What is Meditation? and How to do it?

Meditation is a topic that has recently received a great deal of attention for its benefits, especially those pertaining to mental health. Historically, meditation was considered to be an alternative health care practice originating in the East. However, with the advent of programs incorporating meditation such as Mindfulness Based Stress Reduction by Jon Kabat-Zin and subsequent scientific studies, there is now a large body of research to support its health benefits. Currently, it is common to find meditation courses in hospitals, psychology practices, rehabilitation clinics and other multi-disciplinary facilities.

Despite the rising popularity of meditation a lot of confusion still exists. Common questions include: How do I meditate and does it work? What type of meditation should I practice? How long and how often should I practice for? What should I expect from a regular meditation practice? Meditation is simply a way of calming down the monkey mind observing thoughts, feelings, sensations without judgement. Historically, the monkey mind has kept us safe. Back in hunter gatherer days we needed scattered attention to  survive, scanning the environment for predators. In modern western society we receive information through the internet, social media, television and other forms faster than our nervous system and brain can handle. The result often takes a toll on our mental health with conditions such as stress, anxiety and depression and on physical health with illness such as cancer and heart disease.

If you are new to meditation it can be helpful to try a few different styles to ascertain which method works best for you. There are many different styles of meditation usually classified by the way they focus attention. For example:

  • Passive meditation (sitting in stillness where the focus point can be the breath or a single sound) All perceptions internal (thoughts, feelings, memory) or external (sounds, hearing, smell) are recognized and seen for what they are. The participant is encouraged to experience their perceptions in a non-reactive process from moment to moment. For example in breath meditation you are encouraged to pay attention to the breath. When you notice the mind wandering and thoughts arising you are encouraged to focus your attention back on your breath as a focus point. Eventually the mind is calmed by attention to the breath and the ability to focus attention becomes easier with practice.
  • Active meditation (Using sound, guided meditation, walking meditation) For example, guided meditation involves a process where participants meditate in response to the guidance provided by a trained practitioner either in person or via a sound recording comprising of music or verbal instruction, or a combination of both. This type of meditation is ideal for visual learners  or people who learn best through sight. In contrast, walking meditation is ideal for people who are typically restless and with high energy types or for people with injuries that prevent them from sitting comfortably. It involves slow walking paying attention to all five senses.

Some benefits of meditation include:

Emotional Wellbeing:

  • Lessens worry, anxiety and impulsivity
  • Lessens stress, fear, loneliness and depression
  • Enhances self esteem and self acceptance
  • Improves resilience against pain and adversity
  • Increases optimism, relaxation and awareness
  • Increases mental strength and focus
  • Improve memory retention and recall
  • Better decision making and problem solving
  • Improves overall mood and emotional intelligence

Physical Wellbeing:

  • Improves breathing and heart rate
  • Reduces blood pressure
  • More longevity
  • Lessens asthma and inflammatory disorders
  • Lessens premenstrual and menopausal syndrome
  • Improves immune system and energy levels

So how does meditation work?

Firstly, meditation helps to switch from the stress response in the body (fight or flight), where the sympathetic nervous system (SNS) is activated, to the rest and digest response activating the parasympathetic nervous system (PNS). Our SNS helps us to respond to stress by speeding up our heart rate, constricting blood vessels, decreasing digestive activity, raising blood pressure and sending adrenaline throughout the body. The stress response prepares the body to fight or run which can be helpful if there is an actual emergency however, this often isn’t the case and often the stress response is activated where physical action is unnecessary. Prolonged stress can result in chronic supression of the immune and digestive systems and trigger anxiety and depression. The good news is we can learn to switch to the parasympathetic nervous system (PNS) by activating the vagus nerve, through meditation and slow breathing.  

Secondly, our diaphragm is connected to a nerve group called the vagus nerve also known as the 10th cranial nerve. This nerve group connect to various parts of our system including the belly, the heart, the throat, and the end of the diaphragm. The main function of this nerve group is to active the PNS or we could say bodily functions leading to relaxation. When this nerve group is not active or well toned managing stress is extremely difficult. As we breathe deeply into the belly during meditation the range of motion increases in the diaphragm, which stimulates the vagus nerve sending a message to the brain to activate relaxation and calm. The vagus nerve is also connected to the heart. When we breathe into the belly and the vagus nerve is activated, one of the direct consequences is that the heart rate is slow down.

Thirdly, meditation positively influences heart rate variability (HRV) balancing the SNS and PNS.  This important because steady, rhythmical fluctuations in heart rate and good heart rate variability are the basis of well being. When our autonomic nervous system (ANS) is well balanced, we have a reasonable degree of control over our response to minor frustrations and disappointments, enabling us to calmly assess what is going on when we feel insulted or left out. Effective arousal modulation gives control over our impulses and emotions. As long as we can stay calm we can choose how we want to respond. Individuals with poorly modulated ANS are easily thrown off balance, both mentally and physically. Since the ANS organises arousal in the body and the brain, poor HRV (that is a lack of fluctuation in heart rate in response to breathing)- not only has negative effects on thinking and feeling but also on how the body responds to stress. Lack of coherence between breathing and heart rate makes people vulnerable to a variety of physical illnesses such a heart disease but also mental health problems such as depression and PTSD.  

Typically, most meditation techniques advocate a daily practice of least five minutes in the morning and evening, building up the duration of meditation over time. However, in the early stages of learning meditation, roadblocks can be common, with people reporting:

“My mind is always racing, so I can’t do it”

“I’ve tried to meditate and it didn’t work”

“It’s just too difficult”

“I don’t know what to do, just sit there?”

Regular practice with an experienced meditation teacher and attending group classes can be helpful to overcome these obstacles.

For further details on links to scientific articles on the benefits of meditation:

http://liveanddare.com/benefits-of-meditation/

—YouTube Link Vagus Nerve https://www.youtube.com/watch?v=RpCdqoWRoD4&list=PLPSPqfuv_mRhpEhYr1kF0XWrRxrM8wLca

—B. A. van der Kolk, et al., “Yoga as an adjunct treatment for PTSD.” Journal of Clinical Psychiatry 75, no. 6 (June 2014): 559-65

—B. A van der Kolk The Body Keeps Score (Penguin: London, 2014)

—P. Ogden, Trauma and the Body (New York: Norton, 2009).

—I. Kabat Zinn, Full Catastrophe Living. How to Cope with Stress, Pain, and Illness using Mindfulness Meditation (Piatkus Books: London, 2013)

For regular meditation classes and training:

http://stillnessproject.com

Author: Angela Curtis (Provisional Psychologist)

Email: angela@theresiliencecentre.com.au

Thinking there is perfection is your first imperfection (the first of many)

i-can-t-keep-calm-i-m-a-perfectionistHi, my name is Alison and I am a perfectionist. Actually, let me rephrase that. I’m a recovering perfectionist. Take it from me, the road to recovery from perfectionism is a long and difficult one. Why is perfectionism such a problem that warrants recovery and repair? Does this not mean that I’m a high achiever on the healthy pursuit of excellence, destined for greatness?

Well my friends I’m sorry to be the bearer of bad news, but perfectionism does not in any way resemble the healthy pursuit of anything. It is not healthy. Fullstop. It is actually quite harmful. Perfectionism can seem like a positive trait. It can make you seem smarter, more switched on or driven to succeed in life. Yes, often the perfectionist can present this way. But there is another side to perfectionism that is far less enticing, less rewarding and far more damaging.

Let me take you behind the scenes on some of the core beliefs behind this insidious trait. As a perfectionist:
1. You are motivated by the fear of failure or a sense of duty.
2. You feel driven to be number one, but your accomplishments, however great, never really satisfy you.
3. You feel you must earn your self-esteem. You think you must be very ‘special’ or intelligent or successful to be loved and accepted by others.
4. You are TERRIFIED by failure. If you do not achieve an important goal, you feel like a failure as a human being.
5. You think you must always be strong and in control of your emotions. You are reluctant to share vulnerable feelings like sadness, insecurity or anger with others. You believe they would think less of you.

Basically, perfectionism hampers success. It can lead you on a path towards depression, anxiety, addiction and life paralysis (defined as all the opportunities you have missed out on due to fear of putting anything out there that is imperfect).

These beliefs are incredibly negative and self-deprecating in nature and are inherently different to a healthy mental structure for screening and perceiving information. On the opposite end of the spectrum to perfectionism is the healthy pursuit of excellence, and this is where:
1. You are motivated by enthusiasm and you find the creative process exhilarating.
2. Your efforts give you feelings of satisfaction and a sense of accomplishment, even if you aren’t always ‘the greatest’.
3. You enjoy a sense of unconditional self-esteem. You do not feel you have to earn love and friendship by impressing people with your intelligence or your success.
4. You are not afraid to fail because you realise that no one can be successful all the time. Although failure is disappointing, you see it as an opportunity for growth and learning.
5. You’re not afraid of being vulnerable or sharing your feelings with people you care about. This makes you feel closer to them.

Brene Brown, a well known author of the bestseller, The Gifts of Imperfection, states that the journey towards letting go of who you think you’re supposed to be and embracing who you are starts with learning how to live a wholehearted life. Courage, compassion and connection, as the ‘gifts’ of imperfection, help you embrace your beautifully imperfect world and help you start to embrace worthiness. But don’t be fooled by these seemingly lofty ideas. The training in the use of these concepts involves practice. The art of repetition many times every single day. Not when you’ve gotten through your to-do list or when you have a spare few minutes (because let’s face it, you’re a perfectionist with a to-do list longer than you’re life span allows), but as a priority.

Here are some examples of how and what to practice.

1. Strive for a healthy outlook on life. Start and end each day with reading, watching or listening to something that inspires you.
2. Practice warmth and kindness towards yourself when you feel inadequate. Remember, imperfections are not inadequacies; they are reminders we are all in this together.
3. Tell yourself you are good enough just as you are. For example, at the start of your day say to yourself ‘Today, I’m going to believe that showing up is enough”.
4. Focus on forgiveness rather than bitterness. Be the ‘benefit’ finder rather than the ‘fault’ finder.
5. Work on stillness using mindfulness strategies at times when you feel vulnerable or fearful. By practicing mindfulness you will learn to roll with negative feelings so they stop having control over you. Your aim is not to be anxiety free, but to be anxiety aware.
6. Rather than being defensive, work on being open to suggestions. Embrace your flaws and learn to laugh at yourself by making your mistakes humorous and light-hearted.
7. When problems arise, focus on your sphere of influence. What is in your control to change? Move away from chronic worry that circles around in your head for days. Move into problem solving mode as quickly as you can.
8. Realise you can do one thing ‘perfect’ or many things well. Make a choice to let things go in order to increase your growth and learning.

It’s amazing how implementing such basic changes to your thinking and outlook can move you closer towards excellence from perfectionism. And if your perfectionistic brain thinks it’s not going to work so why bother, then I challenge you to challenge this faulty logic that keeps you stuck in ‘black and white’ or rigid thinking. For the richest, most beautiful and pleasing colour in the world my friends is ‘shades of grey’. That’s right. Shades of grey that go between the black and the white. This resembles flexibility and adaptability. By embracing flexibility, you have a chance to enjoy your life for what it is, in all its imperfect glory. In the words of Albert Einstein:

“Everybody is a genius. But if you judge a fish by its ability to climb a tree,
it will live its whole life believing that it is stupid”.

So, I will keep going on my journey and I wish you all the best of luck on yours. Remember, we cannot cross the sea merely by staring at the water. Positive change is no accident. It comes from hard work, perseverance and a little bit of love.

References:

The Gifts of Imperfection by Brene Brown. 2010.

The Feeling Good Handbook by David Burns. 1989.

The Pursuit of Perfect- How to Stop Chasing Perfection and Start Living a Richer, Happier Life by T. Ben-Shahar, 2009.

By: Alison Lenehan, Psychologist.

7 Secrets of the Mentally Strong

mental strength image
No one wants to be the toxic one. The draining one who exhausts all of their mental energy analysing the many different ways life has been unlucky or unkind to them. Or all the reasons they have to feel sorry for themselves. Let’s be real though, we have all probably found ourselves there on occasion, ultimately leading us down a path of damaging and self-defeating behaviours. But however strongly entrenched these negative patterns are, or however much we are hurting, we do not have to succumb to the allure of negativity, for overcoming misery and misfortune involves making a choice. An important choice. A choice that can remove the shackles keeping us trapped in a web of repeated failure, chronic guilt and pain. One that can help us foster enormous mental strength and acceptance of the person we are. Or the person we want to be.

Feeling mentally strong is not necessarily an automatic gift bestowed on those who easily see the glass as half full. It is a choice that requires cultivation every day (despite what life decides to throw at us). Cultivating this choice repeatedly time and time again creates a habit. And it takes time, patience and a whole lot of hard work to create a new habit (just think of how hard it is to create a habit around regular exercise, eating well or quitting smoking). The good news? Once the new habit is created, the rest is history and we are well on our way to living the life we want.

So how do we train ourselves to exude a ‘can do’ attitude? Well, let’s be real for a minute. Part of this depends on how determined and committed you are to changing. Try to adopt the following principles and evaluate how they make you feel. Chances are you’ll feel a little better. The important thing is to persist- changing negative thought patterns takes time and causes discomfort initially. But practicing these principles repeatedly is a massive step towards breaking out of the vicious cycle of pessimism and toxicity.

1. Realise that the only one who can make yourself feel good is you. People with good self-worth foster internal validation that functions completely independently from others’ opinions of them (the flipside is where you only value yourself when others do, placing an overemphasis and even desperation on the need to please others and be noticed). As the saying goes, ‘what others think of me is none of my business’. Move away from worrying what others think of you and an unhealthy NEED to be liked. If someone likes you, that’s a bonus. If they don’t, move on because someone else will.

2. Avoid comparing yourself with others (this comes from a place of being unsure of your worth). If you find yourself doing this compulsively, you are probably always coming off second best. And how can you foster a positive self-image when you always tell yourself you aren’t good enough?

3. Stop watching for signs of rejection from others and avoid acting based on a fear of getting hurt. If you are acting with this as a motivator then you are ultimately making some bad and self-destructive choices. Be relaxed and confident in the wonderful person you are with your unique gifts and qualities.
Someone can’t get inside and change your feelings of yourself without you letting them.

4. See that no one has a perfect life and is able to be happy all the time. Therefore, when challenges arise they should be viewed as problems needing solutions. Just focusing on the problem and the pain (or the ‘circle of concern’) drains your energy and you will quickly and easily become overwhelmed (and probably build up the problem to catastrophic proportions in the process). Instead, focus on your ‘circle of influence’, or what you can do to solve the problem. If the problem cannot be solved now (or ever), then choose to focus your energy on working at accepting what cannot be changed, thus freeing up your mental energy to change what you can in your life and not stressing on all those things you can’t. The two mantras of the depressed and anxious are the ‘If Onlys’ relating to all the hurt and regret of bad decisions made in the past and the ‘What If’s’ which are the myriad of negative and catastrophic possibilities for the future. These two mantras will only serve to make you unhappy, negative and ‘stuck’.

5. Recognise that the only one responsible (and to blame) for your choices is you. You are not that vulnerable child anymore and you are not the product of other people’s opinions of you (sure these things could contribute to who you have become up until this point but ultimately the job is yours now and into the future). Take your life into your own hands and try to not blame others for your own choices and mistakes. It takes someone with good self worth to admit they are wrong (when this is justified) and to take steps to acknowledge this and repair the relationship (even when the relationship needing repair is with yourself!). Being free of the pressure to please others allows you to take on what you want to and leave the stuff you don’t (could it be that simple?). In the famous words of Dr Seuss:

You have brains in your head.
You have feet in your shoes.
You can steer yourself in any direction you choose.

6. Stay true to yourself by not fearing your uniqueness from others. For its this individual difference that makes you, you and not the person next to you. When we were children we could live disinhibited and free to play in whatever way we wanted. Then why can’t we accept all the facets of our character as adults? We all function best when we are slightly outside our comfort zones. So get outside of yours and take some calculated risks. It can be quite liberating when you do!

7. Leave others alone to steer their own lives as they see fit, not as you do. It takes a strong person to accept that others think differently to you and that’s ok. You can agree to disagree without sensing that as a personal threat. Others need to grow and learn from their own experiences just as you have. Let them do that and you will empower them in the process. Do not be the one who is a caretaker for someone because YOU have a need to feel valued (coming back to that unhealthy need for external validation). If you find yourself being the caretaker of another adult be warned: you risk not being appreciated. This comes from a view that your behaviour represents an attempt to control rather than to provide genuine support.

Even though we can’t control the adversities that happen to us in life, we can control what lens we choose to see our lives through. Good decision making starts with understanding how powerful our thought patterns are and how closely they dictate our actions. Positive begets positive. Negative begets negative. Approaching life using the above principles helps to create more positive experiences into our lives. This typifies mental strength. And builds our sense of self-worth.

Every moment is a place we’ve never been. Meet today with expectation, enthusiasm and surprise. It’s time to start living the life you’ve imagined!

References

Taming the Black Dog, by Bev Aisbett
All of IT, by Bev Aisbett
7 Habits of Highly Effective People, by Stephen Covey

By: Alison Lenehan, Psychologist

Mental health treatment: 7 truths for the journey towards healing

I came across a pretty inspiring book the other day. The book, Beating Bipolar, by Blake Levine, was located during my search to help a client who seemed to be stuck processing her bipolar disorder diagnosis. Recalling his own story of his healing journey, Levine provides an impressive account of how he managed to turn his bipolar diagnosis into strength by guiding others with this illness as a professional life coach.

Bipolar disorder is a condition previously termed ‘manic depression’ because the person experiences periods of depression and periods of mania, with periods of normal mood in between. Mania can involve racing thoughts and speech, irritability and little need for sleep that is not just a fleeting experience. Sometimes the person loses touch with reality and has episodes of psychosis involving hallucinations (seeing or hearing things that aren’t really there) or delusions (for e.g. the person believing he or she has superpowers). The combination of mania and depression can feel like a dangerous and destructive emotional rollercoaster.

Bipolar disorder, and in fact any mental illness, is described by Levine as a disease of choices. You can choose to take one path or another, and there will be many crossroads along the way. Ultimately, you have to choose whether you will stay stuck inside your own world of pain, or whether you are prepared to work towards emotional stability. This is your choice to make and no one can make it for you. As Levine notes, you cannot pop a pill and declare yourself well. Proper healing is not that simple. True, genuine healing is about being selective of how to live your life and adhering to those values.

In the process of exploring, learning and eventually accepting what it means to have a mental health condition, the book asks an individual to answer 7 truths. They are:

1. Accept or reject your illness. Any doctor or psychologist can give a diagnosis and tell you all about it, but you have to be the one to acknowledge it. And that takes an incredible amount of courage. Not for the sake of accepting a ‘label’ but rather in order to seek the correct treatment. By not being invested enough to take on the meaning of the diagnosis, chances are you will become stuck.

2. Accept or reject the work that comes with bipolar disorder (or your diagnosis). Life with a mental health condition can be so challenging that it appears insurmountable and unfair. It is true that maneuvering through substandard mental health units is devastating (and at times traumatising) for most people. However, being able to overcome the setbacks and learn from them, in order to continue to work towards emotional stability (and avoid inpatient mental health units in the process) creates an inner strength that will be able to see you through the lowest points of your life.

3. Accept or reject that you will most likely need medication. For bipolar, medication to tame the mania and lift the depression (and therefore bring increased emotional stability) can be highly effective. However, only if it is used consistently by sticking to the regime over time. Medication must be maintained even when you start to feel better. Finding the right combination takes time, persistence and patience (and close monitoring by your psychiatrist or treating doctor). Weight gain, a common side effect of medication, can throw extra challenges your way, however until emotional stability is achieved, attaining other goals will be futile.

4. Accept or reject that you’ll need therapy and peer support. Levine writes “We share many trials as bipolar individuals, but isolation may be the most profound among them. Feeling alone is a universal experience for people with any mental illness, particularly this one. Not surprisingly, there are many reasons for it. Perhaps you’re too embarrassed about your mood swings and the past damage linked to your illness that you don’t reach out to others. Or maybe you have too many bottled up feelings stemming from other personal baggage to connect easily. Whatever the driving force, working with a mental health professional will help you sort out your issues and learn to connect with people”.

5. Accept or reject that your family’s participation and role in your life and illness might have to be modified to suit your healing. Emotionally stable people have a support network. We all need one, no exceptions. If you have nourishing, strong bonds with your family members, they will play a crucial role in your healing. However, there could also be some family dynamics causing considerable pain and stress and you will be the one to decide whether you can rely on the people in your current network for the long haul. If there are things getting in the way of your connection with them then you will need to find and create a different type of support system. This need is critical for living life in a connected way.

6. Accept or reject that you have to change aspects of your lifestyle. The reality of the situation is this: your mental health condition and any medications you are on do not mix well with drinking and substance abuse. These both cloud your thinking and impair your decision making. If your moods are not regulated yet, they can be lethal. Even having a drink now and then should be discussed with your doctor. Abstinence or moderation combined with a healthy diet, exercise and plenty of sleep are part of living healthy with a mental health condition.

7. Accept or reject that Bipolar (or your diagnosis) isn’t an end; it’s a beginning. The choice is yours. Levine states that the knee jerk reaction to mental illness is to run, particularly if you feel there is nothing to be gained by fighting. But he states that every time we experience pain, we have a chance to see that our struggles in our lives are put here in order to teach us lessons and help us grow. You are stronger than you think, and as long as you have courage, you will face whatever comes your way. The payoff, according to Levine, is to have a life filled with the affirming 4 H’s:
Hope
Health
Happiness
Healing
Whatever your individual journey and constraints, to work towards wellness will allow you to master your illness and your life, and that has to be worth the fight. Staying balanced takes time, patience and unwavering commitment, however hopefully if you are up for the task you too can start the healing journey right now, without wasting another minute, by listening to, exploring and accepting some of these truths. I wish you wellness and great success in your quest for what we are all searching for in life: Hope, Health, Happiness and Healing.

Sources:
Beating Bipolar by Blake Levine
Beyond Blue www.beyondblue.org.au

By: Alison Lenehan
Psychologist

5 Ways to Challenge Your Internal Critic

loving self image
“I can never do anything right” . “I always say the dumbest things”. “Why am I so stupid?”. Have you ever said these things to yourself? If you’re like the rest of us, chances are you have. Often. However, if these thought patterns continue as a form of running commentary all day every day (meaning they are left virtually unattended), they have potentially damaged your sense of self. We get so used to these whisperings that we do not even notice they are there. So they shape our lives.

According to a type of psychotherapy called Acceptance and Commitment Therapy (ACT), our mind is like a master storyteller continuously telling us stories. It is in a constant monologue with us from the second we wake until the second we go to sleep. In fact, even as we sleep our storyteller continues to tell its stories or replay memories (often painful ones). According to this approach, very little of what your ‘storyteller’ (your mind) tells you (via thoughts) is fact where there is a ‘true’ and ‘false’. Rather, the stories are opinions, judgements, criticisms, beliefs, assumptions, and ideals. They are simply a reflection of the way you see the world. And these stories can be changed. So, the mind creates a narrative based on interpretation. Once formed, this narrative is hard to dismantle.

A thought is just a thought. It is neither ‘you’ nor reality. It arises, lingers in consciousness for a relatively short while then fades. It is just a mental event that passes through the mind like clouds or weather patterns passing through the sky. We are always explaining the world to ourselves, and we react emotionally to these explanations rather than to the facts. All the feelings we feel are brought on not by the events in our lives, but rather the interpretation of these events.

We can be drawn into thinking our thoughts are true and they are us and we are them. Once we become them we can fall into ruminative brooding, basically going over and over an event in our minds, all the while pushing our emotional buttons and increasing our stress and anxiety levels, causing overwhelming demoralising feelings.

The ‘blueprint’ for how we treat ourselves was formed when we were children via the emotional availability of our parent or main caregiver . When an infant cries, the emotionally attuned parent attends to the infant. The process that ensues of soothing, reassurance and nurturance are all displays of ‘love’ that, when repeated hundreds of times per day, are critical to that infant’s identity development and sense of self.

So, why is it that the same person with the same ideals can be the nurturing, kind, positive support to their best friend when something goes wrong yet be the harsh, rude and stern internal critic to themself when they face the same type of experience? Do you treat yourself the way you would like others to treat you?

Try these 5 immediate ways to challenge your internal critic as outlined in The Happiness Trap (they’re so simple they may seem unrealistic, but they work):

1. Anytime you feel stressed, anxious or depressed ask yourself ‘what is my mind telling me now?’ Then ask yourself “Is this thought helpful? Does it make me the person I want to be?” If it is unhelpful, practice being more mindful of it using the techniques below.

2. When a distressing thought arises, repeat the thought in your head after inserting this phrase: “I’m having a thought that…”. When you practice this repeatedly you will find some distance being created as if you have ‘stepped back’ from the unpleasant thought.

3. Identify your mind’s favourite demoralising stories then give them names, such as ‘The Loser Story or the I’m Worthless Story. Then, when they pop up say ‘Ah yes, I recognise this familiar story’.

4. When a common self-critical thought comes into your head, defuse its hold on you by singing it to yourself to the tune of ‘Happy Birthday’ or ‘Jingle Bells’ or another tune. As you practice this over time you will realise the thought is simply a collection of words, just like the lyrics of a song.

5. Remember, the story is the story. The story is NOT the event. Avoid holding on to these too tightly.

By practicing letting go of disparaging and demoralising thoughts, we are removing the shackles that keep us trapped in the prison of our own minds. Only then can we begin to learn how to observe the same respect for ourselves that we so readily offer others.

As the common Buddhist saying goes: “You can explore the universe looking for somebody who is more deserving of your love and affection than you are yourself, and you will not find that person anywhere”.

References and further reading:
The Happiness Trap, by Russ Harris.

The Mindful Way Through Depression. Freeing Yourself From Chronic Unhappiness, by Mark Williams, John Teasdale, Zindel Segal and Jon Kabat-Zinn.

By: Alison Lenehan
Psychologist, Alpha Psychology

Battle Scars – Self Harming in Adolescents

By Hazel McKenzieSad-Girl-l

Registered Psychologist at Alpha Psychology and The Resilience Centre

Working with young people is never dull. Far from it. It is humbling, inspiring, frustrating, terrifying, rewarding. Adolescence is complex. It is, at times, emotionally polarised and intense despite the age old cry from teenagers that life is soooo boring. Some young people find they sail through, others find it difficult to put one foot in front of the other some days. Almost all are overwhelmed at some point.

Regulating emotion is a skill that some adolescents lack. There are those whose ability to problem solve is limited; they cannot see a way out. There are those who cannot tolerate negative emotions or see them as transitory. Frequently, when one or more of the above skills are in short supply, adolescents turn to other means to cope with emotions.

Deliberate Self Harm (DSH) can be used by some people to alleviate emotions or cope with painful experiences. DSH can take many forms and includes: cutting, burning, skin picking, hair pulling, scratching, head banging and hitting; infact any behaviour that is direct, intentional and receptive which results in mild to moderate physical injury. It is different to the indirect harm which results from other serious conditions such as Eating Disorders or more social or culturally sanctioned behaviours such as tattooing and piercing.  Research suggests that there is a relationship between self harming behaviours and other mental health issues, especially in girls. Some young people however, engage in this behaviour without having any other symptoms or afflications. They may infact appear on the surface to have near perfect lives.

Parents and concerned friends can be shocked when they discover self harm and associate it with suicidality. Mortality rates for self harmers are higher than for non self harmers, due to the fact that they are more likely to engage in risky behaviours, including suicide attempts. Suicidal thoughts can be a feature and must be taken very seriously, however, it is important to note that suicide is not the desired outcome for the majority of adolescents who self harm. Non Suicidal Self Injury (NSSI) has now been formally recognised as a disorder separate and distinct from other mental disorders. The criteria is specific and not all adolescents who self harm should be labelled with a ‘disorder’. Indeed, research speculates a very small percentage of adolescents will be. Despite this, we need to recognise that self harming behaviours DO indicate that the young person is experiencing psychological distress that they are unable to process or express in a healthy way.

Australian research suggests that around 1 in 11 to 15 young people between the ages of 12 and 25 report self harming at some point in their lives. The numbers are increasing and the age of onset is decreasing. A typical high school class in every high school in every suburb would statistically therefore contain someone who was self harming. They may be obvious, they may not.

Gone are the days when self harming was a thought to be a feature of the ‘emo’ subculture. School captains, athletes, performers, gifted students, all just as likely as the quiet girl at the back of the class to have scars. Some self harmers appear to be functioning well socially and emotionally. There is NO stereotype here that we can look for to try and identify and then support young people who are suffering.

It can be difficult to understand why if someone DOESN’T want to die, they inflict such pain and suffering on themselves? The question of ‘Why?’ is one that many parents and friends struggle with.  It may seem at odds with the perceptions of many but many self harmers do not see their behaviour as ’harmful’, quite the opposite. They describe it as providing relief from and release of negative emotions. It can be spontaneous but can also be planned. For some it enables them to feel alive. One client commented to me that ‘dead people can’t feel, it reminds me I’m alive’. It can be a form of expression, of inner turmoil or self loathing. Identity can be wrapped up in the behaviour and some clients I have worked with identify it as their ‘thing’ , and they don’t want to give it up. Some self harming can be a result of trauma or abuse. Guilt, shame and disgust are common in sufferers, and create barriers to communication and support.

Kneejerk reactions that question the motive of the behaviour and conclude that it is attention seeking are not helpful to share with the sufferer. It may well be, but if this is the method that a young person uses to cry for help you should take it seriously. Sometimes experimentation passes quickly but all too quickly it can become a habitual coping mechanism. A negative reaction (be it over or under reaction) that labels the behaviour as repulsive and attention seeking may shut down the likelihood of healthy communication further. It is important to look beyond the scars of self harm to the reasons behind it and offer support. Understanding is the one thing that young people complain they don’t receive and this often forms a barrier to help seeking. Most often it is friends who are the first to know, they are more likely to be confided in and/or discover the evidence. Most suffer in shameful silence until they are discovered. Some deliberately offer more public signs to make people notice and feel uncomfortable as a form of revenge.

Self harm is treatable and recovery is possible. Research has shown that the longer the behaviour goes unchallenged the greater the likelihood of it becoming an ‘addiction’. The brain releases feel good chemicals that reinforce the calming effect of the behaviour and stopping can result in ‘withdrawal’ urges and ‘cravings’. Treatment is a more complex process than simply deciding or agreeing to stop. Just like with any addiction forward planning is essential and setbacks are inevitable.

Engaging with a professional sends an important message to the sufferer, that their problems (be they the cuts or the reasons behind the cuts) are being taken seriously. Concerned parents can see their GP first of all or contact a psychologist or psychiatrist directly. It is important to find the right mental health professional. Someone who has experience working in this area and with young people is vital. An experienced therapist will engage with sufferers despite their apathy and initial reluctance.

A thorough mental health assessment is needed to identify risk and enable a tailored and effective treatment plan to be formulated. Treatment can be lengthy, depending on the severity of the presentation. The longer the behaviour has been around the more resistant it will be to change. The presence of other mental health issues can be a factor in treatment and recovery. Some programs recommend group AND individual sessions to teach and reinforce skills. Dialectical Behaviour Therapy is seen to be the most effective treatment modality. It is skills based and focuses on controlling emotional responses in a variety of ways.

The journey can be an emotional rollercoaster for parents and friends and talking to others who have survived the ride themselves can give comfort. Dealing with your own fears, discomfort and questions is important. It is important to check in on those who may be finding it difficult to cope, especially young friends. Courageous conversations with family and school are part of the process.

To those who see a mirror reflected in these words I implore you to reach out for help. To those who feel these words are irrelevant to them I implore you to set down your judgement and listen. To those who have lived these words I offer you my respect and understanding and I implore you to love yourself, battle scars and all.

 

(If you are concerned about someone or need support yourself please call Lifeline on 13 11 14 or contact your local Accident and Emergency Department)

References

Lundh, L. G., Wångby-Lundh, M. & Bja¨rehed, J. (2011). Deliberate self-harm and psychological problems in young adolescents: Evidence of a bidirectional relationship in girls. Scandinavian Journal of Psychology 52, 476–483.

Zetterqvist M, Lundh LG, Dahlström O, Svedin CG. (2013) Prevalence and Function of Non-Suicidal Self-Injury (NSSI) in a Community Sample of Adolescents, Using Suggested DSM-5 Criteria for a Potential NSSI Disorder. J Abnorm Child Psychol. 2013 Jul;41(5):759-73

Martin G, Swannell SV, et al. Self-injury in Australia: a community survey. Med J Aust. 2010 Nov 1;193(9): 506-510.

 

Websites

Young People and Self Harm http://www.selfharm.org.uk

National Self Harm Network http://www.nshn.co.uk

American Association of Suicidology http://www.suicidology.org

Suicide Prevention Australia http://suicidepreventionaust.org/

A Call For Honesty and Action

By Hazel McKenzie

Registered Psychologist at Alpha Psychology and The Resilience Centre

Last week I was moved and inspired by the fragility and honesty shown by Australian VJ Ruby Rose in her public Facebook message about her ongoing battle with depression. Ruby’s story has been very public and her vocalism on subjects such as bullying, depression, gay and lesbian rights and surviving childhood trauma has been, still is, admirable and a source of inspiration to thousands of young people. What I most admire about her message however, is the way she talks about her illness as an illness. There is anticipated recovery and improvement just like there would be from the flu or an asthma attack. It goes to the very heart of how she views mental illness. The statement itself is, I believe, an indication of an evolution, dare I say revolution, in the way we are beginning to talk about mental health issues.

There is no doubt that those diagnosed and/or living with with a mental health issue experience stigma and challenge, we are not there yet. According to statistics from the National Mental Health Consumer and Carer Forum (www.nmhccf.org.au) people with a mental illness are among the most disadvantaged in Australian society. The severity and longevity of disadvantage very much depends on the condition. Social and economic hardship can be fleeting or a lifetime reality as people become vulnerable to isolation and discrimination at the hands of their families, communities and at times employers due to a lack of understanding of what living with mental illness means. Misconceptions are often perpetuated by the media and community jungle drums that favour sensational stories that end in tragedy and misery but do nothing to show us that people with mental health issues can live functional and fulfilled lives, and they can recover. The media portrays mental illness in a predominantly negative light e.g.in February this year over 90% of Australian media coverage of mental health issues was negatively reported (SANE StigmaWatch).

1 in 5 of us WILL suffer from mental illness at some point in our lives (see www.oneinfive.com.au). Those statistics are real and have real people and lives behind them. Most people have many more than 4 other people that live, love and work close to them so even if you are in denial that it could ever be YOU then it WILL be someone close to you. Wouldn’t it be a great achievement if 5 out of 5 people were educated about mental illness and no longer felt afraid of talking about it openly or helping a loved one deal with it? Significant others, friends, family members, colleagues, who could be life changers often feel disabled and disempowered due to a lack of knowledge and understanding. We’ve all offered the consolatory, ‘let me know if you need anything’ to friends, after all, most of us are well intentioned people. However, the bit we don’t often remember is that our friends and family who are in crisis or, less sensationally, normalising what you can see is not normal behaviour or coping, then we need to step in without having to be asked. Here are some things to consider (they are not age specific):

TAKE IT SERIOUSLY – You think there’s a problem. Don’t tell them to get over it or presume they are attention seeking. If you notice something that is out of the ordinary for them or a pattern emerging that is out of character share your concern with them. Ask them if they are alright, really. And ask them again until you are satisfied. If you suspect they are not alright then don’t leave it at that. Don’t be aggressive and diagnose them, they may not be ready to admit there’s a problem, perhaps suggesting you both run it past someone else is a logical first step. This also shares the burden so you are no longer feel alone. Let them know it’s OK to talk about it, you are not judging them.

COMMUNICATION – Be persistent. Let them know you are thinking of them, call and drop by – don’t wait for an invitation. Continue to ask them over and suggest outings, even if just for short walks. Depression and anxiety love to stay at home. Be a good listener. Acknowledge things are tough but still be realistically positive and hopeful, things don’t have to be like this forever but right now you can see it sucks. Timing is crucial, don’t push someone to talk if they don’t want to but be ready to stay for awhile if they need you. Give them some helpline numbers they can chat to when you are not there. Often there is no answer to the ‘why’ question, so if it’s not immediately obvious leave it up to the professionals to work this out. You need to make the person feel supported and accepted, assured that you will not abandon them in tough times.

PROFESSIONAL SUPPORT – Many sufferers find seeking help difficult, it means acknowledging there is an issue and it is too big for them to deal with. You can be the person who does the research, finds the right professional, makes appointments, sends reminders. You can facilitate the process without being overbearing. Remember, there is no ‘one size fits all’ when it comes to treatment or treating professionals. Personally, I love to meet my clients’ support team. I ask about them all the time in session and since we have the same objective it may be useful to offer to go along to some appointments. You don’t have to go in but waiting in the lounge area is always a mark of respect and support that I admire.

SELF CARE – you need to look after yourself first and your friend/loved one second. It’s like the air masks on the aeroplane, you can’t help someone if you are struggling yourself. If you have been through a similar situation, don’t presume it’s the same and don’t presume what worked for you will work for them, infact don’t presume anything. You also need to set boundaries. Some conditions are unpredictable and manipulative and may be around for a long time to test your limits. You need to be clear with yourself about what you are able to offer in terms of availability. Getting a group of like minded friends/family members together can help in this. Have someone who you yourself can talk to when things get difficult and you are emotionally challenged.

EDUCATE YOURSELF – You are not a professional (although maybe you are!) but living closely to someone with a mental health issue does make you an expert. An expert in how it effects them. You may need to learn about medications, strategies, warning signs, relapse prevention depending on what you are dealing with. There are lots of support sites and forums out there to connect with people who are walking the same path as you. It helps to know that you are not the first and not alone.

BE THERE – when you can. Don’t make promises that are unrealistic and you can’t keep. Having a safety plan for crises can be helpful and this should be negotiated with a mental health professional if your friend is suicidal or in crisis. Not everyone is equipped to be able to deal with mental illness as well as the next person. Just like my knees go to jelly when I see a child’s wobbly tooth, (I would make a terrible school nurse!); some people find it difficult to be proactive in support. Having said this, we all have a RESPONSIBILITY to treat people with respect, help if and where we can, give them space and support from afar if we can’t. We can’t afford to ignore problems or think they happen to other people. According to the World Health Authority the burden of mental health disorders is set to rise significantly over the next 20 years. The effects on family, friends and caregivers cannot be underestimated. The first step in reducing stigma and discrimination in order to increase helpseeking and support services is to educate our communities to be helpful and supportive rather than judgemental and powerless.

And to you Ruby Rose I say, thank you for once again raising awareness of such an important issue. I wish you well on your journey to wellness.

Resources:

One in Five

Sane

World Health Organisation

Headspace

BeyondBlue

APS Find a Psychologist Service

Hazel is a Registered Psychologist who works at Alpha Psychology and The Resilience Centre. If you would like to talk to Hazel about someone you are concerned about or receive some support yourself you can contact her here.