Damon Ashworth Psychology

Tag: Psychology

  • Can You Improve Your Sleep By Going to a Sleep Retreat?

    Can You Improve Your Sleep By Going to a Sleep Retreat?

    Just the other week, I was featured in the Daily Telegraph and the Herald Sun on sleep retreats. It was weird because I had been planning on running some sleep retreats but hadn’t yet. Stranger still, I hadn’t told anyone about my idea yet, and it was the first article that I have been mentioned in that I am aware of without being interviewed or asked for permission first.

    In the article, the first recommended retreat was Golden Door in the Hunter Valley, NSW. From what others had told me about it, it is generally known as a well-being retreat rather than a sleep retreat.

    An excellent Sleep Physician that I work with at the Melbourne Sleep Disorders Centre, Dr David Cunnington, did inform me that he often goes up there on weekends to be a guest speaker on sleep difficulties and how to improve them. He asked if I wanted to accompany him one time. I willingly obliged.

    We flew up to Newcastle on Friday the 18th of May just after midday, drove an hour from the airport to the Hunter Valley, and settled into our rooms just before 4 pm. It was a charming private villa, with my own balcony with a view, a long couch to relax on, a nice big bathtub to relax in, and my own king bed to sleep in. And that was just the room.

    The main building where the reception was consisted of a huge golden door opening up to steps and a waterfall running through the building. A chef was on-site to prepare healthy meals for everyone for breakfast, lunch and dinner (no red meat or processed carbs, no caffeine and no alcohol). Not to mention a day spa offering five pages of treatments, an indoor pool for deep water running or lap swimming, an outdoor pool for relaxing, a steam room and spa, a yoga studio, indoor basketball court, a huge gym, two tennis courts and even a table tennis table.

    I wanted to get to it all but remembered that this was a perfect opportunity to switch off, relax, and unwind. So instead of participating in the afternoon activities on Friday, I decided to run myself a hot bath, listen to an audiobook, and rest until dinner time.

    Golden door seemed to attract an eclectic mix of people, from stressed executives, burned-out executive assistants, and people needing a career, family or relationship break or change. Everyone was friendly and welcoming, and most obliged with wearing their name tags across the weekend, making it easier to approach and ask people what brought them to Golden Door and what they were hoping to get out of it.

    The staff were fantastic too, often mingling with the guests at meal times and participating in as many activities as possible. After dinner, at about 7 pm, those interested went for a leisurely walk and stopped to lie back and stare up at the stars. Living in the heart of Melbourne, this is an opportunity that I don’t often get, and I relished just looking up without feeling like I had to rush off and do something else.

    After the walk, we headed back to our private villas, where I continued to try to stay away from bright screens. Instead, I did 10 minutes of meditation, listened to an audiobook while relaxing on the couch, and went off to bed once I felt sleepy.

    On Saturday morning, I was awoken by a knock on the door, and a doorbell ringing at 6 am. If you don’t want this, you can put a do not disturb sign on the outside of the door, but it is to help people get up for the 6:30 am tai chi session up on meditation hill. I didn’t want my sleep to be over yet, but I managed to get dressed and strolled up the hill just as the sun rose across the Hunter Valley.

    With 360 degree views of the valley, Meditation Hill is probably the most picturesque part of the Golden Door retreat (it’s all pretty nice, though). I’d never done tai chi before, but it wasn’t too bad, especially with the hot air balloons taking off for their flights from the valley below.

    Following that, it was straight to the pool for some deep water running. I thought it would be some light aqua aerobics for oldies, but it was much more intense. Then there was breakfast and a 10km hike. Followed by tennis after lunch, and table tennis after that. Way more exercise than I expected to do, but I didn’t regret it. I then headed off to yin yoga, another activity I’d never tried before. I may have fallen asleep a little bit during this, but power naps are healthy for you.

    A 50-minute deep tissue massage was next at the Elysium day spa. A bit pricey at $140, but it felt amazing after all of the activity I’d done, especially my calves. These treatments are optional, but quite a few guests seemed to be getting them.

    David’s talk on sleep was after dinner. Then it was off to bed again. My second night of sleep was longer but not quite as deep as the first one.

    When I compare it to how I slept two nights before the retreat and two nights after it, I can see that a wellness retreat really can improve your sleep on the nights you are there. This is because it gives you so many things that can help you to have a good night’s sleep, including:

    • Lots of physical activity during the day but not too late at night
    • A vast amount of morning sunlight helps entrain your circadian rhythms and wake you up for the day. This can also help you to fall asleep earlier that night.
    • Healthy food.
    • No caffeine.
    • No alcohol.
    • Plenty of activities to relax and unwind.
    • More time in nature with beautiful scenery and less time indoors looking at bright screens.
    • Opportunities for engaging conversation with friendly and welcoming people that are also wanting to improve their health.

    It doesn’t offer clear guidelines or individual recommendations around sleep or how to keep improving it once you go home. For example, a 6 am wake-up call is perfect for some to help them not spend too long in bed. For others, it could cause anticipatory anxiety or lead to them putting too much pressure on themselves to get to sleep early the night before.

    Dr Damon Ashworth

    Clinical Psychologist

  • The 10 Best Laws of Power

    The 10 Best Laws of Power

    A fascinating book that I read towards the end of 2017 was ‘The 48 Laws of Power’ by Robert Greene.

    Since the book was first released in 1998, it has sold over 2 million copies worldwide and has influenced many successful people, from Will Smith to Kanye West, Jay-Z and 50 Cent, who later co-wrote a New York Times’ bestseller with Greene.

    It is also the most highly requested book in U.S. prisons due to the synthesis of Machiavelli, Sun Tzu and other famous writers’ key prescriptions for effectively managing power struggles in difficult environments.

    Some of the 48 laws do seem contradictory, and others seem a little repetitive. Still, there are some truly great bits of advice for effectively managing situations where power may play a role. This might be a corporate environment, a difficult but smaller workplace, a large social group, to really anywhere where there is a power imbalance between people or a formal or informal hierarchy.

    Here are my 10 favourite laws, including a description of each law from the following website. The parts that I especially like are bolded. Enjoy!

    Law 4: Always Say Less than Necessary

    When you are trying to impress people with words, the more you say, the more common you appear, and the less in control… Powerful people impress by saying less. The more you say, the more likely you are to say something foolish.

    Like the Danish proverb that says, “deep rivers move with silent majesty, shallow brooks are noisy”, law 4 reminds me only to say things that I believe will be of value. It also helps me stay within my circle of competence and not give advice on things that I do not know much about.

    Law 9: Win through your Actions, Never through Argument

    Any momentary triumph you think gained through argument is really a Pyrrhic victory: The resentment and ill will you stir up is stronger and lasts longer than any momentary change of opinion. It is much more powerful to get others to agree with you through your actions, without saying a word. Demonstrate, do not explicate.

    A parent who smokes but tells their children not to is unlikely to be successful at persuading their children because “actions speak louder than words”. The better option is not to smoke or quit if you want to set a good example. As Mahatma Gandhi said, “you must be the change you wish to see in the world”.

    Law 13: When Asking for Help, Appeal to People’s Self-Interest, Never to their Mercy or Gratitude

    If you need to turn to an ally for help, do not bother to remind him of your past assistance and good deeds. He will find a way to ignore you. Instead, uncover something in your request, or in your alliance with him, that will benefit him, and emphasise it… He will respond enthusiastically when he sees something to be gained for himself.

    As sad as this may appear, most people are self-motivated and want to do the right thing if it makes them look good. For example, a hybrid car such as a Toyota Prius sells well because it is known as a hybrid car. It screams out, “I care about the environment,” in a way that the Toyota Camry Hybrid does not because the hybrid version of the Camry looks almost identical to the regular Camry. The 2014 sales in the US of each car highlights this point: Prius = 194,000; Toyota Camry Hybrid = 39,500; Toyota Camry (non-hybrid) = 428,600. Figure out how what you want will benefit the other person or help them look good before you ask for a favour, and you are much more likely to get them on board.

    Law 18: Do Not Build Fortresses to Protect Yourself — Isolation is Dangerous

    The world is dangerous and enemies are everywhere — everyone has to protect themselves. A fortress seems the safest. But isolation exposes you to more dangers than it protects you from — it cuts you off from valuable information, it makes you conspicuous and an easy target. Better to circulate among people, find allies, mingle.

    Many people that I see try to protect themselves at the cost of a real sense of connection and belonging with others. This law helps by reminding me of the dangers and costs of not opening up to honest people you can trust.

    Law 23:Concentrate Your Forces

    Conserve your forces and energies by keeping them concentrated at their strongest point. You gain more by finding a rich mine and mining it deeper, than by flitting from one shallow mine to another — intensity defeats extensiveness every time.

    This reminds me of the saying, “jack of all trades; master of none”. If you want to make progress in anything, it is important to prioritise and put your energy into the activities and thought patterns that will give you the best results. Law 23 also helps me to build upon my strengths rather than worrying too much about my weaknesses.

    Law 25:Re-Create Yourself

    Do not accept the roles that society foists on you. Re-create yourself by forging a new identity, one that commands attention and never bores the audience. Be the master of your own image rather than letting others define it for you.

    I often encourage my clients to clarify their most important values and see how these differ from what their family, friends, culture, or society may want. The idea of working hard and not enjoying life until retirement is not a role that I want to accept, even though this is considered normal in many respects by society. It’s much better to create and live a sustainable life for myself, whatever that may look like. Then it won’t matter if and when I retire, especially if I keep loving what I do for work.

    Law 28: Enter Action with Boldness

    If you are unsure of a course of action, do not attempt it. Your doubts and hesitations will infect your execution. Timidity is dangerous: Better to enter with boldness. Any mistakes you commit through audacity are easily corrected with more audacity. Everyone admires the bold; no one honours the timid.

    Law 28 reminds me not to doubt myself once I have settled on a course of action and fully commit myself to it for a set period of time instead of remaining uncertain or indecisive. Once a decision is made, it is much better to give it 100% until the next decision needs to be made. Uncertainty only leads to more stress and anxiety and less satisfaction in the long run.

    Law 29: Plan All the Way to the End

    The ending is everything. Plan all the way to it, taking into account all the possible consequences, obstacles, and twists of fortune that might reverse your hard work… By planning to the end you will not be overwhelmed by circumstances and you will know when to stop. Gently guide fortune and help determine the future by thinking far ahead.

    This reminds me of the benefits of thinking into the future and clarifying how I would want my life to look. For example, if I had a 50th birthday and someone close to me stood up and spoke about the person I had been for the past 18 years, what would I want to hear them say? Based on my response to this, it is then important to see if my 1-, 5- or 10-year plan is helping me to head in that direction. If not, more planning and some big changes may be required, as long as my plans are flexible enough to change as I continue to grow with time.

    Law 35: Master the Art of Timing

    Never be in a hurry — hurrying betrays a lack of control over yourself, and over time. Always (be) patient, as if you know that everything will come to you eventually. Become a detective of the right moment; sniff out the spirit of the times, the trends that will carry you to power. Learn to stand back when the time is not yet ripe, and to strike fiercely when it has reached fruition.

    Patience is a massively underrated value, especially in today’s society. How often do you see people multitasking or telling you how busy they are? I know I sometimes do. But slowing things down and really making sure that my attention is 100% on what is most important in any given moment is a great recipe for long-term happiness and well-being. While it is important to “strike while the iron is hot”, I think it is also important not to be too reactive and make sure that the decisions you make are really consistent with your values and long-term plans. Knowing how to say no to the wrong things in life is also a crucial element of success.

    Law 45: Preach the Need for Change, but Never Reform too much at Once

    Everyone understands the need for change in the abstract, but on the day-to-day level people are creatures of habit. Too much innovation is traumatic, and will lead to revolt. If you are new to a position of power, or an outsider trying to build a power base, make a show of respecting the old way of doing things. If change is necessary, make it a gentle improvement on the past.

    Trying to change my eating habits has taught me this law better than anything else recently. As soon as I try to be too restrictive, I rebel against any prescriptions. Long-term sustainable changes are again much better than short-term dramatic changes. The 20-minute walk that you manage to do is better than the 10km run you do not, so start small and try to build up slowly. If you can do this, changes are much more likely to stick.

    If you want to see the remaining 38 laws, please click here or purchase the book. Some of the laws seem pretty ruthless, but pretending that they don’t exist in power dynamics is much more dangerous than learning how they work.

    I also recommend checking out my dealing with toxic people article for more information on successfully managing and surviving difficult interactions.

    Dr Damon Ashworth

    Clinical Psychologist

  • 10 Things You Need to Know About Adverse Childhood Experiences

    10 Things You Need to Know About Adverse Childhood Experiences

    1. There are 10 categories of experience that are considered to have adverse consequences on the later development of children

    These include:

    • Abuse:
    • Emotional
    • Physical
    • Sexual
    • Neglect:
    • Emotional
    • Physical
    • Household Dysfunction:
    • Domestic Violence
    • Substance Abuse
    • Mental Illness
    • Parental Separation/Divorce
    • Crime

    2. It is possible to determine your own Adverse Childhood Experience (ACE) score

    The ACE score is a measure that has been designed to measure the cumulative nature of childhood distress.

    If you are interested in finding out your ACE score, please answer the following questionnaire from acestudy.org:

    While you were growing up, during your first 18 years of life:

    1. Did a parent or other adult in the household often or very often…

    • Swear at you, insult you, put you down, or humiliate you? or
    • Act in a way that made you afraid that you might be physically hurt?

    Yes? No? If yes, enter 1 _____________

    2. Did a parent or other adult in the household often or very often…

    • Push, grab, slap, or throw something at you? or
    • Ever strike you that you had marks or were injured?

    Yes? No? If yes, enter 1 _____________

    3. Did an adult or person at least 5 years older than you ever…

    • Touch or fondle you, or have you sexually touch their body? or
    • Attempt or actually have oral, anal, or vaginal intercourse with you?

    Yes? No? If yes, enter 1 ____________

    4. Did you often or very often feel that…

    • No one in your family loved you or thought you were important or special? or
    • Your family didn’t look out for each other, feel close to each other, or support each other?

    Yes? No? If yes, enter 1 ___________

    5. Did you often or very often feel that…

    • You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or
    • Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

    Yes? No? If yes, enter 1 ___________

    6. Were your parents ever separated or divorced?

    Yes? No? If yes, enter 1 ___________

    7. Was your mother or stepmother:

    • Often or very often pushed, grabbed, slapped, or had something thrown at her? or
    • Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or
    • Ever repeatedly hit at least a few minutes or threatened with a gun or knife

    Yes? No? If yes, enter 1 ___________

    8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?

    Yes? No? If yes, enter 1 ___________

    9. Was a household member depressed or mentally ill, or did a household member attempt suicide?

    Yes? No? If yes enter 1 ___________

    10. Did a household member go to prison?

    Yes? No? If yes enter 1 __________

    Now add up your “Yes” answers: __________ This is your ACE Score.

    3. Adverse childhood experiences are common

    Of the 17,337 individuals surveyed, here is the prevalence of each possible adverse experience, from most to least, represented as a percentage:

    • Physical abuse towards the child — 28.3%
    • Substance abuse in the household — 26.9%
    • Parental separation/divorce — 23.3%
    • Sexual abuse toward the child — 20.7%
    • Mental Illness in the household — 19.4%
    • Emotional neglect towards the child — 14.8%
    • Domestic violence in the household — 12.7%
    • Emotional abuse towards the child — 10.6%
    • Physical neglect towards the child — 9.9%
    • Imprisoned household member — 4.7%

    This graph from acestoohigh.com presents these percentages visually:

    4. It is more common to have an adverse childhood experience than not to have any

    As shown in the graph from cdc.gov, 64% of the population surveyed experienced at least one adverse childhood experience(ACE), with the majority of those reporting at least one ACE reporting multiple ACEs.

    Beyond the ACEs study, at least one in four children will suffer from physical, emotional or sexual abuse at some point during their childhoods, with one-in-seven children experiencing abuse or neglect in the past 12 months (Finklehor, Turner, Shattuck & Hamby, 2015).

    5. Adverse childhood experiences are linked with a higher risk of many things in later life

    This includes:

    • Alcohol abuse and dependence
    • Early smoking initiation and current smoking status
    • Illicit drug use
    • IV drug abuse
    • Obesity
    • Suicide attempts
    • Depression
    • Anxiety
    • Hyperactivity
    • Sleep Disturbances
    • Hallucinations
    • Eating disorders
    • Suicide attempts
    • Post-traumatic stress disorder
    • Conduct disorder
    • Teen or unintended pregnancies
    • Intimate partner violence
    • Improper brain development
    • Impaired learning ability and general cognitive difficulties
    • Attention and memory difficulties
    • Visual and/or motor impairment
    • Lower language development
    • Impaired social and emotional skills
    • Poorer quality of life

    Another long-term study indicated that approximately 80% of young adults who had previously been abused qualified for at least one psychiatric diagnosis at 21 (Silverman, Reinherz & Gianconia, 1996). Neglected or abused children are also 59% more likely to be arrested during childhood, 28% more likely to engage in criminal behaviour as adults, and 30% more likely to engage in violent crime as an adult (Widom & Maxfield, 2001).

    The graph below from vetoviolence.cdc.gov shows the increased risk of many conditions in individuals who have previously had adverse childhood experiences:

    As you can see, there is a higher risk of experiencing these difficulties for individuals with ACEs. However, the prevalence rate is NOT 100% for any of the factors. The importance of this should not be understated…

    Individuals who have had negative experiences during their childhood can still grow and flourish as adults and can also be more resilient due to learning how to overcome significant challenges when they are younger.

    A major longitudinal study even found that what goes right during childhood is often more important than what goes wrong. Having even one safe, stable and nurturing figure in a child’s life can reduce the later risk of psychological and physical health problems (Vaillant, 2015).

    6. Adverse childhood experiences are linked with a higher risk of later disease and early mortality

    This includes:

    • High Blood Pressure
    • High Cholesterol
    • Obesity
    • Chronic Obstructive Pulmonary Disease (COPD)
    • Ischemic Heart Disease (IHD)
    • Liver Disease
    • Sexually Transmitted Infections (STIs)
    • Lung Cancer
    • Death Before Age 65

    As you can see in the table below from acestoohigh.com, individuals with an ACE score of 4 or more are at a significantly higher risk of developing later physical health conditions:

    Abuse and neglect during childhood can also negatively impact the ability of individuals to efficiently establish and maintain healthy romantic adult relationships (Colman & Widom, 2004). As relationship warmth and social connection are vital protective factors for long-term health and happiness, many of these more significant risks could at least be partially explained by the higher risk of interpersonal conflict, disconnection and isolation.

    7. The more adverse childhood experiences one has, the more significant likelihood they have of experiencing difficulties with their mental and physical health and overall well-being later in life

    A “dose-response reaction” exists with most risk factors and following conditions, in that the more adverse childhood experiences one has, the higher their risk is for adverse outcomes later in life, as shown in the above graphic from cdc.gov.

    8. It is possible to conceptualise how these adverse childhood experiences lead to an early death

    The ACE Pyramid from cdc.gov suggests that adverse childhood experiences contribute to premature death via four intermediate processes that develop in a sequential nature:

    9. Reducing adverse experiences of childhood will significantly improve public health and reduce the burden that these issues have on individuals and the society

    Childhood abuse and neglect are not just damaging to the individual. They also place a substantial financial strain on society, with an estimated total lifetime economic burden of approximately $124 billion (2010 dollars) in the US in 2008 (Fang, Brown, Florence & Mercy, 2012). This is similar to the financial burden of other public health issues, such as diabetes and stroke.

    The main reasons for the increased economic burden are lost productivity, followed by increased medical costs, special education, child welfare and criminal justice costs (Fang, Brown, Florence & Mercy, 2012).

    Even though it may be expensive to develop and implement programs that aim to prevent child neglect and abuse, the benefits of these programs, if valid, are very likely to outweigh the costs in the long run.

    10. We need to do something to address and lower the prevalence of ACEs in future generations

    Creating safe, stable and nurturing environments (SSNREs) is the key to positively impacting reducing ACEs from now on.

    The five best practices to do this is shown in the graph below:

    The US Centers For Disease Control (CDC) also suggests:

    • Greater treatment for mental illness and substance abuse
    • More high-quality child care, and
    • More financial support for low-income families.

    Conclusion

    Please help to get this information out there to as many people as possible. Also, if you found something of value in this article, please share it or pass it onto whoever else may benefit too!

    Dr Damon Ashworth

    Clinical Psychologist

  • Are You Asking the Right Questions In Your Search For a Therapist?

    Are You Asking the Right Questions In Your Search For a Therapist?

    If you were searching the web as a consumer, looking for the best Psychologist, would you know what to search for?

    If you said that you would look for someone experienced, it is a good guess, but years of experience don’t seem to make too much of a difference in improving therapeutic outcomes (Minami et al., 2009).

    What may be necessary is that they are a Psychologist and not a Counsellor. In Australia, anyone can call themselves a Counsellor and open up a practice, even without training. However, if they are a Psychologist, they have to have completed at least four years of undergraduate training, plus a post-graduate degree or at least two years of formal supervision. Psychologists are also obliged to abide by the Australian Psychological Society’s (APS) code of ethics, whereas Counsellors are not.

    If you said the company they worked for or how much they charged, these are both good guesses. However, private practice Psychologists are self-employed and set their price for their service, or a company employs and sets their price for them. Therefore, it is unlikely that all Psychologists within the same practice are equally effective, even if they are charging the same amount.

    The current recommended rate for a 45–60 minute Psychological consultation in Australia is set at $238.00 by the APS, but all Psychologists have the discretion to vary this fee. For example, services in more affluent locations often charge more, whereas services in poorer areas often charge less.

    More expensive Psychologists may believe themselves to be better Psychologists too, but this doesn’t mean that they are. The self-evaluations of therapists are often not very accurate, with a largely positive bias suggesting overconfidence in their general abilities. In a 2012 study by Walfish, McAllister, O’Donnell, and Lambert (2012), they found that out of the 129 therapists surveyed, 25% estimated that their therapy results were in the top 10% compared to the other therapists. Not a single therapist believed that they were worse than the average. If this sample represents the general population, this means that at least 50% of Psychologists don’t realise how bad they are and may therefore not be aware of what they are doing wrong and what they need to do to improve.

    What is known is that some Psychologist’s do consistently outperform other Psychologists (Wampold & Brown, 2005). In a 2015 study by Brown, Simon and Minami (2015), they looked at 2,820 therapists, with a combined sample size of 162,168 cases. The researchers found that the lowest-performing therapists required three times more sessions to produce successful outcomes than the average therapist. They also needed as much as seven times the number of sessions as the highest-performing therapists. So choosing the right Psychologist is a crucial task. But,

    What characteristics do the best Psychologist’s have, and what do they do that makes them so successful?

    1. They practice a specific model of treatment that is most recommended for your condition or is a good fit for the type of therapy you are interested in

    (Model of Treatment = 15% of overall outcome variance)

    There are many different schools of Psychotherapy, such as CBT, ACT, DBT, Positive Psychology or Psychodynamic Psychotherapy. They will all have research supporting their treatments as effective, especially with specific conditions (such as DBT for Borderline Personality Disorder or CBT for Panic Disorder).

    What they won’t often advertise is that no matter what school of therapy it is:

    • None of them will help every client
    • The drop out rates can be pretty high
    • Clients who do drop out prematurely tend to fare worse than clients who can complete treatment, and
    • Other psychotherapy schools tend to produce similar results.

    So yes, therapy helps, sometimes, and for some people. However, it is perplexing to think how the research findings are all so similar in the different schools of psychotherapy (Wampold, 2001) until it is made clear that non-specific treatment factors are shared across the various schools of psychotherapy. These non-specific factors are described below and together contribute 85% of the overall outcome variance in psychotherapeutic studies (Hubble and Miller, 2004).

    Whilst one mode of therapy may not generally be more effective than another, the goodness of fit does seem to be necessary. So try to choose a Psychologist who has experience in treating your particular concern, as well as an approach or therapy model that seems to make sense or appeal to you.

    2. They help you to hope, expect and believe that you can improve

    (Expectancy of Treatment Effects = 15% of overall outcome variance)

    An individuals’ belief that they can improve has a powerful impact on their actual improvement (Bergsma, 2008). More considerable reductions in symptom severity occur post-treatment in those with higher expectations of benefit at pre-treatment (Ogles, Lambert, & Craig, 1991; Rutherford, Sneed, Devanand, Eisenstadt, & Roose, 2010).

    Greater expectations can improve hope and increase goal-directed determination, which has been shown to predict treatment completion (Geraghty, Wood, & Hyland, 2010).

    Greater expectations of treatment outcomes can also improve distress tolerance. These skills can reduce distress and depression severity across treatment (Williams, Thompson, & Andrews, 2013).

    Essentially, the more you expect that a Psychologist can help you, the more likely it is that you will have hope, persist with treatment, and get better.

    3. They develop a warm, caring and trustworthy environment where you feel safe to explore and grow

    (Therapeutic Alliance = 30% of overall outcome variance)

    Another critical issue influencing treatment outcomes is adherence to the treatment interventions, recommendations and strategies. A positive therapeutic alliance can improve compliance with treatment recommendations, which plays a vital role in the overall success of a psychotherapy treatment (Wampold, 2001).

    A positive therapeutic alliance improves outcomes by providing professional input and ensuring effective implementation of the strategies. In addition, if a therapeutic alliance can be established, developed and maintained (Cahill et al., 2008), patients are less likely to drop out of treatment and more likely to achieve clinically significant improvements (Miller, Hubble, & Duncan, 2008).

    Regardless of the theoretical orientation or the therapist’s experience, the best outcomes happen when therapists are flexible to the needs of the patient and responsive to the feedback that patients provide. They also repair any ruptures in the therapeutic alliance as quickly as possible (Cahill et al., 2008; Miller et al., 2008).

    Other research suggests that it is crucial to meet relatedness needs, dependent upon the therapist displaying warmth and genuine involvement in the treatment. As a result, the client feels a sense of caring and connection in the relationship (Ryan & Deci, 2008).

    Essentially, the more you can relate to the Psychologist and feel that you are allies working towards a common objective, the more likely you are to improve.

    4. They make sure that therapy is the right step for you at the moment and help you to develop the skills, knowledge and motivation needed to improve successfully

    (Client’s Life-Circumstances, Personal Resources and Readiness to Change = 40% of outcome variance)

    The client is the most significant factor in determining whether or not treatment will be successful, which may be surprising to some people. However, suppose their current life circumstances are unstable, unpredictable, and emotionally or physically unsafe. In that case, it will be difficult for the one hour of therapy every week or two to be sufficient to overcome all of the adverse events that are taking place between sessions.

    Not everyone is a good candidate for therapy, and therapy isn’t everybody’s cup of tea. For example, suppose a client prefers not to question things, has significant cognitive disabilities or memory difficulties, is currently manic or severely delusional or psychotic, or is too emotionally labile or reactive in close interpersonal settings. In that case, therapy can have no effect or be potentially harmful.

    Lastly, if a client does not believe that they have a problem, then there is not too much that can be done by a Psychologist to help them, even if their family or friends or partner or the legal system believes that a problem exists. Unless the client can create intrinsic motivation for change, positive change is unlikely to occur.

    Before seeing a Psychologist, you need to be sure that:

    • You want to change or improve something about yourself
    • You are willing to put in the time and effort that it requires
    • You are eager to explore things to develop and grow, and
    • Now is a good time for you to begin the amount of treatment (both frequency and duration) recommended for you.

    If you follow these recommendations when seeking out a Psychologist, it will not guarantee a successful outcome, but it will help. I wish you the best of luck with your search and therapeutic experience!

    Dr Damon Ashworth

    Clinical Psychologist

  • Trauma – What is it and what can we do about it?

    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.

  • How Should We Define Success As A Nation?

    How Should We Define Success As A Nation?

    The Olympic Slide

    Following the completion of the Rio Olympic Games, a theme of concern became evident across the various media platforms in Australia. Our overall medal tally at the Olympic Games has declined since its peak of 58 in Sydney in 2000, with 49 in Athens in 2004, 46 in Beijing in 2008, 35 in London in 2012, and now 29 in Rio.

    The final medal tally in Rio puts Australia in 10th place with eight gold medals, 11 silver and ten bronze, well behind the Australian Olympic Committee’s predictions of 13 gold and 37 medals. Australia’s performance wasn’t too bad considering our population size, but we were miles behind the two countries with the most gold medals. First place was the usual victors, the U.S.A, with 46 gold and 121 medals overall. Second place was the U.K., with 27 gold and 67 medals overall.

    Australia is a proud sporting nation, and part of our national identity has taken a hit seeing the sharp decline in Olympic glory this century compared to the ongoing ascension of the U.S. and the U.K.

    The U.S. has increased their tally from 37 gold and 93 medals in 2000, while the U.K. has dramatically improved from 11 gold and 28 medals overall back in Sydney. We used to be better than the U.K., not even that long ago, and now we are not even close. Let’s not even get started on ‘The Ashes’, where we have now lost five of the last seven test cricket series to England dating back to July 2005.

    If we were to look at these statistics alone as a measure of a country’s overall success, then it is a worrying trend for Australia and a very positive sign for the U.S. and the U.K.

    If we wanted to reverse this trend, it would be essential to figure out precisely what the U.S. and the U.K. are doing right and try to emulate what they are doing to get closer to their levels of success in the future. It would come down to spending more taxpayer’s money on:

    1. improved programs to get people to participate more in a sport at a young age,
    2. enhanced facilities to increase opportunities to excel,
    3. improved coaching to help bring out the best in athletes, and
    4. more focused investment towards the sports and top athletes with the highest potential of producing multiple gold medals at the Olympic Games.

    The problem is that we have already tried to do this, with the Australian Sporting Commission following the lead of the U.K.’s recent success with their own ‘Winning Edge’ program. But, unfortunately, in the four years leading up to Rio, this program unevenly distributed $340m towards summer Olympic sports. These events were the ones that Australia had a better chance to win in, such as Hockey, which cost us $28million for zero medals.

    At over $11million of taxpayers money per medal won in Rio, it becomes crucial to wonder if the extra cost is worth it or if there are better ways that Australia can measure ourselves or improve on the world stage?

    What if there was a medal tally for non-Sporting indicators of success?

    1. Gross Direct Product

    Traditionally, apart from Olympic Glory, Nations have utilised their Gross Direct Product (GDP) to compare themselves to other countries and show the world how successful they are. Considering the nominal GDP of all nations in 2016, the U.S. once again smashes the field and collects the gold medal with $18,558,130,000,000. China collects the silver with $11,383,030,000,000. Japan picks up the bronze with $4,412,600,000,000. The U.K. comes in fifth place with $2,760,960,000,000, and Australia is lagging again in 13th place with $1,200,780,000,000.

    Per capita, the country with the highest GDP is Luxembourg with $101,994, Switzerland is second with $80,675, and Qatar is third with $76,576, based on the 2015 International Monetary Fund 2015 estimates.

    Let’s look at GDP calculations that consider purchasing power parity (PPP) relative to inflation rates and local costs of goods and services. China picks up the gold, the U.S. is relegated to silver, and India comes from nowhere into the bronze medal position. The U.K. drop to ninth, and Australia drop down to 19th.

    Per capita adjusted for PPP, Qatar wins the gold, Luxembourg pick up the silver, and Singapore takes home the bronze, based on the 2015 estimates provided by the International Monetary fund.

    2. The Human Development Index

    The United Nations no longer believe that GDP should be the sole factor when determining which countries are best at helping their citizens develop. Instead, the Human Development Index considers GDP at purchasing power parity alongside life expectancy, education and adult literacy levels. As a result, based on the 2015 results, Norway picks up the gold, Australia claims the silver, and Switzerland the bronze.

    Notably, Australia’s score has slightly improved each year from 2013 to 2015, a good indication that we are not in an overall decline as a nation. Our ranking has also improved from 4th in 2008 to 2nd from 2009 onward. Meanwhile, the U.S. rank 8th in the world, a significant drop from their bronze rank in 2013. The U.K. is 14th, a massive jump from 27th in 2013.

    Once inequality is taken into account, the average level of human development in Australia is 2nd in the world. Norway wins the gold again, and the Netherlands step up to claim bronze. The U.K. drop down to 16th in the world, and the U.S. slide down to 28th.

    What other factors could we also compare nations on to see how Australia stacks up?

    3. The World Happiness Report

    The first World Happiness Report was released in April 2012 after a resolution in July 2011 invited member countries to measure their citizens’ happiness levels and use these findings to guide their public policies. Reports are now issued each year, with the 2016 release considering six main elements as crucial to how successful we can perceive a Nation. These elements are:

    1. GDP per capita
    2. Level of social support
    3. Healthy life expectancy
    4. Freedom to make life choices
    5. Level of generosity
    6. Trust, or perceived absence of corruption in government and business

    Based on the results of this report, Denmark wins the gold medal, Switzerland get the silver, and Iceland the bronze. Australia is currently in 9th place, with the U.S. 13th and the U.K. 23rd.

    Once again, Australia has improved slightly since the last report, a good indicator that we are not rapidly declining as a country. The U.S. and the U.K. are both on the decline. No nation has taken a more prominent hit recently than Greece. Their significant financial difficulties are beginning to influence the social fabric of the country.

    Surely overall Happiness, as measured by these factors, is more important than sporting or Olympic success. Assuming this is true, shouldn’t we be emulating Denmark or the other seven countries ahead of us on this instead of trying to look up to the U.S. or the U.K.?

    4. The Happy Planet Index

    The Happy Planet Index has a slightly different take on what matters most, and to them, this is sustainable well-being for all. They combine life expectancy with individual levels of well-being adjusted for inequality of outcomes within a country and divide this by their ecological footprint to obtain the overall result on the Happy Planet Index. Most Western Countries fare poorly on this scale, with Costa Rica winning the gold, Mexico the silver, and Colombia the bronze. The U.K. is 34th, with Australia and the U.S. far behind in 105th and 108th place.

    Australia does okay in three out of the four items that make up this scale, coming in 7th place at 82.1 years for life expectancy, 11th place at 8% for inequality, and 12th place at 7.2/10 for subjective well-being. However, our ecological footprint, 139th out of the 140 countries included in the data, really lets us down. Only Luxembourg is worse. The U.S. isn’t much better with its ecological footprint, coming in 137th place, while the U.K. is slightly better, currently in 107th place. More needs to be done by these Western countries to reduce the ecological footprint that they are having on our planet. Haiti wins gold for the most negligible environmental footprint, with Bangladesh the silver and Pakistan the bronze.

    For subjective well-being, Switzerland wins the gold with a score of 7.8/10, Norway gets the silver with 7.7/10, and Iceland claims the bronze with 7.6/10, well ahead of the U.S. (7.0/10) and the U.K. (6.9/10).

    For the least inequality, the Netherlands claimed the gold with 4%, Iceland the silver with 5%, and Sweden the bronze with 6%. The U.K. is 19th with 9% inequality, and the U.S. is 34th with 13%.

    Lastly, Hong Kong claims the gold with 83.6 years for life expectancy, Japan the silver with 83.2 years, and Italy the bronze with 82.7 years. The U.K. is 24th with an average life expectancy of 80.4 years, slightly ahead of the 31st ranking for the U.S. with 78.8 years.

    5. Health System

    If we were to think of ways to improve our quality of life further, having a sound health system should be a top priority, yet none of the U.K. (18th), Australia (32nd), or the U.S. (37th) can claim a medal based on the World Health Organisation’s 2000 ratings. So instead, France gets the gold, Italy the silver, and San Marino the bronze.

    6. Academic Performance

    Equally critical to the future of a country should be a good quality of education at the primary, secondary and tertiary levels. When it comes to the 2014 OECD global education rankings, the U.K. is 20th for maths and science, and 23rd for reading, while the U.S. is 28th for maths and science, and 24th for reading. Australia doesn’t fare much better, coming in at 14th in maths and science and 13th in reading.

    More worryingly, Australia has dropped from 6th in maths, 8th in science and 4th in reading in the year 2000. When it comes to schooling, we seem to be declining as a nation and are now 17th for the percentage of students acquiring at least the necessary skills in these areas. We are also 19th in secondary school enrollment rates, behind both the U.S. and the U.K.

    For reading, China claims the gold medal, Singapore collects the silver, and Japan the bronze. Singapore claims the gold, Hong Kong the silver, and South Korea the bronze for maths and science. South Korea was very similar in their academic performance to Australia back in 2000. Although their increase and our decrease may not seem like such a big deal, a 25 point improvement on what is known as the PISA tests would lead to an approximate expansion of $4.8 trillion to Australia’s GDP by the year 2095. Education matters.

    7. Global Gender Gap Index

    Based on the 2015 data, Iceland wins the gold with the slightest gender gap between males and females of 88.1%. Norway the silver with 85%, and Finland the bronze, with 85% also. The U.K. rank 18th with 75.8%, the U.S. 28th with 74%, and Australia 36th with 73.33%.

    Regarding the gender gap, Australia has improved in their score from 72.41% in 2008 but have dropped 15 places over those seven years. We are closing the gender gap at a much slower rate than many other countries. We’re now 32nd in economic participation and opportunity, 1st in educational attainment, 74th in health and survival, and 61st regarding political empowerment.

    8. LGBTIQ Rights

    Based on the first countries to legally recognise same sex-unions, Denmark gets the gold, Norway the silver, and Sweden the bronze.

    These countries also had to have legalised same-sex marriage and allow same-sex couples to adopt a child to qualify for a medal. In addition, they must have LGB individuals who can serve in the military and ban all anti-gay discrimination. They must also have legal documents be amended based on an individual’s recognised gender without the need for surgery or hormone therapy.

    The U.K. nearly ticks all of these items, except same-sex marriage is still illegal in Northern Ireland. Same-sex marriage is now legalised in Australia, finally. Apart from some tribal jurisdictions, the U.S. now has legalised marriage but still has some laws that discriminate based on gender identity and expression, as does Australia.

    9. Refugee Resettlement Actions

    By the end of 2014, one out of every 122 people were internally displaced, a refugee, or seeking asylum, with half of these refugees being children. Wars, persecution and ongoing conflict now mean that we have more people than ever trying to reach safety and begin their new lives in a foreign land, with 59.5 million forcibly displaced in 2014 alone. In addition, due to their proximity to Syria, both Lebanon and Turkey are taking in vast amounts of refugees annually, with 1.59 million Syrian refugees in Turkey at the end of 2014, and more than 25% of Lebanon’s overall population is Syrian as of the 24th of September 2015.

    Based on this article, Germany should win gold, Sweden silver and the U.S. bronze. Meanwhile, the recent Brexit scandal was related to the U.K. not wanting to take on as many refugees and immigrants. Australia’s treatment of refugees and asylum seekers, especially the children, is so notoriously bad that China (not always the best for human rights issues) and the United Nations have publicly spoken out against it.

    10. Freedom of Press

    Based on the 2008 results, Finland and Iceland both get the gold medal, with Denmark and Norway taking home the bronze. The U.S. was 9th best, the U.K.10th, and Australia 13th.

    11. Lowest Infant Mortality Rates

    According to the 2015 estimates provided by the CIA World Factbook, Monaco wins the gold with 1.81 deaths per 1000 live births, Iceland wins the silver with 2.06, and Norway and Singapore both claim the bronze with 2.48 per 1000 live births. Australia is 31st, with 4.43, the U.K. is 32nd with 4.44, and the U.S. is 50th with 6.17 deaths per 1000 live births.

    12. Soundness of Banks

    Based on the 2009 World Economic Forum rankings on a scale from 1 (banks need more money) to 7 (banks are generally sound), Canada picks up the gold with a 6.7/7, New Zealand the silver (6.6/7), and Australia the bronze with 6.6/7. The U.S. comes in at 108th with a rating of 4.7/7, and the U.K. is 126th with a score of 3.8/7. Resilient financial systems are crucial for economic stability, and unstable or unregulated systems were the main culprits in the 2008 financial crisis.

    13. Unemployment Levels

    Based on 2015 figures, Qatar gets gold with 0.4%, Cambodia the silver with 0.5%, and Belarus, according to their 2014 data, get the bronze with 0.7%. By March 2016, Australia’s unemployment rate is 5.8%, slightly worse than its 31st ranking in 2013 with 5.7%. In 2013, the U.K. and U.S. were 44th and 45th with 7.3% each. However, as of July 2016, the U.K. has improved their rate to 4.9%. The U.S. has improved theirs to 5.0% by April 2016.

    And the overall winner is Norway!

    Final medal tally:

    Country Gold (3 pts) Silver (2 pts) Bronze (1 pt) Total points
    Norway II III II 14
    Iceland II II II 12
    Switzerland I II I 8
    China (excl. Hong Kong) II I 8
    Denmark II I 7
    Qatar II I 7
    Singapore I I II 7
    U.S.A I I I 6
    Australia II I 5
    Hong Kong I I 5
    Luxembourg I I 5
    Netherlands I I 4
    Finland I I 4
    Japan I II 4
    Sweden I II 4
    Italy I I 3
    U.K. 0

    Conclusion:

    Australia is doing alright. We aren’t the best country in the world in any of the critical issues that I’ve analysed. Depending on what it is, we could learn a lot from whoever is ahead of us in the rankings, especially Norway and Iceland. This would be much better than always just trying to emulate the U.S. or the U.K. or overreacting to the media every time they catastrophise and tell us that the apocalypse is near.

    Worldwide murder rates (per capita) have declined since the fourteenth century, especially since the 1970s. In addition, higher levels of equality and rights have been achieved across the globe for different races, ethnic groups, females, spouses, children, people with disabilities, and animals, with some countries being more progressive than others.

    Australia still has a long way to go as a Nation. We could be healthier, including have better mental health, indigenous health and well-being. We could have improved climate change policies, LGBTIQ rights, gender equality, refugee and immigration policies, and other areas where people are mistreated.

    At least with the National Broadband System, a higher percentage of the population will have access to a reliable internet connection. It could help more people become better informed, talk about the critical issues through social media, put more pressure on the politicians, and bring about more rapid social change.

    I invite you all to speak up, take action, and follow in Mahatma Gandhi’s footsteps in being the change that you wish to see in the world.

    Dr Damon Ashworth

    Clinical Psychologist

  • What Do Clients Find Most Helpful About Therapy?

    What Do Clients Find Most Helpful About Therapy?

    When clients first begin their therapy journey, they often ask to be taught specific skills to help them achieve their particular goals.

    Clients believe that if they can be taught these skills, they will overcome their difficulties or the problems that led to them entering therapy. They will then have no subsequent complications or need for additional treatment in the future.

    Cognitive Behavioural Therapy (CBT) is a short-term treatment that clients can easily understand. CBT is based on the premise that all difficulties arise from unhelpful cognitions (beliefs, expectations, assumptions, rules and thoughts) and unhelpful behaviours. Therefore, CBT aims to help clients see that their cognitions and behaviours are unhelpful and tries to teach them skills that can help them replace these unhelpful cognitions and behaviours with more helpful ones. If this is achieved, the assumption is that clients will change and therefore improve.

    I believe that if a client can have more helpful cognitions and behaviours, they will have significantly improved psychological health and overall well-being. I’m just not sure if I agree that the process required to get to this outcome is the same as what many CBT clinicians would believe. For example, focus on distorted cognitions has been negatively correlated with overall outcomes in cognitive therapy for depression studies (Castonguay, Goldfield, Wiser, Raue, & Hayes, 1996).

    What leads to improvements in treatment?

    The article “What Leads to Optimal Outcomes in Therapy?” answers this question in detail and shows that the outcome is dependent upon (Hubble & Miller, 2004):

    • The life circumstances of the client, their resources and readiness to change (40% of overall outcome variance)
    • The therapeutic relationship (30% of total outcome variance)
    • The expectations about the treatment and therapy (15% of global outcome variance)
    • The specific model of therapy (15% of overall outcome variance)

    For cognitive therapy for depression, both therapeutic alliance and the emotional involvement of the patient predicted the reductions in symptom severity across the treatment (Castonguay et al., 1996). Many therapists are now aware of these findings, but clients are generally not.

    What do clients view to be the most valuable elements of therapy once they have improved?

    By the end of treatment, especially if it is a successful outcome, clients tend to have a much different outlook on what they think are the most valuable aspects of therapy compared to what they were looking for at the beginning of their treatment.

    Irvin Yalom’s excellent and informative book ‘The Theory and Practice of Group Psychotherapy’ goes into detail about a study he conducted with his colleagues that examined the most important therapeutic factors, as identified by 20 successful long-term group therapy clients. They gave each client 60 cards, which consisted of five items across each of the 12 categories of therapeutic factors, and asked them to sort them regarding how valuable these items were across their treatment.

    The 12 categories, from least helpful to most helpful, were:

    12. Identification: trying to be like others

    11. Guidance: being given advice or suggestions about what to do

    10. Family reenactment: developing a greater understanding of earlier family experiences

    9. Altruism: seeing the benefits of helping others

    8. Installation of hope: knowing that others with similar problems have improved

    7. Universality: realising that others have similar experiences and problems

    6. Existential factors: recognising that pain, isolation, injustice and death are part of life

    5. Interpersonal output: learning about how to relate to and get along with others

    4. Self-understanding: learning more about thoughts, feelings, the self, and their origins

    3. Cohesiveness: being understood, accepted and connected with a sense of belonging

    2. Catharsis: expressing feelings and getting things out in the open

    1. Interpersonal input: learning more about our impression and impact on others

    The clients were unaware of the different categories and only rated each of the 60 individual items concerning how helpful it had been.

    When looking at these categories, giving advice or suggestions about what to do is often not found to be a beneficial element of the therapy process, even though this is precisely what most of the clients are initially looking for. Instead, it is far more critical to develop a more in-depth knowledge of themselves, their inner world, and how they relate to and are perceived by others in interpersonal situations.

    The top 10 items that the clients rated as most helpful were (Yalom & Leszcz, 2005):

    10. Feeling more trustful of groups and of other people.

    9. Seeing that others could reveal embarrassing things and take other risks and benefit from it helped me to do the same.

    8. Learning how I come across to others.

    7. Learning that I must take ultimate responsibility for the way I live my life no matter how much guidance and support I get from others.

    6. Expressing negative and/or positive feelings toward another member.

    5. The group’s teaching me about the type of impression I make on others.

    4. Learning how to express my feelings.

    3. Other members honestly telling me what they think of me.

    2. Being able to say what is bothering me instead of holding it in.

    1. Discovering and accepting previously unknown or unacceptable parts of myself.

    All 20 clients had been in therapy an average of 16 months and had finished or were about to complete their treatment. These items were about group therapy, so the most critical factors for change in individual treatment may be different. However, even with individual treatment, Yalom believes that the relationship heals in the end.

    For more information, feel free to check out Chapter 4 in ‘The Theory and Practice of Group Psychotherapy’ by Irvin Yalom and Molyn Leszcz (2005) or any of the other studies out there that look into the outcomes or therapeutic factors involved in change across psychological treatment.

    Suppose you have ever wanted to discover and learn more about yourself, accept yourself more, express yourself better or develop more trust in others. In that case, longer-term psychological therapy may be just what you need!

    Dr Damon Ashworth

    Clinical Psychologist

  • How Have Intimate Relationships Changed Over the Years, and Where Does It Leave Us Now?

    How Have Intimate Relationships Changed Over the Years, and Where Does It Leave Us Now?

    I just finished reading the book ‘Modern Romance: An Investigation’ by Aziz Ansari and Eric Klinenberg and was pleasantly surprised to see such a well-researched book written predominantly by a Stand-up Comedian (with a helping hand from a Sociologist).

    For those of you who don’t know Aziz, his stand-up shows typically consist of interesting observations about relationships, as does his new series ‘Master of None’.

    Considering that I liked his stand-up and show, I was intrigued to see his book about relationships in my local bookstore. Here’s what his research found:

    How Has Dating Changed?

    1. Distance

    Back in 1932, a Sociologist named James Bossard examined 5000 consecutive marriage licences in the city of Philidelphia, USA, and looked into how close the partners had lived to each other before they married. Here’s what he found:

    • Same address — 12.64%
    • Same block — 4.54%
    • 1 to 2 blocks — 6.08%
    • 2 to 4 blocks — 7.3%
    • 4 to 10 blocks — 10.16%
    • 10 to 20 blocks — 9.62%
    • 20+ blocks — 17.8%
    • Different cities — 17.8%

    More than half of Philidelphia in the 1930s married someone who lived in a ten-block radius to them. More than one-in-six didn’t even cross the road to find their marriage partner.

    Other Sociologists looked to see if this pattern remained in smaller towns and found that it did whenever suitable marriage partners were available. For example, John Ellsworth Jr., who examined marriage patterns in a Connecticut town of less than 4,000 called Simsbury, declared:

    “People will go as far as they have to to find a mate, but no farther.”

    While this quote may still be somewhat applicable in modern times, it does seem that we are much more likely to date people of different origins, cultures and addresses to us, rather than settling down with someone who lived on the same street.

    2. Places

    Where we meet our romantic partners is much different too. Sociologist Michael Rosenfeld’s survey ‘How Couples Meet and Stay Together’ asked over 3,000 American adults of all ages when and how they met their spouse or romantic partner. Because the age of the respondents differed, it made it possible to see the changes between 1940 and 2010. Here’s what he found:

    • In 1940, the most common way couples met was through family (approximately 25%). The second was meeting through friends (21%), followed by meeting in church (13%), and being neighbours (12%).
    • In 1950, meeting via friends had become the most popular method to meet someone (approximately 26%). Meeting through family was still popular (24%) and was a clear second. Meeting in a bar or a restaurant (14%) was becoming more popular, and meeting at work (12%) or being neighbours (12%) was now more popular than meeting at church (10%).
    • In 1970, meeting through friends was the preferred method to find a partner (approximately 31%). Matching through family (20%) was challenged by meeting at a bar or restaurant (18%). Meeting at work was fourth (15%), followed by neighbours, church and college.
    • In 1990, meeting through friends was just below 40%, finding your partner at work was now second (20%), followed by meeting at a bar or a restaurant (18%). Meeting through family and being neighbours had declined as ways to find a partner. Instead, more people were meeting in college, presumably because more people were also going to college and studying longer. Some early adopters were starting to date online too, but this was still the least favourite method of meeting potential partners.
    • Fast forward to 2010, and meeting through friends was still the most common way couples met, but it was under 30% for the first time since 1960. Meeting at a bar or restaurant fought with meeting online for the 2nd most popular method, with both around 20%. Meeting online was already the most popular option for same-sex partners in 2005 and was up to about 70% by 2010. Meeting at work, meeting through family, being neighbours and finding dates through the church was now much less popular as ways to meet someone, and even meeting at college was beginning to decline. All thanks to the rise of the internet!

    In a separate study looking at how Americans met their spouses between 2005 and 2012, Psychologist John Cacioppo found that more than one-in-three married couples met online (34.95%), which was more than work (14.09%), friends (12.4%) and a bar or club (5.68%) combined. So all of the recent advances in technology, especially the internet and smartphones, really has changed the dating scene dramatically, including how we meet, who we meet, how many potential partners we can meet, and even how we communicate with each other.

    3. Communication Methods

    The first text ever was by a British engineer called Neil Papworth in 1992. It’s crazy to think how much this form of communication has grown in only 24 years. In 2007, text messages began to outnumber phone calls made in the US each month, and in 2010 the world sent approximately 200,000 texts each minute. Since 2010, the number of people owning smartphones has dramatically increased in the USA. It rose from 17% in 2010 to 58% in 2014. 83% of 18- to 29-year-olds already owned a smartphone in 2014. With greater smartphone use comes an increasing use in apps such as Facebook Messenger, WhatsApp, and Viber, which further increases instant messages sent.

    Calling vs Texting vs Face-to-Face?

    First Dates

    Seeing that text messages have been a more popular way of communicating since 2007, does this mean that it is now okay to text someone to ask them out on a first date?

    • In 2010, only 10% of adults under 30 used texts to ask someone out for the first time.
    • By 2013, a Match.com survey found that this number had increased to 32%, with face-to-face still leading the way with 37%, a phone call less popular at 23%, and e-mails virtually non-existent at 1%.
    • For adults over 30, this same Match.com survey found that a phone call (52%) was the most likely method of communication when asking someone out on a date, followed by face-to-face (28%), text messages (8%) and e-mail (7%).

    Older females tended to appreciate phone calls in the focus groups that Aziz and Eric ran about whether to phone or text. They saw them as a sign of confidence and helped separate the person from other potential suitors. It also helped them feel more safe and comfortable going out on a date with someone they may not know very well.

    Younger females seemed just as afraid to receive phone calls as younger males were in making them. They preferred not having to respond on the spot and having time to think of a witty or genuine reply or not even reply at all if they weren’t interested, and texting provided them with these options.

    Breaking Up

    What about breaking up — can this too be done via text without seeing the reaction of the heart that you are potentially breaking? It sure sounds more comfortable, but is it socially acceptable?

    • In a 2014 survey of 2,712 18- to 30-year-olds, 73% said they would be upset if their date broke up with them via text, social media or email.
    • In this same survey, out of those who had ended a relationship in the previous 12 months, 25% had used text, 20% had used social media, 18% had split face-to-face, 15% had broken up through a phone call, and 11% had used email.

    With texting, those who had used this method to break up said that they did so because it was “less awkward” and easier to be “more honest.” I still think it is wrong to end a long relationship over text, no matter how much easier it may be. Even though the majority of young adults still agree with me, their actions say the opposite. It’s only a matter of time before their attitudes begin to change in regards to this too.

    Texting Guidelines for Dating:

    1. Do not just say “hey”, “hi”, “what’s up?”, “what’s going on?”

    • Generic messages like this tend to be a real turn-off for some people, especially females who receive many texts like this from several different guys. It is much better to ask a specific question about them or something that refers to the last time you spoke.

    2. Do not just engage in endless banter that never leads to a real-world catch-up.

    • Endless banter gets boring eventually, and older women, in particular, have less patience for constant text exchanges.

    3. Do not just ask someone if they want to “hang out sometime?”

    • It’s confusing whether hanging out is a date or just friends, and it may never lead to an actual date. So instead, invite them out to a particular event, or ask them to meet you at a specific time and place.

    4. Do try to proofread your text messages for correct grammar and spelling.

    • Incorrect spelling is often a major turn off, as is shortening words or using text slang. Determine the audience first, but stick to “tonight” rather than “2nite” if unsure.

    5. Do use a bit of playfulness and humour, but with caution.

    • Make sure that you have a similar sense of humour before engaging in anything too risky or crude, and remember that it can be challenging to pick up on tone in text messages.

    6. Follow the other basic rules around texting:

    • Please wait a while to text back instead of doing it right away, especially early in the dating process. Waiting a bit implies that you have a busy life and builds suspense, increasing the emotional intensity and attraction in the person who has to wait.
    • If you have already sent a text, do not send another message to the same person until you hear back from them unless it is an absolute emergency.
    • Write a similar amount in your texts to what the other person does. If you increase it slightly, they should too if they like you due to our tendency to reciprocate. If they do not, this may mean that they are not aware of the cultural norms around texting, or they are just not that into you.
    • If you are not interested, others will tell you to be upfront and honest with them, but most people actually either pretend to be busy or stop texting back.

    4. Expectations

    When choosing a partner, it seems that our expectations of what the other person needs to provide us have continued to increase over the past 50 years:

    • Before the 1960s, most people were happy enough with settling for a “companionate” or good-enough marriage. People didn’t spend forever looking for passion and love (even though this may have developed over time). Many people saw passionate love as too volatile or irrational to use as the basis for whether or not they should marry someone.
    • When looking for a prospective husband back in 1939, men with a dependable character, emotional stability, maturity and a pleasing disposition were all more highly sought after by women than men they felt mutual attraction and love towards.
    • By the early 1960s, 76% of women were willing to marry a man they didn’t love.

    “Marriage was an economic institution in which you were given a partnership for life in terms of children and social status and succession and companionship.” — Esther Perel.

    • When looking for a prospective wife in 1939, men also highly valued emotional stability, maturity, a dependable character and pleasing disposition, and interestingly also appreciated ambition and industriousness over mutual love and attraction.
    • By the early 1960s, however, only 35% of men admitted that they were willing to marry a woman that they didn’t love. Men already had more legal rights and financial freedom and weren’t looked down upon for moving out of the house and enjoying single life before getting married.
    • By the 1980s, things had changed, with 86% of men and 91% of women in the US saying they needed romantic love to marry someone.
    • In 2008, mutual love and attraction were rated #1 for men and women looking for a prospective partner.

    No longer do people settle for companionship or what is good enough. We also want passion and the perfect life partner who completes us, gives us belonging and identity, mystery and awe, and makes us happy. Some people even declare that they are looking for their soul mate and refuse to settle for anything less.

    This search for the perfect partner seems to take a lot of emotional investment, trial and error, potential heartbreak, and much stress and indecision. However, if we find our soul mate, the potential pay-off should theoretically be much higher than for an old-fashioned “companionate” marriage. However, with more possible options and higher expectations, how can we know if we have found the one to marry?

    5. Marriages

    At what age do we get married?

    From 1950 until about 1968, the average age of first marriages in the US was about 20 for females and 23 for males. In the mid-1970s, this age rapidly increased until it briefly stagnated at about 24 for women and 27 for men between 1999 and 2004. It then began to rise again to about 27 for females and 29 for males in 2014. In bigger cities, such as New York, it is over 30 for both males and females.

    After how long do we tend to get married?

    Before the 1960s, the average couple wed after just six months, according to Stephanie Coontz, author of ‘Marriage, A History’. However, the dating period and the engagement period tend to be much longer these days, with some couples even choosing to live together in a de-facto relationship without ever marrying.

    Do we even need to get married anymore?

    Before the 1960s, getting married, buying a house, and moving out were the first significant steps that signified the transition to adulthood. Single women rarely lived alone, and many families discouraged their daughters from moving into shared housing with other working girls. Their parents were heavily involved in their decisions, even who they dated, and typically always knew about their whereabouts.

    Women of previous generations would sometimes get married to get out of the house and get their first taste of adulthood and freedom. However, once married, they were not always more free to do what they wanted. Instead, they had to depend on their husbands for legal and financial purposes whilst being fully responsible for looking after the house and the children.

    Although things still aren’t fully equal with men and women, with women typically earning less and having to do more housework and child-rearing, they now have equal legal rights regarding property and divorce. Alongside the greater acceptance of various lifestyle choices, including moving out without getting married, marriage is now a choice rather than a necessity for many women.

    https://youtu.be/cYdsWtku9gg

    6. Choices

    Thanks to the advances in technology, we now have more potential options available to us at the click of a mouse or swipe of a button than we have ever had before.

    Thanks to the greater rights and freedom provided to most women in the Australian culture, we also have a new developmental period between adolescence and adulthood called emerging adulthood (ages 18–29). It is a phase where people can go to university, start a career, travel, move around a bit, and have some fun and relationship experiences before settling down and getting married.

    During emerging adulthood, we end up greatly expanding our pool of potential romantic partners. Once you include online dating and other apps for meeting people, the number of possible partners grows exponentially, especially in bigger cities like Melbourne.

    But does having more choices make it easier to find “the one”?

    Research on the paradox of choice would suggest not. As I’ve already mentioned in a previous post, Barry Schwartz, a Psychologist, describes an experiment at a supermarket where they offered 24 different samples of jelly (jam) to customers on day one and six jellies on day two. The day with only six options outsold the day with 24 possibilities by ten times the amount.

    Too many options lead to indecision and paralysis and higher discontent after a decision. So before you are searching for a partner, especially if it is online, make sure that you have a sense of what is truly important to you and what is not, and try to limit your search to these options. Then if you find someone who seems to be alright, give them a real chance before moving onto the next one. You’re likely to be more satisfied on a long-term basis if you do.

    Dr Damon Ashworth

    Clinical Psychologist

  • My Top 5 Psychology TED Talks

    My Top 5 Psychology TED Talks

    In order of fewest views to most, I will present my favourite TED talks, along with a brief description of what they are about, why I think they are great and where you can find out more information about these concepts if you are interested. Enjoy!

    5. The Surprising Science of Happiness by Dan Gilbert (13 million views)

    Summary: Human beings are the only animals that can simulate experience and imagine what something will be like before we do it. This capacity to visualise future experiences is a helpful tool to have. It is one of the main reasons humans have been able to make all of the advances that we have since the industrial revolution. However, our experience simulator has its limitations and is often not accurate due to what is known as an impact bias.

    An impact bias is the tendency to overestimate the impact that a future event will have on our emotional life and overall happiness levels. The most striking example, which I’ve previously mentioned in another article, is that 12 months after becoming a paraplegic or 12 months after winning the lottery, an individual’s level of happiness is usually the same as before the event took place. It is the same with weight loss, moving houses, relationship break-ups and infidelity, and getting a promotion at work. Whether it is a positive or negative event, they will consistently have less impact, less intensity and lesser duration than what people will expect them to have.

    When things work out the way we want them to, this is known as Natural Happiness, and most people understand why someone is happy. It makes sense. What doesn’t make sense is Synthetic Happiness, which is the happiness that is created by our “psychological immune system” when we don’t get what we want. Research has shown that even though other people respond to examples of Synthetic Happiness with a “yeah right!” response when they hear about it, it is every bit as enduring as Natural Happiness.

    What I liked about it: Even when things don’t go as planned or we don’t end up getting what we want, most of the time, our “psychological immune system” will step into action and help us feel pleased not despite, but because of what has occurred. While most of us might picture ourselves being miserable if things don’t work out, the truth is that we will generally be okay, so don’t spend too much time fretting over all of the bad things that may occur in the future. Humans are amazingly resilient, even in the face of the worst possible outcomes.

    On the positive side, we should also try not to sacrifice too much good stuff (fun, leisure, play, excitement, adventure) in the here and now for that eventual pay-off that is likely to be less rewarding and less enduring than you imagine. It is much better to create the type of life that we want now than always putting it off until a later date (after I finish studying; after I get married; after I retire; after I lose weight etc.).

    If you’d like to learn more: Read the book ‘Stumbling on Happiness’ by Dan Gilbert.

    4. The Power of Introverts by Susan Cain (14 million views)

    Summary: Our society, especially in the West, tends to value being social and outgoing, or being an extrovert, above all else. An extrovert is someone who craves large amounts of stimulation, both environmentally and socially, to feel lively and capable. On the other hand, introverts tend to feel most comfortable, switched on, energised, and creative when they are in low-key or isolated environments.

    The key to maximising everyone’s talents is finding the best level of stimulation for each individual. However, we design our schools and workplaces and social settings to allow the extrovert to thrive. These designs only further disadvantage the introvert and diminish their performance, confidence and level of well-being. Introverts often feel different from mainstream society or ashamed of who they are, but between a third and a half of all individuals are introverted. It’s just that they are often quieter and tend to get lost in the crowd.

    What if, instead of forcing introverts to thrive in an extroverted world, we could instead diversify things to appeal to everyone’s strengths. What if each student and worker could study and perform in the environment that best suited them? Introverts often have talents and abilities in the areas where extroverts are the weakest, so accepting, encouraging, and celebrating the strengths of introverts and extroverts would help society flourish better as a whole.

    What I liked about it: Growing up, I always knew that I became overstimulated and struggled to perform at my best in loud, busy environments. I hated going out to clubs on the weekend and tended to enjoy smaller gatherings to large crowds or festivals. I even found large lectures much more challenging to concentrate on than a small tutorial or studying at home by myself. Some of my favourite pastimes include spending a big chunk of time by myself relaxing, reflecting or reading a book. I love excitement and adventure too, which makes me more of an ambivert, but I need my quiet times to recharge and keep functioning at my best. Accepting myself for who I am and working with my strengths is much better than forcing myself to be like someone else that society values the most.

    If you’d like to learn more: Read the book ‘Quiet: The Power of Introverts in a World That Can’t Stop Talking’ by Susan Cain.

    3. The Power of Vulnerability by Brené Brown (24 million views)

    Summary: Brené Brown is a social worker who has studied human connection, imperfection, shame, fear and vulnerability. She believes that human connection is why we are here on this planet, and it is what gives us meaning and purpose in life. She says that what prevents us from connecting with others truly is shame and fear and that to connect, empathise, belong and love, we need to be seen, which takes extreme courage and vulnerability. It is possible to be worthy of love, connection and belonging without being perfect. We need to be compassionate towards ourselves and believe that we are worthy. While it may seem appealing to not be afraid before we act, it is actually through leaning into the discomfort, embracing vulnerability, and being willing to take emotional risks that we will find the most rewarding experiences and connections.

    What I liked about it: Not only does Brené Brown talk about vulnerability, but she also leads by example by opening up about her struggles with vulnerability. She shows that life isn’t about waiting until we’re perfect or bulletproof before we act upon something or try something out, as seductive as infallibility may be. If we don’t take risks or be vulnerable, we sacrifice the quality of our relationships, and we miss out on opportunities that we may never be able to get again. But, on the other hand, when we are vulnerable, we don’t waste our precious time or turn our backs on our potential strengths. Instead, we manage to connect with others and contribute in a way that is uniquely ours.

    If you’d like to learn more: Read the book ‘The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are’. Even better is the book ‘Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead’ by Brené Brown.

    2. Your Body Language Shapes Who You Are by Amy Cuddy (33 million views)

    Summary: It has been known for quite a while that our body language impacts how others perceive us and how successful our interactions with others are. Amy Cuddy has researched our nonverbal behaviour further and shows that this can also affect our thoughts, feelings, hormone levels and subsequent behaviour. For example, holding any two of the five “power poses” shown in the talk for only 60 seconds each can increase testosterone levels and feelings of power while reducing cortisol levels and stress. It may even change how you perform if done before important meetings, speeches, exams, job interviews, or other stressful occasions. Like Amy says, power posing allows us to “fake it until we become it!”

    What I liked about it: The concept of power posing brings about all types of possibilities for helping people with anything that they usually lack confidence in or feel a high degree of stress doing. If only 2 minutes of power posing can increase their likelihood of success, then it should be taught everywhere, from homes to schools to workplaces. In the last chapter of Amy Cuddy’s book ‘Presence’ she includes some examples of people (and even horses) that have successfully applied power posing in their lives.

    The Imposter Syndrome is another critical issue that Amy touches on during her talk, and it is an experience that a lot of us (between 60–70%) have at one point or another in our life. I know that I did when I first made the state Volleyball team as a junior and when I first started studying for my Doctoral Psychology degree. The Imposter Syndrome is where people feel like they are a fraud or shouldn’t be in the position they are in because they “don’t deserve it” or that “somebody has made a mistake”. They worry that although they have been able to convince people so far of their capabilities, it is just a matter of time before others catch them out for the imposter they are. Realising how common this is and that in time it can go away would provide hope to anyone watching who is going through a similar experience.

    If you’d like to learn more: Read the book ‘Presence: Bringing Your Boldest Self to Your Biggest Challenges’ by Amy Cuddy.

    1. Do Schools Kill Creativity? by Sir Ken Robinson (38 million views)

    Summary: Our current education system is outdated and fails to adequately prepare today’s children for the uncertainty and unprecedented growth that is likely to occur in the future.

    The current hierarchical structure of subjects tends to place maths and languages at the top, followed by the humanities and arts. Furthermore, art and music are considered higher than drama and dance, even within the arts.

    Somehow as we go up in school levels, the creative pursuits are pushed aside, devalued and even stigmatised instead of the more serious subjects that are supposed to ready us for the workplace. But schools are still preparing us for the needs of industrialism, not for the rapidly evolving society where we are not even aware of what is ahead of us in five years, let alone what the world will be like in 2065.

    Wouldn’t it be better to help each child to utilise their creativity in figuring out where they are most “in their element” and encourage them to pursue a career that is consistent with both their strengths (what they are good at) and their passions (what they enjoy)?

    What I liked about it: Considering that we’ll never exactly know what we are preparing students for, teaching them to be curious, creative, innovative, flexible and resilient should be at the top of the list of the skills to help develop in children. If we can do this, then no matter what takes place in the future, today’s children will be in the best position to adapt, grow and evolve.

    We should also let go of seeing intelligence so narrowly and know that it is diverse, dynamic and distinct. We should start looking for and nurturing each child’s unique capacities instead of trying to force them into becoming A+ Maths and English students. Ken uses the example of Gillian Lynne, who her school diagnosed at eight years of age as having a learning disorder similar to ADHD. Nowadays, she would likely be put on Ritalin to help reduce her restlessness and remain focused in class, but luckily the specialist that she saw noticed her need to move and dance to music and told her mother to enrol her in a dance school instead. Gillian did this, began to flourish, and went on to choreograph “Cats” and “Phantom of the Opera”, entertaining millions and making millions in the process.

    If you’d like to learn more: Read the books ‘The Element: How Finding Your Passion Changes Everything’ and ‘Finding Your Element: How to Discover Your Talents and Passions and Transform Your Life’ by Ken Robinson and Lou Aronica.

    Feel free to comment about which ones you liked the best or if there are other TED talks that you would have included in your list.

    Dr Damon Ashworth

    Clinical Psychologist

  • Feel the fear, and do it anyway

    Feel the fear, and do it anyway

    I’ve been thinking for a while about what would be the best way to start a psychology-related blog. I have some great ideas for blog series that I would like to do, but none of them seemed fitting for an introduction to the site.

    Then I realised what was happening.

    I was letting perfection get in the way of production and procrastinating. FEAR was holding me back.

    Dr Russ Harris speaks about FEAR as an acronym for things that can keep us stuck and prevent us from making the changes that we would like to make in our life:

    F — fusion with unhelpful thoughts — An example of this is “that’s not the best way to start a psychology blog — keep brainstorming until the perfect idea or solution presents itself!” By allowing myself to believe what my mind said, I kept putting off what I wanted to do. I want to share some of the things that I have learnt and found helpful through my eight years of University study and hundreds of psychological books and journal articles that I have read.

    E — unrealistic expectations — If I have never written a blog before, how can I know what style is the right way to express what I have to say? I can’t. We learn through trial and error and experience. Sometimes I’m sure that I will write a piece and be happy with it, but other times this won’t be the case. Some articles may get good feedback, and some may not. All I can do is give it a go, reflect upon it afterwards, get input from others, and make changes as required until I find the right voice for myself and my potential audience. What’s more important is that I enjoy the process of clarifying my thoughts and share them with whoever is interested in a way that they can hopefully understand. I believe Hemingway said that the first draft of anything is shit. If a literary great didn’t expect to produce a fantastic story the first time he wrote it, is it realistic for me to hope for more?

    A — avoidance of discomfort — Does putting my thoughts into writing pose any real threat to me? No. It can help me clarify my ideas further and assist the clients that I see by getting my points across more concisely. Will putting my writing out there expose me to judgment and potential ridicule from others? Possibly. Does staying in my comfort zone and doing what feels safe or secure lead to me living a happy, fulfilled life? No. Quite the opposite. It, therefore, becomes a choice between discomfort and growth or comfort and stagnation. Whether it is worth it or not is up to the individual and depends on the situation and how they feel about it.

    R — remoteness from values — Values are guiding principles for life. If we persist through discomfort in pursuing a goal, we need to get in touch with what is really important to us or what we care about deep down. For me, writing a blog is about helping people be informed about psychological theories and empowered with strategies that can make a difference in their lives. There is so much conflicting information about what can help. Sharing what rigorous scientific studies have found in collaboration with my own personal experience will hopefully be useful for anyone who chooses to read it. It will also give any potential clients an idea about my approaches towards my life and work and help them decide if I am the right clinical psychologist. It is much easier for me to persist in writing this blog and the following articles by connecting with these values.

    With that in mind, what do you fear, and what holds you back from making the changes you would like to make? Is it any of the four things mentioned above? If so, can you challenge or detach from those thoughts, set more realistic expectations for yourself, get in touch with your most important values, and persist with the discomfort in pursuit of the type of life you would like to lead? Maybe not straight away, but hopefully with practice, reflection, feedback and support from others.

    The first self-help book I ever read was ‘Feel the Fear and Do It Anyway’ by Susan Jeffers. It transformed my life to think that I didn’t need to stop feeling scared before doing something. Even though anxiety often feels like it is a life-or-death situation, especially when it comes to social anxiety, it never typically is. So now, I embrace whatever awkwardness I can and challenge myself wherever possible. Through a process called habituation, it actually does get more comfortable in time.

    For any anxiety-based psychological treatment, exposure to the feared stimulus will be recommended at some point in the treatment and is a crucial component to the most successful outcomes. But it is also important to start slowly and begin with tasks that feel a bit challenging and scary, and then slowly work your way up to more challenging and scary tasks once your confidence has built up.

    If you want to try this on your own:

    1. Develop a list of tasks that you are afraid to do, but they would not actually harm you if you were to do them.

    2. Rank these from least scary or challenging to most scary or challenging.

    3. Starting with the least scary first, set a goal for yourself to tackle the task and be as specific as possible with date, time, location and duration.

    4. Attempt the task, and if possible, remain in the situation until the anxiety has subsided (usually about 10 minutes).

    5. If you cannot complete the task, try something more manageable that brings a little fear or discomfort but not too much, and gain confidence with this before reattempting the initial task.

    6. Repeat until habituation has taken place and you feel more confident and less anxious doing that task.

    7. Move on to the next most scary or challenging task on the list.

    Doing it step-wise would take a long time, but as long as you progress, you learn the skills to challenge any fears that come your way.

    Remember, feel the fear, and do it anyway (unless it really is too dangerous and unsafe)!

    Dr Damon Ashworth

    Clinical Psychologist