The 'talking cure' is meant to solve depression. But could it be worsening it by disturbing your sleep, asks Sylvia Thompson
The image is ingrained in our culture: the patient on the couch for his weekly hour of therapy, the next small step in his talking cure. But a new approach to psychotherapy claims that too much talking can make your problems worse. It means many psychotherapists and counsellors are unwittingly doing more harm than good, according to Joe Griffin and Ivan Tyrrell, the authors of a new book, Human Givens.
Griffin, who runs a psychotherapy practice in Athy, Co Kildare, when not training health professionals in Britain, says: "The model of psychotherapy based on the idea that we store up emotions from our childhood is simply not true. And the hit-and-miss emotional ventilation of problems used by many psychotherapists often leaves people more disturbed afterwards."
Griffin and Tyrrell, whose approach is based on reducing "emotional arousal patterns", claim the Freudian approach to mental illness has hijacked psychotherapy for the past 100 years. They also argue that other therapeutic approaches can compound problems by encouraging clients to go over excessively negative thoughts and feelings. And they question the suitability of the "critical incident debriefing" commonly used to help treat post-traumatic stress disorder.
The "human givens" are basic emotional needs that Griffin and Tyrrell say are essential to mental health: a sense of control over our lives, an emotional connection to others and a sense of meaning and purpose that stretches us mentally and commits us to something bigger than ourselves.
Their theory, which is particularly relevant to depression, has it origins in sleep research by Griffin, who says he realised his dreams symbolised unresolved emotional issues from the previous day. He concluded that dreams are the brain's mechanism for "deactivating" the day's outstanding issues.
The problem seems to be that we are remarkably active when we dream: our brains use more oxygen than usual, our heart rates increase and we move more than we do during deep sleep. Our eyes also move jerkily, giving rise to another name for the time when we dream: REM, or rapid eye movement, sleep.
It is known that depressed people have more REM sleep than the average person. "It is also known that antidepressants reduce REM sleep," says Griffin, who concluded that excessive REM sleep was the result of excessive worrying the previous day. Too much REM sleep means less "slow wave" recuperative sleep, leading to the exhaustion and clouded thinking that are fundamental symptoms of depression.
"The excessive dreaming of a depressed person drains the energy they need for normal arousal of attention, leaving them unable to motivate themselves or draw any sense of meaning out of their everyday activities," write Griffin and Tyrrell in Human Givens.
Griffin and Tyrrell believe that the priority in treating depression and other mental-health problems with similarly distorted emotional arousal patterns is therefore to lower emotional arousal and stop patients from introspecting negatively. The key to doing this, they say, is to calm patients with relaxation and guided-imagery techniques, similar to hypnosis, before working on ways to solve their problems.
Griffin and Tyrrell believe hypnotic trances are similar to REM sleep, meaning they can be used therapeutically, to allow the natural processing they say REM sleep is designed for. Most of the patients they have tried it with needed no more than six sessions of psychotherapy, according to Griffin and Tyrrell.
"All depressed people are very stressed out physiologically. All their worrying shuts off the frontal cortex of their brain, whose function is to recode events as being in the past and only of limited relevance to the present.
"In therapy you've got a window of opportunity to relax them temporarily, so that they can see their situation is not so hopeless. If they worry less, they will dream less and be less tired the next day. Then you can tackle other issues, like the need to take exercise, mix with friends and do things that make them feel good," says Griffin, who adds that human-givens therapists also teach conflict resolution and relationship skills.
In line with their unorthodox take on depression, Griffin and Tyrrell dispute a standard theory of the condition, which is that it is caused by a chemical imbalance in the brain. "Depression is doubling every 12 years. It would take thousands of years to increase a disorder which was genetically controlled by that amount," says Griffin. He and Tyrrell believe the low serotonin in the brains of people with depression is a result rather than the cause of their condition.
Griffin says depression is on the rise because people's emotional needs are not being met, particularly if they have rejected organised religion. "Many haven't found a replacement for it. Also, Irish people now are stressed and not stretched. And those who believe that an increase in material wealth will result in an increase of happiness haven't even begun their psychological education."
They seem to have their supporters. Through MindFields College, part of the European Therapy Studies Institute, which they founded in Sussex in 1992, they run seminars and workshops in a variety of areas for more than 12,000 health professionals a year, with most of the participants funded by the National Health Service.
But Griffins admits their approach has also met significant hostility. He recently told New Scientist magazine: "We'd get massive walkouts of people trained by the Tavistock Institute in London and places like that. This happens because schools of therapy tend to degenerate into ideologies and don't work with real knowledge. They become cults, with sacred texts and high priests. Then they tend not to be open to new ideas."
Griffin and Tyrrell are also at odds with the British Association for Counselling and Psychotherapy, which accredits only practitioners who have themselves had at least 40 counselling sessions. "Perhaps one of the biggest bars to the advancement of therapy in Britain is the criterion used for recognising properly trained therapists," Griffin told New Scientist. "They should only concern themselves with what works and assessing how effective an individual counsellor or therapist actually is in practice."
A significant problem is that, whereas many psychological theories are backed up with peer-reviewed research, human-givens theory hangs on Griffin's analysis of his own dreams. Ian Robertson, professor of psychology and director of the institute of neuroscience at Trinity College in Dublin, says in Human Givens: "I am dismayed at how counselling and psychotherapy practice in many areas has become wilfully divorced from evidence and science to the extent of becoming self-perpetuating cults in some cases. No one has the right to pick and choose a theory as a matter of personal preference and then offer it as a service to someone when there is a possibility that that service might do harm. We have to move towards evidence-based practice and away from cults and ideologies."
Prof Robertson told The Irish Times: "There are hundreds of therapies with thousands of people trained in them, but one cannot endorse a therapy whose effectiveness has not been demonstrated in published research in peer-reviewed international scientific journals.
"I would appreciate if Joe Griffin could let me have copies of the published research demonstrating the effectiveness of his therapy, as I have been so far unable to find published work on this in the relevant scientific databases."
Human Givens: A New Approach To Emotional Health And Clear Thinking, by Joe Griffin and Ivan Tyrrell, is published by Human Givens Publishing, £25 in UK. Inquiries to 00-44-1323-811662