Can You Improve Your Gratitude?

Out of the 24 possible character strengths in the VIA Character Strengths Survey, only five are strongly associated with satisfaction with life. People with hope, zest, gratitude, curiosity and the ability to love and be loved as their top strengths seem to have higher life satisfaction.

Gratitude has never been a strength of mine. Every time I have taken the survey since 2012, hope, zest, and gratitude have never even been in my top 10 strengths. In fact, only curiosity has been a top-five strength, coming in at #3 in 2017 and #2 in 2018.

But then something happened.

I’ve already written about the details, but I suffered a stroke on January 2nd, 2021, was misdiagnosed three times, nearly died, had emergency brain surgery, and spent over a week in a coma. I was then in a hospital for over a month and spent the next six months doing regular outpatient rehab.

It is now over a year later. Apart from some minor balance and coordination difficulties, everything else is how it was. I’m back to working as a Clinical Psychologist and, in general, enjoying my life.

Last week, I went through different personality assessments with a colleague and re-took four tests to show them what the results would look like.

On the VIA Character Strengths Survey, my #1 strength was gratitude. I was shocked initially, but upon further reflection, I really do feel lucky to be alive and be able to think clearly and interact with those that I care about.

The flap in my artery that contributed to my stroke is still there. So I could have another blood clot and stroke again in the future. Looking after myself and taking regular medication lowers my risk of recurrence, but nothing is guaranteed, and I don’t want to take anything for granted. So I want to appreciate everything I can. My friends and family. Where I live. The work I get to do. As many moments that I am alive as I can.

Life may not always be easy, but at this stage, I’d much rather experience the ups and downs and joys and sorrows than no longer be here.

I haven’t always felt this way. For a long time growing up, I would have been glad if a stroke took away my life prematurely. But it is interesting how nearly losing your life can make you appreciate what you have more.

The Psychiatrist and Author Irving Yalom found something similar when he worked with a group of patients with terminal breast cancer. Many even said that it was a pity that it took until they were nearly dead to start living fully. Yalom concluded that even though death is the end of us, reminding ourselves that we will one day die can enervate and energise us.

Apart from having a near-death experience or reflecting on our inevitable death one day (practising memento mori), there are several things that you can do to improve your level of gratitude.

The two that I have most commonly heard of and tried myself are the What Went Well exercise and the Gratitude Visit.

What Went Well?

For the What Went Well exercise, the aim is to get into a daily habit of noticing the positive things that happen in your life. You could start a specific gratitude journal or include What Went Well in your usual journal. I have been using the Stoic app on my phone and having this question as one of the prompts in my daily writing exercise.

Whatever you choose to write in, take a few minutes each day to think about three things that went well during the day. It might be something that you appreciated, felt good about, or were grateful for. Ideally, this could be different things on different days, but it is okay to also say similar things to another day if you want to. For example, I kept writing down gratitude for my health, being alive, my partner, and her daughter. I’m also thankful for my family, friends, cognitive faculties, reading, walking, and enjoying nature or a nice meal. It can be whatever you want it to be.

The Gratitude Visit

The Gratitude Visit takes more time than the What Went Well exercise and cannot be done as often. However, even one of these visits can have a lasting impact on how you feel. Firstly, try to think of someone who has had a positive impact on your life, but you maybe have never told them just how grateful you are for the things they have done or the influence they have had in your life.

Then, write them a letter, fully explaining the positive influence on you, and how much you appreciate them and are grateful for the things they have done.

If the international borders were open, I would want to fly back to Australia and thank my family for their assistance following my stroke. Unfortunately, this isn’t possible because of the COVID-19 pandemic, but I want to do it the next time I get back to Melbourne.

If you can meet up with the person you have written the letter to, please contact them and catch up together on a particular date and time. Then, when you are in person, find an appropriate place where you can read the letter to them aloud, take your time reading it to them, and allow them to respond back to you afterwards. Give each other a hug if this feels appropriate. Then be thankful that you have taken this step, try to be as fully present as possible, and enjoy the rest of your time together.

Other Gratitude Exercises

By browsing the Internet, there are several different gratitude exercises that you can find that I haven’t tried yet.

You could try the Give It Up practise and deprive yourself of something you usually enjoy for one week every month. It might be chocolate one month, red wine the next month, Facebook the third month, and Playstation the month after that. By seeing how you feel with and without these activities, you might realise more about what does and doesn’t make you feel good and not take the little things in your life for granted as much.

You could take a Savouring Walk for 20 minutes a day outside by yourself and see if you can notice different positive things that you usually do not. It might just be the intricate architecture of the building at the corner, or the smell of flowers or fresh cut grass, or the feeling of warm sun on your skin. Then see how this compares to the walks you do when you are rushing from place to place or caught up in your negative thoughts or worries.

You could Create Savouring Rituals, where you identify activities that bring you pleasure. Then, try to savour two of these activities every day, and allow yourself to enjoy it, not multitask, and feel whatever you do during these times.

You can also create an Awe Diary, Foster Admiration with your partner or another willing person, or try the Mental Subtraction of Positive Events or Mental Subtraction of Relationships. The Positive Psychology website is an excellent resource for more details about these exercises or the myriad benefits of gratitude.

If you find any of them helpful in increasing how much gratitude you experience, please let me know.

Dr Damon Ashworth

Clinical Psychologist

What’s a Better Life Goal than Happiness?

When I type ‘Happiness books’ into Amazon.com, over 60,000 results appear.

Happiness is clearly a popular topic. However, when I hear people say to me in therapy that they “just want to be happy”, I find it hard to write this down as a goal for them to achieve in therapy.

The problem with striving for happiness is that it is simply one of many emotions. Sometimes we can feel happiness or joy, and other times we can feel sad, angry, jealous, disgusted, guilty, surprised, anxious, or many other things. Not only is it okay if we feel these things at times, but it is normal and healthy.

To say that we only want to feel happy is unrealistic and unhealthy. The movie ‘Inside Out’ taught this message that it is essential to allow ourselves to feel whatever we do at the moment, whether it is sadness, fear, disgust or anger. To live our lives to the fullest, we need to make room for our emotions instead of changing them or pushing them away.

So if feeling happy all the time is not the healthiest goal to aim at, what is?

Life satisfaction?

Life satisfaction (Diener, Emmons, Larsen & Griffen, 1985) has been widely measured worldwide. People from different cities and countries have even had their life satisfaction scores compared to each other.

To determine your life satisfaction, simply ask yourself how satisfied you are with your life currently from 0 to 10, where 10 is the best life you could imagine, and 0 is the worst.

Finland has the highest life satisfaction in the latest World Happiness Report findings. But how do we know if one person’s 8 out of 10 is the same as someone’s from another city or country? For example, both Uzbekistan and Somalia have cities that are the two most hopeful in the world regarding their expected life satisfaction in the future. However, neither country has any cities in the top 20 for their current life satisfaction.

Is it better to be satisfied now but expect that things will worsen in the future, or not be fully satisfied now, but hope that things will continue to improve?

High positive affect and low negative affect?

The positive and negative affect scale (PANAS; Watson, Clark & Tellegen, 1988) has also been widely used to assess how strongly people tend to experience positive and negative emotions. Including ten positive and ten negative emotions represents what people feel more than just focusing on happiness, but it can still be hard to determine the ideal.

Asuncion in Paraguay has the highest levels of positive emotion, and Taipei in Taiwan has the lowest negative emotions. Still, neither country has a city in the top ten globally for both.

‘Inside Out’ and I believe it is better to fully experience all emotions rather than not experience feelings at all. But it may be different depending on the culture that you live in. Should negative emotions even be considered “negative” if all feelings have a purpose or function?

Psychological well-being?

Ryff’s (1989) model of psychological well-being proposed additional aspects of life as crucial to well-being rather than just emotions or life satisfaction. She included self-acceptance, positive relations, autonomy, environmental mastery, purpose in life, and personal growth. Now, these seem like good things to measure if you want to see if someone is psychologically healthy.

Seligman also formulated his PERMA model of well-being. He said that we needed five main things in our lives to thrive or flourish. He detailed these five things in his 2012 book ‘Flourish: A Visionary New Understanding of Happiness and Well-Being’. They were p = positive emotions, e = engagement, r = (positive) relationships, m = meaning, and a = achievement.

Self-determination?

Ryan and Deci (2000) came up with self-determination theory (SDT) over twenty years ago. The researchers derived three core needs that they said each human must-have for optimal functioning. They are needs for competence, relatedness and autonomy. Competence covers environmental mastery and personal growth from Ryff’s model and achievement from Seligman’s, and autonomy is in Ryff’s model too. Relatedness and positive relations with others and positive relationships are all similar. However, SDT doesn’t adequately account for self-acceptance, positive emotions, engagement, purpose in life and meaning.

Curiosity?

Kashdan and colleagues (2009; 2017) defined curiosity as “the recognition, pursuit and intense desire to explore novel, challenging and uncertain events“. There are five dimensions of curiosity, including joyous exploration, deprivation sensitivity, stress tolerance, social curiosity and thrill-seeking.

These aspects definitely consider positive emotions, engagement and achievement from Seligman’s well-being model, but less so positive relationships and meaning. Unless social curiosity leads to positive relationships and meaning can be found in trying new things and being curious about everything you encounter?

A Good Life?

The Good Lives Model is a strengths-based approach to rehabilitating offenders. Ward and colleagues (2004) first proposed nine classes of primary goods, which have since been extended to 11 because of further research by Purvis (2010).

The 11 classes of primary goods are life, knowledge, excellence in play, work, agency, inner peace, relatedness, community, spirituality, pleasure, and creativity. If people do not have much of a primary good in their life, approach goals are set to help them achieve more of this good. It can then reduce the person’s risk of reoffending or committing another crime.

Self-actualisation?

Maslow put self-actualisation at the top of his hierarchy of needs. But, according to Scott Barry Kaufman in his excellent book, ‘Transcend: The new science of self-actualisation’, Maslow never intended his hierarchy to be a pyramid of needs, as most people think of when they hear Maslow’s name.

Maslow thought human maturation was an ongoing growth process towards the transcendent experience of being “fully human“. You don’t tick off an area and never think about it again. Instead, over time, you become less concerned with the security needs of safety, connection and self-esteem and more interested in growing and exploring, loving and finding purpose.

The more self-actualised one becomes, the more they understand themselves and their identity. People who have become self-actualised can utilise who they are and their strengths to best help others and the world.

Kaufman has since developed the characteristics of self-actualisation scale (CSAS). In it, there are ten elements of self-actualisation that are assessed. To see how self-actualised you are in each area, say whether you strongly disagree with each statement (1 point), disagree (2 points), are neutral (3 points), agree (4 points), or strongly agree (5 points). Then add up your total for each element, or complete the test here.

1. Purpose

“I feel a great responsibility and duty to accomplish a particular mission in life.”

“I have a purpose in life that will help the good of humankind.”

“I feel as though I have some important task to fulfil in this lifetime.”

2. Humanitarianism

“I feel a deep sense of identification with all human beings.”

“I feel a great deal of sympathy and affection for all human beings.”

“I have a genuine desire to help the human race.”

3. Equanimity

“I tend to take life’s inevitable ups and downs with grace, acceptance, and equanimity.”

“I am relatively stable in the face of hard knocks, blows, deprivations, and frustrations.”

“I am often undisturbed and unruffled by things that seem to bother most people.”

4. Continued freshness of appreciation

“I can appreciate again and again, freshly and naively, the basic goods of life, with awe, pleasure, wonder and even ecstasy, however stale these experiences may have become to others.”

“I often feel gratitude for the good in my life no matter how many times I encounter it.”

“A sunset looks just as beautiful every time I see one.”

5. Peak experiences

“I often have experiences in which I feel new horizons and possibilities opening up for myself and others.”

“I often have experiences in which I feel one with all people and things on this planet.”

“I often have experiences in which I feel a profound transcendence of my selfish concerns.”

6. Creative spirit

“I bring a generally creative attitude to all of my work.”

“I have a generally creative spirit that touches everything I do.”

“I am often in touch with my childlike spontaneity.”

7. Authenticity

“I can maintain my dignity and integrity even in environments and situations that are undignified.”

“I can stay true to my core values even in environments that challenge them.”

“I take responsibility for my actions.”

8. Good moral intuition

“I have a strong sense of right and wrong in my daily life.”

“I trust my moral decisions without having to deliberate too much about them.”

“I can tell deep down right away when I’ve done something wrong.”

9. Acceptance

“I accept all sides of myself, including my shortcomings.”

“I accept all of my quirks and desires without shame or apology.”

“I have unconditional acceptance of people and their unique quirks and desires.”

10. Truth-seeking or efficient perception of reality

“I try to get as close as I can to the reality of the world.”

“I am always trying to get at the real truth about people and nature.”

“I often have a clear perception of reality.”

Once you have scored up the totals for all of your elements, you can see which ones are strengths or weaknesses for you. For example, authenticity was my top score, with peak experiences being my lowest.

Conclusion

Self-actualisation is not precisely the same as psychological well-being or curiosity, but it seems to include elements from both.

Being more curious, psychologically healthy or having optimal psychological well-being are all worthwhile goals in therapy. They are also better to aim for than wanting to “just feel happy”.

Striving for self-actualisation is also another worthy target to aim for in therapy.

Self-actualisation is associated with emotional stability, goal attainment, constructive thinking, authenticity, and meaning in life. It can reduce disruptive impulsivity. Self-actualisation can also increase life satisfaction, curiosity, positive relationships, personal growth, and environmental mastery. Higher self-actualisation scores can also improve work performance, work satisfaction, skill development, creativity and humour ability. Lastly, it can increase one’s feelings of connectedness with the world.

Interestingly, self-actualisation is not correlated with age, education, ethnicity, gender, childhood income or school performance. So while many variables, including one’s environment, can impact a person, it does not look like it has to stop them from becoming more self-actualised.

Exactly how to reach self-actualisation isn’t fully known, but practising Mindfulness Meditation or Loving-Kindness Meditation daily could help. You could write a gratitude letter to thank someone you really care about. Or write down three things that either went well or you appreciated or felt grateful for each day. Or try to look for opportunities to help others, volunteer your skills or time, be curious about others or the world, or engage in a random act of kindness.

Different fields, including mindfulness and positive psychology, are looking into ways to help build psychological health and optimal well-being. Many of these strategies and practices are also likely to help people become more self-actualised.

Now that there is a modern instrument for measuring self-actualisation and its ten components, it will be possible to also create interventions that directly aim to improve these areas over time.

Dr Damon Ashworth

Clinical Psychologist




Five Lessons I Learned After Being Fired

When I was 18, I graduated from high school in Virginia in mid-2004. After a fantastic road trip across the USA, I returned to Australia and needed to find some work until I could attend University in February 2005.

My first job after I returned was walking around and doorknocking at people’s houses, trying to sell the residents a subscription to daily delivered newspapers. I lasted two hours, sold zero subscriptions, and made zero dollars before deciding that the job was not for me. I really feel for anyone who does this type of work. Basically, no one wants a stranger trying to sell them things at their front door.

After applying for a few other jobs, I worked as an assistant manager at Hungry Jacks, a fast-food restaurant. It did not pay well and required sometimes working 11 hours straight without a break from 3:30pm to 2:30am.

Fast food work is not glamorous. It was hot working out the back. The oil from the fryers clogged up my pores, and minor burns were not out of the ordinary.

It can also be a lot of pressure and stress. Cars turning up to buy something in the drive-thru needed to be given all of their order in under 2.5 minutes. The recommended time for in-restaurant orders was even faster.

Eventually, I began turning up to work late a few too many times, especially to morning shifts. I was 18 years old for most of my time at Hungry Jack’s and enjoyed going out with my friends and having some drinks.

After one shift where I slept through my alarm by a few hours, the two store managers called me into a room and asked me not to come back to work anymore. I was shocked, but I also understood why they didn’t want me to work there. I wasn’t really trying to learn the things I needed to and had been coming in later and later.

Here are the five main things I learned from being fired:

1. It doesn’t matter how intelligent you are if you don’t put in the work

One of my favourite personality assessments I recommend to many people is the IPIP-NEO or the five-factor personality model. It is available to be taken for free online and compares your answers to other people of your gender, age and country across five factors and thirty facets.

Conscientiousness is the most crucial factor for determining how successful someone will be at work out of the five personality factors. This finding is independent of intelligence. This means that even if you do not have a high IQ, you can still do really well at work if you apply yourself consistently. Having high self-efficacy and belief in your ability to get things done, being orderly, self-disciplined, dutiful, striving to achieve something and thinking things through before acting can help you be more conscientious and perform better at work.

2. A growth mindset is far better than a fixed mindset

I definitely had more of a fixed mindset in high school than a growth mindset. I didn’t see the point in practising things or working hard to get better at something. Instead, I thought that how good I was at something was as good as I could ever be and tried to only do things that came naturally to me.

I excelled at math until year 10, and then finally, my natural aptitude for the subject couldn’t take me much further. My grades in the subject quickly plummeted. I went from receiving A+ on tests in year 9 to nearly failing my Maths Method exam and obtaining an E+ at the end of Semester One in year 11.

At Hungry Jack’s, I again tried to stick to what I enjoyed or found easy. However, after months of working there, I still didn’t know how to set up the broiler properly, preferring to stick to salad prep or changing the oil in the fryers. Once the store managers realised this, I could only do broiler set-up. I think I stopped turning up in the mornings shortly after this.

If I had instead realised that my performance could indeed get better with more practice and more effort, I might not have been late so much and kept my job.

3. It is hard to motivate yourself to do things that you don’t enjoy

For the six months I worked at Hungry Jack’s, I really didn’t enjoy going to work. I would dread getting up early in the morning for a shift. I would also count down the clock at work until I finally could go home.

I compare this to working as a Clinical Psychologist. The feeling is entirely different. Some days I still can’t be bothered going to work, but I enjoy the process of being there and helping others as much as I can in the time that we have together.

We can’t always find things that we love doing. But if you hate what you do for a job or where you are working, it can really get you down. I’ve had a few undesirable jobs with difficult managers, and they nearly drove me crazy after only a few months.

If you are in one of these situations and can look for other opportunities, please do. Then if you have a chance to move to another job that you think might be better, go for it. If you still feel stuck, compare what you would lose by leaving to what you would lose by staying. Taking a risk can be scary, but ask yourself what you usually regret more: what you decide to do? Or what you want to do but do not?

4. Try to find a job that suits you, not what other people tell you to do

Out of the 10+ jobs I did from 14- to 28-years-old, my favourite job by far was night-fill at a Woolworth’s Supermarket. I would mostly work from 9pm to 2am or 10pm to 3am, with a 10pm to 6am Saturday night shift that paid double-time. It was a decent workout, with lots of walking and carrying boxes. It also led to a lot of reflection time while working, as the store was generally quiet until midnight and then closed after that until 6am. Once it was closed, we could play our iPods and listen to music and not have to engage with anyone at all.

For a casual job, it paid really well. But it also allowed me to do everything else I wanted in my life. I could see my friends and family as often as I wanted to, play lots of sport, and go to all the university classes that I needed to during the day. It also suited my delayed sleep schedule and helped me save enough to travel around the world for eight months after finishing my Honours degree in 2008.

Other people may have hated the exercise or the timing of the shifts at the supermarket, but I loved it, unlike the job I had at Hungry Jack’s. The more you understand yourself, your personality, and your strengths and weaknesses, the easier it will be to know what type of job is right for you.

5. Education is much more important than I realised it was back when I was in school

None of the 10+ jobs I did before I completed my Doctoral degree required a university degree. Many paid minimum wage, including working at a fast-food Tex-Mex restaurant in the USA and as a bartender in the UK.

Comparing how much I was paid in some of these jobs, it would have taken me over 20 hours to make as much as possible in one hour of private practice psychology work in Australia. The difference in pay between working as a clinical psychologist in the USA and the minimum wage is even more extreme.

I agree that schools could have a bit of an overhaul and teach more about mental health and life skills. However, it doesn’t mean that doing well in school and getting a good education doesn’t help give you a more financially secure future.

Sure, there are high school and college dropouts that have more money than I could ever make. But, unfortunately, these are the exceptions rather than the rule. If you don’t believe me, check out the ten points that this article makes on the benefits of obtaining a bachelor’s degree. Not only are you likely to make more money, but you could have higher self-esteem and better job satisfaction too.

Conclusion

Being fired for the first time just before starting my university career may have been a blessing in disguise. It helped me to take my university studies more seriously, taught me that if I wanted to get anywhere, I needed to work hard at it and that I also needed to try to find the right job for me if I was going to do well and stick at it for a long time.

Dr Damon Ashworth

Clinical Psychologist

Is Vanuatu the Happiest Country in the World?

The latest Happy Planet Index puts Vanuatu second in the world in terms of sustainable well-being. To determine a country’s score on the Happy Planet Index, they look at a country’s well-being, multiplied by their life expectancy and then divided by their ecological footprint.

The only country with a better Happy Planet Index score is Costa Rica, with 62.1. Vanuatu is second with a score of 60.4, followed by Colombia (60.2), Switzerland (60.1) and Ecuador (58.8).

Although the Happy Planet Index helps to highlight the importance of living sustainably and trying to slow down climate change, is the sustainable happiness score the same as people’s overall satisfaction with their lives?

Not really. The well-being indicator is probably more indicative. To assess well-being, people in each country are asked to rate the quality of their lives overall on a scale from 0 (horrible) to 10 (the best life you could ever imagine).

The majority of the well-being data is taken from the Gallup World Poll, but Vanuatu is not usually included in this Poll. Therefore, the Happy Planet Index gives us an excellent chance to compare Vanuatu to the rest of the world regarding how satisfied their residents are with their lives compared to residents of other countries.

Here are the top 20 countries:

  1. Finland = 7.84 (out of 10)
  2. Denmark = 7.62
  3. Switzerland = 7.57
  4. Iceland = 7.55
  5. Netherlands = 7.46
  6. Norway = 7.39
  7. Sweden = 7.36
  8. Luxembourg = 7.32
  9. New Zealand = 7.28
  10. Austria = 7.27
  11. Australia = 7.18
  12. Israel = 7.16
  13. Germany = 7.16
  14. Canada = 7.10
  15. Ireland = 7.09
  16. Costa Rica = 7.07
  17. United Kingdom = 7.06
  18. Czech Republic = 6.97
  19. Vanuatu = 6.96
  20. United States = 6.95

Vanuatu isn’t the happiest country on the planet, but the residents of Vanuatu are, on average, quite satisfied with their lives. However, the loss of tourism with the COVID-19 pandemic and the international border closures have made it financially challenging for many people. The capital city of Port Vila can also be quite expensive to live in.

Many young people are also travelling to Australia and New Zealand to work on farms and make as much money as possible. This leads to better financial opportunities for them, their families and communities. However, it also puts pressure on their partners, families and communities left behind while the young people work overseas for months and sometimes years.

The big positives in Vanuatu seem to be the connection that people have to their country, island, land and community. There are close-knit kinship and family ties and minimal large-scale conflict and political unrest.

Vanuatu is also a beautiful country with an exceptional natural environment and many people that want to preserve these resources as much as possible. For example, Vanuatu was one of the first countries to ban plastic drinking straws and plastic bags.

Work is also not an overly important aspect of many people’s lives. Following a death, people grieve with their family and friends and don’t rush back into their daily activities. Vanuatu also allows for up to 21 sick days per year, more public holidays than pretty much any country in the world, and 21 annual leave days a year too.

Based on the 2021 World Happiness Report, Finland once again wins the happiest country on the planet. Vanuatu is not the happiest country globally, but it is in the top 20 in the world. It is also a more joyful place than the USA, France, and many other countries around the globe.

By looking at surveys such as the Happy Planet Index or the World Values Survey, it is possible to see which places may be the best fit for you. If you really care about the environment and climate change, Costa Rica and Vanuatu will be right up there for you.

An excellent work-life balance, close connections with the important people in my life, not too much stress, lots of relaxation, beautiful natural resources and a population that feels like they are living a pretty good life are essential to me.

Dr Damon Ashworth

Clinical Psychologist

The Mental Health Impact of COVID-19

Initially, the pandemic had a significant and negative impact on our mental health. Here is some data that looked at self-reported levels of distress, anxiety, and depression across the USA in 2020:

As you can see, anxiety, depression and distress all spiked in March and April but remained relatively consistent from June 2020 to January 2021. 

By September 2020, the average mental health of all people in the UK was still 2.2% worse than was predicted if there had been no pandemic. However, it wasn’t anything like the initial rate of people’s mental health being 7.9% worse at the start of the pandemic. 

The pandemic has not impacted everyone’s mental health in the same way. If we look at the data of people surveyed in the UK in both April and September 2020, more than one in five people had their mental health significantly impacted at both time points. However, both women and younger people were affected more by COVID-19 than older men:

There is also some evidence that suggests that ethnic minorities and those with pre-existing mental health conditions were impacted more severely by the pandemic. Unfortunately, these impacts only further exaggerate many of the already existing mental health inequalities. 

Lockdowns didn’t seem to worsen people’s mental health as severely as people imagined. Similar to what Daniel Gilbert said in his surprising book, ‘Stumbling on Happiness’, we can adjust more to whatever happens to us the longer it goes on. If something positive happens to us, we imagine that we will feel way better for way longer. But eventually, we get used to it, and our happiness levels return close to what they initially were. On the other hand, if something terrible happens to us, we imagine it will impact our mental health way worse and for way longer than it typically does. By June 2020, many people had already found their new equilibrium. 

By comparing internet searches before and during lockdowns, Google searches increased the most substantially for boredom. Statistically significant increases also occurred for loneliness, worry and sadness. Other studies had also found increased searches for psychological stress, fear and death before lockdowns started. These searches then stabilised at the start of the lockdowns before reducing as the lockdowns continued. 

Another finding that may surprise many people is that searches fell for divorce and suicide once countries imposed lockdowns.

I’m not sure if this is true, but I have heard that suicide rates also decrease during wars. So even though many people feared that lockdowns would increase suicidal ideation, I think that sometimes wars and pandemics give us a reason to feel sad. stressed or worried. Understanding why people feel the way they do and why they have to do what they are doing gives them insight and meaning and hope that things will get better in the future. Which can reduce the risk that someone will want to die by suicide instead of increasing it. 

Possible future mental health consequences of the COVID-19 pandemic

Although most countries are now out of their most severe lockdowns and many people are returning to a new sense of normalcy, we are not entirely in the clear yet. 

The following graph by Banks, Fancourt and Xu in Chapter Five of the 2021 World Happiness Report indicates that we are now in phases three and four:

The COVID-19 pandemic has brought on more awareness of the need for mental health treatment worldwide.

However, there is still insufficient mental health support in many places. One of the latest figures I saw from the World Health Organisation suggested that somewhere between 75 and 95% of people in need of mental health services in low- and middle-income countries cannot access adequate mental health support. 

Even where I was working in Melbourne, Australia, in 2020, there was a shortage of psychologists who could take on new clients because the demand for mental health services was so high. 

Therefore, countries need to find new ways to increase access to evidence-based mental health treatments and support. It is especially true for disadvantaged or discriminated against groups, as they are likely most impacted by the COVID-19 pandemic. 

Many of the long-term consequences of the COVID-19 pandemic are still not fully known. People have died, jobs have gone, businesses have closed, products have become harder to find or more expensive. Inflation and interest rates may have to increase to keep up with the printing of money and the countries’ spending during the pandemic so far. 

There are lots of uncertain things about the future. Each of these things may come with potentially negative mental health impacts too. I am probably less cynical and more hopeful than the graph above shows about how people respond over time, but no one can fully predict what lies ahead. 

Dr Damon Ashworth

Clinical Psychologist

What Qualities Do You Try to Teach Your Children?

Deep in the World Values Survey results, there are some really interesting findings to me based on how people from each country answered questions.

Some of the most fascinating ones were around values that parents consider important in trying to pass on to their children.

There were 11 values that parents were asked about, and each person was not allowed to say that more than five values were important to them. This meant that each person had to prioritize some values over others. It also can give us an indication of which country values what the most.

Let’s look at the results for Australia and the USA on each value and see how many respondents said that this aspect was important for them to try to pass on to their children. Then we can compare these results on each value to the country with the largest percentage of people who think it is important, and the country with the lowest proportion of people who rate this value as important for their children to learn:

soldier-military-uniform-american.jpg

Good manners

Country with the highest proportion of respondents rating it as important: Bangladesh = 98.3%

Australia = 84.2%

United States = 51.7%

Country with the lowest proportion of respondents rating it as important: Tajikstan = 0.4%

brown concrete wall surrounded by trees

Independence

Country with the highest proportion of respondents rating it as important: China = 78.2%

United States = 55.5%

Australia = 51.9%

Country with the lowest proportion of respondents rating it as important: Iraq = 13.8%

person holding grinder

Hard work

Country with the highest proportion of respondents rating it as important: Tunisia = 80.3%

United States = 67.9%

Australia = 47.4%

Country with the lowest proportion of respondents rating it as important: Columbia = 24.6%

person holding white and blue paper

Feeling of responsibility

Country with the highest proportion of respondents rating it as important: South Korea = 87.6%

United States = 59.3%

Australia = 55.8%

Country with the lowest proportion of respondents rating it as important: Ethiopia = 35.3%

close up photo of glowing blue butterflies

Imagination

Country with the highest proportion of respondents rating it as important: South Korea = 52.4%

Australia: 35.8%

United States: 29.8%

Country with the lowest proportion of respondents rating it as important: Zimbabwe = 5%

germany flag in front of building

Tolerance and respect for other people

Country with the highest proportion of respondents rating it as important: Germany = 84%

Australia: 79.7%

United States: 70.8%

Country with the lowest proportion of respondents rating it as important: Tajikstan = 40%

piggy bank with coins

Thrift saving money and things

Country with the highest proportion of respondents rating it as important: Tunisia = 64.2%

United States = 27.2%

Australia = 23%

Country with the lowest proportion of respondents rating it as important: Nigeria = 13.9%

photo of walkway between shinto shrine

Determination, perseverance

Country with the highest proportion of respondents rating it as important: Japan = 63.3%

Australia: 42.7%

United States: 38.6%

Country with the lowest proportion of respondents rating it as important: Egypt = 10.8%

photo of woman holding her toddler

Religious faith

Country with the highest proportion of respondents rating it as important: Bangladesh = 84.5%

United States = 32.1%

Australia = 13.2%

Country with the lowest proportion of respondents rating it as important: China = 1.1%

blue jeans

Not being selfish (unselfishness)

Country with the highest proportion of respondents rating it as important: Tunisia = 61.5%

Australia = 41.7%

United States = 28.3%

Country with the lowest proportion of respondents rating it as important: South Korea = 4%

boy in gray shirt playing on sand

Obedience

Country with the highest proportion of respondents rating it as important: Ecuador = 62.6%

United States = 20.5%

Australia = 19%

Country with the lowest proportion of respondents rating it as important: Japan = 2.7%

I wonder if any of the findings surprised you?

Dr Damon Ashworth

Clinical Psychologist

How to Predict Whether or Not a Couple Will Break Up

John Gottman is a legendary relationship researcher. He began using “The Love Lab” as his research centre at the University of Washington in 1986.

Here, he would have couples stay in the apartment at The Love Lab, and watch as they bring up an old topic that they would typically fight about. During this conflict, he would also film the couple and measure their vitals or physiological responses.

By 1992, Gottman became so accurate at predicting which couples would eventually divorce that he published a study on it. His findings successfully indicated with 91% accuracy which of the 57 couples would later break up after recording them deal with conflict for only five minutes.

How Do You and Your Partner Fight?

The main thing that Gottman realised was what we now know as conflict style. The average therapist will say that the most healthy conflict style is a validating or compromising conflict style. With this style, the partner will want to discuss the issue calmly and rationally, talk about how the couple can resolve the problem, and collaboratively develop an amicable solution that will work well for both parties.

bench man couple love

Now Gottman found that if both parties or people in a disagreement had this validating or compromising conflict style, it worked well and didn’t predict a later break up. It wasn’t the case if only one person was validating or compromising in their conflict style. If their partner was avoidant, volatile or passive-aggressive in their conflict style, this mismatch was more predictive of a later divorce. 

What might be surprising to therapists is that if both people were avoidant in their conflict style, their outcome tended to be no worse than if they were both validating. So if you prefer to only focus on the good and not discuss any of the issues in your relationship, you may not need to start bringing stuff up. Instead, it would be best if you found a partner who also prefers to sweep the bad things under the rug rather than discuss any problematic issues. However, if your partner needs to bring things up, you may need to, too, if you want your relationship to be happy and work out in the long run. 

Similarly, if your ideal conflict style is to be volatile and get everything off your chest regardless of how you say it, this can work if your partner wants to be volatile too. Again, you are likely to fare just as well as the validating or avoidant couples, and much better than if you prefer to be volatile and your partner does not. 

Which Conflict Style Is Ideal for Your Relationship?

It turns out that deciding upon which conflict style is likely to work best for you and your partner, and then both doing this is more important than figuring out which conflict style is best in general. For example, some relationships may work out precisely because the bad stuff is avoided and never discussed. Others may be passionate and work because each partner gets everything they think and feel off their chest. And another couple may work out because they chat about the important things without losing their temper and work together to come up with a solution while both choosing to let some of the more minor things go.

Whether you prefer to be avoidant, compromising or validating in how you manage conflict, try to see if you can get on the same page about how to best deal with disagreements with your partner. Being on the same team about how you want to try and manage fights will give you the best chance to maintain a happy and healthy relationship. On the other hand, if you can’t get on the same team about how you want to fight, Gottman’s research findings indicate that your different conflict styles are more than likely to be the end of your relationship one day.

wood love people woman

If you want to learn more, Gottman has some great books that I would highly recommend reading, including:

  • The Seven Principals for Making Marriage Work: A Practical Guide from the Country’s Foremost Relationship Expert
  • Eight Dates: Essential Conversations for a Lifetime of Love
  • The Man’s Guide to Women: Scientifically Proven Secrets from the “Love Lab” About What Women Really Want
  • The Relationship Cure: A 5-Step Guide to Strengthening Your Marriage, Family and Friendships
  • The Science of Trust: Emotional Attunement for Couples
  • Why Marriages Succeed or Fail: And How You Can Make Your Last

Dr Damon Ashworth

Clinical Psychologist

The Importance of Seeing Fully Qualified Professionals

Please consider the following scenario:

You require open-heart surgery to fix something that could otherwise severely impact your quality of life or kill you prematurely.

I’m guessing that you would have a pretty similar hierarchy to most people of who you would try to book in for the surgery:

  1. The best heart surgeon in the world
  2. The best heart surgeon in your area/state/country
  3. A fully qualified heart surgeon with lots of experience doing the procedure you need
  4. A registered heart surgeon with some experience doing the operation you need
  5. A fully qualified surgeon with lots of successful heart operations
  6. A fully trained surgeon with some successful heart operations
  7. A supervised heart surgeon intern with some successful heart operations
  8. A fully qualified surgeon who has performed successful surgeries
  9. A registered medical doctor (such as your General Practitioner) with some surgical experience
  10. A fully qualified nurse with some surgical experience

Notice that everyone else who is unqualified to perform surgeries is not on the list, regardless of how highly they think of themselves or how much they care about hearts or surgery. Suppose an unqualified person has some experience completing surgeries or comes highly recommended by someone. Even in that case, there is still no way I would risk myself or someone that I love going under the knife with them.

man looking at a rock formation

Now let’s compare this to if you have a mental health issue and want additional support:

Imagine that you are a top athlete and want to improve the mental side of your game.

What would your hierarchy look like for who you’d see to help improve your psychological health and overall performance?

For me, it would look like this:

  1. The best Sports Psychiatrist in the world
  2. The best Sports Psychologist in the world
  3. One of the best Sports Psychiatrists in your area/state/country
  4. One of the best Sports Psychologists in your area/state/country
  5. A fully qualified Sports Psychiatrist
  6. A fully qualified Sports Psychologist
  7. A recommended and fully qualified Psychiatrist with some experience successfully helping top athletes
  8. A recommended and fully qualified Psychologist with some experience successfully helping top athletes
  9. A fully supervised Sports Psychiatry intern with some experience helping top athletes
  10. A fully supervised Sports Psychology intern with some experience helping top athletes
  11. A fully qualified Psychiatrist
  12. A fully qualified Psychologist
  13. A fully qualified Psychiatric or Mental Health Nurse
  14. A fully qualified Social Worker
  15. Someone who has completed a Masters Program in Counselling at an accredited university

Notice again that I do not put anyone on my list who is not a fully qualified and registered mental health professional, regardless of how much they love sports or mental health. Like surgery, I believe that if you are going to pay for mental health support, try to obtain it from fully qualified people.

A fully qualified Psychiatrist has studied at University for at least 12 years, including a complete medical degree and then a four-year residency in Psychiatry. A Psychologist has completed at least a Doctorate or a PhD in the USA. In Australia, they need to study mental health for at least six years before becoming a Psychologist. Both Psychiatrists and Psychologists must also be registered each year with a regulatory body, have professional indemnity insurance, continue to abide by their respective code of ethics and provide empirically supported treatment. They must also continue their professional development and keep a logbook of everything they have learned and the supervision they have sought.

As a Psychologist, if treatment is not effectively helping someone, you cannot continue treating them indefinitely. Because of our ethical code of practice, if someone is not getting any better, we need to refer them to another mental health professional who can hopefully help them more. We’re also not allowed to use testimonials or make unsubstantiated claims about how much we can help you. If these marketing strategies are not banned, someone can use them to persuade you unfairly.

A person working in the mental health field without any qualifications or protected titles does not have these limitations. They can practice unscientifically and unethically. They can continue charging you to see them regardless of the harm they are causing you. They can breach your confidentiality and tell others that they see you. They don’t have to get any professional supervision or do any continued professional development. They also don’t have to keep any notes or records of your sessions together or keep them in a secure and locked place for the next seven years. And they can make up fake testimonials saying how exceptional their services are and how much they help people just like you.

black bird perching on concrete wall with ocean overview

A Difficult Lesson to Learn

In 2017, the Adelaide Crows Football Club had been one of the strongest teams in the AFL all year. They were hoping to win the club’s first premiership in 19 years. But, unfortunately, they lost to Richmond by 48 points in the Grand Final.

After their loss, the football department questioned the players’ mental fortitude. The department told them that they must improve the mental aspect of their game and build resilience to win it all in 2018.

Hoping to gain a mental edge over the rest of the league in preparation for the 2018 season, they decided to head off on an experimental preseason camp involving knives, blindfolds, army gear and the removal of personal phones for the duration of the four-day camp. Run by Collective Mind, a consultancy group of two people who are self-proclaimed Executive Coaches and Trainers.

Since this camp, things have only gone downhill for Adelaide. As of July 4th, 2020, head coach Don Pyke, head of football Brett Burton, senior assistant coach Scott Camporeale and eight of the best 22 players from 2017 left the club.

Eddie Betts left Adelaide to head back to Carlton in 2019 and said in February 2020, “that (camp) was one of the main reasons why it was so hard to enjoy footy.”

Mitch McGovern was another player who left the crows. Furthermore, his manager said, “the reasons Mitch left the Crows was because of the camp and the Adelaide football department, and that’s it.

After finishing minor premiers in 2017, Adelaide dropped to 12th in 2018. In 2019, they won fewer games but finished 11th. They then lost 13 games to start the season and finished last in 2020. This year they improved slightly again and finished 15th out of 18. Collective Minds do not blame themselves for this decline, even though they credit themselves for Adelaide’s first place at the end of the regular season in 2017. Perhaps this drop from first to last in only three years was just a coincidence.

I first wrote this Facebook post back on June 26th 2018:

Dear Adelaide Crows,

If you want to get the mental edge over other AFL teams, why would you choose a company run by two individuals who do not even have an undergraduate degree in psychology?

There are 92 endorsed sport and exercise psychologists in Australia, 322 health psychologists, 513 organisational psychologists, 615 clinical neuropsychologists and over 8,000 clinical psychologists. Generally speaking, there are over 29,000 registered psychologists in Australia in 2018, and 1,469 psychologists in South Australia alone.

Psychologists… are held accountable by the Australian Health Practitioners Regulation Agency. Not all psychologists are amazing, but it is a nice way to monitor psychologists’ behaviours and ensure a certain level of quality control.

Let’s hope that other professional teams, sporting clubs, organisations, businesses and individuals learn from this experience and try to seek support from people that are adequately qualified in whatever services they are offering.”

More than three years later, I still think that hiring people without even a Bachelor’s degree in a mental health field can be a pretty dangerous thing if you want them to improve the mental side of your game.

two man hiking on snow mountain

But Have we Learnt Our Lesson?

It sure doesn’t look like it.

I enjoyed reading ‘The Resilience Project: Finding Happiness through Gratitude, Empathy and Mindfulness’ by Hugh van Cuylenberg. My brother first read it and said that he loved it and found it an emotional read. He recommended that I check it out.

The author was a great storyteller, and it was nice to see someone talk about the benefits of gratitude, empathy and mindfulness. Van Cuylenberg calls these three components GEM and says that they are the key to resilience and finding happiness.

I’ve never seen him run a presentation to a group before, but it looks like Hugh is a compelling public speaker too. He is a qualified teacher who has previously worked in schools as a teacher and has a Masters degree in education. Hugh has some skills in how to craft and portray an engaging message. 

His Resilience Project website says that he has worked with the Australian Cricket Team, Australian Netball Team, Australian Women’s Soccer and Rugby teams, National Rugby League, and ten Australian Football League teams. He highlights that he works closely with the Port Adelaide Football team and has worked individually with Steve Smith and Dustin Martin.

He is not working with these teams or individuals on how to best teach others. Or how to give effective presentations.

He is talking to them about how to improve their mental health or ‘resilience’. And he has zero mental health Bachelor or Postgraduate degrees as far as I can see.

He has mentioned reading some of the work by Dr Martin Seligman on Positive Psychology and the benefits of GEM. But doing some personal reading on topics is not the same as passing examinations and observations year after year and meeting all of the requirements to be fully qualified and endorsed as a practising mental health specialist.

Remember, there are over 100 specialised sports psychiatrists and sports psychologists in Australia and 29,000 psychologists. They are all much more qualified to provide practical mental health support to these teams and athletes. Yet, these athletes and teams overlook this expertise and go with someone with no formal training in mental health. And they are not alone.

The resilience project claims that they have worked with 500 workplaces, 1000 schools, and over one million Australians. Yet, interestingly, none of the 14 Resilience Project employees indicates that they have an undergraduate or postgraduate degree in mental health.

people texture sport ground

The #1 player in the world

Ben Crowe calls himself the Director of Mojo Crowe and a Mindset Coach. He has a Bachelor of Arts degree majoring in Creative Writing and has studied sports management for three years. He convinced Ash Barty, the current #1 female tennis player globally, to be her mindset coach. She seems happy with their working relationship so far.

With his previous experience as a director of sports marketing at NIKE in the Asia Pacific, Ben is well experienced and suited towards working with athletes as the co-founder of his company Unscriptd.com. He says that he helps athletes share and market themselves to the world.

If Barty were working with him in this regard, that would be entirely appropriate and possibly very helpful. Regarding her mental health or ‘mindset’, I don’t see how his education or qualifications relate to this. But he does say that he works with Dylan Alcott, Stephanie Gilmore, the Australian Cricket Team, Richmond Football Club, leaders at Macquarie Bank, and the World Health Organisation. So again, she’s not alone. All of these individuals and companies have enough money to hire the best professionals in an area. How do people think that the best person to teach about mindset is someone without mental health training?

Conclusion

There is a need for more mental health funding and education throughout the world to increase access. 75–95% of people in lower to middle-income countries cannot access specialised mental health services.

Until we can have more qualified mental health specialists, there will be a role for life coaches, counsellors, and psychotherapists.

However, the public needs to be well informed about the differences between the education and regulations required to work in each profession. Twelve years of study after high school for Psychiatry. At least six years for Psychology. A personal coach, counsellor, or psychotherapist may have no formal mental health education or qualifications at all.

As ‘life coach’, ‘counsellor’ and ‘therapist’ are unprotected titles in Australia, you could open up your own business or practice tomorrow and start trying to treat and manage mental health or ‘mindset’ or ‘resilience’ problems. You could also start working with some top athletes and teams if you are a great self-promoter and they are uninformed enough to hire you.

I know it seems like an extreme comparison, but would you allow yourself to be operated on by someone who wasn’t qualified or didn’t go through a long and formal education process to develop and maintain their skills? If not, why should your mental health treatment and support be taken any less seriously?

If there are no psychiatrists, psychologists, mental health nurses or social workers available in your area, see if you can access any of these individuals online. If you still can’t and need mental health support, unregulated professions like life coaches, therapists, or counsellors might help. I would make sure you know how long they have studied for first and hope they practice ethically and scientifically.

Dr Damon Ashworth

Clinical Psychologist

What Does Australia and the USA Care About in Comparison to the Rest of the World?

Inglehart-Welzel Cultural Map (2020)

If you look at the above findings from the seventh wave of the World Values Survey, neither Australia nor the USA is the most traditional or secular of all the countries surveyed. The USA is about as close to the middle as possible, showing a slight preference for Secular Values over Traditional Values (about 0.10 standard deviations above the average). Australia is more secular than both the USA and the world average.

Neither are Australia nor the USA the highest in terms of Self-Expression or Survival Values. The USA is just under 1.5 standard deviations higher than the world average regarding Self-Expression Values. Australia also prefers Self-Expression over Survival Values and is about 2.35 standard deviations higher than the average, which definitely puts them in the top 2.5% of all countries regarding endorsing these values.

Traditional vs. Secular Values

For the Y-axis, more traditional countries value the importance of family, religion and deferring to and being respectful of authority. Therefore, they tend to be more rejecting towards divorce, abortion, and euthanasia. Countries that are more secular place less emphasis on traditional family values, religion and authority. Divorce, abortion and euthanasia are more acceptable there than in countries that have traditional values.

Australia’s score of approximately 0.55 on the Y-axis means that it is half a standard deviation more secular than traditional. It is more secular than the UK and more secular than many countries in the Middle East, Africa and Latin America. Qatar has the most traditional values, but Ghana, Tanzania, Nicaragua, Ecuador, Trinidad and many others are also quite traditional.

Australia is more traditional than all Scandinavian countries, some Catholic European countries (especially the Czech Republic), and nearly all Confucian countries. In fact, Japan and South Korea are two of the highest-ranked countries globally in terms of Secular Values and are both less traditional than any country in Europe. I was quite surprised by this finding, as my Sociology lecturers at university often used Asian countries (including Japan) as the example of collectivist cultures. People in collectivist cultures are meant to put the goals and needs of the group, including what the authorities and their family say, over their individual needs and desires. Yet, their findings on the traditional — secular continuum do not seem to indicate that.

Survival vs. Self-Expression Values

This is where the findings on the X-axis are also important. Countries that endorse Survival Values prioritise physical and economic security over self-expression. As a result, they are less trusting and tolerant of outsiders or people that don’t fit in with what the average person is meant to be or do.

Countries that endorse Self-Expression Values, on the other hand, prioritise environmental protection and want greater participation in political and economic life decision-making. They also exhibit greater acceptance of differences and equality for anyone previously discriminated against, whether based on country of origin, sexuality or gender.

People from South Korea endorse Survival Values more than Self-Expression Values (approximately -0.50). Australia’s larger preference towards Self-Expression Values (about 2.35) in comparison to Asian countries might also help to explain why Asian countries were referred to in my Sociology lectures as examples of collectivist cultures. However, other countries, especially Egypt and Zimbabwe in Africa, endorse Security Values more than all Asian countries. Both Vietnam and Japan also show a decent preference for Self-Expression over Security Values. Perhaps my university Sociology professors were being influenced by inaccurate stereotypes or not using the best examples.

Based on their answers to the World Values Survey and their positions on the above map, the average Australian is more likely to be happy, accept homosexuality, sign a petition and trust others than the average Japanese person or individual from the USA. Furthermore, the average American or Japanese person is more likely to endorse these four characteristics than the average South Korean, who is more likely than the average Egyptian. However, the average individual from these countries is less likely to endorse Self-Expression Values than the average Swede or Norwegian. These countries are the top two in the world, just ahead of Iceland, Denmark and New Zealand.

Which Areas of Life are Most Important?

As a dual citizen of Australia and the USA, I will include each country’s results on the following questions to the countries that most and least endorsed each item as very important. I doubt that many people will find these results as interesting as I do, but here are six areas of life that people are asked about in terms of how important it is to them:

1. How important is your family in your life?

The country with the highest percentage of people who endorse family as very important: Egypt = 99.7%

USA = 91.0%

Australia = 90.2%

The country with the lowest percentage of respondents who endorse family as very important: Nicaragua = 77.8%

2. How important are friends in your life?

The country with the highest percentage of people who endorse friends as very important: Serbia = 62.6%

Australia = 52.4%

USA = 50.7%

The country with the lowest percentage of respondents who endorse friends as very important: Myanmar = 11.8%

3. How important is leisure time in your life?

The country with the highest percentage of people who endorse leisure time as very important: Nigeria = 67.5%

Australia = 42.8%

USA = 39.5%

The country with the lowest percentage of respondents who endorse leisure time as very important: Vietnam = 12.8%

4. How important is politics in your life?

The country with the highest percentage of people who endorse politics as very important: Nigeria = 34.8%

USA = 14.9%

Australia = 10.3%

The country with the lowest percentage of respondents who endorse politics as very important: Serbia = 4.4%

5. How important is work in your life?

The country with the highest percentage of people who endorse work as very important: Indonesia = 92.9%

USA = 39.4%

Australia = 33.1%

The country with the lowest percentage of respondents who endorse work as very important: New Zealand = 29.1%

6. How important is religion in your life?

The country with the highest percentage of people who endorse religion as very important: Indonesia = 98.1%

USA = 37.1%

Australia = 13.8%

The country with the lowest percentage of respondents who endorse religion as very important: China = 3.3%

Neither Australia nor the USA is the highest or lowest country regarding endorsing any of the six categories as very important in their life. It’s interesting and nice to see that family, friends and leisure time are all endorsed as very important in life to a higher degree in both the USA and Australia than work, religion and politics. I wonder if everyone lives in line with what values they say are most important to them.

Dr Damon Ashworth

Clinical Psychologist

What if Being a Therapist is Unhealthy?

The Oura ring that I use to track my health gives me three primary scores every day. When I wake up, I receive a readiness score, a sleep score and an activity level score from the day before. All of these are out of 100, with the higher daily score perceived as better. 

To achieve a high score on my activity level, I need to move every hour during the day, not spend too much time being sedentary and complete my daily energy expenditure goal. For example, on a recent day where I exceeded the 600 calorie goal from exercise, I managed to burn 628 calories by walking 9,015 steps or 9.1km. 

 As a clinical psychologist working in private practice, I often see 7 or 8 people for 50–60 minutes each, five days a week. There was essentially no break between clients except for maybe a lunch break in the middle of the day. Which meant that there was little chance of meeting my daily expenditure goal unless I did at least 90 minutes of walking either before or after work.

Add in the time needed to get to work and back home, plus marketing and consulting with doctors or referrers. Then treatment planning, further reading, and writing of case notes, reports and letters. It sure doesn’t leave much time or energy for the exercise I want to do. Let alone quality relationships, housework, hobbies, self-care, and sleep outside of my work responsibilities.

Photo by SHVETS production on Pexels.com

An Unhealthy Trap?

“If you weren’t loved for who you were, then what you are going to do is work to make yourself loveable. And the way you make yourself loveable is to be of service to everybody else and not have any needs yourself”  

Gabor Mate

As a clinical psychologist, I have tested myself on many validated surveys. One that I particularly like is the Young Schema Questionnaire. It helps people determine which of the 18 maladaptive life traps or schemas they fall into most. Some of my top schemas from 2018 were: Self-sacrifice (1st), emotional deprivation (2nd), subjugation (4th) and approval-seeking (6th).

With these schemas, the predominant traps that I can fall into are sacrificing my needs for others and choosing relationships where others can’t meet my emotional needs. I can also pretend that I don’t have any requirements and try to be what others want me to be rather than who I am.

All of these qualities help me to be a good therapist. I can tune into what others want and need, put these things first regardless of what I want to talk about, disregard my own needs and be what others want me to be.

But what are the personal consequences for me?

Seeing too many clients in a week can make me emotionally drained, physically less healthy than I want to be and chronically fatigued. It can result in me cooking less for myself than I would like to. I instead resort to fast food on these nights because it is convenient and more manageable. My brain also tells me that I deserve to treat myself. So I spend more time sitting on the couch and watching TV or scrolling on the phone than I want to. I can’t be bothered being as creative or as expressive as I would like to be. And I isolate myself too much, choosing to take a break from the world instead of connecting with others in ways that I would like to.

What do I need?

Equal relationships. I need to put my needs at the same level as others. I need to choose friendships and partners that are as aware of my feelings and desires as they are of their own. I need them to be as encouraging towards me meeting my needs as we are towards meeting theirs. I need to be authentic and not be punished for this, even if it is different from what is traditional for society or what they want. I need to be aware of what I want and not feel ashamed of doing these activities or meeting these needs.

While this sounds nice and healthy, a therapeutic relationship is ideally not equal. The role is to be there for the other person to help them meet their needs, understand themselves and become the person they want to be. Yes, boundaries are essential to set and enforce, but for the long term benefit of the client, not for me.

Maybe I can look at a therapeutic relationship as equal in some way. It is at least transactionally. Nobody is forcing me to take on the role of therapist. I am choosing to do it. They are paying for a service, and I am being compensated financially for it. I enjoy helping others improve if they want to. I am also trying to be authentic as a person in my role as a therapist. However, the aim is to help meet the client’s emotional needs and improve their psychological well-being, not my own.

A supervisor of mine once said, “a needy psychologist is a dangerous psychologist”. Therefore psychologists who try to get any of their needs met with clients are stepping away from their proper role. Furthermore, they can harm the other person if they are not careful. 

Yes, I can learn things along the way. I can also make genuine connections with the people that I see. However, it must be about what is best for the client, not myself as the therapist.

As long as I can ensure that my life outside of my job meets my needs, being a therapist is not a problem. However, I must achieve a healthy balance between helping others at work while having enough time and energy to help myself in the ways that I want in my life outside of it. 

Is it possible to find a healthy balance?

To not be exhausted from my work as a therapist, seeing five clients has to be the maximum on any given day. However, I’m not too sure if this maximum would be achievable five days per week either. Two to four days per week seems much more desirable if a healthy balance is an overall goal.

During the pandemic lockdowns in Melbourne in 2020, I was working a lot more than that. One week, I did 39 hours of sessions with clients, or five straight days of nearly eight clients per day. On one day, I also saw ten clients without a lunch break. As all of the sessions were via Telehealth, I’m unsure if I even stood up out of my chair. Although I had the capacity to do this, it sure doesn’t mean that it was healthy for me. 

“If you don’t know how to say no, your body will say it for you through physical illnesses” 

Gabor Mate
two person doing surgery inside room
Photo by Vidal Balielo Jr. on Pexels.com

On January 2nd, 2021, I suffered a stroke in my left cerebellum. I nearly died and was in a coma for a few weeks. After brain surgery and having part of my brain removed, the long road to recovery began. 

I am luckily doing quite well now, only six months later. My personality and cognitive functions are essentially the same as what they were before the stroke. My balance and coordination have improved, but I will never return to playing sport at the level I did before the stroke.

Fortunately, I have a second chance at life. I could rush back to how I did things before. However, I want to live in a way that is positive for me and my health. I want to enjoy my life and the relationships that I have with others outside of my work. 

I want to continue helping others meet their needs and express their feelings through their therapy. I don’t want to be a different psychologist from how I have been or care less about the people I see and talk with. However, I do not want to do this at the expense of my vitality and longevity.

 I hope that I can find the balance that means that I can keep living this incredible life in a way that is enjoyable, nourishing and sustainable for me.

Dr Damon Ashworth

Clinical psychologist