Understanding, Coping skills and Safety First
Treatment of PTSD begins with understanding exactly how the trauma has affected a person as similar events can hold very different meanings to different people. Next, a range of coping skills (like relaxation strategies) are taught to assist with the high levels of distress that may occur while reprocessing traumatic memories and between sessions. 

Once the client feels safe, therapy would move on to working through the trauma and reprocessing it in an atmosphere of support so the client is able to process the traumatic memories and finally put them behind them.

Medication may also play a role in treatment, particularly if psychological therapy is not available, or the client has not benefited from therapy. Either way, if insomnia is a problem, this should be treated, as sleep deprivation aggravates the condition.

Feelings, Thoughts and Body sensations
Trauma has many components that need to be targeted in therapy. Along with intrusive traumatic memories and images, and high levels of emotional distress, people often have negative beliefs about themselves and strong bodily sensations.  Sometimes they cannot put into words what has happened so a therapy that involves more than just talking about it is needed. In fact, just talking about major traumas can make things worse as it may get the person in touch with painful emotions but does not help them process them at an emotional level.

EMDR
EMDR (Eye Movement Desensitization & Reprocessing) is one of the two evidenced- based therapies recommended in the Australian Guidelines for the Treatment of Adults with Acute Stress Disorder and Posttraumatic Stress Disorder. In addition, the World Health Organisation (WHO) recommends EMDR for treating trauma-related conditions in adults and children.

EMDR provides the therapist with a structure that guides the client through their trauma and helps them to reprocess what happened, learn from it and put it behind them. Read this article to see why I prefer EMDR over other treatments for trauma.

I have just returned from a three day training in Compassion Focused Therapy (CFT) with Professor Paul Gilbert who founded this ground breaking therapy. CFT uses understandings of the evolution of our brain and how the brain works to harness a powerful resource we all have within us. This resource will allow you to manage negative emotions and transform the way you relate to yourself and others. What is this resource? You guessed it - Compassion.


Three brain systems
In CFT, we learn that our brains have evolved to have three different systems to help us manage our emotions and feel better. They are:
1. The “threat system” which puts us into the mode of threat detection and self protection. It is associated with feelings of anger, anxiety, disgust, blame, shame and sadness. 
2.    The “reward system” which involves excitement and craving and feeling better by pursuing, achieving and consuming.
3.    The “caring soothing” system which involves compassion and kindness and facilitates calming of distress and feeling safe through connecting and relating with nurturing others.

These systems operate in different areas of the brain, and have different neural pathways which involve different neurotransmitters. This leads to particular patterns of feelings, body sensations, thoughts and behaviours associated with each system. They will all feel different in the body and we can all activate them by using our imagination. 

Choice
We all have access to these different systems at any time.  However, our default state is to be in the “threat system”. Our western society gives us the message that the way to solve this and be happy is to shift into the drive system of competing, consuming and achieving. CFT highlights the alternative system we have access to, of caring and kindness to self and others. With practice, we can learn to master the art of choosing which system we activate.

For example, we can learn to shift modes from defensiveness and anger to self soothing with compassion and being kind to ourselves. This will calm us down so we are not so overwhelmed, and can then engage with the world in a way we aspire to be.  If our way of self soothing is to routinely shift into the reward system of compulsive eating or working, we can train ourselves to shift into the mode of compassionate behaviours and thoughts towards ourselves.

In some situations, we do want to be protecting or achieving. The question is, if you could develop the skills, which one would do you choose to activate - which would serve you best in which situations? Which system offers you the most benefit when dealing with the challenges of life? 

How to develop skills so you can choose
We have the capacity for great cruelty, aggression as well as caring and kindness. What we focus on can shape our brain as it will activate certain brain circuits. For those of you who have grown up in a home characterised by criticism, any form of abuse (or absence of nurturing, protection or guidance), the compassionate system may be under-developed, with the threat system being highly developed. For example, you may have become highly self critical as a way of monitoring yourself to avoid stirring the anger of abusive parents. This helped you to survive and is not your fault.

The good news is that because the brain is neuroplastic  you can strengthen the caring, connecting system by practising compassionate and loving kindness meditations. And this is what CFT is all about. 

Wisdom, Strength and Commitment
The compassionate resource of CFT is not wishy washy, weak or self indulgent. It is a powerful presence that combines three attributes - wisdom, strength and a commitment to your well being:

Wisdom
Your compassionate resource has the wisdom to know that our minds are (as Professor Gilbert says) “tricky....complex and chaotic, dangerous and crazy”. We have evolved to crave, to love, to grieve, to fear, to be defensive and aggressive, to compare and strive to be better than others, with a negativity bias to noticing deficiencies and threats. And our brains seek permanence in a world of impermanence where we will ultimately lose everything we care about.

Moreover, we inhabit a fragile body, and are subject to all kinds of random adversities and health issues. And who we are is a function of the genes we inherited and the environment we grew up in – both out of our control and not our fault. Your compassionate resource knows all of this and that we are all trying to do the best we can with what we have in the midst of this challenging life.

Strength
Your compassionate resource comes from a grounded, present centred place in the body which is strong. It is solid, like a mountain. It is a resilient part of you that has been able to tolerate great distress and has persevered in the face of many difficulties.   

Commitment to your well being and happiness
Your compassionate resource is totally committed to be as helpful to you and others as possible. It has a genuine desire for you to have a joyful life and to nurture your personal growth and inner peace. It delights in the idea of you being free from suffering. It understands and validates your feelings.

Compassion Focused Therapy Techniques
CFT involves developing your compassionate resource and then learning (through particular therapeutic exercises) to identify, understand and disengage from the part of us that criticises and puts us down (i.e. the “Inner Critic”). This approach differs from some other therapies which set up a struggle with the Inner Critic by trying to get rid of it or argue with it. 

As the compassionate resource has the powerful combination of wisdom, strength and commitment to your well being, it is the better authority when it comes to running your life. So it is the authority you can trust when it comes to deciding who to believe – the self critical thoughts that deflate you, or the kind thoughts that enable you to engage fully with whatever life throws at you.

CFT and ACT
CFT melds very well with Acceptance and Commitment therapy (ACT) which also aims at detachment from negative thinking so you can do what matters to you. In CFT, compassion is not to soothe away negative feelings, but to help you be with the pain that is inevitable in life. As with ACT, this allows you to engage fully with life in the midst of painful feelings, so that you are not overwhelmed by what is happening at the time, and you can take life affirming actions.

Surprise yourself
The compassionate pathways in the brain can be activated by using your imagination (in guided visualisations), with a loving body posture, tone of voice and facial expression and kind words to get into a state of compassion, the way a “method actor” would.  Repeatedly activating these pathways with daily practice will lead to you developing a resource that may surprise you one day when you hear a loving kind inner voice soothing you at a time of distress.  It will seem like a voice, coming from out of nowhere, that is wise, strong, and committed to helping you and nurturing your personal growth.

What if I can’t do it?
For many of you, allowing yourself to receive compassion will be very challenging. You may feel you do not deserve kindness and compassion.  Do not give up, as repeated practice will eventually over ride old learning. You may have to fake it until you make it - one of the few times it’s appropriate!  As a start, rather than sending yourself peace and happiness, Professor Gilbert suggested the words “May the part of me that resists compassion for myself find peace”.

Try this for a couple of weeks, just three or four minutes a day and then re-evaluate.  A good time is just before sleep and upon awakening – a great way to start your day. You may also consider seeing a therapist to help you with this if you find yourself struggling.

Free audio guides
I invite you to use my free loving kindness meditation mp3 to guide you in developing your own compassionate resource and begin to transform your relationship with yourself and others. For additional free audios to help you develop compassion, see Paul Gibert's , Kristen Neff's or Chris Germer's websites on compassion. For even more  free loving kindness audios by a leading psychology professor who has done ground-breaking research into how love and other positive emotions enhance your life, go to  Dr Barbara Fredrickson's website here.

The key to managing urges is to delay taking action. Delaying helps in three ways:

1.    If you delay acting on the urge until you have allowed some time to pass, it may recede and then be easier to resist.

2.    The delay allows you time to think about what action you will take – an action in the direction of your values, or an action that is against the way you aspire  to be.

3.    Giving into an urge when it is at its peak will strengthen the brain pathways related to giving into this urge. Delaying may mean the tide has time to turn, and the urge has started to recede. So you are giving in when the urge has started to reduce, which will not reinforce the unhelpful behaviour as much as if you gave in at its peak.

The Five Minute Rule
Make a deal with yourself to wait five minutes and then re-evaluate the urge – you may find that the five minute wait is enough time for the tide to turn. A simple way to delay is to just ground yourself by connecting to your breath. Mindfully observe the in breath and the out breath for five minutes.

Shift brain systems
If you have an urge (e.g. to eat or work) your brain is using the “drive/reward” system to feel better. You can choose to shift the brain into an alternative way of self soothing by activating the “caring soothing system” involved in self-compassion. This shift can be started by putting a facial expression of kindness on your face, and visualising a compassionate figure talking you through (with a gentle voice) what to do. For more about this, see article on Compassion.

Make P-E-A-C-E
For a more comprehensive approach, use the P-E-A-C-E exercise to guide you. Making PEACE with your urges means you:

Pause

Examine and

Allow the urge, with

Compassion for yourself, before choosing to

Engage with life enhancing actions.

The first four steps of PEACE will help you delay acting on the urge, so that when you take the final step of PEACE and do engage, your action is determined by your values and not your urges.

Follow this link for a free guided MP3 of the P-E-A-C-E Meditation Exercise.

We all have urges
Have you ever thought about how many times in a day you have an urge to do something that you do not give in to? Urges may relate to everyday, real physical urges to scratch an itch or go to the toilet or quench your thirst when it is not convenient. If you are a procrastinator, it may be urges to avoid doing something unpleasant or tedious that should be done. If you are a workaholic, it may be urges to keep working. You may have urges to check email, facebook and text messages.

Then there are urges to ask for reassurance when worrying about something. Urges to lash out at someone or smash things when feeling angry. Urges to avoid things that make you feel anxious. Urges to gamble or surf the internet, to drink, smoke or do any other addictive behaviours.

Not to mention urges to criticise or say something that part of you knows will only be unhelpful to a relationship (but you really want to say it!). Urges to eat junk food you have just seen advertised. Urges to buy items on sale. The list goes on and on!

We all have urges, and we have them many times a day ... yet many times a day we do not give in to them. Imagine a world where everyone gave into every urge they had? How chaotic would that be? Clearly we all have learned the skill of not giving into urges. You have the capacity to do this already. You resist urges regularly, and they inevitably pass. 

Urges are tidal
But there are times it is easier to resist and wait for the urge to pass than others. And sometimes, with certain things, it feels impossible not to give in. Not that it is impossible, it just FEELS impossible.

The thing to remember about urges is that they will always pass. Urges are like tides. A tide will gradually get higher and higher and then reach a point where it turns and gradually recedes again.  

Even big urges and compulsions will subside with time. High tides – no matter how big, will always go out again. People fear if they do not give in to the urge, it will keep building. But think about it - even king tides turn and recede. Remember all those times you have not given in to urges, and they have passed.

How to resist urges
So you know you have the capacity to resist an urge. But what to do when you are feeling that the tide is building and you don’t think you can resist? This is where the PEACE exercise will help you. Think of it as making PEACE with your urges. Use the letters of the word PEACE to remind you of what to do. Follow the same steps as you do with making peace with strong emotions. PEACE will provide a structure for you when resisting the urge to give in is more challenging.

P-E-A-C-E
To make peace with your urges –
P- Pause, and take a few breathes, then mindfully... 

E- Examine the urge, notice where you feel it. Notice the thoughts that go with it ......“I have to have it”..... “I must do it”.... I can’t stand it”.... “It’s ok just this once”..... “I deserve it”.

A- Allow these thoughts to come and go, like people passing you in the street. Just like people, thoughts come in all varieties – some may be helpful and some may be harmful. Some thoughts may urge you to give in and feed your urge. Other thoughts may be trying to talk you out of giving in. Either way, they are just thoughts that are popping into your head. Allow them to come, allow them to go.

Know that the urge is tidal and it will eventually start to recede if you give it time, regardless of what you think or do. So allow the thoughts to come and go. Just as ultimately, you will be allowing the urges to come and go. Allow the thoughts and urges to come and go without judging yourself for having them.

C- Compassion
Next, bring some Compassion to your observing. Be kind to yourself. It’s ok to have urges. You can’t stop urges from showing up. It’s what you do in the midst of the urge that counts. Activate your compassionate brain system by visualising a compassionate figure who speaks kindly to you and guides you about what to do.

By stepping back and examining and allowing, with compassion, you are creating the space for a choice. You can choose what to do with this urge and what you do while you are waiting for the tide to turn. Because it will turn, no matter what you do. The urge will pass. This is the power of delaying.

E- Engage (Actions count more than urges)
So the final step is to Engage with the world with an action that is in the direction of how you want to be when you have strong urges. Picture yourself engaging with the world and making a choice that fits with the life you want to create. 

Compassionate learning
Sometimes, when the tide is high, you may end up choosing an action that is not in the best direction for you. If so, when the tide has receded, use this time to plan how you will act next time the tide is in. Review what made it difficult to resist this time.  Learn what you can from it (with a compassionate stance – i.e. do not beat yourself up about it) and move on with a plan of what you might do differently next time. Imagine and see yourself taking these steps in the future when in a similar challenging situation.


Follow this link for a free guided MP3 of the P-E-A-C-E Meditation Exercise.

This meditation exercise is based on principles taken from Mindfulness Meditation and Acceptance and Commitment Therapy (ACT); Compassion Focused Therapy; and Brain Neuroplasticity. Making Peace with your emotions will allow you to slow down, accept emotions with compassion for yourself and others, and then choose actions that are in line with how you aspire to be in the midst of these strong emotions. PEACE brings together all of these principles to give you a resource to use when strong emotions show up. 

The 5 steps are:

P – Pause
E – Examine
A – Allow
C – Compassion
E – Engage

P – Pause
Take a few breaths to ground you so you are able to step back into the role of an observer. Mindfully watching your breathing, giving yourself some space.

E – Examine 
Examine and observe, with the curiosity of a child, what you are feeling and where you are feeling it in your body. Recognise and label the emotion.

A – Allow 
Accept the “clean distress” of this pure emotion, without adding any judgements or struggles to get rid of it. You open yourself up to feeling it fully in this present moment. Even though you don’t want it, you allow it and lean into it.

 C – Compassion
Soften towards yourself and others with kindness and compassion. Build up new brain pathways of compassion by saying kind words to yourself, the same words you would say to a hurting child or good friend. Activate the compassionate pathways in your brain by putting a friendly, kind expression on your face, perhaps with a half smile. Lay your hand on yourself to send some warmth and kindness inwards, just as you would comfort a child. Cultivate a compassionate witness to your emotion.

 E – Engage
Now that you have paused and examined and allowed your feelings to be there with compassion, you have given yourself the space to choose how you will act. Rather than “reacting” you are in a position to “respond.” You can now engage again with the outside world in a way that lines up with your values and how you would like to be in the midst of this emotion.

Applying PEACE
Initially practice this regularly, at times when you are not that upset, beginning with recalling previous situations when you were upset.  Then move onto applying PEACE in real moments of minor emotional upset, as they are happening. With repeated practice, you will be familiar enough with the process to apply this very quickly in the midst of stronger emotional distress at the time that it happens. Eventually, when any strong emotions or urges show up, you will be able to respond, rather than react, with compassion and in a way that you aspire to be.

Follow this link for a free guided MP3 of the P-E-A-C-E Meditation Exercise.

Loving Kindness Meditation
I recently attended a weekend silent loving kindness (“Metta”) meditation retreat and would like to share with you some of the ideas I learned about this powerful practice. Loving-kindness is a meditation practice in which you repeat phrases that reflect love and kindness, caring and compassion, for yourself and others. While the idea of sending oneself and others thoughts of love and kindness may seem a little flaky, there are compelling reasons for why it is a beneficial practice to follow, particularly if you, like most of us, have a strong inner critic.

Shaping your brain pathways
You may have heard of how neuroscience has discovered that the mind is neuroplastic, – meaning that we can change our brain pathways throughout our lives, not just during the early years of childhood and adolescence. While the scientific evidence of this has only emerged in recent years, I was surprised to learn that William James (who is often referred to as the father of American psychology) wrote (as far back as 1890!) “My experience is what I agree to attend to. Only those items which I notice shape my mind.” What a brilliant mind to recognize that we are now discovering to be true – we can shape our brain pathways by actively choosing what we focus on.

Change your brain
This is how you can change your brain – by focusing on positive experiences and thoughts, you will activate positive pathways that you want to strengthen. By choosing not to focus on and repeat negative thoughts and behaviours, you will weaken negative pathways. As the adage about the brain and body goes – “Use it or lose it”. Here we want to use this principle to help us lose unwanted patterns of thinking and create new ones.

 Activate compassion and love
So how does this relate to Loving Kindness meditations? To develop self-compassion, the idea is to activate compassionate and loving brain pathways by choosing to meditate and repeat such loving thoughts over and over. You already have the capacity for love and kindness within you. If you cultivate it, it will grow. Our teacher also pointed out that the Buddha said you “can’t treat hatred with hatred.” So being harsh with yourself when you notice you are thinking negatively is not the way out of negative thinking patterns. Compassion and kindness to yourself begins the process of forgiving yourself and developing a healthier relationship with the person you want to become.

How to do it
The structure of the loving kindness meditation involves four statements of loving kindness which are sent in turn to each of the following:

•  oneself
•  a benefactor or Mentor 
•  a friend or person you care about
•  a neutral person or stranger
• a difficult person 
•  and finally, all sentient beings 

The four statements are along the lines of:

1. May I (you) be safe
2. May my (your) mind be at peace. 
3. May my (your) body be healthy and free of pain and suffering. 
4. May I (you) have a joyful life.

Feel it in your body
If you do not feel comfortable with the wording of the phrases, feel free to change them to fit with more how you would word it, keeping the themes around safety, inner peace, health and a fulfilling life. The idea is not to use the sayings as a repetitive mantra without much meaning, but to allow yourself to really reflect on and connect with the good intentions you are sending out. See if you can really enhance this connection by feeling the feelings of love and compassion in your body as you focus on the words and meaning behind them and send them to yourself or others. You will find that your mind will inevitably wander as you do this, and when it does, use the phrases to help you refocus and reground.

Free from pain and suffering?
Being an ACT (Acceptance and Commitment Therapy) therapist, I was initially not entirely comfortable with the idea of wishing I or others were “free” of pain or suffering. Not only would this be impossible in the face of the reality of life, it could set up a struggle to get rid of unpleasant emotions which only compounds difficulties, especially if you are grappling with chronic anxiety or pain.

However, the point made by my teacher was that you define “free” as “not ruled by it, not enslaved by it,” so it does not run your life. This would fit in beautifully with the ACT approach with its emphasis on creating a rich and meaningful life in spite of conditions of pain and emotional discomfort. So when we are sending good intentions and wishes for ourselves and others to be free of pain and suffering, we are not really expecting that person to never experience these negative states. We are hoping that such states will not be enslaving them and determining their actions and how they live their life.

A way of coping with unpleasantness
This Loving Kindness meditation can also give you a container in which you can hold unpleasant emotions and body sensations. If you can observe and open up to the fear and pain, instead of struggling to get rid of it, a lot of energy can be freed up to put into things that really matter to you. 

Loving Kindness and Mindfulness
Another invaluable aspect of the loving kindness practice is that it cultivates in you acceptance of all people, be they a benefactor, friend or someone you dislike, you practice sending them good intentions by saying something like “Just like me, may you too have safety peace health, and joy.”  Ultimately this cultivates nonjudgemental awareness, the basis of all mindfulness.

Your own loveliness?
One of the interesting suggestions by the teacher was to begin with reflecting on your “own inner loveliness”.  Such an idea seemed really alien, and quite a stretch especially in our culture which does not typically value the idea of stroking our own egos. Our culture and heritage seems to cultivate within us strong inner critics. Indeed, in the days of primitive man, being aware of our shortcomings had survival value as we would be less likely to annoy the other tribe members.  The risk of ejection from the tribe (leading to probable death) was much less likely if we were constantly seeking and monitoring if we were fitting in and had the approval of others. This was great for the tribe, not so good for the individual. So, “reflecting on our inner loveliness” is not something that comes naturally.

Begin with a smile
So how to begin reflecting on our own loveliness? Our teacher helped us kick start it by suggesting we think over times we had been kind to others.  In addition, when teaching this to my own clients, I begin by asking them to visualize a smile and the body sensations that arise with this smiling imagery.  I invite them to also put a “half smile” on their face. Research has found that intentionally making muscle movements of a smile will generate a positive emotional state as it stimulates certain circuits in the brain. You can activate the compassionate pathways in your brain by putting a friendly, kind expression on your face with this half smile.

Free Loving Kindness downloads
If you would like more guidance on how to do Loving Kindness Meditation, I invite you to go this link where I have some free downloadable mp3s. Here you will find an audio where I take you through a loving kindness meditation, along with additional audios with introductory information and some ideas on how to apply loving kindness in your daily life. For other free loving kindness audios by a leading psychology professor who has done ground-breaking research into how love and other positive emotions enhance your life, go to  Dr Barbara Fredrickson's website here.

Tinnitus and negative thinking
Tinnitus is a noise (often ringing, swishing, buzzing or whistling) that is heard in the ears or head. While the perception of the noise is real, there is no actual external physical noise present. It is very easy to fall into the trap of negative thinking when you are coping with a chronic stressor like tinnitus.  As tinnitus is often made worse by stress, watch your thoughts and check you are not adding to the distress with negative thoughts about it. The more stressed you are by tinnitus, the more aware you will be of it, leading to more irritation and distress.

Psychological Treatment for Tinnitus
There are psychological strategies to assist with getting out of these negative cycles.  Cognitive Behaviour Therapy (CBT) has been found to reduce the distress from tinnitus. More recently, Acceptance and Commitment therapy (ACT) has also been used as treatment for tinnitus. Of the two therapies – and I practice both of them – I think that ACT has probably more to offer for this particular problem. This is because the very essence of ACT is learning ways of managing troubling thoughts, feelings and chronic conditions so they do not stop you from leading a rewarding and meaningful life.   

Clean and dirty distress
ACT makes a distinction between “clean distress” and “dirty distress” when dealing with chronic conditions. The essence of clean distress is that you are just experiencing the pure distress (I’m sad, this is unpleasant) without muddying the waters by adding in further negative thoughts like judgements (I should be able to cope better), assumptions (this is my fault) or predictions (I’ll never be able to cope with this). It also refers to additional feelings about your feelings (e.g. sad about being sad, angry about feeling anxious). So feeling irritated about your sadness over how silence is no longer a peaceful experience for you is “dirty” distress. Judging yourself for being sad would also be “dirty” distress. The sadness itself is “clean” distress.

Stop struggling
Coping with tinnitus also means coming to terms with the fact that it is a chronic condition. This means you need to give up struggling with trying to get rid of it. Instead, the key is to work out how to live around it. While you can shift your attention from it and focus on other things (sounds, people, and activities) in your present environment, it may always be there in the background. 

Trying to get rid of something that you cannot control is also “dirty” distress. ACT teaches you ways of acknowledging and accepting “clean” distress and ways of managing and letting go of the “dirty” distress that could pull you into a downward spiral of further distress. 

Enjoy life around it
Fortunately, you live in a world where this challenging problem can now be managed much more effectively than a few years ago. The essence of managing tinnitus it to learn not to fight it, but to enjoy life around it. Making this cognitive shift to true acceptance can free you up more than you might imagine. By applying these strategies, getting appropriate treatment for tinnitus and becoming an expert at identifying your tinnitus free moments, tinnitus can be relegated to just one of life’s myriad, minor problems.

A clean break or stay friends?
If a relationship breakup is painful, is it better to have a clean break and no contact with an ex, or to try to stay friends? This is a question I am often asked.  Intuitively I felt that it would be less painful and speed up the recovery process if all contact was ceased (at least until the feelings for the ex had receded). It seemed to me that maintaining contact would keep alive the hope that the ex may yet change their mind and is still a possible partner. This would make it harder to get over the break up and delay the process of grieving and moving on.
Up until now, I had no scientific basis for this idea. However, recently I came across what the neuroscientists have to say about love attachments, and how they are formed and broken within the brain. 

Love and Neuroscience
Psychiatrist Dr  Norman Doidge, in his book The brain that changes itself, describes how the connections in the brain are "plastic" and changeable rather than set. Doidge says that when you lose a loved one, you need to cull and reorganize these connections so that new connections and a new love can be formed. He suggests that falling out of love with a past love requires unlearning the pattern of attraction to that love. Old attachment networks need to be broken so new bonds can be formed. 

Use it or lose it
To unlearn the love attachments, Doidge argues that you must first unlearn the idea that the person is in your life and is there for you. This is where the adage about the brain - “Use it or Lose it” comes in. If you stop activating brain pathways of connection and attachment with this person, the circuits will die off to make room for new pathways to be formed.

Stop contact with your ex
So it would make sense that stopping contact with your ex will help with the unlearning of the love circuits in your brain connected to your ex. This may mean “defriending” them on Facebook for an agreed period of time - I suggest you start with three months and then re- evaluate. You must also resist any urges to check up on what they are doing on Facebook or other social network sites.

Just friends in the future?
If you think you would ultimately like to be “just friends” with your ex, discuss this with them before you temporarily “defriend” them. This will avoid them being offended and you can make an agreement to cease contact for a period of time. You can agree to check in every three to six months with a view to resuming a friendship in the future once you feel the love bonds are unlearned.

And then grieve and rewire your brain
Obviously, getting over your ex will involve more than just ceasing contact. You cannot move on and get over the break up unless you also do the painful work of grieving for the loss of the relationship. Doidge suggests that in order for the brain to grieve and let go of a love, it needs to rewire billions of brain connections. This is done by turning on the relevant brain networks by bringing up vivid memories of the loved one, reliving them and then letting the memory go.

Remember the good and the bad
When doing this, it is important to recall both positive and negative memories and feelings. So when you are trying to get over someone, rather than just focusing on how your ex let you down and how much better you are without him or her, you also need to recall what you will miss and those really special times you shared. This will hurt.When doing this, it is important to recall both positive and negative memories and feelings. So when you are trying to get over someone, rather than just focusing on how your ex let you down and how much better you are without him or her, you also need to recall what you will miss and those really special times you shared.  This will hurt. 

Talk and journal
How is this best done? Talking to others about your memories is the most common way to get over someone, although finding an interested listener may be difficult. Also, there may be certain memories you wish to keep private, especially from mutual friends of your ex. You may also risk tiring friends with the finer details of all the ups and downs of your past relationship. One way of dealing with this on your own is to start a private “break up” journal to express whatever feelings you have and recall whatever you can about your time with your ex without any need to sensor what you say. It is important to set aside time for this as well as engage fully with your life outside of these special grieving times.

EMDR can help
Another way is to seek help from a therapist to help with getting over the painful feelings of hurt and loss.  The fastest and most effective way I have to help clients if they want to speed up this process is a therapy called EMDR (Eye Movement Desensitization Reprocessing).  EMDR will allow you to rapidly recall the memories, process them and let the associated emotional pain go. 

This therapy was initially developed to treat trauma and has much research to back up its effectiveness in this area. I find it incredibly effective with grief and loss as well as trauma. Compared to more traditional therapies, I see it as a turbo charged form of therapy as I find it works rapidly to help with resolving issues that in the past would have taken much longer. 

The pain fades
My clients tell me that the pain of the break up, and any feelings of jealousy when they see their ex with a new partner, feels more distant and no longer upsets them. It is like a movie that was once sharply focused and brightly coloured has now faded into a black and white still and blurry photo. The ex is not forgotten. It is just no longer upsetting to think about him or her.

Perhaps EMDR is so fast because it uses both sides of the brain to help people process painful feelings and memories rather than the usual “talk therapy” which mainly uses the left side of the brain. EMDR also has the advantage that most of the memory reviewing is done inside your head without having to slow down and explain everything to the listener. 

You’ll fall in love again
Even though it may be hard to imagine, you can get over a painful break up and fall just as deeply in love again because of the amazing neuroplastic qualities of the brain. You don’t have to look far to see examples of this in action. Just listen to the heart wrenching lyrics of Adeles’ song Someone Like you  and then hear her being interviewed about the new love of her life who (in her mind)  far exceeds the subject of her song. You too can make this shift so that the pain of a break up will become a dim memory.

Silence and Suffering
If you suffer from tinnitus it can feel like you never have any respite from this irritating constant sound, and this can be very distressing.  This hidden chronic condition leaves many suffering in silence – literally!   The quieter the ambient background, the more your mind will notice the tinnitus. 

Many tinnitus sufferers talk of their grief about never being able to enjoy the peacefulness of silence again. And this is certainly a loss. However, an interesting point to consider is that “silence” in nature is a sign that a predator is approaching and thus, in reality, a more relaxing and soothing sound environment would have the sounds of nature like chirping birds and crickets. Enriching background surroundings with sounds of nature can provide the tinnitus sufferer with some relief as it distracts and may even mask the tinnitus.

Enrich your sound environment
With tinnitus, it is worth experimenting with a range of sounds such as relaxing music or recordings of sounds from nature like moving water, birds and insects, wind or white noise. You can find more information about tinnitus and some free sound recordings to install on your computer and play in the background on this excellent website (click on "about tinnitus" and then on drop down menu, click on "sound enrichment" and scroll down to their free download called Aire Freshener). Alternatively you will find some Apps with sounds to mask tinnitus that you can always have with you on your phone. As tinnitus often makes sleeping difficult, it may help you to sleep by having these soothing sounds playing in the background.

We notice the negative
One of the reasons that tinnitus is so hard to ignore is that our brains are wired to make us pay much more attention to negative stimuli than positive stimuli. Paying attention to negative stimuli and noticing threats has survival value. Thus, we are automatically more aware of the negative, and tend to easily over look the positive.

Tinnitus Free Moments
To counteract this, we need to actively work at paying attention and recalling positive experiences and times we seem to be free of the tinnitus.  So become more mindful and appreciative of the “tinnitus free moments.” These times occur when ambient sound masks the tinnitus. This will vary for different people, but examples of such moments may include:

•  Having a shower
•  Being outdoors with nature
•  Anything that gives you wind in your ears e.g. riding a bicycle, boat or convertible car
•  Listening to a fountain or other water features
•  Being in a noisy restaurant or nite club
•  Listening to a live band
• Swimming
• Walking along the beach

Make your list
Experiment with situations like these to see if they work for you. Be on the lookout for other tinnitus free moments that you may discover. Start to make your own personal list of these times and learn to savour these moments. Keep this list handy so when your mind tells you things like “I can’t stand this... I am never free of this” you have the evidence to challenge these unhelpful negative thoughts that are compounding your distress. You will also be more aware that there are times you can count on for some respite from the tinnitus.

Side effects?
Clients often ask me about natural remedies and alternatives to  antidepressant medications as they are troubled by possible side effects.  The hope is that a "natural" remedy or supplement will have no side effects and be totally safe. While psychological therapy is the obvious alternative, there  are a range of supplements that have been found to assist with depression that you can discuss with your GP. Two common ones are St John’s Wort (see this) and Omega-3 supplements like Fish Oil (see this). However, it is important to be aware that supplements, like medications, can all have side-effects (note the side-effects for these two supplements mentioned in the links). They can also cause allergic reactions or interact with other medications or natural remedies. Just because a product is “natural” or occurs in a food, does not mean that in a supplement form it is safe.
 
Safety?
Many medications and supplements have only demonstrated safety or effectiveness in short-term studies, often with animals. This does not mean that long term use in humans is safe. Don’t get me wrong – I am all for natural alternatives to medications and have spent many hours looking for natural remedies for my own health issues. This is when I became aware of how hard it is for the average person to work out safety of supplements. At least I was able to apply my years of training to both finding relevant studies and evaluating the research I found. Alternative health professionals gave me conflicting information and were often not aware of the risks of some supplements that my research uncovered. It left me wondering if it was better to take a medication with known risks of X, Y and Z, than a natural remedy with no good research on long term side-effects.
 
Some advantages of medications
While I would prefer to take a natural remedy, there are some advantages to conventional medications. All medications have to go through controlled research trials that demonstrate effectiveness before they can go to market. Research is often ongoing and may reveal side-effects from long term use that then lead to the product being withdrawn from the market (as happened with the arthritis drug Vioxx). With the list of side-effects that pharmaceutical companies are required to provide with their product, patients can do a risk benefit analyses of taking the product with their GP. Interactions with other drugs can also be looked at. Also, with medications, the exact dose of the drug has to be standardised so you know how much you are taking in each tablet.
 
Some disadvantages of natural remedies 
Supplements, on the other hand, are not required to go through the same rigorous testing and standardisation before they go to market and before claims can be made about their benefits.  A lot of information about benefits of natural remedies is “anecdotal” which means that testimonials (i.e John Smith says “this really helped me”) are provided by the seller of the supplement to demonstrate their effectiveness.  It is assumed that because they are “natural”, or can be bought without a prescription, and can be found in food, they are safe. But research has found that food constituents that may be safe in the diet, can increase the risk of developing certain medical conditions (e.g. cancer, heart disease, liver damage) when taken as supplements.  Beta-carotene (an antioxidant found in a range of food sources) noni juice and curcumin are a few examples of this.
 
Quality of natural remedies?
Another thing to keep in mind is, unlike with medications, the manufacturing of supplements is not always standardised.  This means that different brands (and even different lots of the same brand) may have different doses and quality of the constituents. So how well they work, and side-effects may vary and the form you are buying may differ from the form you have found good research on. So you do not always know how good your supplement is if you buy off the shelf. As a guide, higher quality and dose forms are often “practitioner only” (only accessible by seeing a health practitioner) and kept behind the counter of health food stores. 
 
More research on natural remedies needed
Hopefully, as the use of supplements becomes more popular, the government will require higher standards of research to demonstrate efficacy and long term safety before they go to market. A requirement should be that side-effects be listed with the product so we can all make an informed choice about what we take – whether it be medication or supplements. On the positive side, more information is becoming available about risks and interactions of herbal supplements with medications and if you are taking herbal supplements, you should mention this to your GP. 
 
Resource to check out your supplements 
If you are looking at taking a vitamin or supplement for any health issue, a good website to help you check out the benefits, risks, side-effects and interactions of what you might be taking is here.