PsychoBabble

New Thinking in Illness Study

2011-09-20T14:31:00.001+10:00

This study looks at how the way that we tend to think a lot about certain things might influence our thoughts and behaviours that relate to acute illness, represented by cancer, and chronic illness, represented by diabetes. Increasing our understanding of how people think in response to illness may help identify individuals who may experience difficulties in adjusting to illness and also guide us in developing ways to help you overcome these difficulties.

To participate in this study, you need to be aged 18 or over and have been diagnosed with any of the following: Type I or Type 2 diabetes, breast, colorectal, gynaecological, prostate or skin cancer.

If you'd like to find out more about the study, please visit Thinking Style in Illness

NEWSFLASH!!! Now open to international participants.

Direct Current Stumulation Study

2011-09-20T14:28:00.001+10:00

Researchers:

Associate Professor Colleen Loo (UNSW / Black Dog Institute)

Organisation:

School of Psychiatry, UNSW; Black Dog Institute, Randwick NSW

Details:

Researchers are investigating direct current stimulation (DCS) as a treatment for depression and potential alternative to medication and other brain stimulation techniques such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS). Very weak currents are used to stimulate the brain. The stimulation is painless with no known serious side effects, and the person is fully awake and alert during the treatment sessions. Participants will be required to attend the Black Dog Institute from Monday to Friday for 4 to 8 weeks usually for 45 minutes per visit.

Participants required:

Participants must be at least 18 years old and experiencing feelings of depression for at least 4 weeks prior to study entry.

Contact:

If you would like more information or are interested in participating, please call Angelo Alonzo on (02) 9382 3720 or Donel Martin on (02) 9382 9261 or email TMSandDCS@unsw.edu.au

Life....

2011-05-07T16:09:00.000+10:00

Life keeps getting in the way of this blog. So far this year, I have broken three front teeth in a bad encounter with some Scottish shortbread, been hit in the chest by a tree felled by Practical Man (he's NOT a lumberjack and he's definitely not okay!) and now this week put my car out of action by taking out the front of it while reversing down my driveway. No, it doesn't make sense...but I have a very steep driveway, my car slid in the rain on to a wall and then when I tried to get it off the wall, crrunch.

Add to that PhD deadlines, other exams and my mother, in the UK, being diagnosed with dementia, I'm kind of thinking I'd like to rewind this year and start again!

As I am always saying, back soon.

So long Spud

2011-04-14T12:21:00.000+10:00

There was talk in the media last week about a study that showed women care more about their dogs than they do their partners. Of course, it wasn't a serious study, just a survey of pet owners, see here if you're interested to read more. I thought how threatened must PracticalMan be living in a house of three dogs?

Well, today that number shrunk to two as we made the difficult decision to put our beloved golden retriever Spud (noble sounding name I know) to sleep. At the grand old age of nearly 15, and we'd hoped he would make it, Spud suddenly deteriorated overnight. As hard a decision as it was to make, it' was obvious that there was no alternative if we wanted to spare him any suffering.

The Dish (daughter, for new readers) is devastated. Spud had been there every minute of her life. Lifelong friends, they've shared many happy moments together. Spud made me feel safe when PracticalMan was away even though he'd have made any intruder his new best friend. At our previous house, Spud was very smart at finding new ways to escape the back yard but it was never hard to find him. We knew we'd find him at the local shops, curled up under a cafe table, gladly receiving any titbits anyone cared to throw his way. Being such a gorgeous looking dog, he got plenty.

So long dear friend.

Spud, gone walkies.

Hey, good looking!

2011-04-12T16:18:00.002+10:00

PracticalMan takes it in his stride when I eye up French chef Manu Feildel. In fact, he finds it rather funny (and occasionally beneficial) that I have developed a sudden interest in French cooking. Similarly, I don' t blink an eyelid when he rushes to watch anything involving former Miss Universe Jennifer Hawkins, although there's no apparent benefit for me there. 'Chacun a son gout ' as Manu would say in his gorgeous French accent. Let's face it, he could be saying 'Your drains need cleaning' and it would still sound fabulous.

Well, it seems we may be on to something according to a new study published in the Journal of Personality and Social Psychology. While you might reasonably expect that a wandering eye would be detrimental to a relationship, trying to rein in that eye might actually be more destructive to a relationship. Based on the concept of 'forbidden fruit', of wanting what you can't have, trying to limit that wandering eye has a three fold effect in that it reduces satisfaction with and commitment to a relationship whilst increasing memory and attention for attractive relationship alternatives. So, the more I'm not allowed to indulge my newly found passion for 'French cooking' *wink wink*, the more I'm going to think about it, to want to and the more 'ticked off' I'm going to be with PracticalMan when I can't.

Important things to note about the study that may limit these findings are that (1) there was no French chef involved (2) most of the participants were undergraduates and so in early stages of relationships and (3) there was no followup to see if relationships were in fact impacted.

Of course, PracticalMan is sensible. He knows Manu is no threat and, more importantly, he knows which side his brioche is buttered.

For more on the study, see the reference below.

Resource:

DeWall, C. N., Maner, J. K., Deckman, T, & Rouby, D. A. (2011). Forbidden fruit: Inattention to attactive alternatives provokes implicit relationship reactance. Journal of Personality and Social Psychology, 100, 621-629.

The perils of self-disclosure

2011-04-08T10:41:00.000+10:00

I've had a recent spare of new clients complaining to me recently about past therapists, psychologists, counselllors and their preference to talk about themselves. There was the psychologist who liked to spend the session talking about the trials and tribulations of his weekend angling trip, the counsellor who thought that discussing work place issues gave her carte blanche to talk about her own frustrations. This information was given to me early on just in case I might be feeling the same need to unburden myself and to stop me in my tracks.

Self-disclosure, the divulging of personal information about the self, presents a considerable ethical dilemma in therapy, a situation made more difficult by the internet search engines and social networking sites. Not all self-disclosure is intentional. Several clients have told me they've Googled me. I immediately went home and Googled myself. Not too much to worry about there... a few sleep-inducing research papers and not much else. I restricted access to my Facebook page, not that I have ever really bothered about using it. Sometimes self-disclosure is unavoidable. When I was out sick for a while, clients knew that about me, and I had to be extremely careful in dealing with questions about it when I returned to work.

But what about intentional self-disclosure? Used sparingly and judiciously, intentional self-disclosure can be therapeutic, can help to build the therapeutic alliance. It's a double-edged sword, however, and careless or excessive use of disclosure can make make the client uncomfortable, burdened and transfer the focus away from client to therapist.

Similarly, how you deal with requests for self-disclosure from the client is critical. When a personal question is refused with a flat: "no", it may be destructive to the therapeutic relationship. For example, in an environment where trust is key, people might feel there's a lack of reciprocal trust. Maintaining good boundaries at all time is essential but softening that refusal by explaining how the sharing of personal information would change the nature of the therapeutic relationship and exploring the interest further can be useful.

Client side, therapist side - what's been your experience with self-disclosure? What's helpful? What's not?

The Fun of Flying

2011-04-01T19:24:00.001+11:00

I've had some interesting times working with clients with a flying phobia. Luckily for me, no one has requested in vivo exposure. While I'm not phobic, I certainly don't enjoy flying as much as I used to and the 24 hour flight home to the UK is the stuff of nightmares.

When I do go, it's via the US (slightly longer) just so that I can fly Air New Zealand. Blogpal Reality Ravings first blogged on this safety video because it features Phil Keoghan (The Amazing Race) with eyebrow.

So much fun, it even makes me feel like flying.

Comment Moderation

2011-03-31T10:10:00.000+11:00

After some inappropriate comments on very old posts were drawn to my attention, I have decided to implement comment moderation.

Hop on over to help out the kids hospital

2011-03-30T13:36:00.000+11:00

Join the Lindt gold bunny hunt. Yes, you can win $20000 but, more importantly, Lindt are donating $1 for every sign up for the hunt to the Westmead Children's Hospital...up to a grand total of $20000 which has not been reached yet.

It's chocolate, it's bunnies...what are you waiting for?

DSM-V Subcategory Facebook Depression?

2011-03-29T19:15:00.000+11:00

If you believe news reports today, you may be bracing yourself for a new subcategory of mood disorder 'Facebook Depression' in the upcoming DSM-V (diagnostic manual for psychiatric disorders). Researchers claim that this is a possible outcome among adolescents who obsess over Facebook. Dr Gwenn O'Keeffe, the lead author of new American Academy of Pediatrics social media guidelines points out that social comparison may play an important part in making adolescents feel they don't measure up. Comparing number of friends, reading about how others seem to be having non-stop fun, Facebook can provide a skewed version of reality.

Of course, 'Facebook Depression' is not really slated for entry in DSM-V and the validity of this study is highly questionable. It's a catchy term, it draws a lot of media attention...Google 'Facebook Depression' and you'll come up with many references. Maybe, and I don't want to be out there with this idea, people with depression just happen to use Facebook? If you want to read a really good analysis of this research, look no further than Dr. John Grohol over at PsychCentral.

I'd write one myself but according to this study, I should be severely depressed, judging from the limited number of friends (and the good times that they're having - you know who you are!) on my Facebook page.

Self-help resources

2011-03-28T11:32:00.000+11:00

Stumbled across the Centre for Clinical Interventions this morning while looking for something else.

There's a whole series of information packs downloadable that may be of interest to both consumers and practitioners. Topics include assertiveness, low self-esteem, depression, bipolar, disordered eating, perfectionism, shyness and worry.

Earth Hour

2011-03-26T20:25:00.000+11:00

Well, after work today, I decided to fiddle around with this blog a little. I've posted the first book of the month (early for April but hardly worth nominating a book for March!) and reinstated the 'Upcoming Events' in the side bar.

In less than half an hour, we hit Earth Hour and so it's computers off, lights out. OMG....we'll have to talk to each other!
Check out the Earth Hour website.

See you on the other side!

Book of the Month (April): Change Your Thinking

2011-03-26T18:31:00.002+11:00

For me, this is simply one of the best self-help books I have ever read. As further testimony, nearly every person that I have lent this book to has gone out and bought their own copy.

So, what's to like?

I like that it takes the basics of cognitive behaviour therapy and applies them in dealing with a wide range of emotions such as anxiety, depression and anger. I like that it does so in such a way that is understandable to the non-therapist but without completely dumbing down concepts either. I like that it is extremely easy to read and has inbuilt exercises (with solutions). I like that, after therapy finishes, this book continues to be a practical tool for people to revisit skills learnt during therapy. I like that later people tell me 'I'm still using that book you recommended....'

Chapters include:

Cognitive Behaviour Therapy (CBT)
Recognising Faulty Thinking
Disputing Negative Cognitions
Overcoming Frustration
Managing Anger
Coping with Anxiety
Maintaining Self-Esteem
Recovery From Depression
Taking Charge
Effective Communication
Being Happy

Unfortunately, there is no preview available on Amazon.

For those lucky enough to be living in Sydney, Sarah Edelman is running a course on Changing Your Thinking over 8 sessions from the 3rd May to 21 June 2011. See here for details.

Read this book yourself? Leave a comment and share what you think of it.

Don't forget...if you've come across any good resources yourself, drop me a line.

Am I getting on your nerves?

2011-03-24T14:29:00.000+11:00

Arrrggh!!!!

I take it that's a 'Yes'?

Well, for a change of scene, hop on over to The Nerve Blog, a blog written and edited by Boston University undergrads that covers a scintillating range of topics including neuroscience, biology, pharmacology, computer science, psychology and philosophy. Entries range from reviews of current scientific literature to neuroscience in pop culture to opinion and commentary pieces.

A veritable neuroscience smorgasbord. Enjoy!

Good reading

2011-03-23T14:13:00.001+11:00

Let me say upfront that I'm not going all Oprah and starting up my very own PsychoBabble book club. However, I often recommend books that I think will be a useful 'side serve' to therapy to clients and often lend items for people to look at before they choose to part with their own cash, although it sometimes backfires on me and I don't get them back! So, I'm thinking of starting a side bar item with a recommended book of the month. If you want to find out more about the particular item, you can locate the corresponding post that will be titled as per the book.

I'd be really interested to get feedback from anyone who has read any of the items that feature. More importantly, I'd love to hear some suggestions from readers of this blog as to books that they have found useful.

Of course, I hope to feature blog pal Dr. Deb's book once I get my hands on a copy.

First book will be up in a day or two.

National Day of Action against Bullying and Violence

2011-03-18T16:06:00.005+11:00

Today is the first in Australia's new annual community campaign to address bullying and the focus for this year is bystander behaviour.

What does that mean?

It might seem like bullying concerns only the individual under attack but bullying involves us all. Bullying negatively impacts on everyone's environment, standing by and doing nothing effectively makes us bullies by association. We all have a role to play in ending bullying, a role that is more important than ever now that bullying can reach right into the victim's home via SMS, email and Facebook.

While much of the focus is on bullying at school, let's not forget that workplace bullying is also on the increase. A fact that is reflected in the number of clients with workplace bullying issues that I have seen in the past year. For a reminder on workplace bullying, see my earlier post.

Resources

Bullying? No Way! web site created by Australian educational communities
Parent tool kits and videos with leading child and adolescent psychologist Dr. Michael Carr-Gregg
Managing bullying at work, APS article
Workplace bullying, APS article

Great expectations

2011-03-16T10:03:00.003+11:00

I've had several opportunities to think about expectations recently.

There are the clients who, at the start of therapy, are insistent on a strategy that will magically and, more importantly, immediately transform their lives. There are the clients who have started medication and are disappointed to find that, although they may feel a little better, their troubles have not completely resolved or that the medications come with their own costs. Then there's me. I'm not immune from having my own set of high expectations either. As someone with chronic illness that sometimes throws up odd and unpleasant symptoms, I'm guilty too of wanting my doctors to fix it right now.

It would be nice if we could all get our wishes met....if I had that magic wand that I could wave at my clients and their life would magically be transformed.....if I could wave it at myself and suddenly become a bastion of great health.

It's not realistic though and one of the hardest things, particularly in starting therapy, can be to work through acceptance of the fact that change requires time and often considerable effort. Managing expectations in this respect early on is critical to successful therapy.

Expectations come into play later too. Often people expect a straight line trajectory to recovery. Once people start to see an improvement, and this can be valid both in relation to physical disorders and in the management of health conditions, the general expectation is that recovery will simply continue. Yet it is quite common, in both situations, for progress sometimes to go backwards.

This can be quite devastating and often underestimated by physical and mental health practitioners and even by those who love and support us. The thing is, when this happens, it can be be hard to remember the progress made since the onset of our difficulties. In some ways, a step backwards can be more difficult to cope with that the original onset of our problems.

In terms of psychological disorders, relapse can be quite common and part of building people's resilience must involve the management of expectations in this respect and the provision of strategies to recognise when this is occurring so that remedial action can be taken early on.

I always draw a distinction between lapse, a return to some of the behaviours seen in at the onset of a condition suchas hypersomnia, and relapse, a return to most or all of pre-treatment behaviours. A lapse is what will more typically be seen and, if picked up, can allow the implementation of a pre-planned strategy to prevent things from getting worse.

An important thing to do is to kearn to recognise and act on early warning symptoms which will vary by disorder and by individual. When things appear to be going a little pear-shaped, it can be easy to dismiss their importance and to start to avoid certain situations that draw our attention to the fact that problems are beginning to reoccur. For these reasons, and because sometimes the road to lapse/relapse can be subtle, others can sometimes help us to pick up on a lapse earlier. It can be helpful to have someone who can be trusted aware of early warning signs with permission to draw it to our attention if they notice two or more symptoms. Trusted, however, is a word that cannot be stressed enough.

For ourselves, it is important to avoid any tendency towards 'all or nothing' or 'overgeneralisation' thinking....that the return of one symptom means our condition is fully returned or that because we're not functioning so well in one area, all the gains we may have made in other areas are lost. Recognising these thought patterns and challenging them with the evidence, making an effort to recall gains made, can be helpful.

What have your experiences been with managing expectations either as an individual with a physical or mental illness or, from the flipside, as a health practitioner? What do you find helpful?

Please take time to share your views.

Finally......

2011-03-14T18:49:00.002+11:00

......something sensible written about Charlie Sheen.

Japan

2011-03-12T16:31:00.002+11:00

It was only recently, in the wake of the Christchurch earthquake, the Queensland floods and cyclone, the Victorian floods and the WA bushfires, that I posted on the disaster resources made available by the Australian Psychological Society.

Now, there is the terrible news of the earthquake and devastating tsunami in Japan.

Quite simply heartbreaking. What's heartening is the mobilisation of so many nations around the world to extend help. My thoughts are with those affected and with those that will be involved in the search and recovery missions.

A word of caution

2011-03-12T16:08:00.004+11:00

Most of us are iPhone, iPad or iPod users, most of us will have an account with iTunes.

I had my iTunes account hacked this week, with downloads of games neither I or anyone else in the family has ever heard of.

Make sure you keep track of what is downloaded on your account because Apple's response was less than helpful, particularly given that Apple request a debit/credit card to use iTunes. Their suggestion? We take the matter to the local authorities. Like they don't have bigger things to worry about.

A little bird told me.....

2011-03-07T14:30:00.003+11:00

A little bird told me about blueboard, an online support group for people with depression, anxiety disorders, bipolar disorder and borderline personality disorder and their carers. The aim is to provide support and opportunities for people to share coping strategies.

Note that the board is moderated with strict protocols to enhance safety and participation in free and anonymous.

Rare Disease Day

2011-02-28T10:31:00.003+11:00

Today is Rare Disease Day, an awareness initiative for those with rare diseases coordinated world-wide by Eurordis, a non-governmental, patient-driven alliance of patient organisations representing more than 434 rare disease patient organisations in over 43 countries.

From the press release:

'Rare diseases are life-threatening or chronically debilitating diseases. Due to the low prevalence of each disease, medical experts are rate, knowledge is scarce, care offering inadequate and research limited. Very few cures exist. While the diseases are rare, collectively they affect more than 60 million people in Europe and the US alone. Despite their great overall number, rare diseases patients are the orphans of health systems, often denied diagnosis, treatment and the benefits of research.'

The focus this year will be on the health inequalities faced by many rare disease patients.

"Most rare disease patients spend years wandering through the maze

of health systems to find an accurate diagnosis. Many are fighting to

obtain life-saving treatments or to be reimbursed by their health

authorities. Others are denied access to services and to disability

compensations. They have further difficulties finding a job, getting

into school, obtaining a loan or accessing life insurance."

Yann Le Cam, CEO, EURORDIS

How can you help?

Get involved by bringing this day to attention.

Visit the Rare Disease Day website.

Have a rare disease yourself? Consider sharing your story.

2011-02-28T09:06:00.004+11:00

News comes this morning that child care centres in Queensland are following a lead from the UK and banning 'Baa Baa Black Sheep' for its racist overtones.

Is the world going crazy? Should we be teaching our kids 'Baa Baa Rainbow Sheep'? or do you think as I do that making an issue out of the colour of a sheep is actually counterproductive? Interested in your thought.

Thank you

2011-02-27T16:03:00.002+11:00

Over the past year and a half, I've put up a link to either of my two online studies looking at the way people think about illness. I'm just about to stop collection of data on the second study and now starts the hard work (for me, at least) of the statistical analysis of the data and later the write up and (hopefully) publication of the findings.

Being able to conduct psychological research online is great. It opens up your study to participation by a much wider range of people. I certainly very much appreciate the people that have taken the time to complete my questionnaire.

So, a very BIG THANK YOU to everyone who helped me out.

Coping with disaster

2011-02-24T15:57:00.007+11:00

Bushfires, floods, cyclones...Seems that Australia has pretty much copped everything in the past couple of months. Now with the latest disastrous events in Christchurch, New Zealand, it seemed timely to point out the following resources freely made available by the Australian Psychological Society for coping with disasters:

The Psychological Cost of Disasters

Flood resources

General disasters

International Disasters

Bushfire disasters

Direct current stimulation study

2010-10-17T11:40:00.002+11:00

Title:
Direct Current Stimulation as a non-medication treatment for depression

Researchers:
Associate Professor Colleen Loo (UNSW / Black Dog Institute)

Organisation:
School of Psychiatry, UNSW; Black Dog Institute, Randwick NSW

Details:
Researchers are investigating direct current stimulation (DCS) as a treatment for depression and potential alternative to medication and electroconvulsive therapy. Very weak currents are used to stimulate the brain. The stimulation is painless with no known serious side effects, and the person is fully awake and alert during the 20 minute treatment sessions. Participants will be required to attend the Black Dog Institute from Monday to Friday for 3 to 6 weeks usually for 30 minutes per visit.

Participants required:
Participants must be at least 18 years old and experiencing feelings of depression for at least 4 weeks prior to study entry.

Contact:
If you would like more information or are interested in participating, please call Angelo Alonzo on (02) 9382 3720 or Donel Martin on (02) 9382 9261 or email TMSandDCS@unsw.edu.au

Remembering

2010-08-09T08:26:00.000+10:00

Paul Robert Eckna.

Denis Lavelle.

"Death leaves a heartache no one can heal, love leaves a memory no one can steal."Source unknown.

This is one thing I said I would never forget to do, no matter how busy or hectic life was.

About this time in 2006, along with many fellow bloggers, I took part in the 2,996 project to remember those who lost their lives on September 11th.

I was assigned to post tributes to Paul and Denis. September 11th had a huge impact on me, even though I was half a world away. Taking part in the 2,996 project, learning a little about these two men, simply reinforced the sheer horror of that day and my resolution never to forget. I've often thought about Paul and Denis over the past year and I resolved that I would remember them both here every year.

Please join me in taking time to remember Paul and Denis over the next few days.

Men wanted!

2010-08-02T14:24:00.003+10:00

How's that for a headline?

Well, sad to say, it's not for anything exotic. Just for the study. If you are of the male persuasion, please help out by visiting the study here.

Of course, women are still welcome!!

Long time, no blog

2010-07-21T21:34:00.002+10:00

Wah! Where exactly does time go?

This poor blog has been so neglected and I'm missing updating here and catching up with my favourite blogs. So good to see the return of Alison and excellent to hear from old blogpal McKay. Still snowed under, with little disappearing off my to do list.

Study still in progress but lacking numbers and particularly needing men. FOR THE STUDY...just to preempt any funny emails!

Recently had to put my 15 year old cat Mahjong down. Just had a feeling that his health would decline when no one else was around and I would have to handle this alone. Let me tell you I blubbed like a baby. The vet said I could buy him some more time by draining his lungs again but the best thing to do for him would be to end his suffering. Gathering all my resources, I got myself under control. All well and good until Practical Man, stuck at work, sends Mahjong a farewell text. Wah! Thanks.

I hope to be blogging more regularly now as I have a shiny new iPad that allows me to blog in bed..aren't you glad you can't see me?....sadly about the only free time I have!

Missing in action

2010-05-14T17:17:00.004+10:00

I can't believe, well, yes I can, that I have let this blog lapse again. Loads of good intentions, all swept away under a tidal wave of work. I know now why PsyBlog posted lists of things she had to do. Basically, that's how life is currently, lists of things to do...and never getting to the bottom of the list.

I haven't forgotten this blog or the others but am currently tied up with.....

1. Finalising a paper for publication
2. Writing a chapter for a book due at the end of July
3. Managing my current study that I've plugged extensively on here!!
4. Writing up the first study
5. Preparing the next study
6. Completing an advanced course in psychopharmacology
7. Marking copious numbers of student papers
8. Working in private practice

I will be back soon. I've realised I need this blog for my own sanity.

For all those who have taken part in my study, THANK YOU!!!

Still need big numbers, so if you have a few moments and need that kind of excitement in your life (ha!), please see blog post below.

Research study, participants needed

2010-03-19T16:42:00.001+11:00

This will explain why I have been absent from the blog.

Rumination and Informational Preferences in Psychological and Behavioural Outcomes in Illness: Reliability and validity testing of the Multidimensional Rumination in Illness Scale (MRIS)

This project is part of a research program that examines the role of ruminative thinking in psychological and behavioural outcomes in illness. In looking at the way in which thinking style influences a person’s emotional and behavioural response to illness, it is hoped to provide a way of identifying individuals who may experience difficulties in adjusting to illness and also guide the development of appropriate interventions.

This stage of the project involves validation and reliability testing of the newly-developed Multidimensional Rumination in Illness Scale (MRIS).

For this project, I am seeking English-speaking people who are over 18. Participation involves the completion of an on-line questionnaire, which will take approximately 30 minutes.

This study has been approved by the Macquarie University Ethics Review Committee (Human Subjects).

If this project is of interest to you, please go to the following website to start the questionnaire:

Thinking Style in Illness

5000 bum salute

2010-03-02T13:58:00.001+11:00

What Sydneysiders do with their spare time.

Not this one though!

Breathing space

2010-02-28T16:37:00.003+11:00

A regular practice of mine is a so-called 'Mental health day'. When the combination of work, study, chronic health problems and whatever else gets all too much, I schedule a down-day. A day where I do as little as I feel like. I can veg and watch DVDs, lie on the bed and read a book, potter around the garden. I have two rules: I must not specifically set out to achieve anything

AND I am not allowed to feel guilty about taking the time out. A day like this and I'm good to go again.

Lately, I'm not been even getting the option to think about that. However, the 'mini-mental-health' fixes are endless. How about a 10 minute chat, coffee in hand, with friends and family over Skype, a quick read of my favourite blogs, a quick browse of You-Tube for a favourite comedy sketch for starters?

My absolute favourite though is a quick trip to my favourite city, Vienna, courtesy of Merisi at Merisi's Vienna for Beginners. Stunning new photos of Vienna every day, accompanied by beautiful text. Sometimes landscapes, sometimes city shots, sometimes people, sometimes coffee and scrumptious cake (calorie free when enjoyed vicariously). Always a brief respite for the mind. If you haven't discovered it already, I urge you to check it out.

What's your mini-mental-break?

2010-02-26T20:12:00.003+11:00

Yes, it's been a long time between posts again. Now I know why some posters make 'to do lists' on their blog because it's probably the only opportunity they get to put something up.

Things have been a little crazy. Ethics submission for the new study, preparation of the survey for the new study, a conference presentation, a re-edit of a paper, a supplementary course, revision of the literature review, analysis of the last study...add work on top and you can probably understand why I haven't been here much.

Hopefully, I'll get the new study launched in the next week and have a big more free time. If not, it's time to revisit those time management skills again!

Thank God it's Friday

2010-02-05T13:50:00.002+11:00

I'm sure the guy above agrees. I thought my week was bad.

Blowout in mental health costs

2010-01-30T18:00:00.004+11:00

Reports today on Medicare blowouts on psychological therapy, with costs estimated to reach $1.5 billion by 2011.

A welcome move in 2006, concerns are now being raised that the scheme is not benefitting the disadvantaged most at need of such a service, with many patients still being hit by out of pocket expenses to cover the gap between psychologist charges and the Medicare rebate. Certainly, while I bulk bill (no gap) some clients, low-gap others ($25), the decision as to who gets what rate is made on the basis of individual circumstances but also the need to make the practice viable.

With the budget up for review shortly, it will be interesting to see what transpires.

Site of the week: Australian Psychological Society

2010-01-28T08:38:00.004+11:00

Useful resources for community members can be found here. Topics include:

Addictions

ADHD

Coping with traumatic events

Depression

Psychology and climate change

Workplace issues

Also, a series of tip sheets are available here.

Recognition for mental health

2010-01-26T09:55:00.003+11:00

Happy Australia Day.

Good news comes in the recognition of an eminent psychiatrist Professor Patrick McGorry as Australian of the Year. Probably not many people outside of the mental health field will have heard of Professor McGorry and so it's great to see, in this award, that some recognition is going to the importance of mental health issues.

24 hours post award, Professor McGorry has already ruffled some feathers with his comments on Australia's detention centres as factories for mental illness'. Read more here.

Facebook F-Grade

2010-01-25T15:16:00.009+11:00

Months ago I set up a Facebook page. I haven't really bothered with it since and every time I've visited it, I'm overcome with the 'noise' generated....requests to play this, respond to that...much of which I can quite honestly say I don' t have a clue how to respond to! Mafia Wars? Snowball fights? How? I'm Facebook ignorant and probably happy to stay that way.

In the end, I think (and I'm not I even did this correctly) I posted a notice saying that I was on 'L' plates with Facebook and unlikely to progress, so people should not take any non-response as a personal slight.

Some people I know with Facebook accounts have friends in the thousands. I think I remain on single digits. Today, I fool myself into some sense of 'being okay' having read about the Dunbar Number.

Oxford (coincidentally my home town) University Professor Robin Dunbar examined social groups from the villages of the past to modern-day urban environments and found that no matter how sociable we were, the part of our brains that handled interaction, defined as caring for and having interaction with more than once a year, could only process 150 friends.

Well, I fall way short of that. Not sure what that says about my cognitive processing.

What about you? Social network butterfly or social network caterpillar like me?

To read more on this subject, go here.

Thank God it's Friday

2010-01-22T16:52:00.001+11:00

Empire of the Sun. Divine.

Hold it, hold it!

2010-01-21T16:01:00.003+11:00

Yep, it's not quite Friday yet.

According to a paper published in this month's Journal of Social and Clinical Psychology, by this time tomorrow (well, adjust according to your time zone), we should all be feeling happier, with more energy and less aches and pains. These findings held across age, gender, income, working hours and profession. It holds even for those who love their work. Clinical support for 'The thank God it's Friday' syndrome.

Isn't it good to know it isn't just in your head?

Professor Richard Ryan at the University of Rochester in New York relates the findings to the importance of free time to wellbeing. The study reinforces Ryan's "self-determination theory," which states that well-being is based on one's personal needs for autonomy, competence and social relationships. The competing demands of work can make those needs difficult to achieve.

Meanwhile, what about those of us who don't work Friday or who have to work Saturday? Sniff.

Heartbreaking

2010-01-17T11:04:00.002+11:00

World Vision Australia appeal (Australia)

Australian Red Cross appeal (Australia)

British Red Cross appeal (UK)

DEC Haiti Earthquake appeal (UK)

Every little bit helps.

Remembering old 'friends'

2010-01-14T19:16:00.003+11:00

Browsing the internet today, I came across an old 'friend'.

Eliza, the online 'therapist', not to be taken seriously by any means. I remember having a copy of this program on my old Mac way back in the early 90s. By today's standards, it performs poorly but then we now have 'real' online therapists and the likes of e-couch and Mood Gym. Good job really!

If you haven't ever seen Eliza, have a play.

Extremes

2010-01-13T10:14:00.004+11:00

The year has started worldwide with weather extremes. Back home, my family are battling this.

While it looks beautiful and, being a cool weather person myself, I'd gladly swap, the reality is that it is making life difficult for many.

Here. in Australia, many of us are battling this with searing temperatures. Some are facing extreme bush fire conditions and have had to evacuate their homes.

In either case, a time to think about those around us who may not cope so well with these conditions. The elderly who can't get out in the snow to get food or who may not be able to afford to heat their homes and are vulnerable to hypothermia. In the heat, again those who may be more vulnerable to excessive heat - those who have illness, the elderly.

I think most of us assume that people will have family or someone else looking out for them but it's not always the case. Taking the time to ask people if they need help may just be one of the most important things we do.

A spanking, anyone?

2010-01-07T10:55:00.006+11:00

A study by Professor Marjorie Gunnoe from Michigan's Calvin College has caused considerable debate in Australia this week. According to the study, teens who were spanked until the age of six do better at school, are more optimistic about life, are more likely to take voluntary work, and aremore keen to attend than those who had never been spanked.

For the study, more than 2,600 people were asked how old they were when they were spanked and about the frequency with which they were spanked. Their responses were then correlated with information collected on behaviours that could possibly have been influenced by smacking.

The limitations of the study are clear enough. In addition, the findings fly in the face of many other studies which show detrimental effects of spanking. A press release from Society for Research in Child Development (SRCD) states studies from a number of other universities in the U.S. including Harvard and Duke concluded that spanking 1-year-olds "leads to more aggressive and less sophisticated cognitive development in the next two years."

Professor Gunnoe states her study should not give carte blanche to spank but should generate greater consideration in those that would like to see spanking outlawed. Of course, there are all kind of issues around spanking: intensity, emotional control of the parent, location among many others. However, is it the spanking itself or is it the setting of boundaries. Are other ways of boundary setting as effective? The study doesn't evaluate this.

I was spanked as a child and adolescent but in a way that is now outlawed so my view is somewhat skewed. I don't think it had any positive effect for me. What's your experience? To spank or not to spank. What's your thoughts?

Site of the Week: Psyche Visual Online Videos

2010-01-05T01:00:00.000+11:00

I came across theAustralian site Psyche Visual today when looking for some resources on anger management.

This site has a number of video resources for online viewing across a wide area of topics, with a considerable number of key contributors. No doubt the catalogue will continue to expand.

The minor downside is that it is subscription based but at $9.95/monthly for unlimited viewing (or cheaper rates for longer term plans), it doesn't seem unreasonable. I think I will probably sign up once I get this month out the way (more PhD deadlines!)

I have contacted the site owners to see if there are APS personal development points available for viewing the materials and will advise as soon as I hear back.

Therapist bad habits

2010-01-03T15:27:00.000+11:00

Ah, yes, I have to be fair.

Having raised the issue of the 'Last Minute Bomb', thanks to a reader who kindly *grin* directed me to an article by John Grohol over at PsychCentral - The 12 most annoying bad habits of therapists.

Only 12 you say?

Read the article for more depth but basically the list of therapeutic crimes reads as follows:

Showing up late for appointments Sometimes a delay can't be helped if an earlier scheduled client is experiencing a crisis situation. Having a buffer time between clients helps minimise that likelihood.

Eating in front of a client You really don't need to see me eating my lunch. However, I do have a drink of water to hand and I always offer clients tea/water to drink before starting.

Excessive yawning/sleeping during session zZzzzZzz. If I did this to a client, I'd expect them to be looking for a new therapist.

Inappropriate disclosure Therapist disclosure has to be kept to a minimum and used with excessive care. I could spend hours sharing my snake phobia with you and explore why I moved to a country with so many venemous snakes but shouldn't the session really be about you, not me?

Being impossible to reach by phone or email This is where I usually err but in the opposite direction. I believe it is important to be available but boundary setting is critical (and a work in progress on my part!).

Disturbed by phone/cell phone/computer Guilty on occasions. The practice where I work has no land line and I leave my mobile phone on mute for ease of use in an emergency. I don't want to wait minutes to get network (ah, Optus). I always explain this to new clients and everyone is fine with that. Occasionally, either because of my technical ignorance or the pecularities of the iPhone, the mute doesn't work. It's unfortunate and I apologise and reject the call/silence the phone.

Expressing racial/sexual/musical/lifestyle/religious preferences Ha. Might freak clients out totally if only they knew of my musical tastes! An 80s tragic (but, I hasten to add, no MC Hammer harem pants even if they are back in fashion).

Bringing your pet to therapy sessions What all six? That would be a madhouse indeed.

Hugging and physical contact Guilty in part. I have never initiated hugging but clients have hugged me. They have usually asked first and as this has typically happened at the end of therapy, I haven't minded. The most poignant time was for a client who had terminal cancer where we knew this would be our last meeting ever.

Inappropriate displays of wealth/dress I don't think I'll ever have to worry about the first. I'm way too much of a Brit for the second.

Clock watching Wonder why the clock sits directly behind you? When I'm running clients without a break inbetween, I must keep an eye on time and while I usually have a rough idea of how long the session has been running, it's helpful to check out time on occasions. This way I can keep track without explicitly diverting my attention from the client.

Excessive note-taking I used to be guilty of this when I first started out. I think that's possibly true for most therapists. Now I just note keywords to jog my memory later. Sorry, but I'm aging!

Years ago, I had a therapist who used to crack his knuckles incessantly which drove me insane. A good therapist, I managed my reaction to that. What wasn't managable was his insistence on smoking in sessson (obviously in more smoker-friendly times) and that was enough cause to change therapist for me. Those 'crimes' didn't make the list though.

So...anything else missing?

The LMB

2010-01-02T01:00:00.001+11:00

Or the Last Minute Bomb.

Something most therapists experience from time to time, something most of us who have been through any kind of therapy have unleashed ourselves.

What is it? A Last Minute Bomb describes that situation where session time is almost out and the client suddenly raises a critical issue, something requiring far more than the last remaining five minutes of a session. What happens next really depends on the nature of the disclosure - if a risk of self-harm or potential danger to others exists, action must be taken, otherwise the issue usually has to be deferred to the next session, which may leave the client feeling a little disgruntled or that their issues are dismissed.

There's a number of reasons why the Last Minute Bomb happens as detailed in this excellent brief article by Dr. Ryan Howes about the Last Minute Bomb in therapy.

What do you think about the Last Minute Bomb? What are your experiences? Client-side, therapist-side - do you have other views of why this happens?

Depression in older adults and their carers

2010-01-01T01:00:00.002+11:00

Introducing the sixth annual Black Dog Institute writing competition for 2009/2010.

Open to Australian and New Zealand residents, this year's theme focuses on late onset depression, that is depression that occurs for the first time late in life, after sixty years of age. Also of interest are the experiences of carers of older people. First prize receives $2000, second $1500, third $500.

Interested? You need to act fast as entries must be received by the 15th January 2010. App;ication form and conditions can be found here.

You can read winning and short-listed entries from the previous five years by following the links below:

Tackling Mood Disorders in the Workplace (2008/2009)

Mood Disorders in Adolescence - Grassroots Solutions (2007/2008)

The Getting of Wisdom - Managing the Highs of Biploar Disorder (2006/2007)

Living with Depression (2005/2006)

The Black Dog as a descriptor for depression (2004/2005)

Happy New Year

2009-12-31T10:13:00.007+11:00

Here's wishing you all a Happy New Year.

Apologies for the extended absence but, hopefully, I will be back on track with regular posting from this point forwards. Thanks to all of you who hung in there.

Over the Christmas period, we have gained another family member. You might remember the addition of Sushi, bottom photo (helping with the washing), and now 10 months old. We have now gained Wasabi, 10 weeks old, and chilling in the top photo. Both lhasa apsos. Wasabi may have some major health problems, in which case the breeder will want to take him back, but we're hoping he gets a clean bill of health later this week as he's already firmly embedded in our family.

Pets as therapy? Absolutely, and given the number of animals we now have, we should be the most chilled house ever.Or so goes the theory!

With the blog, I am tidying up defunct links. If your link inadvertently disappears or you have a new link you'd like to see added, please email me at clinhealthpsychATgmail.com.

I have checked all links at Psychobabble Resources but intend building on these resources and highlighting key information for the different areas. I want to expand beyond Australian resources. An ongoing project. Again, please, if you come across links/information that would be useful for people, please send me an email as above.

I am also setting up a separate blog Rumin8 covering my research area, rumination, to keep track of developments in rumination research but this progress on this is limited so far. If, however, you have an interest in this area or have some useful links, please email me at the address above.

Seasons Greetings

2009-12-18T17:25:00.005+11:00

Seasons greetings, whatever form that takes for you, and wishing you good things for the coming year.

Psychobabble will return in 2010.

Seasonal woes

2009-11-30T14:09:00.000+11:00

A recycled post but then this is a valid message year in, year out.

Christmas is almost on us again. A happy time for many of us, a time that invokes significant distress for others, as is reflected in the increased number of calls to the office.

Christmas is a time that heightens any vulnerabilities. Whether it triggers grief for those lost or for something we maybe never had, whether it highlights a sense of isolation or perhaps sets off traumatic memories, whether the stress of preparing and the management of family relationships hits home, the flipside of Christmas is less than positive.

Important then, as Christmas nears, that we keep an eye out for those who might not be doing so well at this time of year. Please find some helpful hints in this earlier post.

Perceptual art

2009-07-06T15:42:00.003+10:00

OK, enough of this swine flu business. Time for a change of 'scene'. Literally.

One area of psychology that always intrigued me was perception. Admire the work of 3D street artist Edgar Mueller above. My hometown (b0ttom photo) never used to look like this!

Asking the questions

2009-06-09T17:45:00.003+10:00

It always surprises me that people rarely ask questions when they start therapy. I cover all the legal and administrative issues as you'd expect. I also like to get an idea of what people's expectations are. People seem comfortable with that. It's expected that I ask the questions.

Yet embarking on a therapeutic relationship is not an insignificant matter. I wouldn't allow a surgeon to operate without asking about his or her experience with my particular situation and outcomes achieved. Why should a therapist be any different? A good therapist-patient fit is essential. Therapists are not 'one size fits all' and sometimes it may be necessary to 'trial' a couple before finding one that feels right. Asking some of these questions (as appropriate) at your initial session may be all you need to gauge suitability.

What are your qualifications?

You wouldn't hire an electrician to plumb your bathroom, would you?

What professional body do you belong to?

Membership of a professional body usually requires attainment of a certain level of proficiency/ training.

How long have you been practicing?

Can demonstrate both experience and stability in the profession.

Do you have regular supervision?

Deminstrates ongoing commitment to personal development.

What kind of therapy do you practice?

Important to have some understanding of what to expect or to know if the therapist practices a modality that you personally do not feel comfortable with.

What experience do you have with my particular presentation?

What outcomes have you experienced?

You need to know you're getting someone experienced for your particular issue.

Have you ever been in therapy yourself?

It can be beneficial to know that your therapist has experienced being a patient. A good therapist will be happy to be open (to a certain degree) about personal experience in therapy.

What do you think? As a client, any questions you'd like to ask but don't? Why? As a therapist, what do you feel about these questions?

Emotions during the Grieving Process

2009-06-09T08:58:00.000+10:00

I have been asked to host this guest post by Richard Moyle from the Mesothelioma Cancer Center at Asbestos.com.

Asbestos.com is committed to providing the latest, up-to-date information to visitors in the hopes of spreading awareness about the dangers of asbestos cancer.

Someone who has lost a loved one, whether it is through a tragic accident or a disease like malignant mesothelioma, will go through a range of emotions following the death.

Some psychologists have put these emotions in order, organizing different "grief cycles" that progress through various stages, predicting how the bereaved might feel at a certain point in the process.

However, the fact remains that everyone grieves differently. Some people will go through these emotions quickly while others may take long periods of time in some or all of them. There is no "correct" way to mourn and the bereaved should keep in mind that all the feelings one experiences are normal though sometimes very uncomfortable or even upsetting.

Some of the intense emotions most often experienced during the grieving process might include:

Disbelief – The person left behind often has trouble grasping the fact that their loved one is gone. A person who is experiencing disbelief will often say things like, "This isn’t happening to me."

Confusion – Often distinguished by difficulty concentrating, a dazed appearance, and sometimes depersonalization, confusion is often a result of being thrust into a new scenario that doesn’t include the one who has passed on.

Shock – This emotion generally occurs immediately after the death. Shock can last just a few hours or several days. It can cause bewilderment and confusion and may even lead to temporary memory loss.

Sadness – This is a typical and likely response to the death of a loved one and it could continue for months or even years. Intense sorrow, however, should be watched as it can lead to severe depression.

Humiliation – Though they are certainly not to blame, some bereaved individuals are embarrassed about their situation and feel humiliated when with others.

Guilt – There is a frequent feeling among those left behind that maybe they could have done more for the person who passed on. Generally, these emotions are not justified and should be dealt with by a counselor should they continue to manifest themselves as they could lead to depression.

Grieving is natural, normal, and certainly crucial, and feeling these and other emotions will help the process move along. However, any one of these emotions can get out of hand and hinder daily life. When an emotion reaches that point, it may be necessary to ask for guidance, either from family members and friends or from a professional.

Health anxiety

2009-04-30T09:12:00.003+10:00

I came across this series of videos on youtube from Dr. Brian Fallon, Dr. Arthur Barsky and Dr. Kelli Harding on the subject of hypochrondriasis, which I found quite interesting and thought worthwhile sharing.

You can view all the videos here.

My, what a beautiful blog you have!

2009-04-16T07:54:00.005+10:00

"Your blog always provokes thought, Dr. Deb." "Coffeeyoghurt, you always give me a new spin on things". "Health Skills, your blog offers such useful clinical skills". I could go on complementing many of my deserving blogger pals but this is enough to illustrate the point.

That's right. It's National Compliments Day.

Most of us can feel a little uneasy about giving and receiving compliments. On giving, we might worry about how the other person might respond. On the receiving end, we might start thinking about the motives underlying the compliment. Giving and receiving compliments can be a communication minefield!

However, both giving and receiving a compliment can increase a sense of positivity and enhance self-esteem.

Giving a compliment

There are a number of things to bear in mind:

Be sincere A fake compliment usually stands out like the proverbial sore thumb. I certainly didn't buy it when Practical Man told me 'you look like Heidi Klum in that bikini'. Hmm.

Be specific "That's a great haircut" carries more impact than the simple "You look good". It demonstrates the complement giver is really paying attention.

Back up your compliment It doesn't hurt to expand the compliment by adding a little detail, thus reinforcing your belief in the compliment. "That's a great haircuit, it really frames your face."

Be selective Avoid complimenting on things that the other person really has little control over. Avoid complimenting on things that may have been complimented on frequently. If a compliment is expected, it has much less impact. Try to find something really unique about the person.

Receiving a compliment

How many of us are guilty of discounting a compliment? For example, I just got a couple of papers published and what did I say in response to compliments about that? I said, "ah, but they're only review papers". Discounting a compliment in that way immediately sucks out the positivity and really deflates the opinion of the compliment giver.

Think of a compliment as a gift. Accept with a smile and a thank you.

To read more about compliment giving and receiving, read the Psychology Today online article below.

Source:

The art of the compliment. Psychology Today

Past, present or future?

2009-04-13T16:22:00.004+10:00

Anxiety often comes from the future, of not knowing what is to come. When that's the case, it's often helpful to bring ourselves back to the present. After all, we often have limited control over the future, we certainly can't change the past, and so the present is all we can deal with.

However, a certain degree of forward thinking and preparation can be useful. For some of us, me included, worrying about the future, working through a number of possible future scenarios can enable us to feel prepared and better able to cope. Of course, it's all about degree. When the 'what if' scenarios build upon each other to the extent that we end up anticipating things that really have next-to-zero chance of happening, it becomes a problem.

So, it's interesting to read about new work by Philip Zimbardo. In his new book, Time Paradox: The New Psychology of Time That Will Change Your Life, he argues that decision-making is largely orientated by our orientation towards the past, present or future, although most of us use a blend of past, present or future thinking.

In particular, he relates our orientation to health, with future thinkers likely to be healthier and live longer. A view supported by a recent study published in the British Journal of Health Psychology (see reference below) that shows people who are future thinkers adopt better health behaviours (less drug use, safe sex practices, smoke less and have healthier BMIs).

Kuzco syndrome

2009-03-26T07:53:00.005+11:00

I'm not a big fan of animated movies but I've always LOVED The Emperor's New Groove. So, I had to laugh the other day when a friend described her husband as suffering from 'Kuzco syndrome'. Most definitely not a DSM-IV diagnosis (although possibly could be considered for DSM-V? *grin*).

In case you're not familiar with the movie, Kuzco is an extremely self-centred emperor whose personal motto is 'It's all about me'. Of course, in true Walt Disney style, Kuzco goes through a series of adverse events and comes out a reformed, SNAG. Unfortunately, my friend's husband has yet to get the Disney makeover and she's left battling to get her needs and wants acknowledged.

So, how to best ask for what you want?

Formulate your needs/wants

Asking for things can be hard and so it can be helpful to think about your request in advance. This means gathering all the facts related to any potential request.

From Who is the person who is in a position to give you what you want?

I want What do you want? Make it clear what you want the other person to do. It's not enough to say something vague like "I need you to help", you need to be specific about behaviours. So, "I need you to help me sort through the bills".

When Give an idea of the deadline for getting what you want. Is there a partcular time of day you want someone to do something? How often should they do it?

Where Where should this request be performed?

With Are there any other people who need to be involved?

Use these elements to outline exactly what you are requesting. The more specific you can be in your request, the easier any negotiation is likely to be.

Distil the assertive request

Put the details outlined above into a brief statement.

Deliver a whole messages

Saying what you want is only one part. People will be more responsive if they know a little more about what's behind your request. What are your feelings in relation to your request? Delivering a whole message promotes intimacy and acceptance.

In talking about feelings, always be care to use an "I" message. An "I" message allows you to own your emotions, in contrast to a "You" message which can seem to blame the other person and make them hostile and defensive. "I was disappointed..." sounds far less accusatory than "You disappointed me".

Put it together

I think (my understanding, perception, interpretation) +

I feel ("I" messages only) +

"I want" (from request outline).

So.....

"I think we need to share the housework more. I feel resentful when I'm still clearing up after cooking dinner and you're playing Wii. I need you to help me with the washing up."

Are you listening, Practical Man? Of course he is!

Online psychological research

2009-03-23T09:43:00.004+11:00

One of the great benefits of the internet, particularly from the point of view of psychological research, is that it facilitates access to a much wider pool of potential participants. I've made extensive use of online research at undergraduate and postgraduate level and am now doing so again in my current research.

I'd like to therefore again highlight two key resources for researchers like myself. Both sites host a great number of very interesting studies (including my own currently *nudge nudge, wink wink, say no more*), many of which I often participate in myself when I have a few moments to spare.

If you have an interest in psychology, can I suggest you pop over to both sites to have a look at the kind of research being undertaken online currently and, possibly, if a study is of interest you, donate a little of your time? I know, from personal experience, that your participation will be greatly appreciated.

The first site is Online Psychological Research UK, maintained by Dr. Kathryn Gardiner, from the University of Central Lancashire. Note, you have to be a UK resident to participate in studies. For researchers, it also has a link to a number of useful resources for researchers interested in online research.

The second site is Psychological Research on the Net, maintained by Dr. John Krantz at Hanover College in the US. Participation is open to everyone. Again, there are a number of useful resources for online research.

A permanent link to both sites in the sidebar will be added today.

Anorexia: Not just for the girls

2009-03-22T11:47:00.004+11:00

While eating disorders such as anorexia and bullimia are generally associated with women, it might surprise you to learn that Australia has one of the highest rates of males diagnosed with eating disorders worldwide.

Figures from The Butterfly Foundation, show that one in four children diagnosed in Australia with these conditions are male. The Foundation reports that one in three male year 9 students used strategies such as fasting, vomiting, diet pills, laxatives and smoking to keep weight down.

The Foundation's chief executive Christine Morgan indicates this most likely reflects a greater increase on male body image, similar to that faced by females.

"As the focus turns more and more to men being skinny,

that pressure on their body image increases. You

start down that process of very disordered eating."

I'm not sure we should be surprised. With all the airbrushing of images, which coincidentally Coffeeyoghurt happens to be discussing currently, and the unrealistic images promoted to us all, why shouldn't men be equally affected. What do you think?
.

Psychotherapy and schizophrenia

2009-03-15T08:56:00.005+11:00

A pilot study at the University of Sydney is evaluating the use of intensive psychotherapy in young people diagnosed with schizophrenia. Extensively used in the treatment of anxiety and depression, CBT is being used in Dr. Antony Kidman's study to help schizophrenia patients counter delusional thinking patterns, improve stress management and social skills.

I tried to locate more details of the study but haven't been able to. My understanding is that the project will build on an earlier British study that has shown good results from such a CBT approach used in conjunction with medication, and the link may provide more detail for those interested. There has been a considerable amount of research in this area and you can read a review, available in full, here.

Source:

Schizophrenia therapy hope

What kind of psychologist are you?

2009-03-11T15:27:00.004+11:00

You Scored as Cognitive

A strong proponent of "attitude is everything," you believe how a person views the world is the key to their psychological health. Negative or overgeneralized attitudes are, as well as often wrong, thoroughly unhealthy. Therapy involves the systematic reteaching and reshaping of mindset, which can be quick or slow depending on the patient.

Cognitive

50%

Psychoanalytic

45%

Behaviorism

40%

Humanistic

40%

Physiobiological

15%

A bit of a fun quiz. Somewhat accurate in that I do use a lot of CBT but 'attititude is everything', I can't say I subscribe to that exclusively. The percentage of psychoanalytic surprised me but then I think the questions probably reflect a more psychodynamic approach, which then makes more sense.

And you? Take the test here.

Older dads, poorer IQ

2009-03-10T16:50:00.002+11:00

This story has been making most of the news programs today.

Concern about advancing maternal age is well-documented. Now, a recent study led by Dr. John McGrath of the Queensland Centre for Mental Health Research undertaken in conjunction with US researchers has shown a link between advancing paternal age and reduced IQ in children.

Test results from more than 33,000 children in the US were analysed and revealed subtle impairments associated with delayed fatherhood. These impairments were still significant even after adjusting for socioeconomic differences and the mother's age. While the study doesn't suggest a cause, Professor McGrath suggests such differences may result in more DNA errors contained in the sperm of older fathers.

Note I bolded the word subtle above. Professor McGrath advises against alarm.

The effect we see is very small. There are many, many more

important things to worry about with respect to childhood

IQ, like maternal diet, the child's diet, educational opportunities,

a stable family life, maternal smoking, maternal drinking,"

To read the study in full, please click here.

DepED

2009-03-09T09:38:00.006+11:00

It's over a year since I first highlighted DepEd, an online resource for understanding and managing depression from the Black Dog Institute. As several people have since mentioned to me how useful they found DepEd to be, I thought it worth mentioning again.

There are seven modules in total, from depression in general through to specific types of depression through to getting help and keeping well.

This part of the Black Dog site also include a link to a set of modules for bipolar disorder education, personal stories from people who have experienced various types of depression, links to an extensive set of fact and hint sheets, and to various books available for purchase.

A great set of resources. Let me know what you like (or even don't like)?

Site of the week: E-Couch

2009-03-06T01:00:00.000+11:00

E-Couch is another initiative of the Australian National University. Remember MoodGym?

E-Couch is an informational source for emotional problems - from cause to prevention to treatment and includes exercises and strategies to help understand ourselves and others better.

Best of all, E-Couch is free to use. Check it out and remember to let me know what you think!

Update from the E-Couch team:

This Friday 6th March 2009, there will be a downtime on the E-Couch program in order to add generalised anxiety and social anxiety tools.

Thoughts from 3am

2009-03-05T12:39:00.007+11:00

A common problem is sleep disturbance. I think when most people think about insomnia, they mostly think about difficulties falling asleep, known as primary insomnia. There are many sites that give good sleep hygiene tips to address this problem. Like here, for example, and here and here....

Yet often problems relate to what is called middle insomnia, waking up in the middle of the night. This can often be accompanied by a continual cycle of thoughts that once initiated are very hard to stop. I've never had any sleep problems until recently. Now, every night, I'll fall asleep only to wake up an hour or two later and lie awake thinking, thinking, thinking.

Middle insomnia can be attributed to a number of causes including physical and mental health problems, particularly stress when you may experiencing difficulties 'shutting down' the brain. If you research middle insomnia, you'll mostly find the general sleep hygiene hints. Useful in themselves but not much help in shutting a persistent brain down.

A very simple technique that has proved invaluable to me is called the A to Z distraction task. Basically, you select a theme and then name a suitable item from A-Z. For example, capital cities...so, Amsterdam, Budapest, Cairo and so on. It doesn't sound like much, does it but it works like a dream (ha!) for me every time. Of course, if Practical Man is snoring, nothing can distract!

The only problem is that, after a while, you need to increase the difficulty of the theme otherwise you reach Z before you get to sleep. My last effort was comedians and I was asleep by 'H'.

Do you experience middle insomnia and what do you do to deal with it?

Visual tricks

2009-03-04T15:24:00.003+11:00

Fascinated by some of the visual illusions from cognitive psychology? Then, you'll like the seeing exhibits in The Exploratorium Online. A good place to while away some time (especially when the alternative is reading an endless pile of research papers), although you'll need ShockWave to enjoy some of the items.

Unhappy children, unhappy adults?

2009-03-03T17:08:00.004+11:00

A miserable childhood is likely to result in greater levels of depression and anxiety in middle age. So suggests a recent study that followed over 7000 people born between 1950 and 1955. Undertaken by researchers at King's College, London, the study showed that children who had been described by teachers as 'miserable' or 'unhappy' were five times more likely to be sick and off-work in their forties.

Of course, such a study does not imply causality but, nonetheless, the connection is interesting. Nurture (or rather lack of it) as opposed to nature, especially as the study showed that those children who were physically unwell during childhood demonstrated no difference in rate of being sick in middle-aged.

I'd probably throw the findings of this paper in that my childhood was reasonably happy and my health is probably less than ideal now. How does this fit in with your experience?

If you want to know more, you can read the abstract for the paper from the British Journal of Psychiatry here and the BBC News article as detailed below.

Resources

Henderson, M., Hotopf, M., & Leon, D. A. (2009). Childhood temperament and long-term sickness absence in adult life. British Journal of Psychiatry, 194, 220-223.

Unhappy children end up 'unwell'. BBC News, March 02 2009

Psychologists as Prescribers

2008-12-17T17:41:00.000+11:00

The debate rages on here. Well, perhaps not rages but is, at least, current.

Should psychologists prescribe medication? I have to say that I'm not keen on this move forward.

Why?

Even with the provision of more in-depth psychopharmacological training, I don't believe the level of knowledge would be sufficient to account for all the variables that need to be considered in medicating someone. From a personal point of view, I think a medical background is essential.

I also think that many patients prefer their psychologists as non-prescribers, especially those that don't want to go down the medication route. I'm not adverse to medication at all and patients who are intially resistant to the idea will often reconsider as an interim measure if they're having trouble doing psychological work. When that happens, both the patient and I seem comfortable having either the patient's doctor or a psychiatrist involved.

What do you think? Drop a comment or tick off a box on the poll in the side bar.

A Balanced Life

2008-12-17T12:14:00.000+11:00

I often get offered books to review. Most I don't accept but this one interested me because of the different perspective on mental health that it offered.

A Balanced Life is written by Tom Smith. Based partly on research and, more importantly I think, on Tom's experiences with his daughter who had bipolar and subsequently committed sucide, the book provides a useful insight into what family members and friends can expect when someone in their life suffers from a mental illness.

The book outlines nine key strategies for coping with the mental illness of a loved one. These strategies cover medication, therapist, self-esteem and support issues among others. All of these are well-illustrated by the author's and others' personal experiences but, what I really liked, was the inclusion of a number of questions in each section to stimulate personal reflection.

The only minor issue I might have with recommending the book is the ninth strategy which references to dependence on a Higher Power, akin to some of the 12 step programs. Why? Simply because this can alienate some people, even though by talking of a Higher Power, the author attempts to take a spiritual as opposed to religious approach.

I found the book to be extremely readable, well-structured and a useful for resource for anyone finding themselves in this position.

If you want to learn more about Tom Smith and the Karla Smith Foundation, named for his daughter, which supports parents and loved ones of mentally ill people, please follow the links.

Philip Zimbardo

2008-12-15T18:42:00.000+11:00

As momentous as the Stanford Prison Experiment was, Philip Zimbardo has had a much greater impact on my life.

Philip Zimbardo was the man who got me started in psychology. He was the author of the very first Psychology text book I picked up in PSY101, Psychology and Life, and hooked my interest enough to keep me studying and studying and studying.....

So, it was interesting to see him here recently and in interview on a local chat show, Enough Rope, with Andrew Denton. I've been waiting for the transcript and video to come online and now it's available here for those interested.

Slight disclaimer: it's quite short and nowhere near as in-depth as I'd hoped but I guess it's made for a more general audience.

Also check out Zimbardo.com

World Aids Day

2008-12-01T09:05:00.000+11:00

There seems a greater deal of complacency about HIV/AIDS these days. Some younger people seem to have a level of ignorance about HIV/AIDS that was commonly seen when HIV/AIDS first appeared on the scene, others seem to not think about it at all.

On World Aids Day, take time to remember, AIDS is still with us.

Resilience

2008-11-17T09:49:00.001+11:00

Photo from http://www.worldwork.biz/

Regardless of whatever problems people bring to me, one thing I try to do with everyone is to build their individual resilience, their ability to bounce back from negative experiences, to minimise their chance of further psychological problems or of relapse post-treatment.

In some respects, it’s a little idealistic because our individual level of vulnerability varies. While some may breeze through a major life change, such as a house move or a relationship breakup, others will struggle. For some people, building resilience can be extremely hard work.

An interesting project has been launched in the Sydney Metropolitan Area to promote resilience and targeted specifically towards mental health consumers. The Seasons for Growth project, offered by the Mental Health Association of NSW in conjunction with Good Grief Ltd, is a peer education program to develop resilience, knowledge, skills and strategies to manage emotional responses to change and grief that can follow a number of life-changing experiences. The program follows the change process of the four seasons to describe the journey from identifying and naming the experience(s) to developing skills to cope and accept the changes and how to move on. The peer aspect of the program promotes the value of the life experience and the sharing of recovery journeys. If you’re interested in participating in this project, please see here.

However, if such a program is not available to you, there are a number of things you can do to build your own personal resilience. These include:

Building good, supportive relationships. This may be with family, close friends or through social interaction as appropriate for you. The important thing is to get connected, to join with others, to talk to people, to feel comfortable asking for help and allowing people to help where possible.

Build good problem-solving skills Think about how you can solve problems? Reflect on the past. What have you overcome and how did you do it? What resources are available to you? Who has been able to help you in the past?

Improve your communication skills Effective communication increases our chance of being heard and improves our confidence in asking for what we need.

Have realistic and achievable goals. Sometimes the goals we set ourselves can be overwhelming, with the consequence that we may become disheartened or even give up. Make sure your goals are realistic and increase your sense of mastery or achievement by breaking the bigger goals down into smaller manageable steps.

Maintain a sense of humour. Granted, this can be particularly difficult sometimes.

Look after yourself Both physically and mentally. Relaxation techniques can be useful but some people find them hard to implement. As with anything, the key is commitment and practice. Exercise is a good alternative, even a regular walk outside in nature.

Most importantly, learn to trust yourself. Your personal skills and instincts are very valuable.

Emoting

2008-10-09T15:40:00.000+11:00

I haven't watched many movies of late. While I'm partial to a really good comedy, I also like something where I come away actually feeling something. When that happens, I know I've seen something special. Those kind of movies seem really thin on the ground.

A long time ago (in blogging terms), I wrote about movie therapy. I was reminded about that post today, after watching a movie I'd been intending to see for a long time. Having a work from home day, I decided to ignore the work bit, went and hired the movie, sat and watched it.

This movie stirred so many emotions, it bought home to me how powerful a movie can be, particularly when it has personal relevance. While certain movies may help us generate an emotional release to allow us to further explore our feelings, subjects that impact on us personally can also act as a trigger for a wide range of psychological reactions. So, sometimes, caution in viewing is recommended.

What movie started all this ruminating for me? Die Faelscher or The Counterfeiters, starring one of my favourite actors, Karl Marcovics. If you haven't seen it already (it is from 2007), HP gives it a five star rating.

Resilience

2008-10-04T08:25:00.000+10:00

Mental Health Week starts Sunday the 5th October and runs until Saturday the 11th October.

This years sees the initiation of a three year campaign to build resilience, to help people develop strengths to enable them to cope better with negative events. The focus of this initial year is to appreciate the smaller things in life.

For a slide presentation from the Mental Health Association of NSW please click here.

For more on Mental Health Week in general, read here.

Treating ourselves

2008-09-25T13:36:00.001+10:00

One thing I always try to get my patients to do is to schedule a pleasant activity into everyday. Something that gives a sense of enjoyment or achievement.

Sounds easy, right?

Not so when you're battling a depression, probably lacking motivation and finding it hard to find enjoyment in anything. Not wanting to do anything can add to a sense of hopelessness, which, in turn exacerbates the depression, resulting in less motivation to do anything and so on and so on.

It's extremely important to try and break that depressive cycle and, when people do, they often find they can get some degree of pleasure.

It's not a bad strategy for all of us really. How many of us are snowed under by family, work and social commitments to the point that we neglect to 'self-care' ourselves?

I know I'm guilty. So, I'm going to make a concerted effort to set aside half an hour each day to do something because I really want to, not because I have to. To select something for pure, personal pleasure. Today, I think I might tuck myself away in the depths of the garden, with a good book and no phone.

What about you?

Bad vibrations

2008-09-16T09:26:00.004+10:00

Remember this?

A whole smorgasbord of awful sounds awaits you at Bad Vibes.The classic fingernails on a board? Bone crunching? Roll up and have a play.

Bad Vibes results from a Salford University psychology experiment into what makes a sound unpleasant. The research is done but you can still inflict pain on your nearest and dearest.

I had to quit after sound number 5. The nerves were getting a little frayed.....

Monsters at work

2008-09-14T15:12:00.000+10:00

I'm amazed at the number of people I'm currently seeing who are suffering some degree of post-traumatic stress from events in the workplace. Practical Man also experienced something similar a little while back. With 25 years of service under his belt, his immediate boss was told to do whatever she could to 'get him out'. They made his life hell in many ways. We had to seek legal advice. Eventually, the immediate boss left. For now, all seems fine but that's only on the surface.

Workplace bullying relates to the ill-treatment of a person in the workplace by one or more other people. The mistreatment need not be physical in nature but can involve:

verbal abuse
exclusion from social interaction

restrictive and petty work rules

threat of demotion or being fired

sabotage of work

unreasonable demands

among many other behaviours.

The consequences can be considerable. Stress, depression, anxiety, anger, withdrawal.

Like any form of bullying, it can be hard to take action against the perpetrators. However, employers have a duty to protect workers against this kind of behaviour.

If you find yourself in this situation, consider these useful hints from The Mental Health Association of NSW:

As an initial step, explain to the person bullying you how their behaviour is making you feel and how you would like them to behave instead. This demonstrates that you have tried to resolve the problem and the person cannot claim they did not know.

Ensure you document bullying incidents. Record what is happening, who is doing it and when.

Contact your company's Employee Assistance Program (EAP) if your company has one or otherwise the Human Resources department and consider making a formal complaint.

While these steps make common sense, many people in this position lose confidence and feel powerless, consequently opting to walk away rather than take action. If you know someone in this position, be ready to lend a supportive ear and encourage them to seek help if necessary.

For more resources on workplace bullying:

Reachout

Workcover

Working with Monsters

Living la vida Oprah

2008-08-25T12:41:00.000+10:00

Like her or loathe her, Oprah is a very inspirational woman. She's overcome a lot of adversity to become an overwhelming success. Along the way, she's helped many others too.

I don't watch the show, I sometimes pick up the magazine in our practice waiting room between patients and often find, copious advertising aside, that it has some pretty interesting articles. I admit I followed her recent Eckhart Tolle series.

So I was interested to read this weekend of Robyn Okrant, a woman who has vowed to live life for a year according to the edicts of Oprah, both from the show, the magazine 'O' and the self-help available at the website.

Will she find bliss following Oprah's lifestyle suggestions?

Having viewed some of Oprah's selections of favourite things in the 'O' magazine, I'd like to think I could. Unfortunately, I don't think I could get Practical Man to allow the moths out of the family wallet to spring for them. *grin*

Interesting social experiment, no? See Robyn's blog here.

Smoking volcanos

2008-08-14T09:11:00.000+10:00

I know when Practical Man starts calling me 'Vesuvius' that I need to look at my level of anger.

Anger exists on a scale from mild irritability to full on rage and the earlier we can pick up on our levels of anger, the easier it is to express it appropriately and defuse it where necessary.

People have said to me that their anger explodes from nowhere. I used to think that myself but, with increasing awareness, you can learn, as I did, to recognise the early warning signs. For me, key signs are feeling physically tense, putting my hands on my hips and tightening my lips. The Mick Jagger manifestation of anger and it isn't pretty!

The good thing is now I recognise these early signs, I rarely get beyond irritation.

Learn to recognise your early signs. Key bodily feelings and body language are listed below.

Body feelings

Hot flushes, cold sweat, aching in muscles, visual changes, feeling very alert, adrenaline rush, increased heart rate, faster breathing, 'pumped up' feeling, tight jaw, choking feeling in thoat, feelung unreal

Body language

Pointing a finger, folding arms, rolling eyes, looking away, moving or leaning forward, pacing around, slamming objects, waving away, glaring, hands on hips, scowling, sneering, tapping fingers/foot, tight lips, pushing past people, standing over people.

Time Out!

2008-08-04T09:28:00.000+10:00

Picture from http://www.freewebs.com/behaviourmanagement/timeoutinroom.htm

Seems that almost everyone I'm seeing currently has some kind of anger issue. Practical Man thinks that's kind of ironic seeing he thinks I can be a little grumpy myself on occasion. Really?

Although we're socialised to believe anger is wrong, anger is actually a natural, healthy emotion. Anger is a signal that something is our environment is not right. Blocking it can result in both physical and psychological health problems. Anger exists on a scale from mild irritation to outright fury. What is important about anger is the level and how we express it. When expressed appropriately, we defuse stress and frustration and others can understand that we're upset. When expressed inappropriately, with blame or aggression, we fail to get our message across. People switch off or become defensive and situations often snowball.

One of the techniques people have been mentioning to me that they've been using to manage their anger is timeout.

It's true that timeout can be an effective tool when used properly. However, for many people this translates to leaving the situation in a distressed state, often getting into a car and driving or going for a drink. Not so good. We're less likely to be in control of our behaviour when we're riled up. Let's face it, an angry driver is never a safe driver.

So, do you use timeout when you're at boiling point?

Take the time to explain to the people you're with what you are doing and why. Avoid inflammatory statements such as 'You're driving me crazy'.

Leave the situation for approximately an hour.

During your timeout, try to do some exercise, followed by a relaxing activity to calm yourself.

Take time to objectively identify your thoughts and feelings.

DON'T

Stay away more than one hour.

Drive.

Take drugs or alcohol.

After your time out, return and see if others are ready to talk. If not, be prepared to wait until things have cooled down.

Medicine and psychology

2008-07-28T17:09:00.000+10:00

Interesting to hear of the new centre for Medical Psychology and Evidence-based Decision-making(CeMPED)at the University of Sydney under the management of Professor Butow (Psychology), Professor Martin Tattersall (Medicine) and Associate Professor Alexandra Barratt (Public Health).

Psychological concerns are overlooked in illness yet psychological disorders often occur at greater rates in people diagnosed with medical conditions than the general public.

The goal of the new centre is to redress this stuation and provide understanding of health from both a medical and psychological perspective. CeMPED will have psychologists, nurses, doctors and public health professionals on board.

What a fabulous and long overdue initiative!

.

Roll up, roll up

2008-07-21T19:55:00.001+10:00

and lend your support...please!

Complete an online survey on ‘Hassles of Daily Life’ and go into the draw to receive one of two iPod Nanos. (Note: may be for Australian residents only....)

The University of the Sunshine Coast and the Australian Psychological Society are conducting research on daily events or situations that make people feel irritable, and their reactions to these situations.

The survey takes approximately 10 - 15 minutes to complete. If you wish to participate, go here.

In completing the survey you are not required to provide any contact details. All survey responses are confidential and will be reported only as compiled data. Participants can independently submit their name and contact details to be in a draw for one of two Ipod Nanos. The research will be published by the University of the Sunshine Coast in conjunction with the Australian Psychological Society.

Surveys can be submitted up until 19 September 2008.

National Psychology Week
9-15 November 2008

Red Bull gives you.....

2008-07-11T08:08:00.000+10:00

....wings? So says the advert.

Not so, say researchers at the State University of Buffalo, New York. Red Bull and other high caffeine drinks are more likely to give you 'toxic jock syndrome'. Sounds quite unpleasant and something you might want to see a medic about.

If you needed something else to worry about in relation to your teens, read on.

In a paper published in the Journal of American College Health in March, it is reported that high consumption of these kind of energy drinks can result in risky and aggressive behaviours including violence, unprotected sex and substance abuse. While the study doesn't demonstrate causality between drinking energy drinks and bad behaviours, the study author, Dr. Miller, points out that those heavily into drinking energy drinks are the ones more inclined toward risk-taking.

Of course, it could also be that those more inclined to this kind of behaviour in the first place are simply the same people who buy more of this kind of drink.

A catchy name, I guess the 'toxic jock' label resulted from the fact that the study was based on athletes. Plenty of women indulge in these kind of drinks, many for the desired side effect of weight loss, believing such drinks speed up the metabolism. Syndrome suggestions people?

There is no doubt that over consumption of these drinks can have some nasty side effects, including irregular heart beat and there have been stories of people hospitalised as a consequence of overindulgence. Like everything else, moderation is key.

SMS tracking your moods

2008-06-30T09:01:00.000+10:00

If only I'd read about this last week. Would have been a perfect iPhone entry for Grand Rounds over at Shrink Rap (link in sidebar).

A $1.88 million Federal Government grant has been awarded to the Black Dog Institute and the University of New South Wales (UNSW) to undertake a program to enable Australians to manage their mental health problems via mobile phone and the internet.

The idea is that people will be able to track their status on a daily basis in areas such as mood, sleep, activities, medication, physical activity as well as drug and alcohol abuse. Aimed at adolescents and adults with or at risk of developing depression, anxiety or stress, the first stage of the program will be the internet version, to be followed by the mobile phone version.

Dr Judy Proudfoot, Senior Research Fellow at the Black Dog Institute and the School of Psychiatry at the University of New South Wales, explains that information is fed back to the users on how they are going and alerts are sent when things aren’t going well, along with links to appropriate self-help tools. In this way, the program parallels traditional face-to-face therapy, where people are asked to monitor their symptoms and activities.

A timely project. It will interesting to see how it turns out, particularly in terms of management of confidentiality because, quite coincidentally, someone recently mentioned that they do this kind of thing with their therapist between sessions. In contrast to the Black Dog project, they don't receive any feedback or response until the next session. Initially, it raised questions of boundaries and dependency for me, particularly when they said they would demand that any other therapist (they were thinking of changing) also do this. I didn't even stop to consider the unthinkable which happened when the therapist passed his/her phone along to someone else (not a therapist). All journalling entries then went to this third person who didn't pass them on. As you can imagine, the potential for distress in that situation proved significant.

Wii-habilitation

2008-06-25T10:37:00.000+10:00

Game consoles often get a bad rap. When Practical Man is in the throes of Singstar, we all understand why (and I have the video to prove it).

Sometimes the negativity around game consoles is warranted. If you spend all your time hooked up, not good. Some of the games are questionable. Like most things in life, it's all about good choices and balance.

So it's good to counteract some of that negativity with a really positive application of the game console Wii. The Royal Rehabilitation Centre in Sydney has been using the Wii in some of its rehabilitation programs. Suzanne Stacey, a recreational therapist, points out that research indicates that virtual reality can be a useful tool in rehabilitation, with a particular application in addressing some of the repetitive tasks, while providing opportunities to improve balance and movement skills, hand-eye coordination, strength and cognition in a fun way.

Effectiveness is difficult to gauge because, of course, the Wii is used as an adjunctive therapy to more conventional rehabilitation techniques.

Now there's an interesting study for someone out there....?

Resource:

Sydney Morning Herald 21-22 June

Bottoms down!

2008-06-16T08:29:00.000+10:00

.....after that third glass of wine or fourth glass of beer, unless you want to be classified a binge drinker under the new national drinking guidelines to be introduced next month.

With binge drinking rising, this is the latest weapon in the Rudd government's war on excessive alcohol consumption, following a 70 per cent rise in the excise on so-called alcopops.

Of course, the opposition government are whining that the Rudd government are blowing the binge drinking problem out of proportion. The effects of excessive alcohol use are well-documented. We're yet to see what the impact will be down the track.

Will the new guidelines have any impact? I'm not sure. It may give people pause for thought. However, it probably doesn't have as much of an effect as a financial slog that increases the cost of drinking. The downside of that approach is that it also impacts on people who do use alcohol sensibly and that seems a little unfair.

Note: "Bottoms up!" is a Brit equivalent of "Cheers!" when drinking, just in case you thought I'd completely lost it.

Would you? Should you?

2008-06-12T10:26:00.000+10:00

So you're sitting across from me in a nice, comfortable armchair. The therapeutic relationship is (hopefully) good, you feel comfortable with the process, you feel like you're making progress. All is going well, apparently.

Would you feel the same if you knew I had been turfed out from previous treatment facilities for a history of mental illness and drug and alcohol abuse?

Would you feel the same if you knew I had committed a past criminal offence?

Would you feel the same if you knew that offence related to spousal murder?

Would you want to know this?

Do you think, as a patient, you should know this?

Of course, I hasten to make clear, none of the above applies to me. It does, however, apply to a psychiatrist who is currently practicing in this state. It's a situation that is currently attracting a fair amount of attention and discussion.

According to reports, the psychiatrist was dismissed from four medical facilities in the 1980s due to a personal history of mental illness. In 1987, following a history of alcohol and drug abuse, he fatally shot his wife after their divorce (and there had been an apprehended violence order issued in the previous year). Released on parole in 1990, he was re-registered in 1994 and has been practicing ever since, with no problems reported.

There is currently no obligation for the psychiatrist to tell his patients of his history or for authorities to disclose this information.

The dilemma here is balancing the need for a person who has committed an offence and completed their sentence to be able to commence a new life and the right of a patient to know the background of their doctor.

Of course, this case is extreme. I have to say, as a patient, I'd want to know this. I'd want to be able to check the register for recorded offences, periods of deregistration.

At the other end of the spectrum is the practitioner who's experienced their own depression or other psychological condition but has it under control. Should they be forced to disclose this? I don't believe so.

What does the patient have a right to know? Where do you sit?

Grief

2008-06-02T07:15:00.000+10:00

From www.mentalhelp.net

The first of June. The year is flying past.

I love June because it signals the commencement of winter. The Australian winter is wonderful. Cool days and brilliant blue skies. I dislike June because, in this particular month, I lost two very important people: my father and my stepfather.

Funnily enough, we were discussing grief recently in the group sessions and maybe this is what started me thinking about this. Apparently, the general consensus that the period of grief should last around three months. I can't say that I'm in agreement with that, although this probably relates to the experience of grief in terms of disruption of life. It just seems so unreasonable to put a time frame on grief.

I still experience flashes of grief even though I lost my father 19 years ago, my stepfather 9 years ago. While it doesn't happen on a regular basis, it doesn't interfere with my life functioning, it still evokes powerful emotions. It just requires a trigger....a specific date, a specific chain of events, a particular smell....out of the blue, a sense of loss as keen as it was when I first experienced it. Along with it, guilt and anger. Emotions supposedly long resolved. Kuebler-Ross may have defined a stage theory of grief (denial, anger/anxiety, bargaining, depression, acceptance). I really don't believe many people stick to the plan but switch back and forth between phases.

Of course, grief isn't just related to the loss of someone. The loss can come from any number of sources: the loss of physical or emotional health, loss of independence, loss of a job, anything that is of personal significance. It can be particularly hard to deal with when unexpected or traumatic, when it involves other life changes or when lacking support.

Facing situations like this, how we choose to manage it is key. Finding an outlet for grief can be helpful. Think about talking, writing, whatever takes your fancy. Even though we might want to withdraw, avoiding isolation is important but choose company wisely. Spend time with supportive, empathic people. Eat well, exercise and simply take time to work through the loss, however long it takes.

2008-05-05T16:46:00.000+10:00

My favourite Black Dog again.

Online learning resources for depression and bipolar disorder can be found here.

Sign me up!

2008-04-29T20:12:00.000+10:00

Here's one study I wouldn't mind participating in.

Researchers at the University of East Anglia in the U. K. are recruiting women to eat a bar of chocolate a day for a year. Mounds of Yorkie Bars (a particular favourite of HP but sadly unavailable in Australia) comes to mind. Sounds like heaven, no?

The aim of the study is to examine whether eating chocolate can reduce the risk of heart disease.

Unfortunately, I'm not eligible. Participants must be post-menopausal and have been diagnosed with Type 2 diabetes.

The second sting, the chocolate provided is not your standard Dairy Milk/Hersheys/Lindt/ insert your own particular favourite here. The chocolate has been loaded with extra flavonoids by the addition of soy. Flavonoids are a compound found in cocoa, which is suspected to be beneficial to the heart.

An important study as the researchers state that deaths due to heart disease among women increase rapidly after the menopause and having type 2 diabetes increases this risk by a further three-and-a-half times.

Don't take this as a carte-blanche to eat chocolate though. The researchers point out chocolate is still high in sugar and fat.

Why do scientists have to be such spoilsports?

The Thinker Part 2

2008-04-22T21:52:00.000+10:00

Exactly.

Taking a moment or two to reflect on self-talk and recognising some of the thought processes detailed in part 1, here comes the key question. Now what?

Strategies for changing thinking

All or nothing/black or white thinking

Nothing is clear cut. When thinking about a situation, it is necessary to recognise that most circumstances are usually neither wonderful nor disastrous but lie somewhere in between. Similarly, it's important to note that there isn't probably only one answer that's right and to be open to alternatives, any of which have the potential to offer favourable outcomes. It's also usual to ask how someone else might look at the same situation.

Overgeneralisation

Overgeneralisation often occurs when in a situation that has been encountered in the past. Memories of that event colour thoughts about the current situation so that it is easy to predict that things will turn out the same way. It's important therefore to think in the "here and now" and to try to adopt a new approach.

Personalisation

Instead of taking sole responsibility for everything that happens, it can be helpful to take time to consider how much others may have contributed to the situation. A good way to do this is to draw a pie chart, to illustrate each individual's contribution. Usually, it is likely that such an exercise will prove that no one claim sole responsibility.

Where personalisation relates to incorrectly assuming to be the target of other peoples's responses, it is beneficial to recognise how another person's reaction can often reflect their specific worries and to make a firm choice not to take it personally.

Filtering

Acknowledging filtering often means recognising a focus on a particular issue. This requires assessment of personal sensitivity, an over-reaction perhaps? Again, it can be useful to try and imagine what others would think in the same situation.

Catastrophising

It can be argued that catastrophic thinking can be helpful if it helps to prepare for certain situations. However, more often than not, it leads to inactivity. Catastrophising often means worrying about things that are very unlikely to happen, particularly in situations where the level of control is low. The world is filled with uncertainty. The challenge is to accept that fact, to accept that bad things can happen but also to acknowledge that an ability to cope.

Labelling

Rather than labelling a person, it is important to focus on the action or behaviour instead. So, rather than saying "I'm stupid", using a label, it's better to say "I made a big mistake this time."

Fortune Telling

Acting upon a prediction of what someone will do or say or something that will happen may inadvertently create the very circumstance that is not desired. Ask the person what their thoughts are, face the situation with a planned course of action.

Shoulds

'Should' implies duty and consequently the possibility of guilt. Replace the dreaded 'should' with 'could'. Could represents the fact that you have a choice in the matter.

Well, there's some basic strategies for starters.

How about you? How would you tackle these kinds of thoughts?

The Thinker Part 1

2008-04-21T11:58:00.000+10:00

This past week I had to deliver a session on self-talk and common thinking 'errors' (for want of a better term).

I don't usually have a problem with presenting material but, for whatever the reason, this time I was beset by nerves and stumbled and mumbled my way through it. I was left thinking 'who was that person?' Unfortunately, it was me. Ruminating further later, it suddenly occurred to me I was, in fact, making many of the same thinking 'errors', I'd just been trying to educate others about. Ha. Health Psych does good irony.

Self-talk is what we say to ourselves about the things we experience. Mostly, our self-talk relates to harmless thoughts such as ‘I must feed the cat’. In my household, not having this kind of self talk can be harmful and evoke wrath of kitty!

Sometimes our self-talk can make us feel good, as when we tell ourselves ‘I did a great job today’. Note to self, invoke this self-talk more often. However, at other times, self-talk can also make us feel bad when we tell ourselves ‘I am an idiot’ or ‘I’m hopeless', and that's me post-presentation.

Usually we remain unaware of our self-talk yet our thoughts can have a powerful impact on our lives, affecting how we feel about experiences and how we behave. Our emotions and behaviours are not so much a result of events or other people’s reactions to us, but rather what we tell ourselves about these events and reactions. I'm sure if I canvassed my audience about what they thought of my presentation, they wouldn't be as negative about it as I was, particularly as I'd taken along gluten free chocolate muffins for break. Hee.

Self-talk can be either realistic or unrealistic. If we talk to ourselves rationally about how things really are, we can understand, accept and behave appropriately. However, if we talk to ourselves irrationally about how things should or ought to be, we can feel very uncomfortable or upset.

Some of the common thinking 'errors', as illustrated by some of my very own thoughts post-delivery, include:

All or nothing/black or white thinking When we practice ‘all-or-nothing’ thinking, we see things in a polarised way, which is we consider them either “good” or “bad,” a “success” or “failure.” We fail to recognise that the truth probably lies somewhere in the middle.

"I was a complete an utter failure."

Overgeneralisation When we overgeneralise, we draw negative conclusions about ourselves, others and situations on the basis of limited information. Sometimes just one experience is all it takes for us to start thinking in terms such as ‘always’, ‘never’ and ‘everybody’.

"I always mess things up."

Personalisation We think that everything people do or say is some kind of reaction to us or we feel responsible for things that are not our fault.

"They look bored out of their minds. It must be me."

Filtering Often, beliefs we hold about others, the world and ourselves can bias the way we look at things. We may focus on one aspect of a situation while ignoring all other relevant information. In filtering, we pay particular attention to events that confirm our insecurities and learn to filter out information that is inconsistent with our beliefs.

"I stuttered in my speech. It all went wrong..."

Catastrophising Catastrophising is the tendency to believe something is awful or catastrophic even though usually it is only undesirable or unpleasant. In this way, even inconsequential events, such as being kept waiting, can feel like a catastrophe because that’s what we tell ourselves it is.

"I stuffed up. They're going to sack me."

Mindreading Often, we assume we know how others are feeling, what they are thinking and why they act the way they do towards us.

"They must think I'm a moron."

Labelling Every one of us makes mistakes or has something we might not do so well. Yet when we label ourselves or others as stupid or a failure, we make gross generalisations about ourself and others based on very limited behaviours. In this way, we can diminish our own sense of self worth and experience other negative emotions such as guilt, anxiety, anger, frustration, shame, and depression.

"I'm a blithering idiot."

Fortune telling This is where we anticipate things will turn out badly and can feel convinced that our prediuction is already an established fact, thereby running the risk of creating the very scenario we didn't want. The 'self-fulfilling propechy.'

"They're going to think I'm a hopeless presenter."

Shoulds ‘Shoulds’ are those unrealistic expectations and inflexible rules we all have about how we or others should act and how the world should be in general. We feel guilty if we break these rules and angry or frustrated if others do. It is important to be flexible and accept that in the real world things do not always go our way.

"I should deliver a flawless presentation."

Of course, we all have these kind of thoughts from time to time but it's when these type of thoughts become an established way of thinking that it becomes problemmatic. Recognise any of these patterns in your own thinking?

What to do about them? Ha. Well, as this post is already bigger than Ben Hur, I'll save that for part 2.

Mensline Australia

2008-04-17T10:27:00.001+10:00

I can usually tell when something is bugging Practical Man but getting him to open up about what's eating him is usually harder than drawing blood from the proverbial stone. His behaviour is not that unusual. Many men find it hard to open up about what they're feeling.

So I was excited when I came across Mensline Australia today, a mental health support website specifically dedicated to men of all ages. Mensline Australia is managed by Crisis Support Services, a not-for-profit community organisation and is funded by the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) as part of the department’s Men and Family Relationships initiative, launched in 1997. The initiative offers a range of services and programs to support men in managing family and relationship difficulties.

It offers a wealth of support information in areas such communication in relationships, relationship breakdown, fathering from a distance, family violence and so on.

There is a specific youth section which has information on depression and anger management, being a first time father (coincidentally, I just read an article on post-natal depression in men), unplanned pregnancy, drinking responsibly, same sex attraction amongst others.

The site also has sections for the Arabic, Indigenous and Vietnamese communities.

There's an online forum and a 24 hour support line run by trained professionals (1300 789978 - Australia only).

Drink? What drink?

2008-04-04T11:12:00.002+11:00

Back to the topic of binge drinking. As someone commonly termed 'a one pot screamer', meaning one drink usually makes me very cheap entertainment, I certainly blog a lot about alcohol.

Note that I never address the issues of binge chocolate eating. *cough*

Seriously, the increasing trend for binge drinking is a worry on so many levels. I've previously blogged about associated behavioural inhibition leading to risky behaviours and 'drunkorexia' but the list of concerns continues.

A new study from Northumbria and Keele Universities in the U. K. has revealed that binge drinking can have an impact on memory and that the effects are not transient but can last up to several days. This raises the issue, particularly in the context of adolescent drinking where the brain is still developing, of potential longterm damage.

The study examined students aged 17 to 19. Binge drinking was defined as at least 8 units a session for a man and 6 for a woman once or twice a week. In the study, drinkers consumed, on average, 30 units in just two sessions.

While binge drinkers reported no differences in memory compared to non-drinkers on self-report measures, a video-based test of memory showed otherwise. Binge drinkers reported up to a third less of items than non-drinkers.

Dr Thomas Heffernan, from the University of Northumbria states, "There is evidence that excess alcohol and binge drinking in particular damages parts of the brain that underpin everyday memory. Not only may these teenagers be harming their memory, if their brains are still developing they could be storing up problems for the future." Worrying stuff.

You can read a brief review of the study here.

Resource:

Binge drinking damages memory (BBC News)

Heffernan, T. (2008). The impact of excessive alcohol use on prospective memory: A brief review. Current Drug Abuse Reviews, 1, 36-41 (link provided above).

Office Munchausens

2008-03-29T15:42:00.001+11:00

Baron Munchausen from http://www.vintage-views.com

Most of us have heard of factitious disorder, albeit by its more 'popular' name of Munchausen Syndrome, named for Baron von Munchausen, an 18th century German officer known for embellishing the stories of his life and experiences.

People suffering from Munchausens claim physical or mental illness when, in fact the symptoms are purposefully created, largely for the purpose of gaining the attention and sympathy normally reserved for the ill.

A fascinating disorder but also extremely rare.

Apparently not so in the office environment. I read today, somewhat belatedly, about a 2007 article published in the Harvard Business Review describing what the author calls 'Munchausens at Work'.

Author Nathan Bennett describes situations where employees create fictitious organisational problems, only to solve them, gaining kudos in the process. To illustrate, Bennett tells the story of a manager praised for his personnel management skills, for troubleshooting interpersonal conflict on teams. It was later discovered that he would covertly pit co-workers against one another, giving him the opportunity to play peacemaker later. Other strategies include 'solving' non-existent problems.

Although 'Munchausens at Work' is not a psychological disorder, it's interesting none the less. Thinking back to my corporate days, I can see how this idea flies. My boss was very good at telling you negative things about co-workers. When Practical Man comes home and talks about some of his experiences in the office, you have to wonder how often this kind of thing goes on.

Ever come across this kind of behaviour? Come on, spill the beans!

Resources

Munchausen at Work

Miss Bimbo

2008-03-26T15:41:00.001+11:00

With due supervision, there are many useful resources on the internet for children.

Miss Bimbo isn't one of them.

Miss Bimbo offers the chance to 'become the most famous, beautiful, sought after bimbo across the globe!' In the game, players find a cool place to live, a job, shop for the latest fashions, become a socialite, date famous 'hotties' and, more worrying, resort to medications (diet pills) or plastic surgery in a bid to becoming the reigning bimbo.

While the site warns registrants must get their parents permission if they're under 18, there's nothing to stop any child registering. In fact, the site is targeted at the 9-16 age group.

Concerned about possible impact on body image and associated eating patterns, welfare groups are understandably up in arms. Read here, here and here for starters.

Bill Hibberd, of parents' rights group Parentkind, quoted in the Times article, says the game sends a dangerous message to young girls.

"It is one thing if a child recognizes it as a silly and

stupid game but the danger is that a nine-year-old

fails to appreciate the irony and sees the Bimbo as

a cool role model. Then the game becomes a

hazard and a menace."

However, the creators of "Miss Bimbo" claim it is "harmless fun." As reported in the Times article, Nicolas Jacquart, the 23-year-old French web designer who created it, denies it's a bad influence for young children, saying they learn to take care of their bimbos and that the missions and goals are morally sound and teach children about the real world.

Right. That's okay then.

Of course, while registration is free, there's nothing like the money being charged to players for text messages to buy bimbo dollars/goods to skew your judgement.

Drunkorexia

2008-03-20T08:24:00.000+11:00

Picture from http://www.bbc.co.uk

You won't find 'drunkorexia' in the DSM, the diagnostical manual for mental disorders, but it's a term that's being used to describe current, worrying trends in behaviour among young women.

I blogged before about the increasing problem of binge drinking in young women and the possible outcomes. The problem is now being compounded by young women skipping meals in order to compensate for the number of calories they'll take in during binge drinking episodes.

Behind it is the pressure to stay thin while still enjoying a wild lifestyle.

Besides the dangers of drinking on an empty stomach, the increased likelihood of risky behaviours and the risk of alcohol addiction through binge drinking, this could be a new pathway for the development of eating disorders.

Girls, what are we thinking?

Reference

Drunkorexia snares more young Australians

Writing and mood

2008-03-16T16:27:00.000+11:00

Another day, another study and one that you can participate in regardless of where you are geographically located.

I thought this one might be of particular interest to my fellow bloggers, people who obviously enjoy the written word.

From the Black Dog Institute:

Over the centuries, many people have been naturally drawn to writing about their life and their experiences, through journals, creative writing, and other forms of written expression. Day to day life can be stressful as people strive for balance between family, friends and work. We are interested in whether certain kinds of expressive writing can be helpful for people in managing their moods, stress levels and general health. The ‘Writing and Mood’ study is investigating whether particular ways of writing about our lives and our experiences can offer benefits for our moods, emotional and physical health. We are also interested in whether people with certain personality styles find writing in certain ways to be more helpful than others.

If you are interested in finding out more or even taking part, you can read more about the study or register here.