User:MIDaffin/Human Givens

This is an old draft of the page that is now published here.

The human givens approach is an holistic model of human well-being and brief, solution-focused, therapeutic practise based on the best evidence from the science of evolution, anthropology, biology, psychology and sociology. It was introduced in the 2003 book 'Human Givens: A new approach to emotional health and clear thinking'. The human givens organising ideas describe the nature of human beings, the 'givens' of human genetic heritage and therefore what humans need in order to be happy and healthy.

Human givens theory proposes that all humans, regardless of race or culture, have evolved a common set of fundamental, physical and emotional needs - the so-called 'givens' of human nature. Human beings instinctively seek to meet these needs in their environment in the course of their daily lives. When a person’s innate needs are met he or she will flourish. On the other hand, when these needs are not met in a balanced way, mental distress, and eventually illness, results. In summary, human givens thinking posits that all mental illness is caused by a failure to get innate needs met in balance. The focus of human givens therapy is, therefore, the discovery and rectification/removal of any blocks to these needs being met in an individual's life.

The human givens movement believes that human lives can be made happier, and our future (and that of the other species with whom we share this planet) can be made more sustainable if societies, organisations, communities, professions, families and individuals are more aware of and sensitive to the innate needs, resources and tendencies of ourselves as human beings.

The human givens grew out of a psychotherapeutic method - an integrative, bio-psycho-social model of therapy. A significant part of the diagnostic methods and interventions of this therapy have been incorporated from known effective therapeutic methods - so some of this article links to this established practice from other therapies. The organising ideas are new, however, and so is some of the detailed theory (e.g. on the function of dreaming, how addictions are created and maintained, the cycle of depression).

The human givens approach is not limited in its application merely to psychotherapy, however. The Human Givens Foundation is a charitable organisation devoted to the mission of spreading the human givens philosophy and information into social policy, government, education, social work, the wider care system, into the police and the armed forces, into the organisations in which we spend our working lives, and to support parents, families, couples and individuals to live more harmonious, satisfying and meaningful lives.

Historical Background
For centuries, wise people and ancient texts have described how humans have innate needs for emotional and spiritual sustenance in addition to physical requirements. In more recent times, Abraham Maslow is credited with the first prominent theory which laid out a hierarchy of needs. The precise nature of the hierarchy and the needs have subsequently been refined, and to some extent superseded, by modern neuroscientific and psychological research. Nonetheless, Maslow's key idea has been accepted; that humans have a range of emotional as well as physical needs and that basic needs (e.g. food, shelter, physical safety) need to be met before higher needs (e.g. friendship, achievement) can be satisfied.

Since Maslow's work in the middle of the twentieth century, a significant body of research has been undertaken to clarify what human beings need to be happy and healthy. The UK has contributed significantly to the international effort, through the ground breaking Whitehall Study led by Sir Michael Marmot, which tracked the lifestyles and outcomes for large groups of British civil servants. This identified effects on mental and physical health from emotional needs being met - for instance, it showed that those with less autonomy and control over their lives, or less social support, have worse health outcomes.

In the United States, the work of Martin Seligman, a psychologist at the University of Pennsylvania has been influential. Seligman has summarised the research to date in terms of what makes humans happy; again, this demonstrates themes about universal emotional needs which must be met for people to lead fulfilling lives.

At the University of Rochester, contemporaries of Seligman Edward Deci and Richard Ryan have conducted original research and gathered existing evidence to develop a framework of human needs which they call self-determination theory. This states that human beings are born with innate motivations, developed from our evolutionary past. They gather these motivational forces into three groups - autonomy, competence and relatedness. The human givens approach uses a framework of nine needs, which map onto these three groups.

Many more researchers and neuroscientists have contributed to the debate, and over the past twenty years the scientific evidence for these innate emotional needs has become much stronger than it was when Maslow was researching and writing.

Some of the original research demonstrating the evidence for each need is referenced in the following section, but for an accessible summary written in laypersons language the latest version of the core textbook is recommended as is 'Emotional Intelligence' by Daniel Goleman.

Innate Needs
Human givens thinking suggests that human beings come into the world with a given set of innate needs, together with innate resources to support them to get those needs met. Physical needs for nutritious food, clean water, air and sleep are obvious, and well understood, because when they are not met people die. However, the emotional needs, which the human givens approach seeks to bring to wider attention, are less obvious, and less well understood, but just as important to human health and even, in some cases, survival.

The Human Givens approach defines nine emotional needs:


 * 1) Security
 * 2) Autonomy and control
 * 3) Status
 * 4) Privacy
 * 5) Attention (giving and receiving)
 * 6) Connection to a wider community
 * 7) Intimacy
 * 8) Competence and Achievement
 * 9) Meaning and Purpose

These needs map more or less well to tendencies and motivations described by other psychological evidence, especially that compiled by Deci and Ryan at the University of Rochester. The exact categorisation of these needs, however, is not considered important. Needs can be interlinked, and have fuzzy boundaries, as Maslow noted. What matters is a broad understanding of the scope and nature of human emotional needs and why they are so important to our physical and mental health. Humans are a physically vulnerable species that has enjoyed amazing evolutionary success due in large part to its ability to form relationships and communities. Getting the right social and emotional input from others was, in our evolutionary past, literally a matter of life or death. Thus, human givens theory states, people are genetically programmed only to be happy and healthy when these needs are met.

There is evidence that these needs are consistent across cultures, and therefore represent innate human requirements.

Security
Description: A sense of safety and security; safe territory; an environment in which people can live without experiencing excessive fear so that they can develop healthily as individuals and families.

Evidence: The work of Marmot in the Whitehall Studies, and subsequent interpretation of his data by other researchers, has demonstrated the needs for emotional security to ensure health. A good example is the finding about workers who were subjected to prolonged job security concerns during organisational change processes.

Autonomy and Control
Description: Volition - a sense of autonomy and control over what happens around and to us.

Evidence: The Whitehall Studies are also an authoritative source to demonstrate that autonomy and control are innate needs. Marmot determined that people who are lower in organisational hierarchies have worse health and mental health outcomes, and that this is because they have less autonomy and control over their working lives. A more technical exposition of how autonomy and control are necessary for human health is given in the Whitehall Study further analysis by Stansfeld, Fuhrer, et al.

Attention
Description: Receiving attention from others, but also giving it; a form of essential nutrition that fuels the development of each individual, family and culture.

Evidence: Steve Cole and colleagues have found that "the biological impact of social isolation reaches down into some of our most basic internal processes - the activity of our genes... changes in immune cell gene expression were specifically linked to the subjective experience of social distance.” There is also a growing body of research on the damaging effects of solitary confinement on human mental health (although the distress experienced by people in solitary confinement could be said to be due to a combination of unmet needs including those for attention and autonomy/control).

Intimacy
Emotional connection to other people - friendship, love, intimacy, fun.

Community
Connection to the wider community (we are a group animal) - being part of something larger than ourselves.

Privacy
Time and space enough to reflect on and consolidate our experiences.

Status
A sense of status - being accepted and valued in the various social groups we belong to.

Competence and Achievement
A sense of our own competence and achievements - which ensures we don't feel we are rubbish (and develop 'low self esteem').

Meaning and Purpose
Which comes from being stretched in what we do and how we think - it is through 'stretching' ourselves mentally or physically by service to others, learning new skills or being connected to ideas or philosophies bigger than ourselves that our lives become purposeful and full of meaning. Meaning makes suffering tolerable.

Innate Resources
The human givens model also consists of a set of 'resources' (abilities and capabilities) that all human beings are born with which are used to get the innate needs met. These constitute what is termed an 'inner guidance system'. Learning how to use these resources well is seen as being key to achieving, and sustaining, robust bio-psycho-social health as individuals and as groups (families, communities, societies, cultures etc.).

The given resources include:


 * the ability to develop complex long-term memory, which enables people to add to their innate (instinctive) knowledge and learn;
 * the ability to build rapport, empathise and connect with other others;
 * imagination, which enables people to focus attention away from the emotions and problem solve more creatively and objectively (a 'reality simulator');
 * a conscious, rational mind that can check out emotions, question, analyse and plan;
 * the ability to 'know', to understand the world unconsciously through metaphorical pattern matching ('this thing is like that thing');
 * an observing self - that part of us which can step back, be more objective and recognise itself as a unique centre of awareness apart from intellect, emotion and conditioning;
 * a dreaming brain that, according to the expectation fulfilment theory of dreaming, preserves the integrity of our genetic inheritance every night by metaphorically defusing emotionally arousing expectations not acted out during the previous day.

Three Reasons for Mental Illness
A further simplification or organising idea proffered by the human givens approach to mental illness is to suggest that there are three reasons why an individual may not be getting their needs met. This is thought to provide a practical framework for both diagnosis and treatment:


 * 1) The environment - it is toxic or lacks things we need.
 * 2) Damage - to our 'hardware' (brain/body) or 'software' (instincts and conditioning).
 * 3) Lack of coping skills - we were not taught, or failed to learn, how to (for example) make and sustain friendships.

NOTE: need unpacking in different sections with citations.

Detailed Theory
NOTE: All this stuff needs unpacking into subsections and fully citing.

The human givens model includes many components, some of which are also being discovered by other practitioners and thinkers.

The APET Model

 * A new view of the unconscious mind - the APET model - which is compatible with neuroscience, clinical experience and experiment, and which shows how the brain works through 'pattern mathching'. This supersedes cognitive behavioural therapy because it is more true to the reality of brain brain functioning;

Fast Trauma and Phobia Cure

 * A new insight into trauma and, therefore, how best to treat it;

Expectation fulfilment theory of dreaming
The expectation fulfilment theory of dreaming, proposed by Joe Griffin in 1993 posits that the prime function of dreams is to metaphorically act out non-discharged emotional arousals (expectations) that were not acted out during the previous day. It theorises that excessive worrying while awake arouses the autonomic nervous system which then increases the need to dream during REM sleep, which deprives the individual of the refreshment of the mind brought about by regenerative slow-wave sleep. It regards worry as a misuse of the imagination. Griffin and Tyrrell proffer a connection between REM state dreaming and hypnotic phenomena, and define hypnosis as "any artificial means of accessing the REM state"
 * An holistic understanding of the evolutionary origins and function of human dreaming;

Thinking styles and emotional arousal

 * The crucial link between thinking styles and fluctuations in emotional arousal;

The Cycle of Depression

 * An holistic, integrated theory for why depression develops and is maintained;

The Human Givens approach to treating depression emerged from research into sleep and especially the brain state indicated by the rapid eye movements seen during dream sleep. New Scientist interviewed Joe Griffin about this explanation for why depressed people dream more intensely than non-depressed people and why all depressed people wake up tired and find it difficult to motivate themselves

Practising Human Givens psychotherapists use a number of techniques to get the subject to use imagination in a healthier way which they propose restores a more balanced sleep pattern and consequently can lift the depression.

Addiction and the Motivation Learning Circuit

 * A new explanation for addiction and why withdrawal symptoms occur;

Molar Memories

 * The discovery of 'molar memories' which generate and maintain some instances of compulsive behaviour (such as sexual compulsions, anorexia and bulimia);

Why metaphors can be therapeutic

 * An understanding of why the use of metaphor is so powerful as a form of treatment;

How the placebo and 'nocebo' effect work

 * A comprehensive understanding of the placebo and 'nocebo' effect;

Clinical hypnosis

 * A psychobiological explanation of clinical hypnosis, why it works and what mechanisms are common to all forms of hypnotic induction;

Autism

 * A new, empowering understanding of the cause of autism;

Psychosis

 * A new insight into what psychosis is;

REM state reality generator

 * A more comprehensive understanding of the importance of the REM (rapid eye movement) state in generating reality.

Research & Evidence
Use of the Human Givens approach is not currently widespread; but its supporters are building evidence and its ideas are extending into the UK public workplace.

Research and criticism
There are now a number of independent studies published in peer-reviewed journals of standing. These are:


 * A 5-year evaluation of the Human Givens therapy using a Practice Research Network.


 * Adams, S. (2013). Evaluation of Human Givens 'rewind' treatment to treat trauma. Poster presentation at a veteran-led research conference; Portsmouth, September 9th, 2013


 * Tsaroucha, A, l Kingston, P, Stewart, T, Walton, I and Corp, N. (2012). Assessing the effectiveness of the “human givens” approach in treating depression: a quasi experimental study in primary care. Mental Health Review, 17, 2, 90–103.


 * Tsaroucha, A, Kingston, P, Corp, N, Stewart, T and Walton, I (2012). The Emotional Needs Audit (ENA): a report on its reliability and validity. Mental Health Review, 17, 2, 81–9.


 * Yates, Y & Atkinson, C (2011) ‘Using Human Givens therapy to support the well-being of adolescents: a case example.’ Pastoral Care in Education, 29, 35-50.


 * Andrews,W., Twigg, E., Minami, T. and Johnson, G. (2011), “Piloting a practice research network: a 12-month evaluation of the human givens approach in primary care at a general medical practice”, Psychology and Psychotherapy: Theory, Research and Practice, Vol. 84 No. 3, pp. 389-405.

There is also a chapter in an international text book on trauma: [http://onlinelibrary.wiley.com/doi/10.1002/9781119943242.ch14/summary Andrews, W., & Miller, S. (2012) The Development of a Practice Research Network and Its Use in the Evaluation of the "Rewind" Treatment of Psychological Trauma in Different Settings. In Hughes, R., Kinder, A., Cooper, C.L. International Handbook of Workplace Trauma Support. Oxford. Wiley-Blackwell.]

The development of a first randomised-controlled trial to test the approach is also in process. The Bristol Randomised Controlled Trial Collaboration (a partnership between the University of Bristol and the NHS) has agreed to help design it.

Criticism
NOTE: address all major arguments from the deletion debate on this page here.

Reminiscent of Maslow's hierarchy of needs
The human givens approach appears much more profound than Maslow’s hierarchy of needs, as it provides not just a theory but a practical framework for treating mental illness and ensuring human well-being. It shows how the concurrent meeting of emotional needs essential for both physical and mental health (as demonstrated by decades of health and social sciences research, fully referenced in the new, expanded, 2013 edition of 'Human Givens: The new approach to emotional health and clear thinking'. ), and correct use of innate resources (such as the imagination), can be used to better mental and emotional health in a variety of settings, including health, welfare, education, business and law.

Human givens theory with respect to needs also differs from Maslow's theory in that it suggests that higher needs can only be satisfied if lower needs are, to a certain extent, let go of. For example, the need for intimacy can only be truly satisfied if we give up the need to be totally in control and totally safe.

Human givens is in the process of becoming accredited by the Health Professions Council.

Old Stuff
A peer reviewed research paper, published in Mental Health Review Journal concerned treating people with mild to moderate depressed mood (measured using HADS) with Human Givens therapy or ‘normal’ treatment. "The well-being of these participants was examined at the point of referral, and after four, eight and 12 months using three well-being questionnaires. The results revealed that emotional well-being significantly improved during the first four months following referral for both groups and this improvement was maintained up to and including one year post referral. Compared to the Control group Human givens therapy was found to be of shorter duration, lasting one or two sessions compared to standard treatment, which lasted on average four sessions. Apart from the psychological insight and emotional support, it is suggested that Human Givens therapy might help the client to better function in society and maintain a sense of social integration. This has benefits to other providers of social care."

The Human Givens model recognises itself to be eclectic in nature and its founders explicitly acknowledge that the approach integrates best practice and thinking drawn from existing psychological models such as Cognitive Behavioural Therapy, Interpersonal Therapy and Client Centred Counselling as well as much of their own recent research, most notably Griffin’s “expectation fulfilment theory of dreaming”

The New Scientist and the Washington Times have both featured interviews with Joe Griffin on the Human Givens approach. The British Medical Journal and the Nursing Times have both written articles which have referred to the Human Givens Approach.

In The British Medical Journal the author asks the question 'so where's the evidence?' and Ivan Tyrrell, who is the director of Director of the European Therapy Studies Institute and the Human Givens Institute, comments 'People are starting to do it [research]—but we aren't doing it ourselves. If a plane is flying, you don't need to keep showing that it's possible to fly.’.

A lengthy article discussing the Human Givens Approach was published in the May 2010 edition of the Arab Journal of Psychiatry

Peer reviewed evidence for the effectiveness of human givens therapy, published in Psychology and Psychotherapy: Theory, Research and Practice, showed that, of 120 patients treated by HG therapists in a GP's surgery, more than three out of four were either symptom-free or reliably changed as a result of the therapy. This was accomplished in an average of only 3.6 sessions. This compares favourably with the recovery rate for the UK Government’s IAPT (Improving Access to Psychological Therapies) programme that uses therapists trained in CBT and which expects therapy to take longer and less than two out of four patients to improve or recover.

Bibliography of publications

 * Tyrrell, Ivan; Joe Griffin (2004). Human Givens. Human Givens Publishing. ISBN 1-899398-31-7
 * Griffin, J. & Tyrrell, I. (2004) How to lift depression fast. Human Givens Publishing. ISBN 1-899398-41-4
 * Griffin, J. & Tyrrell, I. (2007) How to master anxiety: Stress, panic attacks, phobias, psychological trauma and more. Human Givens Publishing. ISBN 1-899398-81-3
 * Griffin, J. & Tyrrell, I. (2004) Dreaming Reality: How dreaming keeps us sane, or can drive us mad. Human Givens Publishing. ISBN 1-899398-36-8
 * Griffin, J. & Tyrrell, I. (2004) Freedom from addiction: The secret behind successful addiction busting. Human Givens Publishing. ISBN 1-899398-46-5
 * Griffin, J. & Tyrrell, I. (2004) Release from anger: Practical help for controlling unreasonable rage. Human Givens Publishing. ISBN 978-1-899398-07-2
 * Griffin, Joe. An Idea in Practice: using the Human Givens approach. Human Givens Publishing. ISBN 978-1-899398-96-6.
 * Tyrrell, Ivan; Joe Griffin (2004). Dreaming Reality. Human Givens Publishing. ISBN 1-899398-36-8.