Richard Taylor |

clinical psychologist

Skill five: Thoughts and the self

Dec
16
2007
Our perspectives on ourselves, the future, and the world and just how we think about events, and respond to our own thoughts as a constant flow of consciousness, has much to do with how we feel (our moods) and how we behave.  The message here is that thoughts and feelings determine mood.  Much of the time all of this runs on automatic such that you respond to thoughts and ways of viewing the world in a habitual manner, built up over time, and in which your moods are trapped.  As a result, mood flucuations are often cyclical or repeat themselves and/or are easily triggered off.  Intensity of moods is often determined by the stressors upon us or the responses that we are in turn making in the face of stressful events.  The approach to these issues from the 1970's and 1980's emphasised specific goals to change a behaviour or a thought pattern (cognitive and behaviour therapy).  The actual skills that you need to learn to deal with dysfunctional responses to thinking now go beyond  this initial approach.  So what skills do you need to learn?  Firstly, build awareness of your thoughts through mindfulness-based breathing exercises and also learn to take a decentered perspective on your patterns of thinking (refer to the skills of mindfulness discussed earlier).  You will always have negative thoughts and feelings but you do not have to latch on to them and have them consume your sense of self (and your well-being) in the process.  This moment is also a good time to revisit the first skill you learned, namely values.  This will help you to ask questions about your thinking such as 'What does this event or situation mean to me?' or 'What does it mean about me?'  The latter question is important in that you may have habitual negative ways of reacting to others - changing yourself first, including the way that you are thinking, can lead to big changes in the way others in turn behave.  Secondly, and in the case of thinking about the more concrete problems that you may have in the here-and-now, you may wish to generate some new perspective about the events around you.  For example, your subjective responses to events and the way you think about them may be really at odds with reality.  This is a common problem for many of my clients who make rapid assumptions about people and the world, rather than examining what is really going on.  Too often everything gets personalized and then generalized in making broad assertions about people, events, and places.  As a result an individual may poorly assess and cope badly even with everyday situations involving the behaviour of others.  If you are receiving feedback from others that this is the case, and has been for a period of time, then this is a psychological skill area that you need to develop.  In consultations with a Clinical Psychologist you will be able to determine if this problem area is a component of broader psychological health issues (as it often is).
The Dalai Lama '...I think that to a large extent, whether you suffer depends on how you respond to a given situation'.  (in The Art of Happiness)

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Skill three: Spot meditation

Oct
13
2007
A spot meditation is a conscious exercise that can anchor you in the present under any circumstances. You can take time out to do the mindfulness breathing exercises available elsewhere on this web site. You may simply relax rapidly by focusing on your breathing saying, for example, 'breathe in' and then saying 'relax' as you breath out. You can do this at your desk at work, in a queue, or when you have some time to spare. You can also do spot meditation when you are doing something, washing up the dishes, walking, or doing housework, and so on. The secret here is to be both relaxed and aware, and focused on what you are doing. Most people do things while they are consumed by thoughts of something else. There is much to be enjoyed in the present moment, experiences which so easily pass by unnoticed, colours, sensations, forms, etc. As a psychotherapist I often observe how little people are in tune with their environments or how rapidly their minds are distracted when they are asked to observe or appreciate something. Spot meditations undertaken during the day are a means of noticing that you are alive (using your breathing), calming yourself, and enabling you to return to the here and now. A little time devoted each day to conscious breathing while taking time out, or when you are doing something such as walking, will improve your health and calm your life. Breathe from the abdomen. Just notice the natural flow of your breathing. Spot meditation at work can enable you to pace yourself and assist you to resist the build up of, or compounding effects of, stressful situations. If you do not take time out to relax then you may become a victim of that old but useful phrase 'Work expands to fill the time available' ('Parkinson's Law' which many of you will be familar with). In taking time out at regular intervals there will be less build up of stress and you will be more productive in a more balanced and caring way (valuing yourself is part of this and is a key foundation of psychological health). If you act with a good mind happiness will follow. A peaceful mind will make you more receptive towards both yourself and others. A book I would recommend on spot meditation is 'The 5-Minute Meditator' by Eric Harrison (go to www.perthmeditationcentre.com.au).

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Skill two: Exercise

Oct
05
2007
In the treatment of psychological health problems and disorders I regularly refer clients to the exercise physiologists at the University of Western Australia's Health and Rehabilitation Program at the School of Human Movement and Exercise Science (www.hmes.uwa.edu.au). I have observed over several decades of clinical practice the positive benefit of exercise for someone experiencing psychological health problems. For example, someone who is experiencing stress and anxiety often gives low priority to, and neglects, positive diversions and leisure interests and this includes exercise. Psychological and physical health are not two separate issues. Starting an exercise program can result in someone getting some control back in their life. So I was intrigued to see in the Weekend Australian last year(24-25 June, 2006) an article in the health section headed up ‘Physical effort alleviates depression, there is no doubt about it’. I will summarise below some of the points made by its author Chris Tzar who is an exercise physiologist at the Lifestyle Clinic at the University of New South Wales. The author noted that in the health system depression received little attention. However, psychological (mental) disorders in total account for 60 per cent of all disability costs for people aged 15 to 34 years. There is a ‘cause and effect’ relationship between depression and physical activity. Those who are sedentary are more likely to experience depression, while those who suffer from depression are more likely to be sedentary. The author noted the quite astounding statistic that 59 per cent of people stop taking anti-depressants within three weeks of the drugs being prescribed. One reason for this may be that many people do not like playing the role of patient and receiving care when nothing else has changed in their lives. As such exercise may be the only option for some, and of course, it can be done with minimal if no expense. Those with depression also persevere after starting an exercise programme. The drop-out rates are no greater than for those who do not suffer from depression. So, what are the reasons behind exercise being good for depression? The author noted that exercise releases ‘feel-good’ hormones while exercise can also build self-confidence and enables people to build new relationships. Exercise is also a positive diversion and represents a change of lifestyle. My experience is that exercise is often a type of circuit breaker that can then lead to other, often long overdue, changes to lifestyle and relationships. Various types of aerobic exercise can reduce the symptoms of depression. At six in the morning the pool at the School of Human Movement and Exercise Science (referred to above) is alive with swimmers. It is an open-air heated pool. In the Winter the steam rises from the pool and just one degree of pool temperature can make a real difference to the shock on jumping in. Each swimming lane tells a different story as to why people are swimming at such an hour. In the first lane many swimmers of all ages are slowly walking through the water, some with walking frames, or doing some gentle breaststroke to aid in their physical rehabilitation. The furthest lane always appeared to be the ‘olympic’ lane with swimmers churning up and down with effortless ease. The in-between lanes accommodate the differing levels of swimmers’ abilities - again of all ages. Some time ago I had a friend’s 84 year old father visiting my home in Toodyay, Western Australia from the United States. He was tired from the flight but soon after arrival he asked ‘Where is the local swimming pool?’ His wife had died about two years previously and to cope with his grief his physician, who must have been very wise, recommended that he take up swimming. He commenced swimming every day going very slowly up and down the pool for between one to two hours. This proved to be literally a life saving activity for him plus he enjoyed all the accompanying psychological and physical benefits from this type of exercise. Swimming can involve a lot of social contact with regular swimmers. For the elderly and others swimming is a chance to relax and get exercise with low effort as the above case illustrates. Swimming is a good conditioning exercise and can be aerobic if it is continuous. Persons with joint diseases or weight-bearing injuries may find swimming the most viable exercise. Swimming can involve focussed awareness of pleasurable sensations – being aware of your surroundings, your heartbeat, your breathing, skin temperature, excitement, mood, rhythms, and smile. As such it will reinforce other psychological health skills that we are going to discuss. Accessibility to a swimming pool, tennis court, etc influences decisions to participate in these sports. As with other forms of exercise swimming is likely to make you feel refreshed in body and mind afterwards. It is a valuable exercise for all age groups, particularly those with a sedentary life who need to avoid chronic tension and even disability over time. Strength training and weights might be the exercise of choice for the elderly. This can also have other benefits such as strengthening bones, preventing falls and managing health conditions such as arthritis. The author Chris Tzar (above) provided a useful checklist for those embarking on an exercise program: · Get support from someone or a group. · Keep a diary of your achievements. · See an exercise physiologist and obtain a tailored exercise program based on an assessment of your individual circumstances. We have all heard the phrase ‘just do it’ and this is the best way to kick start an exercise program. Over time the various rewards from exercising regularly will keep you on track. Exercise is a way of caring for yourself and putting you back in control and this is a good starting point in managing stress, anxiety and depression.

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Skill One: Values

Sep
27
2007
Starting today I am going to discuss and illustrate seven foundations for psychological health. You could regard each foundation as an area in which you have to acquire certain skills for coping with the demands of living and for coping with change. What are we trying to achieve? At a general level the objective is to expand your psychological world through building greater flexibility while creating more possibilities for yourself. To achieve this it might involve: building resistance to anxiety and depression; reducing stress; accepting your thoughts, emotions and feelings and being prepared to move on; enhancing your relationships; developing flexibility in your thinking, and working more productively and creatively. Skill One – values. Let us get right into this from the outset. Take a pen and paper and undertake the following assessment in two parts. Step One: Rate on a scale of 1-10 the importance of the following ten valued domains of living, but first take note that not everyone values all of these domains. Some areas may be more important to you than others and some domains or areas of living may be important in different ways and different times at different stages of your life. The 10 areas are: (1) family, other than parenting and intimate relations (2) marriage, partners, couples, intimate relations (3) parenting (4) friendship (5) work (6) education (7) recreation (8) spirituality (9) citizenship and community activities, and (10) physical self-care. Step two: On another page make an estimate, using the same 1-10 rating scale, of how consistently you have lived in accord with those values over the past week. This assessment hopefully puts your whole life back into perspective or helps you to see the ‘big picture’. I often refer to having a helicopter view of your life circumstances as sometimes the experience of stress, anxiety and depression is pervasive and consumes all available energy. Look at the results and ask yourself the following questions: In what areas have I lost the freedom to act?; What are the obstacles to increasing or decreasing your commitment to these domains of your life, and what changes do you wish to make? During this exercise write down any relevant thoughts, memories, emotions, and other aspects of your experience that act as barriers to moving forward in any domain. For example, you may think that your excessive work hours are for your family’s benefit but your quality of life may be compromised. Through identifying your values you are more likely to realise the goals in life that really matter to you. All of this leads to some principles of time management that we will discuss at another time on this web site. The values exercise here asks you to be reflective, to take time out in order to be reflective and not simply be lost in endless activity. David Brazier has noted in his book Zen Therapy ‘When our stock-taking shows that what is revealed by our contact with the environment is in harmony with what we inwardly believe and value, we feel confirmed. When our experience (body) and beliefs (mind) disaffirm one another we feel disturbed’.

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Introduction

Sep
21
2007
Commencing Friday September 28, 2007 I will share with you many practical step-by-step ideas to improve your quality of life. I will be concerned with fostering understanding, developing skills and strategies that you can apply in your particular life context. Hopefully through observation, insight and lots of practice you can apply these skills across relationships at home and at work. Gradually your life will become more enjoyable as you experience positive gains in terms of your mood, effectiveness and productivity, psychological health and overall wellbeing. I have identified seven basic skills that are the basic building blocks of psychological health.

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