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The sleep paradox: a glimpse into a typical therapeutic journey

 

Meet Robert*

*Robert is an imaginary client but a typical example of my work.

 

In the demanding realm of entrepreneurship, dedicated individuals like Robert often confront an under-recognised challenge: disrupted sleep. As responsibilities mount, restful sleep often eludes them. This narrative, purely illustrative and not referencing any specific client, mirrors many therapeutic experiences, shedding light on the journey towards understanding and reclaiming restful sleep.
Before even considering therapy, individuals such as Robert typically resort to practical solutions. For instance, they might realign work schedules, spend prolonged hours trying to sleep, experiment with various supplements, or consult a GP for antidepressants or sleep medications. Yet, sometimes, these efforts fall short.


Such challenges often prompt individuals to seek help. For Robert, this translated into embracing psychotherapy. Within this therapeutic space, you enter an environment conducive to introspection, self-awareness, and self-compassion. Instead of perceiving insomnia as a foe, I aim to help clients like Robert approach it with understanding and empathy. The turmoil of sleepless nights gradually transitions into a realm of acknowledgement and comprehension.


During these therapeutic sessions, a frequent epiphany, as witnessed by Robert and many others, is the incongruence between deeply held beliefs about sleep and actual sleep experiences. The mind’s propensity to weave varied narratives becomes apparent. Some reflections are grounded in reality, while others are mere constructs. Some insights illuminate, and others mislead.


Therapeutic recommendations are made based on individual needs as uncovered using a sleep diary. For example, one is to establish a consistent wake-up time; there are many more. This simple regimen provides a sense of daily rhythm and subtly encourages more restful nights.


While distinct in its nuances, Robert’s narrative resonates with many who embark on a therapeutic journey. By cultivating understanding and nurturing self-compassion, many find their way to reconciling with insomnia. This tale underscores the transformative essence of therapy in navigating commonplace challenges.

A uniquely blended approach. 
While traditional psychotherapy, as depicted in Robert’s narrative, delves into the emotions, thoughts, and behaviours affecting sleep, it is combined with CBTi, which is focused solely on insomnia with pinpointed strategies.


Here’s an exploration of the distinctions:

  • Psychotherapy: This approach facilitates open exploration of any issue you introduce, including insomnia. The therapeutic trajectory spans various personal concerns, memories, emotions, and patterns.

  • CBTi: This action-driven therapy exclusively targets insomnia, intending to discern and modify detrimental thoughts and behaviours.

 

Duration:

  • Psychotherapy: Sessions can be indefinite, extending as long as you feel necessary.

  • CBTi: This therapy is usually short-term, spanning several weeks to a few months.
     

Strategies & Techniques:

  • Psychotherapy: Unfolds in response to what you might bring; we might delve into past traumas, addiction, familial backgrounds, or other profound concerns.

  • CBTi: Employs specialised techniques, including sleep restriction, stimulus control, cognitive restructuring regarding sleep beliefs, relaxation training, and sleep hygiene education.
     

Goal:
In psychotherapy, the primary aim is holistic, aspiring for overall well-being, enriched self-understanding, conflict resolution, or enhanced relationships. Sleep improvement is a beneficial by-product – the reasons for sleep issues often have profound roots. Nonetheless, it’s vital to synergise this with evidence-based techniques from CBTi, where the primary objective is explicit: enhancing sleep quality and duration.


Homework:

  • Psychotherapy: While I may suggest tasks or reflections, it’s not a staple component.

  • CBTi: Assigning homework is essential. You may need to maintain sleep diaries, adhere to specific sleep schedules, or execute distinct exercises.
     

Evidence Base:

  • Psychotherapy: I have a masters in a mindfulness-based modality with further training in trauma, acceptance, breathwork and body-focused practices.

  • CBTi: I combine psychotherapy with training in CBTi, the gold-standard recommended therapy for chronic insomnia, fortified by substantial empirical evidence.

  • While traditional psychotherapy extends insights and relief across a spectrum of psychological challenges, including sleep issues, CBTi emerges as a specialised, structured, and evidence-grounded approach devised explicitly for insomnia.

 

Benefits of a combined approach
Fusing traditional psychotherapy with CBTi paves the way for a comprehensive strategy in treating insomnia and other sleep disorders such as nightmares, circadian rhythm disorders and more, especially when deeper psychological concerns linger.


Comprehensive understanding: Merging the depth of traditional psychotherapy with the precision of CBTi ensures exhaustive exploration of both superficial and fundamental causes.
 

Holistic healing: Insomnia can intertwine with other concerns such as anxiety, depression, or past traumas. The therapy offers a dual remedy by addressing both the symptomatic insomnia and potential root causes.
 

Flexible adaptability: Every individual’s insomnia journey is distinct. By integrating CBTi and traditional psychotherapy techniques, we work out your roadmap together. It is a joint process.
 

Enhanced coping skills: Combined therapy aims to arm you with robust coping skills, preparing you against insomnia and life’s challenges.
 

Support for comorbid conditions: Insomnia often coexists with other conditions. This holistic approach ensures that such concurrent conditions receive attention.
 

Sustained long-term outcomes: The amalgamation offers sustained benefits, addressing deep-seated emotional and psychological patterns.


Improved self-awareness: Therapy often leads to heightened self-awareness, helping you better understand your behaviours, emotions, and thoughts.


Reduced relapse: Tackling immediate sleep issues alongside underlying causes minimises the chances of recurrence.


In essence, combining CBTi and traditional psychotherapy harnesses both strengths, promising a comprehensive and holistic remedy. It assures that symptoms and underlying challenges are meticulously addressed, carving a path towards profound healing and lasting sleep improvement.

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