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

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

Are You Looking After Both of Your Selves?

Imagine that you could go on a holiday to anywhere that you want to go in the world. However, you couldn’t take any pictures or tell anyone what you got up to while you were away or afterwards?

Furthermore, you can only experience the holiday while away and feel all the emotions you do in the present. Once the holiday is over, you will have no memory of where you went or what it was like.

Where would you go, and what would you do?

Next, imagine that the trip has no limitations. It is just like any other holiday that you have been on, except you have no budget. So you can take as many photos and videos as your heart desires and look back on these as much as you want.

You can tell whoever you want to, both during the trip and for the rest of your life afterwards. You can also think back and reminisce about the trip and your memories of it as much as you would like to in the future.

Where would you go, and what would you do?

Would your dream holiday be the same in the first situation as it is in the second scenario? If so, do you know why? If not, why?

For the first example, I want something fun, easy, pleasurable and relaxing. I want a resort with a pool and a spa, tasty food, 27-degree sunny weather, a cozy bed and a comfortable recliner. The resort would have a nice view, maybe of the ocean, or the mountainside. If other people came, they would have to be okay relaxing and occasionally chatting or playing a game. All cleaning and washing and any chores would all be done for me. And I could enjoy each moment as much as possible without any sign of difficulty or personal strain.

For the second example, now a hike to the Himalayas or Macchu Picchu seems more appealing. More movement, more effort, some beautiful scenery and remarkable experiences. Having a few celebrities who come on the trek is suddenly more enticing because now I can take some snaps and share this with friends or on my social media. Alongside all of the effort that I put into the trip and the natural beauty of the place. Flying first class may even be worth it if I take some videos and photos to show off to everyone else.

Experiential vs Narrative Self

If I’m not going to remember the holiday or talk to others about how it was, why would I bother splashing out on heaps of money or putting in a lot of effort or even hanging out with celebrities? Comfort, ease, and enjoyment become the highest priorities. The things that make for a good story, memory or Instagram post become less so.

This is one of the biggest dilemmas that we all have inside of us.

We have the part of ourselves that wants to enjoy the moment as much as possible. This is the experiential self. It usually wants to do an activity that requires the least effort and is enjoyable in the short term. This is often why people procrastinate, play video games, lie on the couch, watch TV or a movie, eat junk food, etc. To this part of ourselves, it doesn’t matter if the activity is beneficial to us in the long run as long as it feels good at the moment.

EXPERIENTIAL SELF

Want to doHave to doWant to doHave to do
Enjoy in the short-termYESYESNONO
Find beneficial in the long-run????

But we also have the part of ourselves that cares about the stories we tell about our lives to ourselves and others. This is the narrative self. It wants to do activities that are challenging, meaningful and worthwhile in the long run. Doing housework, working hard, eating healthily, exercising consistently, and child-rearing may not always be fun from moment to moment. However, they help us become what we want to tell ourselves and others that we are over time. House proud, successful, fit, healthy, and a good parent. To this part of ourselves, it cares much less about how enjoyable something is in the moment as long as it helps us tell the story about who we are and what we have done.

NARRATIVE SELF

Want to doHave to doWant to doHave to do
Enjoy in the short-term????
Find beneficial in the long-runYESYESNONO

Because these two parts of ourselves seem so different, it can be quite hard to keep them both happy.

Several clients I have seen prioritise the experiential self over the narrative self. They spend most of their day doing enjoyable things at the expense of anything perceived as challenging or uncomfortable. Their experiential self is satisfied, but their narrative self is not. Over time, they are likely to become more and more dissatisfied with where they are in their lives or the story they tell.

The opposite can also happen but is seen less frequently. These individuals work all the time, never eat any junk food, or let themselves relax and have fun. Instead, they clean all the time, put the kids first nonstop, exercise excessively, and never give themselves a break. As a result, their narrative self can view themselves positively and share this with others, but their experiential self is miserable.

Want to do vs Have to do

To see if you could obtain a better balance in your life, ask yourself some of the following questions:

  • What are the things that you have to do in this life?
  • Which of these chores/responsibilities do you enjoy doing in the short term while you are doing them?
  • Which of these chores/responsibilities can you look back at once they are finished and feel glad that you have completed them?
  • Do any of these chores/responsibilities tick both boxes and are fun at the moment and consistent with who you want to be in the long run? Can you do more of these and less of other chores and responsibilities that don’t tick these boxes?
  • Are there any chores/responsibilities that are not enjoyable and don’t help you feel like you are the person you want to be in the long run? In other words, is there anything that you only do because you worry about what others would think if you don’t do them? Can you do less of these chores and responsibilities in your life by not doing them as much? Could you pay someone else to do them or negotiate with someone you live with to do these tasks more in exchange for you doing more of other chores and responsibilities that you enjoy and maybe they don’t?
  • What are the things that you want to do in your life?
  • Which of these activities do you also enjoy doing while you are doing them? Are you doing these things as often as you would like to? Or are you doing them too much for what feels like a good balance? Or too little?
  • Which of these activities do you not enjoy while doing them, but you can look back at them once they are finished and feel glad that you have done them? Are you doing these things in your life as often as you would like to?
  • Which of these activities do you find both enjoyable in the moment and consistent with the person you would like to be in the long run? Do you schedule enough time in your life for these sweet-spot activities?

How balanced does your life feel between your want-to-dos and your have-to-dos?

If your have-to-do responsibilities far outweigh your want-to-do activities, you are unlikely to be as happy and as satisfied with your life as you would like to be.

This is likely to be the same if you are doing many things only because you worry about what others would think if you didn’t do them. For example, if you hate cleaning and ironing and can afford to pay someone to do these tasks for you weekly so that you don’t have to worry about them, what difference could that make to how you feel? Furthermore, what could you do that you might find more rewarding with the newfound time, energy and mental space you would have?

If you are lucky enough to have at least one sweet spot activity, you will find these tasks the easiest to put your energy into and get better at over time.

Sometimes people call these activities their passions, and they will be the easiest activities for you to persevere at for a long time. This can be how I feel editing movies or playing sport, or snow-skiing. I enjoy myself, am no longer in my head, and am fully immersed in the task. Then, before I know it, a long time has passed, and it is lunchtime or the end of the day.

I’m sure that you have heard the famous quote: “Find something you love to do, and you’ll never have to work a day in your life.” If anything helps you feel this way or get into a state of flow regularly, you won’t regret making it a priority in your life.

Dr Damon Ashworth

Clinical Psychology

A Stroke of Insight

Back on the 2nd of January, 2021, I suffered a stroke. I was in the sauna at the time, and I felt something “go wrong” in my brain. All of a sudden, I experienced severe balance issues and felt nauseous. I hopped out of the sauna and went outside to lie down, but it didn’t seem to be getting any better.

I then tried to relocate upstairs back to my room eleven floors up, but my balance was still off. I managed to get there eventually, falling into and touching the side walls as I went. Even standing up straight was incredibly difficult, and walking without falling sideways was impossible. I called the emergency hotline in Australia – 000 and informed the other end that I was having a stroke and I needed someone to come over as soon as possible.

Two paramedics came over to my place. By that time, I had already thrown up multiple times into the bathroom sink. They assessed me for a stroke using the acronym FAST and determined that I didn’t meet many of the typical symptoms they would look for in someone suffering from a stroke.

The acronym F.A.S.T. stood for:

F = Face: Check their face. Has their mouth drooped? Mine had not.

A = Arms: Can they lift both arms? I could lift both of my arms.

S = Speech: Is their speech slurred? Do they understand you? I could understand them, and my speech was not slurred.

T = Time: Time is critical. If you see any of these signs, call 000 now. I had none of these signs, but I did call 000.

Even though it is important to get to the hospital as immediately as possible after a stroke, I did not exhibit any general signs that people look for following a stroke. As my stroke occurred in my cerebellum, none of these symptoms was present, and the paramedics told me that I was unlikely to have a stroke. The paramedics said they could take me to the hospital, but it would cost me a few thousand dollars because I was uninsured.

Instead, they encouraged me to get a medical appointment booked that day to see a GP so that they could follow up on how I was doing before they left. The first GP clinic was all booked out for Saturday morning, so I called 13SICK, the national home doctor service in Australia. They said they could come that afternoon at 3 pm, and with that, the paramedics were satisfied and left my apartment.

My parents then called as I said I couldn’t talk to my brother because of my current health concerns. My mum told me to call health direct to speak to a registered nurse about what was going on if I was concerned. I called 1800 022 222, and the female nurse agreed with the paramedics that I was not suffering from a stroke. She thought that I was experiencing vertigo or migraine, and recommended bed rest and medication to assist with the headaches and nausea that I was experiencing.

I called my parents again and informed my mum that I felt scared and wanted dad to come over. As mum had broken her leg playing tennis in 2020 and was still in a moon boot, I thought that dad coming over and spending the night was a better way to ensure that he could help me if I needed it.

At 7 pm, the doctor called 4 hours after he was scheduled to visit in person. Following his brief assessment, he agreed with the paramedics and nurse that I was not having a stroke and was instead suffering from vertigo or a migraine. The doctor suggested medication to my father, who went and bought this from a pharmacy for me. My sister had also ordered paracetamol for me by this stage and had it ubered to my apartment complex and delivered upstairs by a concierge at the place where I lived.

The night of sleep was horrible, and I kept waking up with a severe headache, vertigo, and frequent nausea that resulted in me vomiting multiple times. By early the next morning, I told my father, who was asleep on the couch, that I needed him to take me to hospital, as things seemed to be getting worse rather than better.

opened door
Photo by Erkan Utu on Pexels.com

The Next Day

We drove to the Alfred Hospital nearby. My dad assisted me to the car from the apartment and to the hospital’s emergency department. Due to the COVID-19 pandemic, he was not allowed inside to wait with me at the emergency department. Being early on a Sunday morning, very few people were waiting, and a doctor called me to move to another waiting room in the hospital soon. I remember walking there and sitting down, but I don’t remember anything else for a few weeks until I woke up in a ward of the Alfred Hospital.

I later found out that my condition was treated conservatively initially but then deteriorated quickly. My blood pressure spiked, and my stroke had worsened. I required surgery to remove most of my left cerebellum, and I woke up a few weeks later with several tubes and stitches at the back of my head. My head hurt a lot, both in the middle and at the back. They had me on a lot of medication to assist with my blood pressure, cholesterol, pain, and bowel movements. I wasn’t allowed to move out of my hospital bed at all because of my high risk of falls.

Before I realized that I was back in the Alfred Hospital, I thought I was in Nepal on a hiking expedition, in New Zealand, or somehow in an NBA JAM game back from the 1990s. It also felt like I was in an old exercise contraption with tubes up my nose and all over my face. Eventually, I came to and realized that I was back in the hospital that I had arrived at. Still, everything seemed so surreal.

My family kept coming by, especially my parents, even though they were limited in how much time they could spend with me due to the COVID-19 pandemic. One of my closest friends, a Neuropsychologist, decided to start up a chat group to let as many people as possible know how I was doing and whatever the latest update was. My mum tried to get a few people to send video messages to me but was told not to do this by the hospital staff as my brain needed to recover. Watching the videos would be too stimulating.

I remember feeling so uncomfortable with the tubes coming out of my face and head that I kept trying to pull them out. I was fed up with some of the nurses and their inconsistent rules for what I was meant to do or not do every day. Eventually, they tied my hands down or together so that I didn’t keep pulling at all of the new things attached to my head.

Even going to the toilet or having a shower was a massive ordeal. I wanted to do it myself, but they kept telling me that I needed to buzz the nurses before moving anywhere. I remember waking up once during the night and trying to move to the toilet by myself. I fell on the ground as soon as I tried to move by myself in the dark, only barely saving myself from a hard fall by holding onto the edge of the bed as I went down.

After a month in the Alfred, I moved to Caulfield Rehabilitation Hospital to continue my recovery. After 10 days in there, I was back to trying to continue my rehabilitation at home.

red dice stacked on table on terrace
Photo by Matthias Groeneveld on Pexels.com

A Big Challenge

One of the hardest things was being away from my partner and her daughter back in Vanuatu. Due to the COVID-19 pandemic, I couldn’t easily see them either, but after about three weeks, I was slowly able to talk to them via an audio or video chat again.

Knowing that I had some life-saving surgeries and was in intensive care for a few weeks, this really did feel like a near-death experience for me. Not being able to see my partner and her daughter, who I had been separated from since the 20th of March, 2020 due to the COVID-19 pandemic, really hurt. Luckily, my partner agreed to come and visit for 2 weeks at the end of March/start of April 2021.

I am so grateful that she was willing to quarantine for two weeks before seeing me in Australia and for another two weeks once she returned home to Port Vila. Having those two weeks together definitely helped with my recovery. It also helped me overcome my disappointment at the medical insurance company delaying my return to volunteering.

brown wooden dock
Photo by James Wheeler on Pexels.com

How Things Are Now

It has been nearly five months since my stroke, and things feel like they are returning somewhat to normal. I am back riding my bike and running, and I have even tried to shoot some hoops and play some doubles in tennis. Of course, things are not the same as before the stroke, especially with my high-end balance and coordination, but I am doing everything that I can to do most of the things that I could do before the stroke.

One of the biggest changes is how much work has decreased in my overall priorities since suffering the stroke. Instead, spending time with friends and family has become much more important, and I try to fully give my time and attention to whoever I am with instead of thinking at the back of my head about all the other things I need to do.

Yes, working hard for the future is great, especially financially. But it should not occur at the point of hurting my health or saying no to connecting with the people that mean the most to me in my life. I hope that I can keep this insight in my mind going forward to earn enough to have a good future, but not at the expense of the quality or quantity of life that I have left.

Dr Damon Ashworth

Clinical Psychologist

What Are the Virtues and Faults of Your Personality Style?

The five factor personality model has been researched and written about extensively. If you have never taken a Big Five Aspects Scale before, you can find out what your results are for under $10 at the Understand Myself website. A free version called the IPIP-NEO can also be found here.

woman in white long sleeve shirt sitting beside woman in green long sleeve shirt

My Big Five Results

All of the below descriptions are taken from my Understand Myself test that I completed on the 7th of September, 2020. This was in the middle of a Stage 4 lockdown in Melbourne due to the COVID-19 pandemic, and I was stuck in a one-bedroom apartment by myself, so this may have influenced my results a little bit.

EXTRAVERSION: 40th Percentile = Typical or Average

You are average in extraversion, which is the primary dimension of positive emotion in the Big Five personality trait scientific model. Extraversion is a measure of general sensitivity to positive emotions such as hope, joy, anticipation and approach, particularly in social situations. Women are slightly more extraverted than men.

Extraversion has two aspects: Enthusiasm and Assertiveness.

ENTHUSIASM: 30th Percentile = Moderately Low

Individuals who are moderately low in enthusiasm are rarely excitable, not particularly easy to get to know, and not known for their talkative nature. When they do talk, it tends only to be about things in which they find particular interest. They do not easily open up to people, particularly in larger social gatherings or parties. They laugh more rarely than others. They tend to prefer solitude, although they can enjoy themselves around other people, in moderation. They are more private people, and are not particularly positive or optimistic. They do not crave the spotlight and, if creative, may find performing less desirable.

ASSERTIVENESS: 52nd Percentile = Typical or Average

People of average assertiveness will sometimes take charge, spontaneously, but often let others step in first. They can put forward their own opinions but do not feel compelled to do so. They are not particularly dominant and do not generally strive to control social situations. At times, they can act in an influential or captivating manner, but it is not habitual. They can act, in ambiguous situations, but will often let others lead the way. They tend not to be particularly impulsive, and tend not to act without thinking.

AGREEABLENESS: 77th Percentile = High

You are high in agreeableness, which is the primary dimension of Interpersonal interaction in the Big Five personality trait scientific model. People high in agreeableness are nice: compliant, nurturing, kind, naively trusting and conciliatory. However, because of their tendency to avoid conflict, they often dissemble and hide what they think. People low in agreeableness are not so nice: stubborn, dominant, harsh, skeptical, competitive and, in the extreme, even predatory. However, they tend to be straightforward, even blunt, so you know where they stand. Women are higher in agreeableness than men.

Agreeableness has two aspects: Compassion and Politeness.

COMPASSION: 88th Percentile = High

Highly compassionate people are much interested in the problems of other people, and other living things, particularly if they are young or helpless. They are quite concerned about helping other people avoid negative emotion. They make more time and do more kind things for others, even when doing so may interfere with fulfilling their own needs and interests. They have a markedly soft side. Other people consider them sympathetic and nice, and will turn to them often for a listening ear. They are highly empathetic and caring. However, because they are so other-oriented, they may find it difficult to negotiate on their own behalf, and may not get what they deserve (for their hard work, for example). This can lead to resentment.

POLITENESS: 52nd Percentile = Typical or Average

Typically polite people can be deferential to authority, but can also be challenging, when necessary. They are not particularly obedient. They can be respectful, but will also push back if pushed. They are not made uncomfortable by the necessity of standing up to other people. Typically polite people will avoid conflict, reasonably, but are not completely averse to confrontation.

CONSCIENTIOUSNESS: 80th Percentile = High

You are high in conscientiousness, which is the primary dimension of dutiful achievement in the Big Five personality trait scientific model. Conscientiousness is a measure of obligation, attention to detail, hard work, persistence, cleanliness, efficiency and adherence to rules, standards and processes. Conscientious people implement their plans and establish and maintain order. Women are slightly more conscientious than men

Conscientiousness has two aspects: Industriousness and Orderliness.

INDUSTRIOUSNESS: 88th Percentile = High

Highly industrious people are likely to believe that people fail because they don’t apply themselves or work hard enough. They feel guilty, rapidly, if they do not do their duty. However, because they typically stay on or ahead of schedule and accept their responsibilities, they rarely experience actual guilt.

ORDERLINESS: 60th Percentile = Moderately High

Moderately orderly people would rather keep everything tidy and organized. They tend both to make and stick to schedules. They like everything where it should be—and are happier if it stays where it should be. They are somewhat detail-oriented but tend not to be obsessive. They are generally aware of social rules and tend to abide by them. They like routine and prefer the predictable. They can be good at ensuring that complex, sensitive processes are managed properly and carefully.

NEUROTICISM: 5th Percentile = Very Low

You are very low in neuroticism, which is the primary dimension of negative emotion in the Big Five personality trait scientific model. Neuroticism is a measure of general sensitivity to negative emotions such as pain, sadness, irritable or defensive anger, fear and anxiety. Females tend to be higher in Neuroticism than males.

Neuroticism has two aspects: Withdrawal and Volatility.

WITHDRAWAL: 19th Percentile = Low

Individuals low in withdrawal rarely suffer from or are impeded by anticipatory anxiety. They can handle new, uncertain, unexpected, threatening or complex situations well. They are substantially less likely to avoid or withdraw in the face of the unknown and unexpected.

VOLATILITY: 1st Percentile = Exceptionally Low

Individuals exceptionally low in volatility are extraordinarily stable and predictable in their moods. They are virtually never irritable, and very rarely experience disappointment, frustration, pain and loneliness. People find them extremely easy and calming. They very infrequently express their frustration, disappointment and irritability and appear remarkably reasonable when they do so. Even on those unusually infrequent occasions where they become stirred up, upset, angry or irritated, they calm down almost immediately. They are not at all argumentative and almost never lose their composure.

OPENNESS TO EXPERIENCE: 95th Percentile = Very High

You are very high in openness to experience, which is the primary dimension of creativity, artistic interest and intelligence (particularly verbal intelligence) in the Big Five personality trait scientific model. Openness to experience is a measure of interest in novelty, art, literature, abstract thinking, philosophy as well as sensitivity to aesthetic emotions and beauty. Men and women differ very little in openness to experience.

Openness to experience has two aspects: Intellect and Openness.

INTELLECT: 94th percentile = Very High

People very high in intellect find complex, rapidly changing occupations necessary and will generally excel at them (particularly if they are also high in conscientiousness and low in neuroticism). However, they are very much less well-suited to stable, straightforward and more traditional occupations, where the rules don’t change, and will experience frequent periods of boredom and intolerable levels of frustration in such positions.

OPENNESS: 87th Percentile = High

Highly open, creative people can be impractical and flighty (particularly if low in conscientiousness). It can be extremely difficult to transform creativity into money, or into a career. High levels of openness are, furthermore, necessary for entrepreneurial success, and often prove useful at the top of hierarchies, even in very conservative occupations such as banking, accounting and law, which need creative people in leadership positions to provide new vision and direction.

black psychologist with african american client

Main Findings Based on the Five-Factor Personality Model

Judge, Heller & Mount (2002) found that highly conscientious people are most satisfied with their job (.26 correlation), followed by highly extraverted people (.25 correlation), then highly agreeable people (.17 correlation), then those who are high on openness to experience (.02 correlation) People high on neuroticism were negatively correlated with job satisfaction (-.29 correlation). My introversion is the only aspect that may negatively impact how much I enjoy a job.

For academic performance, Poropat (2009) found that agreeableness, conscientiousness and openness to experience correlate significantly to academic performance. Conscientiousness was related to academic performance in a way that was largely independent of intelligence. My personality style likely helped me to do well in school and complete eight years of university studies.

For intimate relationship satisfaction, Malouff, Thorsteinsson, Schutte, Bhullar and Rooke (2009) found that low neuroticism, high agreeableness, high conscientiousness and high extraversion were all correlated with greater relationship satisfaction. These variables did not vary significantly from men to women or from unmarried to married individuals. Unfortunately, my introversion and low enthusiasm in particular make it a bit harder for me to be satisfied in intimate relationships.

For citizenship, Chiaburu, Oh, Berry, Li, and Gardner (2011) found that people that are low in neuroticism, high in extraversion and high in openness to experience are more likely to engage in more individual, organization and change-oriented citizenship. Again, not being too extraverted and enthusiastic holds me back a little here.

For occupational type, Barrick, Mount and Gupta (2006) found that extraverts are most likely to enter an enterprising career (.41 correlation). People that are high on openness to experience are most likely to enter an artistic career (.39 correlation). Some say therapy is more art than science, which may indicate why I have chosen this over a career in research.

For clinical disorders, Malouff, Thorsteinsson and Schutte (2004) found that psychological disorders are more closely linked with high neuroticism, low conscientiousness, low agreeableness and low extraversion. Healthy populations in comparison to clinical populations show higher levels of extraversion and lower levels of neuroticism. Again, my introversion puts me at a greater risk.

For alcohol abuse, Malouff, Thorsteinsson, Rooke and Schutte (2007) found that people that are low on conscientiousness, low on agreeableness and high on neuroticism are more likely to have difficulties with alcohol. These individuals are less likely to improve through treatment. Another meta-analytic finding by Malouff, Thorsteinsson and Schutte (2006) found that these three factors are also significantly related to smoking prevalence. Never smoked, but have drunk more than I should have at times. If I want to cut down, my personality style should help me.

For physical activity, Sutin and colleagues (2016) found that lower neuroticism and higher conscientiousness is associated with more physical activity and less sedentary behaviour. Higher extraversion and more openness to experience is also associated with more physical activity ,and that these variables don’t change much based on age or sex. Consequently, being a bit introverted is the only factor that lets me down.

For workplace harassment, highly neurotic people are most likely to be exposed to workplace harassment (.25 correlation), with highly extraverted and conscientious people least likely to be harassed (.10 correlation). I thought Susan Cain said it was good to be an introvert in her book ‘Quiet’, but there doesn’t seem to be much that is positively linked with Introversion?

black and white people bar men

What About Individual Faults and Virtues?

Even though across the population as a whole there seems to be benefits to being extraverted, agreeable, conscientious, open to experience and not neurotic, there are advantages and disadvantages to each trait, particularly at the extremes.

Extremely sociable, extraverted people can be dominant and impulsive, while introverted, quiet people can easily become isolated and depressed.

Extremely open people can be scattered and overwhelmed by their own thoughts and ideas, while closed-minded people may become narrow and inflexible.

Exceptionally conscientious people can be obsessive about order, judgmental and rigid, while their more carefree counterparts may be messy, undisciplined and careless.

People very high in emotional stability may engage in risky, dangerous behaviour, while those who are more neurotic can become so preoccupied by anxiety and pain that they are unable to function.

Finally, extremely agreeable people may never stand up for themselves, while those who are too disagreeable can be aggressive, callous and bullying.

To find out your individual faults and virtues on each of the five personality factors, the Self Authoring program can help you to clarify your own personal traits and help you to clarify what you would like to strengthen and improve. Below are my results:

Extraversion/Introversion Faults

  • Can spend too much money
  • Keep in the background
  • Lose opportunities because I am too isolated
  • Am too quiet around strangers
  • Find it difficult to approach others
  • Bottle up my feelings
  • Feel drained by social interactions
  • Have a social circle that is too small

Extraversion/Introversion Virtues

  • Feel comfortable around people
  • Don’t mind being the center of attention
  • Can take charge and lead
  • Am skilled in handling social situations
  • Am often happy
  • Can listen well
  • Do not always talk about myself
  • Enjoy time in natural surroundings
  • Let other people have the spotlight
  • Think before I act

Agreeable/Assertive Faults

  • Avoid conflict even when it is necessary
  • Will sacrifice my own feelings for the comfort of others
  • Can bottle up my feelings until I become resentful
  • Am polite to a fault
  • Trust people too easily
  • Can be detached and cold when others are hurt and upset

Agreeable/Assertive Virtues

  • Trust people
  • Am interested in people
  • Feel others’ emotions
  • Inquire genuinely about others’ well-being
  • Know how to comfort others
  • Make people feel at ease
  • Am a good peacemaker
  • Am aware that malevolence exists in the world

Conscientiousness/Carelessness Faults

  • Get obsessed with details and lose the big picture
  • Cannot stand to be late for an appointment
  • Feel that I am being unproductive if I relax
  • Believe that I have to be flawless
  • Can be contemptuous of other people and of myself
  • Find it difficult to get down to work
  • Neglect my duties
  • Frequently make excuses
  • Am sometimes willing to bend the truth to get out of an obligation
  • Feel unmotivated to complete my work

Conscientiousness/Carelessness Virtues

  • Have a very long attention span and can work without being distracted
  • Do things according to a plan
  • Strive for efficiency and economy
  • Pay attention to details
  • Am extremely reliable
  • Always arrive at appointments early or on time
  • Am very goal-oriented
  • Do what I say I am going to do
  • Know how to go with the flow
  • Don’t waste my time thinking about little details

Emotional Stability/Low Stress Tolerance Faults

  • Am sometimes not afraid of things I should be afraid of
  • Don’t appear to learn as well from my mistakes as others do
  • Don’t pay enough attention to costs and potential future dangers 
  • Often take counterproductive or unnecessary risks
  • Blow little things out of proportion
  • Let my fears stop me from doing things I want to do

Emotional Stability/Low Stress Tolerance Virtues

  • Am difficult to offend
  • Am in control of my emotions
  • Calm down quickly when I do get upset
  • Seldom get disturbed or upset
  • Am rarely incautious
  • Am a cautious, careful person
  • Don’t rush into things before I feel comfortable
  • Am good at identifying the risks in new situations

Openness/Traditionalism Faults

  • Pursue too many activities at the same time
  • Am interested in so many things that I don’t know what to focus on
  • Have a hard time planning for the future because I am interested in everything
  • Have a hard time making up my mind because I can always see all the sides of an argument
  • Am so interested in creative activities that it is hard to concentrate on things that are practical
  • Have had a hard time forming a clear identity
  • Have done crazy things just because I was curious about what might happen

Openness/Traditionalism Virtues

  • Am quick to understand things
  • Can handle a lot of information
  • Catch on to things quickly
  • Am always learning new things
  • Spend time reflecting on things
  • Can always see new possibility in things
  • See the value in tradition and custom
  • Am resistant to radical, dangerous thoughts
group of young multiethnic cheerful colleagues having party after workday

So, as you can see above, your personality style is never all good or all bad. I’m sure that even if you are introverted, disagreeable, careless, neurotic and closed to new experiences, there will still be some virtues associated with your personality style. I also think that, even though it may be more of a challenge, it is still possible to find the right career or job and the right relationship and friendships for you.

You may not be the right fit for everyone or everything, but no one is. What is more important is to first try to understand yourself, change what you would like to and are able to, accept what you do not want to or cannot change, and then find the places and people that love and appreciate you for who you are.

Happy New Year, and all the best for 2021!

Feeling Burnt Out? What Would Happen if We Worked Less?

In the 18th Century, employees worked up to 16 hours per day. Everyone knew this was unsustainable and led to severe burnout and horrible quality of life for the working class. Then in 1856, the 8 hours movement began in Victoria.

The Labor unions fought hard for the idea of 888. They wanted 8 hours for sleep, 8 hours for work, and 8 hours for family, rest and play. This statue was erected at the top end of Russell Street in Melbourne in 1903, meaning that they had achieved this goal for most people sometime between 1856 and 1903.

Eight Hour Day Monument (Melbourne): UPDATED 2020 All You Need to ...
Eight Hour Day Monument (Melbourne): UPDATED 2020 All You Need to ...

In the US, railroad workers began to work eight-hour shifts in 1916. Ford Motor Company followed suit in 1926 when they cut the working hours of their employees to 8 hours per day while doubling wages. The reduced work hours and better pay led to a happier and more committed workforce, and productivity increased. More leisure time and money also led to more workers buying more stuff (including Ford cars), which the government realised was better for raising GDP. Other companies also discovered that workers were more focused and productive when they worked less. So an eight-hour workday subsequently became the new norm.

Since then, the working hours have begun to creep back up again, especially in the US. Among people employed full-time, the average employee works 47 hours per week. 40% of full-time employees now work over 50 hours per week, with only 8% working less than 40 hours. So much for 8-hour workdays being the standard.

The Negative Consequences of Long Work Hours

Research has shown:

  • Working more than 10 hours per day can increase your risk of cardiovascular issues by 60%
  • Regularly working more than 10 hours a day can also increase your risk of stroke by 29%.
  • Working more than 11 hours a day leads to increased depression risk.
  • Working 12 hours days increases your risk of making mistakes at work by 23%.
  • In companies where the average weekly work time is under 43.5 hours per week, barely any fatigue-related problems are found.
  • In companies where the average weekly work time is between 43.5 hours and 46 hours, minor fatigue problems are detected.
  • In companies where the average weekly work time is over 46.5 hours, severe fatigue-related issues are seen.
  • The rate of relationship problems in those working 50-60 hours per week is 10%
  • The percentage of relationship problems in those working more than 60 hours per week is 30%.
  • Long working hours are linked to poorer mental health and sleep quality.
  • Long working hours are also linked with increased smoking, excessive alcohol consumption and weight gain.
  • Long working hours are related to lower job performance, as well as less job satisfaction and lower overall life satisfaction.

What if We Did Work Less?

Six Hour Workday infographic

The above infographic by Ohio University highlights why we need to work less. If the top 10% of employees in terms of productivity work in 52-minute blocks followed by 15- to 20-minute breaks, they can only do seven 52-minute work blocks daily. That is 7 x 52 = 364 minutes of work per day. That means we shouldn’t be putting in more than 6 hours and 4 minutes of work per day.

We also should be taking 1 hour and 56 minutes of breaks spread out across the day if we want to be at our most productive. That’s six breaks that are 19 minutes and 20 seconds long, or five 15-minute breaks and one 41-minute lunch break. As the infographic says, eight-hour days are only productive when we take sufficient breaks, and few people do.

A shorter workday is an alternative for people or organisations that don’t want to take regular breaks. However, the average person is only productive for 2 hours and 53 minutes daily. So what would happen if we reduced the workday to only 6 hours per day and paid people the same amount?

For a 6-hour workday to be effective, it would be necessary for companies to make it harder for their employees to waste time. Putting a block on news and social media sites would give the average person 1 hour and 49 minutes of their typical workday back. With the extra time after work, these employees could check the news and social media if they wanted to. If the average employee is 20% happier and healthier with six-hour workdays, they will be less likely to look for other jobs.

Microsoft has also recently experimented with four-day workweeks in Japan. When workers took the Friday and the weekend off, productivity went up 40%. Only 10% of the staff who tried this weren’t more productive overall. They also cut meeting times down to a maximum of 30-minutes each. I’m sure that this helped as well.

When other companies have tried four-day workweeks, they manage to produce 25% more output with the same size staff. They also find it easier to fill vacant positions when they arise, as more people like the four-day-a-week full-time job than a typical five-day-a-week role.

Conclusion

Since returning to Melbourne and full-time work, I have noticed that much of my stress and fatigue has returned. Finding the right work/life balance isn’t easy, especially with the uncertainty and anxiety created by the COVID-19 pandemic. I’m grateful to have full-time work doing what I love to do, but working in a way that isn’t harmful to my health and well-being is still a work in progress for me.

However you decide to manage your workload, please understand that working long hours without regular breaks is not sustainable. We can address this by working fewer hours in a day or fewer days in a week. Or you can merely get up from the desk and walk around a bit more when you notice that your productivity and energy levels are dropping. Getting outside for lunch and away from screens can also help. As can taking some pressure off of ourselves.

Working hard and being busy are seen as status symbols in Western society too frequently. Stepping out of this culture and into “island time” for 18 months was one of the best things I could have done for my fatigue, happiness and overall well-being.

The biggest question I still have is whether or not we can learn from our experiences and what the research says. Again, it seems counter-intuitive, but working less could help us be a healthier, happier, and more productive society.

How to Improve Your Motivation

People often ask me how they can improve their motivation. Generally, I tell them that there are two big motivators in life. One is your values, or what is most important to you in your life. The other is fear, or trying to prevent the worst from happening.

Research by Tversky and Kahneman found that losses loom much larger than gains. This means that fear is usually better for motivation than values because we are more willing to try to avoid something terrible than we are to create something good. This bias is one of the main reasons your direct ancestors survived long enough to reproduce. So without their loss aversion, you may not be here today.

The problem with only using fear for motivation is that it triggers our fight-or-flight response. In addition, it increases our cortisol levels if we activate this response too often, which isn’t so great for our mental and physical health in the long run.

Being motivated by our values, on the other hand, is very rewarding. We aren’t just in survival mode. We are creating the life we want, and it feels enriching.

Intrinsic vs extrinsic values

Values are not the same thing as goals. Instead, they are guiding principles for life. They help you identify whether you are on the right track in your life or not. If you are unsure which values are most important to you, this clarification exercise can help.

The biggest problem with values is that it can be hard to know why your most important values are essential to you. Is it because society says they are? Or movies and TV shows? Or marketing companies? Or is it because your family or religion says so? Or just because it feels essential deep down?

Research has found that we are much more likely to experience motivation when motivated by our intrinsic rather than our extrinsic values. Extrinsic means something outside of us. Intrinsic implies something within us.

I remember back when I was doing my doctoral studies. I was not on a scholarship for the first six months and was studying for free. Then I was placed on an academic scholarship and was paid to learn. Being paid to study (an extrinsic factor) diminished my intrinsic motivation to study and made it harder overall. Before receiving the scholarship, I thought it would have been the opposite and that getting paid to learn would have helped me remain focused and finish my research even quicker. It did not.

Professional sports players who start getting paid to play can feel the same way. Growing up, you couldn’t keep them off the court or field. They just loved the game. But now, it’s a job. Some NBA or NFL players refuse to play unless they get more money or are playing for a contending team. Their intrinsic motivation has become overshadowed by their million-dollar salaries.

Volunteering in Vanuatu was the opposite. Because I was no longer getting paid to offer mental health support across the country, I could fall in love with psychology and therapy all over again. I was helping people to improve their mental health and the overall quality of their lives. I felt connected with my essential values and experienced lots of motivation.

Three Intrinsic Ways To Build Motivation

In his excellent book ‘Drive: The Surprising Truth About What Motivates Us’, the author Daniel H. Pink says that there are three ways to increase your intrinsic motivation:

1. Autonomy

  • What do you want to do?
  • Why do you want to do it?
  • Is it for others or for you?
  • If it is for others, do you feel forced to do it, or is it because it is important to you?
  • If it’s important to you, what personal value is being highlighted as very important for you:
    • Dutifulness?
    • Obedience or Loyalty?
    • Altruism?
    • Empathy?
    • Sympathy?
    • Being supportive?
    • Being kind or compassionate?
    • Not being indebted to others?
    • Equality or fairness?
    • Something else?

2. Mastery

  • What skills do you want to build?
  • What do you enjoy learning?
  • What areas interest you?
  • What comes easily to you that doesn’t come easily to others?

3. Purpose

  • What are you passionate about?
  • What is personally meaningful to you?
  • If you didn’t have to earn money, what would you do?
  • What would you want your epitaph or tombstone to say?
  • What would you want to hear someone say at your 80th birthday during a talk about you and the person you have been?
  • What do you want your legacy to be?
  • What do you want to add to the world?
  • How would you like to be remembered?
  • If the world was going to end in 2 years, and you couldn’t do anything about it or tell anyone else about it, would you do anything different to what you are doing now?
  • If your kids didn’t listen to what you said and only looked at what you did, would you change your daily actions or what you do? If so, what would you do differently?

Is FEAR Holding You Back?

Let’s say you know what you want to change but still struggle to do it. Perhaps FEAR is holding you back from making the changes you want to. FEAR is an acronym Russ Harris created in his books The Happiness Trap’ and ‘The Confidence Gap’.

FEAR stands for:

F = fusion with unhelpful thoughts

If you are fusing with unhelpful thoughts, you need to practice defusion skills to let go of unhelpful thoughts and increase your motivation. Defusion techniques involve recognising thoughts, images, and memories for what they are. They are just words and pictures. You then allow them to come and go as they please, without fighting them, running from them or giving them more attention than they deserve. Google search Acceptance and Commitment Therapy (ACT) defusion exercises and try some until you find one that allows you to let go of unhelpful thoughts. My favourite activity is on the app ‘CBT-I coach’ in the ‘quiet your mind’ section called ‘observe thoughts – clouds in the sky’.

E = expectations that are unrealistic

If you have unrealistic expectations, review your goals and write the new ones down to improve your motivation. Break these goals down into smaller steps, give yourself more time to achieve them and allow yourself to make mistakes. For example, you are hoping to obtain seven hours of sleep per night, and you only sleep five hours currently. Start with improving your total sleep time by an average of 10 minutes over the next week. Once you achieve this, you can then aim for another 10 minutes. Within 12 weeks, you could get to where you want to be, so try to take the long-term approach instead of looking for a super quick fix. It is okay if you do not reach your sleep goal in one night. Just stick to your plan, and do not give up until at least two weeks have passed. Everyone has a terrible sleep from time to time, so it is important to keep realistic short and long-term goals to ensure your motivation remains high.

A = avoidance of discomfort

If you avoid discomfort, challenge yourself to improve your motivation by taking action. Remember that gradual exposure is the most effective intervention for any anxiety disorder, including post-traumatic stress disorder. With anxiety, we want to avoid it, but this only keeps the fear alive as our brain tells us that what we are avoiding is dangerous. So instead, we must challenge ourselves to do what we want and make room for our emotions in these moments. By doing this, we will generally realise that doing what we feared was not nearly as bad or uncomfortable as we imagined. Try expansion ACT exercises or a body scan meditation to increase your ability to sit with painful or difficult emotions. The CBT-I coach app has a body scan meditation under the ‘quiet your mind’ section that I recommend checking out.

R = remoteness from values

If you are not living consistently with your most important values, reconnect with them to increase your motivation. Then see if your plan or desired outcome will help you live more consistently with your most important values. If your plan will, put the list of your top values in a visible place to remind yourself why you are currently doing what you are doing. If your plan will not, change it to be more consistent with what is most important to you.

Remember, change is generally always hard but worth it if it will help us live the life we want to be living in the end. Remembering why you are doing something is also the key to improving your motivation to push through when things get tough.

Good luck with improving your motivation, and do let me know if these strategies help!

Dr Damon Ashworth

Clinical Psychologist

Things You Can Do to Stay Mentally Healthy During Self-Isolation

These past few months have been wild and not in a good way.

On February 4th, I partially dislocated my knee while playing basketball in Port Vila, Vanuatu. It hurt—a lot.

On the 8th of February, I was medically relocated back to Australia, where an MRI confirmed the extent of the damage. I had ruptured my ACL, torn my meniscus, injured my MCL and fractured my tibia. Surgery was recommended, but the waiting list to see a specialist was lengthy. I worried that I would need to terminate my volunteer role as a Mental Health Specialist at Vanuatu’s Ministry of Health early. Fortunately, a private medical specialist said that I could go on a public waitlist for surgery and medically cleared me to return to Vanuatu to finish my role. I was still in pain, but I could walk and work, and the surgery could wait.

On March 7th, I returned to Port Vila and was super happy to see everyone again and put my psychological knowledge and skills towards reducing mental illness in Vanuatu.

Around this time, the number of Coronavirus cases began to escalate worldwide. Quickly. Before I had even re-adjusted to life in Port Vila again, the Australian Volunteer Program (AVP) informed us that the program was being suspended worldwide. All volunteers would be sent home in the next one to three weeks.

On the 16th of March, the program told us that we would need to pack up all our stuff and book a flight to return to Australia before the 31st of March. Then, on the 19th of March at 6:30 pm, AVP told us that we needed to leave the following day. After living in Vanuatu for 18 months, I did not even have a full day to pack and say a proper goodbye to everyone there, including dear friends, coworkers and patients. It was extremely tough and something that I am continuing to try and process both cognitively and emotionally.

Now that I am back in Melbourne and self-isolating, I suddenly have a lot of free time, no job and no demands except to stay on my property and away from other people.

Many of the things that we are all being asked to do during the pandemic are almost the exact opposite of what psychologists would normally recommend for people to do. This is especially the case for people with a diagnosable mental illness, such as depression or anxiety.

For depression, not doing things that we have previously enjoyed and isolating ourselves from others are two of the biggest traps that we can fall into. For anxiety, the biggest trap is continued avoidance of the things that we are afraid of.

A common psychological intervention for depression with a lot of scientific evidence supporting it is behavioural activation. This means that we push ourselves to do the things that we know are likely to be good for us, even if we don’t feel like doing them. For anxiety, the most empirically supported intervention is gradual exposure or slowly challenging ourselves to face our fears, especially with situations that feel like life or death situations to us but are actually pretty safe. Once we begin doing these things again, we realise that they are actually more enjoyable and less scary than our minds tell us. Over time, it can become easier and easier to do these (and other) activities.

What about Coronavirus?

Regardless of where you are in the world, the most important thing that we can do for the physical safety of ourselves and our loved ones is to follow the directives from your government about COVID-19, and the trusted health organisations that are helping to determine these directives in your area. If you are being asked to self-isolate, don’t go outside your property. If you are being asked to work from home and you can, please do, unless you are considered an essential service and needed out in the community. Wash your hands with soap and warm water for 20 seconds regularly, or use a hand sanitiser if you have access to them. Don’t touch your face and cough into your elbow and away from others. Practice social distancing and stay at least 1.5 metres from others. Don’t hang out in groups or touch or shake hands or hug and kiss others. Wear a mask if you are worried that you have any symptoms. Call the emergency numbers or hotlines in your region if you are concerned about your symptoms. Ask medical professionals about what you should do rather than just turn up to unannounced clinics or hospitals.

Hopefully, most of you know the relevant recommendations in your area by now and why they are important to help flatten the curve. If we can all do our part, it will help reduce how overwhelmed our medical facilities become with severe or critical COVID-19 cases, which will reduce the overall fatality rate.

How Can We Mentally Cope?

The current Coronavirus pandemic does seem to be having a huge psychological impact on people across the globe. Many people were in denial initially or trying to minimise the seriousness of the virus or the impact that they thought it would have. However, once it began to spread more, people began to feel scared, afraid, fearful, anxious, worried, nervous, panicky and overwhelmed about what was going on in the present and what may come in the future. Others report feeling sad, shocked, despondent, hopeless, helpless, or in grief about what they have already lost and what they can do about it at the moment. Or they feel annoyed, frustrated, mad, or angry about what has happened, how it has happened, and the decisions that governments and others are making to try and slow down the spread of the virus.

It is a challenging time for everyone.

During my first few days of self-isolation, I think I was still recovering from the panic associated with trying to pack up my life and leave Vanuatu in less than 24 hours. I was in shock, maybe, or denial. For the first three days, I didn’t even unpack my bag. I just communicated with friends and family, read some books, worried, played video games, watched Netflix, ate and slept.

By day four, which was yesterday, enough was enough. So I pulled out a notebook and decided that I would try the Ivy Lee Productivity Method. This 100-year-old method to boost productivity is quite simple, with only five steps:

By figuring out my top 6 priorities and writing them down, I managed to feel a lot better and more in control, even before I started doing the tasks. I also managed to fly through the tasks and feel productive again for the first time since being back in Melbourne. I resumed my daily meditation practice using the ‘Waking Up’ app. I unpacked my bags and tidied my room. I switched my SIM card in my phone back to my Australian one. I did some much-needed paperwork online and did a weights workout while watching some TV. It was a good day.

If you are feeling overwhelmed or unproductive at the moment, try the Ivy Lee Productivity Method. Just make sure that you only put six items on the list, and do the most important things first.

Having a schedule or consistent routine is also something that I would highly recommend during this pandemic. Work and school often provide this for us, but you need to create this yourself if you are at home 24/7. A helpful routine might consist of:

  • trying to sleep and wake at relatively consistent times,
  • not spending too little or too much time in bed (7–9 hours for adults, more for children),
  • regularly eating with lots of vegetables and not too much junk food or sweets,
  • staying hydrated by drinking enough water and minimising consumption of alcohol, nicotine and illicit drugs,
  • communicating via phone or the internet with at least one friend or family member daily,
  • doing some form of strength training or cardiovascular exercise for 20–30 minutes a day, even if you are confined to a single room,
  • having some daily tasks that give you a sense of achievement, engagement or mastery, and
  • getting fresh air and sunlight regularly if you can do this without breaking any restrictions in your area.

The more you can build these things into your daily routine, the greater the chance of maintaining or improving your mental health. Having some activities that we enjoy each day and look forward to doing can also really help.

Which Activities Can Help?

If you still aren’t exactly sure what you can do from day to day at the moment, a pleasant activities list or pleasant activity schedule can help. There are many different ones available online for free. Still, the one I will use for this article is the ‘Fun Activities Catalogue’ by the Centre for Clinical Interventions in Western Australia.

Out of the 365 activities listed, there are some that I can definitely not do while in self-quarantine, including going ice-skating, going out to dinner, socialising in person, flying a plane, scuba diving, going on a tour or to the zoo or movies, or playing sport.

What is surprising, though, is just how many items I still can do. Read the list of self-quarantine friendly activities below, and rank on a scale from 1 to 5 how much you think you would enjoy doing the task if you were to do it. If you can’t do that particular item where you are living, just skip it. For this exercise, 1 = I would hate to do this activity, 2 = I wouldn’t really like doing this activity 3 = doing the activity would be okay, 4 = it would be pretty fun to do this activity, and 5 = I would love to do this activity!

  • Spending time in my backyard
  • Watching the clouds drift by
  • Debating with someone online or over the phone
  • Painting my nails
  • Scheduling a day with nothing to do
  • Giving positive feedback about something (e.g. writing a letter or email about good service)
  • Feeding the birds
  • Spending an evening with good friends online or on the phone
  • Making jams or preserves
  • Getting dinner delivered by a restaurant and having them drop it at your doorstep
  • Buying gifts online
  • Having a political discussion online or over the phone
  • Repairing things around the house
  • Washing my car
  • Watching TV, videos
  • Sending a loved one a card in the mail
  • Baking something
  • Taking a bath
  • Having a video call with someone who lives far away
  • Organising my wardrobe
  • Playing musical instruments
  • Lighting scented candles, oils or incense
  • Spending time alone
  • Exercising
  • Putting up a framed picture or artwork
  • Looking up at the stars at night
  • Birdwatching from my backyard or window
  • Doing something spontaneously in the house
  • Going on a picnic in the backyard
  • Having a warm drink
  • Massaging hand cream into my hands
  • Fantasising about the future
  • Laughing
  • Clearing my email inbox
  • Getting out of debt/paying debts
  • Looking at old photo albums or photos on my computer or Facebook
  • Exploring Google Earth
  • Walking around my house and yard
  • Researching a topic of interest
  • Redecorating
  • Donating money to a cause
  • Smelling a flower
  • Opening the curtains and blinds to let light in
  • Doing jigsaw puzzles
  • Sorting through old clothes or items that you could donate to a charity eventually
  • Lying in the sun
  • Learning a magic trick
  • Talking on the phone
  • Listening to a podcast or radio show
  • Noticing what I can see in the neighbourhood from my house or yard
  • Doing arts and crafts
  • Sketching, painting
  • Mowing the lawn
  • Doing the dishes
  • Sitting outside and listening to the birds sing
  • Watching TED talks online
  • Planning a holiday for the future
  • Playing cards
  • Putting moisturising cream on my face/body
  • Re-watching a favourite movie
  • Gardening
  • Going camping in the living room or backyard
  • Entering a competition
  • Doing crossword puzzles
  • Patting or cuddling my pet
  • Cooking a special meal
  • Putting extra effort into my appearance
  • Doing a favour for someone online
  • Building a birdhouse or feeder
  • Looking at pictures of beautiful scenery
  • Talking to family members online or over the phone
  • Listening to music
  • Learning a new language using the app Duolingo
  • Taking a free online class
  • Working on my blog or seeing clients via telehealth
  • Washing my hair
  • Singing around the house
  • Creatively reusing old items
  • Stretching
  • Maintaining a musical instrument (e.g. restringing guitar)
  • Buying clothes online
  • Snuggling up with a soft blanket
  • Listening to an audiobook
  • Watching an old stand-up comedy show on Netflix or Youtube
  • Writing down a list of things I am grateful for
  • Teaching a special skill to someone else online (e.g. knitting, woodworking, painting, language)
  • Playing chess using an app
  • Playing video games
  • Jumping on a trampoline
  • Sending a text message to a friend
  • Doodling
  • Putting a vase of fresh flowers in my house
  • Participating in an online protest or campaign
  • Baking home-made bread
  • Walking barefoot on the soft grass
  • Watching a movie marathon
  • Skipping/jumping rope
  • Wearing an outfit that makes me feel good
  • Cooking some meals to freeze for later
  • Hobbies (stamp collecting, model building, etc.)
  • Talking to an older relative over the phone and asking them questions about their life
  • Listening to classical music
  • Photography
  • Watching funny videos on YouTube
  • Doing something religious or spiritual (e.g. praying)
  • Making my bed with fresh sheets
  • Lifting weights
  • Early morning coffee and news
  • Planning a themed party for next year (e.g. costume, murder mystery)
  • Wearing comfortable clothes
  • Shining my shoes
  • Trying to act like the characters in my favourite movies or TV shows
  • De-cluttering
  • Arranging flowers
  • Working on my car or bicycle
  • Juggling or learning to juggle
  • Contacting an old school friend
  • Calligraphy
  • Sleeping
  • Playing with my pets
  • Listening to the radio
  • Doing Sudoku
  • Planting vegetables or flowers
  • Surfing the internet
  • Doing embroidery, cross-stitching
  • Buying books from Amazon or bookdepository.co.uk
  • Meditating using Smiling Mind or Headspace or Calm or Balance or Waking Up apps
  • Training my pet to do a new trick
  • Planning a day’s activities
  • Waking up early and getting ready at a leisurely pace
  • Organising my home workspace
  • Writing (e.g. poems, articles, blog, books)
  • Dancing in the dark
  • Reading classic literature
  • Putting on perfume or cologne
  • Reading magazines or newspapers
  • Calling a friend
  • Sending a handwritten letter
  • Reading fiction
  • Meeting new people online by joining groups that you are interested in
  • Doing 5 minutes of calm deep breathing
  • Buying new stationery online
  • Turning off electronic devices for an hour (e.g. computer, phone, TV)
  • Buying music (MP3s, Spotify premium subscription)
  • Relaxing
  • Watching an old sports game (rugby, soccer, basketball, etc.)
  • Doing woodworking
  • Planning a nice surprise for someone else
  • Saying “I love you” to someone important in your life online, over the phone or in a letter
  • Making a playlist of upbeat songs
  • Colouring in
  • Doing a nagging task (e.g. making a phone call, scheduling an online appointment, replying to an email)
  • Shaping a bonsai plant
  • Planning my career
  • Reading non-fiction
  • Writing a song or composing music
  • Having a barbecue
  • Sewing
  • Dancing
  • Looking at art online
  • Making a ‘To-Do’ list of tasks
  • Having quiet evenings
  • Singing in the shower
  • Refurbishing furniture
  • Exchanging emails, chatting on the internet
  • Knitting/crocheting/quilting
  • Napping in a hammock
  • Making a gift for someone
  • Having discussions with friends
  • Trying a new recipe
  • Pampering myself at home (e.g. putting on a face mask)
  • Reading poetry
  • Savouring a piece of fresh fruit
  • Eating outside in my backyard
  • Making a pot of tea
  • Using special items (e.g. fine china, silver cutlery, jewellery, clothes, souvenir mugs)
  • Doing a DIY project (e.g. making homemade soap, making a mosaic)
  • Taking care of my plants
  • Telling a joke online or over the phone
  • Discussing books online
  • Watching boxing or wrestling online or on TV
  • Giving someone a genuine compliment
  • Practising yoga or Pilates
  • Shaving
  • Genuinely listening to others
  • Tidying-up
  • Rearranging the furniture in my house
  • Blowing bubbles
  • Buying new furniture online
  • Watching a sunset or sunrise from the balcony
  • Watching a funny TV show or movie
  • Recycling old items
  • Boxing a punching bag
  • Cleaning
  • Daydreaming
  • Learning about my genealogy/family tree
  • Setting up a budget
  • Writing a positive comment on a website /blog
  • Eating something nourishing (e.g. chicken soup)
  • Taking a class online (e.g. Masterclass, Udemy, Coursera)
  • Combing or brushing my hair
  • Writing diary/journal entries
  • Scrapbooking
  • Cooking an international cuisine
  • Reading comics
  • Trying new hairstyles
  • Watching a fireplace or campfire
  • Whistling
  • Working from home
  • Playing board games (e.g. Scrabble, Monopoly)
  • Savouring a piece of chocolate
  • Hunting for a bargain online
  • Buying, selling stocks and shares
  • Buying myself something nice
  • Solving riddles
  • Watching old home videos
  • Making home-made pizza
  • Origami
  • Doing something nostalgic (e.g. eating a childhood treat, listening to music from a certain time in my life)
  • Joining a club online (e.g. film, book, sewing, etc.)

Hopefully, there are at least a few items in the above list that you would find fun or would love to do. If so, put them on your to-do list or build them into your routine somewhere over the next week, and see what happens. If it’s been a long time or you have never done it before, it may be even more fun than you expect once you get started. Just make sure that you give the task a proper go for at least ten minutes before stopping and trying something else.

Conclusion

In the 21st Century, our lives have become extremely busy, full and fast-paced. With the COVID-19 pandemic, we are now being told that the most helpful thing we can do is stay at home and remain physically distant from others. Unless you are in an essential profession, this could be a time to slow down. To check in with those that you care most about. To chat for longer and to connect emotionally. To reflect on your life and rediscover what really matters to you. To hope and dream and plan for a better future. And to try things that you otherwise may not have had the chance or the time to do.