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Where can I get psychotherapy and help in Enfield and Southgate?

Enfield Therapy

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Psychotherapy covered by BUPA

If you are covered by BUPA, you can receive psychotherapy here. For an appointment, please call LONDON PSYCHOTHERAPY on 0207 467 8564.

Gestalt Questioning: London Psychotherapy Information

As far as I can tell, there is no such thing as ‘Gestalt questioning’ per se. What I mean by this is that the expression, as far as I know from the literature, has not been used regularly in this form. Only Sapp (2010) and Hall (1977) use the expression in this form. However, questioning in Gestalt therapy is an extremely important tool/technique in Gestalt therapy. Gestalt therapy focusses on the here and the now.  Questioning using the words what and how can be used to help clients’ awareness of the moment. It helps client to ask themselves how they are feeling and to enjoy or discover information about the present, whereas why question illicit inwardness and rationalizations. Here is an example of this. If the therapist asks the question, ‘What is happening now?’, the client will think about the experience at that moment. Other questions such as, ‘What are you feeling at this time?, and ‘What does that hand position you are doing mean to you?’ can also help in this process. The Gestalt therapist encourages his client to experience the moment and to live his feelings rather than to talk about them. It is perhaps the questions that help clients to be able to re-enact the past in the present. Nevis (1987) talks about guided questioning. He points out that by using questions, the therapist can help the client to re-discover the present and feelings of the moment in a form which he describes as ‘open, undirected awareness’.

Nanci Bell (1991) uses her questioning skills in her work which focuses on Gestalt imagery. She feels that it is important in therapy for her clients to be able to visualize a whole image. She points out that some individuals are unable to visualize a complete image during language communication and that, despite having good communication skills, they are sometimes unable to embrace the meaning of some verbal interactions such as understanding directions, a joke or group conversations. She describes this as being one of the main causes of dyslexia. She uses her questioning skills to help her dyslexic clients to illicit more specific information. Nanci showed her clients pictures and ask her clients to describe in detail what was happening. The questions she asked included ‘What does it look like?, ‘What shape is it?, ‘What colour is it?, ‘Where did it happen?’. What mood is being evoked?, and so forth. This form of questioning helps her clients to understand the elements of the image. Questioning using choice and contrast provides the client with more control of the images presented to him. Later, Nanci uses her questioning to ask the client what words can be used to describe an object or a person; finally, she asks the clients how to describe stimuli using sentences.

But I feel that in the consulting room, if one uses what and how questions, one challenges the client to think about how he or she behaves, feels and thinks in the moment. Perls (1967) spoke of the ‘safe emergency’ of the situation. During the interaction with Gloria, it seemed as if he believed that the confrontation was safe and that by accepting our actions we can move on to understanding our reality. He constantly challenged Gloria by asking how and what questions in order or her to act authentically in the here and now. And, during this ‘playful’ exchange, he was encouraging her to be able to interact successfully with him so that she could then do it with other people.

When Gloria says that Perls was not sharing her pain and anger, and that he was detached, Perls asked the question, ‘How should I be?’, and ‘Tell me you fantasy; How should I behave?’ With these questions, Perls is encouraging Gloria to accept her ‘authentic’ feelings.

These questions are very helpful in Gestalt therapy, and I would be happy to use these sorts of questioning in psychotherapy where appropriate.

 

A Critique of Tracy Anderson’s Diet: Weight Loss Diets and Hypnotherapy

A Critique of Tracy Anderson’s Diet

The following report looks at a diet which has become popular with some celebrities recently—it is similar to the ‘Baby Food Diet’ (Anderson,  2009; Aniston, 2010; Cole, 2010) but, as we shall see later, although it claims to be a new, special diet which ‘kickstarts’ the body in a form of ‘self-renewal’, it is essentially another version of the baby food versions. This method is the Tracy Anderson Diet. Tracy Anderson was originally a dancer who struggled with her weight. Now, Tracy is highly successful entrepreneur who practises what she preaches: she has also been very popular as a personal trainer and ‘nutritionist’ to some top stars in the acting and singing profession, including Jennifer Lopez, Penelope Cruz, Nicole Ritchie, Shakira, Madonna, Courtney Cox, Gwyneth Paltrow, Shakira and Cheryl Cole. In fact, Tracy helped Cheryl lose weight before she was employed as a host on the X-factor.

Tracy begins most of her introductions to her diets by pointing out that diets have negative connotations. She quite rightly says that many of us eat on the go and ingest the wrong types of foods—for example, salts, fats, sugars and complex carbohydrates—because we are so busy. She also points out that many of us need to re-learn how to enjoy eating food and to build a positive relationship with food in general. However, after this very positive introduction, she goes onto say that, for the first 90 days, one needs to go on a strict eating and exercise regime before one can hope to enjoy eating meals ‘normally’ again. She also points out that it will be unlikely that anyone will be able to go out for a party during both phases of the diet, and that, apart from the occasional glass of wine, alcohol is not allowed, and any substitutions from her strict menu is strictly prohibited.

The 90 day diet (Anderson, 2012) is divided into twelve weeks, and individuals are expected to alternate between ‘nutrient boost weeks’ and ‘body reset weeks’. During a nutrient boost week, the meals are very small indeed, and many of the meals are purified. Tracy says that it is not a cleansing week, and yet she does suggest that this regime will help to detoxify the system. Throughout the body reset week, dieters will return to three meals a day. You can drink as much tea as you like, and should drink a lot of water; you may also drink one glass of red wine or white wine a day. She points out that it is important not to add any oils, sugars or herbs to the diet and the regime should be kept strictly with no substitutions. The nutrient boost weeks have the same format for each day, as follows:

Breakfast

Green Juice (which consists of kale, and an apple)

Each Day (in any order)

Chicken or Tofu Protein Soup

Kiwi Basil

Blueberry Apple Sauce

Sweet Potato Corn

Choco Chestnut Pudding

Gazpacho

The food for the body reset week is a bit more interesting and less time consuming to prepare. The breakfast, unfortunately, consists of the ‘green juice’ but the first ‘meal’ that she suggests comprises turkey bacon and some fruit—one can also vary the protein from day to day. On other days, one can eat both protein and vegetables. The following is a suggestion for the first meal.

Pick one item from the protein list and one from fruit list.

 

 

Protein Options

2 Hard Boiled Eggs

2 Poached Eggs

4 Pieces of Turkey Bacon

Fruit Options

1 Cup of Blueberries

1 Cup of Blackberries

1 Cup of Raspberries

1 Green Apple

1 Kiwi + 1⁄2 Cup of Blueberries

1 Cup Frozen Blueberries + 1⁄2 Cup of Vanilla Almond Milk

Other options for meals include ½ grilled chicken breast, 3 slices plain tofu (grilled), a turkey burger patty, chopped kale, black beans, ½ avocado topped with cucumbers and tomatoes, spinach, jicama, green peppers, yellow pepper, tomato, parsley, radishes, red peppers and celery. However, in meal 2, one can only choose one protein and one vegetable from the following list:

Protein Options

1⁄2 Grilled Chicken Breast (without oils or skin)

3 Slices Plain Tofu (grilled)

1 Turkey Burger Patty (no breadcrumbs, mayonnaise)

1⁄2 Cup Black Beans

Vegetable List

1⁄2 Avocado (topped with cucumbers and tomatoes)

Handful of Chopped Kale (you may add lemon or lime to season)

Handful of Chopped Spinach (you may add lemon or lime to season)

Handful of Chopped Jicama, Green Pepper, Yellow Pepper, Tomato, Parsley,

Radishes, Red Peppers and/or Celery

There are also combined meal options in which means that one can have a dessert as well. For example:

 

Combined Meal Option

Tuna Fish (in spring water)

1 Tablespoon Yellow Mustard

1 Teaspoon Cayenne Pepper

1 Chopped Celery Stick

1⁄2 Chopped Red Pepper

Dessert

Choco Chestnut Pudding

1 Frozen ‘Function Drink’

Blueberry Applesauce

Finally, meal 3 consists of a ‘Thick Thin Bar’, ‘Kashi Go Lean Crunchy Bar’, or a ‘Kashi Go Lean Roll’.

The overall 90 day plan can be set out as follows:

Nutrient Boost Weeks

 

During these weeks, participants eat the small meals which are set out by Tracy Anderson. The foods have nutrients but are very small indeed.

 

Body Reset Weeks

Here, participants go back to eating three meals a day. There are also food choices for these weeks, and Tracy advertises a food bar as a replacement. Participants are also allowed a glass of wine per day. The regime can be set out as follows:

 

The 90 Day Eating Schedule

Week 1: Nutrient Boost Week

Week 2: Body Reset Week

Week 3: Nutrient Boost Week

Week 4: Body Reset Week

Week 5: Nutrient Boost Week

Week 6: Body Reset Week

Week 7: Nutrient Boost Week

Week 8: Body Reset Week

Week 9: Nutrient Boost Week

Week 10: Body Reset Week

Week 11: Nutrient Boost Week

Week 12: Body Reset Week

The diet sounds strict already before one takes a look at the ingredients in each of the dishes. I have included the main recipes here below:

 

Recipes

 

Green Juice (8 ounces)

1 Bunch Kale (chopped)

1 Apple (peeled)

Juice thoroughly and chill.

Chicken Protein Soup (8 ounces)

Peeled and Chopped Carrots (½ cup)

Chopped Celery Stalk (½ cup)

Boneless Chicken Breast (2 ounces), or Tofu [cubed]

Low-Sodium Chicken Broth, or 2 cups low-sodium vegetable broth (2 cups)

Chopped Broccoli Spears (1/2 cup)

Chopped Fresh Parsley

Fresh Cracked Pepper

Simmer the carrots, celery, and chicken or tofu in the stock gently for 20 minutes,

then add the chopped broccoli and cook for an additional 10 minutes. Add the

parsley, season with black pepper, and serve.

Kiwi Basil (4 ounces)

4 Kiwis (peeled)

12 Basil Leaves

½ Orange (juiced)

Puree and chill.

Blueberry Applesauce

1 Medium to Large Apple (quartered, cored, and steamed)

Fresh Blueberries (½ cup)

Blend the steamed apple in the food processor with the blueberries.

Sweet Potato Corn Pudding (4 ounces)

1 Sweet Potato (peeled and diced)

1 Ear Fresh White Corn

Steam the sweet potato. Slice the corn off the cob. Combine ingredients

in a food processor and puree, adding water as needed until you have

the right consistency.

Choco Chestnut Pudding (4 ounces)

1⁄2 Cup of Semi-Sweet Chocolate Chips

Cooked chestnuts (2 tablespoons)

Unsweetened Cocoa Powder (1 tablespoon)

4 Whole Pitted Dates (prunes or dried blueberries)

Unsweetened Coconut Flakes (2 tablespoons)

Water (½ cup)

Melt the chocolate chips slowly in a double boiler. Puree the rest of the

ingredients. Add the melted chocolate and pulse until all the ingredients

are combined. Add the water and make sure it has a soupy consistency.

Tomato Gazpacho (8 ounces)

Chopped Mixed Bell Peppers (¼ cup)

Chopped Cucumber (½ cup)

Cored and Chopped Sweet Apples (¼ cup)

Chopped Red onion (1/8 cup)

Chopped Fresh Tomatoes (1 cup)

Chopped Fresh Chives (1 teaspoon)

2 Teaspoons Chopped Fresh Cilantro (2 teaspoons)

Pinch of Paprika

Pinch of Cayenne Pepper

Pinch of Black Pepper

Puree the first four ingredients in a blender for few seconds to a small dice, then

add the remaining ingredients and pulse until combined. Excess liquid can be drained.

In the first instance, it is important to point out that Tracy Anderson has made a huge amount of money as a personal trainer, entrepreneur, ‘nutrition expert’ and ‘fitness advisor’: these diets are extremely expensive to maintain especially as Tracy herself points out that there should be no substitutions made. For instance, during both body reset and nutrient boost weeks, one would need to go shopping daily or at least every other day to make sure that one’s ingredients are fresh, and one’s fridge will need to have a permanent supply of herbs, fruits, fresh vegetables and meats. In addition, certain ingredients—for instance unsweetened coconut flakes and unsweetened cocoa powder, Kashi Go Lean bars and so forth are extremely hard to come by. Dieters would need to search health food stores in the local area and then pay over the top prices for each separate ingredient. ‘Ear Fresh White Corn’ is also very difficult to find outside the United States of America.

This strict diet is time consuming during the week, especially during the nutrient boost week and may cause significant problems in a social context. For busy people, the dishes would mean getting up very early indeed, or spending an entire day preparing the produce for the whole week, putting foods into small containers and labelling each meal type. For this period of time, you will not be able to visit friends for a meal or for a drink, unless you have just one glass of wine (or nothing at all) and bring your own food. The soup sounds appetizing but when you evaluate the ingredients it is more or less another puree like the ‘baby food diet’. The ingredients are as follows: two ounces of chicken (or tofu if vegetarian), chopped carrots, celery, two cups of low-sodium chicken broth, ½ a cup of chopped broccoli spears, parsley and some cracked pepper. Sound appetizing? In essence, Tracy has very cleverly called this baby food a soup in order to give the dieter the feeling that he or she is eating ‘real food’. Further, on the page which outlines the diet, Tracy has made a point of adding the heading ‘No Restaurants or Parties’. It seems clear from this message that the diet, with its ‘no substitutions policy’, will affect the dieters’ social life and overall happiness. Indeed, not only are the foods boring but the exercise regimes—for example, the daily pilates-type toning movements and cardio work—are for most people uninspiring and repetitive. Apart from the chicken soup which includes real chicken, carrots and broccoli, and the Kashi crunchy bars in the body reset weeks, you are unlikely to chew very much for weeks on end. The rest of the food is blended or processed and will all look like various forms of baby food, and will take a great deal of time to make. At the end of each day, most dieters will feel hungry and many have reported that this affects sleep (Author, 2011).

With the hype that celebrities cause in modern-day society and the way in which many young women try to emulate their heroines, their clothes body shape and physiognomy, it is little wonder why this diet has become so popular. People even talk about getting a ‘celebrity body’. This diet, with its advertising and examples of ‘beautiful’ physiques lures young women into the clutch of mass advertising and the world of Hollywood. Even some of the advertising on the website uses hypnotic communication. In the example below, Tracy, knowingly or otherwise uses an implied causative (Yapko, 2003; Kaplan, 2007) to intimate the inevitable success of this approach (Anderson, 2012, p1):

‘And as you see the changes in your body, see the pounds melt away and a new, sexy shape emerge, your commitment will only grow stronger’.

Indeed, Gwyneth Paltrow and Tracy Anderson are now partners and have released a book entitled ‘Tracy Anderson’s 30 Day Method’ (Anderson, 2010) and produced four highly successful exercise courses on DVD. In fact, if one looks at the advertisements and the comments on this diet on the internet, it is clear that the dieters have to ‘buy in’ to the Tracy Anderson method, without exception, in order ‘to succeed’. Many feel compelled to buy a complete range of materials including the books, the exercise DVDs, and a box set, entitled ‘Metamorphosis’, which one can only start if one has completed the ‘30 Day Method’. All the merchandise in this collection are expensive and are aimed at getting you hooked on the approach. Participants on chat forums and internet discussions lines are told to ‘trust in Tracy Anderson’ and to ‘believe in the method’: these statements sound distinctly as if this regime has become some form of cult.

More alarming is the effect this diet will have on the body. According to Tracy, she recommends that we all follow her diet and exercise 1 ½ hours to 2 hours a day, six times a week. The videos consist of toning exercises which are repetitive and lengthy: indeed, both Tracy and Gwyneth do not recommend running because of the fear that this will build unwanted muscle in the thigh region. After a period of time some dieters may experience unwanted effects on the body including lethargy, loss of concentration, mood swings and.or dizziness. But this is the beginning. If one stays on the diet for too long, even with the body reset weeks, problems can become greater still. The effect of the stress alone on the body can be enough to cause problems in the immune system which, in turn, can lead to psychosomatic problems or other more serious conditions. Tracy, for example, put a huge amount of strain on her dieters, insisting that they keep rigidly to the rules and measure their wastes—of course with a special Tracy Anderson tape measure—every ten days. Dieters are also told to weigh themselves at regular intervals. This can build into an obsession with body size which may also lead to anorexia nervosa and/or bulimia nervosa (Kaye, Klump, Frank & Strober, 2000). Some women complain that their periods are not regular and this can lead to amenorrhea, due to an endocrine disturbance. Indeed, apart from the use of specific medication and hormone imbalance (for instance, polycystic ovary syndrome, thyroid malfunction, pituitary tumour and premature menopause), there are three main reason for causing amenorrhea or an irregular menstrual cycle in young women—namely, stress, low body weight and excessive exercise. All three problems can be caused by this diet.

On closer analysis, if following the regime is adhered to strictly, dieters will be eating approximately 700 calories a day which is not adequate enough to be healthy. It also lacks the fibre and the vitamins that one needs on a weekly basis. Further, it does not contain the calcium, iron, salt, proteins and carbohydrates that one requires to function normally. This can lead to loss of concentration, muscle strength, exhaustion, lethargy and hyponatremia (low levels of sodium) and the low levels of iron can lead to anemia. And, as dieters get better at hiding their hunger, the problems will worsen: in extreme circumstances, some dieters might begin to suffer from regular episodes of constipation or might able to feel full after a small quantity of food (Gross, 1984). Some individuals, of course, might experience the other extreme, IBS-D (diarrhoea predominant IBS), as a result of eating too much liquid food. Further, in some situations, dieters might begin to suffer from from bradycardia (Kollai, Bonyhay, Jokkel, & Szonyi, 1994). These cardiac abnormalities may be associated with hypophosphataemia and delirium (Beumont & Large, 1991). Other dieters may suffer from osteoporosis: indeed, Gwyneth Paltrow herself has already been diagnosed with suffering from this condition already. It is clear here that some of these extreme problems are those which are associated with anorexia but, even after a period of two months, some of these associated problems may begin to emerge. Further complications include thiamine deficiency (Smith, Ovesen, Chu, Sackel, & Howard, 1983), zinc deficiency, dry skin and sunken eyes (Voorhees & Riba, 1992; Katzman, 2007).

Some of the messages given by Tracy also encourage perfectionism, something can never be achieved. On her website, Tracy claims that her diet is a, ‘regimen to help you get that perfect physique in the shortest time possible!’ Even the running title to the Metamorphosis programme (‘The weight-loss kick-start that makes perfection possible’) may suggest to impressionable minds that this diet will help them achieve a ‘perfect body’, while she describes her approach as ‘Tracy Anderson’s perfectly healthy diet’. This theme continues with the ‘perfect sit up’, the ‘perfect performance wellness shake’ and the ‘perfect dancer’s body’. This striving for perfectionism, obsessive dieting and exercising can lead to anorexia (Kraft & Kraft, 2006), malnutrition and/or depression.

Of course, it is more common for individuals to spend huge amounts of money on this diet only to return to regular routines, binge eating sessions and/or fatty processed foods. A change in diet should involve a lifestyle change which incorporates some realistic rules, healthy smaller-sized portions and some regular exercise (Biddle, 2012). Extreme diets, for example, in helping individuals suffering from obesity, should only be employed if it is monitored closely by a health professional. Tracy gives some excellent tips on exercise, particularly the cardio workout and lower body exercises; however, her generalizations on how to build smaller muscle groups do not account for compound movements in her exercises, and her understanding of basic anatomy is limited. There are also no warm ups or cool downs on the DVDs. Certainly, by telling individuals to stop all other cardiovascular activity and only to do her work-out is not only controlling but is also absurd. Further, she gives a great deal of advice about what to eat over a long period of time but it is important to note that she is not a dietician. The book contains a great deal of tips on exercise, some inspiring phrases to help you continue with the diet; however, there are very few recipes and little, if any, information on nutrition. Ideally, if you are involved in a sport regime, you should increase your calorie intake—certainly the intake of carbohydrates before exercising—unless you are eating too much in the first place.

As more and more men and women become obsessed with celebrities, their clothes and bodies, more of these diets will go on the market. There is nothing magical about this diet. It does not, as Anderson puts it, help you to, ‘rediscover your relationship with food so that you can sit at the table and enjoy a meal without worrying about how it will impact your weight’ (Anderson, 2012, p1), nor does it, ‘detoxify your system and recalibrate how you think and feel about food’ (Anderson, 2012, p1). It is a 700 calorie a day regime which is based on pureed foods which do not give you an adequately balanced diet; and, if this combined approach of dieting and exercising is followed meticulously, it is likely to have a deleterious effect on an individual’s health and overall sense of well-being.

Weight Loss Hypnotherapy

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If you are overweight, phone 0207 467 8564 now for an appointment.

Others, who are just over weight by a few pounds who would like to get back to their optimum weight, please phone for a healthy weight coaching session.