Category: Deliberately Better

It’s Okay to Still Fall into Life Traps… We All Do!

Life traps are self-defeating ways of perceiving, feeling about, interacting with oneself, others, and the world.

If you want to get a sense of what your life-traps may be, the book ‘Reinventing your life’ by Jeffrey Young is an excellent place to start, as it goes into 11 different ones. If you want a more in-depth analysis, however, then go and see a Psychologist who specialises in Schema Therapy.

A Psychologist has much more thorough and scientific questionnaires that can give you results on 18 schemas (life-traps), help you identify your most common traps, and show you what you can do both in therapy and outside of it whenever you realise that you have fallen into a trap.

My Life-traps

I have taken the Young Schema Questionnaire (YSQ-L3) three times to help identify my main life traps. The first time was at the beginning of 2014 when I was stuck in the middle of a complicated relationship while also trying to complete the last part of my Doctoral thesis and play basketball at a semi-professional level.

The second time was in April 2017, when I was in a Clinical Psychology job that I loved. I had also stopped playing basketball at such an intense level and played with some friends (and without a coach) twice a week, which was way more fun.

The most recent time was August 2018, where I had just finished up my work in private practice in Melbourne, Australia and was about to leave my friends and family to volunteer for two years in Port Vila, Vanuatu, as part of the Australian Volunteers Program (funded by the Australian Government).

I want to share these results with you to show you that:

context influences personality and how people view themselves, the world and others,
personality and ways of perceiving yourself, relationships, and the world can change, and
Even though it is possible to grow and improve over time, we all still fall into traps at times, which is okay. It’s about identifying when you have fallen into a trap and then knowing what you need to do to get out of it.

When looking at the results, a 100% score would mean that I have answered every item for that life-trap a 6, which means that they describe me perfectly. The higher the % score, the more likely I will frequently fall into this life trap.

YSQ-L3
2014 Results	2017 Results	2018 Results
Schema or life-trap	Schema or life-trap	Schema or life-trap
1. Subjugation – 75%	1. Self-sacrifice – 60.78%	1.Self-sacrifice – 60.78%
2. Dependence – 64.44%	2. Punitiveness (self) – 57.14%	2. Emotional Deprivation – 59.26%
3. Self-sacrifice – 61.76%	3. Emotional Deprivation – 51.85%	3. Punitiveness (self) – 50%
4. Approval seeking – 54.76%	4. Unrelenting Standards/ Hyper-criticalness – 48.96%	4. Subjugation – 50%
5. Punitiveness (self) – 51.19%	5. Approval Seeking – 48.81%	5. Unrelenting standards – 43.75%
6. Unrelenting standards – 48.96%	6. Subjugation – 48.33%	6. Approval seeking – 41.67%
7. Insufficient self-control – 46.67%	7. Negativity/ Pessimism – 43.94%	7. Vulnerability to harm/illness – 40.28%
8. Emotional inhibition – 46.30%	8. Mistrust/ Abuse – 41.18%	8. Negativity/Pessimism – 39.39%
9. Emotional deprivation – 42.59%	9. Dependence/ Incompetence – 41.11%	9. Dependence/ Incompetence – 38.89%
10. Abandonment – 41.18%	10. Emotional Inhibition – 40.74%	10. Mistrust/Abuse – 37.25%

What’s Changed?

people riding canoe boat view from inside pipe

By looking at the table above, the green items indicate an improvement in comparison to the prior assessment, meaning that these life-traps are a little bit less powerful for me. The yellow indicates no change since the last assessment, and the red indicates a worse score, meaning that these life-traps may have a more powerful sway over me.

From 2014 to 2017, 7 out of the initial top-10 life-traps had improved, one stayed the same, and two had worsened. Two additional traps not included in the initial top 10 had worsened and made the list (Negativity/Pessimism & Mistrust/Abuse).

From 2017 to 2018, seven out of the 2017 top ten life traps had improved yet again, with one staying the same and two becoming worse. One additional trap (Vulnerability to harm/illness) had increased. Still, I believe this was due to the medical and safety briefings that I had been going through in the preparation of moving to Vanuatu for 2 years.

Overall, I am less likely to fall into any life trap in 2018 than in 2014 and 2017. For example, the average of my top ten in 2014 was 53.29%, whereas in 2017, it was 48.28%, and in 2018, it was 46.13%.

I also rated 21 items a 6 (= describes me perfectly) in 2014, only five in 2017, and none in 2018. This means that I am much less likely to get completely pushed around by my life traps. However, they still have some sway on me, especially the self-sacrifice and the emotional deprivation schemas, and to a lesser degree, punitiveness and subjugation.

Here is Young’s description of these schemas:

SELF-SACRIFICE: Excessive focus on voluntarily meeting the needs of others in daily situations, at the expense of one’s own gratification. The most common reasons are: to prevent causing pain to others; to avoid guilt from feeling selfish; or to maintain the connection with others perceived as needy. Often results from an acute sensitivity to the pain of others. Sometimes leads to a sense that one’s own needs are not being adequately met and to resentment of those who are taken care of.

EMOTIONAL DEPRIVATION: Expectation that one’s desire for a normal degree of emotional support will not be adequately met by others. The three major forms of deprivation are:

Deprivation of Nurturance: Absence of attention, affection, warmth, or companionship.
Deprivation of Empathy: Absence of understanding, listening, self-disclosure, or mutual sharing of feelings from others.
Deprivation of Protection: Absence of strength, direction, or guidance from others.

SUBJUGATION: Excessive surrendering of control to others because one feels coerced — usually to avoid anger, retaliation, or abandonment. The two major forms of subjugation are:

1. Subjugation of Needs: Suppression of one’s preferences, decisions, and desires.

2. Subjugation of Emotions: Suppression of emotional expression, especially anger.

Subjugation usually involves the perception that one’s own desires, opinions, and feelings are not valid or important to others. Frequently presents as excessive compliance, combined with hypersensitivity to feeling trapped. Generally leads to a build up of anger, manifested in maladaptive symptoms (e.g., passive-aggressive behaviour, uncontrolled outbursts of temper, psychosomatic symptoms, withdrawal of affection, “acting out”, substance abuse).

PUNITIVENESS: The belief that people should be harshly punished for making mistakes. Involves the tendency to be angry, intolerant, punitive, and impatient with oneself for not meeting one’s expectations or standards. Usually includes difficulty forgiving mistakes in oneself, because of a reluctance to consider extenuating circumstances, allow for human imperfection, or empathize with one’s feelings.

Three out of my top four life traps have improved since 2014, but emotional deprivation, unfortunately, continues to climb with each assessment. I think that self-sacrifice, subjugation, and emotional deprivation schemas may be common life traps for people who decide to become psychologists. The therapeutic relationship is meant to be one-sided and focused on the patient or client’s needs, not the psychologist’s needs. For this reason, psychologists must get their relational needs met outside of their job and get their own therapy if needed to ensure that they can have a space about them. I wonder how these life traps will continue to evolve over the next two years in Vanuatu…

How Can Life-traps Be Overcome?

The first step to changing anything is awareness. If you are not aware that you are falling into any traps, it means that you either don’t have any, or you are so enmeshed in your experience that you cannot see them.

Once you are aware of your traps, the next step is to understand them and why they occur for you. Most life traps originate in childhood typically, which is why most psychologists and psychiatrists will ask about your upbringing and your relationship with your parents in particular.

Life traps are actually considered to be adaptive ways of coping with maladaptive environments. This means that your life traps were probably quite useful in the particular family dynamic that you had, or you wouldn’t have developed them in the first place. For example, my family often called me a martyr when I was younger because it didn’t matter what I wanted. In reality, it was just much more comfortable to let everyone else decide and take charge. Then if things didn’t work out, others couldn’t blame me. I saw it as a win-win but often didn’t get what I wanted because I didn’t speak up and then complained that my parents loved my siblings more, who were more than happy to speak up and ask for what they wanted.

However, once you move out of the family home, these coping methods are generally ineffective. They tend to become maladaptive ways of interacting with yourself, others or the world. If I keep playing the martyr and refuse to speak up as an adult, my needs still don’t get met. As a result, I may become excessively demanding of others as a counterattack measure (not likely for me), or I may try to escape from all relationships where I need to speak up about my needs. Either way, it keeps the life trap going, and it isn’t helpful.

I need to realise that there are relationships out there where it is beneficial for me to speak up, as people then know what I want and respond effectively to the situation at hand. It still doesn’t “feel right” when I think about telling others my wants or needs (and I’m not sure if it ever will), but I logically know that it is the best approach for me to take going forward. If I want to break free from my main life traps, I must learn to speak up reasonably when important to me (and others). By doing this, eventually, the life traps will become much less prevalent and less powerful too.

If you have been trying with therapy for a long time but don’t think you are getting anywhere, please seek a Psychologist with experience in Schema Therapy. Also, if you are stuck in a relationship where your needs aren’t being met, it could help too.

Learning about Schema Therapy and undergoing training in it has taught me more about my own personal life traps than anything else that I have done before and really does give me a sense of what my most significant challenges are going forward. I’ve made a lot of progress so far, but there is still a long way to go, and that is okay. I know that I will continue to improve with acceptance, self-compassion, patience, reflection, and perseverance, and I am confident you can too!

Dr Damon Ashworth

Clinical Psychologist

P.S. For a full description of the other 14 maladaptive schemas, please click here.

September 19, 2018

How Do You Deal With Your Problems?

Throughout my schooling years, I was a horrible procrastinator. I would leave everything to the last minute, sometimes even having to take a day off high school to finish an assignment that was meant to be due that day.

Once I got to university, I couldn’t do this anymore, as the due date remained the same whether I went to classes or not. So I would instead consume a lot of energy drinks the night before an assignment was due and generally do the majority of the assignment in an anxious, tense and sleep-deprived state, printing it out and submitting it 20 minutes before the deadline.

Exams were the same. I’d miss classes, not pay attention when I was there, and then try to cram an entire semester’s contents into the last 4 days before an exam. I would lock myself in my room and study up to 12 hours a day, only leaving for toilet breaks and something to eat until I was utterly exhausted. Luckily, I have a knack for remembering vast amounts of information in short periods of time, so I always passed, but it wasn’t easy or fun.

I sometimes tried to start early but never found this effective, as the negative consequences seemed far away. So eventually, I figured I would follow the mantra, “if you leave everything to the last minute, it only takes a minute”. This mantra actually helped me fit a lot of things into my life by being more efficient, but it did have its limitations.

Once I got to my Doctorate of Clinical Psychology degree at Monash University, I was suddenly faced with the prospect of having to do a 70,000-word thesis that was meant to take 3.5 years to do. How could I possibly cram something so big, especially when it consisted of making a research proposal, ethics application, recruiting participants, conducting a clinical trial, collating all the results, running data analysis and writing up the thesis and journal articles? It turns out I couldn’t.

The thesis ended up taking me 4 years to complete, and there wasn’t too much of it that I enjoyed. Moreover, it required a direct challenge of my usual defence mechanisms, which was no easy feat, especially because I didn’t know what they were. I knew that I had always procrastinated with my studies, but I was never entirely sure why.

What Are Your Defence Mechanisms?

Fortunately, a fun test over at personalityassessor.com on coping styles’ titled ‘How Do You Deal?’ helped me identify which defence mechanisms I typically used. So if you are interested in knowing what yours are, I definitely recommend taking it.

It is a bit time-consuming as there are 2 parts and over 200 questions, but I like this questionnaire so much because it is tough to fudge the test to get desirable results. This is because the survey doesn’t have face validity, and therefore doesn’t appear to measure how much someone engages in a particular defence mechanism. Two examples of questions are:

“I am bothered by stomach acid several times per week” or

“It is annoying to listen to a lecturer who cannot seem to make up his mind as to what he really believes”.

I’m not sure which defence mechanisms these questions are tapping into or if the correct answer is true or false. However, previous research has shown that specific patterns of responses on the questionnaire are quite good at identifying people who regularly use 10 common defence mechanisms, including repression, displacement, denial, regression, projection, reaction formation, intellectualisation, rationalisation, isolation and doubt. My results were astonishing to me.

My Defence Mechanisms

I first took the ‘How Do You Deal?’ questionnaire in February 2013. I had just finished a year-long practical internship at Peter MacCallum Cancer Centre, and I found supporting individuals with cancer really rewarding and meaningful, but also quite challenging as I had lost a dear friend to cancer when I was 21. In addition, I wanted to finish my thesis by July but was falling way behind, and I was also a month away from getting married and moving in with my then fiancé. So I had many big changes coming up, and I was both stressed and scared about how everything would go.

Here are my February 2013 results, alongside the descriptions of these defence mechanisms given by the personality assessor website:

1. Denial — 94th percentile — extremely high

Denial is a defense mechanism where people avoid thinking about problems, or even pretend like their problems don’t exist. For example, someone might deny that they have a drug problem. Or someone might deny that they’re currently having conflict in their romantic relationship.

Since denial can be subconscious, people who use denial might honestly believe that their problems don’t exist!

2. Isolation — 91st percentile — extremely high

Isolation is a defense mechanism where people compartmentalize their thoughts and feelings so that their thoughts don’t affect their feelings.

Isolation differs from denial. Using denial, a person with a drug problem might refuse to even see that they have a drug problem. Using isolation, a person with a drug problem would acknowledge they have a problem, but would not let the fact they have a problem affect their feelings. If intellectualization is all about staying in your head to avoid your heart, isolation is about keeping your head and your heart separate.

3. Displacement — 81st percentile — very high

Displacement occurs when we “take out” our frustrations on someone/something else. For example, imagine that you hate your boss. It might have dire consequences if you expressed your hate toward your boss. So, if you displaced those feelings, you might go home and yell at your family.

This is different than projection. In projection, we don’t see our own feelings — we see them in other people (e.g., I am not angry, my boss is). In displacement, however, we still “own” our feelings (e.g., I am angry) but we “take out” those feelings on the wrong target (e.g., angry at boss, but kick dog instead of boss).

4. Regression — 73rd percentile — high

Regression is a defense mechanism where people essentially start acting or thinking like a child. The idea is that when life feels too overwhelming or our problems feel too big, that we regress to an earlier, easier time when other people (our parents) used to take care of us. As such, regression can include:

* desiring for other people to take care of your problems for you

* acting dependent on other people

* acting like a child (e.g., temper tantrums)

* refusing to take responsibility for your actions

5. Doubt — 72nd percentile — high

The defense mechanism of doubt occurs when people doubt their senses or thought processes when they encounter problems. For example, imagine a good friend tells you they don’t really like you. You might utilize the defense mechanism of doubt by thinking “I must have misunderstood what they meant.”

Doubt is kind of like a mixture of denial, intellectualization, and rationalization. Doubt lets us deny that our problems are real (or avoid making big decisions we’re afraid of) by questioning our ability to accurately see the world and make good decisions. In contrast to denial, when people use doubt, they are aware of their problems on some level.

6. Rationalization — 68th percentile — high

Rationalization is when people excuse their actions with usually irrational false explanations. For example, if someone binges and eats an entire large pizza, they might think “Well, the food was going to waste anyway! I might as well have eaten it.”

Rationalization is kind of like a mixture of denial and intellectualization. Essentially, rationalization allows people to “explain away” their problems (usually bad habits, personal flaws, etc.) with a superficially valid explanation. The biggest difference between rationalization and intellectualization is that intellectualization is used to avoid feelings, whereas rationalization is used to avoid seeing our own personal flaws.

7. Intellectualisation — 64th percentile — high

Intellectualization occurs when people avoid painful feelings by thinking oftentimes inappropriate impersonal thoughts. For example, if someone’s pet dies, they might think, “Pets die every day. Why should I be upset?”

Basically, the idea is that people who use intellectualization minimize their problems — or at least their feelings — and avoid the pain in their hearts by staying lodged solidly in their heads.

8. Projection — 47th percentile — about average

Projection occurs when we project our own thoughts and feelings onto other people. For example, you might really hate your boss. If you used the defense mechanism of projection, you might be unaware of your own feelings toward your boss, but instead think your boss hated you. This defense mechanism would allow you to deny your feelings and, in turn, believe that any conflict between you and your boss is your boss’s fault (not yours).

Projection basically lets us believe that are problems aren’t really ours — they’re someone else’s!

9. Repression — 37th percentile — low

Repression occurs when people push down or block-out memories or desires that they feel are threatening. For example, someone might repress painful childhood memories and try to not think about them. As another example, someone might repress their attraction to a friend that they fear wouldn’t reciprocate their interest.

Repression is similar to denial, but slightly different. Denial is about convincing yourself that your problems don’t exist. Repression is about blocking out part of yourself — memories or desires, usually — perhaps to avoid creating a problem!

10. Reaction formation — 15th percentile — very low

Reaction formation is a fascinating defense mechanism where we do the opposite of what we really want to do. For example, imagine you are very attracted to another person. If, for some reason that attraction is a problem (e.g., you are married, they are married, etc.), you might start to feel the opposite toward them — you may think they are disgusting and/or actively dislike them.

Reaction formation allows you to avoid your problems — and also creates a buffer to ensure you avoid your problems. In the example above, you’re not merely repressing your attraction toward the other person — you’re actually feeling negative feelings toward them. These negative feelings will ensure the attraction doesn’t resurface.

Seeing that my marriage ended up being far worse than I had predicted, I maybe should have paid attention to these results a bit more, especially my denial and doubt scores.

It did help with the writing up of my thesis. I stopped trying to avoid the problem, started coming into the lab from 9 am — 5 pm every weekday regardless of how I felt and began making some real and consistent progress without cramming for the first time in my life. I finished a full draft of my thesis by September 2013, started working as a Psychologist in private practice shortly after that, and submitted the final copy of my thesis for examination in February 2014.

Have My Defence Mechanisms Improved?

I retook the ‘How Do You Deal?’ questionnaire at the end of April 2017. I now live a life that is much more consistent with the experiences I want to have rather than what society says that I should be doing. I believe that I am a lot happier and in the best place that I have ever been psychologically. But have my defence mechanisms actually changed?

Defence Mechanisms	2013	2017
Denial	94th percentile	75th percentile
Isolation	91st percentile	92nd percentile
Displacement	81st percentile	77th percentile
Regression	73rd percentile	68th percentile
Doubt	72nd percentile	64th percentile
Rationalisation	68th percentile	53rd percentile
Intellectualisation	64th percentile	18th percentile
Projection	47th percentile	56th percentile
Repression	37th percentile	20th percentile
Reaction formation	15th percentile	9th percentile

As you can see, eight of my results had improved, with denial dropping 19 percentile points and losing its position as my most used defence mechanism. This is great, as I am now more aware of my issues and can actually do something about them.

My most noticeable improvement was my reduction in intellectualising things, but I also repress things much less than I used to, rationalise my actions less, and doubt myself less too. This means that I am now turning into what I feel and need more, not just remaining in my head. By understanding and accepting my emotions rather than avoiding them or explaining them away, it really does make it easier to know what action I need to take. Regular journaling, mindfulness and therapy have definitely helped me to create these changes. So has being more honest and authentic with others.

The two defence mechanism scores that have increased are projection and isolation. The increase in projection isn’t helpful, as this means I could be externalising some problems rather than taking responsibility for my role in creating them. The high isolation score isn’t so bad, though, as separating my head and heart is something that I have worked on to make sure that I am making decisions in line with my values and not my fears going forward. If this never changes, that will be fine by me.

Can We Change How We Deal With Problems?

It’s not possible to completely avoid engaging in defence mechanisms. We all have different coping methods, and many of these coping styles are developed in childhood and modelled on what everyone else in our family did.

However, some defence mechanisms are more helpful than others, and they can change in time with deliberate practice. Head researcher of the Grant longitudinal study, George Vaillant, has separated defence mechanisms into immature, intermediate and mature defences. Acting out, projection, passive-aggressive behaviour, and denial are considered immature. Reaction formation, repression and displacement are intermediate defences. Mature defences include:

humour: seeing the funny side of things,
sublimation: channelling difficult emotions into something prosocial and constructive,
anticipation: planning for upcoming situations that might be challenging,
suppression: not reacting to your feelings or letting them show if this would interfere with you achieving your goals, and
altruism: deriving pleasure from helping others.

A 2013 study by Malone and colleagues found that men who used more mature defence mechanisms between 47 and 63 years of age had better health between 70 and 80. This was mostly because the people who regularly engaged in more mature defence mechanisms had better social support and stronger interpersonal connections than individuals who used immature defence mechanisms (Malone et al., 2013).

If you want to build up healthier coping strategies, understanding which defences you currently use is a great place to start. The best way to do this apart from taking the ‘How Do You Deal?’ questionnaire is consulting with a therapist, especially a psychologist or a psychiatrist trained in psychoanalysis or psychodynamic psychotherapy. Friends and family might be able to point out some potential defence mechanisms that you use, but I think it is better to get this feedback from professionally trained and impartial. They can then help you replace these defences with more mature and adaptive coping strategies to have more supportive relationships and better long-term health and well-being.

Dr Damon Ashworth

Clinical Psychologist

July 25, 2018

The 5 Lessons I Discovered From Being Kind
On January 1st, 2018 we kickstarted our Deliberately Better movement.

Along with other passionate and driven allied health professionals, we aimed to highlight the various ways that people can choose to act if they wish to scientifically improve their health and well-being.

In January, we aimed to engage in a random act of kindness each day.

This was a fun experiment, and I tried to make a video of my acts of kindness every second day, which I was mostly successful with:
- On day 4, I supported a friend on a hang gliding expedition
- On day 6, I spent some quality time with my dad and played a round of golf with him
- On day 8, I donated some spare change to the Royal Children’s Hospital
- On day 12, I bought a copy of the big issue to support a rough sleeper
- On day 14, we left a big tip at a restaurant that stayed open for us
- On day 16, I donated plasma to the red cross blood bank
- On day 18, I topped up some stranger’s parking meters
- On day 20, I donated some clothes to charity
- On day 22, I supported an organisation that was trying to raise money to protect a wilderness area in Tasmania
- On day 24, I proofread a book that my friend had written and wanted to publish
- On day 28, I went and played a beach volleyball tournament with my sister.
- On day 30, I handed out bottles of water to people who were homeless around Melbourne.
Even though it was weird to film and promote the acts of kindness that I engaged in, the month really did teach me a few valuable lessons. These are:
1. Trying to be kind to others feels good
2. Viewing or hearing about others acts of kindness feels great

3. Hearing about or seeing others acts of kindness encourages people to be kinder too

4. Trying to be kind to others can improve social anxiety

5. Trying to be kind to others can enhance energy levels and physical health

To assess changes in how I felt from the beginning to the end of the month of kindness, I completed the Positive and Negative Affect Scale (PANAS), as developed by Watson, Clark and Tellegen (1988). This scale has two 10-item scales; one for positive affect and one for negative affect.

If you would like to assess your levels, please answer from 1 to 5 on the following questions for how much you have felt this way recently:

1 = very slightly or not at all

2 = a little

3 = moderately

4 = quite a bit

5 = extremely

Positive affect items:

_______ active

_______ alert

_______ attentive

_______ determined

_______ enthusiastic

_______ excited

_______ inspired

_______ interested

_______ proud

_______ strong

Negative affect items:

_______ afraid

_______ scared

_______ nervous

_______ jittery

_______ hostile

_______ guilty

_______ ashamed

_______ upset

_______ distressed

If you want to compare your scores to previous norms, first add up your totals for your positive affect and negative affect.

A 1989 study of 815 Detroit adults by Quinn found an average for positive affect of 36.0. For negative affect, the average was 18.2 (Quinn, 1989).

In 1993, an unpublished study by Wilkinson found an average of 33.5 for positive affect in 114 adult men and 33.9 in 115 adult women. For negative affect, it was 14.2 for the men and 15.5 for the women (Wilkinson, 1993).

What I find interesting about these findings is that US adults report both higher positive and higher negative affect, indicating that they may be more expressive (and more aware) of their emotions than Australians.

My score for positive affect before the kindness challenge was a 32, which was below the norms for both Australian and US adults. Given that I was feeling exhausted by the end of 2017, this makes sense to me. Extraverts are more likely to experience higher levels of positive affect also, and I would consider myself more of an ambivert.

After a month of kindness, this score had shot up to 41, which was more than one standard deviation higher than the norm for Australian men, and much higher than the average for US adults too.

My negative affect was less impacted by my acts of kindness, however, with my score remaining at 16 at both the start and the end of the month. I was slightly less irritable by the end of the month, but I was also a little bit more afraid, and this could have been due to the videos that I was putting up.

Either way, I seem to experience slightly more negative emotions than the average 1993 Australian, and somewhat less than the average 1989 individual from Detroit.

My experiment with being kinder didn’t solve all of my problems, but it did help me to take a few risks, challenge myself, put myself out there more, grow as a result, and hopefully put a few smiles on some people’s faces. That is enough for me, for now.

2018 DELIBERATELY BETTER AGENDA:

* In February, we gave up or cut down on something that was having a negative impact on our quality of life.
* In March, we focused on our diets and looked at what were the most effective ways to lose weight or get into the best shape of your life.
* In April, we looked into the different habits of high performers and how they improve their skills and become as effective as they are at what they do.
* In May, we’ll be looking at how to hijack your hormones and get in control of your sleep, metabolism and energy.
* In June, we’ll be checking out the latest and greatest developments in health and wellness literature, and passing on the top tips from the fields of medicine, psychology, neuroscience, behavioural economics, fitness and nutrition.
* In July, we’ll be exploring the benefits of minimalism, looking at ways to develop and stick to a budget, how to financially plan for the future, how to cut back on spending, how to create passive income streams, and the top tips for investing in or trading on the stock market.
* In August, we’ll be getting into the gym and out onto the track to explore how to bulk up, shred down, get ripped and be the most physically capable than you have ever been in your life.
* In September, we’ll be looking at the latest trends in health technology, and exploring the various options that you have if you want to improve your psychological and physical well-being.
* In October, we’ll be focusing on how to stress less, and sharing the latest tips to calm down quickly if you are distressed and want to live a more relaxed lifestyle in general.
* In November, We’ll be trying something new, and looking at the multitude of benefits that novelty can play in our lives.
* Last, but not least, in December, we’ll be taking stock of the year, reviewing what worked and what didn’t, and cultivating gratitude for all of the fantastic things in our lives.

Thanks,

Dr Damon Ashworth

Clinical Psychologist
June 12, 2018
Are You Living the Life That You Want?
In 2016, I decided to take on the challenge of accountability. As a Clinical Psychologist, being accountable was all about evidence-based living — engaging as much as possible in thinking patterns and behaviours that have been shown to lead to a happier, more satisfying, higher quality of life.

The following were the five key areas that I highlighted in my ‘Do You Want to Be Deliberately Better?’ Article:

1. Tuning in rather than tuning out

2. Turning towards my values rather than away from my fears

3. Maintaining an ideal work/life balance

4. Writing things down rather than keeping things in

5. Developing a growth rather than a fixed mindset

I made this declaration public as I was aware that people’s desire to remain consistent meant that I would be more willing to follow through on these targets and achieve these goals. All of them were based on solid research and were expected to have a positive flow-on effect for my long-term psychological well-being in 2017 and beyond.

While I did make some progress in being more accountable to myself, especially with numbers 2, 4 and 5, I continued to struggle with numbers 1 and 3.

Part of the problem was that I’ve always wanted to be able to do everything, and I struggle at times to prioritise and separate what is essential to me from what is critical to others. The other part of the problem is that I was working too hard, not saying no to what I didn’t want to do enough, and not leaving adequate time for leisure and socialising or even personal growth, creativity and health.

I was often extraordinarily drained and fatigued by the end of the workweek. I would spend most of the weekend recovering and trying to catch up on chores and paperwork to avoid falling even further behind with administrative duties than I already was. I was also financially in debt even though I was working full-time, and I was stressed out.

Mainly, I didn’t have enough time or space to reflect on where I was or what I needed, and when I did, I still didn’t make the necessary changes to ensure that my life was consistent with how I wanted it to be.

It’s not just me

What seemed to help me a lot was reading the thought-provoking self-help book ‘Take time for your life’ by Cheryl Richardson. She highlights the seven common obstacles that people seem to face in living their best lives. These are:
1. They generally have difficulty putting themselves first
2. Their schedule does not reflect their priorities
3. They feel drained by certain people or things
4. They feel trapped for monetary reasons
5. They are living on adrenalin
6. They don’t have a supportive community in their life
7. Their spiritual well-being comes last
I don’t know about everyone else, but I could check yes to all of these items except for number 6. I wasn’t spending as much time as I wanted with friends, but I felt well supported by them all when I did. As for the rest, I wondered, “How does she know me so well?” but then I realised how many people there are out there that must be falling into similar traps.

My aim for 2017 was to take time for my life.

Here’s how I’ve gone towards creating my ideal lifestyle so far:
- I have moved into a fantastic apartment in the city where I am within easy access by bike, foot or public transport to all of my work, sport and leisure commitments.
- I have begun regularly using the swimming pool, spa, sauna, and gym part of this unique apartment complex. As the gym here is excellent, I have saved by cancelling my external gym membership.
- I have sold my car to avoid having to pay $70 a week for a car spot, not to mention the registration fees, car insurance, petrol, parking fees, fines, and depreciation in the car’s value. This also has the added benefits of never getting stuck in peak hour traffic and more walking and bike riding to get to places, which reduces the amount of time I need to set aside for these activities elsewhere.
- I have started listening to audiobooks more whenever I am walking around the city by myself. This has resulted in me getting outdoors more, reading less inside, and opened up more time for other personal growth, leisure and social activities.
- I have finished working at Mill Park and moved into the city for all of my workdays. This means that I can get up later in the morning on workdays and ride or walk or catch public transport to work no matter where I am.
- I have cut down the days I see clients from 5 to 4, with Mondays now dedicated to maintenance, administration, health, creativity, and well-being. Because of this reduced workload, I am less stressed and more energetic. I am currently up to date with all of my administrative duties, paperwork, and continued professional development for the first time in 3 years.
- This has also helped me enjoy my weekends more, as instead of playing catch-up on things, I can socialise and relax and plan various adventures that I may not have had the time or energy to do in the past.
- Even though I am working one day less per week, by buying less stuff and reducing my expenses, I am no longer in any financial debt and am saving towards buying a place of my own.
- I have now donated plasma and platelets through the Red Cross Blood Bank three times. This can be done every two weeks and takes about 45 minutes, and really can make a huge difference for those who have leukaemia and certain autoimmune diseases.
- I have found a new General Practitioner, Nutritionist and Dentist to ensure that my physical health is going well and made the necessary appointments to assess or fix up any of the issues that have become apparent.
- I have had a DEXA scan to assess my bone density, lean muscle mass and fat. I will be having another one of these in 3 months to monitor my progress and ensure that I remain in the healthy range for a male my age.
- I have resumed monthly sessions with my Psychologist to ensure that my mental health and clinical practice are as optimal as possible.
- I have signed up for a year membership with the meditation app Calm, which will help me to continue strengthening my meditation practice. I will aim to practice this for at least 10 minutes per day to make sure that I keep trying to tune in rather than tune out.
- I have also booked in for a 10-day Vissapana meditation retreat in April and a 12-day P&O cruise at the end of July. Both of these getaways involve switching off from all technology for the duration of my stay. They will provide me with plenty of time for rest, relaxation and reflection, essential elements for tuning in and developing greater insight.
No Regrets?

Now that I’ve shared the changes that I’ve started to make towards my ideal lifestyle, I want to ask you this:

If you only have one life to live, and that life is yours, what changes do you need to make now to ensure you don’t accumulate any more regrets in the future?

In her viral blog post and subsequent book “The Top Five Regrets of the Dying”, palliative nurse Bronnie Ware listed the top five regrets that the dying people she cared for typically had. These were:
1. They wished they’d had the courage to live a life true to themselves, not the life others expected of them.
2. They wish they hadn’t worked so hard.
3. They wish they’d had the courage to express their feelings.
4. They wish they’d made a bigger effort to stay in touch with their friends.
5. They wish they had let themselves be happier.
Remember, we tend to regret the things that we don’t do much more than those we do. So be brave, give it a go, and see what happens. If you’re not sure what you want or how to figure it out, booking in for a session with a Psychologist could definitely help!

Dr Damon Ashworth

Clinical Psychologist
June 5, 2018
Trauma – What is it and what can we do about it?
What is Trauma?

The Diagnostic and Statistical Manual for Mental Disorders (DSM-V) describes a traumatic experience as exposure to an event that involves death, serious injury (actual or threatened), or sexual violence (actual or threatened). It usually creates intense feelings of helplessness, horror, or fear in the individual. It is direct exposure to an event that causes trauma but can also be caused by witnessing an incident that happened to someone else. Other forms of trauma include indirect exposure by hearing about a close friend or family member undergoing trauma, or through extreme or repeated exposure to aversive details of an event, typically through professional duties, such as first responders to a fatal crash site, or repeated exposure to information of child abuse.

Trauma can create long-standing changes in the brain. For example, imaging studies have shown heightened brain-stem activity, which controls the fight-or-flight (or freeze) system. It is the brain’s inbuilt survival mechanism. Imaging studies also show increased amygdala activation, which floods the body with feelings of fear. These changes can be pretty effective in keeping people safe in times of imminent danger. They allow individuals to scan the environment and react quickly to anything perceived as dangerous.

The problem is that once these areas of the brain become overreactive, they will respond to anything that is potentially similar to a traumatic experience from the past without first trying to assess the actual level of threat accurately. As a result, it makes it more difficult to respond calmly and rationally in an individual’s everyday life.

The hippocampus, an area of the brain responsible for memory, can also be severely affected by traumatic events. The more extreme, unexpected, and inconsistent an event is with previously held beliefs about themselves, the world or other people, the harder it is for the brain to fully process and integrate this experience. As a result, some of it remains unprocessed or “stuck”, which reduces the capacity to move on from the traumatic event and process and integrate following information taken in by the senses.

Re-experiencing symptoms, such as flashbacks and nightmares, are thought to be the brain’s attempt to process and integrate the traumatic experience. As scary as this can be, it generally does help in healing and resolving trauma symptoms over time. Unfortunately, with Post-traumatic stress disorder (PTSD), the brain continues to be unable to process and integrate what has taken place. As a result, it can lead to devastating consequences and severe functional impairment for the individual suffering from the condition, especially if they don’t understand the symptoms or what to do with them when they occur.

How to Best Respond to Each Cluster of Trauma Symptoms:

Four clusters of symptoms indicate that a person suffers from an acute stress reaction or post-traumatic stress disorder after exposure to a traumatic event. Even if you do not have all of these symptoms, it can still be helpful to know what is occurring when you experience these symptoms after trauma and what you can do about it.

A: Intrusion symptoms — This includes intrusive memories, traumatic nightmares, dissociative reactions, such as flashbacks, and marked physiological reactivity and intense or prolonged distress after exposure to trauma-related stimuli or reminders.

When these intrusive symptoms occur, our brain rushes back to the past and starts to think and feel the same way it did when the traumatic event occurred. The mind feels in imminent danger, and the initial feelings of intense helplessness, horror or fear come rushing back in.

I have found a grounding process to be most effective when this occurs, as it helps me reconnect with my senses at the moment and brings my brain back from the past to the present.

Next time an intrusive symptom occurs, ask yourself the following:
1. What are five things that I can see right now?
2. What are four things that I can touch/feel right now?
3. What are three things that I can hear right now?
4. What are two things that I can smell right now?
5. What is one thing that I can taste right now?
Once you are present, ask yourself, “Am I safe right now?” If you are in danger, remove yourself from the situation. If not, you are not at risk of harm and instead need to focus on reducing your distress and physiologic reactivity through self-soothing activities.

The more that these activities can engage you and your senses at the moment, the better, as it will help you to continue to feel present and safe. Grounding must occur first, though, or the brain will want to stay in a hypervigilant state to protect you from the perceived threat, even if the danger is only a memory in your head.

B: Avoidance — Persistent avoidance of distressing external (people, places, conversations, activities, objects or situations) or internal (thoughts or feelings) reminders of the trauma

Avoiding any reminders of the trauma in the first month after the incident is a good thing, as it can lower your arousal levels and reactivity, assisting your recovery.

Ongoing avoidance of these reminders, particularly after a month, is not recommended, however, and may prevent a full recovery. Chronic avoidance prevents processing and integration of the traumatic event. Moreover, it sometimes means that people begin to avoid more and more things that may seem dangerous when they are logically relatively safe.

Gradual exposure to the things you fear (as long as they are relatively safe) is essential in treating an anxiety disorder, including PTSD. I have gone through the steps of doing this in my first article titled “Feel the Fear and Do It Anyway”. I followed these steps to challenge myself to get outside at night and stop hiding when cars came past. It did get more comfortable with each time as I realised that my fear of being attacked was much higher than the actual probability of it occurring (it’s never happened again).

Also, remember that we cannot entirely run away from our thoughts and feelings. Acceptance and Commitment Therapy teaches Defusion and Expansion skills to help us better manage our thoughts and emotions. Research shows that these are more effective long-term strategies than continually avoiding internal reminders of trauma through drugs and alcohol, emotional eating, meaningless distractions, or keeping busy all the time.

C: Negative alterations in cognitions and mood — including the inability to recall critical components of the trauma, persistent and distorted negative beliefs and expectations about oneself, others or the world, or blame of self or others for causing the traumatic event or its consequences, persistent negative emotions, including anger, fear, horror, impending doom, guilt and shame, diminished ability to experience positive emotions, as well as loss of interest and engagement in previously important activities, and feeling isolated, alienated, detached or estranged from others.

Exposure-based treatments, particularly cognitive processing therapy, are essential for addressing the extreme shifts in cognition and beliefs that can occur after trauma, particularly if they prevent you from doing the things you used to enjoy.

If you are feeling detached or physically or emotionally numb, movement can help a lot. It doesn’t matter what type of movement, but there’s a bonus if you enjoy it. So the next time you feel this way, go for a walk or run, stretch or try yoga, play a sport or even twist and dance. They all may help bring you back into your body more and feel a bit less distant and more connected.

Writing about how your beliefs and feelings have changed or explaining these changes to a friend that you can trust can help you feel more connected and better in time, but it should be done in collaboration with a therapist if you are concerned about how you may react.

If I ever felt disconnected, which happened occasionally, I found any movement to be the best strategy to reconnect. It could be playing a sport, doing yoga or Pilates, weight lifting, walking or running outside, or even dancing. Anything that helps you get out of your head and into your body or the world around you.

D: Alterations in arousal and reactivity — trouble falling asleep or staying asleep, difficulty concentrating, feeling jumpy or easily startled, and being super alert or watchful.

Learning emotional regulation and distress tolerance skills are critical to managing arousal levels, which diminishes reactivity.

Emotional regulation skills include adequate rest, recovery, leisure and socialising, or ensuring that things are in the right balance. For example, too much work and stress without sufficient breaks will slowly increase our arousal levels over time. Ensuring that we minimise caffeine and alcohol intake, eat a healthy, well-balanced diet and get a consistent 7 hours of sleep each night also help us to lower our arousal levels and better regulate our emotions.

Distress tolerance skills include relaxation and mindfulness skills, as well as a distraction at times. Practising these regularly when you feel calmer makes them easier to implement when you are most distressed so that things do not become too overwhelming for too long and you can calm yourself down.

Diagnosis of PTSD and Recommended Treatments

All four symptom clusters must be present to a significant degree and cause significant distress or functional impairment to warrant a diagnosis of PTSD.

If you are concerned that you may have PTSD from a trauma that you experienced more than a month ago, please complete the Post-traumatic Checklist for the DSM-V (PCL-5) questionnaire, which you can access for free online. If you score above 38 on this checklist, I encourage you to visit your GP or primary care physician to discuss the matter further and collaboratively decide on which treatment path you would like to go down.

Sometimes a referral to a Psychologist or Psychiatrist will be essential to give you the best chance of making a full recovery.

It is vital to realise that the most effective psychological therapies for trauma all include exposure (imaginal or in vivo) to parts of the traumatic experience or the impact it has had on you. For example, it could be trauma-focused cognitive behavioural therapy (CBT), Cognitive Processing Therapy (CPT), or Eye Movement Desensitisation and Reprocessing (EMDR) Therapy. All are considered first-line approaches for treating PTSD in Australia (NHMRC, 2007) and should be recommended before pharmacological interventions or alongside antidepressants (SSRIs) if sufficient benefits have not occurred through psychotherapy alone.

Even 8–12 sessions of 60–90 minutes of therapy are usually sufficient in treating PTSD. You can then address any co-morbid issues in further treatment once the PTSD symptoms have subsided.

Traumatic events can change the brain and the way that we respond to situations afterwards. Often the brain can heal itself over time, especially if we are engaging in the right strategies. However, if it doesn’t, practical psychological help is available, and it can make a big difference in helping you heal and grow.

You can also check out my new podcast ‘Deliberately Better’, which discusses PTSD and how to manage it.
March 5, 2017
Do You Want To Be Deliberately Better?

“Good company in a journey makes the way seem shorter.” — Izaak Walton

It was 2016 when I first decided to take on the challenge of being accountable to myself. I later wrote this blog to take responsibility for my actions in an open, transparent way, do what I said I was going to do, and “practice what I preach.”

For me, as a Psychologist, becoming deliberately better is all about evidence-based living. It is about engaging as much as possible in thinking patterns and behaviours that research has shown to lead to a happier, more satisfying, higher quality of life.

The following were five key areas that I planned to focus on for 2016, with the idea of it having positive flow-on effects for my long-term psychological well-being in 2017 and beyond.

The best part is that just by stating these objectives where they can be seen publicly, my desire to be consistent and faithful to my word did seem to help me to stay more committed to achieving these goals:

1. Tuning in rather than tuning out

Too often in Western Culture, we spend all of our day “doing”, rushing around and completing tasks. We do not spend enough time “being”, simply living in the moment with whatever we are experiencing.

People tune out of their experiences by distracting themselves with watching too much TV, spending too much time on social media, or surfing the internet. They could also smoke cigarettes or use drugs, drink too much caffeine or alcohol, eat junk food, and keep busy with too much work. Some of these strategies are successful in blocking out what we feel in the short term. However, suppose you never listen to the signals that your body sends you. In that case, they will only amplify in intensity over time until, eventually, we will have no choice but to notice the message given.

Formal mindfulness practice is the best way to get the most benefits from tuning in and just being. Mindfulness practice consists of maintaining our attention on whatever is occurring at the moment in an open, curious, accepting, patient, non-judging, and non-striving way. I recommend learning guided meditations first and then practising on your own if you’d prefer once you have figured out the various forms of meditation and how they help you. I would recommend a few free apps if you are interested in learning these skills: Smiling Mind, Calm, and Headspace.

Once you have learned the basics of mindfulness, it becomes a lot easier to also engage in informal mindfulness practice, where you apply these same mindfulness principles in whatever task you do throughout the day. By tuning in through Mindfulness, the benefits include reduced stress, pain and anxiety, improved sleep and mood. There is also a higher capacity to soothe yourself when distressed and a reduced risk of a future depressive episode.

2. Turning towards my values rather than away from fear

I regularly bring up values with my clients. It is for a good reason. The way I see it, there are two primary motivators in life. We can either be motivated to move towards what is important to us (our values) or move away from the things we fear.

As first pointed out to me in Daniel Kahneman’s book ‘Thinking, Fast and Slow’, most people are predisposed towards being risk-averse or more motivated by what they may lose rather than what they could gain. As a result, most people play it safe, stay in their comfort zone, try not to change things too much, and don’t take any chances, even if the potential gains outweigh the potential losses.

Most people need at least a 2:1 ratio of things being likely to turn out well before taking a risk, and some people will never take a chance unless a positive outcome can be 100% guaranteed (which isn’t a risk at all). For example, the risk of dying in a plane crash or being eaten by a shark are minuscule. However, I’ve met several people who choose not to fly or swim in the ocean because of these fears. My question to these individuals is, “What do you lose by not taking this risk?” The chance for fun? Excitement? Adventure? Considering that these values are all important to me, I’d allow myself to feel the fear, sit with it, and take the risk so that I can live a more vibrant, enjoyable and meaningful life.

All of the most successful treatments for anxiety involve exposure to the feared stimuli as an essential part of the treatment. By facing our fears, stress can be reduced and no longer cause significant distress or functional impairment. It is uncomfortable but worth it in the pursuit of a goal that is consistent with your values. By living in line with your values and not those of others, you are more likely to feel energised, motivated and satisfied with where you are at and where you are headed.

3. Maintaining an ideal work/life balance

One of the biggest traps that I see with my clients is putting off enjoyment today until some designated time in the future (e.g. once I finish uni, once I get a job, once I pay off the house, once I’ve saved a certain amount). What tends to happen in the meantime is that they dedicate most of their life to study and work and saving, and postpone looking after themselves or having fun, exercising, engaging in hobbies, being creative, learning a new skill, travelling, and socialising with others.

The Grant Study, which began in 1938 with 268 Harvard undergraduate men, is still running and collecting data over 77 years later. Across all of this data, they found that one thing was the most significant predictor of health and happiness later in life: relationship warmth. Individuals in loving relationships with close families and good friends outside of their partner were the most satisfied with life. But, of course, it wasn’t just about the number of friends or family either. It was about having those quality relationships where you knew you could depend on the other person when you needed them the most.

Making more money did correlate with overall happiness and health outcomes, but individuals with higher relationship warmth also tended to make more money. Therefore, it is crucial to spend time with others and put energy into cultivating positive relationships. Given this data, socialising with those we care about should never be seen as a waste of time.

4. Writing things down rather than keeping things in

Planning and reviewing are essential for minimising stress and ensuring that we stay on track with our goals. In the excellent book ‘Getting Things Done’ by David Allen, he recommends both a daily review and a weekly review. In these, you can go through everything and process it into an all-encompassing management system. By having everything where it is supposed to be, and either filed away or waiting to be done at a particular time and place, it is meant to ensure that our head is as straightforward as possible. In addition, it can enable us to focus on whatever is most important to us at the moment (e.g. the task that we are doing).

I recommend that my clients quickly jot down whatever is incomplete or still to be done at the end of the workday. It is crucial to follow this with a quick plan on when you can address this task and the first step that you would take. It shouldn’t take any longer than 5 minutes a day and can help make sure that you can switch off from work once you are at home. For individuals who don’t sleep well due to a racing mind, doing this same process with anything on their mind two hours before they go to bed will also reduce their likelihood of being up all night thinking.

The crucial step is to write down when you will do it (and what the first action is), rather than just making a to-do list. The Zeigarnik effect shows that our brains will continue to remind us of something incomplete until we have done it or have a plan to do it. But, surprisingly, once we have a plan in a place that we won’t forget, our brains treat the task as already being done, and the result is a less busy mind, less stress and more energy. So even if you want to finish painting the house but won’t have time until your annual leave in 3 months, write it down. Or create a someday/maybe file, and put it in there.

5. Developing a growth rather than a fixed mindset

In her book ‘Mindset: The New Psychology of Success’ Carol Dweck has identified a more crucial concept towards academic and occupational success than intelligence.

Individuals with a fixed mindset believe most of their traits, including intelligence and personality, are fixed or unchangeable. Because of this, they tend to view successes as evidence that they are amazing and mistakes as evidence that they are horrible or not good enough. Unfortunately, this means that whether they win or lose carries massive consequences because their identity is on the line with everything they do in many ways. If they experience a setback, they won’t try to learn from it or improve because what’s the point? They aren’t good enough, so why bother trying. They’ll also give up more quickly when things become challenging and demanding.

Conversely, the individuals with a growth mindset will view their performance on a task as just that — their performance, and not an indication of how smart or capable they are. Instead, they see setbacks as chances to learn and grow and improve their skills in the future. Because of this, they are happier to challenge themselves and persevere through difficulties. They are also much more compassionate and understanding when they make a mistake, rather than self-critical like the individuals with a fixed mindset.

Fortunately, you can teach a growth mindset. By praising behaviour and effort (“You tried so hard”) rather than characteristics (“You are so smart”) and viewing mistakes as an essential part of the learning process, growth mindset training increases motivation, resiliency and achievement. So even if you don’t naturally look at things in this way, it’s never too late to learn and grow.

Dr Damon Ashworth

Clinical Psychologist

December 31, 2016