How poor sleep can cause depression...and what to do about it!

Throughout my career in mental health I’ve felt compelled to share knowledge; whether through the writing of books like ‘PTSD Resolution’ about the extraordinary Rewind Technique, training programmes for practitioners or replicating my own working methods in the Fusion five session manual. 

Through Lockdown, that compulsion has become even stronger. I think the need for psychological support is going to be far greater than the UK government anticipate. I am already hearing reports of suicides. Some have lost friends, colleagues and loved ones. Some have lost jobs and businesses … and some have lost hope. 

I do find therapists appreciate practical tools and ideas they can use straight away to help others. Following my last newsletter I was contacted by psychotherapist, Jo Ham 

‘’I … enjoyed your blackboard sleep relaxation, thank you. I adapted the blackboard idea for an online client with autism yesterday to help erase unwanted images, so it was doubly useful….there are lots of lovely possibilities with this idea.  

I actually invited her to reduce the scary image to a very simple chalk outline on a fairly small blackboard, which in itself I hope was helpful, and then to rub out not just the image, but the blackboard itself! Leaving a lovely sunny sky on the beautiful beach where she had chosen to relax.’’ 

Really creative Jo; it’s rewarding to know how sharing this technique has helped you to help your client and sounds to me like it would work in a similar way to the Rewind.by reclaiming cognitive control over emotional memories. 

Ideas and apples 

Many years ago I came across a quotation which, in a few words, summarised a key principle that would underpin my entire professional career. It was George Bernard Shaw who said:

"If you have an apple and I have an apple and we exchange these apples then you and I will still each have one apple but if you have an idea and I have an idea and we exchange these ideas, then each of us will have two ideas." 

Sharing knowledge changes lives. It empowers. In mental health in particular, offering psycho-education is critical. Clear explanations of the physical mechanisms that fuel emotional distress can dispel fear, restore hope and return a sense of control. Rather than a diagnosis, most clients actually want to understand what is going on and have a practical treatment plan that will improve things quickly so they can just get on with their lives. 

My article this week describes how disordered sleep can lead to depression. It’s information I share with clients and supervisees alike. I owe much of this understanding to the great Joe Griffin, co founder of Human Givens and author of the book ‘Dreaming Reality: How dreams keep us sane or can drive us mad.’ 

There was a time when, encouraged by the misinformation put out by pharmaceutical companies, I bought into the lie that depression is all about imbalanced brain chemistry. The more helpful (and more accurate) explanation is that, in the absence of actual brain damage, depression is caused by a lifestyle that doesn’t get your needs met, by disordered sleep, or by a combination of the two. 

It’s about Ali, who felt deeply depressed and just didn’t know why. 

I hope it helps… 

How poor sleep can cause depression… and what to do about it! 

As I opened the door to Ali, her face was a picture of misery, ‘Sorry I’m late’ she said ‘I’m not a morning person these days.’ 

A few minutes later, seated in my office, she explained what was going on. 

‘I’ve just got no motivation to do anything’ she said. I’m so low. ‘If I could, I would lie in bed all day…and still probably feel tired!’ 

‘When did this start?’ I asked her. 

‘I had some trouble at work last year’, she said. ‘My boss was a bully. He micro managed everything I did; gave me deadlines I couldn’t meet and was super critical of all my projects. The upshot was I was worried all the time. I didn’t want to go into work in the end and contracted HR about the whole thing. 

‘Turned out he was bullying other people too. He’s been moved on now so the problem’s gone but I still feel down. It’s weird. I sleep all night but wake up so tired in the morning I can hardly get out of bed. I’m hoping you can help me sort this out. Soon I won’t have a job to go to. My time keeping’s got worse and worse and I’m having trouble concentrating too. I missed a couple of deadlines and people are starting to notice something’s wrong.’

It looked to me as though Ali had got into a worry cycle. It had started with her boss. Her sleep was affected and now, even though the original problem had gone, she was still like a washing machine on permanent full spin, worrying now about her low mood, her ability to do her job and about what her future might be. 

Problem steps 

Problems compound if they are not dealt with early on: There are three distinct steps that can lead to depression: 

Step #1 Find something to worry about and, rather than set aside time every day when you calmly sort through those worries and problem-solve, churn the same issues over and over in your head 24/7 without any plan of action for resolution. 

Step #2 Worrying so much in the day will affect the quality of your sleep at night.

All mammals dream for around two hours a night. It’s what the brain does in Rapid Eye Movement sleep (REM) to clear the circuits. REM processes the emotional arousals of the previous day.

 More emotional arousals in the day (as in worry) will require more REM at night to process them but if you dream for more than two hours, you start to eat into the deeper, slow wave, restful sleep that repairs the body, leaving you tired. 

REM sleep is also tiring. The brain is firing off the orientation response behind closed eyelids almost as though it is awake. The orientation response specifically uses motivational energy which is your ‘get-up-and-go’. Sadly that can mean your get-up-and-go has got-up-and-gone by the time you wake up in the morning! 

Now you’ve got more problems; the original set of worries and the new worries about your low mood and lack of energy. 

Step #3 Tiredness and lack of motivation can mean you start withdrawing from social activities, lose concentration at work, make mistakes and begin to panic about the future on top of everything else. 

The whole cycle now repeats itself day after day and night after night as you slowly get more tired and head down the road to emotional burn out. 

Solution steps 

Fortunately there are also three steps that will help you quickly reverse back up that road:

Step #1 Put a fence around the worry by using a system like ‘The 4D Technique’ which encourages you to spend no more than 30 minutes a day worrying, problem solving and putting your worries into categories like ‘Do, Delay, Delegate and Ditch’. 

This will mean your brain knows you are on top of the issues and have a plan of action (even if that plan of action is to delay worrying or delegate the worry to someone else). 

Less worry by day equals less dreaming sleep at night and leads to deeper, more restful sleep that restores both body and mind leaving you feeling more refreshed in the morning. 

Step #2 Use something like ‘The Blackboard Technique’ to get to sleep quicker and get back to sleep speedily if you wake in the night. The technique drowns out niggling thoughts with a repetitive mental task that essentially bores the brain into slumber! Listening to The Blackboard Technique audio can also help. 

You can listen to The Blackboard Technique here.  

Better rested, the brain is now more able to deal with daily activities, and stresses and strains. You start to function better at work and have energy to get back in touch with friends and family and to do the things you stopped doing before. The depression cycle is reversed and you can start to refocus on creating the future life you want to live. 

Step #3 This is a good time to find yourself a Therapeutic Life Coach who can help you step back and take a holistic look at what’s been working or not working in your life and help you look at your choices to create a picture of a future you want to step in to. 

Ali

 For Ali, having a clear explanation of what had gone on for her was enough to stop the spin cycle of worry that had been interrupting her sleep. Soon she was back to her old sunny self and how she had been before all those problems with her boss. 

She also now had a few more mind management tools in her self-help toolbox and felt more prepared for whatever the future had in store for her. 

‘I just feel like I’ve got more resilience now’ said Ali. 

‘Indeed. It’s what I call bounce-back-ability’  I said, with a smile. 

You can still access your free 'Time for a Change' workbook here. I hope it is helpful for you and for your clients.

Stay safe and well. 

Frances Masters  MBACP accred GHGI

The Fusion Therapeutic Coaching Distance Learner Skills Certificate*  

Bringing together for the first time, advanced counselling, cognitive behavioural and human givens skills in a solution focused coaching framework. This is the first and only independently accredited distance learning therapeutic coaching course in the UK. 

The integration of coaching and counselling is a new paradigm. Fusion is at the leading edge with a fully integrated model which has been successfully used over several years with thousands of satisfied clients.  

Do you have an interest in mental health and wellbeing? Do you want to take your career to the next level? Perhaps you’re a counsellor looking to add advanced coaching tools to your therapeutic toolbox or you may be a coach, who wants to deepen and broaden your therapeutic skills? Perhaps you are a hypnotherapist using powerful psychological techniques and would like a safe and solid theoretical frame for your work? You may be working in schools, human resources, the police or the NHS or in another helping profession and just want to be more effective for your clients. 

Fusion can help you, with tried and tested training which brings together the very best of coaching and counselling into a powerful new integrated model that really helps and really works. 

On completion, Distance Learner graduates will receive a certificate from NCFE, an awarding organisation recognised by the qualification regulators for England and Wales. NCFE's regulators are the Office of Qualifications and Examinations Regulation (Ofqual) in England, Qualification Wales and CCEA regulations. The general Conditions of Recognition can be found at ww.ofqual.gov.uk 

Order your workbook here

*There is a 10% discount for all NHS workers 

The Fusion Model 

The innovative Fusion Mental Health First Aid model draws on Person Centred Counselling, Cognitive Behavioural Therapy, Human Givens Psychotherapy and Holistic Life Coaching to bring together a unique toolbox of skills to help you provide the very best support for your clients. This is not just any coaching course or the GROW model in another format. Fusion has an innovative and unique approach to emotional health and wellbeing which has been tried and tested over ten years with thousands of client successes.  

On the programme you will learn:

• The SAFE SPACE ‘recipe’ for emotional wellbeing
• How to dramatically accelerate client outcomes
• How to conduct a ‘life audit’
• What us the ‘essence of the problem/essence of the solution’
• The important first session: How to pace, turn and lead your client
• When and how to use the Fusion Wheel of Life
• Present, future and super-future focusing
• How to use guided imagery to effect change fast
• integration of therapeutic story and metaphor
• How to successfully treat anxiety and depression, fears and phobias
• How to deal with panic attacks and anger attacks
• What to do to resolve PTSD fast
• The utilisation of powerful brain filters 
• The mindfulness based STOP System
• Effective goal setting 
• And much, much more… 

Frequently asked questions 

Who can take Fusion’s Therapeutic Coaching Distance Learning programme? 

You may wish to use the programme for continuing professional development, personal development or to gain an understanding of the integrated principles and practice of the Fusion Therapeutic Coaching Model. 

You are likely to have good communication skills, experience of working in a caring role and have a deep desire to help others. 

How does distance learning work? 

Distance learning means you can study at home, at your own pace and in your own time. Learners receive a working course manual and study guide, together with a series of written assignments, reflective tasks and questions. 

You will also have access to a professional tutor to provide you with support via email, post or telephone. They will be happy to answer any questions you may have and give you advice on successful completion of the course. Ongoing support will last for one year from the date you receive the course. 

How long do I have to complete the programme? 

12 months. If the course is updated, the information will either be posted on our supporting website or sent to you free of charge. Completion of the course will take in the region of 80 study hours which can be spread over the 12 month period and claimed as CPD hours. 

Is there an end of course examination? 

No, the programme is completed by an end of course Q and A which you send by e-mail or post for assessment. The Integrated Coaching Academy runs the only accredited Distance Learning Therapeutic Coaching course in the UK. 

Do I get a certificate? 

A completion certificate will be provided by the Integrated Coaching Academy. If you wish to have Level III NCFE endorsed completion, your work will be assessed by your tutor then internally and externally verified. If successful, a certificate will be issued by NCFE. 

Assessment of your work 

The assessment of your coursework will be carried out by your tutor. A sample of assessments will be referred to an internal verifier.These are available to be seen by an external verifier from the accrediting body, NCFE. 

Is there tutor support? 

The course is supported by a friendly and accessible tutor who appreciates the needs of distance learning students. If you experience any difficulties with the course, or need clarification on some points, then please get in touch. We are here to help. 

Order your workbook here 

What is covered in the programme? 

The 70,000 word, 426 page work book covers a broad range of theory and skills. 

Module 1 

The Therapeutic Coaching Timeline

Professional evolution

The Therapeutic Coach: A new paradigm

The big experiment

What is therapeutic coaching? Is it different from counselling?  

About the NCFE accredited Therapeutic Coaching Diploma

Effective Therapy: Affordable training 

Module 2 

Work Book

Zen philosophy; an auspicious beginning

Setting SMART Goals

Self Reflection

Learning something new

Recognising emotions

Module 3 

Communication Micros Skills

S.O.L.E.R

Listen

Mirroring and reflection

Paraphrasing

Summarising

Open questions

Empathy

Carl Roger’s core conditions

About Carl Rogers

Look back, but don’t stare 

Module 4 

Human needs

Create a SAFE SPACE to get your emotional needs met:

The work life balance

Attunement and the therapeutic alliance

Accelerated rapport

Smile

Information Gathering: Using Clinical Measures and feedback

CORE 10

Taking an emotional needs ‘audit’

Actualising tendency versus learned helplessness

How to restoring hope 

Module 5 

A first session with a client

Placebo-nocebo

Confidentiality in therapeutic work

Positive expectation

SUDS scaling 

Module 6 

Dealing with anxiety and panic attacks

Fight or flight

Pattern matching

Thinking errors or cognitive distortions

Resilience and Base Stress

Diaphragmatic Breathing

The Observing Self and Meta awareness

Misuse of the Imagination

What else do I need to know? 

Module 7 

Setting therapeutic goals

The Magic Question

The Reticular Activating System (RAS)

RAS and focused attention

What are your Hobbies and Interests?

Developing metaphor therapeutically 

Module 8 

Psycho Education

Triune theory

Sleep

Pattern matching and neural pathways

Patterns of response 

Module 9 

Supervision and the helping professions

Referrals

Diversity: Celebrating Difference, Celebrating ‘Sameness’

Challenging the labels

HAPPINESSISNOWHERE 

Module 10 

STOP: GO Bridging the gap between counselling and coaching

Holistic Life Coaching

Ploughing new furrows: Counselling in a coaching context

Where are you on the wellbeing continuum?

React or respond?

Thought stopping

Neuroplasticity and the changing brain

Affirmations 

Module 11 

The STOP System

STOP and diaphragmatic breathing: How to test your own breathing

STOP and ‘Taking a Step Back’

STOP and the Observing Self

STOP and Emotional intelligence

STOP and interrupting old or habitual patterns 

Module 12 

The Wheel of Life

Case study: Geoff #1

Using the coaching wheel of life

Assessing and scaling life as it is

The life wheel protocol 

Module 13 

Case study: Geoff #2

Wheel of life doc 1

A holistic view of the client

The preferred future

Story: What a bird should look like

Write it down-make it happen 

Module 14 

Case study: Geoff #3

Wheel of life doc 2

SMART goals

Case study: Geoff #4

SMART goals doc 

Module 15 

Visualisation

Describing guided imagery

Visualisation: a history

Meditation and mindfulness

Metaphor in guided imagery 

Module 16 

Case study: Geoff #5

Therapeutic time travel

From problem focused to solution focused

A progressive relaxation and bespoke visualisation for Geoff 

Conclusion 

Intelligence plus intuition equals ‘whole brain’ learning

The Ebbinghaus Curve of Forgetting

A privilege 

Appendix

 TASK documents

Therapeutic stories 

Resources

 Therapeutic Coaching in practice

First session questionnaire

SAFE SPACE audit sheet

CORE 10 questions

Case study: Shelly

Case Study: David; coaching a client with M.E.

BACP ethical guidelines

Association for Coaching: coaching competencies

Articles Is the Therapeutic Coach a ‘brain mechanic?’

What do you do if you don't like your client?

Smile and the world smiles back.

The Top Five Regrets of the Dying

Swim towards the light.

A Nice Result

Better to do something imperfectly than nothing flawlessly

No need for my services?

The Super Organising Idea

All boxed up?

Working at the cutting edge

Epigenetics

Mapping the connectome

The gut microbiome

Polyvagal theory

The seven pillars of mindfulness

Mental health first aid 

Order your workbook here 

Testimonials 

Founding Chair of BACP Coaching Linda Aspey

 In the field of coach-counsellor integration, Frances is a trailblazer'  

Health journalist and BACP Coaching Executive Specialist for Communication Sally Melissa-Brown  healthjournalist.co.uk

 'Fusion teaches you a fast, effective way to diffuse stress and take control of your emotions. It's deceptively simple and includes lots of fun techniques and exercises which will appeal to children of all ages.'

Make Menopause Matter founder Diane Danzebrink:

 ‘I discovered Fusion therapeutic coaching when I needed it most. When personal circumstances left me with mental and emotional issues I was lucky enough to find Frances Masters. Fusion has quite literally changed my life!  

Having studied traditional counselling some years ago I was left feeling disappointed that I had not been taught how to help my clients move forward with their lives. I was so disillusioned I abandoned my dream of becoming a counsellor and followed an alternative career path.  

My personal Fusion experience provided a real ‘light bulb’ moment for me, this was what my counselling training had been missing and I went on to complete the diploma in Fusion therapeutic coaching. I am passionate about my work, having experienced the mental and emotional trauma of depression when I was least expecting it made me determined to use my experience to help others’

Principal Teaching Fellow, University of Southampton John Perry, MA, MA, MA, MSc, FHEA, https://www.southampton.ac.uk/medicine/about/staff/jwp.page

 ‘Frances is an inspirational and engaging trainer. A highly-skilled facilitator, Frances is responsive to learners’ needs, flexible, good humoured and positive in her approach.

I whole-heartedly recommend both Frances and her approach to all who are committed to helping others to move in the direction of accomplishing their full creative and constructive potential.’ 

Order your workbook here