"Why am I so weak?" The function of self compassion.

I have been hearing the statement "Why am I so weak?" and other variations such as "I don't want to be weak", or "I am not usually a weak person". In this article I would like to address the problematic thinking behind these statements. Firstly I would like to commend anyone with courage enough to admit their deepest vulnerability to anyone. Unfortunately a statement such as this admits to a problematic sense of self that will almost certainly lead to difficult emotional states lasting longer than they should. The main issue here is a lack of flexibility in thinking style. I often see clients when an intersection of stressors occurs. A death in the family, as well as an illness, in the middle of a home renovation. The experience of all these issues at once is unique in your life and therefore your emotional reaction is going to be unique. In this case, you can read "unique" as "scary". 

This leads me to one of my key phrases that you would hear in a session with myself, "Sometimes your brain decides for you when you've had enough". Someone who identifies as the "strong" person often relies on their determination and rational mind to push themselves through difficult times. This will often work. Until it doesn't. The shock of no longer being able to choose whether to be resilient can be so anxiety producing for the "strong" person that they will be all the more terrified. This anxiety will create a self-perpetuating cycle that traps the person in this "weak" state.

Every person goes through very difficult times. Emotional intelligence in these situations includes the capacity to accept in the difficult emotions, to give yourself time to process what you are going through and most importantly to take time off or slow down. I can already hear some of you saying, "but I don't have the luxury of slowing down". Unfortunately, there will be a time when your brain decides for you when you slow down, and that can include the signs of depression or anxiety. Take control and slow yourself down now, or have your brain run out of steam and take that control away from you.

This is where Self-Compassion is important. Understanding that you are unable to cope with everything going wrong at once and being able to ask for help, or take some time off is the necessary first step. I wonder if you are strong enough to be able to tell accept that you are at the end of your tether. Admitting your own limits is possibly the most courageous thing you can do. It removes your sense of pride as the priority in your life and begins to include your needs as a human being. 

I will expand on this concept of self-compassion and how to let it into your life in my next article.

 

 

Broadening my love of the Annandale Clinic!

This post is just to announce that I have recently opened up more hours for my Annandale Clinic. There has been some delay in getting a session and that has been frustrating for everyone. I'm glad to say that I can now see clients on Wednesday afternoon from 2pm to 6pm. 

I've long had a love affair with Annandale as a suburb with it's leafy, broad streets and friendly but diverse crowd. I've seen many a live show at The Annandale Hotel (before it became so recently gentrified) and I lived on Annandale Road for two and a half years.

I'm looking forward to spending that little bit more time around the traps and spending a few too many lunch hours at Fat Fish!

Removing the Romanticism from the Suicide Note

This article was first seen on the online magazine The Big Smoke: http://thebigsmoke.com.au/2015/10/27/removing-romanticism-suicide-notes/

As a literature major and a psychologist, the idea of writing about suicide brings conflict. There is a burden to dispel the stigma around suicide with as blunt a force as necessary. At the same time, while I have repeatedly seen suicide discussed in stories, sadly it is often coloured with Romanticism’s watery pastels. To perfectly illustrate my point, at the time of writing, the Wikipedia link to Romanticism in Literature has a photo of a young man dead at 17 years of age from suicide.

At the turn of the 19th Century, notable Western intellectual heroes admitted their urge toward self-harm. This triggered a heated debate against the prevailing understanding of suicidality as weakness. In contradiction, the Romans considered suicide noble, depending on the circumstances. When Christianity prevailed (and also where most other religions outside the West held power) suicide was considered a sin.

This black and white thinking is clearly still prevalent today.

The current understanding of depression and suicide is one of a tendency to dysfunctionally over-think. Analysis is useful to uncover problems and protect ourselves from threat. In the case of the over-thinking associated with depression, it is often due to an interpersonal threat.

Too much analysis and your bias will be to find threat everywhere. You may even fall into a habit of searching for what could possibly go wrong. That is a deep rabbit hole; when someone runs out of energy to dig, the claustrophobia can be intolerable.

It’s from this position that someone might consider suicide, and possibly write a suicide note. I want to pare back the complexity of the issue with the force I alluded to earlier. At the same time, I want to address the romanticism that worries me.

To do this, I’d like to look into the phenomenon of the suicide note.

Can words adequately explain such a profound act? My initial professional reaction is that a suicide note is reflective of a perception heavily reliant on an internal state that, while perhaps felt frequently, is transitory.

But what is that experience, and what do these notes tell us when it comes from the source of an unusually unreliable narrator (which is to say, all of us)? One of the most strongly carried experiences described through suicide notes is a heightened sense of perceived burden on others, which reiterates the research that a suicide note is the attempt to address an overwhelming interpersonal issue.

From my practice, it seems the want to not burden friends is often told as a concern of seeming too negative, or not wanting to share their struggle at all. This takes us back to the idea of interpersonal threat, feeling like you do not belong. A suicide note is terrifying in the sense that it is the written expression, to which someone felt they could not give voice.

Romanticism glorified the sensitivity of the soul of the philosopher or artist, and it created the most extreme narrative to represent that sensitivity. The original emo kids. Unfortunately, the latter is the kind of negative stereotype that only succeeds in solidifying an identification with persecution or the sense of being alone.

Generally, inner torment is not enough to have someone commit suicide. It also requires repeated exposure to the resistance inherent in the survival instinct and a slowlyaccumulated capacity to override it.

This can be achieved through regular self-harm or even exposure to mental anguish in a variety of forms.

So, how can we avoid playing into the glorified romanticism that surrounds suicide, but still try to discuss it openly?

I have a few ideas about how the idea of the suicide note can be salvaged from what might feel like an impotent representation of the complexity of the impacts of suicide. Perhaps we can use the clues within one to try and ward it off where possible.

A great deal of my work in a one on one session is to directly address suicidal thoughts in a way that reduces the fear of them. There is research around a technique known as defusion, which treats words similarly to objects in so far as that it understands that we can experience the meaning we create in too literal a sense. Or: we can feel the fear of a snake by stepping into long grass.

A valid fear, a sensible instinct, but not a guaranteed pairing. Yet experiences such as a panic attack exists, completely outside any real exposure to a threat. In an example more related to the topic, however, specifically the idea of social connectedness, is the phenomenon of someone becoming overwhelmed when presented with the word “weak.”

Defusion is the process of diluting the power of this association between language and the literalism that leads to our misery. (For some great examples of delusion techniques, visit:https://contextualscience.org/cognitive_defusion_deliteralization).

An important process that might be paired with defusion includes asking how these thoughts might provide a secondary gain. A benefit that comes aside from finding a solution to the problem at hand. Many of those who experience suicidal thoughts often feel a sense of unusual sense of calm and release when deciding on suicide; researching it feels like finding an answer.

My question is how do we help someone achieve this feeling in a sustainable way without having to follow through with the behaviour.

We need a replacement act.

Part of that alternative could come from the precursor to suicide, the function inherent in a suicide note. If depression has the adaptive function of looking for a solution to socially based problems such as feeling disconnected, how might the suicide note help that person be heard, feel understood?

I want to make it clear that suicide is often not a “cry for help.” Many people are sick of asking for help that is not forthcoming, has come, or more tragically, that when it does come, will not make them feel any better. There is a strong argument for medication in some cases. That is not to say that these techniques alongside cannot make a world of difference in self-care.

Firstly let’s extract from the suicide note the expression of desperate hopes.

In this case, many people could engage with this exercise. What do you long for but have difficulty articulating? Finding words for painful emotional states is research-proven as a way of reducing the power of those emotions.

Writing down onto the page why you feel so horrible, then continuing writing toward some small step of a solution is also a time honoured saviour (sometimes the solution does not even require inclusion). Your brain is not always in a state to contain all of your options at the front of mind to carefully compare and contrast at once. As a functional description (but a significantly reductionist one), this exercise draws the blood back to your frontal cortex (where long-term planning and complex decision making occur) and away from your lower brain regions (such as your amygdala; responsible for emotive states).

A cry for help isn’t a problem if someone is literally asking for it, rather than acting out in a way that scares people and confuses people. The person overwhelmed by their emotions is often more scared and confused than you are by their actions, particularly after the fact. It is our obligation as decent humans to put aside the judgement as to whether their expression deserves our wild cynicism.

Finally, it is the strangest paradox of the human mind that the constant search for a moment of happiness can be the biggest obstacle to achieving it at all.

If you try to stop white knuckling on expectations of how you should feel right now, that is, if you change your relationship with your emotions, you might be able to achieve relief, specifically due to the fact that you aren’t holding on so desperately.

Maybe that includes writing a note that forgives yourself for you.

Work Development Orders and SDRO Fines.

This latest blog is a quick community service announcement. You may or may not know that I Bulk-Bill clients who are receiving Centrelink benefits. It is an important part of my own values to offer services to those that are going through hard times regardless of their financial capacity. When heavily burdened financially and socially people can make mistakes that they never would under normal circumstances. This understanding is written into a variety of government policy. Which brings me to the concept of the Work Development Order

What you may or may not know is that the SDRO (State Debt Recovery Office) who recover all manner of fines have a program of leniency for those with a mental illness or other vulnerability. The program allows those eligible to pay off their fines through engagement with a Community Services provider or other officially registered sponsor. I have recently signed up to this program which would provide you with what is known as a Work Development Order. 

For more information have a read of the PDF document below and you may be eligible to relieve a large financial burden.

http://www.sdro.nsw.gov.au/lib/docs/forms/sfs_wdo_009.pdf

Compassion Fatigue

Article first published on thebigsmoke.com.au

Compassion Fatigue is a clinical term to describe the extreme, functional burn out of people in the helping professions. Nurses, paramedics, social workers and psychologists are all “first responders”, whose resilient and compassionate personality types can eventually erode until they find themselves looking for a job as a travel agent. As a psychologist myself I spend most of my time within the world of struggle and I can tire to the point of assuming that struggle is the rule and not the exception.

The impacts of similar phenomena at a societal level, can have just as significant an impact. Even the mention of the names of Andrew Chan and Myuran Sukumaran, the two convicted drug smugglers recently executed by the Indonesian Government, can leave the most compassionate of my friends shaking their heads and mumbling that they don’t want to talk about it anymore. A compassion fatigue of sorts, on a communal scale. A mental exhaustion that was strained long before the deaths of the two men. The incessant focus of mass media, both institutionalised and social, has saturated our awareness with their names and plights to the point where the intensity of focus will lean as heavily on our opinions, or the expression of such, as all the complex political variables that are gradually laid bare.

This fatigue is something to consider when you find many have dropped the topic as fickly as many commercial media outlets will have in a few days’ time. When I am talking to clients about coping with a circumstantial stressor, which has been punishing them for far longer than they had ever predicted, we often work on shifting to a curiosity toward the dynamics between themselves and the stressor. If it is the case of a ruthless manager we would work on becoming curious of the motivations that trigger the behaviour, such as the need for control or the conflict between personality traits. Knowing the dynamics behind the impact can shift attention away from the instinctual human shriek “Why am I under attack?”.

We all have an innate drive to define the dangers that befall others as resulting from their own character flaws. This creates a sense of being safe ourselves as we benefit from feeling different from those in danger, and therefore less at risk. However for those of us who have compassion for the tragic outcomes of others, including Chan and Sukumaran, their circumstances will seem beyond our control and as a result our compassion will be sapped.

The executions of Chan and Sukumaran will trigger these instincts, and the saturation of the story will stoke our fears. As their lives fade from the public discourse, consider the impact that media saturation has on your capacity for compassion? As most of us feel powerless in the face of international politics, our dialogue seems the last place to exert power, to construct social norms. But it is through talking, when we are tired of talking, that we begin to see the importance of sustaining compassion as it importantly leads to a communal reduction in the sense of feeling under attack. We need to be resilient enough to act with compassion toward those who are too afraid to expend any more. This can lead to a greater sustained capacity for action even when we are worn out by the inevitable commercialisation of these very values. But this fight to care affects us all. It is a fight that must continue and one that gives inspiration to those of us lucky enough to still be alive.

Take Care What you Share.

The Eastern Suburbs of Sydney has it’s own insular culture, fortunately tempered by a constant influx of back packers and ex-pats. I have a number of clients who have found themselves in these beach side suburbs and have not found a reason to leave.  Generalisations of people who inhabit a particular area are almost always exclusionary. Meaning someone is bound to feel left out of, or invisible in a community that begins to define itself by its media and most visible members. You’ve heard the clichés; Bondi locals are the hipsters, Coogee locals the hard workers, Maroubra locals the underdogs. Of course there is the style and pomp of the Double Bay and Vaucluse locals as well. I’m sure this already has some of you irritated at what these labels exclude, particularly if you are the one being excluded.

Today I wanted to use this generalisation to draw everyone’s attention to that which social media makes visible and invisible. If you find yourself reacting strongly to a headline or becoming frustrated at the repeated exposure to someone’s holiday snaps, perhaps it’s time to ask the question, What is it that I am reacting to? If you’re sick of photos of your friends babies, does it mean they are shameless show-offs or are you looking for stimulation of a different kind and are finding that social media no longer serves that purpose? The fun part is that both of these answers might be correct, but only one really serves insight that you can work with.

Confirmation Bias is a phrase used to describe the phenomenon that occurs when we look for information in our environment that confirms what we already believe. Next time you share a news story on social media perhaps question the emotional motive that has your finger furiously tapping. Emotive states are important to inform our behaviours, but they should almost always be diluted with some solid thought. As example, I once heard an eminent psychology researcher tell a story of him as an eight year old. He had heard about a group of people who had died in a plane crash and had instinctively stated, “They must have deserved it”. His mother was understandably horrified, but what his most recent research revealed was the functional gain of that statement. That if that group who was harmed share a common “blame-worthy” set of traits, then he would be safe from the same fate.

How often do you pidgeon hole people to avoid association with suffering of any kind?

How do I cope with Christmas and New Year’s Eve?

Every time New Year’s Day clicks over, people around the world use the date as a psychological reset. The New Year’s Eve party is the rite of passage that takes us through to a new cycle of working, living and loving. However, statistics seem to suggest that most of us who attempt to hold to New Year’s Resolutions fail to fulfil them long term (http://www.statisticbrain.com/new-years-resolution-statistics/). The figure sits around about 8% according to a study in the United States.

Now that is a sobering fact. Unfortunately this sits beside another fact that Christmas and of course all the other end of year religious festivals, is generally a stressful time of year for a large number of people, and in a smaller proportion it is among the MOST stressful or depressing times of year. Now I know specifically that due to the importance placed on Christmas and New Year’s that they can also be some of the most life affirming times as well. A time to perform that which I share with all of my clients; the process of a Consolidation of Gains. A Consolidation of Gains is short hand for counting your blessings. Before you scream in frustration at that concept, try and stick with me here.

Now I’m sure you’ve heard of this from thousands of friends before, and particularly the ineffectiveness of this when faced with an episode of Major Depression. Nevertheless, it is certainly a skill that is ravaged when either experiencing a bout of “The Blues” or suffering a depressive episode. I would recommend, rather than thinking of your plight in comparison to the starving millions in Africa, to make the Consolidation more personal. Comparison to unfortunate others is akin to making the suggestion that your internal experience is not valid, which is more depressing. If your Consolidation is personal, specific and accumulative then you have another technique that can be added to your armoury.

Let’s quickly check in with those three aspects of a Consolidation of Gains. When I suggest you make the Consolidation personal, I mean to say that you should concentrate on (and write down) the things in your life that you still experience or actively do that bring even a slight spark of joy, happiness, contentment or even relief from your current heaviness. This can also include those things that you are doing that are an attempt to work against your condition. Don’t let anyone else define those moments for you, use some mental muscle to define these little moments for yourself.

Secondly, make your Consolidation specific. This will always include some kind of diary, or a collaborative list made with your psychologist or even a good friend. Writing down the exact instances of your positive moments and when they occur will assist in giving a good picture of how your condition is truly progressing, as opposed to how you feel it might be progressing.

Lastly, the accumulative aspect of your consolidation refers to the fact that while you may feel down right now, that you do not write off your gains, suggesting to yourself that nothing has changed. One of the most destructive elements of depression is that it ruins your ability to recall your positive experiences, meaning that to an extent this skill has to be relearnt. When you are making your Consolidation List, the process might include “feeling” around internally for the vague shadow of the positivity you felt at that time and “allowing” yourself to feel that positivity again. Try and think of a few of these moments at once and let all of that positivity bubble up if it is there.

Clearly, the description above might seem a little vague, but with supportive direction this process can be particularly useful.

Walk behind someone slow.

I recently had a personal revelation that aligned well with the tenets of mindfulness. Mindfulness is the process in which someone attempts to sustain their attention on the present moment as long as possible, the sensation of their feet on the ground or the food in their mouth, without getting lost in thought. In the way I would ask of my clients I tried to convert my revelation into a behavioural experiment. Behavioural experimentation can be understood as a small step toward a larger goal. Sometimes you might know it is trivial, but it can feel like a huge obstacle. Firstly, I would speak with a client to determine in which direction they wish to grow. Then it will be time to work out what is the first step in that direction. Following up from these behavioural experiments will be an analysis behind the surrounding thoughts, behaviours and emotions that the client felt stopped them from completing that experiment.

As with many of you I have a busy lifestyle, and often feel like the next point in my timetable is the priority. Running between meetings, doctors’ appointments, or social occasions. On our way there will be obstacles. In the traffic it is the other cars, in the city it is the other people. It is easy to get angry and wonder why people have to be so careless or inconsiderate. It is very easy to forget that there are other timetables, other agendas. Of course there will always be people who are inconsiderate or careless, keep in mind that sometimes that person will be you. It doesn’t have to be intentional, particularly in a busy city. Paths are bound to not just cross, but collide.

The frustration that you might feel from day to day, the accumulated irritation that builds to anger is almost always not an individual’s fault but rises from tripping up on a series of small obstacles prior to your moment of aggravation. As the aggravation builds, your body becomes tight and your perspective shrinks. It is very easy to start living in your own head, from your own point of view. My revelation was simple and has been considered in a variety of ways before, but involved a conscious decision to step into someone else’s shoes… almost literally.

As it is a simple behavioural experiment, perhaps you would like to try it. Next time you are presented with the choice to overtake someone either on the footpath on the highway, try choosing to stay behind them. Keep safety in mind, don’t travel too close behind them and do not put anyone’s safety at risk, and especially don’t follow in a way that could be perceived as invading a person’s personal space. Then notice what thoughts come to mind, especially the excuses as to why you should immediately pass them by. Notice the emotions that rise up in you. Even if you don’t have a life threatening issue or are late to something acutely urgent you may notice the same level of frustration or anxiety.

Attempt to challenge those thoughts, sooth those anxieties. Look around you, absorb your surroundings, feel your feet on the ground, breathe deeply and remember it is not necessary to be hard on yourself if calming down takes longer to achieve than you expect. A deliberate behavioural choice such as this can almost spontaneously elicit compassionate thought; “This tourist is taking in a gorgeous building that I take for granted”, “This driver is clearly lost and is worried about it becoming worse”. This is not only usefully altruistic but is functionally calming for yourself. The less enemies you perceive, the safer you feel.

So, that is my challenge for the week. Go and unmake a few enemies.