Forgiveness – the process of “letting go”

Clinical psychologist, Lyn Worsley talks to Leigh Hatcher about forgiveness in this three part series of weekly podcasts. Forgiveness is so much a part of healthy relationships and in the first of the series Lyn discusses the process of moving to a place of “letting go” and how even in the psychological sphere of our minds, every action has an equal and opposite reaction.

How to achieve an optimal healthy Brain?

How to achieve an optimal healthy Brain?

The engine is the most vital part of a car. When we refuel, many cars require a high-performance petrol to run the engine. It appears the intake is going to affect the outcome, i.e. enhancing the performance or functions of the car.
By the same token, the brain is the commander of the mind and the body. It consists of the cognition, long term and short memory, decision making, controlling emotions, and also coordination of the whole body system through the spinal cord, all the nerves and muscles in the body. There are many self-help books, fitness centres, and programmes to advocate for physical health. On the contrary, there are not many books or advocates talking about how to achieve an optimal, healthy brain both short term and long term.
Every organ or devise has a lifespan. We occasionally hear that someone needs a lung transplant, a heart transplant or a kidney transplant. Have you heard of any brain transplant? How do we protect our brain life or even maintain the various functions of the brain to enable it to be run effectively? In other words, how do we reduce the chance of clinical dementia when we are going to age? Younger people may say it will not happen now as dementia only happens in older people. One thing worth mentioning is the brain starts ageing from the age of around 24. We need to think about how to match our brainspan with our lifespan now. According to the neuroclinical psychologist Dr Nichola Gates (2016), there are four steps to achieve optimal brain function and reduce clinical dementia.

Boosting our healthy brain

Most people already know what to eat to reduce heart disease, diabetes, lowering our cholesterol, etc. But is there any food out there that is particularly beneficial for our brain?
First of all, we need to include elements of the Mediterranean diet in our meals. Food that is low in saturated facts, and high in anti-oxidants are preferable, and also include wholegrains, high amounts of omega 3 food such as oily fish, eggs, avocado, etc., vegetables and fruits. Processed meat such as ham and salami might have to be avoided as it might be carcinogenic. Food that can promote good mental health should include food containing calcium, protein, vitamins D3, B3, B5, B6, and B12, folic acid, Vitamin C, zinc, copper, and amino acids including Tryptophan. All vitamins Bs are good for mental health especially B6 and B12.

Research indicates that there is a link between the brain and the gut. Most of our serotonin neurotransmitters are manufactured in our gut rather than in our brain. Chronic stress can affect our immune system as well as changing the barrier function in the gut making it more prone to infection. Most of the Irritable Bowel Syndrome is caused by anxiety, and it demonstrates the gut-brain-stress link existence within our system.

Reducing our brain burden

All drugs have a different pharmacological effect on the brain as they have different effects on the perception and cognitive function. Too much or over stimulation of dopamine due to substance abuse can increase the dopamine level by five to ten times the normal levels thus overwhelming the brain, leading to the consequences of reducing the capacity for critical thinking, decision making, learning, and memory, as well as poor brain function.

Research shows that there is a 16% chance of getting dementia for smokers. Some life style factors that can also lead to dementia such as lack of exercise, chronic stress, cardiovascular disease, smoking, poor sleep, illicit drug, alcohol, diabetes, and obesity are unhealthy brain burdens.

Excessive consumption and chronic alcohol abuse will damage the brain. When alcohol reaches the brain, it damages the connective tissue at the end of the neurons which results in disrupting neural communication. Fortunately, it is a temporary damage, and the brain will repair it once the ethanol remits. Chronic alcohol abuse and excessive consumption of alcohol over a period of time will affect the cerebellum and the frontal lobes. Frontal lobe dysfunction leads to difficulties to make decision and judgement, regulate emotions and affect the executive functioning. Cerebellar atrophy will lead to the classic symptom of ataxic gait which affects muscle coordination in balancing and walking. Wernicke syndrome can also happen due to extreme loss of Vitamin B1 as it is being depleted by alcohol. People with Wernicke syndrome shows ataxic wide gait, and involuntary changes to eye gaze with rapid side-to-side movements. Moderation of alcohol consumption is crucial in order to extend our brainspan.

The nicotine in cigarettes will disrupt the neurotransmitter systems that associated with dopamine and reward, as well as causing oxidative stress. In addition, research suggests that a new compound in tobacco called NNK has been found to provoke white blood cells in the central nervous system to attack healthy cells. As a result gray matter is decreasing in the brain that leads to the thinning of the cerebral cortex which involves thinking and memory.

Building brain reserve

The last ten years of neuroscience research suggests that our brain can change and grow due to neuroplasticity. Reserve here means resilience. We have to build up this capacity for the brain to function well and develop functional resilience against pathology and trauma. The research found out that by engaging the brain in more stimulating and mental activities, physical exercise, and social connection will benefit our brain by increasing the performance, stimulating brain growth and decreasing the chance of developing dementia.
A study (2017) revealed that adults who participate in high levels of physical activity tend to have significantly longer telomeres than their counterparts. Telomeres are nucleoprotein structures positioned at the end of chromosomes. As a consequence of mitosis, telomeres naturally shorten and as telomeres shorten, cell senescence increases, and eventually cell apoptosis occurs. In other words, high level of physical activities can enable us to live longer as telomeres will be lengthened instead of shortened. Another research revealed meditation also has some effects on telomere length by reducing cognitive stress and stress arousal, and thus it increases positive states of mind and hormonal factors that promote telomere maintenance. In short, both physical activities and meditation can lead to longer telomeres which mean cell division can still be continuing when we are ageing.

Cultivating wise mind

Marshal Linehan (1995) explained that the wise mind is the balanced part of us that comprises our inner knowledge and intuition. It is that place where reasonable mind and emotion mind overlap. Emotion mind is driven by our emotion whilst reason mind is mainly based on our logic and analytical mind. It can be cultivated through practising of mindfulness skills. The practice of mindfulness skills over time will help us develop our self-awareness and insight. It enables us to look inside and the environment around us without judging, as well as accepting the whole situation. This will foster an internal calmness which empowers us the capacity to regulate our emotions and alleviate our stress. As we know that chronic and long-term stress will develop into depression as stress hormones damage the hippocampus.

References:
Epel, E. Daubenmier, J.; Moskowitz, J.; Folkmna, S.; and Blackburn, E. (2015). Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres. Journal of American New York Academy Science, 1172:34-53.
Gates, N. (2016). A brain for life: How to optimize your brain’s health by making simple lifestyle changes now. Australia: HarperCollinsPublishers.
Linehan, M. (2015). DBT Skills Training Manual, second edition. NY: Guilford Publications.
Tucker, LA. (2017). Physical activity and telomere length in U.S. men and women: An NHANES investigation. Journal of Preventive Medicine. July, 100:145 -151.

Gabriel Wong
Clinical Psychologist

…But What About The Grandparents!? Parenting and Grandparents after separation and divorce

Senior woman and her two granddaughters smile while looking at freshly baked cupcakes.

The impact that parental separation has on children and parents is a topic that has been thoroughly researched. Many therapeutic, as well as legal interventions hold the child’s perspective as paramount in knowing how to navigate through what is often a challenging process for many families. In supporting children, as well as managing traumatised or grieving adults, a valuable resource within family systems can be sometimes overlooked -grandparents.

Many cultures view grandparents and elders with great respect, recognising their part in maintaining intergenerational relationships. It is no secret that maintaining family contact contributes to improved health and wellbeing outcomes for all family members. In recent years, grandparents seem to have become increasingly more active in the daily lives of their grandchildren, especially in families in which both parents are working outside the home. The grandparent-grandchild relationship holds particular strengths rarely found in other adult-child relationships. Why then is it, that there is such little research that explores the experience of grandparents with disrupted, lost or denied relationships with their grandchildren? We need to know more about how the rupture comes about and, importantly, how to protect this precious relationship.

Grandparents may have to work harder at pursuing contact with their grandchildren following a divorce or family breakdown. Many grandparents experience grief from reduced or lost contact with a grandchild. Grandparents, as the older generation play a role in caring or supporting, not only their grandchildren but also their grandchildren’s parents in giving emotional and sometimes practical, support to their grandchild’s parent. Discipline, parenting decisions and daily living skills are all things that will evolve for many newly separated parents after separation. What was often the role of one or the other parent, becomes a competency that each single parent will need to master. Not only can this be extremely stressful for separating parents, but they may require the assistance of their own parent or parent of their ex-partner to manage this.… Enter a potentially difficult time!

Parenting was challenging the first time around, and it’s likely going to be even more of a challenge when your adult child is now a parent. That’s what you might think, but really, it’s more like what you remember than you think. Your adult child may still think – he or she knows more than you and better than you, just like they did when they were an adolescent. But before you spring into action, take a minute to stop, listen and connect. Providing support through difficult times can often strengthen family bonds. It is important to be able to support your adult child in their adjustment to being a single parent, and that means working to your strengths. If you have a strong relationship with your grandchild, then you may wish to talk things through with them, help them to understand their sadness, disappointment, anger or relief. These may even be reactions that you share on some level.

Grandparents can do something that parents can’t. So, I invite you to do it. And remember, ‘There’s no such thing as an ex-grandparent!

What is Mindfulness and How is it Useful?

 

Written by Ivette Moutzouris

Mindfulness appears to be the new fad at the moment. It has become so popular that it is even being called ‘the mindfulness movement’ and has expanded beyond the therapy room and into everyday life. I thought it would be helpful to explain its origins and some basic core beliefs underpinning Mindfulness because there is so much talk about it and a mixed response about its effectiveness.

 So What is it?

Mindfulness is basically the process of being intentionally aware of the moment, with acceptance and with a non-judgemental attitude. The way in which this is achieved is through a set of strategies/meditative exercises and also by understanding and practicing a more mindful lifestyle.

It has been practiced in eastern/buddhist traditions for over 2500 years as a form of meditation and inorder to simplify and create a more meaningful life experience.

In the late 1970’s Jon Kabat-Zinn (known for his work as a Scientist, author and Meditation Teacher) introduced Mindfulness into a Medical clinic which was treating patients with chronic pain symptoms. Jon Kabat-Zinn refined Mindfulness practices and used these strategies to treat his patients and the results were very positive. From this point it was applied to treat other psychological issues such as Anxiety, Depression, Personality Disorders, Addictions and Chronic Pain.

How Do I Practice It?

Mindfulness is Experiential – it involves learning to be more present in the moment by increasing your skill of attention and focus.

An example of this could be sitting and closing your eyes and noticing the sounds around you for at least 10 minutes or more. There are many variations of Mindfulness exercises but the key to Mindfulness is to slow down and notice what is be happening around you and also within you– i.e. to connect more with your world and to find meaning and enjoyment from it. In therapy we also use it to help notice the internal emotions and thoughts and decide whether to accept, reject, defuse or challenge our internal dialogue.

Mindfulness is an Attitude -It is a lot more than just exercises. It involves learning to have a big picture perspective when you approach issues/hardships and life in general. By this I mean learning to not just notice (and even obsess) about the problem but also notice what else is going on in your life. A mindful attitude helps you to see the positives and the simple joys of life that we often neglect or miss when we are preoccupied, worried or constantly busy.

Some people think that Mindfulness is about being positive and/or ignoring issues but it is actually the opposite. It is about accepting and learning to cope with the hard times by slowing down and working through the issues instead of either automatically reacting or avoiding.  Mindfulness teaches you to be ‘more reflective’ and ‘less reactive’ and when this occurs we are better able to come up with solutions or accept our situation.

Mindfulness is Educational – this occurs as you slow down and begin to notice how you respond to situations. It also teaches you about other people as you nurture more mindful relationships and learn to listen and understand others better. It encourages us to be less focused on ourselves and to have better connection with others. I recently heard an interview with Tara Bach, who teaches and writes about Mindfulness and she mentioned the difference between Illness and Wellness, i.e. the ‘I’ is in illness and ‘We’ is in Wellness. We are relational and it is often helpful in recovery to connect with other people.

 Why is Mindful helpful?

Mindfulness is helpful because as you focus more on the ‘now’ you are less caught up in the past and situations that cannot be changed and also less focused on the future and all the worries about what may or may not happen. Being caught up too much in your past or your future can cause Depression and Anxiety because they are situations that you cannot control. Mindfulness instead teaches you to find meaning in the ‘now’ and even when you are going through a difficult time learning to not avoid it but get through it. It encourages you to look for your strengths and resources and to calm down the automatic emotional reactivity.

When you learn to slow down and observe it not only helps you to alter the emotional intensity of your reactions but also increases your attention, memory, problem solving skills, empathy and compassion. Research has shown that people who practice mindfulness exercises daily for 2 months experience these benefits and brain scans show that other parts of the brain are more active, for example the prefrontal lobe which is responsible for activating positive emotions.

 

Siegel, Ronald.  (2010). The Mindfulness Solution. Everyday Practices for Everyday Problems. New York: The Guildford Press.

Harris, Russ. (2012). The Reality Slap. Finding Peace and Fulfillment When Life Hurts. CA: New Harbinger Publications.

Williams, M., Teasdale, J., Segal, Z., Kabat-Zinn,J. (2007). The Mindful Way through Depression. New York: The Guildford Press.

www.mindfulness-solution.com

Grieving after a suicide

sunshine

Recently I found out that an ex-client from my old workplace had completed suicide, which really rattled me as a person and a psychologist. I immediately thought of the pain and despair they must have had to feel that it was impossible to continue living, pictured the grieving family and friends and then reflected on my past interactions with them. A week after I heard this awful news, I happened to have a supervision session which quickly turned somewhat into a therapy session. My supervisor gave me a space to grieve and reminded me to do what I often tell my grieving clients – try to find meaning in loss. This supervision/therapy session was exactly what I needed at that time to process my grief.

I was surprised when I heard the statistic from a recent episode of ABC documentary series called ‘You Can’t Ask That Question’ on suicide attempt survivors – 8 people died from suicide each day in Australia. This concerning statistic is double the number of Australians who died from road accidents! Most of the suicide attempt survivors interviewed in the program reported that they did not actually want to die instead they wanted a break from the painful feelings they had been experiencing.

What is grieving? Grieving is a healthy human reaction to a loss experienced, which typically involves acceptance of loss and learning to manage daily life without the person who died. Everyone grieves differently (even in the same family) because everyone has a different relationship with the person who died, carries varying past experiences of loss, and expresses their grief differently; for example, one person may prefer to share their feelings and thoughts while another may find it hard to show their emotions or verbalise their grief. Remember, there are no set rules on how to grief or what emotions one should be feeling.

When someone dies suddenly, it is not uncommon to feel overwhelming arrays of emotions and thoughts. Below is a list of feelings and thoughts that may be experienced:

  • Anger towards the person for taking their own life and leaving pain behind; or towards someone else who might have been perceived to cause or contribute to the suicide; or towards your God (if you have faith). It is also not uncommon to try and find someone to blame from the suicide.
  • Defensiveness as a protection against other people who may ask intrusive questions or say something upsetting.
  • Depression and anxiety from the intense grief.
  • Despair over prospect of life without the person who died.
  • Fear of how life will be like without the person who died.
  • Guilt over something that they believe they could have done differently to prevent suicide.
  • Numbness or feeling ‘nothing’ – for some people if may take a while before pain shows up.
  • Physical reactions – sometimes grief manifests in physical symptoms such as headaches, upset stomach, sleeping difficulty, change in appetite and/or poor immune system.
  • Intense longing to have the person return to life and experience their presence either physically (to see, touch, hold or smell) or emotionally.
  • Questioning “what if?’’ – It is not uncommon to question if suicide could have been prevented or if something could have been done differently.
  • Questioning “why?” – This is a common question that people who were left behind ask themselves and sometimes this question may never be answered completely. The reasons for suicide are often complicated and only the person who died could answer this question.
  • Rejection – sometimes people may feel that their love and care were rejected by the person who committed suicide; or sometimes people may feel rejected by others when they seemingly don’t offer appropriate support.
  • Relief – some people could not help but feel relief especially when the person who died had been experiencing distress and pain for a long time. This is a natural response from a long period of tension and stress and does not mean wishing the suicide to happen.
  • Sadness is the most frequent response reported after death of a loved one.
  • Searching for the person who died for instance by visiting places where the person used to go in case they will be there. It is also not uncommon for the grieving person to think that they have caught a glimpse of the person who died, to dream about that person or to call their name.
  • Sense of acceptance. It is possible to both accept the person’s death as a choice they made to end their pain and feel sadness over what has happened.
  • Shame maybe from regret that more could have been done to prevent death or maybe from stigma associated with suicide.
  • Shock and disbelief can manifest in different ways, such as losing ability to breathe normally or to complete daily tasks, or to feel detached from reality.
  • Stigma. Despite the concerning rate of suicide in Australia, suicide is still considered a taboo subject to discuss. People bereaved by suicide have reported feeling judged by others when death was by suicide.
  • Suicidal thoughts.

Can unresolved grief be problematic? The new Diagnostic and Statistical Manual for Mental Disorder (5th Ed., DSM-5) listed Prolonged grief disorder as a syndrome when a bereaved person experiences persistent yearning of the deceased for at least six months after the death. Criteria for prolonged grief disorder include preoccupation with the circumstances of death, difficulty of positive reminiscing about the person who died, and a desire to be together with that person. Prolonged grief disorder has been associated with 6 to 11 times greater risk of suicidality.

Regardless of how one chooses to grief, it is important for the grieving person to continue looking after themselves. It may be by doing things that they enjoy, spending time with other people or being alone by themselves. Looking after self is about identifying what is needed and getting those needs met. Many people also find talking about their grief helpful – it may be to a friend/s or family member/s, a professional who does not know them, and/or to a support group or other people who have been affected by similar experiences. Some people prefer to express their thoughts and feelings on paper instead of talking to others. Other things that can help include spending time outside, making opportunities to remember the person who died, and/or developing a personal ‘emotional first aid kit’ that can be used when feelings associated with grief get too much. Grief can feel crushing and relentless, but processing grief over time will give space for growth to occur and hope to return.

Below are telephone numbers for crisis help and support:
Mental Health Telephone Access Line 1800 011 511
Lifeline 131144
Suicide Call Back Service 1300 659 467
Kids Helpline 1800 55 1800
MensLine Australia 1300 78 99 78

References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Public Health England. (2015). Help is at hand: Support after someone may have died from suicide. doi: http://supportaftersuicide.org.uk/support-guides/help-is-at-hand/

Psychologists Are Human After All

Sarah Piper

Psychologists are regarded as experts in the human condition but they are still very human themselves. Psychologist Sarah Piper talks to Leigh Hatcher about her resilience journey, from working in indigenous and war torn communities, through parenthood, to psychologist at The Resilience Centre.