All About Psychos

What exactly is the difference between a counsellor, a psychotherapist, a psychologist, a psychiatrist and a psychoanalyst... or “All About Psychos”.

 

As some of you out in the cyberworld may have guessed, I very much appreciate the films of Pedro Almodovar, who made a film called “All About My Mother”,

which was a film reference to another film called “All About Eve”.

So in talking about the differences between all of the above, we can basically call this post: All About Psychos. And no, we are not talking about the Alfred Hitchcock film, either.

I think I mentioned in one of my other posts that I would talk about the differences between all of these professionals. So here it is.

 

Okay, so we have five designations for professionals who work in mental health. And to someone who might be considering going to see someone for some issues that they have, the bewildering array of mental health professionals might be a little intimidating and/or confusing.

 

Whom do I see? And for what?

 

Or more likely, or perhaps.... “I have a brother/sister/wife/cousin/uncle/friend , etc., etc. (fill –in-the-blank) whom I am concerned about, whom should he or she go and see???

 

Right then, let’s begin. First of all, the designations about are in relative order of education from least to greatest. And, accordingly relative order of cost/expense to the consumer/mental health client.  Now, I stress the word: relative.  I am sure there are exceptions out there.

I am sure that there are psychoanalysts and psychiatrists out there who command an impressive hourly rate (or as I call it: charge a bomb!) but are unskilled or even unhelpful or even damaging to the clients. Just as I am sure that there are counsellors out there who charge very little (or as I call it: get by on a pittance!) and conversely aid the client to go through a tremendous amount of change and vice versa.

 

Now I should also state that I personally have met and interacted with all of the above types of mental health professionals and there are some in each category whom I highly respect and regard and then there are some who.... well, let’s just say I wouldn’t!

 

So the thing is you can find a psychiatrist who is wonderfully helpful or one who is...well...

And you may run across an ordinary, garden-variety counsellor who helps you tremendously.

 

So, time for a quick interlude. So in the immortal words of Smokey Robinson and the Miracles:

“Ya gotta get yourself a bargain, son.

Don’t be sold on the very first one.

... My mama told me.

Ya better shop around.”

  http://www.youtube.com/watch?v=dA5509mcQd8

 

So shop around. Most counsellors, psychotherapists, psychologists, psychiatrists, psychoanalysts usually will offer a first session or consultation for free. And if they don’t... Ask.

You need to know that you feel comfortable with your professional.

Both in terms of what you have to pay, but also and perhaps more importantly, that you feel comfortable interacting and trust the professional.

 

Remember, just like the song goes, you will be having an “intimate” relationship with this person. Now, I don’t mean intimate, like the expression “intimate relations” but, nonetheless you are going to be sharing private, personal details with this person.

 

So, for example if you are a woman and you working through past memories of a sexual assault that may have happened several years ago but which haunts you still, you may not want to see a male therapist, because you feel he may not understand or perhaps you may feel intimidated by such a situation. So maybe a female might be better. Or maybe not. Perhaps you feel angry and you wish to work with a man, in order to “get over your anger and work out your feelings of injustice”. I don’t know. But you, as the client, will know.

 

Or perhaps you are a man, and you are struggling with an issue that involved a past girlfriend or wife or your mother. Perhaps you feel distrusting of females and so would feel more a camaraderie with another male to whom to tell your story. Or perhaps you might feel that it would be better to speak to a female professional in order to understand and review “what you did wrong” or “if you did wrong” and therefore get a so-called “female” perspective.  I write so-called because, in experience in mental health any and everything you expect to find in one gender, you will invariably find in the other as well. So there is no true “male” or “female” perspective. There are only perspectives.

 

But I digress.

Okay, so you need to find a mental health professional.

You need to trust the individual and you need to pick the one right for you. We have that now.

 

So, generally “counsellors” are kind of like resource personnel. The term counsellor is somewhat vague. To counsel someone generally means to advise someone. So, as I see counsellors, they generally offer information and resources to the person and gently assist the client to make a decision based upon what the client says they want. The counsellor tends to be a little bit more actively involved in the decision-making process with the client. Edging the client nearer and nearer towards a healthy decision

So as a result, most counsellors are usually drug and alcohol counsellors or sometimes they can be social workers, who assist the client to find resources to help them alleviate the stress in their lives. They help them find housing, advise them on how to find employment, assist them on how to navigate the legal system and even sometimes to manage money.

 

            Psychotherapists, will and can do some of what a drug and alcohol counsellor will do or what a social worker will do, but tend generally, but not exclusively, to stay away from advising the client. Part of the reason why psychotherapists avoid trying to give advice freely is that at times when a client tries a solution to a problem and it doesn’t work, the client may come back and either accuse the therapist of “giving bad advice”, which may or may not have been the case as the advice may or may not have been carried out correctly.

            But more importantly, when a client tries a new behaviour or a new solution to a current problem they are experiencing they may be fragile and are expectantly hoping the solution will work. If the person then comes back the next week saying: “I followed your advice and it didn’t work. In fact, I feel worse” This then immediately damages the relationship between the therapist and the client. The client may then feel they can no longer trust the therapist to “guide them in the right direction”. However, the job of the therapist is not to guide the client but rather to empower the client to make decisions for themself. The idea is that the therapist trusts that the client will make their own, adult decision about what they want to do with their life. If however, the therapist perhaps sees the client moving in a potentially destructive direction, like drinking more or doing (more) recreational drugs or repeating patterns of behaviour that are detrimental, the therapist will draw the client’s attention to it and get them to ponder their behaviour.

 

Generally speaking, sessions with a counsellor are shorter in course than with a therapist. Generally. And generally as we move from a counsellor to a psychotherapist, the level of education increases and length of engagement with the client (usually) increases. But not always.

 

So for example, if one engages in psychoanalysis, usually it involves seeing an “analyst” two, three or even five times a week for a number of years at considerable expense.  Whereas work with a regular psychotherapist may take place once weekly for several months or even upwards of a year. 

 

Most psychotherapists usually have a designation with a university degree or, more often, a masters degree.

 

Most psychologists have a masters degree if not a doctorate in psychology, specializing in a particular area. A number of psychologists also have the ability to be able to do formal psychological assessments and testing on clients for use in a clinical setting or for legal or medical reasons. In terms of “counselling work”, many psychologists have a little bit more skill that an average psychotherapist although, this is up for debate, depending on whom you ask and what regulating body is answering.

 

            Psychiatrists are usually first and foremost medical doctors by training. On top of this training there is also an element of experience with true psychiatric disorders. So for example, yes you could go and see a psychiatrist to discuss your marital problems or your anger issue. But you probably would not go to see the psychiatrist to talk about how you lost your rental housing or where to go to learn English as a second language as you are an immigrant or if your brother-in-law or your roommate has a serious substance abuse problem.  For these issues you might rather just talk to a drug and alcohol counsellor or a social worker.

 

However, if you are critically or chronically suicidal or if your 22 year old son appears to be showing signs of paranoia and starts to tell you that he “is hearing messages from aliens coming through the television”. Or that your next door neighbour states he or she is hearing voices, then it is time to see a psychiatrist. As a medical doctor and mental health professional, he or she will be able to help you and even prescribe medication if necessary. A psychologist or psychotherapist does not have this level of skill or education to intervene to this degree.

 

And finally, what does a psychoanalyst do?

 

Well, as already mentioned a psychoanalyst can conduct sessions with a client that can go two, three or even five times a week for several years. And yes, psychoanalysis is where the person finally gets to lie on the proverbial couch and regress/go back to childhood. Really, only in psychoanalysis do you ever see this cliché, however the cliché has a very valid reasoning behind it.  Psychoanalysis may seem like overkill. And indeed, before I, myself even got into this profession, I remember hearing from someone else, when I was a teenager that “Therapy is great but I have heard of people going for therapy for years and never really changing all that much”.  

 

Now if that really were indeed true, the validity of psychoanalysis would go right out the window. However, psychoanalysis is usually used for patients or clients who are really hardened or difficult cases --  and no, I am not talking about someone who has smoked filter-less cigarettes by the case and drinks gin and whisky and hangs out in tough biker bars! What I am referring to are patients or clients who are highly “resistant” in terms of being able to be relieved of their problems – I won’t say “cured”. So you have someone for example who has a personality disorder, say something like borderline personality disorder, who disrupts the session with the analyst/therapist with questions and/or causes drama in the session or seeks to test the therapist/analyst, e.g.
            “I will see if he really cares about me! I will go and make a suicide attempt and then if he does not respond within the hour, I will just KNOW that he doesn’t care about me”.

            This kind of blatant manipulation by the client is counter-productive to the client getting better, because at some point the therapist/psychiatrist/analyst is just going to want to get rid of the client – not because the client is intrinsically “bad” but because the therapist is being frustrated and emotionally manipulated by the client. However, the client does this precisely because  they have a dysfunctional past history with regards to trusting people and being honest (among other things). They therefore have what is known as a personality disorder. A personality disorder typically will have something endogenous within the person’s character which will limit their being able to obtain help. Hence the personality disorder is rarely able to be worked with or helped, because certain elements of their personality prevent them from being able to be helped at all.  We have all met people like this. In fact there is a rather well-known book which illustrated the Borderline Personality Disorder: I Hate You, Don’t Leave Me, by authors Jerold J. Kreisman and Hal Straus.   

In any event, people will such severe difficulties or personality disorders often cannot be helped. However, psychoanalysis, which is kind of like “super-intensive” psychotherapy for lack of a better description, promises to help people who have such personality disorders, such as Borderline or Narcissistic or Obsessive-Compulsive or Dependent personality disorder.  One Danish study showed that psychoanalysis was effective at relieving symptoms for people who had Borderline Personality Disorder. Here is the link:

 

www.psychcentral.com/news/2012/10/24/borderline-personality-disorder-sufferers-can-improve-with-psychoanalytic-therapy/46573.html

 

Psychoanalysis can also be extremely helpful for people with severe trauma or PTSD. A quite famous French psychiatrist by the name of Boris Cyrulnik, 

 

 a Jewish psychoanalyst of Russian, Ukrainian and Polish émigré parents, is known in France for his coining the concept of psychological resilience – the ability to bounce back from all kinds of trouble and trauma in life. And no one should know more than he, as he lost both his parents during World War II after they were arrested and murdered. 

Cyrulnik went on later to become the famous psychoanalyst who worked with Samira Bellil. Bellil, pictured here:   was famous in France as she was a high-profile case of a young woman who was sexually assaulted multiple times. Her book: Dans l’enfer des tournantes  described her experience with the multiple rapes she suffered and her journey to overcome her very severe trauma.  I can think of no better argument and proof for the use and need for psychoanalysis than this. However, Bellil, who has since died, poor soul, founded a national organization, Ni Putes, ni soumises, which functions to this day.




If anyone is interested the link can be checked out here, (note though, that the website is in French): www.npns.fr/

 

However, the average person does not usually experience the types of trauma that Bellil encountered in their day-to-day life. But in the media, at least here in Canada, there is a growing awareness that many soldiers, serving in the Canadian Armed Forces, come back from tours of Afghanistan often with
 
PTSD, which leads them to very destructive, reckless behaviour: drinking, drugging, fighting, etc., and oftentimes to suicidal thoughts if not suicide itself.

 

So on that pleasant, happy and joyful note!!! (not!)

 

Mental health workers run the gamut from counsellor to psychoanalyst. What you want to do is find the professional that you feel most comfortable with and that will work for your needs. You probably won’t want to go into 3 years of four times weekly psychoanalysis in order to deal with an alcohol problem or conflicts you are having with your husband about the housework.

 

But now at least for some of you, dear friends, hopefully the idea of what a counsellor, psychotherapist, psychologist, psychiatrist and psychoanalyst does is a little clearer.

 

I welcome comments, questions for clarification and dialogue respectful to this post and any others.

 

If you are interested in this or other posts, why not click on the Google + button or submit your email, either way, and follow?

 

Take Care,

 

Steve.  

Can I have your identification, please (Part Two)

Dear Friends,

As I stated yesterday or the day before yesterday, the post on “Identification” was going to be a long one.  Part one talked about personal identification at the individual level and how – if you are misrepresented or mislabelled by yourself or others then there is conflict. Internal conflict. Between what you want or believe you are and what you actually are and/or how others see you or view you and thus label you.

In this (second part) of this post, I want to talk about how this can happen at a broader, even national level and how this can lead not to interpersonal conflict, but real-life war conflict.

Let us witness the current, recent situation with Ukraine. Ukraine is not one unilingual, uniracial country. It is mixed with Russians, Germans, Jews, Armenians, Tatars, Georgians, Greeks, etc., etc.,

Recently I discovered a youtube video celebrating the diversity (multiculturalism, as we call it here in Canada) which was made a few years ago.

Ukraine is seemingly struggling between East and West, yet is made up of multiple “identities”, yet they are all Ukrainian.  The series of videos ends with the Ukrainian national anthem (sung in different languages) and a slogan for national identity: “We are all different, but we are all one!” Similar to Shakespeare’s line that “One man plays many parts”. In one particularly interesting video in this series, there are a group of people all gathered for a picnic out in the country and quite clearly all of different ethnic backgrounds: Greek, Middle Eastern, African, etc.  and yet they all come together.

Here is the video:

 

 

 

This is most intriguing, given the current push and pull of national politics lately in that country: “Do they identify as Russian?” “Do they identify as European?”  “Are people in the east of the country really anti-Ukrainian or secretly pro-Soviet?” or “Are the people in the west of the country really covert Nazis or anti-semites?”

All of this bickering and backing and forth-ing (is "forth-ing" a word I can use?) can be construed as internal national conflict: People who on the outside speak, look and act like Russians but IDENTIFY as Ukrainian, even if they don’t speak Ukrainian. Or, conversely people, particularly in the west, who act, speak, look and identify as Ukrainian but NOT anti-Russian, anti-semite or anti-peace.

So this, dear friends, both on a personal, individual level and even on a larger, national level is why identity is so important: when you know who you are and are happy with who you are there is no conflict, distress or anxiety. And you probably know why you are here on this planet. And most distressing is probably to be identified and/or labeled as something you personally feel you are not and does not reflect your internal (i.e. emotional) experience.

Many Canadians, for example, in my own country resent being mislabelled as “Americans” when abroad. Many Welsh, Scots and Irish similarly dislike being labeled as “English”. And certainly those persons who are Basque, are not fond of being called “French” or “Spanish”.

 And why, ultimately is identity and how you identify so important? Because your identity is a question linked to a big, fancy word called: “existentialism”, which is basically the question of: “Why do I exist? And What is my reason for being on this planet?”.

With luck, I will tackle this question in another post.

But for now, think about who you are and what you do. How do you identify yourself? And if you lost your job or career or significant relationship with someone else (or your country, yikes!), would you be a blank?

Consider and treasure all that you are and the relationships you have right now at this moment, for they define and identify you as you are now. And if you wish to change something, then, like plastic surgery, you will become your more authentic self as you grow and evolve towards that which you want to become.

I welcome comments, questions for clarification and dialogue respectful to this post and any others.

If you are interested in this or other posts, why not click on the Google + button or submit your email, either way and follow?

Take Care,

 

Steve.

Can I have your Identification, please?

by Stephen B.Chadwick, MA Counselling Psychology.
www.cowichancounselling.ca

WARNING: LONG POST: WARNING: LONG POST

So I am starting this next post with a familiar quote that everyone hears when they get stopped by the cops and are speeding or run a red light or did some minor infraction. What, you may ask does this have at all to do with counselling and psychotherapy? Wait for it. We’ll get to it.

Okay, Identifications can have a couple of different meanings. Apart from your passport or your driver’s licence, How you identify... how you identify yourself... and what you identify with can have some pretty important meanings. All of us have multiple identifications in this life: father, son, daughter, mother, cousin, grandson, sibling, co-worker, employee, boss, lover, etc., etc. and that’s just for starters.

            Think about this:

When you go to a party or a social gathering, what is usually the first thing that most people ask, apart from your name? You introduce yourself and then your “interlocutor” (my fancy word for the day, meaning the person you are having a conversation with) ... Anyway your interlocutor, says:  “So... what do you do?”

And you immediately, say... “I’m a _________(fill in the blank)”, as if an individual can be reduced to a single word. You can’t. Both male and female, we fulfill multiple roles in our lives.  Shakespeare mentioned this in his monologue from As You Like It where the character of Jaques, in Act II, Scene VII who states that “All the World’s a stage and... one man in his time plays many parts”.

So, identification is important. Perhaps more so for men that for women, because, and here I overgeneralize, because for men, they identify (generally) with who they are and what they do, whereas (generally) women identify with their roles in relation to others. Hence when the average man loses his job, he becomes a blank, a nothing. Like the fill-in-the-blank above. Whereas most women, again, these are overgeneralizations, may not feel the loss nearly as keenly because their identity is not so wrapped up in their job or career. This of course is not true for all women or all men. And any job or career loss is devastating. But perhaps some women (and men) can weather it better when their identity is less dependent upon what they do but rather their relationship to whom they do it.

Now, this doesn’t mean that the loss of the relationship can’t also be devastating. Take for example, the play by Tennessee Williams, Suddenly, Last Summer. Granted, there is a song by the Motels from the 80’s about this film. The original had some heavyweights: Montgomery Clift, Elizabeth Taylor and Katharine Hepburn. There is a line in the film where Katherine Hepburn turns to Clift and says: “After all, I’ve buried a husband and a son. I’m a widow and a... Funny there’s no word. Lose your parents and you’re an orphan. Lose your only son and you are... nothing”.

 

 

This was a very powerful play but it illustrates the power of identification with what you are and  to whom you relate.

 

Taken to the other extreme, when you don’t identify with anything you have very little reason for existing... which I will discuss in a moment. Take for example another film, however this is Sci-Fi – Logan’s Run from the seventies. In this futuristic world, everyone is identified as a number – sound eerie already – Logan 5, Jessica 6, etc., etc. simply because real identification, interaction and meaning with other people are simply no longer possible because the world population has exploded and everyone is obliged to give up their life for “renewal” at age 30. Everyone goes around identifying themselves with a super, glow-in-the-dark chip implanted, Jesus-like,stigmata-like, in the palm of their hand. 

 

So, identification, how and what you identify as in this world is important. Important, so that your life has proverbial meaning and you are not just a number, like in Logan’s Run. But it is also important just how your identification is derived. And as I hinted at earlier, this can be what you do, but also what role you play in relation to others.

 

Now, you are probably asking why is this identification jazz so important anyway? Well, I’ll tell you. Because often the most difficult conflicts/stressors can come about psychologically AS A RESULT of the discrepancy BETWEEN what you are externally and what you are internally. In other words, what other people say or think you are and what you yourself think you are. In other words how you yourself, define yourself.

 

Again, you may think to yourself.... “Oh, what is all this malarkey?” “Who cares already?”

So, I will give a real, hard, concrete example. Two, in fact. I will start out with the most obvious one on the individual level and then I will go to the more abstract one on a national level.

Bear with me.

In a film by Pedro Almodovar (1999), called All About My Mother, there is a character called Agrado. Now, bear with me as Almodovar’s characters tend to be a little unusual if not bizarre. In the film, there is a play which is cancelled in a theatre as the main actress is sick. So, Agrado, who happens to be transgendered, offers to entertain the audience who would have otherwise left the theatre, by telling the audience her life story. In it she relates how she had endless amounts of plastic surgery in order to look like how she does and how much money and time it cost. She states that it was all worth it because “now the outside matches the inside” or “you are more authentic, the more you resemble what you have dreamed of”.

The clip is below with subtitles in English

 

 

 

Now, the character is talking about the externalities of what you look like – as a man, as a woman, etc. So, in this case, who are we to judge people who get plastic surgery? Yes, of course it is not “authentic”, but then the internal reality then matches the external reality and then the external identity matches the individual’s internal identity.  Problem solved. No more conflict.

 

Now, most of the population of this world are not transsexual. But stop and think for a moment. For all the women and girls out there who are looking to resemble something in a magazine. Should we begrudge them? No. They are in fact IDENTIFYING with the models in the magazine. Of course the lack of acceptance of how they actually look as opposed to how they would like to look, is what causes the conflict. You can either help them to accept they way they are or help them to become what they would like to be.

This conflict is even more profound for those who are indeed transgendered and are women inside men’s bodies or vice-versa.

But then, again, in terms of identification, for every man and for every woman, they will become their more authentic self when they either can become what they envision themselves to be and/or accept their external situation in congruence with their internal situation.

So, if you have always wanted to be an astronaut – and IDENTIFIED as one or if you have always wanted to be a ballerina – and IDENTIFIED as one and yet have not achieved the external reality to match the internal reality, then it is possible, perhaps strongly possible, that there will be some conflict or distress or disappointment.

Would it be that you could accept and love yourself as you are, where you are, then things would be okay. However, most people are not in that headspace.

 

In the next installment, I will talk about how this IDENTITY conflict can have national
consequences.

I welcome comments, questions for clarification and dialogue respectful to this post and any others.
And if you are interested in this or other posts, why not click on the Google + button or submit your email, either way, and follow?

Take Care,
Steve.

 

Tips and Strategies for Dealing with Anxiety and Depression BEFORE you need to see a counsellor.

Now, don’t take these tips as a be-all and end-all. They are just meant to be strategies that can tide you over until you are able to get into see a counsellor.

That having been said, when you make a decision to see a therapist, you may not be able to see one right away. In some cases, therapists, psychiatrists, psychologists and even mental health teams may have a waiting list. Sometimes these waiting lists can stretch for up to three months! By which time the client (you or someone else) may already have ridden out the crisis or the situation and may no longer think that you need to see a counsellor. Think that one over carefully. Indeed, the situation you may have experienced may have been temporary or “situational”, like losing a job or a girlfriend or boyfriend and you may have gotten over it within 3 months because – hey! Now you have a new job/boyfriend/girlfriend/ whatever (fill in the blank here).

However, in some situations where as I mentioned before in another post, you have been experiencing chronic, ongoing stressors, you may need to still see a therapist. So, for example, maybe you did lose your job/girlfriend/boyfriend/whatever (fill in the blank here) but perhaps you did so and had your “meltdown” due to something else. Maybe you lost your boyfriend because of some relationship difficulties that chronically spring up in your relationships whenever you get involved with a fellow. Or maybe you lost your girlfriend because you get into a pattern of behaviour that sabotages the relationship. The difficulties we find in our intimate, interpersonal relationships, like our love lives, can also be apparent in our interactions, but in a more muted way obviously. You are not going to have an intimate relationship with your boss. Or maybe you try to and maybe that is why you lost your job. Who knows?

However, as I said our patterns of behaviour in our intimate relationships often show up in our ordinary, day-to-day relationships with neighbours, co-workers and bosses. You should also know that some of these patterns also come from our relationships with our first “intimates” namely our parents, our siblings and childhood friends.  But I am digressing.

In any event, you have a problem: anxiety or depression and you need to get in to see someone but the waiting list is miles long and you are in the lineup but it stretches down the corridor, around the hallway, down the stairs and out the front door and into the parking lot ......  across the street! What do you do in order to keep yourself together until you can get into see someone?

Here are some tips. These are tips, mind you, NOT a substitute for therapy. Think of these as an analogy with a snack or a meal. One wards off your hunger, the other will satisfy you longterm.

For Anxiety:

Anxiety can often be “misplaced intellectual or psychic energy” and no, I am not talking about the person you phone up on a 1-800 number to get the winning lottery ticket numbers. I am talking about the endless energy of thoughts running through your head: “What should I do about this?”, “What should I do about that?” “Did I do the right thing here?”, “Did I say the right thing there?” This is psychic energy.

1. Calm yourself down with a grounding exercise. For five minutes, do the following: Sit comfortably. Tell yourself aloud (or if you are in public, silently) 5 things you: see; 5 things you hear; 5 things you feel and can touch. Then get yourself to find 4 more things you can see, 4 things you can hear; 4 things you can feel or touch. And so on. Do this until you are down to the number one. By the end of the exercise you should be more in touch with what is currently going on around you in the moment rather than what is running around inside your head.
2. A second exercise: close your eyes or, if you are in public stare at a single spot. Slow your thoughts, if you can and if you can’t simply listen and concentrate on your breathing. Often when you have anxiety or an anxious moment, your breathing will become shallow and fast. Forcibly concentrate on trying to extend your breathing time – both in and out. Count the seconds in – make it as long as you can – and then count the seconds out – again as long as you can. And finally, if you can close your eyes, listen to your breathing. Listen to the quality of the breathing.  Listen to it going in and out of your lungs. Feel the rhythm of your breathing and your ribcage expanding and contracting and your shoulders relaxing. Get “in touch” with your body and your bodily sensations while you do this exercise.
3. Finally, the third exercise is not really an exercise, but a good suggestion. This suggestion is also useful for depression. You see, depression and anxiety can often be two sides of the same coin. It’s too long to talk about here, but people can flip from having no or low energy – depression, depressed mood to hyper-anxious and endless running thoughts. In this instance the best suggestion is: Get Out of The House! EVERYDAY!   Often, a simple change of scenery can change your thought patterns if you’re into a groove – be it anxiety or depression. For anxious people, getting outside of their heads (and into their surrounding environment, observing the trees, the flowers, hearing the birds, etc.) can be useful to take their minds off of their problems. For depressed persons also, getting out and about is useful, because depressed people will often isolate themselves. One good way to alleviate depressive symptoms is to get out (and ideally socialize). Again being able to interact with the world, even in just a small way, will often help lift a person’s mood.

For Depression:

Depression can run the gamut from just low mood or the blues to full-scale depression, where you isolate yourself, can see no other option or solution to your current problem and see no end in sight. Your energy is at an all time low and you have little hope and don’t feel like anything you do will be of any use. You may feel “beaten up” or “beaten down” and feel despondent, guilty, despairing and like there is no way out of your situation. It is most hard for people who are depressed to feel “revved up” or hopeful. Hope, you see, generates positive thinking and positive thinking generates energy and initiative to do things.

 

1. Again, just like anxious people: Get Out of The House! EVERYDAY! Just the mere physical act of getting out of your (literal) current environment can help to change your mind and brain. External stimuli – birds, flowers, sights, sounds, saying hi to the neighbour or going to the store or downtown to go shopping, helps to lift your mood.
2. Physical activity --  of any sort, helps to get things going. Natural endorphins are released into the body. Especially if this is hard, physical activity. Your heart is pumping; your blood is flowing. You are literally “on the move”.
3. Set a task and accomplish it that day. Do not make the task too big or you will defeat the point of this exercise. You see, with depressed persons, often they have a lot of inertia – inability to get up and get on with things, simply because they are, well, depressed! So as a result of feeling inertia and an inability to hope they tend to isolate, become bogged down in their depression, hopelessness and inertia and tend to vegetate or do nothing. This is precisely why you should get out of doors every day. Just to do something physical and active. However, if you also combine it with a moderate, ACCOMPLISHABLE (is accomplishable a real word?) task or goal you also increase your sense of well-being and hope and thus lift your mood.
4. Finally, a last exercise or suggestion for warding off the effects of depression.... until you can see a counsellor or therapist, is to do something for someone else or volunteer. This tackles a number of the above exercises. It gets you out of the house (changes your mind/brain chemistry and your environment). By the way, anybody remember the video by Sheryl Crow from a few years ago entitled: A Change (would do you good). The link is here: Check it out. It’s all about the craziness of people’s lives and how – taken from a broader perspective – like an angel or a benevolent witch up on a cloud somewhere – it would make you laugh, seeing the ridiculousness of it all. This helps a lot with depression.

 

 

1. And if you want a really good laugh, and want to see this illustrated on a bigger broader perspective, check out Pedro Almodovar’s film from the 80’s, Women on the Verge of a Nervous Breakdown. Same principle as the Sheryl Crow idea, but just reframing the idea of chronic frustration.

  Moreover, volunteering or doing something for someone else helps you to get a task accomplished (see exercise 3). And volunteering, or doing community work, like, ahem, the kind that Lindsay Lohan or Paris Hilton has had to do in the past (‘cause we all know orange IS the new black), helps you to gain a sense of usefulness to the world, a sense of purpose, which depressed people often lack but also helps to increase your sense of gratitude. Despite your personal situation, there will ALWAYS be people who will be worse off than you. Guaranteed. And this does not mean to say that you need to suffer your situation, regardless of what it is, but rather that there will always be people whose personal situation is far worse than your own.

So that is it in a very brief nutshell.  But bear in mind that these are exercises and suggestions for keeping yourself together UNTIL you can see a therapist and if you’re in an emergency, reach out for immediate help by dialing 9-1-1. They are not meant to be permanent solutions. They are like putting a temporary patch in a roof while it is leaking, until you can afford to, or until the weather dries up to put a new roof on your house.

 So until then, keep your house and your soul together,

Take Care,

I welcome comments, questions for clarification and dialogue respectful to this post and any others.
And if you are interested in this or other posts, why not click on the Google + button or submit your email, either way, and follow?

Steve.

 

 

When Talking to friends isn’t enough: When to seek professional help in counselling.

 

As my second entry in this blog, I would like to start to talk about psychotherapy, counselling  and what is the difference between: counselling, psychotherapy, psychiatry, psychoanalysis and generally just to help dispel some of the myths and misconceptions out there.

 

First of all, what is counselling or psychotherapy? And how do I know what it is and when I need it? Well, psychotherapy or counselling is really no different from talking to a good friend or buddy about problems and issues you might be struggling with. The only major difference is really is that the psychotherapist or counsellor has more skills at listening and reflecting back to you what your story is and what you are suffering with. This assumes of course that your friends have enough time and patience to put aside their own needs and agendas when talking with you to be able to do this. Not all friends can.

 

Moreover, because they are friends or buddies, they sometimes have an interest in maintaining your current situation, aka the status quo. Perhaps for example you have a drinking buddy and you want to quit drinking. In this case, although your buddy may hear your concern about drinking, chances are, he (or she) won't exactly support your efforts to quit. And so, counselling is like just speaking to a friend or buddy, but friends or buddies may also have an agenda. A lot of simple emotional difficulties can indeed be solved just by talking it over with a friend, but some cannot.

 

So, say the problem is complicated, and maybe talking to a friend is not so useful, because your friend just “doesn’t get” your problem or like talking about the example above, the friend has a vested interest in you staying the way you are! What to do then? Then you should probably speak to someone else or speak to a counsellor.

 

But what if you are having a problem, you friend DOES listen and knows how to listen and she or he does not have an interest in swaying you in one direction or another.  How do you know when you need to seek professional help and your friend can no longer help you?

So, you need to look for clues in your friend’s behaviour.

 

First off, do they say up front: “You need professional help!” , or something like that – That’s a huge, big red flag clue. You need go no further. Do not pass GO, do NOT collect 200 Dollars. Put down the Monopoly Game. Look for a counsellor or psychotherapist.

 

Secondly, how does your friend react when you want to talk about your problem? Do they sigh? When you ask if you can speak to them, do they put you off or try to brush you off or try to avoid you or the meeting or try to “reschedule” your talk together? This is possibly an non-verbal, unspoken clue that they either are emotionally exhausted trying to help you grapple with your problem and/or they themselves feel helpless to assist you and don’t know how to help you.  They may be trying to be a good friend: helpful, supportive, but the problem you present them with may be so complicated or overwhelming they may not know what the right thing to do is.

Big clue:  if you ask them point blank: “What should I do?” and they answer: “I am not sure. I really don’t know”. 

Look at it this way, if you feel that you are at a standstill in resolving the problem just by talking to your friend, then you probably are. Next step: go find a counsellor!

So if you are talking to your friend about something as complicated and powerful as feelings of suicide, depression or trauma. Almost for sure, your friend will not know what to do. Seek a counsellor.

 

And finally, in what typical situations should you seek out a counsellor right away, if you were thinking of just talking to a friend in order to “get over it”.

Here is a short, helpful list of emotional situations where a person would benefit from seeing a counsellor or seeking professional help:

 

1.      Long term blues (or depression): crying, sleeplessness, worry, anxiety – that has lasted more than a month or two. Feelings or thoughts that you are better off dead or wanting to kill yourself.

2.      Intense feelings of anger or hatred towards someone else that have lasted more than a month or two.

3.      Recurring nightmares, sleeplessness, “flashbacks” or seeing stuff that you witnessed before. These are trauma-like reactions.

4.      Any major (negative) change in your behaviour. This is usually another clue that something is not right. So,... major loss of weight. Major gain in weight. Major change in sleep patterns – sleeping too much, not sleeping enough, having broken sleep. Major increase in substance use. For simplicity, just think: Major Change, or simply Major.... majorly!

Seriously though, if you or your friend(s) recognize a significant (negative) shift in your behaviour, then it’s likely something’s going on and you should speak to a therapist. And hey, if nothing is going on it won’t hurt. It’s like going to the doctor for a pain in your side. It might be nothing at all just a muscle twinge. But then again it might be something more serious.

 
I welcome comments, questions for clarification and dialogue respectful to this post and any others.
And if you are interested in this or other posts, why not click on the Google + button or submit your email, either way, and follow? 

Take care.

Steve.