Anxiety, Trauma and Panic Services West Perth in West Perth, Western Australia | Mental health service

Anxiety, Trauma and Panic Services West Perth

Locality: West Perth, Western Australia

Phone: +61 407 610 982

Address: 44 Kings Park Road 6005 West Perth, WA, Australia

Website: http://christophersemmens.com.au/contact.htm

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24.01.2022 The B C Connection I introduced the second principle of emotional management in my last post the Principle of Emotional Responsibility which states: Each of us, ourselves, mainly determine our own emotional experiences by way of the processing we apply to the circumstances we encounter. The mainly part of this clearly implies that there are other factors operating most obviously the initiating circumstance. As will be discussed in future posts, there are other signi...ficant aspects of the other than mainly contributions to the manifest emotional experience. For now we are building things up from the foundations. My already referred to great mentor Albert Ellis called the initiating circumstance the activating event or the adversity and gave it the letter A. Ellis called the emotional experiences part of this the C for consequences. Included in the C are not only the emotional experiences but also behavioural and physiological (bodily) reactions and responses. The processing bit Ellis calls the B or the belief system. Yes, if the A is changed, removed or avoided an alteration in the C is possible. Reliance on this avenue to emotional balance, however, is limiting for a number of reasons and has its difficulties. It is not always possible; it can be costly to us; and it can keep us in an ongoingly emotionally vulnerable state. Far better to focus on what Ellis calls the B-C connection the processing.

23.01.2022 While Fathers Day is usually about fathers being recognized and pampered, it also presents an opportunity for fathers themselves to reflect on the quality of the fathering experienced by their children. A couple of days ago I saw Richard Linklaters wonderful movie Boyhood. Portrayed in the movie were a number of fathering roles that warrant reflection. It was easy to glean the potential for real enduring psychological harm to have been reeked here but for the resilience of ...the son and the reliably solid loving and caring of the mother played out in an Oscar-winning performance by Patricia Arquette. Not all are so resilient and sometimes it falls to the father to provide the bedrock of consistent demonstrable love in adverse circumstances. I advocate each father taking a moment on Fathers Day to arrive at a Fathers Day resolution towards an improvement in their fathering for the ensuing 12 months. A core quality to cultivate or reinforce is that of responsible and enlightened flexibility, tolerance, acceptance and unconditional love.

21.01.2022 Principles of Emotional Management: 2. Emotional Responsibility My last post featured what I call the Golden Rule The only kind of negative emotion that you ever, ever, ever, ever want to have is that which is going to be helpful to you in some way.... We human beings are formidably prone to lapsing into negative emotional states that are self-defeating unhelpful for us in maintaining our compelling orientation towards having a good life despite any frustrations and adversities with which we are inevitably and unavoidably confronted. In essence, we do this by applying judgments, evaluations, interpretations, appraisals and attitudes to the circumstances we encounter that are rigid, inflexible, intolerant, demanding, imperative and absolutistic. These rigid attitudes put us at risk of the brain deriving from this input information about the environment consistent with: No way out, no escape danger and threat and the ensuing activation of a survival emotional response such as anxiety, anger, guilt, depression and hurt. If, alternatively, our attitudes and evaluations related to frustration and adversity are of a flexible, tolerant, preferential, conditional and relative nature, it is much more likely that this kind of input will result in information to the brain characterised more like: There are alternatives if we cant go this way, we can go that way and under these circumstances a survival response lacks a trigger. Accordingly it is likely that the emotional response will be more aligned to a problem solving orientation such as concern, annoyance, regret, sadness and disappointment. So our second principle of emotional management is the Principle of Emotional Responsibility, which holds that: Each of us, ourselves, mainly determine our own emotional experiences by way of the processing we apply to the circumstances we encounter. I will discuss more about this principle in my next post.

20.01.2022 Clinical Psychologist Christopher Semmens focuses particular attention in the areas of anxiety and panic, traumatic stress and pain management and cigarette smoking cessation.

17.01.2022 In my sessions with my clients I often will be scribbling things down on A4 copy paper - diagrams, frameworks, flowcharts and sagacious musings. It's active-directive therapy that I do. The bit of paper that I will frequently nominate as the most important of these is one that contains the "reality" statements from the graphic I shared last time. How we deal with those realities can be a key consideration when it comes to the "bottom line" - having a good life. These realitie...s - the imperfect world and the fallible human beings in it - mean that frustration and adversity are inevitable and unavoidable - to a greater or lesser extent. This is not what we want too hear! So, the challenge for us is to become well-equipped to navigate these inevitable and unavoidable frustrations and adversities allowing us to still have a good life despite the realities. What is involved in this "navigating" will be touched on in my next entry in a week's time.

17.01.2022 How chronic stress can affect the brain's size, structure, and how it functions:

13.01.2022 Many people lead difficult lives with hardships, challenges and stressful circumstances to a greater or lesser degree - maybe even most of us. What can often be a significant fillip is the joyful thrill of their football team doing well - a temporary weekend distraction from the challenges of everyday life. So when your team is doing well, wring every little bit of satisfaction from the success being achieved on the field - I encourage you to cultivate a mindful, in the present time, attitude to the enjoyment derived from the excellent performance of your team. This is especially relevant when you realise that, perhaps for most teams, this sort of situation is usually a once in a decade opportunity. GO WEST COAST EAGLES!!

12.01.2022 A Departure and Some History There is a lot more to say about the As, Bs and Cs; the B-C connection; and the elaboration of the wriggle room construct. There are the Ds and Es for a start. We also want to go into the whole concept of the role of thinking processes in the generation of emotional responses as being an interim association. What I mean by this is that, ultimately, the principal determining consideration is our fundamental philosophical outlook. This can be consid...ered as the way that we see ourselves in relation to the world and the other people in it. More about this later. For now I want to discuss something else. While there is great value in understanding what we have said so far (and the further ideas that we are yet to consider) in regard to the B-C connection, fostering an awareness of our own B-C operations, and thereby facilitating the exercise of choice and the ensuing eventual establishment of a new set of automatic B-C executions, it is my view that this approach is infrequently sufficient. The perspective that we have been discussing so far in these pages is largely derived from the work of my great mentor Dr Albert Ellis. I trained with Ellis first in Oxford in 1989 and subsequently a number of times in New York where he was based, as well as in Toronto and Copenhagen. Ellis revolutionized clinical psychology in 1955 when he first presented his new approach, initially called RT rational therapy; then rational emotive therapy (RET); and finally rational emotive behaviour therapy (REBT) since 1994. His formulation for the practice of clinical psychology came as a revolutionary alternative to the then dominant Freudian tradition (and its offshoots) of psychoanalysis. Ellis had dutifully undergone training in classical psychoanalysis with a trainer oriented to the Karen Horney Freudian offshoot. Ellis was well regarded in New York as a psychoanalyst but he became increasingly sceptical of the efficiency and efficacy of classical analytic technique. Derived from Ellis increasingly engaging in a more directive approach with his clients, and informed with the philosophy both ancient and modern that he voraciously absorbed in his teens and early 20s, his new system emphasized the notion that people themselves could actively operate to improve their lives by reducing or eliminating the emotional disturbance that they largely self-generate. The something else that I want to discuss will have to wait until my next post. Meanwhile this photo is of myself with Dr Albert Ellis in his study at East 65th Street, New York in 1990.

11.01.2022 In my first session with a client I will often take them through a framework that outlines some key considerations in the work that we will be doing together. The first thing is what I call "the bottom line" - what it is all about , as I see it. I will often say that if I am forced to describe what I do for a living in a few words it would be this - "I set out to help people have a good life." So the bottom line is "having a good life." So far so good - however there is a ver...y big "but" that can, and very frequently does, present one of the most significant challenges to our bottom line - "reality." A realistic view of the circumstances of life compels us to acknowledge the conditions of life for us human beings. As my great mentor Dr Albert Ellis used to say: "Things may be different on some other planet!" But here on earth we cannot bypass the fact that the world is an imperfect place - we only need to pick up a history book, watch television news or read a newspaper to be starkly confronted with this reality. The other brutal truth is hat all human beings are fallible - i.e. prone to making mistakes. I call this being "stuff-up-able" - and we are all amply endowed with this challenging characteristic. Reality then is: 1. The imperfect world and 2. Human fallibility. We can look at human beings as having two forms: (a) ourself and (b) others - giving us three Realities: (i) the imperfect world; (ii) the fallible us; and (iii) the fallible others. In my next post - in a weeks time - I will continue to outline this initial framework. For now we have got:

08.01.2022 Navigating the Frustration & Adversity Having outlined a way of looking at the approach that I take to what I do as helping people to have a good life despite the realities of living where frustration and adversity are inevitable and unavoidable," we now want to look at what can actually be done to contribute to having a good life. I have called this navigating the frustrations and adversities. What I consider to be a foundational notion in being well-equipped to navigat...Continue reading

08.01.2022 PTSD versus traumatic stress Over the past 20 years my approach to the clients seeking my assistance with the various struggles in their lives has been driven by the question in my mind: What has happened to you? With this I am interested in what traumas have occurred in their lives; the disruptions they have endured; the losses they have suffered; and the quality of the parenting they experienced growing up. These exposures set up patterns of response and connections in th...Continue reading

08.01.2022 Principles of Emotional Management 1. The Golden Rule Previously we considered the determining link between events that occur and our reactions to those events. Rigidity and flexibility were proposed as directly generative of survival mode responses and problem-solving mode responses respectively. Actually the directly generative bit requires a little bit of nuancing it is more a matter of putting ourselves at significant risk when it comes to the bottom track survival mo...de response rather than it being a strictly cause-effect relationship. In this post I was going to discuss some of the specific kinds of thinking processes that can operate in these ways - but I am first going to look at the first two of my principles of emotional management. The first of these I call the Golden Rule of Negative Emotions. It goes: The only kind of negative emotion that you ever, ever, ever, ever want to have is that which is going to be helpful to you in some way. Now of course integral to this statement is the implied idea that at least some negative emotions are helpful to us at times. This can seem somewhat counterintuitive to those who might be more accustomed to a positive emotions/negative emotions dichotomy where the positive emotions are the desirable ones and the negative emotions are to be avoided. But if we bring ourselves back to the real world reality the imperfect world and the fallibility of all human beings then there are, inevitably, going to be challenges for us to confront. The right kind of negative emotions can help us to effectively navigate these realities the wrong kind can see us crashing into them. In a civilized society in the 21st century it would in fact require an exceptional circumstance for us to require activation of the survival mode bottom track negative emotions. Accordingly, compliance with the golden rule will usually ensure that this kind of negative emotional activation is indeed a rarity. My next post will look at the second principle of emotional management the Principle of Emotional Responsibility.

08.01.2022 Love this quote !

07.01.2022 More on the B - C connection. Last time I introduced the B C connection. This is the idea that while the A the activating event, adversity or frustration with which we may be presented or encounter has something to do with the C the emotional, behavioural and physiological consequence the association between the two is merely a correlational one. It is not a cause-effect relationship. It is not fixed, inevitable or determined. There is something else that is importa...ntly going on and that something else is modifiable subject to our personal influence. It is the B C connection that is the cause-effect relationship. It is the attitude, evaluation, interpretation, judgment or appraisal the B - that we apply to the A that is the principal determinant of the quality of the C. We are capable of having a top track negative set of responses (emotional, behavioural and physiological) and our brain operating in problem-solving mode; or a bottom track negative set of responses and our brain operating in survival mode - to any kind of A. The determinant is what it is that goes on at B, primarily. Remember that top track negative emotional experiences include sadness, concern, regret, annoyance and disappointment. Bottom track negative emotional responses include depression, anxiety, guilt, anger and hurt. At B it is useful to think of the key distinguishing feature between a top track C and a bottom track C as that between flexibility and rigidity, respectively. Flexible, tolerant, accommodating, accepting, relative and preferential Bs are consistent with top track negative emotions (and associated behaviour and physiology). Rigid, intolerant, imperative, absolute and demanding Bs accord with bottom track negative emotions (and associated behaviour and physiology). So, it is best for us to operate with flexible Bs in all circumstances. In life-threatening situations we can rely on our innate automatic responsivity which operates in advance of the thinking processes and itself can go awry in ways that we will discuss in future posts to deliver the requisite response. In the graphic below, certain thinking processes at B (the blue arrow) in response to frustration and adversity are likely to result in top track healthy and functional negative emotional responses and problem-solving brain activation. Other kinds of thinking processes at B (the red arrow) in response to frustration and adversity are more likely to promote bottom track unhealthy and dysfunctional negative emotional outcomes and survival mode brain activation. The next post will consider some of the specifics of these different kinds of Bs.

06.01.2022 The Role of Phylogeny and Social Evolution In my last post I discussed the distinction between top track (problem solving mode) negative emotions and bottom track (survival mode) negative emotions. I commented that the bottom track negative emotions are abundantly experienced all around us when, in general, there is the barest possibility (living in a civilized society in the 21st century) of us requiring such activation more than a handful of occasions in an entire lifetim...Continue reading

04.01.2022 Demandingness Cherchez le Should A central element when considering the Bs of the B-C connection is demandingness. This is where we apply rigid insistent imperative demands to the circumstances we encounter. It is absolute demandingness that can set us up for distress and disturbance. Here we are thinking in terms of should, must, have to, got to, ought, and need. Where we apply these thought processes in a conditional way, as opposed to an absolute way, it is not necessa...rily damaging e.g. If you dont want your phone cut off you should pay your bill. On the other hand, absolute demands are inconsistent with the realities of the imperfect world and its fallible human beings. They put us at risk of a bottom track, survival mode, distressing and disturbing emotional response at C. This is particularly the case when we then, as we usually do, apply various irrational evaluations to these fundamental demands. There are four prominent kinds of irrational evaluations that we typically apply to our demands that can lead us to disturbance. There will be more about these in a future post. In the graphic below we revisit the fundamental realities of life: (i) the imperfect world and (ii) human beings as fallible prone to making mistakes. I call this human fallibility being stuff-up-able. Also, I point out that, while obvious, there are benefits to distinguishing two kinds of human beings ourselves and others. Where we apply should and must imperative demands and insistences to the realities of the imperfect world; the fallible us; and the fallible others such as: The world should be fair! I shouldnt make mistakes, Other people should be considerate towards me! and then when we are subsequently and inevitably confronted with the actual reality that the world is imperfect, that we do make mistakes, and that others can treat us inconsiderately we find ourselves at considerable risk of becoming devastated, distressed and disturbed; on the bottom tracks and in survival mode. So, we want to cherchez le should look for the imperative insistences and vigorously adjust them to preferences such as I would very much like the world to be fair, It would be nice if I never made mistakes, and I would much prefer it if other people acted in a considerate manner towards me. The preferences dont need to be wishy-washy they can be very strongly, firmly and emphatically held but still with the vital quality of flexibility being operative. This then allows for what I call wriggle room in the brain where the brain registers that it is more likely that there is a problem to solved than that there is mortal danger to have to contend with. More about wriggle room in a future post.

04.01.2022 All the best for a safe and peaceful time this Christmas and New Year. Be kind to yourself. You are a worthwhile, fallible human being, deserving of love and happiness! Merry Christmas all!

02.01.2022 The Departure In my last post I referred to all the good stuff that had been the content of many previous posts and there will be much more of that good stuff as infrequently sufficient. What can I mean by this? Well Im referring to the fact that a thinking and philosophising (and behaving, emoting and physiologing) human being, having lived a life in our imperfect world, is likely to have encountered adverse experiences along the way. Our system has a way, in many cas...es, of accommodating, adjusting and achieving a resolution of these adverse experiences. But not all the time. So often these adverse experiences remain unresolved and become very relevant to our considerations as to how we can best make a difference for those seeking assistance for emotional distress. Taking these kinds of factors into account has generally not been very popular with the followers of Albert Ellis and Aaron (Tim) Beck who independently arrived at similar formulations to Ellis some 7 years later. Their movements were predicated on a flight to efficiency. This was seen to necessitate a turning of the back on the longwinded psychoanalytic formulations that made the forensic examination of adverse experiences, aimed at generating insight, a sine qua non of psychotherapy. Not until one of Becks early close collaborators Jeffrey Young (with whom I have twice trained) brought the consideration of (particularly) early adverse life experiences back into what is the current mainstream in psychotherapy through his schema therapy has there been somewhat of a renewal of the recognition of the relevance of considering the adverse experiences that people go through in their lives. On the other hand, the medical and psychiatric approaches to people in emotional distress have largely relied on the unsubstantiated hypothesis of biochemical brain imbalance and genetic defect oriented medical model. There have been serious challenges to this medical model approach, with its reliance for therapy on psychoactive medication, in numerous publications in recent years. Sir Michael Marmot, in the first of his 2016 ABC Boyer Lectures, took a swipe at the medical model of emotional distress when he said: The idea that she was suffering from red pill deficiency was not compelling. It seemed startlingly obvious that her depression was related to her life circumstances. The medical model approach to emotional distress centres on the question: What is wrong with you? seeking to arrive at a label or pigeonholed categorization. The approach that I have been taking with my clients over the past 20 years has been one oriented to the question: What has happened to you? There will be more about this important distinction in my next post. The graphic is a representation of the medical model approach to emotional distress.

02.01.2022 I have been discussing some of the foundational considerations relating to the approach that I take with my clients in assisting them towards becoming really skilled and adept at navigating the inevitable and unavoidable frustrations and adversities of life. In a practical sense there are perhaps three principal areas of focus in implementing this objective. The first is essentially a philosophical approach how we see ourselves in relation to the world and the other people ...Continue reading

02.01.2022 The Tram Tracks of Negative Emotions My focus in my sessions is on the negative emotions. I often will say, tongue-in-cheek, that "this is a positive thinking free zone!" If it is positive affirmations that are sought - then it's a Life Coach that will deliver. Not this clinical psychologist. The achievement of effective management of the negative emotions puts one well and truly on the pathway to having a good life. It equips us to navigate the inevitable and unavoidable fr...ustrations and adversities of life. Immunisation for distress and disturbance! It's actually fundamental to our functioning. More of this in next week's post. And . . . having the negative emotions sorted facilitates the positive emotions taking care of themselves - there is an openness and receptivity to the enhancing and joyous positive emotional states. For now I want to elaborate on the tram tracks from the last post. So - on the top we have sadness; regret; annoyance; concern; and disappointment. On the bottom it's: depression; guilt; anger; anxiety; and hurt. This is not, of course, an exhaustive list. Now the thing is that the top track emotions are qualitatively different to the bottom tracks. There is NOT a continuum from mild sadness, through moderate sadness, into severe sadness and then to depression. No. Sadness and depression are separate emotional states. There are different things going on - objective, identifiable, discernible, observable and measurable differences - at a number of levels. There are physiological distinctions - measurable on a polygraph. Other measures are being looked at in this territory such as heart rate variability (HRV); voltmeters; and even measures of pH using litmus. I will be discussing these measures - in particular HRV - in a separate post down the track. There are also cognitive differences - identifiable as problem-solving capacities. Behavioural correlates are also discernible - some examples of bottom track behavioural manifestations would be: withdrawal; avoidance; shouting; violence; destruction; furtiveness; and agitation. No graphic this week - they are quite an effort! Hopefully a nice one next week that I am currently agonising about how to get it down. Next - the functional origins of our emotional propensities.

01.01.2022 Over the years I have had quite some success in assisting women who have been struggling to become pregnant. Most of these women have come to see me for assistance with a problem other than the fertility issue e.g. anxiety; insomnia; or depression. In general they have been on IVF programmes for many years. One woman was referred directly from an IVF clinic, at her request, prior to the initiation of the technology. The referral letter detailed the gynaecological pathology t...hat was preventing the achievement of a natural pregnancy. My approach to the presenting problems was one that is usual for me these days - trauma-informed care and practice. I ask what I call the "four questions plus one" - "Tell me a bit about your life - Has there been any trauma, loss or disruption in your life? How was the parenting that you got? Is there anything else that you think I should know?" In all cases there were significant issues that emerged in answer to these questions. The traumas, losses, disruptions and issues related to dysfunctional parenting were dealt with and resolved. Pregnancy ensued, through the IVF in most of these cases, within a few weeks of therapy cessation. The woman who was referred from the IVF clinic gave birth to a little girl without ever revisiting the clinic. When asked if any of these questions had been asked of them at the IVF clinics that they had been attending for years the answer, uniformly, was "no." Keep a look out for my new programme FertilityFlows in the new year.

01.01.2022 Rigidity versus Flexibility We essentially get ourselves on the bottom tracks (depression, anxiety, anger, guilt, hurt and others) mostly to no avail in terms of a benefit to be derived let alone contributing to our bottom line of having a good life. How is it that we do this? As discussed earlier we are at quite some risk of switching on the survival mode negative emotions because our brains are still organised, set-up, structured and configured to be readily responsive t...Continue reading