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Stigma and suicide-let's get talking!

Posted on September 10, 2013 in Uncategorized - 0 comments - 0

candelAn Interview with Clinical Psychologist Dr Eve Klopper     World suicide prevention day- September 10 2013

Q: The theme for World Suicide Prevention Day in 2013 is “Stigma: A major barrier to suicide prevention.”  How does the stigma associated with suicide impede suicide prevention?

A: Unfortunately, many people are uncomfortable discussing or directly considering issues surrounding suicide.  This limits awareness of risk factors or “red flags” that someone may be suicidal, and can make people who are suicidal less likely to seek help.  Feeling rejected and isolated can increase the risk that a person who has previously attempted suicide will make another suicide attempt.  Social stigma can also isolate those who have lost a loved one to suicide.

Q: So how can we respond to this?

A: Key steps to reducing stigma include understanding why people attempt or commit suicide; being able to identify risk factors and warning signs and knowing how to respond; knowing how to respond to someone who has attempted suicide and knowing how to support those who have lost loved ones to suicide.

Q: Why do people attempt or commit suicide?

A: Suicide is sometimes seen as the “only way out” of unbearable psychological or physical pain.  This can include people experiencing severe mental illness, such as clinical depression or schizophrenia, or intense mental anguish, for example loss, shame or guilt, people facing extremely difficult life events, as well as those undergoing chronic or terminal physical illnesses.  Some other reasons for suicide include attempting to benefit others, expressing ambivalence about continuing to live, attempting to “send a message” or achieve an outcome by one’s death, or exercising control over the timing or manner of one’s death.

Q: What are risk factors and warning signs we should be aware of?

A: While some suicides are impulsive actions with no warning, others are planned carefully.  People feeling suicidal may or may not express their feelings to other people.  Factors which put a person at greater risk of considering suicide include having mental health difficulties, alcohol and substance abuse, being male, being isolated geographically or socially, experiencing financial stress or family violence or bereavement, and having attempted suicide previously or having a family history of suicide.  Warning signs that a person may be contemplating suicide include expressing the intention to harm or kill themself or saying goodbye to family and friends; preoccupation with death or dying; expressing strong feelings of hopelessness, of the pointlessness of living, of feeling trapped or of anger and revenge; withdrawal from other people; increased alcohol or substance use; undertaking reckless, risky or self-harming behaviours; dramatic mood changes, including suddenly changing from long-term depression to happiness; and extreme anxiety or agitation.  It is also important to be aware of the kinds of events which may “trigger” a person to commit suicide.  These include traumatic life events, relationship breakdown, job loss, diagnosis or recurrence of severe physical or mental illness, major change in life circumstances, financial or legal stress, and the death or suicide of a loved one or public figure.

Q: What can we do if we suspect someone is suicidal?

A: If you observe warning signs in someone you know, it is important to remain calm but act immediately.  Ask the person if they are feeling suicidal, whether they have made a plan to kill themselves and whether they have the means to carry out that plan.  Contrary to popular belief, talking calmly with someone in this way will not increase the chance of them carrying through with a suicide plan.  If the person has a clear plan and intends to carry it out imminently, call 000 or a health professional who can see the person immediately, or take the person to hospital.  Do not leave the person alone.  If the person is at lower risk of suicide, talk with them about their suicidal thoughts and help them to plan how they will stay safe, including assisting them to find appropriate support services.  Acknowledge their feelings but express your hope that, with help, they will be able to cope.

Q: How do we respond to someone who has attempted suicide?

A:  While it is normal to feel a range of emotions including shock, guilt and anger when a loved one has attempted suicide, providing acceptance, care and support can help them to recover and reduce the risk they will attempt suicide again.  Practical support includes encouragement to attend appropriate medical and psychological help, making sure the person cannot access means to attempt suicide again, if possible, preventing access to alcohol or drugs and assisting the person to manage re-building their lives, for example returning to work or school.  Providing such support can be psychologically tiring, so access help wherever possible.

Q: How does suicide affect loved ones, and how do we help those bereaved by suicide?

A:  Bereavement following suicide is usually intense and complex, including feelings of shock, disbelief, anger, guilt, sadness and shame.  Loved ones may have many “unanswered questions” and may also be experiencing trauma from discovering the deceased.  The most important thing we can all do to help is to express support and demonstrate our care.  We may feel awkward but it essential to say (or write) something to show our love and concern.  Let the bereaved person talk – when they are ready – and listen supportively.  Try to understand how they are feeling and allow them to grieve in their own way.  Be patient – understand that it may take years for the person to work out how to live with their loss.  Don’t avoid talking about the person who has died, but don’t press for details or make judgments – it is important to honour and accept both the person who has died and those left bereaved.  Offer practical support.  With children and teenagers, answer questions honestly and take their concerns seriously.  And remember – it is never too late to approach someone bereaved by suicide in the past and say “I didn’t know what to say to show you that I cared, and I’m sorry.  How are you going now?”

Q: What part can psychologists play?

A:  Psychologists can assist people who are feeling suicidal, and those who have attempted suicide, to address the causes of their pain and distress and to build their coping skills.  This includes providing treatment for mental illness, often in consultation with GPs or other doctors; providing coping strategies to manage life stressors or psychological or physical pain; and helping people to build relationships and social support networks.  Psychologists can also help those who have been bereaved by suicide to cope with grief and other emotional reactions, to build social support networks and to rebuild their lives.

Q: What should a reader do if they are feeling suicidal?

A: Please don’t suffer alone – help is available to you.  Tell someone you trust how you feel, or call one of the free, confidential counseling lines listed below.  If possible, stay with someone supportive.  Seek help from your doctor, a psychologist or another health professional.  Avoid drugs and alcohol, try to exercise and eat healthily.  You may find it helpful to write down your thoughts and feelings.  And if you need immediate, urgent help, call 000 or ask someone to take you to a hospital emergency department.

Q: Where can people get more information?

A: Confidential, 24/7 support is available at Lifeline: 13 11 14; Kids Helpline: 1800 55 1800; Mensline Australia: 1300 78 99 78 and the Suicide Call Back Service: 1300 659 467.

Useful information and further resources: www.wspd.org.au; www.livingisforeveryone.com.au; www.beyondblue.org.au

 

 

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Work Stress

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

Workplace bullying

Workplace Bullying Awareness Month-June 2013.

Clinical Psychologist Helen Perry shares her story. Matthew* a 37 year old project manager sits across from me, sleep deprived, anxious and jobless- a broken man.

The Working Mother

Juggling Act

By Psychologist Kylie Layton

Today it seems that parents and particularly mothers are expected to be super heroes, their superpower is multi-tasking. The question is what is a working mother’s kryptonite and how do we sustain the juggling act?

The decision to go back to work after having a baby can be a difficult one for many women, provoking a complex web of emotions, from liberation and pleasure to guilt and anxiety.

Case Study

The stress of modern technology

Gerard, a sales executive in an international IT company, first came to Psychology Consultants because he felt stressed. After discussing his current situation, we quickly became perplexed. He had a good relationship with his wife, a busy, fulfilling job, he exercised regularly, found time for hobbies on the weekends, and his diet was impeccable. Why was he stressed?

Employees

Assisting employees through programs

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

In any one year, one in four Australians experience psychological symptoms that would meet criteria for clinical diagnosis.

Redundancy

Stages experienced by employees facing redundancy Change is a central issue for all organisations today. And sometimes the difficult decision to “let people go” has to be made.

Coaching at Work

Enhancing Your Work and Personal Performance

By Dr Stan Steindl, BA PGDipPsych MClinPsych PhD(Clin) MAPS
People in business often refer to work difficulties:

“How can I get through to my staff?”
“What should I do when staff don’t get along?”
“Are the ideas I’m having worth pursuing?”
“How do I plan ahead for my business?”

Case Study

Major mental illness in the workplace

Jacob is 37 years old. He has worked for the public sector for 12 years and performs his tasks well. He is quiet at work, but is pleasant and unassuming. He lives with his wife in a rented house and has one daughter who is 8 years old. The family usually walks their dog before Jacob goes to work of a morning. On the weekend they enjoy indoor bowling. Jacob has a bookshelf full of bowling trophies.

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Stress and Trauma

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

Stress and Trauma

Trauma

Life-shattering events: The debriefing debate

Recent debate over the effectiveness of psychological debriefing following trauma has sparked some interesting opinions, discusses Dr Stan Steindl, director of Psychology Consultants.

Trauma

Responding to people’s trauma

Trauma regularly touches our community. Events like car accidents, assaults, hold ups, and natural and man made disasters seem to happen all too often. Experiencing a traumatic event can have a marked impact on people’s lives.

Case Study

A case of complex posttraumatic stress disorder

Probably one of the more challenging cases a psychologist can face is treating “complex posttraumatic stress disorder”. This usually involves clients who have an already established, yet often unidentified, personality disorder when they face a traumatic event.

Anger

Managing Anger

by Dr Stan Steindl, BA PGDipPsych MClinPsych PhD(Clin) MAPS Simon is a 45 year-old happily married man with two daughters. A litigation lawyer, he seems successful and has many friends.

Bullying

Beat Bullying

Teasing, threats, verbal abuse, harassment, hitting or pushing. Research suggests one in six children are bullied at least once a week. Here are some facts and hints to help beat the bullying.

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Sleep

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

Sleep

Insomnia case study

Can’t Sleep?

by Kathryn Smith, BA GradDipPsychEd MPsych(Clin) MAPS
Everyone likes to have a good night’s sleep, but not everyone sleeps well all the time. John is 43 and divorced from his wife five years ago. He came to Psychology Consultants indicating he had been chronically unable to fall and stay asleep since he divorced his wife.

Sleep advice

What can I do to get to sleep?

By Dr Stan Steindl BA PGDipPsych MClinPsych PhD(Clin) MAPS.This is one of the questions we are most frequently asked. Irrespective of a client’s other problems, sleeping difficulties are usually also present, either as a part of their primary condition or as a disorder in its own right.

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Relationships

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

Separation and Divorce

Kids Needs after parental separation

Psychologists can provide practical advice to parents going through separation. Recent research published in the APS’s latest InPsych magazine indicates that the reactions of children and adolescents to their parents’ separation differ with age and is thought to be due to cognitive maturity, as older children may be more capable of understanding the reasons behind a marital separation than younger children.

Happiness

Want a long and happy relationship?

Research indicates that marital satisfaction decreases within the first two to three years of marriage.

Feelings

Improving Couple’s hurt feelings

Psychology Consultants’ Dr Jennifer Fitzgerald has completed her Clinical PhD in the area of relationship therapy, particularly couples and family relationships.

Case Study

Marriage difficulties affect work

John worked as a warehouse manager for 17 years. His supervisor noticed that John wasn’t himself when he asked for some time off to deal with some “problems at home”. As a part of their Employee Assistance Program, John’s supervisor referred him to Psychology Consultants.

A Case Study

Parent-Child Relationships

Relationship problems can often be the cause of other emotional and behavioural problems.

Family Relations

Tips to becoming a Step-Family

Statistics indicate that around a third of all families include step children. Consequently, there is a growing need for support to help step families create a positive experience for all family members. Following are some tips. You may also find the book Step-Parent Survival Guide by Leila Henderson a useful resource.

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Medicare

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

Medicare Rebates

Medicare Referrals and Rebates

It is common for misunderstandings to occur regarding the Medicare requirements for a client to claim the rebate for their session with a Psychologist.

To help our valued clients and GP’s who refer to us we have outlined these requirements below so you can ensure these have been met prior to your session.

Medicare Review

Better Access to Mental Health

Despite speculation, the Federal Government did not amend the Better Access to Mental Health the recent Federal Budget, but it is reviewing the expenditure on mental health. Director of Psychology Consultants and clinical psychologist Kathryn Smith said the review is necessary to ensure the program is working effectively.

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Health and Well-being

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

Irritable Bowel Syndome

IBS: There is hope for those suffering from this often debilitating condition.

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

Acceptance and Commitment Therapy

Getting out of our heads: ACT and Defusion

By Clinical Psychologist Erika Fiorenza

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!”

Compassion and Motivational Interviewing

Having you heart in the right place

By Dr Stan Steindl


I recently presented at the International Symposium on Motivational Interviewing (ISMI) in Melbourne on the topic of Motivational Interviewing (MI) and Compassion.

Athletes

Assisting professional sports people

Psychology Consultants has experience in providing a range of player welfare and development programs to professional sports teams and individuals, which encompass a wide variety of services assisting players in all aspects of their lives.

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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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