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Depression

Posted on September 6, 2013 in Mental Health Topics - 0

Living with depression

An interview with Clinical Psychologist Dr Dawn Proctor

Illness

Chronic Illness a big cause of depression People with chronic illnesses can be two to three times more likely to suffer from depression than the general population, says psychologist Briohny Cotter.

CBT

Fighting depression with Cognitive Behavioural Therapy Feeling sad or depressed is a normal part of life. But life pressures can often cause otherwise normal depressed feelings to interfere with people’s personal and working life.

Case Study

Postpartum Depression

While childbirth is a natural phenomenon and is joyful for many, it is also often a stressful event that is associated with a substantial risk for psychological distress. Unfortunately, a mother’s need for assistance is often not met and some endure psychological problems following childbirth for many years. This was the case with Claire.

ACT

ACCEPTANCE AND COMMITMENT THERAPY- ACT TO IMPROVE WELLBEING

WHAT IS ACT?

Acceptance and Commitment Therapy is now recognised as a powerful evidence based therapy for a range of conditions from depression, anxiety and stress to post-traumatic stress disorder, drug and alcohol abuse and even schizophrenia.

The aim of ACT is to help people create rich and meaningful lifes while effectively handling the pain and stress that life inevitably brings.

HOW DO PSYCHOLOGISTS HELP?

By teaching clients mindfulness skills to deal with painful thoughts and feelings so that they have much less impact and influence.

Helping clients clarify what is truly important and meaningful, so that they can use these values to guide, inspire and motivate them to change life dor the better.

HOW MUCH DOES IT COST?

ACT Group sessions cost a total of $360 for the six week course. Each payment is required of $60. If your GP has provided you with a referral for a group session a Medicare rebate of $41.70 per week is available, making the gap only $18.30 per week, or $109.80 for the six week course.

Note the group therapy referral is separate to the individual Mental Healthcare Plan your GPmay have provided you with for individual sessions.

MAKE YOUR BOOKING NOW

The ACT Group takes a maximum of 10 people. To book your place now please call our friendly reception team on (07) 3356 8255.

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Child Behaviour

Posted on September 6, 2013 in Mental Health Topics - 0

WE SAY NO TO BULLYING

WE SAY NO TO BULLYING ON NATIONAL DAY AGAINST BULLYING

In her 17 year professional career Clinical Psychologist Miranda Mullins has seen many cases of bullying and the serious effects that it can have on children. However, in more recent years, Miranda has seen a more powerful form of online bullying.

“Bullying can trigger anxiety, feelings of loneliness and even anger. It can impact on a child’s self-confidence, concentration at school and enjoyment of day to day activities.

Sometimes it triggers feelings of shame and distress that prevent disclosure to those who can help. Sometimes the impact on a child’s beliefs about themselves and their relationships with others can have long-term effects” she says.

In recent years the accessiblity of the internet and social networking has increased the opportunity for bullying, extending its reach beyond the school yard into the home.

“New technologies are rapidly changing out social interactions and can result in home no longer being a safe place for those being bullied” she says.

Online social networks, like Facebook and Twitter and the accessibility of mobile phones can be a key source of emotional distress for a child or teenager who feels excluded or victimised.

New research from Kids Helpline (2013) suggests that due to the more covert nature of cyber bullying and the ablity to reach a wider audience, it may indude a more severe reaction in children and adolesecents and traditional bullying.

For example, cyber bullying can involve the public humiliation or embarrassment of a child across a wider audience, plus the bullying behaviour can be more invasive as the bullying can infiltrate the victims’ home and privact through the use of the internet and mobile phone.

According to a survey by Kids Helpline (2013) most cyber bullying occurs in late primary school, focusing on physical appearance and is experienced slightly more often by girls.Source: Kids help line online March 2013.

Miranda explains that there are some complex aspects to online interaction that can lead to specific challenges but there are many effective tools to deal with it, which will depend on the specific situation.

Miranda shares some professional advice with parents and teachers dealing with bullying and cyber bullying:

  • Encourage open communication about school and social experiences and be aware of changes in your child’s behaviour or emotions.
  • Supervise internet and phone use where possible, this will be more difficult with older children and teenagers so developing boundaries and rules surrounding this technology might help
  • Be aware of any reluctance to go to school, reports of stomach aches or other physical symptoms and an increase in irritability can all be signs of bullying (but can indicate other worries and sources of stress also).
  • In some instances damaged or missing possessions and scrapes and bruises can be indicators.
  • Responding calmly will help the child to feel supported and safe. Explain what bullying is and that verbal attack via email, social media or phone is not acceptable.
  • Make it clear that any type of bullying is unacceptable, is not their fault, and that you are available to help.
  • Help them think of different coping strategies and consider what might work best.
  • Encourage and support reporting the bullying.
  • The awareness of bullying when it is occurring and the message that it is unacceptable are the best antidotes, so education in the classroom and development of an anti-bullying community is essential

To discuss strategies for dealing with bullying, contact Miranda Mullings at Psychology Consultants Morningside.

(p) 3395 8633 (e) Miranda@psychologyconsultants.com.au

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Anxiety

Posted on September 6, 2013 in Mental Health Topics - 0

Worry

Why do we spend so much time worrying?

By Clinicial Psychologist Elizabeth Galt

Worry is something that almost everyone will do from time to time. However, sometimes people find that their worry has become a large and interfering part of their daily life. They may not like it but might believe that it is a part of who they are – to be a worrier. Or they may think that it is necessary to worry as much as they do. Sometimes it is hard for people to acknowledge how much they are worrying because the thoughts seem to be justified if about their real life problems. Often their worrying is pointed out to them by other people.

Frequent and interfering worry is associated with anxiety but not all people who worry a lot are aware of feeling anxiety in their body. Some people may have habituated to a higher level of daily anxiety, accepting it as their normal.

Worry is different from constructive problem solving. Problem solving is “here and now” action. Worry typically becomes repetitive and looping patterns of thought that don’t resolve to any practical action or outcome. For example, problem solving a bill that might be difficult to pay could look like calling the company and making a payment arrangement. In the same scenario a worry pattern would look like repeated thoughts of “what if I can’t pay it?”, “what will happen if I can’t pay it?” and similar.

Not all situations that provoke worry will be able to be problem solved. Some situations may be completely out of our control or may require time or other events to unfold. Often people get into the worry habit because it paid off for them a few times. Maybe they were prepared for a situation or felt partly protected from disappointment when something went wrong. It might seem counterintuitive  but often people will have some positive ideas or beliefs about the value or benefits of worry. Unfortunately worry tends to get worse over time and then people find themselves worrying more and more about minor things. Then they can become worried about how much they are worrying, or feel stressed about how easily they are getting stressed.

The good news is that worry doesn’t have to keep its hold and reduce a person’s quality of life. A psychologist can assist with helping an individual to understand their worry pattern and why it has been persisting in their life. The psychologist can then provide strategies and activities that reduce the worry pattern.

There are also self-help approaches that target worry. Resources for these can be accessed at many reputable mental health websites. The Black Dog Institute has some tip sheets available (see http://www.blackdoginstitute.org.au) and the Centre for Clinical Interventions has full modules and workbooks available in their Resources section (see http://www.cci.health.wa.gov.au)

PTSD

Posttraumatic Stress Disorder (PTSD) helped by cultivating compassion.

By Dr Stan Steindl

Joe (not his real name) sits with me in my office, wringing his hands as his legs twitch. His experiences as a soldier in Afganistan have been the topic of our conversation. Despite a growing amount of time since his return to Australia following this deployment, he continues to be troubled by thoughts, memories and flashbacks of road side explosions, hunkering down among the rocks and dirt of the desert, and injured children caught in the cross fire. Right now, he’s feeling pretty angry.

Posttraumatic stress disorder (PTSD) is a common disorder that develops following trauma, especially trauma in which the person feels fear, helplessness and horror. It has far reaching implications for the individual, and also for the community. Apart from the many symptoms of re-experiencing the symptoms through flashbacks, symptoms of avoidance and emotional numbing, and symptoms of hyperarousal, fear and anger, a central problem of PTSD is the severe self-criticism, self-loathing, guilt and shame that is often associated.

While psychological therapies such as cognitive-behavioural therapy have been found to be effective in the treatment of PTSD, there is a growing interest in helping veterans further through programs aimed at cultivating compassion, and also self-compassion.

I invite Joe to close his eyes. “Think of someone in your life you care about. Develop a picture of that person in your mind. Feel the presence of that person in your life, in this room.” Joe sighs, shifts his body in the chair, and then settles. “Now consider and say to yourself, that person is just like me. And just like me, this person’s had ups and downs in his or her life. Just like me, this person’s had goals and dreams.”

We go on to explore other people in Joe’s life, people he knows, people he doesn’t know, people in other places in the world, and eventually all sentient beings. And eventually, we come to a place of compassion also for himself.

Compassion is very difficult for Joe. In combat, and throughout his training, he learned to think of everyone as a potential threat. Fear and distrust were essential for survival and you can’t allow yourself to see the enemy as a human being “just like me”. But with PTSD, things stay that way, even after combat is over. The veteran with PTSD finds it so difficult to relate to people as just people, let alone to relate to themselves with acceptance and forgiveness.

Compassion meditation, such as the one Joe and I practiced, is about getting that ability back, learning to see oneself in others, and learning to accept and forgive oneself as well. And results are encouraging. Compassion and self-compassion can be learned and practiced through meditation techniques (Jazaieri et al., 2012) and such approaches can help to reduce anxiety and stress (Berger et al., 2012).

About 15 minutes later the meditation comes to an end. Joe opens his eyes, rubs them a little and stretches his arms and shoulders. He gives me a wry smile. “Never thought I’d be a hippy,” he says, “But I know what you’re saying. I feel more relaxed. It’s good to just let go of the anger.”

References

Berger, R., Gelkopf, M., & Heineberg, Y. (2012). A teacher-delivered intervention for adolescents exposed to ongoing and intense traumatic war-related stress: A quasi-randomized controlled study. Journal of Adolescent Health, 51, 453–461

Jazaieri, H., Jinpa, G., McGonigal, K., Rosenberg, E., Finkelstein, J., Simon-Thomas, E., Cullen, M., Doty, J., Gross, J., & Goldin, P. (2012). Enhancing compassion: A randomized controlled trial of a Compassion Cultivation Training program. Journal of Happiness Studies. doi: 10.1007/s10902-012-9373-z

Acceptance and Commitment Therapy

ACT GROUP THERAPY

Acceptance and Commitment Therapy (ACT, pronounced as the word ‘act’) is now recognised as a powerful evidence-based therapy for a range of conditions – from depression, anxiety, and stress, to post-traumatic stress disorder, drug and alcohol abuse, and even schizophrenia.

Case Study

Obsessive Complusive Disorder

By Dr Stan Steindl, BA PGDipPsych MClinPsych PhD(Clin) MAPS

Matt, a 25-year-old store man who lives with his parents, was having difficulties with excessive washing. This compulsive washing he explained was conducted to cleanse himself from the contamination of the past. He was obsessed about the past and had developed elaborate, compulsive washing rituals to manage his feelings of anxiety about the contamination.

Panic Disorder

By Kathryn Smith, BA GradDipPsychEd MPsych(Clin) MAPS

Psychologists treat the emotional side of panic attacks

Perhaps the most prevalent psychological conditions fall under the umbrella of anxiety. Panic Disorder is one of the most common presentations with many individuals diagnosed with the disorder also meeting criteria for Agoraphobia. A diagnosis of Agoraphobia is given if (a) the patient reports anxiety about places or situations where escape may be difficult or embarrassing or in which help may not be immediately available, and (b) these situations are avoided or endured with marked distress.

Patients who present with panic attacks may appear as composed, competent individuals with full and fulfilling lives, however, beneath the surface they are enduring extreme discomfort and are often struggling to keep going. A patient may be experiencing a panic attack if they report discrete periods of intense fear in which 4 or more of the following anxiety symptoms develop abruptly and reach a peak within 10 minutes:

  • Palpitations, pounding heart
  • Sweating
  • Trembling or shaking
  • Shortness of breath or smothering
  • Feeling of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, lightheaded or faint
  • Feelings of unreality or being detachment
  • Fear of losing control or going crazy
  • Fear of dying
  • Numbness or tingling sensations
  • Chills or hot flushes
  • Panic Disorder is diagnosed if panic attacks are:

Recurrent and unexpected
Have been followed by 1 month of either persistent concern about additional attacks, worry about the implications of the attack, or a significant change in behaviour related to the attacks
Not due to the direct physiological effects of a substance or general medical condition
Treatment of Panic Disorder may require a combination of pharmacological and psychological treatment. Pharmacological treatment has come to include selective serotonin reuptake inhibitors, tricyclic antidepressants, high-potency benzodiazapines, as well as certain anticonvulsants.

Psychological treatment focuses on the emotional side of panic targeting the anxiety that builds in anticipation of an attack or leads to agoraphobic avoidance. Psychologists work with the cognitive and behavioural features of the disorder in an attempt to deal with the triggers of physiological reactions. By addressing the underlying cognitive features, the cycle of anxiety is frequently broken and the individual is able to learn skills to better manage high anxiety.

There is ongoing debate about whether treatment should focus initially on cognitive-behavioural or pharmacological approaches, however, a combination of treatments has been well documented to lead to greater maintenance of good treatment results. Thoughtful application of the available therapies alone, or in combination may enable individuals to experience resolution of disabling distress, regain confidence, and compensate for a vulnerability to anxiety.

Self-Help Resources for Patients
Aisbett, B. (1995). Living With It: A Survivor’s Guide to Panic Attacks, Harper & Collins Publishers, Sydney.

Beckfield, D.F. (1994). Master Your Panic and Take Back Your Life!, Impact Publishers, California

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Irritable Bowel Syndrome

Posted on August 1, 2013 in Uncategorized - 0 comments - 0

IBS-There is hope for people suffering with this often debilitating condition. 

Clinical Psychologist  Dr Matthew Evans

Clinical Psychologist
Dr Matthew Evans

Matt Evans, Clinical Psychologist, has worked for several years in a specialist gastroenterology outpatient clinic providing psychological support services for people with Irritable Bowel Syndrome (IBS). Below he writes about what he has learned along the way.

There is hope for people suffering from IBS. Over the last decade, the evidence has mounted to support a variety of different pharmacological, non-pharmacological and psychological treatments to help with the management of this condition. Unfortunately, health professionals, sufferers and the general public are not fully aware of this evidence and IBS remains often misunderstood.

There are probably many people with IBS who could be feeling better, but, without the knowledge of some of these more recent findings, haven’t had the opportunity to access the kinds of supports that we now know might help. Below are a few findings that are well-worth knowing about and considering for people with IBS.

First, IBS is not as rare as some people might think. It has been found to affect about 1 in 10 Australians, although more than that suffer from unexplained gastrointestinal symptoms1. It is important to identify these problems to then access the appropriate treatments.

Second, the severity and impact of IBS varies from one individual to another; from quite manageable to almost intolerable. Despite this variation, studies have found that IBS has a significant impact on health-related quality of life with issues such as low energy/fatigue, role limitations caused by physical health problems, bodily pain, and negative general health perceptions being common consequences 2,3,4.

Third, IBS has clearly defined diagnostic criteria called the Rome criteria. In the past, clinicians tended to rule out all other possibilities before diagnosing IBS. This often involved lots of tests and procedures. With better definitions of IBS symptoms and improved identification of IBS, the need for extensive testing has decreased5,6. If concerned, see a doctor familiar with diagnosing IBS.

Fourth, it was originally thought that IBS was “psychosomatic”, which means caused by psychological distress. More recent research findings show that this is not the case. Although the exact cause of IBS not been identified, studies have now found reliable biological markers for the condition7. However, psychological distress does appear to make symptoms worse in people with IBS. Often distress about IBS symptoms can make those symptoms worse leading to more distress. Psychological treatments aim at helping patient break this “vicious cycle”.

Finally, it is no longer the case that there is nothing that can be done to help alleviate the symptoms of IBS. It is true that IBS is a chronic disease, in that it is ongoing and there is no cure. However, there exist several pharmacological and non-pharmacological treatments that have been shown to significantly help manage the symptoms and improve quality of life8,9.

There is also increasing research showing that psychological interventions can be effective. Despite not knowing exactly how they work, psychological interventions do seem to work in improving quality of life in people with IBS. Psychological interventions often recommended include cognitive behavioural therapy, psychodynamic psychotherapy and hypnotherapy.

The American College of Gastroenterology, following their review of the research evidence for the treatment of IBS concluded, “use of psychological therapies can be strongly recommended for most patients in most circumstances”11 It is, of course, vital to have IBS properly assessed, diagnosed and medically treated. Psychological treatments can also offer added benefits that complement these medical treatments, providing further hope for people suffering with IBS.

References:

1 Lovell RM, Ford AC (2012). Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol , 10:712-21.

2 Gralnek IM, Hays RD, Kilbourne A, Naliboff B, Mayer EA (2000). The impact of irritable bowel syndrome on health-related quality of life. Gastroenterology. Sep;119(3):654-60.

3 Chang L. (2004). Review article: epidemiology and quality of life in functional gastrointestinal disorders. Aliment Pharmacol Ther. Nov;20 Suppl 7:31-9.

4 El-Serag HB (2003) Impact of irritable bowel syndrome: prevalence and effect on health-related quality of life. Rev Gastroenterol Disord.;3 Suppl 2:S3-11.

5 Ford AC, et al. (2008).Will the history and physical examination help establish that irritable bowel syndrome is causing this patient’s lower gastrointestinal tract symptoms? JAMA, 300:1793-1805.

6 Ford AC, et al. (2009) Yield of diagnostic tests for celiac disease in subjects with symptoms suggestive of irritable bowel syndrome: systematic review and meta-analysis. Arch Intern Med, 169:651-58.

7 Ford AC, Talley NJ. (2011). IBS in 2010: advances in pathophysiology, diagnosis and treatment. Nat Rev Gastroenterol Hepatol, 8:76-78.

8 Brandt et al. (2009). An evidence-based systematic review of the management of IBS. The American Journal of Gastroenterology, 2009, vol 4, supp 1, s1-s25

9 Johannesson E, Simrén M, Strid H, Bajor A, Sadik R. Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol 2011;106:915-22.

10 http://s3.gi.org/patients/ibsrelief/treatmentmatrix/treatment_matrix.pdf, pg2

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Getting out of our heads: ACT and Defusion

Posted on July 25, 2013 in Uncategorized - 0 comments - 0

By Clinical Psychologist Erika Fiorenza

Erika Fiorenza Clinical Psychologist

Erika Fiorenza
Clinical Psychologist

There is a great scene in Finding Nemo where Nemo’s dad, Marlin, and his newly found friend, Dory, have been swallowed by a whale and are holding on for their lives.

Dory: “It’s time to let go! Everything is going to be alright”

Marlin: “How do you know? How you know something bad isn’t gonna to happen?”

Dory: “I don’t!”

For me, this scene sums up Acceptance and Commitment Therapy or ACT.  It’s about opening up and accepting fearful or painful thoughts and feelings while taking action towards our values, which in Marlin’s case was love for his son Nemo.  In ACT, this is referred to as ‘Psychological Flexibility’.

Acceptance and Commitment Therapy, said “act”, is an evidence based therapy which teaches clients ways to handle painful thoughts and feelings and take action with full awareness of what is important.  One of the core processes taught in ACT is called ‘defusion’.

Our thoughts can often get in the way of living the life we want to live.  Thoughts can be like bullies – pushing us around, telling us what to do.  ‘Defusion’ means separating from our thoughts, and seeing them as just that – thoughts.  In ACT, we teach clients ways to look at, rather than from their thoughts.  We ask clients to look at what their mind is telling them.  For clients with depression, their mind may say things like “I’m worthless” and “what is the point”.  There are a number of exercises psychologists use to help teach the process of defusion.

A simple defusion exercise (Harris, 2009):

I invite you to think of a thought that may bully you around, and say that thought in the form of “I am X”. For example, “I’m a bad mum”

Now, in front of that thought say “I notice I’m having the thought that…” For example, “I notice I’m having the thought that I’m a bad mum”

What did you notice when you did this?

Painful or unwanted thoughts are part of being human.  It is important to emphasize that the aim of defusion is not to get rid of these thoughts, but to hold them lightly so they have less hold over us, and we can be present and engaged with our world.

I recommend checking out www.actmindfully.com for more on ACT and defusion, or the CD ‘Mindfulness Skill Volume 1’ which can be ordered from the site

Harris, R (2009). ACT made Simple. Oakland, CA: New Harbinger

 

 

 

 

 

 

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Striving for control of food and body

Posted on July 11, 2013 in Uncategorized - 0 comments - 0

 

Psychologist Cathy Dart

Psychologist Cathy Dart

By Clinical Psychologist Cathy Dart

We are taught subliminally from a very young age that being thin is good.  Advertising, the media, celebrities and society place huge importance on physical appearance and the drive for perfection.

So it’s not surprising to hear that eating disorders affect 9% of Australian population and 15% of women. That is 2 million people across the nation experiencing an eating disorder (Eating Disorders Victoria, September 2012).

The statistic we don’t know is what percentage of Australian’s will seek medical help to resolve the eating disorder. Speaking to a Psychologist or Doctor about your eating disorder can significantly improve your quality of life but the first step is recognising that you have a problem.

Clinical eating disorders like anorexia and bulimia are very serious with life threatening health risks, they often require intervention from a family member and many years of medical help.

However, more recently clinicians have found that there is a much wider spectrum of non-clinical eating disorders that derive from body image distortion and a drive for thinness.

A ‘drive for thinness’ or in some cases overeating a ‘drive for self protection’ are often primary issues or impediments to recovery for a person with an eating disorder.

The person with an eating disorder often experiences significant alterations in their ability to rationally appraise their bodies. They actually feel and see a very different shape to what exists. Their feelings and thoughts about their bodies are nearly always extremely negative and critical.

Commonly the person with an eating disorder initially finds some benefit in their restrictive eating, overeating or compensatory behaviours that may include purging, exercise, laxative and diuretic abuse.  Ironically they may experience a noticeable decrease in other mental health issues including symptoms of anxiety, depression or low self-esteem.

Fuelled by an overwhelming drive to achieve very specific goals usually relating to eating, weight, sport, academic or vocational achievements the person may experience a sort of artificial euphoria associated with chemical changes and reduced circulation in the brain and body.  This affect is caused by “Starvation Syndrome.”

The first step to recovery is recognising that you have a problem, whether it is big or small. The next is asking for help and this is one of the most difficult steps for a person with an eating disorder.

Often awareness of the disorder can be very delayed for both the individual affected and their family and friends.  Health practitioners will often struggle to identify and/or achieve the patient’s agreement that there is a problem.

Patients have often said to myself and other health professionals “I thought it was all ok, I would stop when I was ready.  It was only when I couldn’t stop that I realised that it was a problem.”

Reversing starvation or poor nutrition alone does not ‘cure’ an eating disorder. The emotional relationship and psychological factors that contributed to the condition need to be addressed.

Shifting awareness and developing insight into the traps created by an eating disorder and/or severe body image distortion can be extraordinarily difficult for a person with eating disorder symptoms and their carers- but it can be achieved.

Establishing a network of support that may include an experienced psychologist, general practitioner, dietitian and psychiatrist is a critical factor in achieving wellness.

Carers and family members also play a very significant role in the recovery of a loved one with an eating disorder. Family Based Therapy involving the whole family in the recovery process is the primary evidence-based approach to intervention for children and teenagers.

It can also be very important for parents, partners and carers supporting a loved one with an eating disorder of any age to access their own support.  Regular appointments with an experienced psychologist who is aware of the complexities of eating disorders can be very beneficial.

For many persons with eating disorders meeting others with similar illnesses and joining in with the activities provided by community organisations can be an important step in reconciliation and recovery.

Some of the support services available here in Brisbane include:

The Butterfly Foundation. This is Australia’s only national charity for the support of people with eating disorders and their families and carers.  The Butterfly foundation is dedicated to bring about change to the culture, policy and practice in the prevention, treatment and support of those affected by eating disorders and negative body image.

http://thebutterflyfoundation.org.au

The Eating Disorders Association Inc (Qld) is a non-profit organisation funded by Queensland Health, to provide information, support, referrals and support group services for all people affected by eating disorders in the state of Queensland, Australia.  The EDA also provides tailored workshops for positive body image and eating disorders to schools, universities, health professionals and the community.

Telephone (07) 3394 3661 or 1300 550 236.

12 Chatsworth Rd, Greenslopes Q 4120.

http://eda.org.au

Isis – The Eating Issues Centre Inc.  Isis works therapeutically with women and men of all ages from 17 years onwards. 
As the majority of those with eating issues are women, Isis offers more women-focused time at the centre: 
Please telephone first before visiting.

Telephone (07) 3844 6055

58 Spring Street, West End 
Q 4101

 http://www.isis.org.au

Eating Disorders Outreach Service and North Brisbane Outpatients Cognitive Behaviour Therapy Program. EDOS is a publicly funded state-wide health service that plays a significant leadership role and service development in Queensland including a state-wide specialist consultation liaison service which facilitates patient access to local general medical and psychiatric facilities, and a specialist outpatient clinic for patients residing north of the Brisbane River.

Telephone (07) 3114 0809
Rosemount, Windsor QLD

www.health.qld.gov.au/rbwh/services/mental_health.asp

Additional information is available:

F.E.A.S.T. – Families Empowered And Supporting Treatment of Eating Disorders is an international organisation of and for parents and caregivers to help loved ones recover from eating disorders by providing information and mutual support, promoting evidence-based treatment, and advocating for research and education to reduce the suffering associated with eating disorders.

http://www.feast-ed.org

Australian and New Zealand Academy of Eating Disorders (ANZAED) is a the peak body for eating disorder professionals committed to leadership and collaboration in research, prevention, treatment and advocacy.

http://www.anzaed.org.au

If you are experiencing body image distortion or think you may have an eating disorder, Psychology Consultants can help you overcome what can be an all consuming, negative force in your life.

To see our full team of Psychologists visit: www.psychologyconsultants.com.au or call 3395 8633 to make an appointment.

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Why do we spend so much time worrying?

Posted on June 10, 2013 in Uncategorized - 0 comments - 0
Elizabeth Galt

Clinical Psychologist
Elizabeth Galt

Worry is something that almost everyone will do from time to time. However, sometimes people find that their worry has become a large and interfering part of their daily life. They may not like it but might believe that it is a part of who they are – to be a worrier. Or they may think that it is necessary to worry as much as they do. Sometimes it is hard for people to acknowledge how much they are worrying because the thoughts seem to be justified if about their real life problems. Often their worrying is pointed out to them by other people.

Frequent and interfering worry is associated with anxiety but not all people who worry a lot are aware of feeling anxiety in their body. Some people may have habituated to a higher level of daily anxiety, accepting it as their normal.

Worry is different from constructive problem solving. Problem solving is “here and now” action. Worry typically becomes repetitive and looping patterns of thought that don’t resolve to any practical action or outcome. For example, problem solving a bill that might be difficult to pay could look like calling the company and making a payment arrangement. In the same scenario a worry pattern would look like repeated thoughts of “what if I can’t pay it?” “what will happen if I can’t pay it?” and similar.

Not all situations that provoke worry will be able to be problem solved. Some situations may be completely out of our control or may require time or other events to unfold. Often people get into the worry habit because it paid off for them a few times. Maybe they were prepared for a situation or felt partly protected from disappointment when something went wrong. It might seem counterintuitive but often people will have some positive ideas or beliefs about the value or benefits of worry. Unfortunately worry tends to get worse over time and then people find themselves worrying more and more about minor things. Then they can become worried about how much they are worrying, or feel stressed about how easily they are getting stressed.

The good news is that worry doesn’t have to keep its hold and reduce a person’s quality of life. A psychologist can assist an individual when their worry has become so severe that is causes considerable anxiety, feels uncontrollable and has an impact on their daily life. The psychologist can identify you worry pattern and what triggers it and then provide strategies and activities that reduce the worry pattern.

There are also self-help approaches that target worry. Resources for these can be accessed at many reputable mental health websites. The Black Dog Institute has some tip sheets available (see http://www.blackdoginstitute.org.au) and the Centre for Clinical Interventions has full modules and workbooks available in their Resources section (see http://www.cci.health.wa.gov.au)

Listed below are a few ways to identify if worry is a real problem for you.

·       Do you feel a sense that worry is taking over and filling up too much of your day? Are events that are positive or likely to be enjoyable overshadowed by too much worry?  e.g- what if we can’t get a car park, what if something goes wrong with our booking.

·       Are you bothered by, or preoccupied with, all of the things that seem to be going wrong in the world and those that could go wrong? e.g- natural disasters, disease, accidents.

·       Have other people commented on how much you worry or indicated that it has an impact on them? e.g- I wish you wouldn’t worry so much.

·       Sometimes there may be a lonely or isolating feeling to the worry e.g., why isn’t anyone else worrying that her plane might crash or she might get robbed? They’re all so happy for her.

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We Say No to workplace bullying on national Know Bull Day!

Posted on June 3, 2013 in Uncategorized - 0 comments - 0

Today, 3 June is ‘Know Bull Day’ marking the start of Workplace Bullying Awareness Month.
Helenweb
Clinical Psychology Helen Perry shares her professional experience on this serious issue and how we can begin to combat it.

 

Matthew* a 37 year old project manager sits across from me, sleep deprived, anxious and jobless- a broken man.

Over the past few months going to work every day had become a nightmare for Matthew. He had fallen victim to workplace bullying, his new senior manager was the main offender, but the effects trickled down resulting in complete isolation from his colleagues.

Seeing no alternative but to resign, Matthew sought help from his GP who referred him to see me with reports of insomnia, anxiety and low self-esteem.

In our first session he told me how he had been struggling to sleep, was having frequent headaches, was worrying about almost everything and was having panic attacks when he went anywhere near his old work place or saw his work colleagues.

Despite wanting to move on and seek new employment, Matthew struggled to focus, sitting at his computer for hours consumed in anger, animosity and regret at this unfair situation.

Matthew worried about how he would get a fair reference from his old manager and was angry with himself for not confronting his manager or making a formal complaint. His decision to resign seemed like the only option, he was aware of another colleague who complained in a similar situation and the result was not in his favour.

Psychologists see countless men and women each year who have similar experiences. People from a wide range of settings, including government, schools, building sites, hospitals, retail, police, army and academia fall victim to work place bullying.

They tell of many kinds of bullying which occur regularly and on an ongoing basis, sometimes by an individual and sometimes by a group of people.

The bullying behaviours described include being belittled both privately and publicly, being overloaded with work, having rumours spread about them, being insulted, verbally abused, sworn at or called names, being monitored excessively (“micromanaged”), being threatened, falsely accused, criticized publicly, being retaliated against after filing a complaint or being ignored.  Men are more frequently reported as the bullies though when women bully, they tend to bully other women.

Sadly, despite laws that set out to prevent this, workplace bullying is common and comes at large expense to our society, resulting in poor physical and mental health and resultant days off by the victims.

It is also true to say that most people don’t do anything about it, as reporting it often leads to an escalation of the problem rather than a resolution of the problem.

How can a Psychologist help?

A Psychologist can help to manage and treat any symptoms or the psychological impact from the situation and perhaps prevent these problems from escalating.

They can also help with problem solving: brainstorming and exploring different possible responses and action plans to address the bullying issue.  A very important role of the Psychologist is to provide a safe and confidential place for a person to unburden about what they are experiencing and to provide impartial support.  Some Psychologists (with particular training and experience in Organizational Psychology) specialize in issues relating to work places so could be particularly skilled in assisting you to deal with the issues related to workplace bullying.

What can I do about it?
There is no right or wrong way to respond and any action you take may help or could result in an escalation of the problem. It is often a good idea to discuss any action you might take with an impartial person before you do anything. The following is by no means advice, but merely a list of some of the sorts of things people often try with varying degrees of success:

1)    Educate yourself about workplace bullying and find ideas from experts in the field (both in person or through on-line resources, books etc.) on how to manage particular situations.  For example, see http://www.bigbadboss.com http://www.psychology.org.au/publications/inpsych/workplace_bullying/
http://www.beyondtheofficedoor.com for tips, articles, actions you can take, advice and other resources.

2)    Keep a detailed diary of the bullying and any relevant correspondence including emails and text messages.  Keep doing this even if you have already filed a complaint.  Document any conversations with supervisors, human resources etc.  For a template and an example of a diary, visit:

http://www.know-bull.com/images/bullydiary.pdf
(Don’t try and secretly record conversations as this may be illegal or result in dismissal if the company has a policy about this).

3)    Refer to your job description so that you know what your responsibilities are and always have phrases like, “any other duties as assigned” clarified so that you know what is expected of you and whether you are being exploited or manipulated.

4)    Know what is written about you on the internet (via blogs, online forums, social media etc.) to be sure that those in your workplace are not using personal information about you to target you in some way.  Google yourself and see what’s out there!  Be careful what you post online about yourself and others.

5)    Talk to the person bullying you if you think this might help, requesting that they cease certain behaviours (be specific about what they are doing rather than talking about “attitudes” and ask them to be specific about what behaviours you might change if they accuse you of having “attitude problems”).

Perhaps saying how stressed you are might not help, as knowing you are suffering may be their goal! Let them know that customers and sales are being affected by their behavior e.g. setting you unrealistic targets results in customers feeling they are being pressurized to buy; criticizing or ignoring you in front of a customer reduces customer’s confidence in the company etc.

Document your conversation or do it by email making sure you send the email when you are clear-headed and that you have not included inflammatory or accusatory statements.  Be sure to not retaliate or spread defamatory information about the person bullying you.

6)    Escalate the complaint to a supervisor or Human Resources if the bullying does not stop.
7)    Consult a lawyer who specializes in employment law and is experienced in dealing with workplace bullying.
8)    See your GP immediately if you start to suffer with significant stress that is affecting your physical and mental well-being.  You may need some support through this experience.

*  Matthew is not a real client, but represents a number of different clients and their stories as heard over the years.

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Can a psychologist help you quit smoking?

Posted on May 30, 2013 in Uncategorized - 0 comments - 0

Today- 31st May is World No Tobacco Day, so we’ve interview Dr Stan Steindl about how a Psychologist may help you give the habit up for good!

I-Quit

1.  Generally speaking, how can a Psychologist help a person quit smoking?

Psychologists can sometimes help at three critical stages when a person starts to consider giving up smoking.

First, finding the motivation to quit can be a challenge. A psychologist can help a person to consider what the major motivating factors are for them. Exploring what the person would like to change, why they’d like to change and what makes it important can help create the motivation and willingness to commit to change.

Second, a psychologist can help in the planning and action phase. A discussion around how to make the change, action planning and then confidence building can all help the person take that next step.

Finally, like all behaviour change, relapse is a real consideration. A psychologist can help with relapse prevention, which often involves identifying situations that might trigger relapse and planning ahead to cope better or differently with those situations. Importantly, a person trying to quit smoking has to manage their reaction to any lapses. For example, the Abstinence Violation Effect relates to a person’s feeling of failure and resignation that can come from a lapse, and managing that is an important part of staying on track with quitting.

2.  What are some different approaches to quitting smoking that have proven successful with your clients?

The most successful clients seem to be those who have a combination of a medical managed approach and a behavioural approach. For example, nicotine replacement therapy (NRT) and psychological therapy often work well in combination. The NRT helps the person to gradually reduce the nicotine in their body over several days, and the psychological therapy helps develop coping strategies. A vital contribution of psychological therapy relates to the fact that smoking often provides a function for the person, for example, managing stress. If they try to give up without having an alternative method of managing stress, then the chance of relapse is much greater. A psychologist can help the person identify those functions of smoking and develop alternatives.

3.  What are some common reasons for relapse once a smoker has quit?

People often have their own unique risk factors for relapse, and identifying them early and planning ahead is the key. For some, it is emotional factors such as stress or anxiety, or even boredom. For others it is social situations and pressures, such as living with a partner who smokes. And for others, simple opportunity and access can be a critical factor. I have often heard people say they thought they could ‘just have one’, and this can put people at a major risk of relapse just by itself.

4.  Are there ways to combat a relapse or some self help methods to prevent this from happening?

Effective, evidence-based approaches to combating relapse have been available since the mid-1980s. “Relapse Prevention” is a body of work that covers how people can identify triggers, plan ahead for them, and manage relapses when they occur. More recently, the Relapse Prevention approach has been coupled with mindfulness-based strategies, which are all about dealing with being on autopilot. It seems that being on autopilot and reacting to urges and cravings without thinking is a major risk for relapse, and mindfulness strategies helps the person to be aware of urges and then have the presence of mind to consider what’s important to them and respond accordingly.

5.  Is relapse related to the number of years the person has been smoking? (ie- how bad the addiction is)

The severity of nicotine dependence can influence how difficult it is for a person to quit smoking. This does not necessarily just include how long they have been smoking, but also how much they are smoking and how early in the day they have their first cigarette. No matter how long the person has smoked for, and how much they have smoked, it is never too late to quit.

On the flip-side, and although there is no hard and fast rules about this, often time passing of no smoking after quitting does reduce the risk of relapse. In fact, there does seem to be something about the passing of 9 to 12 months that starts to reduce the risk of relapse significantly.

6.  Is cigarette addition harder to ‘cure’ in those who have drug and alcohol addiction/substance abuse?

Quitting smoking is a difficult task, and it can be made more difficult when other factors are in the mix of a person’s life. Certainly, if a person is misusing alcohol or other drugs, then quitting smoking can be more difficult. Sometimes a person may wish to prioritise what changes they might make first, and this may or may not be smoking. Other factors might include mental health issues, chronic disease issues, and general life stressors. Where a person is facing multiple challenges with quitting, a psychologist may be of particular assistance in helping them cope.

7. What are five things a smoker should consider when they decide they want to quit?

1. What would YOU like to do about your smoking? What is your preference? How would you like your life to be?

2. What are your personal reasons for quitting smoking? How would things be better as a non smoker? How might things be worse if you continue smoking?

3. What makes quitting smoking important for you? How does smoking really fit with who you want to be? Putting aside what others say, what is the clincher for you?

4. If you were to make such a change, how would you go about it? What might work for you? What sorts of things need to be addressed to up your chances of success?

5. What will you do? What is going to be your next step?

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