Tag: strategies

  • 20 Fascinating Paradoxes About Life

    20 Fascinating Paradoxes About Life

    What is a Paradox?

    According to the Oxford dictionary, a paradox is a noun that has two meanings:

    1. A seemingly absurd or contradictory statement or proposition which when investigated may prove to be well founded or true.

    2. A person or thing that combines contradictory features or qualities.

    I love paradoxes because they are sometimes funny and usually also quite insightful. Listening to the audiobook version of the Tao Te Ching by Lao Tzu was like listening to one paradox after another. This was especially surprising to me because it is an ancient book of wisdom. So a great paradox is much more than just a cliche, even though it can appear like that over time.

    Below is a list of some of my favourites, starting with one from the Tao Te Ching:

    1. New beginnings are often disguised as painful endings” – Lao Tzu

    young game match kids

    2. “Who you are speaks so loudly I can’t hear what you’re saying.” – Ralph Waldo Emerson

    man wearing brown suit jacket mocking on white telephone

    3. “I’d rather be hated for who I am, than be loved for who I am not” – Kurt Cobain

    hi haters scrabble tiles on white surface

    4. “I refuse to join any club that would have me for a member.” – Groucho Marx

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    5. “You know what the issue is with this world? Everyone wants a magical solution to their problem, and everyone refuses to believe in magic.” – Alice in Wonderland

    woman holding teacup

    6. “I am the wisest man alive, for I know one thing, and that is that I know nothing.” – Socrates

    man wearing brown jacket and using grey laptop

    7. “Yesterday I was clever, so I wanted to change the world. Today I am wise, so I am changing myself.” – Rumi

    adventure cliff lookout people

    8. “We judge ourselves by our intentions and others by their behaviours.” – Stephen Covey

    man in blue crew neck shirt staring at woman trying to lift barbell

    9. “If you don’t risk anything you risk everything.” – Mark Zuckerberg

    action adventure challenge climb

    10. “The more we do, the more we can do; the more busy we are, the more leisure we have.” – William Hazlitt

    man and woman holding hands walking on seashore during sunrise

    11. “Only you can take responsibility for your happiness…but you can’t do it alone. It’s the great paradox of being human.” – Simon Sinek

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    12. “If you try to fail and succeed, which have you done?” – George Carlin

    man person street shoes

    13. “Seek freedom and become captive of your desires. Seek discipline and find your liberty.” – Frank Herbert

    red and blue hot air balloon floating on air on body of water during night time

    14. “Nowadays most people die of a sort of creeping common sense, and discover when it is too late that the only things one never regrets are one’s mistakes.” – Oscar Wilde

    active activity adventure backpack

    15. “Whatever you do will be insignificant, but it is very important that you do it.” ―Mahatma Gandhi

    man person mountain hiker

    16. “He who fears he shall suffer, already suffers what he fears.”― Michel de Montaigne

    close up photo of jack o lantern

    17. “A lot of people never use their initiative because no-one told them to.” – Banksy

    microphotography of orange and blue house miniature on brown snail s back

    18. “If someone doesn’t value evidence, what evidence are you going to provide to prove that they should value it? If someone doesn’t value logic, what logical argument could you provide to show the importance of logic?” ― Sam Harris

    battle black blur board game

    19. “Let go of certainty. The opposite isn’t uncertainty. It’s openness, curiosity and a willingness to embrace paradox, rather than choose up sides. The ultimate challenge is to accept ourselves exactly as we are, but never stop trying to learn and grow.” Tony Schwartz

    two men assisting woman riding on swing

    20. “If you don’t get what you want, you suffer; if you get what you don’t want, you suffer; even when you get exactly what you want, you still suffer because you can’t hold onto it forever. Your mind is your predicament. It wants to be free of change. Free of pain, free of the obligations of life and death. But change is law and no amount of pretending will alter that reality.” – Socrates

    bench cold dawn environment

    Dr Damon Ashworth

    Clinical Psychologist

  • Sleep Medicine Recommends Only Five Strategies for Insomnia

    Sleep Medicine Recommends Only Five Strategies for Insomnia

    If you have tried my sleeping tips from the prior article and your sleep is still problematic, there are several things that you can do.

    The safest option is to go and see your medical doctor or GP and get a referral to a Sleep Physician. They will be able to do a more comprehensive sleep study with you and see if you have any underlying sleep conditions impacting your sleep and feel. You may have to do a polysomnography (PSG) or sleep study to rule out conditions like sleep apnea, restless legs syndrome, periodic limb movement disorder, delayed sleep phase disorder, narcolepsy or idiopathic hypersomnia.

                If it’s unlikely that you have any of the above sleep disorders, you may have insomnia. As many as 33% of people have sleep problems, and between six to ten percent have serious enough sleep concerns to warrant a diagnosis of chronic insomnia. Once you have had it for a few months, it may not get better on its own without treatment or applying the right strategies to your sleep.

                Everyone will tell you what they think is the solution to sleep problems, from earplugs to eye masks, comfy pillows, new beds and weighted blankets. However, there are still only five strategies with enough evidence to be empirically supported insomnia strategies by the American Academy of Sleep Medicine (AASM). If you think you have insomnia and want to improve your sleep, please try one of these five strategies: Cognitive behavioural therapy for insomnia (CBT-I), sleep restriction, stimulus control, progressive muscle relaxation, and paradoxical intention.

    Photo by Alex Green on Pexels.com

    STRATEGY 1: COGNITIVE BEHAVIOURAL THERAPY FOR INSOMNIA

    CBT-I consists of four main components. Psychoeducation, sleep scheduling, relaxation techniques and cognitive techniques. Together, these four components target all three underlying sleep mechanisms. CBT-I has sleep scheduling to improve homeostatic pressure and circadian rhythms. It encourages people to get morning sunlight and remain off bright screens before bed to strengthen circadian rhythms. It also teaches relaxation strategies to help people learn how to relax and reduce their arousal levels. Finally, CBT-I teaches cognitive strategies to help people to challenge their unhelpful beliefs about sleep and further reduce their arousal levels.

                If you want to try CBT-I, you can check out my Udemy course ‘Improve Your Sleep with CBT for Insomnia’. I’ve also seen the positive results published on other online CBT-I courses such as Sleepio or Somryst. CBT-I Coach tries to teach some of these strategies at no cost, including what times are best for you to go to bed and wake up if you do sleep restriction. If you’d prefer in-person CBT-I, you can search on the internet and see if there are any psychologists or behavioural sleep medicine specialists who specialise in CBT-I.          

    Photo by Teresa Howes on Pexels.com

    STRATEGY 2: SLEEP RESTRICTION

    Sleep restriction is a strategy that increases homeostatic pressure by reducing your time in bed each night to only the amount of time you are sleeping. It also helps to strengthen your circadian rhythms by improving the regularity of when you go to bed at night and rise from bed in the morning, seven days a week. However, it is important that you set your sleep times at the right time for your body clock to be the most effective. Morning people would better choose earlier to bed and rise times, whereas evening people will need to stay up later and get up later.

                Sleep restriction can increase distress and arousal levels initially. It can be especially difficult for people with chronic insomnia, who are already worried about not getting enough sleep and the consequences they will feel and face during the day. This can make it very hard for people to initially try and even harder to fall asleep or remain asleep at night. Once they sleep better, their arousal levels can drop significantly, as the individual can begin seeing how effective this strategy is.

    Sleep restriction instructions are as follows:

    1. Determine your average total sleep time over the past 1-2 weeks. If it is less than five hours per night, say it is five hours. 
    2. Add 30 minutes to this amount. The total is your new time in bed prescription. Only spend this time in bed every night for the next two weeks.
    3. Figure out when you would like to wake up seven days a week. It is your rise time or time to get up each morning. Set the alarm to help you wake up at this time. When the alarm goes off, get out of bed and try not to sleep again until the next night. 
    4. Minus your time in bed allocation from your rise time to figure out your bedtime. For example, if you wake up at 6 am and are meant to be in bed for 6 hours and 30 minutes every night, aim to go to bed around 11:30 pm.
    5. For sleep restriction to be maximally effective, bedtime should be approximate rather than absolute. For example, if it is 11:15 pm and you notice many sleepiness signs, go to bed rather than wait until 11:30 pm. On the other hand, if it is 11:30 pm and you are wide awake, wait up a little until you feel a bit sleepier. Then go to bed.  
    6. Once you have your bedtime, rise time and time in bed prescription, track your sleep for the next two weeks using a sleep diary or activity tracker. Then figure out your sleep efficiency, which is the percentage of your time in bed spent sleeping.
      • If your sleep efficiency for the next two weeks is under 85%, cut your bedtime by a further 15 minutes each night. If it is between 85-90%, keep your time in bed prescription as it is.
      • If it is above 90%, extend your time in bed by 15 minutes each night.
    7. Keep tracking for another two weeks and repeat until your sleep efficiency is between 85-90% regularly. 
    Photo by Lina Kivaka on Pexels.com

    STRATEGY 3: STIMULUS CONTROL

    Stimulus control is a strategy that ensures that your homeostatic pressure is high enough when you are going to sleep by encouraging you to get up at the same time every morning, seven days a week, no matter how well you have slept. By not napping during the day, your homeostatic pressure also remains high. Not going to bed until you feel sleepy means that you won’t go to bed until your brain and body are ready for sleep, which reduces how much time you spend in bed awake. Being out of bed whenever you can’t sleep for 20 minutes also means that you’ll never spend excessive time in bed awake each night.

                Stimulus control also helps to strengthen your circadian rhythm with the regular rising time in the mornings and only going to bed when you feel sleepy. Stimulus control is better than sleep restriction if you strictly follow both of the rules as they are written. Stimulus control helps you to find out when your brain and body most want you to go to sleep, as opposed to going to sleep at the same time every night.

                Like sleep restriction, stimulus control can also initially increase distress and arousal levels, especially for people with chronic insomnia. People with insomnia tend to already be worried about not getting enough sleep and the potential consequences they will feel and face during the day if they do not get enough sleep or have to be out of bed during their usual time in bed. This can make it very hard for people to initially try stimulus control and even harder for them to fall asleep or remain asleep at night.

                Once you begin sleeping better through stimulus control, your arousal levels can drop significantly, as you can begin seeing how effective this strategy is. It also means that you will no longer have to get out of bed after 20 minutes of being awake if you fall asleep regularly within this time, which will likely reduce your worries further. The better you sleep at night and the less tired you feel during the day, the less you will feel the need to sleep in longer in the morning or nap during the day. So, the more effective stimulus control becomes as a strategy, the lower your arousal levels.

    The stimulus control instructions are as follows:

    1. Only go to bed when sleepy, 
    2. Wake up at the same time every day, 
    3. Only use the bed/bedroom for sleep and sex, 
    4. Avoid naps during the day, and 
    5. Sit up or get out of bed if you cannot fall asleep within about 20 minutes of retiring to bed.
    6. If you have to get up at night, do something calming or relaxing until you feel sleepy again, and then lie back in bed for sleep. Ideally, this activity during the night should not involve bright light, rigorous exercise or be too cognitively demanding.
    Photo by Ketut Subiyanto on Pexels.com

    STRATEGY 4: PARADOXICAL INTENTION

    Paradoxical intention is probably the least used strategy that is effective for chronic insomnia. This is because it is quite counter-intuitive and, therefore, a hard sell to patients that are already struggling with less sleep than they would like. It also doesn’t target circadian rhythms or sleep pressure directly. Paradoxical intention instead indirectly targets both of these sleep mechanisms by helping patients to take off all the pressure they put on themselves to sleep.

                As long as the individual follows the recommended paradoxical intention instructions, it can reduce sleep effort, performance anxiety and hyper-arousal levels. This allows homeostatic pressure and circadian rhythms to work better for the individual, as long as they have been up for long enough during the day and are going to bed at the right time for their internal body clock.

    The instructions for paradoxical intention are as follows:

    1. Go to bed at your usual bedtime.
    2. Lie down in bed with the lights off. 
    3. Don’t read or look at your phone or anything else.
    4. Try to see if you can stay awake for “just a little bit longer” without doing anything to force yourself to stay awake. 
    5. If you are still awake, congratulate yourself for successfully achieving your goal. Then, don’t look at the time on the clock and keep focusing on staying awake for “a little bit longer”. 
    6. Keep this up all night if you have to. But, whatever you do, do not try and force yourself to sleep and keep trying to stay awake “just a little bit longer”.
    Photo by Kelvin Valerio on Pexels.com

    STRATEGY 5: PROGRESSIVE MUSCLE RELAXATION

    Progressive muscle relaxation is a sleep strategy that predominantly reduces how much physical tension someone feels before bed. Spending much of the day stressed or worried can lead to physical tension, especially around the neck, shoulders and upper back area.

                Progressive muscle relaxation can also reduce cognitive arousal levels by helping individuals focus on different parts of their bodies and become more aware of their feelings. It is, therefore, a much better cognitive strategy than either suppression or worry.

                Progressive muscle relaxation really doesn’t help with someone’s homeostatic pressure or circadian rhythms. It is an intervention that specifically targets someone’s hyper-arousal, particularly any physical tension they feel. It can help people feel more relaxed and calmer; therefore, the other two sleep components can work effectively and help them sleep enough at the right times.

    PMR instructions are as follows:

    1. Tense the muscles in your arms, bringing your hands towards your shoulders to feel your biceps tighten. Then take a deep breath through your nose and down into your stomach. Then relax your arms as you breathe out the air through your mouth. Next, let your hands hang down by your side and give them a shake. Then repeat one more time by tensing, breathing and relaxing your arms.  
    2. Then tense the muscles in your face, including the ones in your forehead, nose, jaw and around your eyes. Notice the tension. Then take in a deep breath through your nose and into your belly. Relax all the muscles in your face as you breathe all the air out through your mouth. Let your facial muscles droop as your jaw hangs loose. Then repeat one more time.   
    3. Tense the muscles in your neck by bringing your shoulders up to your head. Hold this pose tight for a few seconds. Then take a deep breath through your nose into your stomach. Pause for a second or two. Then breathe all the air out through your mouth as you relax your neck and let your shoulders drop. Next, move your head around slowly in a circular motion if this helps you to relax your neck. Then repeat once more. 
    4. Tense the muscles in your stomach and back, bringing your abdomen closer to your spine. Hold this for a second, then take a deep breath into your belly while keeping your stomach and back tense. It may make it a little harder to breathe in as deeply as with the other muscle groups. Then breathe all the air out of your mouth as you slump down and push your belly out. Repeat one more time.  
    5. Tense the muscles in your buttocks and thighs, squeezing them tightly. Take a deep breath, pause, and relax these muscles as you breathe all the air out. Shift back and forth from left to right in your seat, then repeat.  
    6. Lastly, stretch out your legs and tense your calves and feet, bringing your toes back towards your body. Breathe in, pause, breathe out and relax your calves and feet. Shake out your legs, and then repeat one last time. 

     

    Photo by Pixabay on Pexels.com

    HOW DO YOU KNOW WHAT TO TRY FIRST?

    Based on what I have written above, trying CBT-I is good if you think all three underlying sleep mechanisms are an issue. CBT-I is also the most recommended if you currently have some beliefs about sleep that are unhelpful for you.

                If your sleep pressure is not high enough at night when going to bed, but your arousal levels are okay, try sleep restriction. Try stimulus control if your circadian rhythms impact your sleep or if you spend lots of time awake in bed each night. Stimulus control can help to recondition your bed by feeling calm and sleepy and sleeping well over time, so it can be a helpful strategy in several ways.

                If elevated arousal levels are your main issue, but you are doing okay otherwise, give progressive muscle relaxation a proper go. If you find that you are putting in too much effort to try to sleep at night and your pre-sleep arousal is too high, I would recommend trying paradoxical intention first.

                No matter what you try, try it every night for at least a week, ideally two, before deciding if it is the right or wrong strategy. Both stimulus control and sleep restriction are difficult and anxiety-provoking initially. Still, they can have some of the largest improvements for you and your sleep if you stick to the instructions over time. Even a year after people have completed a course of CBT-I treatment, the best predictor of who continues to sleep well is individuals who still follow the sleep restriction and stimulus control rules.

    Dr Damon Ashworth

    Clinical Psychologist

  • The Four Ultimate Concerns in Life

    The Four Ultimate Concerns in Life

    I’ve been afraid to say this for a while because of how it will be perceived, but my favourite book of all time is actually a textbook. So before you think that makes me someone you would never want to speak to, I’ll ask if you have ever read anything by Irvin Yalom, American Psychiatrist and Author?

    His book ‘Existential Psychotherapy’ is a true masterpiece he worked on for 10 years and is written as eloquently as any of his other titles, including ‘When Nietzsche Wept’, the best fiction novel award winner in 1992.

    What is Existential Psychotherapy?

    Existentialism is the philosophical exploration of existential issues or questions about our existence that we don’t have an easy answer for. We all suffer from anxiety, despair, grief and loneliness at times in our lives. Existential Psychotherapy tries to understand what life and humanity are about.

    In the book, Yalom explores what he considers to be our four most significant existential issues in life:

    1. Death
    2. Freedom
    3. Isolation
    4. Meaninglessness

    These existential issues or ultimate concerns are “givens of existence” or “an inescapable part” of being an alive human in our world. He shows how these concerns develop over time, how we can run into problems with each of these issues, and what they might look like in patients coming to therapy. He also talks about how we can try to live with these concerns to negatively impact our lives less, even if we don’t have clear-cut solutions to them.

    Let’s go through each of these ultimate concerns…

    1. Death

    Homo sapiens, or humans, as far as I know, are the only species in the animal kingdom that are aware that one day they are going to die.

    The first time I heard this, it fascinated me and made me wonder if life would be more comfortable not being aware that one day we cease to exist.

    Imagine it. Life is going well. Then suddenly, it is no more. No worry about what the future holds. We are born. We experience life. Then we are no longer there. No fear. Just nothingness.

    Being aware that we will die shapes and influences our lives much more than we would like to admit. This is because so many of our anxieties and phobias at their core are fear of some loss or death.

    Irvin Yalom says that while the actuality of death is the end of us, the idea of death can actually energise us.

    If we don’t know when we will die, being in touch with the fact that one day everything will vanish is enough to overwhelm some people and make them panic.

    For others, it is enough to make them follow the maxim of carpe diem and helps them to seize the day by appreciating everything they have so that they can make the most of the precious time they have left on this planet. Time is really just a bright spark of lightness between two identical and infinite periods of darkness — one before we are born and one after.

    Death is the ultimate equaliser, for no matter how much we have achieved or done with our time on this planet, the truth is that we will all one day die.

    It is also true that we will not know exactly when death will happen. It might be with a car accident tomorrow, from cancer in ten years, motor neurone disease in twenty years, a heart attack in thirty years, a stroke in forty years, or during our sleep in fifty years.

    Because our knowledge of our inevitable death is so inescapable and hard to confront and deal with directly, we instead focus on smaller and more manageable worries or concerns in our lives that we can do something about if we want to. If we successfully address all these minor concerns, however, we then come in contact with our fear of death again, and the cycle repeats itself.

    Most people tend to have one of two basic defence mechanisms against their fear of death:

    A. They can think that they are “special” and that death will befall others but not them, and try to be an individual and experience anxiety about life.

    Or

    B. They can think they are an “ultimate rescuer” and try to fuse with others and experience anxiety about death (their own mortality and that of their loved ones).

    A breakdown of either of these defences can give rise to psychological disorders:

    • narcissism or schizoid characteristics for the “special” defence, and
    • passive, dependent or masochistic characteristics for the “ultimate rescuer” defence.

    In general, trying to be an individual is a more empowering and effective defence than fusing with others. Still, the breakdown of either can lead to pathological anxiety and/or depression.

    The way to feel better about death anxiety is through an exercise called “disidentification”:

    1. To begin with, ask yourself the question “Who am I?” and write down every answer that you can think of.
    2. Then, take one answer at a time, and meditate on giving up this part of yourself, asking and reflecting on what it would be like to give up this part of yourself and your identity.
    3. Repeat this with all the other answers until you have gone through all of them.
    4. You have now disidentified yourself from all parts of your identity. See how you feel, and if there isn’t still a part of you, that feels separate from all the labels you give yourself. This provides comfort and reduces anxiety about death and life for a lot of people.

    What I try to manage death anxiety is to only focus on whatever is most important to me that I can do something about in any given moment. I try to appreciate and be grateful for the time that I have had with each important person in my life. I try to be as fully present in the moment and with others as I can be. I try to use every moment and meeting as an opportunity to impact someone’s life positively. That way, I’ll hopefully not have too many regrets and be glad for the time I have had on this planet, no matter how long it ends up being.

    2. Freedom

    The second ultimate concern is about freedom, responsibility and will.

    Every country in the world talks about fighting for the freedom of its citizens and about taking away some people’s freedom to ensure the safety and security of all. Therefore, the existential dilemma is how much freedom do we give up to others to feel safe and secure, or how much safety and security do we give up to feel genuinely free? Are these concepts in direct opposition, or is it sometimes possible to have enough of both?

    Responsibility means taking full ownership of:

    one’s own self, destiny, life predicament, feelings, and if such be the case, one’s own suffering” — Irvin Yalom

    In the past, one’s life was set out for them by their parents or society, and many people struggled to fight for the right to live an authentic and genuine life.

    These days, most people struggle instead with the amount of choice that they have in their lives. They come to therapy because they don’t know what they want to do or how to choose, given all of the available options. They also know that if no one else is telling them what to do, it is ultimately their responsibility if things do not work out the way they want them to. People wish to choose for themselves but fear not having someone to blame when things don’t work out.

    There are various defences that we engage in to avoid responsibility and shield ourselves from freedom, including:

    • compulsivity
    • displacement of responsibility to another
    • denial of responsibility (“innocent victim” or “losing control”)
    • avoidance of autonomous behaviour, and
    • decisional pathology

    We can do something over and over again to relieve anxiety or stop thinking about things. This can present as OCD, hoarding, or any addiction ranging from technology to drugs and alcohol and even dependency on others.

    We can try to coerce others to make decisions for us or seek out and find controlling partners, bosses or friends. But, we can also play it safe and try to do what we think everyone else does; focus on keeping up with the Joneses, engaging in passive activities that don’t require much effort, and feeling stuck in an unfulfilling relationship or career.

    The problem with giving up the responsibility for how our lives turn out is that it creates an external rather than an internal locus of control. Depression and other forms of psychological disorders are more highly correlated with an external locus of control. It can also lead to learned helplessness, where people no longer feel like they can do anything to change their life in a positive direction.

    The way to manage the responsibility and freedom paradox is to develop an internal locus of control. This is generally more beneficial for most people’s well-being unless we blame ourselves or change things out of our control. This includes what has happened in the past, what other people do or say, and acts of nature.

    The serenity prayer nicely spells out how we should approach responsibility:

    God, grant me the serenity to accept the things I cannot change,
    Courage to change the things I can,
    And wisdom to know the difference.” — Reinhold Niebuhr

    Paradoxical intention is a good antidote too. This means that we try to do the opposite of what we typically do for a period of time and keep an open mind and observe how things go. We can then see if the outcome is better than what we usually do or if it has taught us something about what will be best for us going forward.

    Anything that creates a double bind is potentially helpful for encouraging people to take more responsibility in their lives. One way is to remind someone who struggles to make their own decisions that by not deciding, they are still making a choice not to choose. This means that no matter what they do, it is impossible not to make a decision that impacts the direction of their lives. Even if we choose to follow what someone else wants us to do, we still choose to do this. Therefore, why not take responsibility for our own lives and forge our own paths?

    3. Isolation

    There are three types of isolation:

    “A. Interpersonal isolation: isolation from other individuals, experienced as loneliness

    B. Intrapersonal isolation: parts of oneself are partitioned off from the self, and

    C. Existential isolation:an unbridgeable gap between oneself and any other being.”

    A common way that people try to escape from existential isolation is to fuse with another fully. This is also a strategy for dealing with death anxiety, with people trying to be the “ultimate rescuer” of someone else. It can lead to an individual feeling temporarily less alone. Unfortunately, however, the less isolated we are from others, sometimes the more isolated we are from ourselves.

    Other people try to overcompensate for their feelings of isolation by never relying on anyone and trying to be fully independent. Both extremes can have negative consequences.

    The main thing we can do to manage our feelings of isolation is to realise and accept that we are social creatures and have always relied on others to survive. This drive creates a desire to feel closer to, more understood, and more connected to people than we can ever achieve and sustain.

    Growing up, many people feel loved and comforted in an unbalanced relationship towards their needs being met over their parents. They then try to reenact this within their adult relationships and usually end up feeling resentful, angry and disappointed as a result.

    Yalom believes that a good relationship involves “needs-free love”, which is about loving someone else for their sake. This is opposed to “deficiency love”, a selfish love where we only think about how useful the other person may be to us. Creating a relationship where you want the best for the other person is a healthier way to manage interpersonal isolation than demanding for them to meet every need for you.

    Some of the best solutions to intrapersonal isolation are to have time to get to know ourselves through practices such as journaling, therapy and meditation. Introverts may need to have more of this time than extroverts, so it’s important to tune into how agitated or lonely you feel to know if you have found the right balance or not.

    Unfortunately, existential isolation cannot be fully breached, and therefore needs to be accepted, as it is out of our control. To feel the pain that comes with this isolation and our desire not to have it is challenging, but it can help reduce the intensity of the feeling. Being grateful for the meaningful connections we have in our lives and trying to strengthen them without losing our sense of self is another way to lessen the intensity of the feeling.

    4. Meaninglessness

    According to Yalom and many non-religious philosophers, humans are meaning-seeking creatures in a world without a universal sense of meaning. As a result of this, most of the world turn to a religious or spiritual belief system of one type or another that clearly lays out the meaning of the world and our purpose in it. People who truly believe these systems often provide a lot of clarity, reassurance, and guidance. The tricky part is that these belief systems can vary widely, and it is hard to know which one is more correct than another or if some of them are even harmful.

    What we do know is that most belief systems tend to agree that

    it is good to immerse oneself in the stream of life”.

    People can try to find meaning through:

    A. Hedonism: Seeking out pleasure and positive experiences and trying to avoid pain,

    B. Altruism: Dedication towards a cause that helps other people, and

    C. Creativity: Transcending oneself through art.

    Many philosophers believe that both the search for pleasure and the search for meaning are paradoxical. By this, they mean that happiness and meaning or purpose in life are tough to achieve when they are aimed at directly, but possible if they are aimed at indirectly.

    So if you or someone that you know is complaining about a lack of meaning in life, try to see if there are other issues. If possible, address these other issues first, and see if your worry about meaninglessness has lessened or gone away.

    The best indirect way to increase a sense of purpose and meaning in life is to build kindness, curiosity and concern for others. This is often best done by helping out with a charity, joining a club, fighting for a cause, or attending a group activity or group therapy.

    Yalom strongly believes that a desire to engage in life and satisfying relationships, work, spiritual and creative pursuits always exists within a person. Therefore, the key to managing meaninglessness is to remove the obstacles that prevent the individual from wholeheartedly engaging in the regular activities of life.

    We may never be able to find the absolute meaning of life. However, what we can do is work at creating a life that is personally meaningful to us.

    Dr Damon Ashworth

    Clinical Psychologist

  • Which Archetype Are You?

    Which Archetype Are You?

    Ever notice how any successful story throughout history tends to have a similar cast of characters?

    If you haven’t bothered counting, I’ll let you know that most characters will fall into one of 12 principal roles, and this explains why and how we can find favourite stories so relatable. Carl Gustav Jung, a famous psychoanalyst, defined these characters and their journey as Archetypes.

    What is an Archetype?

    An archetype is something that symbolises primary human motivations, drives, desires and goals. It influences how one finds meaning in life, what one values, and personality characteristics. Most people tend to identify primarily with one archetype, although it can be a mix of a few different ones.

    Below are the 12 archetypes, with a brief description below them:

    If you’re a visionary, you value innovation above all else. You look for patterns in the ordinary and try to create order out of chaos. You are intuitive and tend to find it much more comfortable than others to predict trends and look into the future accurately. You love to exchange ideas, share your opinions, and try out new gadgets. But you also tend to overthink things or catastrophise if stressed and overwhelmed. When this happens, you need to retreat to somewhere secluded and/or scenic to once again focus on your next innovative idea that you would like to put into action.

    The visionary archetype includes the designer, the detective, the director, the entrepreneur, the hermit, the futurist or the strategist.

    If you’re a caregiver, you value being compassionate, caring and kind to others, especially your family and friends. You struggle to say no to people because you love to help out and give as much as you can. Burnout is a risk if you spread yourself too thin, however. You are easy to get along with, flexible to various situations, and always willing to do what is required to adapt to and fit in with others without losing your sense of self. Your favourite activities involve spending time with those you love, and you are the person that people call or talk to if they have been going through something tough or are in crisis.

    The caregiver archetype tends to include the loving parent, the teacher, the nurse, the doctor, the best friend forever, the rescuer, the mentor, the healer, the veteran and the civil servant.

    The royal wants power and to be in control. They love being a leader and the boss and love living the high life and the sense of entitlement that comes with this. The royal is not afraid to throw money at a problem so that it will go away and is willing to use their status, title or name to get what they want and feel that they deserve. Activities, holidays and clothes all need to be the best that money can buy.

    Royal archetypes include the king, the queen, the prince or princess, the boss, the executive, the politician, the diva and the networker or social climber.

    The performer is all about entertaining others and being the centre of attention, even at social and family gatherings. Like Lady Gaga, they live for the applause and moving others emotionally or making them laugh. The performer wants to be seen and believes that being dramatic and in the right places with the right people is the best way to achieve this.

    The performer archetype includes the actor, the entertainer, the comedian, the clown or fool, the eccentric, the trickster, the storyteller, the spellcaster, the magician and the provocateur.

    The spiritual person has their faith as the cornerstone of who they are. They are belief-driven and pray and seek for what they know to be true to come to fruition. They love to engage in yoga, meditation, and connecting with others on a deeper level and feel very connected with others and the world around them. The biggest trap for the spiritual person is magical thinking and not doing enough to take action and change the questionable things in their lives. They instead have hope and faith that things will work out the way they want, even when all the evidence suggests otherwise.

    The spiritual archetype can include the shaman, the saint, the mystic, the guru, the angel, the missionary, the martyr, the disciple and the Samaritan.

    The tastemaker values the beautiful nature of things above all else. They pay attention to trends, fashion and decor, and ensure that whatever they have is as aesthetically pleasing as possible. But, unlike the royal, they don’t assume that this is just about what is most decadent or expensive. A tastemaker loves to explore new restaurants, shops, technology and holiday spots. Their weakness is judging others who do not prioritise aesthetics as much as them.

    The tastemaker archetype includes the fashionista, the goddess, the gentleman and the metrosexual.

    The explorer loves adventure, exploring the world, and seeking excitement wherever they are. They are curious about everything new and things they are yet to encounter, and as a result, they fear commitment and being stuck in one spot or tied down by someone else in any way. The explorer feels drawn to things unseen and undiscovered and is willing to be practical about what it takes to live their lives in this way. They love meeting new people and immersing themselves in new cultures and experiences.

    The explorer archetype includes the adventurer, the traveller, the seeker, the discoverer, the wanderer, the individualist, and the pioneer.

    The advocate is always being a champion for a good cause and hoping that things will get better if they fight for what they believe in. They may tend to get too caught up personally in the cause but are willing to back up what they believe in by getting signatures for a petition, fundraising money for a campaign, or organising a protest. They also try to live their lives in a way that is consistent with their values and standing up for those less fortunate or those without a voice, such as flora and fauna.

    The advocate archetype includes the hero, the environmentalist, the crusader, the vegan, the lawyer, the feminist, and the human rights advocate.

    The Intellectual takes pride in their extensive knowledge about things that are important to them. They are always seeking new information and trying to apply it in a useful way to increase their wisdom. The intellectual can come across as a know-it-all, but they never feel like they have enough new things to learn. They love to spend time reading books and going to museums and are happy to impart their knowledge to anyone willing to listen.

    The Intellectual archetype includes the philosopher, the student, the geek, the sage, the scientist, the theologian, the crone, the inventor, and the judge.

    The rebel’s core values are justice and autonomy. They are fiercely independent and cannot be contained by the social niceties, order and dutifulness. They do what they want at all times, and like adventure and excitement, challenging convention and being deliberately provocative too. They are at risk of not thinking through the consequences of their decisions, and as a result, can overconsume drugs or alcohol or get into trouble with the law, at work, or with those closest to them.

    Rebel archetypes include the warrior, the hedonist, Don Juan, the femme fatale and the wild man or wild woman.

    The athlete lives for staying active, fit, and in shape. They love to compete in anything involving physical activity and are happiest when they have achieved a big, athletic goal. The athlete tends to turn everything into a competition, which can annoy others, but they are just as happy pushing themselves to improve their health and body. Clothing is worn for comfort and performance only, not aesthetics. The athlete loves to attend sporting events and is also happy to watch sport on the TV.

    The Athlete archetype includes the competitor, the outdoorsman, the dancer, and the tomboy.

    The creative loves being original and genuinely expressing themselves. The creative hates to repeat or copy what others have done before them. They are happiest creating something from nothing, and this may include a piece of art, but it could also be a meal, an outfit, a room in a house or even an idea. The creative tends to be a perfectionist, which can make it difficult to begin a new project. Once you get started, you tend to get into the zone until a project is complete or you need a break.

    The creative archetype includes the artist, the chef, the child, the poet, the novelist, the shapeshifter and the romantic.

    What Are Your Main Archetypes?

    At archetypes.com, it’s possible to find out which archetypes you are most similar to. This may help you identify what journey you need to take in life or what areas may be best for you to focus on going forward. Included below are my results:

    I’m pretty happy with these results and not surprised by my top 2, but I was surprised to see visionary my third highest archetype. I’ve never thought of myself as imaginative or innovative, but I do want the world to change for the better and am willing to do what I can to improve the mental health of others.

    Based on these results, it’s apparent that I love to help others. Still, I need to be cautious about taking on excessive responsibility for others or feeling too guilty or inadequate when I can’t help as much as I would like to. I love to learn and be curious about new things, but I still need to be humble and understand that there’s still so much that I’ll never know. I also need to realise that not everyone wants to learn as I do, which is okay. Lastly, when I have an innovative idea, it is vital that I put this plan into action to make a real difference. I would also benefit from connecting with others and collaborating with the right people to help make these dreams a reality.

    I know that archetypes and the test are not highly scientific, but I still found them useful to think about what story I am trying to live out and what values or principles I am being guided by. Caring for others, learning new things, and creating positive change is what I care about. What about you?

    Dr Damon Ashworth

    Clinical Psychologist

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

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

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

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

    My Life-traps

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

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

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

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

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

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

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

    What’s Changed?

    people riding canoe boat view from inside pipe

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

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

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

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

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

    Here is Young’s description of these schemas:

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

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

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

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

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

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

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

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

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

    How Can Life-traps Be Overcome?

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

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

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

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

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

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

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

    Dr Damon Ashworth

    Clinical Psychologist

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

  • How Do You Deal With Your Problems?

    How Do You Deal With Your Problems?

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

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

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

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

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

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

    What Are Your Defence Mechanisms?

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

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

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

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

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

    My Defence Mechanisms

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

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

    1. Denial — 94th percentile — extremely high

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

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

    2. Isolation — 91st percentile — extremely high

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

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

    3. Displacement — 81st percentile — very high

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

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

    4. Regression — 73rd percentile — high

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

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

    * acting dependent on other people

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

    * refusing to take responsibility for your actions

    5. Doubt — 72nd percentile — high

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

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

    6. Rationalization — 68th percentile — high

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

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

    7. Intellectualisation — 64th percentile — high

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

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

    8. Projection — 47th percentile — about average

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

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

    9. Repression — 37th percentile — low

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

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

    10. Reaction formation — 15th percentile — very low

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

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

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

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

    Have My Defence Mechanisms Improved?

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

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

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

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

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

    Can We Change How We Deal With Problems?

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

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

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

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

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

    Dr Damon Ashworth

    Clinical Psychologist

  • 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

  • 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.