The Impact of Traditions on Creating Meaning

As we enter into the festive season I have been reflecting on the past year and how different things are for so many people around the world, myself included. Currently in the midst of a global pandemic, most of us could not have predicted or even imagined what was in store this time last year. Every year brings about change, and this year is no different. Life requires constant adaptation and reminds us that we can at any point be thrust into unforeseen circumstances outside of our control!

Traditions and rituals can ground us, return us to a space of comfort and familiarity, and can help us to feel safe and loved. This is especially important for children, and a reason why so many kids love Christmas in a way that on the surface may appear to be related to presents and toys, but which often runs far deeper than that. Traditions and rituals signify belonging, purpose, love, and connection. And even as adults, the meaning we create can last a lifetime; transporting us back in time or being passed down to future generations.

We all have different feelings towards Christmas and the New Year. For some people, the holidays are a time of excitement, joy, and celebration; for others it may be a time of grief, loneliness, or stress. I’m acutely aware that my own feelings towards Christmas come from a place of enormous privilege. My parents gave me the gift of memories of a magical time which have stayed with me throughout my whole life. And with this in mind I wanted to add a disclaimer that the topic for today’s blog is certainly not meant to invalidate those who are currently suffering, or for whom Christmas is either not celebrated or is a time of pain or a reminder of unhappy times. It is instead intended to help create reflection on how no matter what life throws at us there is something incredibly powerful about having a clear sense of meaning in our lives: with traditions and rituals being a way of helping to create this. 

Research by Dr John Gottman, a world-renowned relationship expert, suggests that when we have rituals or traditions as a couple or a family, these create a sense of belonging and connection and can strengthen our relationships. There is something so comforting and stabilising to all of us about familiarity, but re-enacting traditions or familiar rituals is about more than the repetition - it can also make us feel part of a team or group whereby we’re included and have shared experiences of joy, humour, excitement, responsibility, or love. Perhaps we have thoughts like “This is what we do in our family”, “This is what matters to us”, and at times like Christmas “This is how we celebrate”! Even if you are alone, there may still be the opportunity to create meaning through individual traditions and rituals that feel special or important to you. Perhaps these connect you to others in the wider world, or perhaps they honour memories of loved ones with whom you’re no longer able to celebrate. Many people with religious beliefs believe the meaning of Christmas is to celebrate the birth of Jesus. For each of us that celebrates it though, regardless of our spirituality it is usually also tied up in multiple layers of what it also means for us individually, in the context of our own lives. We create our own meaning through the choices we make, the things we focus on, the sense of purpose we feel through acting in accordance with our values; and through the gifts of love, kindness, or service to others or to ourselves that we can offer. 

For me, Christmas has always been my favourite time of the year. Because it carries enormous meaning to me that relates to a sense of connection, belonging, anticipation and joy at re-living rituals and traditions. Some of these feel unique and special to my family and give me a sense of being part of that. Others feel shared with the wider community of my culture growing up in the UK and my now-adopted home of Australia. Others are more global and help me to feel connected to humanity as a whole.

What I know for sure though is that whilst I loved receiving presents as a child, I loved giving them more. The memories I have that fill me with such warmth don’t relate to material gifts but are instead intrinsically tied to the specific acts we carried out together as a family this time of year. I remember times it snowed when we tobogganed down the hill near my Grandparent’s house on black bin bags! I remember the tradition of attending local school fetes and being filled with joy at winning a tombola prize I thought would make a good gift for a family member (even if one year it was a bottle of gin that needed a parent to collect!). I remember waking up in the night with my younger brother every year to sneak a peek at the presents under the tree and try to guess what was in our stockings knowing we couldn’t open them until the whole family was awake. I remember the thrill of checking the doorstep in the morning to see if Father Christmas and his reindeer had eaten our offerings. I remember the whole family attending church, singing my favourite carols, and feeling so much gratitude for my life and loved ones. I remember being allowed to open one present from under the tree and needing to wait until after the Queen’s speech for the rest (which had to be watched in complete silence – an excruciating test of patience but simultaneously a critical part of the tradition that made the day so special!). I remember helping peel Brussel sprouts for Christmas dinner, and all sitting together pulling crackers, telling jokes, and wearing paper hats before tucking into the most delicious feast on earth! I remember playing board games as a family, watching old James Bond films and BBC Christmas specials together, and passing around boxes of chocolate, knowing we had to save the caramel ones for my Dad. It’s not just the big details like rules around presents or all attending church together which created meaning, it’s the smaller details that added to the sense of being part of our family with our own unique way of celebrating. The fact that there was always a satsuma and apple at the bottom of the stockings each year, the way my mum always made homemade mince pies with a star on top, the way me and my brothers always tried to choose presents for my Dad that would make him laugh (a battery-operated farting gnome was a definite highlight for him I’m sure!).

Traditions can be established any time. Honouring and cherishing them can bring enormous joy to all who are a part of them but can also create shared memories to reflect on, laugh at, or look back on. They can evolve throughout time; and can be something which spontaneously becomes part of the way things are done, or which is a carefully planned activity. 

Reflecting on the rituals and traditions you already have can be a valuable gift to yourself and others this time of year. Perhaps seeing them through the lens of a cherished activity that creates purpose and magic for those around you and yourself. Maybe reflecting on any new traditions you would like to introduce, or rituals you used to do that had been forgotten about in the chaos and exhaustion of what has been a tough year for many. Even small acts can have significance! Perhaps spend time reminiscing about things you used to do or sharing ideas with friends or family members about your experiences and most treasured memories. Or if you are a parent yourself, reflecting on how you can or already do create a little magic for your kids. Sometimes we get caught up in the big picture. We feel our life lacks meaning because we’re too busy focusing on the overall year, relationship, or life we have, rather than noticing the individual moments that shape our existence. One of my favourite quotes comes from Victor Frankl’s Man’s Search for Meaning and it goes as follows: “The meaning of life differs from man to man, from day to day, and from hour to hour. What matters, therefore, is not the meaning of life in general, but the specific meaning of a person’s life at a given moment.” I feel like the meaning that our own traditions and rituals can signify in each moment is equally personal; and may also change in time as our circumstances do.

We can choose to engage in acts that create or connect us to a sense of personal meaning. This can be done anytime, in any situation. It is not just what happens in our life that gives us a sense of meaning, but the way we interpret or make sense of it. One family’s traditions may be meaningless to another. One person’s most poignant memories may relate to the smallest act that signified something of great value to them. Each moment in time is what shapes our experiences and memories, and filling this season with traditions and rituals, however small, can enable us to strengthen the meaning from each individual act as it is repeated over time. For me, at Christmas, this means introducing some lightness, spark, humour, fun, excitement, anticipation, joy, and vitality through a conscious effort to connect and continue familiar activities which relate to a purpose tied into my sense of family, love, connection, gratitude, fun, kindness, and belonging. It’s not about creating extra pressure to do things in what is often already a stressful time, but instead about noticing the small things that matter to me; the feelings that come up when I honour them, and making sure they don’t get swept aside or lost in the chaos!

Why We Worry So Much About What Others Think & What To Do About It

Personally and professionally I have experienced and seen firsthand how much we worry about what others think. 

Unfortunately this is a necessary part of being human! I so wish I could tell you the secret to eliminating this fear, so that you could stop worrying about what other people think. To offer you a way of deleting the fears about how others are judging you and what you do in your life.

But it is just not possible.

Way back in our human history, this wiring in our brain was an important and in fact necessary part of our survival. Our brains have developed to become expert judging machines, in order to make sense of the huge amounts of information we are bombarded with on a daily basis. To sort through pieces of information, to categorise it, to remember what’s important, to shortcut mental effort and make living more automatic. 

We are also wired to care about what others think.. because belonging and acceptance are important for us to survive. If your clan judged you, your behaviour and your contribution positively, then it ensured that you had access to the clan’s resources - like food, shelter, information and protection. Positive judgment meant that you belonged and were safe. If the clan judged you or your behaviour as negative, that meant that there was a risk you could be banished or even killed. A negative judgment back then meant rejection, which would deprive you of access to the clan’s resources, threatening your future survival. So there is a very good reason why it is wired into our DNA to judge (ourselves and others) and care about the judgment of others.

Add on to this the fact that experiences in our past that have involved negative judgment are stored entirely differently in the brain. This is our brain’s way of trying to protect us, to help us avoid any situation in the future that might cause us physical or emotional pain. What this can mean is that there is a red flag attached to any situation, any experience that has the potential to elicit judgment. This kind of supercharges our propensity to avoid risk, to stay stuck, to stop us stepping out of our comfort zone.

This means that not only does judgment hurt, but it can hurt A LOT. It can not only cripple us with distress, but it can alter what we do moving forwards… it can have a huge impact on how we show up, on our life decisions, and therefore the very architecture of how we choose to spend our time on this earth. 

So, if we can’t stop our brains from judging, and if we can’t delete the fear of judgment, what can we do about it?

First of all it’s important to work out if there is a need to do anything about it. Fear of judgment only becomes an issue when it is getting in the way of stuff for you. When it is stopping you from being the kind of person you’d ultimately like to be, from working towards goals that are important to you, and from showing up in your life in a way that you’re going to be satisfied with when you’re 80 years old. It becomes a problem when fear is the one controlling your decisions and actions, rather than your true self, the person underneath the worry and emotions that has big dreams and a rich vision of what your life could look like.

Ask yourself this question: “If I could get rid of all fear, just delete it from my brain, along with all the worries about what other people would think…. What would I do differently?”

Any answer to that question apart from “nothing”, means you may benefit from learning how to respond differently when fear surfaces. 

Here are some tips to get you started:

1. Be Aware

   Bringing our conscious awareness to fear, to worries about judgment is an extraordinarily powerful step. To label something, to acknowledge it, means it is separate to us. It means that space, distance and choice become part of the picture - and places power back in our hands. Try to not only notice when your worries about what others think show up, but also when you are drawn into judging others (and yourself) too. 

2. Helpful or Unhelpful?

   Ask yourself - if I give my attention to this worry or judgment, if I spend time and energy focused on it.. Where does it get me? Does it help me towards my goals? Does it take me closer to or away from the things that matter from me? How will I feel?

3. Use Mindfulness

   Mindfulness is one of the most powerful tools to help ‘unhook’ your mind from unhelpful places. With practice and time, you can get better at learning to let go of those thoughts, stories and fears so that they don’t control your behaviour.

4. Compassion, Compassion, Compassion

   For yourself, and for others. You’re doing the best you can, other people are doing the best they can (even if it is entirely unworkable). Be patient with yourself and others, and hold the hand of the part of you that is wounded, that is scared, that is hurt. In fact, those people that are critical and judgmental of others are generally the ones that struggle the most. Tearing down others is a way of trying to make themselves feel better, an attempt to manage their own pain and sense of inferiority. 

5. Take Action

   Action is the best antidote to anxiety. Notice the fear, label the judgments, and make room for them as you continue to do those things that matter to you. Take your power back and walk towards the person you want to be and the life you want to build. You will be scared. You will be judged. But when the reward is the richness, depth and fulfillment of living your life on your terms, it can give you the courage to hold the inevitable difficulty and keep going. 

Our judgment and the judgment of others is part of the human condition. And sadly, decisions and actions to try and avoid judgment lead us to a small life, a life that doesn’t even work to escape judgment. And if we pretend we don’t care about what others think, we end up becoming guarded. We end up putting our walls up, which prevents us from being vulnerable, from inviting true connection, authenticity and fulfillment. We can’t stop the pain associated with judgment, and as much as it hurts, that’s OK. It’s a sign that we’re human and that we care. Where we do have agency, is learning how to respond to it.. Choosing whether we let it assign us to the sidelines of our own life or bravely face it as we take the field. 

Depression in Young People: Impacts on Learning

As we move towards the end of the school year, we often reflect on the year that has passed. And what a unique year it has been! It is also a time when many parents and students notice the effects of mental health challenges on the school year that has been. This is obviously difficult to quantify, and varies from person to person. But awareness of the potential impacts of conditions such as depression on well-being and education can help both the student, and those around them, to recognise, validate, normalise, and address educational difficulties as they arise.  Recognising possible signs of depression at school can also help in identifying depression early, and facilitating timely support and treatment.

Unfortunately, depression in young people is under-diagnosed and so can be left untreated, leading to compounding difficulties. Some reasons why depression in younger people is not picked up are that they may have difficulty explaining how they are feeling, the symptoms of depression can be dismissed as ‘normal’ in the context of adolescence, or the symptoms may be masked by anger or other negative behaviours. 

It is important to note that depression is more than feeling sad. Depression affects all areas of an individual’s wellbeing, including sleep, diet, physical health, self-esteem, social activities, interests, family life and learning. Depression affects the way an individual thinks, how they see themselves and how they view their future. 

Of course, depression exists on a continuum, from mild to severe, and the symptoms will similarly vary. However, the main symptoms of depression are to do with feeling sad or irritable, mood changes, and feeling that nothing is worthwhile and that things will never get better. These signs of depression are particularly notable if they occur together, or are not typical of the young person.

Depression affects young people in many ways. These are some of the key signs that the person might show:

• Low motivation and loss of interest in activities they usually enjoy

  They may be very difficult to motivate to engage in anything and lose interest in hobbies or activities they previously enjoyed. Disinterest in pursuing passions, learning new things and planning for the future may also be evident.

• Have difficulty listening, concentrating on tasks and remembering things

  Decreased ability to focus and make decisions, and poor working memory. Depression can leave people feeling confused, vague, overwhelmed and frustrated. Even basic everyday tasks can seem difficult.

• Low self esteem

  Make negative comments about themselves. Thinking they cannot do things, and so it is not worth trying.

• Focusing on the negatives

  Look for what’s wrong, rather than seeing the positives in situations

• Social withdrawal

  Withdrawing from social situations and not want to spend time with friends or others.

• Irritability and anger

  May appear agitated, easily annoyed or upset. May lash out at those around them. May be very difficult to please.

• Sadness 

  Seems sad and cries easily. Can be difficult to reassure or calm.

• Eating 

  May either have no interest in food, or overeat.

• Poor sleep and low energy

  Has difficulty with going to sleep, staying asleep, waking early, or sleeping excessively. Even after a good night’s sleep, they can feel tired. 

• Physical symptoms

  Headache, fatigue, nausea and unexplained illness are common. 

These symptoms of depression will clearly cause problems in many areas of a young person’s life, including social and family relationships, and engaging in activities. Depression may also have a major impact on a young person at school and in their learning.

The following describes some ways in which the symptoms of depression can impact a young person at school and in their learning

• Difficulty with tasks and assessments

  Commencing tasks/staying on task or even attempting tasks can be impacted due to factors such as decreased ability to attend, concentrate or make decisions.  In addition, compromised memory function makes it challenging to retain new information and recall previously learned information. Cognitive function may be further impacted by physiological effects such as being sleepy or very tired if sleep affected, or by decreases in blood sugar levels and energy if food intake is inadequate. 

• Change in interest in school work and activities, and poor motivation to engage

  Reduced motivation or disinterest may be noticed earlier at school than other areas of life because of the lower priority of school work for many students, and leads to poor engagement.

• Lowered self esteem 

  Focus on negative and worrisome thoughts can be distracting, exhausting and demotivating.  Feelings of hopelessness or low self-esteem can lead the student to believe they are not capable of learning and that they shouldn’t bother trying. 

• Reduced social interaction and isolation

  The young person may have problems sustaining friendships, and difficulty relating to classmates and teachers because of social withdrawal. They may feel unable to engage in class activities or seek learning assistance as needed. Depression can leave some individuals feeling irritable, agitated, and anxious. They may also become uncharacteristically defiant, disruptive, or aggressive towards others. These factors can result in the student feeling lonely and unsupported.

• Lateness to school, frequent absences and/or truancy

  This may be due to poor motivation, avoidance of school, or physical symptoms (including fatigue or excessive sleep). 

So a young person’s school engagement and ability to learn may suffer due to a range of factors stemming from depressive symptoms. However, it is also important to note that inconsistent academic results are often associated with depression, with students producing great work at times, and seemingly unable to engage or complete a single task at other times. Nonetheless, overall depression will likely negatively influence their academic progress and result in under-achievement and falling behind, leading to exacerbation of the depression.

Identifying depressive symptoms early, including through impacts at school, is important for engaging with effective treatment and minimising longer-term consequences and higher risk.

A Healthy Digital 'Diet'

There’s been a lot going on online and in the news recently – the daily suspense of COVID cases, new and harsher lockdowns overseas, the chaotic and emotive US presidential election, multiple government inquiries and royal commissions, the compelling but pressing new David Attenborough documentary, the ongoing coverage of the Black Lives Matter movement, protests and unrest, attacks and beheadings, it goes on and on. 

The internet can feel pretty overwhelming at times – the content we are exposed to on a daily basis is serious, and global, and never ending. 

It can be helpful to think about what you digitally and virtually consume in the same way that you think about the things that we literally consume, what we eat and drink. Most of us know the general principles of a healthy diet – think the ‘food pyramid’, and sayings such as ‘everything in moderation’. These principles, with a little adapting, can be applied to the way we use and consume digital content. 

Consume variety

The best meals and the best diets are those that have variety! Think about what you digitally consume on a daily or weekly basis – is it mostly Instagram, TikTok, youtube, gaming, news, or Netflix? And even within those formats, think about what types of content you consume, and how you do it. Is it lifestyle, exercise, clothing, makeup, mental health, sports, news, decorations, craft, school or work related? Is it on your tablet, phone, television, or laptop. Try not to spend too much time on one type of content – get a variety of input in your digital diet! This is a recommendation to adddigital content from other forms, but a warning against spending too much time on one form of digital ‘food’.  

It’s important to let ourselves consume a variety of things. If you find yourself getting anxious at the news, let yourself watch something fun or light-hearted. If you notice yourself following a lot of health and fitness accounts, perhaps seek out some body positivity ones. 

Take a break

Much life ‘meat free Mondays’ or ‘Dry July’ – it can be helpful to, at times, challenge ourself to mix up how much we consume. We may want to change our consumption of digital content perhaps by having a screen free evening once a week, or a digital detox once a month. Or perhaps even just leaving your phone at home when you go for a walk. This gives us the opportunity to see how we go when our usual routine of consumption is different – do I feel anxious away from my phone? Do I feel happier when not reading the news? Do I feel more content when not searching online shopping sites? Do I feel more disconnected when not online gaming? Our reactions to shifting up our consumption can be a helpful signal of how things are or aren’t impacting us. 

Some things are better than others… but everything in moderation

It’s true to say that different forms of digital content have different impacts on us. Each of us as individuals can work out what parts of our digital diet ‘agrees’ with us, and what doesn’t. Staying attuned to your own mental and emotional health whilst using our digital devices is so important. Everyone has a different capacity for what they can tolerate, particularly when it comes to the news. 

However, just like making drastic changes and cutting out entire food groups for good isn’t usually a healthy move – we don’t necessarily have to cut out our digitial content all together! There are many aspects of our life that require digital consuming – work, school, uni, shopping, travel, etc. But also, allowing ourselves to consume ‘guilty pleasures’ such as re-watching an old sitcom or movie on sick days, or scrolling Instagram after work to switch off, or sharing TikTok videos with friends – all of these things aren’t too harmful in moderation!

Try to focus on one change at a time

If I tried to focus on all the possible ways I could improve my diet at once, I would probably be unsuccessful. If I attempted to eat less refined sugar, more vegetables and whole grains, less salt, less meat, more calcium, and reduce my food spending whilst buying locally sourced food – I’d struggle!

So many of the teenagers and young people I meet with are so switched on – they are intelligent and aware people who consider it important to be informed about a variety of social and political movements and events. However, as noted in the opening paragraph of this blog – the list of things to be concerned or invested can be endless. There may be many things we want to know about or be involved in, but trying to do all of them can be tiring! Working out which social or political concern(s) are most important to us, and then focusing on those whilst accepting that we can ‘let go’ of the others for the moment can be a helpful way to free up our energy to really invest in those areas, whilst also maintaining our own good mental headspace. 

Know what you’re consuming 

It can be helpful to recognise the biases and distortions of what we’re consuming. In the same way you might check the ingredients list of the food you eat, it’s helpful to be aware of some of the factors behind the digital content we see.

And we’re getting better at this – most of us know that the Instagram influencers we follow use editing software, the newspapers can sometimes sensationalise what they write, ‘good news’ stories of hope and change rarely make the front page, so called ‘reality television’ is often highly scripted and produced, and Facebook is using an algorithm to curate our newsfeed. Reminding ourself of these factors can be helpful when we feel disheartened or overwhelmed, or notice our own internal critic showing up.

Whatever you do, most of all be mindful of the way that digital content impacts you on a day to day basis. Don’t forget that small changes can make a big difference! Consider small ways that little tweaks to your ‘digital diet’ might impact your wellness. 

Making Mindfulness Fun

A lot of people are becoming more and more aware of the benefits of incorporating mindfulness into their lives. There is a wide body of research now demonstrating that mindfulness can promote a greater sense of wellbeing, reduce psychological suffering, improve attention, decrease emotional reactivity, and increase behavioural control. For those experiencing anxiety, depression, or other mental health challenges it can be particularly important- because a lot of distress can be linked to worrying about the future or ruminating on the past; which is kind of the opposite of mindfulness!

What is often not clear though, is what exactly mindfulness is. Whenever I ask people what their understanding of mindfulness is, they usually say something along the lines of meditation, breathing exercises, or using a guided app. And these can certainly be one way to practice it! There are many fantastic apps around, but some that I often recommend to clients include Smiling Mind and Insight Timer.

What sometimes happens though is that people have preconceived ideas that these guided exercises or meditations are “boring”, “a chore” or that they “don’t work”. And this is where it can sometimes help to be mindful of how we understand what mindfulness is, and flexible with how we practice it!

What Exactly is Mindfulness?

Let’s start with a definition. Mindfulness can be thought of as a conscious, non-judgemental, moment-by-moment awareness of the present moment. This means it is a state of being, not a trait that is permanently fixed or a part of who we are. The goal of mindfulness is simply to be fully present in the moment. Aware of information arising from our senses or non-judgmentally noticing our internal experiences!

When we do experience a sense of calm or relaxation, that’s great, but this is not the primary goal of mindfulness! If we go into mindfulness with the expectation it “should” make us feel a certain way, we will be too busy analysing or judging whether that is happening to actually be present in what is occurring moment-by-moment! And this is often what people mean when they say mindfulness “didn’t work”. They mean it didn’t work to change their emotional state in that exact moment. And the irony is that by letting go of the agenda of trying to alter their emotional state, that is often the very thing that happens. And even if it doesn’t, by noticing and being mindful of it without judgement they can often feel more able to respond to it effectively, rather than automatically reacting without any conscious awareness!

When people report mindfulness is “too hard”, it is often because they hold unrealistic expectations that they “should” be able to control their mind without it wandering. Once again, letting go of these judgments and expectations can be really helpful. And at the same time, we can also be aware of how over time, the more we practice, the more we can increase our ability to stay focused for longer periods or to catch ourselves when we do get distracted!

Fun Ideas to Try!

Having said all of that though, if you have tried meditations or guided apps, or genuinely feel they are not helpful or workable in your life right now, that’s ok too! The good news is that there are a million ways we can practice mindfulness. So, here’s some ideas to get you started!

1.     Music! Choose your favourite song, or one that resonates with you, and instead of it playing in the background whilst you multi-task or do other things, try pausing and focusing completely on the experience. You can choose to focus your attention on one aspect of it – the lyrics, the instruments, the bass, the tempo etc, or you can choose to just mindfully let the music wash over you and notice the feelings and sensations you experience internally as you listen. Each time your mind wanders and you start thinking about other things, just gently bring your focus back to the song.

2.     Mindful dancing! We’ve all heard the old saying “dance like no one is watching”. Why not give it a try when nobody actually is watching! Try to go with the flow, moving your body in whatever way the urge arises! Practice letting go of self-consciousness and just being in the moment!

3.     Mindful Art! Experiment with painting, drawing, colouring, flower arranging, sculpting with clay or play-doh, and once again try to really be present in the activity. Notice the colours you create, the textures or patterns arising, the feel of the pencil, paintbrush or material in your hands. You could try getting an adult colouring book, or experimenting with mandala circles, or practicing still-life drawing; or just go with the flow of creating something abstract!

4.     Mindful appreciation of a loved one.  This can be a really beautiful activity to do with a child, pet, or partner. Just spend a few minutes silently observing what you notice as you focus your full attention on them. With a child you might like to pause and watch them immersed in play: noticing their expressions of joy or concentration, the way they move, or the way their eyes light up when they look at you. Or you might like to snuggle them and inhale their scent or notice how soft their skin is or the way their body softens as they relax. With a pet you might like to softly stroke them and notice the sensation of their skin, fur or feathers, or spend time observing the different colours or patterns. With a partner you could try observing them as they go about everyday activities, noticing things about them you have taken for granted or stopped seeing in the everyday familiarity, or you could consciously spend a minute or two looking into each other’s eyes. Noticing what emotions arise as you engage in this silent intimacy.

5.     Mindful Eating. Buy or prepare the most delicious food you can think of and consciously savour the experience. Use as many of your senses as you can- inhaling the scent, observing the colours or textures, really noticing how the flavours change. Slowly savouring each step in the process of tasting, chewing, swallowing. How is this different to eating the same food mindlessly whilst watching tv or multi-tasking? A similar thing can be done by pausing as you drink your coffee, tea, or juice in the morning: devote a minute (or even just one sip!) to savour the experience whilst letting go of everything else!

6.     Mindful Pampering. Take a shower with the conscious intent to be as present in the activity as you can. Notice the feel of the water, the temperature on your skin, the scent of your shampoo, soap, or shower gel, the noise of the water beating down. How does this differ from a quick shower whilst mentally running through a to-do-list of all the things you need to complete. Or try luxuriating in a bubble bath, or spending a few minutes gently rubbing in hand cream or body lotion and noticing the sensations, really observing your skin with fresh eyes and noticing what it’s like to consciously nurture your body.

7.     Mindful Exercise. Some forms of exercise like Yoga, Tai Chi, or Pilates naturally lend themselves to a mind-body connection and present-moment awareness. But get creative and find out what works for you! A mindful walk where you notice the nature around you, focusing your attention on your senses instead of walking whilst your mind is elsewhere? Or perhaps a team sport or kick-about with the family! Immerse yourself fully in the activity and just go with the flow!

8.     Mindful Games. Any kind of game can be turned into a mindfulness activity simply by focusing your attention on what is happening in the moment -  Have you ever played a family board game and noticed everyone is fully present, participating, and connected? Living in that exact moment instead of pre-occupied with earlier events of the day or worries of tomorrow? That’s mindfulness! 

If you do want to try some specific fun activities to practice though, here are some ideas that are great for kids, but that teens, and grown-ups can enjoy too:

·      Create a story together. Take turns to say one word or one sentence before the next person has to follow it up. “Once” “There” “Was” “A” etc. It requires focused attention without being able to predict or jump too far ahead! Let go of judgments about what you say and just go with it!

·      The Alphabet game – Similar to the one above, take turns to say an animal that starts with the last letter of the word before. Eg “Alligator” “Rhino” “Orang-Utan” etc.

·      Simon Says – An old classic, but so good for helping kids focus their attention in the moment!

·      Balancing Egg- This was one of my favourite mindfulness activities from a group therapy program I co-facilitated. Give everyone a raw egg and sit at a table – Get everyone to practice balancing their egg upright. It requires focused attention and patience and can be lots of fun! But it often elicits frustration and judgments which can be a great chance to practicing noticing this and non-judgmentally coming back to the activity.

9.     Mindful nature: Spend some time at the beach, near a lake, in a park, or a forest. Try to focus on just observing all the information coming through your senses in that moment. Noticing the sound of the waves or of birds chirping, the leaves moving in the wind, the clouds in the sky, sunlight reflecting off the water etc. You can try embracing a still presence where you simply sit back and notice the nature surrounding you, or you could try an active form of mindfulness where you throw yourself fully into an outdoors activity in that moment: swimming, hiking, horse-riding, running, bike-riding, rock climbing, or anything else that takes your fancy! To embrace mindfulness the only thing you need to do is be present! Observe any worries or distractions or self-judgments as they arise, and simply practice letting them go through redirecting your attention to exactly what you’re doing in that moment!

Hopefully by now you have a few ideas for other ways to embrace mindfulness, but the wonderful thing about it being a state of being we can cultivate is that we can make any moment in our lives a mindful one! Mindfulness doesn’t have to mean planning extra time in your schedule to practice. Sometimes it’s just about noticing what’s already happening!

When A Psychologist Sees A Psychologist

Following the birth of my second baby, I was not in a good place. Jack was so different from my first baby - he seemed to feed every 1-2 hours day and night, he wouldn’t settle, I was constantly changing his nappies and he would just cry, and cry, and cry. I would find out when he was 5 weeks old that this was because he has cystic fibrosis, and the poor little guy couldn’t absorb the goodness of the breastmilk, so he was just hungry! Of course he couldn’t settle, of course he couldn’t sleep. 

Meanwhile I spent 5 weeks blaming myself, breastfeeding and expressing around the clock, wondering how I could be doing this so wrong.. Especially as I’d already done it before!

Throw in epic sleep deprivation, the arrival of Covid-19 and an avalanche of negative thoughts that I’d ruined my first child’s life forever as I had no time or space to give her - I was a ball of tears, exhaustion and overwhelm.

The navy colour-coordination was accidental, and that smile is forced!

As a psychologist, I knew how important the early weeks, months and years are for a child’s development, so I knew that if I didn’t get myself right, not only would I suffer, but so would my relationship with my children, and ultimately their future selves. 

So thankfully with the Medicare-funded Telehealth sessions in place, I reached out and found someone who specialised in the difficulties I was facing. 

Ohhh being on the other side of the couch! I was nervous! I was skeptical. I felt guilty - shouldn’t I know all this stuff already?

Thank goodness I overcame my own ego and started therapy. Here are the main things I have learned from my journey so far:

• It is actually helpful

  • This was almost a relief to arrive at this one. I mean, after 8 years of education and pouring my heart and soul into my work for 10 years, it feels good to realise that therapy works!

• You need someone objective

  • I’d spoken openly to my husband, my friends and my family about how I was feeling, and they were amazing. But you need somebody outside of your circle, somebody you doesn’t know you as a wife/daughter/sister/friend. Who can be totally objective - not only in making sense of what’s going on for you, but also someone who you can listen to and potentially accept what they’re offering in a different way. Many things that my psychologist said to me I’m sure my husband had already tried to say… but it was much easier taking it on board from her! Maybe that’s a reflection of my stubbornness. 

• Emotions shut down your brain

  • Some of the things my psychologist pointed out seemed blindingly obvious once she’d shone a light on them. But given the state I was in, my brain was flooded with cortisol, my fight-flight response had taken over and I was absolutely depleted. I was not seeing things rationally, and I was not utilising the brain capacity I normally have available to navigate my life and the lives and paths of my clients. 

• It is worth the money

  • As with a lot of people throughout Covid, and being on maternity leave, my financial situation was not one of abundance. So I was hesitant to spend the money on therapy, and thought of all the other ways the money could potentially be better used. This was a very unnecessary barrier. Every session was worth every dollar. 

• It is worth the time

  • Between feeding, expressing, sterilising, washing, settling, burping, changing the nappies and playing with two under two as well as running my own business, I hardly had time to have a shower. And in fact that was not a daily event during this period. And oh yeah I also have a husband that has needs too! So trying to find the space to schedule an appointment in between all the demands placed on me was a challenge in itself. And of course there were the thoughts of what else I could be doing in that one hour that may be better value - sleeping? Meal preparation to get ahead? Cleaning? Nothing could have been better value. It was definitely worth the time, and, in fact, I should have had sessions more frequently. 

• Leaning on others makes you stronger not weaker

  • I carry this longstanding and entirely unhelpful belief that I should be able to cope with everything by myself. Not only is it actually counterproductive, but it is so false! We are not designed to be solo creatures! We have evolved to live within a community, to rely on and be supported by those around us. Every time I was able to loosen a grip on this belief and take a step towards support it helped me breathe easier and move forward faster. 

• Everyone should have therapy

  • I truly believe this. The power in objective reflection, in someone holding a mirror up to you and your life and your behaviours, and supporting you with the skills to make changes if your life is out of alignment is invaluable. And this doesn’t have to be formally with sessions with a psychologist (although this is an excellent way to acheive this goal). It can be through reflection, through some form of meditation or mindfulness practice, or whatever space you can access to connect with yourself in a deeper way. But whichever way you choose to do it - you must. As Plato said, “An unexamined life is not worth living”.

When concern for your health becomes anxiety

While having some concern about our health is normal and generally helpful, some people are excessively and obsessively preoccupied with their health, to the point where it interferes with their life, including work, study, relationships and daily life, resulting in significant distress. 

This is preoccupation with health and illness, and particularly that they have symptoms of a serious illness, is the hallmark of ‘illness anxiety disorder’ or health anxiety. Health anxiety can develop in people that are ‘healthy’, as well as those who have a real medical condition with physical symptoms that are excessively distressing to them (the latter is termed ‘somatic symptom disorder’). However, I will be focusing illness anxiety disorder here.

Of course, with the symptoms of COVID-19 constantly in the media and in the forefront of many people’s minds, anxiety and distress about health has been amplified, and this is particularly so for those who were already preoccupied with their bodily sensations and health.

Some of the main symptoms of illness anxiety disorder include:

·      Excessive preoccupation with having or coming down with a serious illness 

·      There are no, or mild, physical symptoms

·      Anxiety persists despite receiving negative results on medical tests and reassurance from medical professionals

·      Health-related behaviours such as:

o   Repeatedly checking your body for signs of illness 

o   Either avoiding, or frequently seeking reassurance from, medical professionals 

o   Searches for information about illness symptoms

o   Avoiding situations or stimuli that are perceived as anxiety-provoking

What keeps illness anxiety disorder going?

There are a number of factors that can contribute to keeping us stuck in a health anxiety state. These include cognitive factors, including interpretation of bodily sensations, or worry), and behavioural factors such as checking, avoidance and reassurance-seeking.

Unhelpful thoughts and beliefs

·      Misinterpreting harmless bodily sensations as a threat (indicating serious illness) can lead us to pay more attention to those sensations, which can amplify their intensity. This increases anxiety, and then the symptoms of anxiety (e.g. breathlessness, chest tightness/pain, faintness) are interpreted as a further threat and worried about. 

·      Worry and repetitive thoughts keep the fears ever-present. Intrusive thoughts and images can be upsetting.

·      Trying to dismiss or get rid of unwanted thoughts and doubts can make them come back stronger.

·      Thoughts about perceived symptoms become distorted or inaccurate, leading to overestimation of the probability of having or developing a serious illness, and underestimation of ability to cope with illness.

Avoidance, reassurance and checking behaviours

·      These are things that you do to help you cope when you feel anxious, or to try and prevent feelings of anxiety from occurring. 

·      For example, 

o   Avoiding hospitals, medical appointments, sick people, or reminders of illness such as TV or newspapers. Or avoiding anything that gives you bodily sensations that make you anxious, such as exercise, coffee, or specific foods

o   Keeping a mobile phone or companion with you, or staying close to hospitals, in case you have a health emergency, 

o   Information and reassurance seeking, such as repeated medical consultations and tests, searches for information

o   Checking. For example, of your body or memory. Checking is unhelpful in that it keeps your focus on your worries, can lead you to see a problem where there isn’t one, increases uncertainty or doubt (leading to more checking!), and can actually lead to symptoms (e.g. constantly feeling an area of the body leads to tenderness or redness).

·      Avoidance, reassurance and checking behaviours can feel good and provide relief initially, but in the longer-term they stop you from learning that you can survive without them or whether your fears are real, and they often lead to needing more reassurance and not being able to cope with anxiety symptoms and uncertainty.

Tips for if you find yourself preoccupied with bodily sensations 

A core feature of illness anxiety disorder is that harmless bodily sensations are misinterpreted as dangerous and threatening and become a focus of attention. This misinterpretation of sensations is key. 

Tip #1: Explore the relationship between your bodily sensation and your focus and anxiety. Notice if your experience of the bodily sensation changes as your anxiety rises and falls, or if your focus on the physical symptom is triggered by anxiety thoughts (e.g triggered by something in the news or hearing about someone else’s illness). Try focusing on your stomach for a minute and noticing any physical sensations (e.g. gurgling, tightness). Had you been aware of these sensations before you focused your attention on them? Did the sensations appear to increase over the time you focused on them? By observing and understanding how attention and your anxiety may impact your experience of physical sensations, you can start to change this relationship.

Tip #2: To further test the connection between bodily sensations, anxiety and attention, try focusing on how a ‘safe’ part of your body feels (e.g. your left thumb), and notice how your attention wanders when the sensations are interpreted as unimportant and ‘safe’.

Tip #3: Learn and practice mindfulness in everyday tasks to learn how to focus your attention on the here and now. Move your attention from your body and its sensations, and focus on whatever everyday task you are doing (e.g. doing the dishes, eating, vacuuming, having a shower). Focus on your senses (what can you see, hear, feel, smell, and taste? notice the details), and gently bring your attention back to the task whenever you notice that your mind has wandered (which is perfectly natural!). 

Tip #4: Set aside time to worry. Focusing on worries, including trying to stop worrying, can create more worries and symptoms. One strategy for tackling worries is to postpone them. To do this, decide on a set time, place and length of time (no more than half an hour and not just before bed) that will be your ‘worry time’. Then, when you notice a worry or focus on a symptom, write it down (briefly) to worry about later, and then bring your attention back to whatever you are busy with. Remind yourself that you will be able to come back to your concerns later. When you get to your ‘worry time’, only think about the worries on your list that still seem really important at that time (some things might seem less important or no longer relevant), and do not worry for longer than the time set (you can carry items over to the next day’s worry time if necessary).

Tip #5: Remind yourself that while any anxiety symptoms may feel unpleasant, they cannot not hurt you, and will pass. Try using distress tolerance strategies to get you through the wave of anxiety. For example, use relaxation (e.g. calm breathing) or mindfulness strategies, engage in distracting or soothing activities, or use your senses to ground you in the world around you (what can you see, hear, feel, smell, and taste?).

Of course, while the above tips can be helpful in starting to address illness anxiety disorder, you should still speak with your doctor about any concerning symptoms. If you need guidance as to wen it is appropriate to seek medical attention, it may be helpful to agree on some guidelines with your doctor.

These tips start to address some aspects of health anxiety – the focus on, and misinterpretation of, bodily sensations that often occur. However, the many unique factors experienced by those affected by health anxiety can be addressed successfully and more fully through individualised psychotherapy approaches, such as Cognitive Behavioural Therapy (CBT).

How To Discuss Screen Usage With Your Teenager

Like many people, I recently watched ‘The Social Dilemma’ – a new documentary produced by Netflix examining the way that large social media and technology companies are manipulating our behaviour. It’s a pretty challenging two hours – most of us use our phones daily, if not hourly – for work, family, friends, socialising, shopping, organising, entertainment, planning, the list goes on. But the documentary provides some compelling reasons to consider reducing our exposure to the internet, particularly social media. It’s not the first documentary of it’s kind – there’s been a couple released over the past few years providing some thought provoking, at times scary, statistics. After finishing the documentary, I spent some time reflecting on my own social media and internet use – there are so many benefits to our phones, but I found it helpful to decide on what I was happy with and what I wanted to change. 

These are questions often asked by many clients – how is my phone or social media use affecting my wellbeing? Are there things I need to, or want to, change? And it’s a common question from many parents of young people – how do I get them to use their phone less? 

It can be pretty worrying as a parent when documentaries or reports come out suggesting the darker side to social media and phone use. It’s easy to feel helpless or confused - changing our own phone habits can seem difficult, let alone encouraging young people to do so. So how should you discuss this topic with your young person?

Acknowledge Change Takes Time

First, it’s helpful to recognise that change takes time, it doesn’t happen overnight. Psychologists often refer to the ‘Stages of Change’ model, which outlines the process we go through in order to make and sustain a behavioural change. The stages are 1. Pre-Contemplation (not even thinking about it!), 2. Contemplation (possibly considering a change). 3. Preparation (deciding on what changes to make), 4. Action (taking steps to make the change), 5. Maintenance (engaging in things which sustain the change), and possibly 6. Relapse. 

What this framework shows us is there are three important stages to go through before someone is able to actually take action! Notice that your teenager might be ‘pre-contemplative’ about changing their phone use – it’s not necessarily that they’re against it, they just haven’t considered it, or don’t considered it a problem yet. 

Express Concern To Your Teenager

When trying to help someone make a change, it can be pretty easy to just suggest or even mandate the new behaviour. Maybe you want to jump straight in and set new rules or boundaries regarding social media or phone us with your young person. However, this isn’t always the most effective strategy.

Most people, but particularly young people, respond better to suggestions when they can understand why it’s being suggested. We need a rationale. And sometimes facts and logic don’t cut it. Particularly some of the facts and figures regarding the impact of phone usage don’t always connect with young people – they personally don’t feel impacted by it. Work our what your feelings are in regards to the issue – do you feel worried, anxious, confused, frustrated, guilty, powerless, lost...? Try expressing these feelings first to your teenager – beginning conversations with feelings and questions, rather than directives help reduce defensiveness and perhaps might assist with moving them through the ‘stages of change’. Approach things with a curiosity – try to understand more about their phone usage (when, why, with who, how) before trying to change it. 

Develop A Plan With Them Not For Them

Try and develop a plan for change in collaboration with them. This will have to involve some compromise – for both you and your teenager. Ask lots of questions! Ask them what they think is an appropriate amount of time they need to use their phones for each day, or when might be a good time to reduce or shift phone usage. Ask them what they might struggle with about using their phone less. Ask them what they are willing or not willing to change and why. Demonstrate your own willingness to adapt by agreeing with as much as you can, and being open about your own expectations and boundaries. 

Often I suggest a trial period for the new rules – it can be hard to commit indefinitely to change, so suggest a 1-2 day ‘experiment’ or one week of your plan, and one week of your teenager’s plan before settling on the new behaviours or rules. This can be helpful in testing out assumptions about what will be ‘too hard’ or ‘impossible’. 

Have Things To Replace The Old Behaviour

Whenever we remove an action, an activity, a behaviour, or a coping mechanism, we need to have something to take its place. Before setting the new rules or guidelines, plan what to do instead of using your phone, device, or social media site. Sometimes being active helps distract us (being outdoors, running, swimming, taking the dog for a walk). Sometimes it’s helpful to have a good morning or evening routine involving a bath, face mask, listening to music, reading a book, having a good meal which makes us less likely to engage in automatic phone use. Maybe it’s easier to still do something on your phone, but avoid social media – perhaps it’s reading the news, watching a video, looking at old photos, face-timing a friend or family member. Find something that you can do when the impulse to check your phone kicks in. 

Set And Hold Boundaries

Once the plan is set, it’s going to take some reinforcing. Remember that your young person’s brain isn’t fully developed, particularly the all important frontal cortex which deals with emotional regulation, consequences, self-reflection, and planning. 

You’re going to need to hold the boundaries for them, with both flexibility and consistency. It can take a while to set a new habit, so have some compassion for the challenges, but remember that ‘giving in’ too early often means we don’t give ourselves enough time to adjust. Be clear with your young person in the planning stages how you’ll manage setting the new rules and boundaries. 

Focus On Rewarding Good Behaviour Not Punishing Bad Behaviour

Recognising and rewarding positive behaviour is often a better way to change patterns rather than punishing negative behaviour. Be on the look out for when your young person is managing well without their phone, or has been considerate, kind, thoughtful, funny, or helpful. Perhaps plan a reward with your young person for making a positive change. Also try not to pick up on mistakes or challenges early on. 

Demonstrate Changing Your Own Behaviour With Your Teenager

If you’re asking your young person to change their phone or social media use, it might also be a good idea to reflect on your own use. Are there ways that you can demonstrate commitment by changing your own behaviours? Could you charge your phone outside your bedroom at night, remove your email notifications on weekends, put your phone on silent during meals or social time? You might even ask your young person what they wish you did differently. Modelling coping with the difficulties of changing our behaviour is a great way to engage your young person and perhaps get some more ‘buy in’ to discussions around changing their behaviours. And you might even notice you feel better for it!

Loneliness: Feeling alone in feeling lonely?

Loneliness is a powerful feeling. And just like most human emotions, it is experienced by nearly all of us at some point in time. Even prior to COVID-19, according to the Australian Psychological Society’s 2018 survey, 1 in 4 people reported experiencing a current episode of loneliness. And yet it’s something that’s rarely talked about. It’s a feeling akin to shame which seems to cut to the core and elicit immense vulnerability when truly acknowledged. People often share they feel anxious or depressed, but what’s often not spoken about is that at the heart of this there is often a feeling of being lonely, disconnected from others, different, or separate in some way. Lacking in true meaningful connections. Perhaps the reason it’s so difficult to acknowledge the feeling of being lonely is that by its very nature most of us feel very alone when we’re experiencing it. Or perhaps there is a stigma attached to loneliness; a belief that if you’re lonely there is something wrong with you, that you lack the capacity to build relationships, or that others don’t want to be around you. These beliefs are often totally unfounded! When we take a step back, most of us can recognise that loneliness is a feeling, not a measure of how many friends you have. Some people who feel lonely are genuinely socially isolated, but for many, the feeling of loneliness can be just as intense when they’re surrounded by people.

Where does loneliness come from?

There’s no definitive answer to this question. Sometimes loneliness is a deep-seated feeling which relates to our earliest childhood experiences. Many people who have experienced childhood abuse, neglect, trauma, or experiences of being unloved will carry through very painful feelings that they are unwanted, unlovable, or different to others- which often correlates to feeling very alone as a teen or an adult- no matter how many people surround them. For others, the loneliness may come from feelings of being bullied or socially rejected, or from longstanding feelings of “not fitting in”. For others, the grief of losing somebody who matters at any stage in life can precipitate the onset of intense loneliness: feeling alone in a world with pain that strong, in combination with missing someone who was an important source of connection, support, or companionship.

Loneliness can also be linked to social anxiety or depression and can be very self-perpetuating due to the withdrawal or avoidance of social interactions which often accompanies them. For many it could be precipitated by other changes in life circumstances; and those who live alone, or who experience a separation or significant relationship breakdown are at particular risk of increased loneliness. Or it can simply be a gradual process whereby one day you become aware you have become distant from those around you; mentally, physically, or emotionally. I have sat with many individuals who are in relationships, or employed, or who report having families who love them; always surrounded by people yet feeling intensely alone on an emotional level. 

What is also sometimes overlooked is how we live in a world whereby it is easier than ever to connect with others through technology. For some who live alone or away from loved ones, or who have limited capacity to see people in person, this can be beneficial. The flipside, however, is that often the connections we have online lack the genuine authenticity that is necessary for true meaningful connectedness. And social media often elicits comparisons to others and feelings that we come up short. Or a pattern whereby our self-esteem is impacted by how many likes or comments we get. Whilst the many available social media platforms may seem like they bring us together, often the reverse is true, with the pressure to present an image of our best selves or comparisons with others driving feelings of loneliness and separation rather than feelings of closeness. And often the more we communicate via technology rather than in person, the less comfortable or necessary it feels to actually spend quality time with others. 

How to respond to loneliness

The best antidote to loneliness is connection.

And it’s not about quantity, it’s about quality. Feeling truly connected is a subjective feeling, but it often requires us to feel able to reveal our true authentic selves. To feel valued and accepted for who we are as an individual. To feel safe in the relationship.

It sounds obvious, but we often lose sight of how important this fundamental human need is. Connection to others serves a powerful evolutionary purpose in ensuring we are part of tribe; surrounded by those who are willing to step-up in times of stress, illness, danger, or need. Years of infant attachment research highlights how emotional connection is just as vital to our wellbeing as having our physical needs met. The desire to be truly close and connected to others is extremely powerful. And it doesn’t ever cease to matter. Ever. Healthy connections to others can be linked to mental and physical health throughout our entire lifespan!

So, if we feel lonely, the first step is to figure out where our loneliness is coming from? Is it an external problem that needs to be solved such as not having many people in our lives we want to connect to?

Or is it more that we are choosing to isolate ourselves or are holding ourselves back in some way when we are around others? Are there thoughts or beliefs getting in the way of us relaxing and being ourselves even with an abundance of more superficial connections? Are we driven by a fear of rejection rather than a belief that others will accept us as we are and will want to build intimacy with us? Or have we simply become so busy “doing” we are spending less time simply “being with” others? 

Whatever the reason, if you’re currently experiencing loneliness, the following ideas may be a place to start:

·      Allow yourself to observe the emotions that come up when you reflect on what it’s like to feel lonely. Approach this with curiosity rather than judgment. What messages are your feelings trying to tell you about what is currently happening in your life?

·      Reflect on what your needs really are. We all have different thresholds for proximity and intimacy with others. Some of us enjoy spending time alone. This is solitude, not loneliness. Whereas others might feel very alone unless physically in the presence of others. Is your loneliness related to feeling alone physically, or does it show up more when others are around through a sense of being different, misunderstood, judged, unaccepted, or unable to relax and be yourself? What does this tell you about what would be helpful for you?

·      Work on connection to yourself first. What really matters to you in this world? Who do you want to be? How do you want to live your life? The more you understand this, the better chance of connecting to others who have similar values, or of communicating your needs to those already in your life. 

·      Practice self-compassion and letting go of self-criticism and judgment. Working on being comfortable with who you are is often fundamental in learning how to be authentic in the presence of others too. For any of us, shame around who we are is often a massive barrier to connection.

·      When you feel ready to start reaching out to others, start small. Is there someone who matters to you that you would like to become closer to? Could you start with a message, work up to a phone call, and then meet for a catch up if feasible? Or could you start with initiating conversations or replying to messages you’ve been ignoring and work your way up in terms of the depth of the conversations and vulnerability required? Have you become distant from your partner? Fallen into the trap of seeing each other every day but never really connecting on a deeper level? Could you organise a date night where you agree to rediscover each other’s interests instead of talking about mundane tasks, or instead even start with small daily acts of connection such as an extra hug or kiss, putting down your phone when talking to them, doing something small but meaningful to demonstrate you care?

·      If the issue is a lack of friendships or relationships could you brainstorm ways to get around this and take a chance on meeting new people? Join a social club or team sport? Say yes to any invites that come your way instead of automatically thinking of reasons you can’t! Reach out to old contacts you have lost touch with? Volunteer for a cause that matters to you or explore any events in your local community? If you attend school or university could you smile at someone in your class, or sit next to someone different? Or if you have young kids, could you ask a fellow parent if they would like to organise a playdate? 

·      If feasible, consider getting a pet or spending time around animals. Whilst human connection is often vital, many people report significantly lower levels of loneliness when connecting with a non-human companion as a way to bridge the gap and experience some unconditional affection!

·      Reach out to professional helplines. If you feel alone and isolated there are a number of helplines such as Lifeline (13 11 14), Kids Helpline (1800 55 1500), Mensline (1300 78 99 78) and BeyondBlue (1300 22 46 36) that have trained individuals ready to listen.

·      If you are experiencing social anxiety or depression that significantly impacts your life and limits your ability to engage in interactions with others it might be worth considering professional support. Working on the thoughts, beliefs, behaviours, and physical symptoms that compound your difficulties can help you overcome any barriers! And building a connection with your therapist in a safe space can be a great way to become more comfortable with vulnerability, authenticity, and figuring out who you are, and what kind of people you would like in your life!

·      And perhaps, most importantly, remember you are never alone in feeling lonely.

Why do psychologists always talk about breathing?

If you’ve ever spoken to a psychologist or a counsellor, you’ve probably been encouraged to try out breathing techniques as a way to manage a range of mental health concerns.

It’s something that I raise with most of my clients at some point during our therapy journey.

But a common comment I hear in from many of the people I see, usually in the first session or two, is that they don’t find ‘breathing’ helpful and they aren’t keen for it to be suggested again.

And it’s totally understandable why they feel this way! Whether you’ve suffered with extreme anxiety or not, most of us have had the experience of someone telling us to ‘just breathe’ or ‘take a breath’ when we’ve shared our worries or stresses. Maybe we’ve even attempted to regulate our breathing during an anxiety or panic attack before. Being told to ‘just breathe’ can be very invalidating, and often increases our frustration and worries rather than taking them away. Attempting to change our breathing during a panic attack can also feel impossible, particularly when we’re hyperventilating, feel like we’ve lost control, or even feel like we might be dying.

So why do psychologists keep suggesting it?

Breathing techniques come in all shapes and sizes. And they have a range of purposes and aims that can help us in recovery from mental health concerns

Sometimes it’s as simple as DISTRACTION – regardless of where we are, who we’re with, and how we’re feeling we’ve always got our breath. Being able to draw our attention to our breathing (and just being mindful of it, without having to change it) can be a great way to circuit-break our cycle of negative or anxious thinking, or it might help us shift our focus from something else that’s triggering. It might help you ground or get a bit of focus whilst you wait for something else to pass.

Sometimes breathing techniques help us connect with the PRESENT MOMENT. When we draw our attention to our breathing we naturally have to be more mindful! Our mental health can often take a turn when we use too much of our ‘headspace’ on the past or on the future, so training our attention muscles to remain in (or shift back to!) the present moment is a really helpful way to improve our mental health.

But a big reason why I often work on breathing with clients is that our breath is a great way to IMPACT OUR NERVOUS SYSTEM! I often find that clients don’t understand the science behind why breathing techniques can be so effective!

Within our body we have two systems – one called the sympathetic nervous system, and one called the parasympathetic nervous system.

Our sympathetic nervous system is like the accelerator in a car – it helps everything ‘start up’. It helps us stay safe by quickly and automatically responding to threats or danger. It helps us with ‘Fight/Flight/Freeze’ responses.

Our parasympathetic nervous system is like the brake in a car – it helps everything ‘slow down’. It helps us to recover after a threat, and return back to normal. After all, it’s unsustainable to remain in a state of hypervigilance for too long. It’s responsible for what we call the ‘Rest and Digest’ response (i.e. the opposite to the Fight/Flight/Freeze response).

For those of us with mental health concerns, particularly anxiety, we’re often ‘stuck’ in our sympathetic nervous system – we feel on edge, flighty, hypervigilant, often unable to focus on certain things, and find it difficult to switch off or even sleep. We need to keeping switching back into our parasympathetic nervous system and teaching our bodies that we’re safe.

Switching between our sympathetic and parasympathetic nervous system is often outside of our control – it’s determined by the automatic part of our brain.

Thankfully, however, our breath is one bodily function that can switch us between sympathetic (accelerator) and parasympathetic (brake) nervous system. When we bring conscious awareness to our breath – to slow it down, extend our exhales, and/or deepen each breath, we give ourselves an opportunity to turn on our nervous system ‘brake’.

As proof of this, I sometimes get clients to think about how their breathing looks when they want to be running (short, sharp, shoulders lifting, chest heaving) compared to when they want to be sleeping (very slow, only our lower belly moves, very deep and even). Shifting our breathing is a sign to our bodies to ‘rest’, to ‘slow down’, that we are safe and able to relax.

Sometimes we find it hard to notice or challenge our thoughts, particularly if we know they’re illogical already. So breathing can be a handy way to manage moments of anxiety. And that’s why you might find your psychologist suggesting it (again!).

If you’ve tried breathing techniques and they haven’t been useful, if you’re frustrated when your psychologist suggests it, or if you’re keen to hear more about them or give them another go – always let your psychologist know your thoughts and feelings!

Most importantly, keep giving them a go. It’s a bit like any other skill or practice – we often need to attempt it on several occasions to get the hang of it. I often think back to when I started jogging – it took me and a friend an entire year of running every week (sometimes twice a week) to build up to running 5kms. We ran a few hundred metres at first, and slowly built up each week. It was uncomfortable and tiring the whole way, but our muscles and lungs progressively got stronger and more accustomed. It’s the same with our “brain muscles” – our ability to focus on and use or breathing will be difficult at first, but with practice will get much easier!

Self-grooming habits that harm us

Most of us have habits that we would like to change or stop, such as compulsively checking messages on our phone, or chewing the end of our pen. Luckily, for most of us our habits are simply annoying, rather than actually harmful. But for around 2-5% of the population, their habit is highly problematic, and harms their body. These habits include picking at their skin (excoriation disorder or compulsive skin picking), pulling (out) their hair (trichotillomania), biting the inside of their cheeks, and biting their nails (onychophagia).

The term body-focused repetitive behaviour (BFRB) is used to refer to this group of self- grooming behaviours that are performed with a loss of control, and harm the person’s body. While there is a wide rang of BFRB severity, most people with a BFRB cannot stop the behaviour despite multiple attempts to decrease or stop, and these disorders result in distress and interfere with daily functioning.

BFBRs often first emerge in early-mid adolescence, although they can occur at any age. Perhaps surprisingly, given the prevalence of BFRBs, these behaviours are under-researched and poorly understood. However, experts have established that BFRBs are not a form of obsessive compulsive disorder (OCD), and are not due to previous trauma or bad parenting. BFRBs are also not considered to be a form of self-mutilation or self-harm. So what may account for the onset and maintenance of these habits? It appears that some people are genetically predisposed to developing a BFRB, and it is also thought that stress may play a role for some people as their habit can be experienced as soothing or providing a relieving function. However, for others the only significant stress they experience is due to their BFRB. Overall, BFBRs are acknowledged as being highly complex behaviours.

As well as causing hair loss, skin lesions, scarring and other visible effects, BFBRs can potentially have more serious physical consequences. For example, skin picking and nail biting can result in infections if the exposed wounds are not allowed to heal. Similarly, if hair is pulled from the eyelashes or the pubic region, infections may also occur. More rarely, if people who pull their hair also eat the removed hair, this hair can build up in the gastrointestinal tract, with very serious health implications.

While BFBRs can potentially result in medical complications, they also result in significant psychological distress and impacts on the person’s quality of life. Most people struggling with a BFRB hide their disorder because they feel intense shame and embarrassment, which can prevent them from seeking medical or psychological help. These disorders often negatively impact the person's self-esteem and social relationships, contributing to them feeling hopeless and isolated. BFRBs can also affect their ability to engage effectively in education, work, or other activities that they would like to pursue.

A large part of the negative psychological impact of a BFRB can stem from the belief that the disorder is the sufferer’s fault, and that they should be able to address it on their own. They are often not aware that, contrary to common belief, BFRBs are not trivial habits that a person should be able to change with a bit of willpower – they are highly complex behaviours that result in real and significant challenges. Expecting someone to simply stop such a complex behaviour will only add to the burden of shame and confusion felt by the person struggling with the BFRB.

Most people who seek help for a BFRB, only do so when they reach a point of desperation. The shame and secrecy associated with BFRBs not only prevents timely support and treatment, but also contributes to the lack of awareness of the problem more generally. Fortunately, there is increasing awareness of BFRBs, and there are now a number of recommended psychological treatments for these disorders, which all fall into the broader approach known as Cognitive Behaviour Therapy (CBT). These CBT treatments may be applied in conjunction with other psychological approaches, such as Dialectical Behaviour Therapy (DBT) or Acceptance and Commitment Therapy (ACT). While CBT is considered the most effective treatment for BFRBs, medication may also be considered prior to, or while, engaging in CBT.

Radical Acceptance in the face of COVID-19

What is Radical Acceptance

Radical acceptance is a powerful skill taught in Dialectical Behaviour Therapy (DBT). It involves truly accepting reality as it is. This means completely accepting with your mind, your heart, and your body. It also involves letting go of the struggle, bitterness, and resentment that life is not the way you want it to be, that life is cruel or unfair, or that painful experiences shouldn’t have happened, or shouldn’t be happening right now. It is about letting go of judgments and attempts to control things you cannot control; and completely accepting things exactly the way they are in this moment.

Why is it important?

Radical acceptance is a really helpful skill in times of pain, uncertainty, loss, or grief. Without accepting reality as it is we, are essentially trapped with our pain, adding immense suffering on top of it. If we judge or deny reality, we often feel stuck and unable to let go of the idea things should be different. We cannot even begin to contemplate how to change things, or work with things, or how to manage the pain life has thrown our way.

Why is Radical Acceptance so hard?

Whilst it may sound like a good idea in theory, many people struggle with radical acceptance. This is often because there are misconceptions about what it involves. We often think of acceptance as meaning approval, or liking, or agreeing with something. When life is painful, that is understandably impossible for most of us to do! That’s why it’s important to note that that’s not what radical acceptance actually is, and that’s definitely not what we’re trying to do. It is about acknowledging the facts of the situation and accepting these facts of reality to be true: even if they are completely unwanted, and even if they cause immense pain!

People also sometimes get confused around what needs to be accepted. Whilst radical acceptance may involve non-judgmentally accepting the existence of our thoughts and feelings, it doesn’t involve accepting negative thoughts, interpretations, or beliefs to be true. For example, if you were to lose your job, you might need to radically accept the fact that you are no longer employed in that position in order to direct attention towards moving forwards, but you would NOT have to accept “I’ll never get another job” or “It’s because I’m terrible at what I do” etc. We only need to accept reality, or at least very realistic probabilities – not imagined catastrophes, judgments, or criticisms of ourselves or others as being facts.

Radical acceptance is often a journey. To get to a level of complete and total acceptance is not easy. And it rarely happen instantaneously. We can choose to turn our mind towards acceptance, but to truly feel it with every part of ourselves is often a journey of repeatedly turning towards acceptance. Many people feel a sense of peace when they truly accept things or themselves exactly as they are, but to get to that point often requires opening yourself up to experience an enormous amount of painful emotions along the way. And it’s totally natural that part of this journey may involve swinging back out of acceptance. One day acknowledging without struggle that things are the way they are, the next, noticing thoughts such as “Why me?” “This can’t be happening!” “This isn’t fair!”. When this occurs, it’s a sign you might need to turn your back mind towards acceptance once more!

So how does this apply to COVID-19?

In the space of six months, the whole world has changed. The pandemic has changed our lives in ways many of us couldn’t have imagined. For some of us it has had a bigger impact than others, but for all of us, there has been a lot of uncertainty, lack of control, and need to make changes to how we live our lives. For many there has also been a lot of fear, terror, grief, frustration, sadness, and a lot of questions no one can answer. “Will I catch it?” “Will my loved ones?” “Will I lose my job?”, “When will I be able to travel?”, “When will it end?”. It is natural there has been a lot of fighting against reality. A global pandemic is scary and for most of us it is an unprecedented event! It makes sense it wouldn’t be easy to radically accept!

What this has looked like across the world though is a lot of struggle. Struggle to accept the uncertainty, restrictions, changes, or losses that this pandemic has created. A lot of reactions driven by denying or rejecting reality, or by instead treating catastrophes as though they ARE reality, when they might not actually be very likely to occur at all. Swinging between trying to reassure ourselves or others by downplaying or dismissing the facts, through to feeling completely hopeless and helpless because our attention is hooked by worst-case scenarios. By focusing on sticking to the facts and accepting we cannot individually control or change the pandemic (or subsequent rules or restrictions!), we can refocus our energy onto living with the circumstances as they are in the most effective and meaningful way. When we let go of fighting reality and the things we cannot change, we can instead refocus on what we can still control, and how we can make the best of our situation.

Even those people who have experienced the most immense pain of losing loved ones may find radical acceptance to be beneficial. Allowing and accepting whatever emotions come up without judgment is sometimes crucial to processing a loss. Radically accepting there is no easy or “right” way to experience grief can help individuals validate their own experience and allow the process to unfold. And over time, finding a way to truly accept the loss has occurred (whilst remembering we are definitely not diminishing the pain or significance of this!) can be part of moving forward in life.

Ultimately though, working towards radical acceptance is something that can benefit us all, no matter what life has thrown at us. Here are some inspiring examples of people turning towards acceptance that I have come across over the last 6 months:

• A first-time mum facing the reality of giving birth in a world where their partner was not been allowed to support them throughout the majority of labour, and where family members have not been able to meet their newborn. Initially this realisation created a lot of painful emotions, however, instead of getting trapped by thoughts that this isn’t fair and this isn’t how they pictured their journey into motherhood, they have managed to accept that this is the way things are right now; and they’ve transitioned with acceptance and grace into doing what needs to be done, even with far less practical support then they had ever imagined!  A family experiencing extreme lockdown in another part of the world letting go of the frustration and resentment around the restrictions and instead focusing on making the most of reality as it is. Instead of complaining they can only leave the house for one hour’s exercise they have embraced that hour by going for mindful walks and breathing in fresh air, sights, and sounds of the world exactly as it is in that moment! 

• A young boy handling with astonishing acceptance the realisation that his birthday party needed to be cancelled. He didn’t have a tantrum or get stuck in how unfair it was that he’d already invited his friends, and that he had been looking forward to it for months. Instead he calmly accepted that it needed to be done; and redirected his energy to planning how to have fun at home that day instead! 

• Many people with fears of wearing facemasks, or anxiety that makes it hard for them to breathe. Instead of getting caught up in how they don’t want to wear one, or saying it’s too hard, they have stated they accept the recommendations are what they are, and they choose to not let it hold them back, even if it’s difficult for them. 

• Healthcare and other essential workers accepting the reality that to continue turning up to work is to accept there is a risk they will contract COVID-19, and to feel at peace with their decision. Equally, other professionals making different choices and accepting that in order to protect themselves or vulnerable family members to the best of their ability they cannot continue to work; or need to adapt and work from home; even though this creates other challenges that are so hard!

These are just a few examples of how each of us has a choice to turn towards accepting ourselves, our lives, our reality, and all that comes with it in each moment. To work on letting go of judgments that things aren’t the way they should be, that others aren’t doing what we think they “should” be doing, that by ruminating about the past we can somehow change it, or that by worrying about the future we can somehow prevent things that are out of our control. Instead, finding peace in allowing each moment to be just as it is.

This also includes radically accepting ourselves and all our “flaws”, and accepting each and every emotion we experience, even if we don’t want to feel that way. It’s not about “perfectly” handling the challenges that Covid-19 has thrown at us, it’s about accepting there is no such thing as perfection, no such thing as one right or wrong way to do things, no such thing as a pain-free existence. There is just us, as unique individuals, all experiencing the shared humanity of a world filled with things we often cannot control. “There is something wonderfully bold and liberating about saying yes to our entire imperfect and messy life” (Tara Brach).

Managing Toddler Tantrums

Toddlers are little whirlwinds of emotion, sensitivity and curiousity, and thanks to their developing brains – are totally uncontained, unregulated and unable to control their impulses. 

Think of toddlers as all accelerator (big, intense emotions) with no brake (ability to manage these emotions, consider consequences, make good choices or shift their thinking).

As a parent, your whole life, effort and existence revolves around serving this little person. So it can be so easy to take tantrums personally – “I have sacrified everything for you, serve you meals six times a day, are the reason you are still alive, clean and healthy and you repay me by kicking me for slicing your sandwich the wrong way?!”; “Have a raised a sociopath? Why would my child smile while they go ahead and do the exact thing I just politely requested they not do?!”.

To help preserve your sanity, and provide you with some tools when you are completely bewildered by the shifting moods of your toddler, I’ve put together some steps to consider:

1.     REFRAME

• Understand their stage of development, rather than react to their age-appropriate behaviour as if they are our peers. Yes it is totally unacceptable for an adult to assault a waiter if they serve their drink in the wrong cup. However, it is NORMAL and EXPECTED for a toddler to be unable to regulate their emotions and behaviour. Their little brains are just not capable of this.

• Don’t take it personally – this behaviour does NOT mean your child doesn’t love or appreciate you. They do, more than you know.

• Challenging behaviours come from discomfort. 

2.     SHIFT YOUR EXPECTATIONS 

• You don’t need to change their emotion. You don’t need to prevent tantrums. You don’t need to keep them happy all the time. When your little one is having a tantrum, your role is to keep them safe, and wait for the storm to pass. Interfering, or getting triggered yourself often just intensifies the storm. 

3.    EXPLORE THE FUNCTION 

• There are different types of tantrums:

                                               i.     System breakdown (fatigue/hunger/overstimulation/constipation/sickness)

                                             ii.     Learning (pushing limits to see what happens in order to learn what they can do and make sense of the world). 

                                            iii.     Connection (sometimes children learn that the best way to get connection is through misbehaviour).

                                            iv.     Emotional release (sometimes tantrums are just a way of discharging stress from the body. These are much more likely to occur with ‘safe’ people – like caregivers, at home).

• Try and record when and where they are happening and what the trigger was. See if you can notice a pattern. Understanding the function can help address the behaviour more effectively, and set them up to succeed.

4.     BE WITH

• Your number one job in a tantrum (and in life) is to “be with” them in their emotion. Not change it, not try and reason with them or discipline them (the time for reasoning and learning comes later). Your child needs to feel heard, seen and understood. 

• Acknowledge what you think they may be feeling – validating their emotion. You want them to know you get their message.  

  • “You’re feeling frustrated. It’s so hard when you don’t get what you want isn’t it”.

  • “You’re disappointed that we had to leave.”

  • “You’re upset because that didn’t work out the way you wanted it to.”

  • “I know you’re not happy about it, but the answer is no.”

  • “I can see that this is hard for you.”

• Normalise and provide safety:

  • “It’s okay that you feel this way”

  • “You are safe. I love you.”

  •  “I’m here to help you”.

• Accept their emotion. This is my child’s emotion, it’s not about me – I can let it be. 

5.     HAVE FIRM, CONSISTENT LIMITS

• Try and respond the same way each time. By giving in to demands in the face of a tantrum every now and then, but saying no at other times, you’re actually making the behaviour more likely to occur in the future.

6.     STAY CALM

• This is so so hard when you’re activated and emotional yourself – especially when all you want is for someone to feed you 6 meals a day, bathe you, dress you and cuddle you!! – but it is so important. Work out a way of keeping your own emotions in check when you notice you’ve been triggered by your toddler’s tantrum. A few deep breaths, an affirming mantra, leaving the room for 5 minutes until your blood cools, smelling lavender oil or sucking on a lemon are just some of the strategies that might help. By all means rant and rave in your bedroom later and scream into a pillow – but be the duck on the pond with your legs furiously paddling underneath, out of sight.

7.     MODEL HEALTHY COPING

• Toddlers are sponges, and will mimic behaviours they see in the home, seemingly more of the ones you DON’T want them to pick up! The way you respond to them and others will become the framework they use to structure their own behavioural choices. NB: my husband has to remind me of this point ALL the time when I get upset because things haven’t gone my way. 

8.    BE BIGGER, STRONGER, WISER & KIND

• This line is straight out of attachment-informed research that emphasises the importance of providing loving and firm limits for your little one. They need a secure base for exploring and making sense of the world, and a safe haven to come back to. They need a parent, not a friend. You will upset your child. I find it helpful to constantly ask myself “What I am teaching you?”. Because if you are never saying no and attending to their every request in order to prevent a tantrum, you’re teaching them that they will always get their way, and that they can’t cope with difficult emotions. By “being with” them in their emotional storms you’re teaching them that feeling a full range of emotions is normal and healthy, that they can cope with them, and that they are loved and not alone with them. This is all about building resilience which is one of the most important skills to develop.

9.     LOOK AFTER YOURSELF

• Don’t expect to navigate this extremely challenging period perfectly. It is not possible. You are constantly learning, so give yourself the space to work out how you can parent a strong-willed dictator. If you’re not attending to your own needs and looking after your own mental health, it is impossible to look after anyone else. Expect to make mistakes, expect to lose it at times, and make self-compassion a non-negotiable. Some parents find it very helpful to seek their own therapy to understand why certain behaviours within their children press their buttons so intensely. This generally takes you back to your own childhood, allowing you to process how you were parented in order to tweak your ideal parenting approach.

Key Takeaways:

·      Toddler tantrums are a wonderful sign that your little one is developing as they should.

·      When the lightning strikes – keep your child safe while you wait for the storm to pass. 

·      Be with them in their emotion – acknowledge, normalise and accept it. Your job is to keep them safe, seen and heard.

·      Be calm, bigger, stronger, wiser & kind. And work out what you need to do in order to achieve that.

Parenting is so so tough! If you’re finding there is a gap between the parent you’d like to be, and how most of your days are going, firstly you are not alone, and secondly – there is help available! Seeing your GP for a referral to see a psychologist is one way to give yourself some extra support.

What to Say When Someone is Struggling

So everyone is doing it tough right now. I think we’ve read “We’re all in this together” enough times to accept that point. 

Drought, bushfires, Covid-19, home schooling, isolation, an economic recession and rising unemployment has combined into a bubbling, messy, painful, uncertain and unpredictable mixture we’d all like to CTR+ALT+DEL.

And do you know what makes 2020 even tougher? That the regular, run-of-the-mill hard stuff that happens in life hasn’t been paused. You’d think the universe would have enough insight to say “I can see that the humans have enough to deal with this year. Let’s just hold off on the general difficulties until they can wrap their head around these mega life bombs.” Unfortunately, that hasn’t happened. We still have to deal with physical illness, mental illness, relationship conflict, relationship breakdown, loss, failure and the general gaps between our expectations/wants and reality. In fact, all these difficulties have only been heightened amidst the stress and uncertainty of our current context.

Dealing with my baby’s diagnosis of Cystic Fibrosis has been one of those bombshells for me. And I know plenty of other people who have had hardships unrelated to or directly due to coronavirus. I mean, isolation alone is stressful enough in itself, let alone a global pandemic.

Being at the receiving end of so much love and support, I was struck by how much of a difference loved ones can make. I also know that it can be SO hard to know how best to support someone going through a difficult time. You don’t want to say the wrong thing but you want to say something so you can be helpful and make a difference. It is so hard to watch loved ones in pain. You want to take the pain away. You want to wrap them up in love-scented bubble wrap so that nothing can hurt them and they are safe and happy and protected from any difficulty ever. But….. that’s not possible. Unfortunately life brings pain, and it can hurt.

So, if we can’t take away our loved ones’ pain, or protect them from hurt, what can we do? You know who answers this question really well? Guy Sebastian. His latest song – “Standing With You” articulates beautifully how you can best give your support to loved ones struggling. So, to summarise Dr Guy:

·      Be there: Don’t shy away from talking to someone or making contact for fear of saying the wrong thing.  

·      Don’t think you need to be their therapist:

o   You don’t need to change how they’re feeling (you can’t)

o   You don’t need to say the “right” thing to make them feel better (there isn’t such a thing)

·      Instead of asking “Is there anything I can do?” (Although that can be helpful, you’ll generally get a reply like “No thanks, I’m fine”), just DO:

o   Drop off a meal

o   Show up and take their kids out so they can have some alone time

o   Go over and clean their bathroom

o   Drop off (or order) a care package for them filled with things they love

·      Send regular messages without expecting a reply (and tell them you don’t expect a reply). Some of the beautiful messages I received included:

o   You are not alone and you don’t have to go through this alone, never forget that. 

o   You are so loved, so many people care about you.

o   I know it feels like your life is over but you WILL feel differently 

o   I love you no matter what you look like/do/feel like.

o   Or just go with Dr Guy and say “I’m standing with you”

·      Encourage them to get professional help – they can start with their GP or call Lifeline. There are people (like me) who have studied for YEARS to learn how to help people manage their thoughts and feelings. 

·      Do ask them if they are having thoughts of suicide (and if they are – stay with them while you seek professional help).

·      Keep checking in

·      Give yourself permission to be imperfect

·      Look after yourself first to be able to support others well

No you can’t change how someone’s feeling, or make things better with a magic wand. But walking beside someone in their season of difficulty is a pretty special gift that can be the difference between pain and suffering for someone.

When might ‘dementia’ be reversible? When it is depression.

Dementia is a broad term that refers to deficits in cognitive functioning, such as memory, language or attention, to the extent that it significantly interferes with a person's ability to function in their usual activities. We usually think of dementia as being caused by a neurodegenerative disease such as Alzheimer’s Disease, which affects brain neurons and is both progressive and irreversible. However, a number of mental health conditions, most commonly depression, can cause cognitive impairments that mimic what is seen in what we typically think of as dementia. This phenomenon has been termed pseudodementia. Note that pseudodementia is not a diagnosis.

While there is a lot of debate about the appropriateness of the term pseudodementia, it is useful in describing and highlighting the dementia-like cognitive impairments that can be caused by depression and other mental health conditions. This is of particular importance because, unlike neurodegenerative dementias, pseudodementia is often reversible with the right treatment. 

This link between depression and dementia is particularly relevant to older adults, because major depression often manifests in older adults in a way that is more likely to appear dementia-like. This also increases the risk of the depression going unnoticed, and a misdiagnosis of neurodegenerative dementia being made. 

People with pseudodementia due to depression typically experience impairments in memory, executive functioning, and speech and language, and they generally find these declines in cognitive functioning very distressing. Their deficits may be evident as impaired:

·       word finding 

·       speed and fluency of speech 

·       memory in general

·       processing speed 

·       motor response

·       focus and concentration

·       ability to complete tasks 

·       organisation

·       decision making 

In addition, people with pseudodementia may suffer from other symptoms of depression including:

·       withdrawal from activities and social interactions

·       anxiety

·       poor sleep patterns

·       appetite/weight loss or gain

·       feelings of helplessness or hopelessness

·       low energy

Importantly, older adults are more likely to experience depression without significant sadness, and may not realise they are depressed, adding to the difficulty in diagnosis. 

Clearly even a subset of these symptoms is concerning. However, people with cognitive impairments associated with underlying depression can respond to a variety of treatments targeting the depression, such as psychological therapy and antidepressant medications, or a combination of the two. Evidence-based psychological therapy approaches that can be effective in the treatment of depression include cognitive behavioural therapy (CBT), and interpersonal therapy (IPT). CBT focuses on exploring and changing thoughts and behaviours that affect how we feel, while IPT investigates and addresses patterns in relationships with others that may negatively impact mood.

It is important to note, however, that while depression can lead to cognitive difficulties that look a lot like neurodegenerative dementia, dementia due to Alzheimer’s Disease can also involve low mood symptoms (particularly in the early stages). Therefore expert assessment and investigation of the underlying cause of any cognitive impairments is important in order to provide appropriate diagnosis and optimal treatment or management. Your GP is a good place to start if you have concerns, and documenting all the symptoms you have noticed will also be helpful.

Managing Well in Social Situations

For almost all people, social situations bring up an element of anxiety - for some the anxiety is as minor as pre-event jitters, for other it can be as extreme as a panic attacks and avoidance of all social situations entirely.  

Social anxiety is one of the most common forms of anxiety, and it’s something the clinicians at the practice work with people to overcome on a daily basis.

While treatment of social anxiety (however extreme) is best done in a manner that is specific to you and your situation, there are some general tips that can be helpful for all of us:

Notice your (over)thinking

When researches and clinicians have looked at what separates people who experience heightened social anxiety and those who don’t, they found that people with social anxiety tend to engage in intense thinking about the social event (or situation) both before, during, and after it. They called in ‘anticipatory rumination’ and ‘post-event processing’. These thoughts before, during, and after the event are often:

-       more negative – that is, their thoughts are are more critical, comparative, hopeless or worried in nature 

-       more self-focused - that is, their thoughts are more focussed on what they are saying, wearing, doing, or how they are acting or being perceived by others (rather than what those around them are doing)

-       and more ‘threat’ based – that is, their thinking is biased towards assuming things might (or will) go wrong

When we notice our patterns of thinking, we are more equipped to manage them.

 Identify the core worries

Spend some time thinking through what is making you anxious. Perhaps allow all your anxious thoughts to come to you and don’t push them away – just observe them as you would cars down a street, or leaves on a stream. Perhaps you might find writing down your thoughts helpful. Other people might want to discuss with a friend, family member, or therapist what is making them anxious.

For example, you might be anxious about: saying something stupid, or being asked a particular question, or not knowing who to speak to, or not dressing appropriately, or getting lost on the way there, or having a flushed or sweating face (or hands), or not knowing anyone there, or getting sick from the food, or feeling trapped and unsure how to leave, or being judged by someone for something…

By identifying the anxious voice in our brain we are better able to manage and challenge the ‘what if…’s as they arise. Perhaps use some of the skills used in therapy – cognitive challenging or cognitive defusion to minimise the impact these thoughts have on your feelings and behaviour. 

(Helpfully) plan the event

If your social anxiety is more mild, doing a bit of pre-event planning can help alleviate some of the stress.

For some people, arriving early can be less anxiety-inducing. It gives you more time to find the place you’re going to, it means you can deal with traffic or public transport delays with more patience, it means you might have a few minutes to do some mindfulness or breathing before you enter the event.

For others, extra time before the event might be more anxiety inducing. For these people, spare time might encourage that anticipatory rumination mentioned above, and it might be more helpful to arrive slightly later so that you know you won’t have time to over-think before entering. 

Maybe you want to identify some people you know who are attending the event, or do a practice drive of the route before you go, or scope out parking or public transport options. Maybe you want to think of some questions to ask prior to the event, or practise answering some likely questions. Helpfully planning the event can assist in addressing your specific worries.

However, there are ways that we can engage with or plan social situations that can make our anxiety worse (not better) – read below on Avoidance and Safety Behaviours. 

Recognise thought distortions

As mentioned above, people with social anxiety often have thinking that is more negative, self-focused, and threat-based. Identifying the ways in which our thinking might be distorted is a helpful way of correcting our thinking, and perhaps making us feel less anxious.

For example – you might spend hours planning and changing your outfit before an event, becoming increasingly anxious about what to wear and what people might think of you. But spend a moment to see if you can remember what a friend wore to an event 1 month ago – you probably can’t. So, logic follows that others probably can’t remember what you wore either. Similarly with worrying about saying something embarrassing – can you recall a situation from the last social event you were at where you judged someone for what they said, and can you remember exactly what they were saying? Most people can’t. 

Avoid avoidance

Avoidance is often short-term gain for long-term pain. Avoiding an anxiety-inducing event or situation always makes us feel immediately better in the moment. However, when researchers and clinicians looked at what makes social anxiety worse, they found that continual avoidance of social situations often just perpetuated the anxiety for individuals, not solved it.

With the help of a support person (professional or personal), set some realistic goals about how, what, and when to attend certain social events. Slowly build up from what you feel most comfortable (or least uncomfortable with) and set a slightly new challenge each time (perhaps an event with more people, or remaining longer at the event).

Remember to check your thinking after the event, and to not engage in post-event negative processing! See the section of Self-Compassion below.

Correctly label (or re-frame) the feeling

How we label the sensations in our body impacts how comfortable we are with them. For most people, anxiety is uncomfortable, whilst excitement is manageable. However, anxiety and excitement share many similar bodily sensations – shaking, tingling, sweating, flushed face, elevated heart rate, increased breathing, and feeling ‘jittery’.  Many people experience those physiological symptoms before an event, however if we’re able to label those feelings as the emotion ‘excitement’ rather than ‘anxiety’ or ‘fear’ we are better able to manage and ‘ride the wave’ of the feelings. 

Identify your safety behaviours

Another core element of social anxiety is safety behaviours. Safety behaviours are things we might do or not do to make ourselves feel safe or to take away some of our anxiety, however, in the long term, they often make us feel worse. A safety behaviour might be (but also might not be) – needing to always attend an event with a person, always needing to have drink in your hand, wearing many layers of clothing to hide sweat, drinking a lot prior to an event, standing near an exit at all times… Doing one or all of these things can have the short term benefit of reducing anxiety (e.g. you don’t have to turn up alone if you always arrive with a friend, the alcohol takes the edge off your shaking if you drink before, you don’t feel as trapped if you stand near the exit, your hide your sweat by wearing a jumper, etc.). However, over time, safety behaviours can make our anxiety worse – such as when you don’t have a friend to arrive with or they cancel last minute, or maybe you need to start drinking more alcohol to manage the anxiety or you avoid events where you can’t drink, or wearing lots of clothes makes you sweat more. 

Identify possible safety behaviours and work towards removing or reducing them (or at the very least, monitor to make sure they’re not having an adverse effect). As you remove or reduce the safety behaviours, expect that the anxious voice in your brain will make the anxiety peak – but remember that it will subside! Challenge thoughts that you might have about what will happen if you remove or reduce the safety behaviour. 

Have some self-compassion

Lastly, it’s helpful to focus a sense of compassion and gratitude towards yourself, particularly if you’re working at challenging your thoughts or avoidance. As mentioned above, those of us with social anxiety are often very self-critical. Managing and challenging our social anxiety is an effortful process! Switching your internal voice towards one that recognises your own efforts, praises your attempts, forgives yourself for setbacks, and allows failures and imperfection. Set aside 5 minutes after each event or attempt and spend some time thinking through ways you surprised yourself, or were proud of yourself. 

Effective Goal-Setting

Setting goals in life is one of those things that seems so easy on the surface yet is actually really hard to do. Especially if you don’t have the right knowledge or mindset on how to do it effectively. Many people find themselves caught in a trap of setting endless goals, working towards them for a few days or weeks, then beating themselves up for “failing” to achieve what they set out to do. Others feel like they’re doing all they can but the results never seem to eventuate. For others, it can be so overwhelming to even know where to start they keep on promising themselves they’ll get started tomorrow, or next week, or when life gets a bit easier. Yet that day never seems to come! Other people have an idea of where they want to go in life, but not enough clarity or confidence to truly set things in motion! 

All of these challenges are really common, and at the same time can be really frustrating.  Often, as humans we get stuck in a pattern of beating ourselves up for feeling like we “should be” achieving certain things, yet feel incapable or unmotivated to do so, which leads to a sense of hopelessness or decreased confidence and motivation.

If you feel stuck, it can be really helpful to take some time to reflect and ask yourself what is truly standing in the way. Yes, things like lack of clarity, motivation, energy, time, confidence etc, can all play a part. But sometimes it runs deeper than that.

Often the answer is fear.

Setting goals often comes hand in hand with change. And change is uncomfortable and scary; even if it’s something we really want! We can experience fear of the discomfort that comes with challenging ourselves. Or fear of how things might be different and whether we will actually like it. Or fear of making a “wrong decision”. Or fear of failure and not being able to handle the pain of not succeeding or of being rejected. Or even fear of success, and the increased responsibility, expectations, or lifestyle that may come with that. 

Fear often leaves us to stay exactly where we are. In our comfort zone; even if it’s miserable and not actually very comfortable at all! Or it can lead us to self-sabotage once we start working towards goals, making progress, and noticing things are starting to change. 

If you’ve ever experienced any of these things you are not alone. And you are not a failure. With all these complicating factors it is pretty amazing when any of us successfully set and achieve goals! The good news is, that with some self-reflection and guidance the process can become a whole lot easier!

Practical tips for setting effective goals:

1. Clarify your own values. Separate out what you think you “should be” achieving, and work on finding out what truly matters to you! Who do you want to be? What do you want to stand for? How do you want to live your life? Having a greater understanding of this will drive you to strive for things that clearly add value and move you towards the life you want! This will naturally increase your motivation and commitment!

2. Make sure the goal is actually within your control. There’s nothing more frustrating or demotivating than working towards goals that keep getting derailed or blocked by factors outside your control. For example, “My goal is to get a new job”. “My goal is to lose 10kg” “My goal is to be in a committed relationship”. The problem with these goals is that there are so many other things that could influence the chance of you succeeding  - perhaps it will take a while to find a job that’s suitable, or perhaps you will attend lots of interviews but will miss out to other candidates. Perhaps you will diet and exercise yet the scales won’t budge, or perhaps you will date a bunch of people but not find the connection you are hoping for. 

3. One way to ensure goals are within your control is to set behavioural goals rather than outcome-based goals. Focus on your own behaviours and how you want to act, rather than focusing on specific outcomes. For example, instead of saying “I want to be less depressed” you could try something like “I want to commit to doing one pleasant activity each day ” or “I want to go for a mindful walk during my lunch break”. Hopefully these things will have a positive impact on your mood, but that outcome is a bonus, not the measure of whether or not you’ve succeeded! Increasing healthy behaviours often brings about the change we are looking for without the pressure or expectations that we “should” feel a certain way!

4.  A concept in Acceptance and Commitment Therapy (ACT) is to avoid “dead person goals”! It’s often not that helpful for us to set goals that a dead person could do better than a living one. For example, “Argue less with my spouse about housework”, or “Eat less chocolate” or “Be less anxious”. A dead person never argues, eats chocolate, or feels anxiety! To be alive and full of vitality we often need to strive for things we DO want to do! When we set goals about things we don’t want to do or things we want to get rid of, we often struggle to achieve them because our brains are not very motivated by NOT doing things or by cutting things out of our life. Or we lack clarity around how to NOT do them! We might also be trying to get rid of things that are actually impossible to eliminate, like the feeling of anxiety, which is a normal human emotion! If you notice yourself doing this, try switching it around to think of what you would be doing instead. E.g. “ I want to make time to calmly discuss with my spouse how we can collaboratively divide chores in a way that’s fair” or “ I want to pre-prepare healthy snacks for each day this week” or “I want to learn strategies to help me cope when anxiety shows up”.

5. Turn your goals into SMART goals! Make sure they are: 

Specific (break things down, have sufficient clarity, and enough detail)

Measurable (make sure it can be evaluated and quantified)

Achievable (make sure it’s challenging but possible and within your capabilities/skill)

Realistic/Relevant (make sure it’s in-line with your resources and meaningful to you)

Time-Bound (set a specific deadline to check in and evaluate).

For example, instead of “ I want to get healthier” you might try “I want to walk for 30 minutes 3 x a week for the next 2 weeks”. Instead of “ I want to be less anxious” you might try “ I want to practice controlled breathing for 5 minutes as soon as I wake up for the next 3 days”. Instead of  “I want to get more sleep” you might try “ I want to be in bed with lights off by 10pm every night for a week”. 

Once that deadline arrives, it’s a great opportunity to evaluate how you went! If you achieved your goal, fantastic! Reflect on the accomplishment, give yourself some praise, and use it as an opportunity to decide how you want to continue moving forward. Perhaps setting a new deadline to stick with the behaviour, or even adding another behaviour or ramping it up if that seems achievable and relevant! If for any reason you didn’t meet the goal, reflect on what got in the way, and use it as a chance to problem solve before trying again! FAIL can be thoughts of as meaning “First Attempt in Learning”!

6. Working within the framework of SMART goals it is often helpful to start small. Every big goal we achieve is a result of lots of small actions. Allow yourself the best chance of succeeding by breaking things down! This can boost motivation and a sense of accomplishment, increase your confidence and self-esteem, and inspire you to believe in your capacity to change and achieve what you set out to do. This can then be used to help you gain momentum. So instead of setting a goal for months from now or 5-years-time, start with  a goal for the next 24 hours, or 7 days and make sure it is something you feel confident you can stick to! Then keep on going! And if you get stuck, come back to asking yourself “What are my values here?” “What am I afraid of?” “What unhelpful thoughts are holding me back?” “ What uncomfortable emotions or experiences am I trying to avoid?” “What barriers are getting in my way?”. Let go of judgments, re-evaluate your expectations, remind yourself of why it’s important, and then set a SMART goal you know you can achieve for the next 24 hours to get yourself back on track!

Coping Skills for Children: Physical and Sensory Strategies

In previous blogs I have explored some relaxation and distraction skills, which children can use in many situations when they feel anxious or afraid. There are, of course, many other strategies that children can also learn and use. These include using movement and sensory experiences to cope. Many of these skills overlap, and may fall into more than one ‘category’, but what is important to note is the wide variety of strategies that children can choose from. This makes it likely that with some exploration a child is likely to find a number of strategies that resonate with them, and that they can use in a variety of contexts (e.g. at home or school; when alone, or when with parents or friends).

Physical strategies can be very helpful for children to calm down and get rid of excess energy. This can be particularly relevant when they are feeling worried, anxious or angry, because the fight, flight or freeze mode creates adrenaline, or they may feel like lashing out at those around them. Moving is also helpful for focusing and attention, so it is helpful to always include physical activities throughout the day. Regular organised activities and sport can also be great, particularly if they’re with other people.

There are many simple physical or sensory options that children can be encouraged to use when they might need to calm down, get rid of some energy or cope with anger. Consider creating a list of appropriate activities with the child (draw them for younger children), that can serve as a ‘menu’ of options for when they feel like physical strategies would be helpful.

Here are a few suggestions:

·       Squeeze a stress ball, play dough, or putty

o   A good way to do this is to repeatedly squeeze it, hold it for a few seconds, and let go. Make sure to use each hand.

·       Fidget with a fidget toy, or another object that feels nice to hold and fiddle with. For example, a beaded bracelet, Rubik’s Cube, pipe cleaner, makeup sponge, pebble or shell, key chain, unfilled balloon, rubber band, or dice.

·       Bounce a ball

·       Pop bubble wrap - try different kinds!

·       Shred paper, such as scrap paper or newspaper

·       Punch or hit something safe and appropriate if feeling angry and like lashing out. For example a pillow or soft sofa.

·       Move parts of the body, such as wiggling toes and/or fingers, shrugging shoulders, pushing hands together

·       Dance or move to music or do gymnastics

·       Do simple exercises, such as jumping jacks, running around a circuit (e.g. in the house or garden), jog on the spot, use a skipping rope, or do stretches or yoga poses.

o   Try having a set number of repetitions or time to do the exercise for

·       Go for a walk or run

o   Even a short walk can create a break and be calming and focusing

o   Maybe ensure it is with an adult if the child is young

·       Bounce on a trampoline

·       Ride a bike, scoot or skate

·       Go to a playground

·       Swing

·       Swim

·       Use sensory options, such as:

o   Have a shower or bath (with bubbles)

o   Drink through a straw

o   Wrap up in a blanket

o   Curl up in a beanbag or comfortable chair

o   Have a hug

o   Suck on some ice

o   Use some scented cream or oil

o   Watch a lava lamp

o   Pat a pet

o   Brush hair

o   Have a warm drink

Remember to encourage children to try a few physical and sensory coping strategies at least once when they are feeling worried, anxious or angry, before deciding if they are helpful or not.  

Finally, don’t forget that many of the techniques and strategies that help children cope may also be helpful to adults in similar situations – be sure to give them a try yourself if you don’t use them already.

Some Thoughts on Feelings

As a psychologist with training in CBT (Cognitive Behaviour Therapy), a lot of time in session can be spend on Thoughts: what we’re thinking about ourselves, others, the world. However, it’s always worth spending some time on Feelings: what we notice in our body, and how we choose to label it.

I sometimes tell clients that it’s not feelings that are (necessarily) the problem, it’s our relationship with the feelings. 

What do I mean by that?

There are different types of feelings; ‘primary emotions’ and ‘secondary emotions’. Secondary emotions are the feelings that arise after an initial emotional reaction. For example – sometimes I’ve heard people describe feeling sadness or grief after a loss, and then feeling angry at themselves for feeling that sadness or grief.

Often what keeps us ‘stuck’ is the response we have to our feelings that we naturally might experience. We often respond with either suppression, or anger, or avoidance. 

Having a healthy relationship with feelings and emotions that come up is another way of functionally managing our mental health and wellbeing

Here’s some tips on how to have a healthy relationship with feelings:

Watch how we label feelings

I often hear people talk about ‘good’ feelings and ‘bad’ feelings. Usually, when we refer to ‘good’ feelings we mean things like happiness, gratitude, peace, and love. And often when we refer to ‘bad’ feelings we are talking about emotions like anger, pain, sadness, grief, regret, and shame. 

It can be quite easy to classify some feelings as either ‘good’ or ‘bad’, but some others are less clear – what do we do with anticipation, or nostalgia, or longing, or solitude?

The problem with rigidly labelling our feelings as ‘good’ or ‘bad’ is that we can begin to avoid the emotions that we call ‘bad’. And when we try to avoid certain feelings that make us feel ‘bad’, then our life might start to look a bit smaller. 

Avoidance is often a functional coping mechanism. Think about someone who just got food poisoning - it’s in their best interests in the future to avoid that the type of food they ate or the restaurant that served the food that made them sick. However, when it comes to feelings, it is a guarantee that we will feel emotions that we call ‘bad’ as we live life. It’s a ‘when not if’ situation. So avoidance of ‘bad’ feelings is very hard. It is very difficult to live a life as a human on planet Earth without experiencing loss, sadness, frustration, pain, regret, and embarrassment at some point. 

Avoidance of ‘bad’ feelings will probably feel good at first! But often these feelings catch up with us. Think about when you procrastinate for an exam for a subject that you find very stressful and challenging – by deciding that you can put off studying until tomorrow afternoon, you suddenly feel a surge of relief. But then tomorrow comes around and you might put off studying again – before you know it, the exam is today and you’ve either done nothing or crammed as much as you can in the past 24 hours, and you’re feeling stressed, overwhelmed, guilty, or angry. 

Maybe you start avoiding events with really large crowds (such as sports matches or festivals) because they make you anxious, and at first your life isn’t too impacted. However, perhaps then smaller crowds begin to seem pretty anxiety inducing, so you begin to avoid shopping centres and cinemas, then restaurants and cafes. Before you know it, you might be ordering your shopping online or declining every invitation from friends to socialise. 

Being able to tolerate and ‘sit with’ negative feelings can keep us living functional, fulfilling, and values-driven lives. 

We actually need the whole spectrum of our feelings, not just the ‘good’ ones. 

Feel feelings

Acceptance of feelings can only come if we recognise what we are feeling. Often we’re aware that we’re feeling something, but we’re not sure exactly what it is.

I sometimes work with people who find it very difficult to know what they are feeling. It’s can be surprisingly hard to do, and takes practice to get better at! Some ways to address this:

-        Use a ‘feelings chart’ or ‘feelings wheel’: There are lots that are available online after a quick google. Sometimes we don’t know what we’re feeling because our language around feelings is limited. This is particularly relevant for children! By looking at a list of feelings, sometimes we find it easier to describe what we’re feeling. Especially for children and adolescents, it can ease some of the frustration of trying to communicate what they are experiencing.

-        Think about what you know you don’t feel: When we feel really stuck with describing what we’re feeling, it can be helpful to name what we’re not feeling. For example, after a death of a friend or family member, we might know we’re not feeling the emotions of excitement and hope and playfulness. 

-        Sit for a bit: Sometimes we try to ‘rush’ feelings. Being able to identify a complex feeling immediately is not always possible, particularly when we are living very busy and hectic lives. It’s important to allow ourselves to take time to ‘check in’ with what we’re feeling in an unhurried way. This is where mindfulness or meditation can play a role. Or even just going somewhere without your phone, or giving yourself some time before bed with no work or Netflix!

-        Think about locations or sensations: if you’re not sure what emotional label to put on your feeling, use a physiological description, such as “shaky”, “cold”, “heavy”, “tingly”. If you can, locate where in your body you are feeling it such as “in my head/hands/feet/chest/stomach etc.”

Think about what they’re telling you

Think for a minute about physical pain. Physical pain is a very unpleasant experience – the more intense the pain, the more unpleasant it is. However, we need the experience of pain to learn what is safe and unsafe, to be able to take care of our body, to teach others, and stay well.

There are documented cases of people who can’t feel physical pain, and rather than life being blissful, it is actually surprisingly difficult. Think about a young child who can’t feel pain – they might  touch the oven when it’s on and won’t flinch away from the heat and so will probably burn their skin. They will trip over and break their hand but won’t realise immediately how serious the fall was, until they notice swelling or bruising. They might be dehydrated but not know it because they won’t notice a headache in the same way that we would. 

It can be similar with emotional pain. Despite how uncomfortable it is, emotional pain can teach us when a situation or event didn’t sit well with us. It can help us decide which relationships are worth pursuing or not. It can teach us to act differently in certain situations. It can remind us what things to avoid (within reason!).  

I often encourage clients to think about the ‘job’ of emotions. And to think about what their emotions are ‘telling them’. 

Love tells us when we care for someone. Excitement tells us when we are looking forward to something. Guilt tells us when we might want to make a shift in our behaviour. Shame tells us when we might need to apologise. Anger tells us when we might need to protect ourselves or someone we care for. Pain tells us that something mattered to us. Fear tells us when to be careful and cautious. 

Every emotion has a purpose, and when we tune in to our feelings and consider what they might be alerting us to, we might find that we have a better relationship with our feelings, and live more fulfilling and rich lives. Notice I say a ‘fulfilling’ life, not necessarily a ‘good’ or ‘happy’ life.

Lastly, it goes without saying that if you’re feeling consistently ‘bad’ or noticing an increase in emotions that are heavy, or get in the way of life – then definitely seek help! Whilst it’s helpful to tolerate ‘bad’ emotions, we also want to live in a way that promotes ‘good’ emotions also!

Adolescent Self-Harm - A Parent's Guide

Few things strike terror into the hearts of parents like discovering their child or adolescent is self-harming. I have sat with multiple parents who report they cannot understand why their child would do that to themselves. Does it mean they want to die? Does it mean they hate themselves? Does it mean they have a serious mental illness?

Sometimes yes, but often no. 

Self-harm is reasonably common in Australian teenagers with as many as 17% of females and 12% of males between the ages of 15-19 reporting they have self-harmed at some point. Some may become aware of it, try it once and never again; whilst others will try it once and discover it serves a function for them and then repeatedly engage in it. Some teenagers regularly self-harm whereas others report only doing it occasionally. 

Self-harm is sometimes referred to as Deliberate Self Harm (DSH), Parasuicidal behaviours,  or Non-Suicidal Self-Injury (NSSI) depending on its nature. It is a non-specific psychiatric symptom that is sometimes associated with those experiencing depression, anxiety, eating disorders, developmental disorders, and borderline personality disorder; however, it can be engaged in by those with any mental illness, or by those without.  This means that by itself, it is not an indicator of any one particular disorder. Mental health issues are certainly a risk factor for self-harm behaviours, and whilst statistics vary depending on whether individuals require medical treatment or emergency care, it is thought that as many as 50% of young people who self-harm would likely not actually meet full diagnostic criteria for a mental illness.

For many, self-harm is also not a sign that they are suicidal. In fact, it is often described as the opposite by many who engage in it: a way to actually help them live with the difficulties they are experiencing. If an individual is experiencing suicidal thoughts or plan it is crucial that they get appropriate help. Even in the absence of suicidal intent though, self-harm must still be taken seriously. It can have short and long-term medical consequences and is certainly an indication that there is something the individual is struggling with. The most common forms of self-harm include deliberately cutting, overdosing on medications, or burning oneself. Other methods including hitting or punching, hair-pulling, scratching or interfering with wound healing.

Why do teenagers self-harm?

Adolescents, and in fact many adults, self-harm for a variety of reasons. Research suggests that for many, self-harm serves as an emotion-regulation strategy. Meaning that it is a way of coping with difficult or overwhelming emotions that they are struggling to know how to manage. Similarly, others report doing it to distract from or suppress painful thoughts, memories or images. Sometimes people report doing it to feel “something” when they otherwise feel numb, whereas for others they report doing it to feel “less” or to feel something “different”. Some people say the physical pain relieves the emotional pain, whereas others say it gives them a sense of control over the pain they are in. Some teenagers try it because their friends do and they are curious or want to fit in, and for others it may serve a function of self-punishment if they are experiencing intense shame or disgust towards themselves. For others it serves as a way of communicating their pain to others. At least half of young people who self-harm do not seek help though, meaning it is often done as a private way of self-soothing or regulating distress rather than as a way of eliciting a response from others. Whatever the function for the individual, it is usually in response to painful feelings or experiences of some description, and those who self-harm require compassion and empathy, not judgment.

Adolescence is a challenging time, with many developmental, hormonal, and psychosocial stages impacting a young person’s mental health and emotion-regulation capabilities. Common experiences which can trigger a young person’s distress include bullying, academic concerns or pressure, family or parental conflict, social concerns, relationship difficulties, low self-esteem, perfectionism, sexuality, gender identity concerns, body image concerns, and trauma.

What do I do if my teenager is self-harming?

·      Firstly, take a deep breath and calm yourself before reacting. It is totally understandable you may be feeling shocked, scared, angry, sad or confused… and at the same time there’s a much greater chance you’ll be able to manage the situation effectively by being contagious with your own calm. If your teenager is already in emotional pain, adding your own intense emotions on top of whatever they are already feeling is unlikely to be helpful.

·      This doesn’t mean you can’t share your concern; but try to do it with empathy and a non-judgmental approach to convey to them that you care about them and want to find a way to help. Many teenagers are very worried about their parents finding out about their self-harm for fear of judgment, criticism, invalidation, punishment, or shame. 

·      Approach it with compassionate curiosity and empathy rather than judgment. To you it may seem irrational to be hurting yourself when you’re already suffering, but to a lot of young people they perceive the self-harm to be helpful rather then harmful. Or at least that it provides immediate short-term benefits which outweigh any consequences or risk. Try to understand what function it serves for them rather than making assumptions.

·      Remember, for most of us, whatever occurs in life we are doing the best we can at any given point in time. This doesn’t mean we can’t learn to do better or get help to do better if we’re struggling, but it does mean that if your teenager is self-harming, it is likely that it is the most effective way they currently have to help themselves cope.

·      Many teenagers want to stop or reduce self-harming. What often holds them back is not knowing how to do this without giving up their most valuable coping-strategy. To take away their way of managing their distress without replacing it with something else can often increase their distress significantly. Once you understand the function, it’s possible you can help them try some alternative ways to meet the need they have.

·      On the other hand, your teenager may not be ready or motivated to stop self-harming immediately. Or they may try to stop and yet be unable to cease it straight away. Try not to panic, blame, or shame them if this occurs. If it has been happening for a while it may take time to change these behaviours.

·      Get support for yourself. Whether it’s a partner, friend, family member, or even professional help, this can be an extremely stressful situation to try to navigate. Ensuring you have people to support you whilst you try to support them can be invaluable.

·      Get professional help for your teenager if you are concerned. For some teenagers, their parents knowing about either the self-harm itself, or the underlying pain they are in, can bring about a sense of relief they are no longer alone or needing to hide it. For others, their parents knowing fills them with dread, shame, or guilt which exacerbates their struggles. Your teenager may open up to you once they know you know, or alternatively they may clam up and refuse to talk about it. If you believe your teenager is experiencing mental health concerns or trouble coping in some way, it may be beneficial to get them professional assistance to help them work through their issues or learn healthier coping tools.

·      Finally, try not to allow your mind to spiral you into panic. Self-harm is generally very treatable. Whilst it seems scary and naturally elicits a lot of concern, we deal with people on a daily basis that engage in self-harm. We have a number of evidence-based treatments we can discuss with you and your teenager that can help.