robert, The importance of Nutrition for mental health (2016) Naturally Healthy News, Issue 30.
Patrick Holford (2010) Optimum Nutrition for the Mind. London, Piatkus.
Perlmutter, D. (2015) Brain Maker: The power of gut microbes to heal and protect your brain – for life, London, Hodder and Stoughton.
Brogan, Kelly. A mind of your own: The truth about depression and how women can heal their bodies to reclaim their lives, (2016) London, Thorsons.
S. J. Schoenthaler, ’The Northern California diet-behaviour program: An empirical evaluation of 3,000 incarcerated juveniles in Stanislaus County Juvenile Hall,’ Int. J. Biosocial Res, Vol 5(2), 1983, pp.99-106.
Fish Oil Helped Save Our Son, by Dr Joseph Mercola, November 2012. Available online: http://articles.mercola.com/sites/articles/archive/2012/11/05/fish-oil-benefits.aspx
Fighting Depression, and Improving Cognition with Omega-3 Fatty Acids. October 2007, By Laurie Barclay, MD
Byrne, J. (2011) How to Reduce and Control Your Stress Level, and to Have a Happier Life: The CENT approach. Hebden Bridge: Institute for CENT Publications.
Jacka FN, O’Neil A, Opie R, Itsiopoulos C, Cotton S, Mohebbi M, Castle D, Dash S, Mihalopoulos C, Chatterton ML, Brazionis L, Dean OM, Hodge AM, Berk M. A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Med. 2017 Jan 30;15(1):23. doi: 10.1186/s12916-017-0791-y.
SMILES Study: Depression and Nutrition, By Bonnie Kaplan, PhD & Julia Rucklidge, PhD. February 18, 2017. Available online: https://www.madinamerica.com/2017/02/smiles-study-depression-nutrition/
Byrne, J. with Renata Taylor-Byrne (2016) Holistic Counselling in practice: An introduction to Emotive-Cognitive Embodied Narrative Therapy. Hebden Bridge: The Institute for E-CENT Publications.
