self-esteem

T’is the Season To Be Jolly.. Or Else?

wandalun

So, I returned from an appointment the other week (back in November, actually!), to discover that my neighbours had already started decorating for Christmas 😐 this is something that does not make me happy; in fact, I had been hoping to hold off on the ‘Christmas Blog’ for a few more weeks yet. But, when another neighbour decorated with lights outside their house (in a bizarre pattern!) last week, I felt that I could not contain this blog anymore; batten down the hatches, Christmas is coming (not said in a Game of Thrones style, I promise).

So, when DO we start getting ready for Christmas and how does all this affect us? I am a bit of a traditionalist; to me, Christmas decorations and trees should not appear before the 15th December, as the earliest! However, there has been a growing pattern of people starting the festivities earlier and earlier; the first year we moved in here, four years ago, the decorations came out the first week of December and they have crept earlier and earlier every year since!

This made me think- am I being ‘Bah humbug’ or are other people feeling the same as me? I found a study by (Werner, Peterson-Lewis and Brown, 1989) that suggests that neighbours who decorate their houses, and perhaps do not have many friends in their street, are doing so to show their openness and cohesiveness in their local community. So, does that mean I don’t want to get involved with my neighbours? Well, yes, to a certain extent, but this doesn’t explain WHY people decorate so early? Maybe it is to welcome the neighbours to the coming festivities?

What about those people whose decorations are ridiculous to the extremes? And I am thinking this;

http://www.bbc.co.uk/news/uk-20669944

Now, perhaps this level of decoration could actually alienate the neighbours? Who wants to live next door to lights of that extreme, or that many visitors during December? The only positive thing I can think of, is that I think your house would be fairly safe from burglars throughout the whole of December?

So, if lights can either make you more (or less) tolerant and accepting of your neighbours, what does give you the ‘Christmas Spirit’? Well, a popular study I have found, cited by all the Christmas Naysayers, is from a couple of scientists in the Journal of Happiness Studies. (Kasser and Sheldon, 2002) asked 117 people, ranging in age from 18-80. They asked them to answer questions about their satisfaction, stress, and emotional state during the Christmas season, as well as questions about their experiences, use of money, and consumption behaviors during the festive period!

Now, I don’t know if this was what you were expecting, but peoples satisfaction was actually greater for the festive period, when it was based around family and religious experiences, rather than spending loads of money and giving/receiving gifts. Was that what you were expecting? I don’t know if I was; I know that, for me, I am very lucky and have a wonderful family, so Christmas is all about being with them. I don’t really mind present giving and receiving, or maybe that is because I am far too old, and bah humbug!

I find it hard to get too exited about Christmas until late December because, for me, it can’t start without my family. So until I am doing those activities like the Christmas food shop, or the kids start the school holidays it really is not Christmas time.

The Christmas period starting in late November, or early December is more about retail. Shops have to be able to sell goods and toys for two paydays before the 25th to give people a chance to buy things. For many people this leads to Christmas fatigue before Christmas arrives, and this is why I choose to ignore the holiday season for as long as possible.

So, I guess this brings us to the crux of the issue; what if it isn’t about spending, money and presents. What if it is about spending time with loved ones. And, lets just say, you are alone and don’t have any loved ones to spend it with. What then? What if you are left alone for Christmas, and I don’t mean in a cutesy ‘Home Alone’ movie style? What happens then?

It can be very hard to be alone for Christmas, but conversely, some people love being alone at this time! So, what can you do to keep yourself from being lonely at Christmas?

Scouring the Internet, the ideas are all the same;

  • Volunteer- helping others always makes us feel good about ourselves, and lets be honest, Christmas is probably the best time to volunteer!
  • Say YES to everything you are invited to- even if you are not feeling up to it, say YES! You can always leave early and go home; you never know what you might be missing out on, if you don’t even try
  • Work, Work, Work- if you enjoy working, then work! We are all different and different things make us happy. If it isn’t interrupting your life, perhaps you can get a jump-start on next quarters budgets!
  • Indulge yourself- comfort food, stay in your pajamas all day, dancing around the front room, watch your favourite movies all day long, whatever it is, DO IT!
  • Don’t wallow in your loneliness; find some support, internet, friends, chat rooms, whatever- just don’t feel like you are on your own!
  • Planning your time in advance is a good way of staving off the loneliness; if you have planned your time in advance, you know that you are not going to get bored and lonely, as you have a full itinery of things to do. Sounds like a plan to me J
  • Random acts of kindness and having faith can be quite important; I don’t mean an all encompassing faith that demands your presence at church 24/7, but perhaps some Mindfulness meditation, some relaxation or just getting in touch with your spiritual side and your ideas of what life is all about. Whatever it is that can make you happy.

So, there you have it, you’ve got some ideas to get you going. But what if none of those things appeal to you, and you don’t have anyone special to spend the holidays with? Well I would say that you do… You are special, buy yourself a present and enjoy it, you deserve it!

Kasser, T. and Sheldon, K. (2002) ‘What Makes for a Merry Christmas?’, Journal of Happiness Studies, vol. 3, no. 4, December, pp. 313-329.

Werner, C., Peterson-Lewis, S. and Brown, B. (1989) ‘Inferences about homeowners’ sociability: Impact of christmas decorations and other cues’, Journal of Environmetal Psychology, vol. 9, no. 4, December, pp. 279-296.

 

 

Still Waiting For That Email?

wandalun

So, having been sick from work for a while, I am slowly getting back in to the swing of things. As I run my own private practice, this includes responding to emails, a task which is usually reasonably quick for me!

However, I am having difficulties with my ISP (internet service Provider) at the moment (they shall remain nameless!) and some of my emails are not being sent, going missing, I am not able to pick up some emails and, perhaps the most frustrating of all, some emails I am being sent are bouncing back to clients, so I am not even getting them!

Whilst I am trying to find fixes for these (oh-so frustrating) issues, I came across this article which was from the Conference Steering Committee for the World Wide Web in Florence, Italy this year, which explains quite a lot as to the difference in responses with some of my clients and colleagues!

Have you ever been frustrated at how slowly (or quickly!) some people reply to your emails? I am one of those people who respond as soon as I am in a position to, as quickly as possible! So, when I have to wait for a response, from a friend, client or colleague, I can become quite eager to see that little red circle with a number in it appear on my email app!

I began to wonder, what is the difference in the speed of replies for emailing people? Is it based on IT skills- would a younger generation respond more quickly, being that email/messaging has been around for most of their lives, or because it plays such an important part in their lives? Or would the older generation be quicker? Seeing it as a politeness issue; non-response would be like ignoring someone? Or maybe every age group felt exactly the same?

The study ‘Evolution of Email Conversations in the Age of Email Overload’ by (Kooti et al., 2015) found a variety of answers to some questions, namely;

  • More than half of the responses contain fewer than 43 words.
  • If people are going to respond to an email, 90 percent will do it within a few days.
  • Responses on the weekends are the shortest.
  • Teens reply the fastest, shooting back a response in 13 minutes, on average.
  • It takes people, ages 35-50, about 24 minutes to reply.
  • People age 51 and older take a whopping 47 minutes to reply to their emails, on average.
  • Women take about four minutes longer than men to send a reply.
  • Only 30 percent of emails exceed 100 words.
  • People aged 20-35 are almost as speedy, sending a reply in 16 minutes, on average.
  • Half fire off a response in under an hour.
  • Want a lengthy reply? Make sure your email arrives in the morning.
  • The most common responses contain five words.

So, what did I learn from that? Well, I learned that people deal with email information (over) load in very different ways! Younger people are quicker at responding, but respond with fewer words- could this be down to the urgency of life when you are younger, or just that fewer words are needed to get your point across? What it didn’t explain, for me, was why some people respond and others don’t? No one likes to be ignored, and not receiving a reply to an email is a way of being ignored. The study also did not stress the importance that we place on emails and responses, only that we do try to respond.

As we get busier and busier, and our working lives’ get more stressful, this study shows that we do still try to answer our emails, but that we answer fewer emails and with fewer words. The main take-away from this, is that if you have an email that you really need a reply to, ensure it is there, bright and early for the recipient to read, when they arrive at work!

But how does this affect us? Does it just mean that when we arrive at work, instead of 10 emails, we are going to arrive to 100? Does it mean that we need to change the way in which we work?

What this boils down to is how much work we have on and how willing we are to prioritize our work- are you good at prioritizing you work? Do you know what is the most important work to get done?

Do you procrastinate and go to the easy to answer emails first? Leaving the harder ones to deal with as the day wears on, and indeed, you wear on? What the study found was that social importance was of higher importance than the actual importance of the content of the emails; so for example, if the email was from a friend at work, we would be more likely to reply to that, than to an email from our boss asking if our work was done. But, does this then add more pressure on us? Are we making our working lives harder?

These are all questions that need to answered by further studies, but I wonder how many of you can empathise with what the study found? Do you feel under more pressure to reply to more and more emails? Do you find that you need to answer emails out of working hours? And, if so, when does that stop?

The pressure can be different for people who run their own business, as for people who ‘traditional’ employees- I know from my own experience, working for myself means that I am never ‘off’ work. So, what can we do to limit the stress?

Well, to start with, we can learn to switch our mobile devices off when we get home from work! I have been doing this for a while now- on days off, evenings and weekends, I will not answer calls/texts/emails from my clients. I am not being rude, I just need to have boundaries that mean I get some time off too! Perhaps that could be a good starting point for you?

Do you give yourself a lunch break? It is really important, during your working day to give yourself a complete break from work; to let your mind rest and recover, to give you the energy to get through the day. It is really easy to just grab a quick sandwich, at your desk, replying to emails or answering phone calls, but are you getting a rest and do you feel like you are getting a break? If you feel that your work is encroaching into your lunch break, make a ‘lunch date’ with friends, try going out for a walk (yes, even in this grotty weather!), or what about sitting in your car for 15 minutes? Something that will mean you are taking your mind off of your work and on to other things!

What about practicing so mindfulness or relaxation at your desk? You could do this in the morning for 10 minutes, or the afternoon, or both! You could even invest in a cheap pair of ear buds, to block out the noise! Anything that relaxes you a little and helps you get through the day is a good thing, wouldn’t you say?

Some colleagues I work with go for a power walk, or yoga session at lunch time; maybe you don’t have the time for that, but at least getting up and having a walk around the office can get you moving and break that habit of sitting there all day!

Finally, what about being kind to yourself? If you get 50+ emails in one day, on top of your daily work, being honest and accepting that you cant possibly answer all of those emails. Yes, I know, it feels rubbish to do that, its like accepting defeat, but is it realistic to expect you to do all of this extra work? If it can’t fit in to your normal working day, perhaps a chat with your boss about your work expectations and the level of work you are getting is needed?

We always expect more of ourselves, but this has to be within sensible limits, doesn’t it? Life isn’t all about work, or at least, I don’t believe it should be, do you? If you are worried about your work/life balance, perhaps it is time to take a look at it. Maybe you can’t reply to all those emails in one day, maybe you shouldn’t have to? But the study above does show us that we need some better management tools to manage our emails, so perhaps it is time we invested in ourselves, our own ‘management tool’ for our working lives?

That said, it is Friday night and time for me to enjoy my weekend! I hope you all have a great weekend; step away from the phone and stop answering your emails! Monday will be here before you know it- surely they can wait until then?

Kooti, F., Aiello, L.M., Grbovic, M., Lerman, K. and Mantrach, A. (2015) ‘Evolution of Conversations in the Age of Email Overload’, Proceedings of the 24th International Conference on World Wide Web, Florence, 603-613.

 

 

 

 

One Year On and Has There Been Any Real Change?

wandalun1 Comment

One year ago today, the world was rocked by the unexpected death of Robin Williams. He had been suffering from severe depression and, sadly, took his own life. What caused him to do this is unknown, and sadly, suicide remains very prevalent in our modern society.

According to The Samaritans 2015 report, Suicide Statistics 2015,

  • In 2013, 6,233 suicides were registered in the UK. This corresponds to a rate of 11.9 per 100,000 (19.0 per 100,000 for men and 5.1 per 100,000 for women).
  • The male suicide rate is the highest since 2001. The suicide rate among men aged 45-59, 25.1 per 100,000, is the highest for this group since 1981.

SuicideChart

 

Screen Shot 2015-08-11 at 18.10.11

So, why is this happening and what is going on? The rates of suicide are increasing- but aren’t we more aware of our mental health now, more than ever? The Mental Health Foundation estimates that;

  • One in four people will experience a mental health problem at some point in their lives.
  • Around one in ten children experience mental health problems.
  • Depression affects around one in 12 of the whole population.
  • Rates of self-harm in the UK are the highest in Europe at 400 per 100,000.
  • 450 million people worldwide have a mental health problem.

So, mental health issues are pretty common place- so why are the suicide rates increasing? One reason that is consistently studied is the idea of stigma that is attached to admitting that one is suffering from a mental health difficulty. Different forms of stigma include personal stigma (negative attitudes towards others), perceived stigma (perceived attitudes of others) and self-stigma (self-attribution of others’ negative attitudes), so we can see the possible effects of ‘owning up’ to a mental health difficulty.

A study published this year asked 350 members of the public and university students to complete an online survey assessing their knowledge and contact with depression and anxiety, perceived stigma and self-stigma for both anxiety and depression (Grant, Bruce and Batterham, 2015). They found that (surprise, surprise!) the more contact you have with anxiety and depression- be it yourself or a friend or colleague- the less stigma you perceived from other people.

Men reported that they felt more personal stigma around depression and anxiety than women and the more the participant had personal experience of anxiety and depression, the higher their levels of self-stigma were towards mental health illnesses. So, really, there were no surprises. The more you experience mental health difficulties, the more you think other people will judge you negatively. So, now are we getting to the crux of why suicide’s are rising year on year? Despite the fact that we all think we are tolerant towards mental health illnesses, there is still a huge amount of perceived stigma, particularly from people who are suffering.

If you are feeling bad, who is going to want to risk telling people, who may then judge them and make them feel worse? Or just the idea that we have a mental health difficulty can be enough to stop you even acknowledging it, and certainly stop you getting help for it. What this study found was that we need to increase interventions aimed at increasing help-seeking behavior- we need to make it easier and less traumatic and worrying to get help.

We still assume that we are going to be penalized, personally, financially and professionally if we admit to having difficulties; but, and here is the crazy part, ONE IN FOUR PEOPLE will experience mental health problems at some point in their life. It could be you, your mum, dad, partner, children, best friends or colleagues from work. How would you feel if your loved one was feeling depressed, or, heaven forbid, suicidal, but didn’t want to tell anyone for fear of shame?

We really like to think of ourselves as sophisticated and non-judgmental, but, if this were the case, more people would seek help for their health, and surely, suicide rates would decrease? Mental health difficulties don’t discriminate; the old, young, rich, poor, male, female, cultural differences- it doesn’t matter. So, if mental health illnesses don’t discriminate, why should we?

What Robin Williams sad death highlighted for our society was the fact that no matter how rich or successful you are, if you are feeling low, depressed or anxious, money and fame and success won’t fix it- it’s time we were more open about mental health. Life is hard, sometimes, and we all need help from time to time; why should we have shame and stigma attached to that?

I wrote a blog piece earlier in the year on teenage depression, but, you know what? A lot of the symptoms are the same! The other point about this piece I am writing, is that even if you are not suffering from depression or anxiety, it’s really helpful to know what the symptoms are, so we can help and support our friends and family! Also, what’s the harm in spreading information and destigmatizing the issue of mental health? Anyway, back to the point of this particular paragraph; when it comes to mental health illnesses, please seek some help if you are experiencing three or more of these;

  • Do you feel a sense of hopelessness or sadness? It can be for no reason at all.
  • Do you have thoughts of death or suicide? ‘Everyone would be better off if I wasn’t here’ can sometimes be a common thought.
  • Do you suffer from a lack of energy? Are you fatigued more than normal?
  • Are there any changes in your eating habits? Eating more, or less?
  • Are there any changes in your sleeping habits? Sleeping more, sleeping less, night waking and being unable to return to sleep, waking up early?
  • Have you withdrawn from family and friends? Does work seem harder than usual, for no particular reason?
  • Are you tearful? Do you cry easily? Are you crying frequently?
  • Have you lost interest in your usual activities? Is there a sense of apathy that wasn’t there before?
  • Are you agitated? Restless? Unable to sit still?
  • Are you suffering from feelings of worthlessness and guilt?
  • Have you developed difficulties in concentrating?
  • Have you lost your usual enthusiasm? Have you developed a lack of motivation?
  • Are you feeling irritable? Angry? Hostile?
  • Have you any increased feelings of anxiety?
  • Have you become extremely sensitive to criticism?
  • Do you have unexplained aches and pains? Headaches or stomach aches, for example?

Please do go and see a Doctor. Seek out some help. Everybody goes through a rough patch at some point or another and sometimes things are just really difficult to deal with.

There are lots of different ways to tackle depression- medication is not the only thing available! I work in the NHS with clients who are referred from their Doctors surgeries. Sometimes, just talking to someone can help. Knowing that you are not the only one who feels that way can help to normalise what is going on for you. The NHS offers CBT therapy and courses to help deal with depression, anxiety and other issues. Please believe me when I say that you are not alone, many, many others feel this way too.

It might sounds ridiculous, when you are feeling so rough that you don’t want to get out of bed, but try and see your friends and family- research shows that getting out there and talking to people really does make you feel better. It is hard work, I know, but the more you see your friends and family, the easier it gets to go out and see them and the less you isolate yourself from the people who care.

Get some exercise! Go for a walk, run, swim- whatever it is that makes you feel better! Exercise releases endorphins, which are the feel good hormones in our body, so after we exercise, we get a hit of endorphins that makes us feel good. Even If it is just a walk- it will still do the same!

Concentrate on ‘me’ time- whether that’s a face pack, a bath, and meeting friends, going to the cinema. Whatever it is that will relax you. I know, I know, there are far too many things that need to be done before you can have some relaxation. But, the dishes will still be there when you have spent some ‘me’ time, and you know what? Doing those dishes might not be such a big deal when you have had time to relax.

As adults, especially if we have families to look after, we don’t feel like we deserve to have ‘me’ time, but realistically, having some ‘me’ time can help you so much more than you think it will! Spending a small amount of time de-stressing yourself will make all those things you need to deal with easier. Go on, try it- what have you got to lose?

Are you worrying too much? Do you find yourself spending all your time worrying? One thing that can really help is to have a ‘worry book’ on hand. Every time you have a worry, write it in your worry book. Then allocate yourself a period of time during the day to acknowledge your worries- make sure its not bedtime though, as those thoughts will just swim around your head! Take 30 minutes (no more- it’s worry time, not worry hours!), perhaps after dinner, or when you’ve put the kids to bed, and get your worry book out. Have a look at your worries. Can you do something about it? If so, it’s a problem, not a worry- and problems we can do something about!

If it is something in the past, or something that we physically cant do anything about, it is a worry. Write it in your worry book, acknowledge it in your worry time, and whenever it pops back in to your head during the day, say to yourself ‘Yep, that’s a worry for me- but, it’s in my worry book/I’ll put it in my worry book, and I will look at it later in worry time!’ distinguishing between what is a worry and what is a problem can be very helpful and give us some perspective about things we can do and things we cant.

Finally, seek out help- if you are feeling low, call a friend, call the Samaritans, CALM or SANE to talk to someone. Don’t suffer alone! If you don’t feel like your GP is taking you seriously, talk to another one. Just like some people specialise in holiday insurance and others in pet insurance, GP’s have specialisms too! Some are just better dealing with mental health difficulties than others!

If you do decide to go for counselling, it is really important that you find a counsellor who fits with the way you think and feel. If you don’t feel safe and listened to by one counsellor, go to another- as counsellors, we really want you to feel confortable with us; we wont take offense if you don’t! You cant like everyone in this life!

So, don’t let your mental health get to the point that you feel there is no hope. There is help out there, if only you can find it. And, you know what? People are a lot less judgemental than you think, and that stigma you perceived from your colleague? Well, maybe they just don’t really know what to say, but they do want to help!

 

Grant, J.B., Bruce,  .P. and Batterham, P.J. (2015) ‘Predictors of personal, perceived and self-stigma towards anxiety and depression’, Epidemiology and Psychiatric Sciences, vol. 1, August, pp. 1-8.

Samaritans 08457 90 90 90

SANE 0845 767 8000

CALM 0800 58 58 58 or by text on 07537 404717

 

 

 

Stuck For Something To Do?

wandalun

So, in honour of our (not so) wonderful British summer, I thought that this week’s blog post should be aimed at all those parents out there- Just how do you survive the holidays with you children at home?

I happen to be one of those strange parents- the holidays for me are a joyous time! Yes, they are filled with shouting, crying, laughing and lots of rain, but it also means no school run, lie-ins and some real quality time with the family! Summer holidays are different for everyone- some people love them and some people loathe them, but, whichever one you are (a lover or a loather), we still have to get through them!

 

♯1 RELAX!!!

Unless you have an appointment or somewhere to be, why rush? Enjoy the fact that there is no school to rush about for and no clubs to ferry the kids to! Your kids have been working really hard for the last academic year- they deserve to have some time off!

One thing you could do is to get the kids involved in some meditation! No, not the kind of meditation you are thinking of, but a guided meditation. Using a progressive muscle relaxation can be a really useful life skill, believe it or not! By teaching your kids to relax and take a minute for themselves, you are arming them with weapons of defence for future stressful times, and lets face it, school, with all its testing and social pressures, can be a really stressful time!

There are plenty of free apps or websites available to get progressive muscle relaxation scripts- I quite like this one, which is available free (always a bonus!) https://www.law.berkeley.edu/files/Progressive_Muscle_Relaxation.pdf

You could also teach your kids to find a special place that is calming and relaxing- these techniques are great for pre-exam butterflies! Why not give it a try?

 

♯2 SLEEP!!!!

Remember when your little one’s were babies, and you thought you would never get a good nights sleep or a lie-in again? Well, now you can- legitimately!!! Again, your kids have had a hectic busy year- so have you! What else are the holidays for, but to kick back, relax and have a sneaky lie-in? So what if you didn’t get the washing done- there’s always tomorrow! Sometimes it is good to take things at a slower pace, recharge your batteries and get your head back in to a good space!

 

♯3 Switch off the electrics!!!

I don’t mean X-boxes or PlayStations- after all, research has found that (limited!) access to gaming teaches kids a lot about coordination, socialising, sharing, story telling and creativity! Have you ever played Minecraft with your kids? The stories and characters they create can be totally fascinating! But what I mean, is Social Media- we can spend all too long flicking through Facebook, Tweeting on Twitter or posting photo’s to Instagram. When we are doing this, and our kids see it, it becomes normalised. That’s what you do when you go out with people; you play on your phone.

Tear yourself away from it for a few hours- instead of taking a million photos in the play park, go ON the play park with your kids. Release your inner child!!! Now, wasn’t that fun?

 

♯4 Divide and Conquer!

What? Well, this one is for the parents who have multiple siblings to look after. I am sure that you will have the experience of having a 10 year old not want to do what your 3 year old wants to do; so, what do you do with that?

Well, contrary to popular opinion, children thrive on boundaries and timetables- they like to know what is happening and when it is happening and for how long it is going to happen! Why not spend Sunday night planning the week ahead? So that when your three year old wants to go to Peppa Pig world, and your ten year old complains, you can show them that you have space for them to choose something later in the week. This way, they can learn responsibilities and that dreaded word, sharing!

 

♯5 Don’t Compare!

This one ties in with number 3- don’t compare your activities to those of your online friends! There life is different to yours, and yes, they may have gone to Euro Disney for a ‘quick’ weekend with the kids, but that doesn’t mean a camping holiday is inferior! Your time is what you make of it, so be CHILL! Engage with your kids and stop worrying about the Jones’s, because I can promise you, they’re trying to keep up with you, as much as you’re trying to keep up with them!

 

♯6 Let your kids get BORED!

You do not have to produce activities for them every single day! It’s part of childhood to get bored and then to experiment with trying to entertain yourself! Get them to create games, art projects, have a story telling competition- there is nothing wrong with suggesting activities to them, but they will never learn to entertain themselves if we don’t leave them to it!

 

♯7 SPORT!

Sport can be a fantastic activity- cycling, playing in the park, football or even just a yomp through the local forest or park! Whatever you do gets them out of the house, expending energy and, guess what? When you expend energy, you get tired! So, a nice early night for the kids can give you just that little bit longer to relax by yourself, or with your partner, in the evenings. Now, what is so bad about that?

 

♯8 RELATIVES!

Do you have relatives that the kids could go and visit? Maybe for a morning or an afternoon, or, if you are really lucky, an overnight sleepover with Grandma and Grandpa! The kids will love it, you will love it and it gives your relatives time with the kids, unpressured, which might not happen the rest of the year!

 

♯9 Got a tent?

Have a sleepover in the garden! Did you ever do that as a child? Remember how exciting it was to sleep in your back garden in a tent?? You could have a little midnight feast, burin some marshmallows on the bbq or the kids might just be old enough to sleep in the tent alone. Whatever happens, there will be a buzz of activity in your house, and we know what releasing adrenaline produces, don’t we? Sleepy times!

 

♯10 Plan as a family

Finally, you are a family- so; if the kids are old enough, plan the holidays with them. Give them options- it doesn’t have to cost a fortune! Get them involved with running the house- baking kids (the cakes are their own rewards here!) doing the dishes or hanging out the washing. You can choose to give them pocket money for tasks, with a special visit to the sweet shop at the end of the week, or just teaching them that running a household means everyone needs to pitch in. The choice is yours- it is your family, after all!

Anyway, there are some ideas for dealing with the holidays. Yes, they’re not perfect and yes, they may not all suit you, but anything is worth a try, isn’t it? As you all know, your children are only young and wanting to hang out with you for a very small amount of time, and that time flies by even quicker. Making the most of the holidays can actually be really fun, it depends on which perspective you take!

Remember, you can always try some relaxation techniques, if the excitement gets too much!

Reality Check for Experts!

wandalun

In our therapeutic work, we are trained to ensure that we understand and respect the fact that we are ‘not the expert’- the client (you!) is! It’s your life and your emotions and expectations; how can I possibly be an expert in your life? You, your thoughts and how you make sense of them lead me. Yes, we can offer suggestions, challenge unhelpful thought patterns, offer another way of looking at things, but, ultimately, this is your life, your choice. I can never be the expert in that!

So, I was rather tickled to find a study this week that suggested the more ‘expert’ we are in our field, the more likely we are to fall for made up facts! The study, from Cornell University in the USA (Atir, Rosenzweig and Dunning, 2015), took 100 subjects, who were asked to rate their knowledge of personal finances, with 15 specific finance terms; however, 3 of the 15 terms were actually made up! What they found was that the more the subjects knew about personal finance, the more they were likely to over claim their knowledge of financial terms, and in this particular case, fictitious terms!

What was really interesting was that the same pattern of over claiming emerged for other areas, namely biology, philosophy, geography and literature. Even if the subjects were pre-warned that there would be fake terms in the questions, they still made the same patterns of over claiming. To cement these findings, they further split the subjects in to 3 groups; one group took an easy geography tests (thus boosting their confidence in geography), one group took a difficult test (thus convincing them that they were not experts in geography) and the third group took no test.

When the hypothesis was then tested, the group who took the easy quiz were more likely to claim that they had specific knowledge of non-existent towns in the US.

What the researchers actually want us to take away from this study is the fact that many of us may actually stop learning about a subject when we start to consider ourselves experts. Hmm. So, where does that leave us?

Well, as I mentioned at the beginning of this piece, is that we are experts in ourselves, but we often decide to stop learning. We decide to stop learning about ourselves and how we work and what we want from life, but the thing is, although we are experts, life changes. It changes in ways that we are not expecting, and sometimes, it changes in ways that we did not want.

Just because we are an expert in ourselves, doesn’t mean that we should ever stop learning about ourselves. If you were feeling low or demoralised, wouldn’t it be great to explore those feelings and learn why we are feeling like this? How it has affected us and how we can learn and grow from this?

Quite often, we are too scared to learn any more- after all, if things have gone so badly wrong for us at this point in our lives, what is the point? Life is a journey, it is not a destination (I am sure you will have heard that in a lecture somewhere, or even on a Christmas cracker!), and we are free to choose how we complete our journey and what we do along the way. By learning how to make ourselves feel fulfilled, we are not ‘faking it’. We are not professing to know the meaning of life! As a Counselling Psychologist, I do not know everything about life. I still make mistakes, I am no expert, but one thing I do want to do, is I want to carry on learning and growing. Each client I have teaches me something about life, psychology, my practice and the world. I wouldn’t want to stop learning for anything- would you?

 

Atir, S., Rosenzweig, E. and Dunning, D. (2015) ‘When Knowledge Knows No Bounds Self-Perceived Expertise Predicts Claims of Impossible Knowledge’, Psychological Science, July.

 

 

When is a Therapy not a Therapy?

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I have been on a lot of training lately- some I have loved, and some I have found less impressive-  the techniques just don’t resonate with me, so I have decided not to adopt them in my therapeutic work. That isn’t to say that the types of therapy do not work, I just don’t see them fitting in to my practice, be it because of a lack of a rigorous scientific background, or I just didn’t like the form of therapy! This got me to thinking- who is to say what works and why? Whilst pondering this (eternal) question, I found a study in the Psychological Bulletin that really intrigued me.

The study is called The Effects of Cognitive Behavioural Therapy as an Anti-Depressive Treatment is Falling: A Meta-Analysis, so perhaps from this, you can see why my interest was piqued! The study is a meta-analysis, which means that they have taken all the studies (between 1977 and 2014) that are about CBT (Cognitive Behavioural Therapy) (Johnsen and Friborg, 2015) and have analysed them to produce an overall investigation in to the efficacy (how it is working) of CBT. The results are, interesting, to say the least!

The study tracked the fluctuations in the effectiveness of CBT over time, and what the study found was that CBT appears to becoming less effective over time. This is not good news for the NHS, as this is the main type of therapy that they advocate. So, why does it appear to be falling out of grace, and why?

The study shows that over a period of time, 1977 to 2014, CBT has become roughly half as effective in treating depression as it used to be. I have to say, that from my clinical practice, I am finding that clients are becoming more and more resistant to CBT- in my (limited!) opinion, it is because we are becoming more self aware, and the more self aware we become, the less we can justify it to ourselves. But then, I am just one psychologist and that is my opinion!

One theory that is being bandied around is the idea of the placebo effect, which I am sure you have all heard of. The placebo effect is the idea that if you take a pill for your headache, and you believe it is paracetamol, but it is actually just a sugar pill, that the power of your mind is so strong that you will believe that this ‘tablet’ has made you better and your headache disappears, even though there was no ‘active ingredient’ in the pill you took.

Perhaps, like a popular friend in your network of friends, CBT’s reputation precedes it; the fact that CBT was hailed as a miracle cure, could mean that people really thought it worked (the placebo effect) when in actual fact, it didn’t work as well as was expected.

Part of this theory is about our expectations, which kind of ties in with my theory on the efficacy of CBT- in comparison to when CBT came about, when it was developed by Dr Aaron Beck in the 1960’s, our expectations of life have changed greatly. We are more realistic about life, in general. So, perhaps we do not expect a ‘miracle cure’ anymore? Perhaps we accept that we are who we are, and we can only change things if we want to? Who knows? That, my friends, is another study waiting to happen!

Another theory is that, as any therapy develops and becomes more popular (which is inevitable!), that the number of incompetent or inexperienced therapists applying these techniques increases. This means that the efficacy of the therapy decreases- if you are not attending CBT therapy with an experienced practitioner, it is not going to work as well. It’s like taking your Porsche to the Skoda garage- it’s similar, but not quite the same, and a Porsche has a specialist management system, so a Skoda garage wont be able to give you as good service as the Porsche garage will; although your car may be fixed to a certain extent, there is still work left to do.

Whatever the reason, life has changed and therapy changes with it. Who is to say that the placebo effect can’t actually help? I mean, if CBT works for you, who cares if it is the placebo effect at work? As long as it works, right? The problem though, lies in if it doesn’t work for you because you have been to an inexperienced therapist, or perhaps, as in my experience, you are actually self-aware and you know what is happening for you. Either way, if the only therapy available to you is CBT, and it doesn’t work, what do you do?

Well, the current therapy du jour happens to be mindfulness. Now, I have been using mindfulness for a few years, and just attended a course to brush up on my techniques, learn any new theories and to make sure I am not an inexperienced practitioner! But, is mindfulness just the next buzz word- in 40 years time, will the studies be there to show us that, just like CBT, mindfulness has become less effective also?

Last week I attended training on a course called Havening TechniquesÂŽ. Yes, yet another new form of therapy. I have not had enough experience with Havening to fully make my mind up about it, which is why I need volunteers to work with. But, this brings in to question, again, the efficacy of a therapy and the placebo effect- who is to say what is right and what is wrong? If a therapy works for you, and a competent therapist is treating you, then does it really matter what the modality of therapy is? Perhaps, in our ever-changing world in which we live in, the changing modality of therapies is actually useful. Perhaps therapy is adjusting to our different lifestyles and expectations in life?

Back when Freud was just at the beginning of his Psychodynamic theory, life was very different. People did not understand how their emotions effected, and affected their lives. The ‘new therapy’ gave us an understanding of what was happening in our lives. But now we understand, we want to solve our problems. And, in true modern fashion, we don’t want to wait; we want to fix them NOW.

Perhaps this is where Havening® could fit in? Dealing with trauma and emotions in a focused way, whilst, at the same time, giving you techniques to practice at home, where you do not have to be an expert? I don’t know, but I do know one thing- I am looking forward to finding out!

 

★ if you have contacted me with regards Havening therapy; I am in the process of writing contracts etc. to begin the therapy. I hope to be in contact with you in the next week or so to book appointments!

Johnsen, T.J. and Friborg, O. (2015) ‘The Effects of Cognitive Behavioral Therapy as an Anti-Depressive Treatment is Falling: A Meta-Analysis’, Psychological Bulletin, May.

Being Mindful of Mindfulness!

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I was on a Mindfulness course last week- Mindfulness is a really hot topic with Mental Health workers at the moment. I have been working with Mindfulness for around 4 years, so I thought I would scrub up on my techniques and ideas and get back into my Mindful practice for myself!

Did you know that in 2012 there were 40 new papers on mindfulness published every month according to Google Scholar? Guardian journalist Barney Ronay noted that 37 new books had been released that week alone! I think that this demonstrates just how popular mindfulness has become.

Mindfulness, the act of paying attention, in a non-judgmental way, to ones own experiences of the here and now. So, what exactly does that mean? Well, exactly what it says- paying attention to what is happening to you, around you, in the moment that you notice them.

Whenever anyone is going on a mindfulness course, the first thing people who are experienced in mindfulness will say to him or her is “Wait until you do the raisin exercise!” What? What on earth is that? Well, a good way to explain mindfulness is to take a raisin. Don’t eat it- you are jumping the gun there! Hold it in your hand. Have you ever really looked at a raisin? Have you noticed the colours? Have you held it up to the light and looked at the brown and amber hues that are in front of you? Have you ever looked at the creases, the ridges, and the folds? The size of the raisin or the shape of it? Have you felt it between your fingers? Is it squishy? Hard? Smooth? Textured?

No? I am sure you haven’t. Not really. Not closely.

Well, let’s not stop there! Pick up the raisin. Put it to your ear. Do you hear anything? No, of course you don’t, but then roll the raisin between your fingers. Can you hear the squeakiness of the raisin now? The slight grinding as you roll the raisin between your fingers?

Take the raisin and hold it up to your nose. Take a deep breathe in- can you smell it? What does it remind you of? Christmas cake? Cinnamon rolls? Is it a slight smell, or pungent?

Now, put the raisin in your mouth- but don’t chew it or swallow it! Roll it around in your mouth and really feel it. Put it between your teeth, give it a little squeeze. Can you feel the textures and the taste starting to spread? Gently chew the raisin, experience the flavour. Is it sweet? Bitter? Finally, swallow.

Now. I bet you haven’t experienced a raisin like that before, have you? You could do the same with making a cup of tea or brushing your teeth- any activity that you do during the day, that you can break down and really pay attention too!

So, what on earth has fiddling with a raisin for the last 10 minutes done for you, eh? Well, by exercising all of your five senses, your cortisol level has decreased (stress hormone) and you will feel calmer than you did before you started. By looking at things from a visual, auditory, kinaesthetic, gustatory and olfactory sense (see, hear, touch, taste, smell!) you have brought yourself into the present moment. You are not thinking of that annoying colleague today at work and you are not thinking of all the work you need to do tonight to prepare for tomorrow. You are in the moment, and that moment is peaceful and calm.

So, by practising this every day (for those of you in the know, it is VAKGO. Yep, snazzy, eh?) we can just stop what is happening, take a few minutes out of life to relax and calm down, before we go on to the next busy period of the day.

So, how exactly does being mindful, which can actually be a personality trait anyway, actually be beneficial? A study in 2011 suggests that

“Evidence suggests that mindfulness practice is associated with neuroplastic changes in the anterior cingulate cortex, insula, temporo-parietal junction, fronto-limbic network, and default mode network structures” (Hölzel et al., 2011)

Say, what?! Well, what this means is that by practicing mindfulness, area’s of the brain, associated with neuroplastic changes (referring to changes in neural pathways and synapses that occur due to changes in behavior, environment, neural processes, thinking, and emotions – as well as to changes resulting from bodily injury) in areas of the brain that are responsible for attention, focus and regulation. Simply put, by utilizing mindfulness you can actually change the structure of your brain (the area’s that are ‘plastic’) for your benefit; to increase your sense of personal perspective awareness, your attention and focus, your emotional regulation and your body awareness.

Nah, that’s not real. Once your born, your brain doesn’t change. Well, actually it does- as we grow so does our brain. Our neural pathways and synapses develop and change, according to our environment, what we learn, what we don’t learn and genetics. So, if we train our brain to be present in the moment, really present, we can grow the area that we use to focus and pay attention. What magic is this, I hear you ask? Well, it is simply the wonder of the human mind- although science has come along way over the last 100 years, we still do not really know how the brain functions; we are learning more every week.

So, if mindfulness is so magic, why isn’t everyone doing it? Well, I cannot answer that one, I am afraid! What I can say is that mindfulness is NOT a cure all. It is a technique you can use to develop and enhance your day-to-day life. In fact, there are studies available that say certain people should not practice mindfulness; a study in 2012 concluded that there was not enough data available to fully analyse who should or should not partake in mindfulness meditation or therapy, but that people for whom there are deep-seated mental health difficulties or long term psychological affects, mindfulness meditation may not be appropriate (Dobkin, Irving and Amar, 2012).

The reason that mindfulness may not be appropriate for some people is that the act of mindfulness takes us deep in to meditation- by doing so, we are relaxing and allowing ourselves to be in the moment. If you have any traumatic experiences that you perhaps haven’t dealt with, or that still trouble you, the by going in to the mindful state can reduce your inhibitions, and the safety mechanisms, the defence mechanisms you have in place, to protect you from your difficult thoughts, are suddenly lowered, which can leave you in a very troubled place.

So, this blog then becomes a cautionary tale! Mindfulness, to some, seems like it is a waste of time, however, this is not what we are seeing from the studies that are coming out. Mindfulness has been shown to reduce anxiety and depression and to help with many other issues people have. However, it is not a one size fits all therapeutic achievement. In fact, if you are not in the right place in your life, in the right state of mind, mindfulness could in fact be quite dangerous for you- raising traumatic memories that you have repressed, hidden deep down or simply memories that you actually don’t want to, or can’t, deal with. Mindfulness is not the be all and end all that we originally thought it to be, the studies are showing this, but. That said, it could really work for some people.

So, if you are having difficulty sleeping, or are feeling stressed from your busy life, why not take 10 minutes out of your busy day to practice some mindfulness meditation (as long as you are not in the group of people discussed above, for whom mindfulness is contradictive!)? It doesn’t have to be the raisin, although, why not? Perhaps you are just going to use the VAKGO to notice what is going on around you, or you are just going to close your eyes and concentrate on your breath. In and out, slowly, clearly, purposefully. You never know. After 10 minutes of it, you may feel like a whole new person!

 

Dobkin, P.L., Irving, J.A. and Amar, S. (2012) ‘For Whom May Participation in a Mindfulness-Based Stress Reduction Program be Contraindicated?’, Mindfulness, vol. 3, no. 1, March, pp. 44-50.

HĂślzel, B.K., Lazar, S.W., Gard, T., Zev, S.O., Vago, D.R. and Ott, U. (2011) ‘How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective’, Perspectives on Psychological Science, vol. 6, no. 6, November, pp. 537-559.

 

 

Procrastination- What Are You Waiting For?

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Procrastination. We all do it at some time or another. I know I have- if there is a deadline for an assignment, you will always find me playing a game, or anything to avoid the inevitable! But, I always start with just enough time to get it done. For some people, procrastination is far more stressful- it really affects their lives and can change things for the worse.

So, why do we procrastinate? And does it do us any harm? I read a study posted in the Association of Psychological Science last month, the study stated that procrastination, or rather Trait Procrastination– the tendency to delay important tasks despite the negative consequences- was significantly associated with hypertension and cardiovascular disease (Sirois, 2015). So, although this study highlighted that procrastination was associated with hypertension and cardiovascular disease, it did not provide a causal link- phew, all you procrastinators out there, we can breathe a sigh of relief. For the moment.

20% of people identify as chronic procrastinators (Marano, 2003); meaning that procrastination cuts across all aspects of their lives, from paying bills on time to filing tax returns. Luckily for me, my procrastination only seems to affect writing reports and studies (and yes, this blog, too!), but for other people, procrastination can be literally life ruining.

Chronic procrastination is not a problem of time management, believe it or not! Procrastinators are actually more optimistic than other people- they genuinely believe they will get the work/project/bill paid completed in time! We are also not born procrastinators- procrastination is a learned habit, generally from our familial habits, albeit not directly from our families- it is generally our own responses to being raised within an authoritarian lifestyle.

So, for example, having a harshly authoritarian father will keep you from developing an ability to regulate yourself, by internalizing their own intentions and then learning to act on them. Procrastination can also be a form of rebellion- one of the only ways we feel we can act out within our familial situation. Sometimes parental support is not there, so we tend to look to our friends for support. Now, the thing with friends is that they tolerate our BS, don’t they? They don’t call us on it when we say ‘yeah, sorry, my dog ate my homework’. They empathise with us and let it go- thus reinforcing our procrastination techniques and habits.

Situational procrastinators, on the other hand, make delays based on the task at hand. Procrastination becomes a form of self-regulation failure- you know you should do it, but you just can’t bring yourself to do it, for whatever reason it is, you just cannot get around to doing it, till it is either too late, or it has caused you a problem.

What wont come as a surprise, is that procrastinators actively look for distractions! I remember writing my dissertation and finding that the whole house was ‘desperately’ in need of a clean before I started the work! The thing is, procrastinators tell themselves lies- we say ‘I work best under pressure’ or ‘its not important, I have plenty of time to do it if I start tomorrow’. So, what happens is, procrastinators run out of time- the work that is produced is not of a high enough standard, or we missed buying those bargain tickets to the next gig we wanted to go to.

It may also surprise you to know, that there are three different types of basic procrastinators;

  • The first type is the ‘avoiders’- avoiding fear of failure or fear of success. They would rather that people think they lacked effort than ability.
  • The second type is the decisional procrastinators- when you find it difficult to make a decision. You know, when your friends or partner say ‘where would you like to go for dinner?’ and your response is ‘I really don’t mind’.
  • The third type is ‘arousal type’ of procrastinator- the thrill seekers who are waiting for the last minute for the rush of adrenaline they experience.

So, have you identified which type of procrastinator you are? Are you a chronic procrastinator, or just a casual one- procrastinating in one field or area only? But hey, there’s no problem with procrastination, is there? It doesn’t really matter? Well, actually, that is not true. As I said earlier, there is a study that links procrastination to heart problems, but there is also evidence that procrastination harms the immune system- over the course of one academic term, college students who procrastinated suffered more colds, suffered from insomnia, suffered more gastrointestinal issues and more cases of flu.

Procrastinators have higher levels of stress and lower levels of emotional and harmonial wellbeing. Joseph Ferrari, Professor of Psychology at DePaul University in the USA found that ‘everybody may procrastinate, but not everyone is a procrastinator’ (so, there is hope for me after all!). The Professor says ‘telling someone who procrastinates to just do it, is like telling someone with chronic depression to cheer up’ (Ferrari, 2010). So, what can we do then?

Well, the current level of thinking is that what lies behind a procrastinator’s thought patterns are actually based on our Emotional Regulation. If we can regulate our emotions, and deal with them, then we can stay on task. If we are not enjoying the task, we are more lightly to procrastinate. Ok, so, that’s fine, but as humans, we need to do things on a weekly or daily basis that we don’t want to do, or that we don’t enjoy. So, how can we go about changing ourselves, to reduce our stress and make ourselves feel more harmonious, and less likely to get sick?

One thought of how to do this, is to try to make your current mood a positive one- if we handle this situation well, then our ‘future self’ will be better equipped to deal with these issues in the future (Wohl, Pychyl and Bennett, 2010). Sounds simple, but how do we go about doing it?

One-way could be through Counselling- by attending Counselling we can help the client to realise that they are compromising their long-term goals and aims for short term happiness. Perhaps there is a way that we may feel like we are punishing ourselves for past transgressions- until we open up the emotions and reasons why a client procrastinates, then we cant really get to the core of what we can do to stop it, or improve the situation.

Mindfulness therapy can be really helpful with this- by really appreciating the current moment, and not thinking so far in to the future. By learning Mindfulness skills, you can really put yourself in the present moment and appreciate that moment for what it is. Perhaps then, you can possibly see the damage that procrastination is doing to your self, your stress levels and your ability to actually ‘get the job done’.

Secondly, the procrastinator could split their goal down to smaller tasks- this is basic CBT and can be achieved by you or with the help of a Counsellor. Finding and exploring ways in which you can work with your procrastination can be difficult to see or achieve; sometimes it is only when we talk to some one else about what we are doing, that we really see what is going on before our eyes. After all, as I said earlier, our friends kind of let us get away with our procrastination, a Counsellor will not. We wont be mean or cruel, but we will challenge your beliefs and expectations; that’s our job, it’s what we are good at and we do it in a way that is safe and guided by you.

You could also start by imposing your own personal goals and deadlines- if your bill is due to be paid on the 30th of the month, start splitting the task down at the beginning of the month. Start small; with achievable steps that you can tick off when they’re done- nothing encourages us to carry on with our goals than when we actually start to see results!

Emotionally, this can be a slightly tougher nut to crack- you’re going to need to find something positive in the task that you are trying to achieve, which could lead us back to breaking the task down to smaller components and allowing ourselves to be proud of our achievements, not matter how small or trivial they may seem. When it comes to our loved ones, perhaps it is a good idea to not let their procrastination go- challenge them, did the dog really eat your homework, or could you just not be bothered?

But the key to procrastination could be as simple as self-forgiveness- forgive yourself for procrastinating and acknowledge the fact that you did procrastinate. The next time, maybe you will find yourself actually doing the work a little quicker, and hitting your goals and achievements on time.

 

 

Ferrari, J.R. (2010) Still Procrastinating? The No Regrets Guide to Getting It Done., 1st edition, Hoboken: Wiley.

Marano, H.E (2003) Procrastination Psychology Today; https://www.psychologytoday.com/articles/200308/procrastination-ten-things-know. Accessed May 2015

Sirois, F.M. (2015) ‘s procrastination a vulnerability factor for hypertension and cardiovascular disease? Testing an extension of the procrastination–health model’, Journal of Behavioral Medicine, vol. 1, no. 12.

Wohl, M.J.A., Pychyl, T.A. and Bennett, S.H. (2010) ‘I forgive myself, now I can study: How self-forgiveness for procrastinating can reduce future procrastination.’, Personality and Individual Differences, vol. 48, pp. 803-808.

Medication or Therapy- Which is Better?

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Depression- we all know the signs, right? Wrong. I have lost count of the amount of clients I have seen, who have sat in front of me saying “But, I’m not depressed though, am I?” after having reeled off a very impressive list of depressive attributes. Depression creeps up on you, slowly. At first, you’re just having a bad day. Then a bad week, and before you know it, you’ve had so many bad weeks; they’ve turned into months and possibly years.

There has been a lot of academic argument lately, within the Institute’s of Psychiatry and Psychology- an argument is being put forward that the long-term use of psychiatric medication is causing more harm than good. Professor Peter Gøtzsche, the director of the Nordic Cochrane Centre at Rigshospitalet in Copenhagen is currently arguing that the ‘minimal’ benefits of psychiatric drugs are exaggerated and the harms (including suicide) are underestimated (Gøtzsche, Young and Crace, 2015). For those people who are on medication, and find it works, I am sure that they would argue the odds with these authors, and be angry at their assertion that medication has minimal benefits. Medication, which for some people is a lifeline, seems to be being dismissed so out of hand and so easily.

There have also been articles with regards to Mindfulness – and other talking therapies, that have appeared recently, advocating the benefits of Mindfulness Based Cognitive Therapy (MBCT), which was developed as an explicit intervention to reduce relapse and recurrence in depression; the study goes on to find that there is no evidence that MBCT is better at avoiding depressive relapses than antidepressant treatment (Kessler et al, 2015). So, what does that mean for the ‘layperson’? Well, it means that talking therapies can be as effective as medication, but that it depends on the illness that is being treated and the person themselves, but also how that person responds to the medication and the talking therapy.

Let’s not forget- medication needs to be taken regularly, and may need to be adjusted to find a dose that works for the person effectively, or that the medication prescribed is not actually working for the individual and a change of medication may be needed. But also that, in terms of talking therapies, it is crucial that you find a therapist that you can get along with, that you trust and that you can open up to- creating the working alliance of the therapeutic relationship is key to ‘good’ therapy (Clarkson, 2003).

The combination of using medication and talking therapies can prove to be very useful for some people- the medication can work to combat the symptoms of the depressive illness and the talking therapy can help to support the patient to deal with any underlying issues that may have caused the depression (Hollon et al, 2014). So, as you can see, a two-pronged attack seems to work also. There was another study in 2013 that suggested that neither medication nor talking therapies worked any better than each other (Cuijpers et al, 2013) which was a meta-analysis- a meta-analysis is where all the current studies for the related field are looked at, and an overall summation of the findings is given.

So, what does that leave you with? You are not a study, cohort or focus group- all the studies I read tell me what I may find, but in reality we are all very different and we each need to find what works for us. A doctor can help you find the right medication, and a therapist can supply the therapy – the important thing is that whether its meds of therapy type, if it did not work for you, don’t give up, try something else; another therapist, go back to you doctor, go to a new doctor. Keep trying until you find the help and support you need.

Well, in my experience, medication is great- if you can find one that works, get the dosage right, then it can really help to resolve the physical manifestation of depressive illness. Sometimes, we do not know what has triggered the depressive illness, and sometimes we do- when we do know what has caused it, coming to therapy can really help gain a sense of perspective, or put old ghosts to rest. Even if you don’t know what has caused your depression, talking to a professional can really help and may even help you understand the cause. As therapists we are there to listen and be non-judgmental; we wont tell you to ‘buck up’ or ‘snap out of it’, as we know that saying that to you wont help you and it certainly wont work! If you could really just ‘snap out of it’, wouldn’t you have done that months ago?

The World Health Organization (WHO) believe that 1 in 10 of us will suffer with depression at some point in our lives, and it is the leading cause of disability in the world (yes, really!). Depression can affect anyone, at any time. We don’t know what causes depression and much, much more research needs to be done in the area. Depression does tend to run in families and it can be caused via a genetic and environmental combination. You may not realise you are depressed to start with, other people may recognise it in you first, or you may recongise that you are just not feeling as good as you used to.

It can be difficult to support someone going through a depressive illness, especially if you have no experience of depression and don’t understand what is happening to your loved one or friend. The important thing is to listen to them; be patient and encouraging, but above all, show kindness and compassion. And, you know what? The same applies to yourself, if you are suffering with depression- be kind to yourself, acknowledge that you are going through a bad period and do not beat yourself up over it. Something I like to say to my clients is “What would you say to a friend, if they were in your situation?” because, you can guarantee, you wouldn’t be harsh on a depressed friend, so why be harsh on yourself?

 

Clarkson, P. (2003) The Therapeutic Relationship, London: Whurr Publishers.

Cuijpers, P., Sijbrandij, M., Koole, S.L., Andersson, G., Beekman, A.T. and 3rd, C.F.R. (2013) ‘The Efficacy of Psychotherapy and Pharmacotherapy in Treating Depressive and Anxiety Disorders: a Meta-analysis of Direct Comparisons’, World Psychiatry, vol. 12, no. 2, pp. 137-148.

Gøtzsche, P., Young, A.H. and Crace, J. (2015) ‘Does long term use of psychiatric drugs cause more harm than good?’, British Medical Journal, vol. 350, May, p. h2435.

Hollon, S., DeRubeis, R., Fawcett, J., Amsterdam, J., Shelton, R., Zajecka, J., Young, P. and Gallop, R. (2014) ‘Effect of cognitive therapy with antidepressant medications vs antidepressants alone on the rate of recovery in major depressive disorder: a randomized clinical trial.’, JAMA Psychiatry, vol. 71, no. 10, October, pp. 1157-64.

Kessler, Lewis, G., Watkins, E., Brejcha, C., Cardy, J., Causley, A., Cowderoy, S., Evans, A., Gradinger, F., Kaur, S., Lanham, P., Morant, N., Richards, J., Shah, P., Sutton, H., Vicary, R., Weaver, A., Wilks, J., Williams, M., Taylor, R.S. et al. (2015) ‘Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial’, The Lancet, April, Available: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62222-4/fulltext [20 May 2015].

 

 

Disappointed with the Result? Bear this in Mind!

wandalun

Here in the UK, we have just had our General Election, which we have once every five years. Now, I know that some of you out there are going to be left feeling disappointed and disenfranchised, but others will be feeling the opposite (I will not be pledging my own Political allegiance here- I learnt at a very young age not to argue about Politics, Religion and music!). And this is where this blog is going- disappointment and how it affects our lives.

There is a general feeling of apathy and dysphoria in the Nation, at this moment in time- I am wondering, have you ever felt that in your life? Do you sometimes wonder where you are going with your life, why you are in a cycle of repeating mistakes, or just that you seem to be disappointed with your lot in life? We all do, at some point in our lives, but it can become a problem if this is our outlook for extended periods of time. In fact, for some people, even just a short period of time feeling like this can be extremely detrimental to their mental health. You know, ‘cos Mental Health Matters, don’t it?

Lots of people are sceptical about therapy- I encounter it all the time. “Oh, you’re a Psychologist? Read my mind then” or the other familiar “Oh. You’re a Psychologist.” Then nothing. They don’t want to talk because they think I will psychoanalyze them the whole time! This doesn’t happen, I just want you all to know this- even Psychologists need time off to kick off our DM’s and enjoy a party!

Saying that, there has been some articles in reputable UK publications of late, to do with something you may never have heard of; Mindfulness. “What is Mindfulness?” I hear you ask! The Dictionary definition of Therapeutic Mindfulness is;

“A mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations, used as a therapeutic technique.”

 I bet you’re thinking “Mumbo Jumbo?” Well, according to a recent study published in the most ‘reputable’ of medical publications, The Lancet (Kuyken, 2015), Mindfulness-based Cognitive Therapy (MBCT) is nearly as effective as taking prescription Antidepressants alone- out of 424 participants, after two years, 44% of the MBCT patients relapsed as opposed to 47% of Medication only patients. So, what does this tell us? Well, surprisingly, MBCT is more effective than first believed.

There are a few issues here, with the Mindfulness study- the scientific description of Mindfulness changes from provider to provider. Now, because it is available on the NHS, MBCT has proven its efficacy (that it works) and so, if it can work on the NHS, then maybe, going to a reputable provider (if seeking private therapy), will also be the same.

The main critique with this study is that the Mindfulness patients had already suffered three or four bouts of depression (depression can be a right b*gger that way) and were already on a maintenance dose of medication. The common thinking has been that the combination of talking therapies, be it MBCT or CBT or Person-Centered, with medication is the best form of support for someone with recurring depression.

So, where does this fit in with disappointment? Well, disappointment and depression can both be caused by life’s tribulations. In one study, disappointment was ascribed to being the resultant causes of ‘what might have been’ or the ‘outcome of unfavourable decisions’ (Zeelenberg et al., 1998). Sound familiar to anyone? Mixed up in there is also the emotion of regret; perhaps you regret your vote yesterday? Perhaps you regret making a decision that ‘could’ of had a more favourable outcome? Whatever it is, life is full of mistakes, disappointment and regret- as well as happiness, joy, love and positivity! The problems only come when these two opposing forces are unbalanced.

So, that Mindfulness stuff, eh? How does that work then? Well, MBCT blends Mindfulness with CBT, so we learn to be in the present, instead of focusing on the future and the past. It helps us to come to terms with the decisions we have made; the disappointment, the regret, and focus on the here and now and how we can make the most of our lives as they are.

MCBT looks at what is going on for you now, and how the impact can be lessened for you- it gives you a specific set of skills, to practice for everyday life. No, it is not just meditation, it is being mindful of what is happening, your surroundings and not skipping forward to the end result.

According to the London School of Economics, 1 in 6 adults will be affected by depression during their lifetimes. That is a significant number; really, a lot. So, if you are feeling that way, please know that you are not alone and there is help available.

If you are interested in Mindfulness based therapy, have a look at the NHS website for more information. Many of your local GP surgeries, in the UK, will also offer free courses in Mindfulness. So, what are you waiting for?

 

 

Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial; Dr Willem Kuyken, Rachel Hayes, PhD, Barbara Barrett, PhD, Richard Byng, PhD, Tim Dalgleish, PhD, David Kessler, PhD, Glyn Lewis, PhD, Edward Watkins, PhD, Claire Brejcha, BSc, Jessica Cardy, BSc, Aaron Causley, BSc, Suzanne Cowderoy, MSc, Alison Evans, MSc, Felix Gradinger, PhD, Surinder Kaur, BSc, Paul Lanham, Nicola Morant, PhD, Jonathan Richards, BSc, Pooja Shah, Harry Sutton, Rachael Vicary, PhD, Alice Weaver, BSc, Jenny Wilks, MSc, Matthew Williams, MSc, Rod S Taylor, PhD, Sarah Byford, PhD The Lancet, April 2015.

Zeelenberg, M., Dijk, W.W.v., S.R.Manstead, A. and Pligt, J.d. (1998) ‘The Experience of Regret and Disappointment’, Cognition and Emotion, vol. 12, no. 2, pp. 221-230.