Rational judgment, soothing behavior, and calm observation often go out the window when responding to stress. This book presents hypnotherapeutic skills (including breathing exercises) and other easy-to-learn techniques that help people maintain healthy responses to stress and facilitate effective clinical work and a happier life.

CUSTOMER REVIEWS (Average Customer Rating: 5.0 based on 11 reviews)

Excellent Cliinical Scripts and Protocols

Invaluable tool for the clinician, this book brings suggested scripts for the therapist to use as is, or to use as model for her/his own style when working with patients whose reactivity warrants emotional regulation.

October 18, 2008

Affect Regulation Toolbox

"Affect Regulation Toolbox" by Carolyn Daitch PhD
March 1, 2007 (ISBN 10:0-393-70495-5)
Review by Dr. Sandra E. S. Neil

As Claire Frederick M.D., says in her foreward to Dr. Carolyn Daitch's book" `Affect Regulation Toolbox' is a clinical classic". It seems appropriate to comment that these affect regulation skills are used as part of hypnotherapy by Dr. Daitch in her own practice. However, as presented by Dr. Daitch at the International Council of Psychologists workshop in Kos, Greece in July 2006, these skills can also stand in their own right, and could easily be used in non-hypnotic therapies.

The book comprises a collection of therapeutic interventions, consisting of four components, or as Dr. Daitch calls them "Tiers". Tier 1 is recognition of an overreaction, and initiation of a brief pause to interrupt it. Tier 2 is standard hypnotic induction and deepening techniques. Tier 3 is a set of tools aimed at shifting unhealthy reactive styles. Tier 4 comprises tools to address therapeutic transfer of suggestion and practice.

Dr. Daitch describes symptoms of anxiety disorders including the following: uncontrollable worry, panic attacks, poor concentration, addictive behaviours, obsessive thoughts and phobias (page 25). Further, she describes anxiety in relationships; she sees overly reactive behaviours to be at the core of many troubled relationships. These typically include: escalation and conflict, disconnection from each other emotionally, inability to access positive affect and inability to practise beneficial therapeutic behaviours. This augurs poorly for the future of the relationship when two people experience such negative states every time they enter a conflict situation.

In Chapters 4-6, Dr. Daitch looks at ways of diminishing over-reactivity, by using a set of skills, and I recommend the reader read these themselves (page 28). It makes excellent reading and excellent clinical practice.
1. Identifying the start of an overreaction and responding appropriately,
2. Calming and focussing.
3. Mindfulness.
4. Somatic awareness and cues.
5. Impulse control.
6. Co-existing affective states.
7. Resource utilisation.
8. Positive affect development.

Dr. Daitch says that it is the mastery of these skills, in the midst of stress and conflict, that will truly enable patients to experience freedom from the heightened emotions and reactions that keep them trapped for so long.

In Chapter 9, "Application of Tools with Severe Anxiety Disorders", Dr. Daitch uses tools from Tiers 1 and 2, before using tools from Tier 3 to address a Panic Disorder. Further the patient is given strategies from Tier 4 that she can implement in her daily life. These include tight fist, mindfulness with detached observation, mindfulness and releasing, sensory cue/anchor, age progression short-term and long-term, imaginary support circle and parts of yourself (very reminiscent of Virginia Satir's Parts Party).

In Chapter 10, Dr. Daitch applies these rules within a marital, committed relationship. These include Gottman's description of the "Four Horsemen of the Apocalypse" as applied to couples - the four main destructive behaviours which are often evident in failing marriages: criticism, defensiveness, contempt, and stonewalling (Page 186).

Dr. Daitch's gives an example of a couple at marital war with each other, Jonathon and Janice, who attend for therapy. Dr. Daitch lays out her treatment goals as follows:
* Diminish defensiveness by each taking responsibility and owning their parts in conflict
* Practise active listening or mirroring
* Validate and empathize
* Practise using visualisation to rehearse effective communication
* Help the couple learn from each other's adaptive style
* Contain verbally damaging exchanges
* Increase empathy
* Close `exits' (that is, activities which are designed with the express purpose of avoiding each other)
* Establish `date nights' away from the children
* Develop positive expectations about the relationship and experience regular positive affect
* Increase the awareness of the impact of verbal and nonverbal communication

The tools which she used for Jonathon and Janice were `Arm and Leg Heaviness', and `Parts of the Self'.

Chapter 12 is called "Roadblocks and Challenges". The most significant challenge to a therapist's successful implementation of the Toolbox is getting the patients to practise. She also talks about working with those who have low hypnotisability, managing resistance from different perspectives, and matching tools with client needs and styles.

In the epilogue, in which she focuses on the therapist, she describes how we have to learn to trust our own voice and style. She emphasizes the importance of self-care and self-acceptance for the therapist. Daitch quotes Louise Hay, stating that the most important thing the therapist can do for their patients is to love themselves, and stop self-criticism.

After 36 years of clinical practice myself, I believe that Dr. Daitch's therapeutic tools are very useful, and I have used variations of them in different ways and in different situations throughout my own career. "Affect Regulation Toolbox" is an invaluable resource, allowing patients to maintain a healthy response to stress, and facilitate effective clinical work for a happier life. Dr. Carolyn Daitch has done a service to the whole field of psychotherapy.

Dr Sandra E S Neil PhD, MA (Clinical Psychology), BA, BEd (Counselling), FAPS
Clinical Psychologist and Family Psychologist
Fellow, Australian Psychological Society
Past-President, International Council of Psychologists
World Area Chair, International Council of Psychologists
International Affiliate of American Psychological Association
Australian National Representative International Academy of Family Psychology
Australian Psychological Society College of Clinical Psychologists
APS Division of Independently Practising Psychologists
Member, Australian College of Psychologists in Clinical Private Practice
Member, Avanta Virginia Satir Network and IHLRN

June 06, 2008

As a Hypnotherapist, I use this book with other Therapists....

This book has proven to be an excellent resource for interfacing with other Therapists who are unfamiliar with hypnosis. Many traditional counselors fail to see the relevance of hypnosis in their practice. This book is very easy to follow and provides a great set of tools for use with over-reactive clients. It can help Hypnotherapists understand how to interact with traditional counselors to improve results with their clients, as well as the therapist themself, to whom it is directed.

As Daitch explains, people who are over-reactive pay dearly for their emotional styles in the untold sacrifice of their peace of mind and the diminished satisfaction in their lives. They find it difficult to do one or more of the following:
* Make decisions using rational judgments
* Remain calm and clear in the face of stress
* Observe and reflect on their emotions and behavior
* Tolerate uncomfortable, "negative" affect or concurrent conflicting emotions
* Tolerate criticism without defensiveness
* Suspend judgment
* Soothe themselves or their partners
* Consider positive, objective interpretations of events or communications

A stress reaction is triggered very quickly. One must offer an intervention that is powerful enough for the person to gain control of inappropriate or excessive response. Simply providing insight or teaching them to reinterpret triggers alone is often insufficient. One must consider diffusing the stress response first before a change in reaction is possible.

Immediate benefits of Hypnotherapy to clients include:

* Stop escalation of conflict with others
* Have tolerance when experiencing difficult emotions
* Handle a juxtaposition of different emotions
* Remain calm and flexible within stressful situations

Long term benefits to clients include:

* More resiliency in the face of long-term stress/conflict
* Significant reduction in symptoms of stress disorders
* Increased maturity and spiritual development
* Greater receptivity to the wisdom of others
* Increased trust and connection with others and self
* A healthier sense of self (self-esteem, productive perspective)
* Elevated positive affect

By working with a Hypnotherapist, a variety of quick and easy to learn techniques can be learned that help clients maintain, in their daily lives, the dramatic emotional shifts they experience in the therapists office.

June 01, 2008

Practical Tool for Clinicians

This is a practical book that both seasoned and newly trained clinicians will love. Written by a highly experienced therapist, it fills a void that has existed in therapy literature on the topic methods for helping patients with affect regulation issues.

Dr. Daitch has compiled more than 30 specific self-regulatory skill sets. She describes them for the therapist along with the indications for their use, and then models the practical language in the form of a script. Therapists are not going to get bogged down in this book, but will be able to easily and rapidly begin using what they read. The techniques are specifically tailored for use with over-reactive types of patients-the population where traditional talk therapy commonly proves frustrating and inadequate. The methods are applicable to either individual or couples therapy.

A valuable table at the beginning of the book recommends which of the techniques may be most applicable in the treatment of conditions such as generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, PTSD, and phobias. The table also guides the clinician to the most appropriate techniques for reducing various symptoms such as worry and rumination, counterproductive thoughts, self-criticism, hopelessness, fear of the future, irritability, insomnia, somatic distress, hypervigilence withdrawal, codependency, and feelings of abandonment. The practitioner is also directed to which techniques are most applicable for the enhancement of resiliency, self-efficacy and self-esteem, self-soothing, skill rehearsal, impulse control, positive affect, empathy, positive expectancy, detached observation, emotional connection, and mental flexibility.

The author begins by assisting other therapists to understand over-reactivity and then provides a scholarly overview chapter on the psychophysiology of emotional reactivity. The remainder of the book is very pragmatic. One chapter focuses on helping clients identify the start of an over-reaction and how to respond appropriately. Another chapter is on focusing attention and calming strategies. Still other chapters concentrate on healing strategies, behavioral and practice session rehearsal, tools for common anxiety disorders, tools for severe anxiety disorders, tools for use in relationship therapy, and tools for use in parent/child, sibling, work, and friendship relationships.

As each technique is introduced the author lists the 4-5 goals of the method. The practical wording of a script is then modeled for the reader, followed by a commentary and sometimes an example. Thus the book provides the therapist with techniques that he or she can begin to immediately use in treatment, providing the patient with new, practical skills for affect regulation which they may then be assigned as home work. A final chapter assists the reader in handling roadblocks and challenges (e.g., noncompliance with practice sessions and resistance).

Although many of the techniques have their origin in hypnosis and cognitive behavior therapy, a high level of sophistication in either of these approaches is not essential to finding the book useful clinically. An appendix provides therapists with further useful resources, including videotapes, books and sources of training, as well as resources for clients (workbooks, CD's). I highly recommend this book.
January 04, 2008

A Must have for every Hypnotherapist

As the director of The Denver School Of Hypnotherapy, I am always looking for really good books on hypnosis/therapy to use as a textbook or to put on our recommended reading list, and this book fills both needs. About 1/3 of the way into the book, I had decided to use it as one of our main textbooks, replacing one we have used since the school opened. Ms Daitchs' professional easy to read style of writing makes this book a must for any psychotherapist who wants to expand his/her practice and offer the best support possible to clients. When Ms Daitch states, "For clinicians who are discouraged with unsuccessful traditional psychotherapeutic methods and want to be able to offer their over-reactive clients explicit strategies with long-term results, Affect Regulation Toolbox is an invaluable resource..." I couldn't agree with her more. This book gets two thumbs up and 5 stars from me

Pam Mills, CCHt
Board Certified Counseling Clinical Hypnotherapist
Director of The Denver School Of Hypnotherapy
November 24, 2007

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