Damon Ashworth Psychology

Tag: therapy

  • Is it Better to be Completely Honest, a Strategic Truth-Teller or an Occasional Liar?

    Is it Better to be Completely Honest, a Strategic Truth-Teller or an Occasional Liar?

    I used to lie a lot growing up. Not quite as bad as Holden Caulfield in ‘The Catcher in the Rye’:

    “I’m the most terrific liar you ever saw in your life. It’s awful. If I’m on my way to the store to buy a magazine, even, and somebody asks me where I’m going, I’m liable to say I’m going to the opera. It’s terrible.”
    ― J.D. Salinger, The Catcher in the Rye

    I remember lying to my mum about cleaning my room to go outside to play. So instead, I would push all the mess under the bed or throw it in the wardrobe.

    I remember lying about doing my homework so that I didn’t have to do it and could play video games. I would then lie about being sick the next day to finish the assignment I needed to do the night before.

    I remember lying about how many points I scored in basketball to friends or how many alcoholic drinks I had to my parents whenever they picked me up from a high school party.

    I even remember lying to my brother’s friend about my surfing skills (I didn’t have any) and to a classmate about how many languages I spoke (I can say maybe 30 words in Indonesian, Spanish, and Italian, but not much more).

    I think back to these moments, and I’m not proud of saying these things, but I can also understand why I did it.

    I wish I could have been a less lazy, more confident and self-assured kid who was always honest with his friends and strangers and did the right thing by his parents and teachers. But how realistic is that scenario, and is it even ideal?

    “The truth is always an insult or a joke. Lies are generally tastier. We love them. The nature of lies is to please. Truth has no concern for anyone’s comfort.”
    ― Katherine Dunn, Geek Love

    Why Do People Lie?

    We lie to:

    • fit in and pretend we are like others
    • stand out and pretend we are different to or better than others
    • seek approval from others
    • be seen as more loveable/desirable/acceptable
    • feel better about ourselves
    • avoid getting into trouble
    • protect other people’s feelings or avoid hurting them
    • be polite
    • avoid feeling hurt, sad, disappointed, guilty or ashamed
    • keep a secret
    • maintain confidentiality
    • be consistent with societal norms

    “I’m not upset that you lied to me, I’m upset that from now on I can’t believe you.”
    ― Friedrich Nietzsche

    What Happens if We Are 100% Honest?

    Jim Carrey plays the main character in the 1997 comedy ‘Liar Liar’. He’s a high flying lawyer who keeps disappointing his son Max by making promises to him that he doesn’t keep by putting work first. Finally, after his dad doesn’t turn up to his birthday celebration, Max wishes for his dad not to be able to tell a lie, and the magic of movies makes this wish come true.

    What results is some hilarious situations in which Jim Carrey’s character gets himself into trouble for telling the whole truth when it would be more polite to lie. It includes telling his secretary why he didn’t give her a pay rise, telling his boss that he has had better than her, and confessing to everyone in a crowded elevator that he was the one who did the smelly fart.

    The moral of the story was two-fold:

    1. Sometimes it is necessary to lie, or at least not always be brutally honest and say everything that comes to your mind, and
    2. By being tactful and as honest as possible, you may become a better person who upsets people less and has more authentic relationships.

    “One lie has the power to tarnish a thousand truths.“
    ― Al David

    Radical Honesty

    In 2007, A.J. Jacobs wrote an article for Esquire magazine about a month-long experiment on a movement called Radical Honesty. It was titled ‘I Think You’re Fat’ and is worth reading. Much more than the 1995 book called ‘Radical Honesty’ by Brad Blanton that initially inspired the article:

    Blanton had worked as a psychotherapist for 35 years in Washington D.C. and ran 8-day workshops on Radical Honesty that retailed for $2,800 back in 2007. Blanton says his method works, although he may distort some of the positive benefits for personal and financial gain. He’s been married five times and claims to have slept with more than 500 women and six men, including a “whole bunch of threesomes.” He also admits to lying sometimes.

    “She looks honestly upset, but then, I’ve learned that I can’t read her. The problem with a really excellent liar is that you have to just assume they’re always lying.“
    ― Holly Black, Black Heart

    I Think You’re Fat

    In Jacobs article, he wasn’t overly optimistic about Blanton’s version of Radical Honesty either. If we didn’t have a filter between what we say and what we notice in the world, in our body and our thoughts like Blanton advocates, the results would probably be less funny and more consequential than what happened to Jim Carrey in ‘Liar Liar’. He declares:

    “Without lies, marriages would crumble, workers would be fired, egos would be shattered, governments would collapse.” — A.J. Jacobs

    Jacobs found it impossible not to tell a lie during his month-long experiment but did cut down his lying by at least 40%. But unfortunately, he also scared a five-year-old girl, offended numerous people, and spoke about sex and attraction to the point where he felt creepy.

    On the positive, being radically honest did save Jacobs time, resulting in him having to talk less to the people he didn’t want to talk to and do less of the things he didn’t want to do. In addition, it saved him mental energy by not having to choose how much he would lie or massage the truth. It also meant that people were usually more honest with him in return, and he found out that his relationships could withstand more truth-telling than he expected. So, similar to the ‘Liar Liar’ take-away message, Jacobs concluded:

    1. Being radically honest all the time and never having a filter is likely to be inappropriate in many settings and lead to more confrontations with others, and
    2. We could probably benefit by being more authentic, honest and truthful with others, especially in intimate relationships, as secrets tend to weigh us down.

    “There is beauty in truth, even if it’s painful. Those who lie, twist life so that it looks tasty to the lazy, brilliant to the ignorant, and powerful to the weak. But lies only strengthen our defects. They don’t teach anything, help anything, fix anything or cure anything. Nor do they develop one’s character, one’s mind, one’s heart or one’s soul.”
    ― José N. Harris

    What is a Lie?

    In his interesting small book ‘Lying’, Sam Harris defines a lie as:

    “Anything that is done to intentionally mislead others when they expect honest communication.” — Sam Harris

    Omission vs Commission

    In ‘Lying’, Sam Harris distinguishes between lies of commission, where the person is active in their intent to deceive, and the more passive act of omission, where the person fails to do something or say something they probably should. Both are deceptive and misleading to the audience who is the target of the action or lack of action.

    Harris believes that lies of commission are a more serious violation of ethics and likely to be more harmful. It is similar to how pushing someone in front of a train is a more serious ethical violation than not saving someone who was hit by a train when you had a chance to do so.

    Harris argues for people to stop all forms of commission and says that we can enhance our world, build trust and improve relationships by always being honest in our communication. While he believes that omission is also lying, he does not think that we can or should eliminate all forms of omission. Instead, he says that “skilful truth-telling” is sometimes required to be both honest and tactful in our words and avoid causing unnecessary harm.

    Let’s look at the following three examples to see the difference between radical honesty, lying and skilful truth-telling.

    SCENARIO ONE: Your husband asks if he looks fat in an outfit that you honestly believe isn’t flattering for him. You could say:

    A) “Yeah. You do look fat. I’d say about 10 pounds overweight. Maybe you should skip dessert for a while.”

    B) “Not at all, sweety. You look amazing!”

    C) “You look nice, but I think I prefer the black jumper and blue jeans I bought you a few weeks ago. Want to try that one and see which one you feel better in?“

    SCENARIO TWO: Your sister and her family are in town for the week and have decided to stay at your place for the whole time because they want to save money. You don’t dislike them, but you’d prefer to be catching up on your work that you are behind on. On night four, she notices you are a little tense and asks if you mind them staying there. You could say:

    A) “I do. I wish you weren’t so tight and could have paid for a hotel if you planned to stay more than three nights. A week is pushing it, and I’d prefer you left.”

    B) “Mind? Are you kidding? I love it. The more, the merrier, I always say! Stay for as long as you’d like.”

    C) “It’s a busy week for me in terms of work, so it wasn’t ideal timing for me. If I seem a bit tense, I’m sorry. I do want to be able to help you guys out because family means a lot to me.“

    SCENARIO THREE: You’ve been unemployed for six months and get a job interview to wait tables at a restaurant in town. You’d ideally prefer an acting job. The restaurant boss asks what your career plans are, as they want to hire someone who will stick around. You could say:

    A) “Well, acting has always been my passion, so this is just a stop-gap job to pay the bills and put food on the table. I couldn’t care less about the job or your restaurant. I want a regular paycheck so that I can pay my rent and bills until I get a real job.”

    B) “I’d love to become a professional waiter. I’ve always thought that providing great service to people is my calling in life, and I plan to stick around for at least five years and show everyone just how amazing your restaurant is. So I’m in it for the long haul.”

    C) “I’m not too sure about what will happen with my career, but at this stage, I’d like to be able to work here. I am available seven days a week and will put in 100% effort whenever I am on shift. I am also willing to learn whatever skills are required, and I can promise that I will give you as much notice as possible if my plans ever do change in the future.“

    In each scenario, A is the radically honest response, B is the active lying or commission response, and C is the skilful truth-telling response. Some truths are unsaid in the C responses, which is technically a lie of omission.

    Many people still believe that omissions are a big no-no:

    “When truth is replaced by silence, the silence is a lie.”
    ― Yevgeny Yevtushenko

    “A lie that is half-truth is the darkest of all lies.”
    ― Alfred Tennyson

    “At times to be silent is to lie. You will win because you have enough brute force. But you will not convince. For to convince you need to persuade. And in order to persuade you would need what you lack: Reason and Right.”
    ― Miguel de Unamuno

    “People think that a liar gains a victory over his victim. What I’ve learned is that a lie is an act of self-abdication, because one surrenders one’s reality to the person to whom one lies, making that person one’s master, condemning oneself from then on to faking the sort of reality that person’s view requires to be faked…The man who lies to the world, is the world’s slave from then on…There are no white lies, there is only the blackest of destruction, and a white lie is the blackest of all.”
    ― Ayn Rand, Atlas Shrugged

    Is it Ever Helpful to Lie to Ourselves?

    The short answer is yes. It is psychologically healthier to be slightly optimistic rather than entirely realistic. Research indicates that people with depression are often more realistic in their appraisals of situations and other people’s judgments than people without depression. Most “healthy people” believe that they are better drivers, more intelligent, better workers, better parents, and better lovers compared to the average person.

    People lie to themselves because they like to feel that they are important and maybe more unique or special than they are. To prove this point, how would you feel if someone told you that you were just “average”? People also like to see themselves as good people who behave in particular ways for sound reasons. Even people that consistently cause harm to themselves or others.

    Anyone with an unhealthy addiction becomes an expert at lying to themselves and others. This secrecy and dishonesty only further fuel the sense of depression, shame and guilt that people with addiction feel. As long as they are in touch with the truth of the situation and the consequences of their actions. Most addicts are not, however, thanks to in-built defence mechanisms.

    Defence mechanisms are mostly subconscious or unconscious methods that we engage in to protect our ego or positive sense of self. Some of the more famous ones are denial, humour, repression, suppression, rationalisation, intellectualisation, projection, displacement and regression. My personal favourite is reaction formation (click here for a full description of these defence mechanisms and how to identify yours). Most people will deny engaging in defence mechanisms if you ask them directly about it, but they’ll tell you that others do. The reality is we all lie to ourselves at times, and maybe we need to lie to maintain a “healthy” outlook on ourselves, others, the world and our future.

    “The visionary lies to himself, the liar only to others.”
    ― Friedrich Nietzsche

    “I lie to myself all the time. But I never believe me.”
    ― S.E. Hinton, The Outsiders

    “The best lies about me are the ones I told.”
    ― Patrick Rothfuss, The Name of the Wind

    “Anybody who says they are a good liar obviously is not, because any legitimately savvy liar would always insist they’re honest about everything.”
    ― Chuck Klosterman

    So What Can We Do?

    The most accurate recommendations that I could find on lying were also some of the simplest:

    “If you don’t want to slip up tomorrow, speak the truth today.”

    ― Bruce Lee

    “If you tell the truth, you don’t have to remember anything.“

    Mark Twain

    I agree with Sam Harris that it is a worthwhile aim to never be actively dishonest. Furthermore, this approach is consistent with one of Jordan Peterson’s better rules from his ’12 Rules for Life’ book — Rule #8: “Tell the truth — or, at least, don’t lie“

    The philosopher Robin Devenport wouldn’t agree with either Harris or Peterson. He states:

    “it is impossible for anyone to be truly honest about many things, as long as he (or she) carries biased perspectives, hidden resentments, unresolved longings, unacknowledged insecurities, or a skewed view of self, to name just some inner human conditions… if absolute honesty is impossible, then we are all liars by nature, at least to a degree.”

    Dan Ariely concludes in his excellent book ‘The Honest Truth about Dishonesty’ that we all tend to lie to everyone, especially ourselves. We lie only as much as we know we can get away with, but not so much that it becomes hard to keep seeing ourselves as good people.

    Devenport continues:

    “Perhaps the best we can do, then, is only to lie in ways that are intended to promote another’s well-being or spare her unnecessary pain, and so further our integrity. The ‘noble liar’ is someone who tries to live by good intentions, even if that means intentionally lying to another person, if doing so is the lesser of two evils…Before we cast too harsh a judgment on the liar, let’s first understand what his motives are.”

    Robin Devenport

    We all need to be as honest as we can, especially with those we love and make sure that it is for a good reason when we lie. We also need to realise that it will never be possible to be 100% honest about everything to anyone, including ourselves, and that is okay. Other people won’t be 100% honest with you or themselves either, which doesn’t make them bad people. It’s what we lie about and why that matters.

  • Positive Psychology – The Secret to Optimal Well-being

    Positive Psychology – The Secret to Optimal Well-being

    For many years, Psychologists focused exclusively on alleviating suffering. A worthy objective, but the treatments tried to reduce depression or anxiety, not increase happiness or life satisfaction. If someone is no longer feeling sad, will they suddenly feel happy? Perhaps, but not necessarily.

    The field of Positive Psychology tries to address these concerns.

    Martin Seligman has written three major Positive Psychology self-help books titled ‘Learned Optimism’, ‘Authentic Happiness’ and ‘Flourish’.

    Seligman was interested in studying depression and ran some experiments at the University of Pennsylvania in the late 1960s to develop his theory of learned helplessness. Initially, the dogs were given electric shocks at random intervals and were not allowed to stop the shocks or escape the situation. After a while, even when Seligman provided the dogs with a chance to stop or exit the shocks, he found that they would not do anything about it. The relevance to people with depression is that an individual in an aversive environment who learns that they cannot change their outcome will continue to hold this belief even in situations where this isn’t the case. They won’t improve their position because they think it won’t make a difference anyway. But what if it does?

    ‘Learned Optimism’ was seen as the antidote to learned helplessness and focused on changing people’s outlooks and teaching them resiliency to better distinguish between things you can change and things that you can’t. By putting their energy into what they can do instead of blaming themselves for something out of their control, they became more motivated to develop knowledge and learn skills to make changes they desired in their lives. Regardless of what has happened in the past, having a slightly optimistic outlook on life leads to better emotional and physical health. It helps people persevere through the bad times, look after their health and put their best long-term interests first. Research has even shown that it can lead to a better survival rate following a heart attack.

    In ‘Authentic Happiness’, Martin Seligman extended these ideas and said that happiness was not just a matter of genes or good luck but could be sought out and created. You can do this by discovering your character strengths and virtues and putting these into action as much as possible.

    If you are interested in discovering what your natural character strengths are:

    1. Please go to www.authentichappiness.sas.upenn.edu and fill out the VIA Survey of Character Strengths.

    2. The survey results will rank your Strengths from first to last. First, determine if your top 5 strengths are your key character strengths or virtues — you will know if the responses “feel right” to you. Then, if a lower-ranked item seems to better fit you than any of your top 5, write down your new top 5.

    3. Ask yourself, how much do you currently put these strengths into practice? In what ways do you apply them or live by them? For example, if love of learning or creativity is your highest ranked strength, do any changes need to be made in your life so that you can experience these more (e.g. study a new course or take on another creative pursuit)?

    4. If changes need to be made, set yourself some SMART (S — specific, M — measurable, A — attainable, R — realistic, T — timely) goals for how you can put these virtues into action. If these are your key character strengths and virtues, it is likely to lead to a higher overall sense of emotional well-being.

    In ‘Flourish’, Seligman proposed only five elements crucial for optimal psychological well-being or for someone to flourish. He called this his PERMA model of well-being:

    P — positive emotions — We all need love, joy, hope, compassion, gratitude, awe and excitement in our lives. What activities frequently bring about these emotions for you? Can they be sought out, or can you engage in these activities more regularly?

    E — engagement — Sometimes referred to as ‘flow’, engagement is the state when we are no longer in our heads or consumed with worries but completely immersed in whatever we are doing. By reading the book, ‘Finding Flow: The Psychology of Engagement with Everyday Life’ by Mihaly Csikszentmihalyi, I realised that we could create the conditions for these engagement experiences. Typically, you can achieve this with activities requiring some skill and challenge but not too much. So it is when I am playing a sport, in session with a client, or engaging in a creative pursuit. However, it is different for everyone and doesn’t always happen each time you do an activity. It is what athletes refer to when they are “in the zone” or what M. Scott Peck referred to when he spoke about how his best-selling book ‘The Road Less Traveled’ seemed to write itself. Mindfulness training, apart from its other benefits on stress, pain and prevention of depression relapse, can also lead to a higher likelihood of full engagement with a situation.

    R — positive relationships — Whether we are extroverted or introverted, humans are still social creatures who seek to be understood and accepted for who we are and have a sense of belonging with others. We also like to share experiences, as you will notice with any child who waits for their parents to look and see what they are doing before engaging in an action. It was the moral of the story in “Into the Wild”, the 2007 movie starring Emile Hirsch, where the main character wrote, “Happiness only real when shared”. But negative relationships also cause a lot of pain, so the secret may be in how to seek out and foster the right connections (e.g. friends, partners), as well as how to improve the ones that we already have or may not be able to choose (e.g. family, bosses). If you are having problems with this area of your life, the book ‘The Relationship Cure’ by John Gottman is an excellent place to start, as is seeking out a trained relationship therapist.

    M — meaning — Friedrich Nietzsche first said: “he who has a why to live can bear almost any how.” Viktor Frankl also determined in ‘Man’s Search for Meaning’ that purpose was required to withstand the daily atrocities he faced as a Jewish prisoner of a German concentration camp during World War II. Frankl, a Psychiatrist, believed so much about the importance of meaning that he developed a treatment called Logotherapy, which focused on helping others find meaning. He dedicated the second half of his book towards this goal and his subsequent psychotherapy. Depending on your beliefs, there may or may not be a universal meaning of life, but each individual must determine its importance. Where possible, it is then essential to try to live your life in that way, as long as it doesn’t break the laws of your society or cause harm to others. Values clarification exercises can assist with this.

    A — achievement — People like to achieve things, succeed, and win for their own sake. It is why there are so many cheats for video games and corruption in the corporate world, and drug cheats in athletic competition. So many people will do what they can to win. Achievement can be winning something, gaining knowledge, building skills, or completing a task. Having three achievable goals each day would go a long way towards improved well-being.

    Psychology is about more than the alleviation of suffering. It is about helping people understand, grow, develop mastery and self-efficacy, and live the best life they can!

    Dr Damon Ashworth

    Clinical Psychologist

  • How Can We Effectively Manage Guilt and Shame?

    How Can We Effectively Manage Guilt and Shame?

    What are shame and guilt?

    Neuropsychologist Dr Harvey Jones and I discuss shame and guilt and how to manage these tough emotions in our latest podcast.

    The fascinating and comprehensive book ‘Shame and Guilt’ by June Tangney and Ronda Dearing describe shame and guilt as universal human emotions that are functionally important at both an individual and a relationship level.

    Features shared by shame and guilt (Tangney & Dearing, 2002):

    Shame and guilt are both very private and personal emotions. They are predominantly internal experiences that are more difficult to observe or measure than other universal emotions, such as anger, sadness or joy.

    Yet, they are also social emotions, in that these emotions develop during interpersonal interactions with our family and those closest to us.

    Both shame and guilt can be classed as “moral” emotions in that our experience of them can hopefully propel us to act more morally.

    They are both closely linked with how we see ourselves about others. They continue to profoundly influence our behaviour in interpersonal situations throughout our lives, especially in contexts involving perceived transgressions, mistakes or moral failures.

    Shame and guilt both involve becoming self-conscious following a personal transgression and evaluating our behaviour about our perceived self, familial and societal norms. Based on this evaluation and what we internally attribute the violation to, we judge our behaviour and potentially internal sanctions towards ourselves if we deem the behaviour morally or socially unacceptable.

    Although Philosophers and Psychoanalysts have been theorising about shame and guilt for over a century, it is only really since the late 1980s that Psychologists have begun to systematically research and examine the nature of shame and guilt and the implications that these emotions and experiences have. Unfortunately, as well as being difficult to observe directly, many people tend not to have a clear understanding of the differences between shame and guilt.

    Features where shame and guilt differ (Tangney & Dearing, 2002):

    Focus of evaluation

    • With shame, the focus of the evaluation is on the global self (e.g., “I am horrible!”)
    • With guilt, the focus of the evaluation is on the specific behaviour (e.g., “What I did was horrible!”)

    Degree of distress

    • With shame, the degree of distress is generally much higher than with guilt, with more significant pain.
    • With guilt, the degree of distress is generally much lower than with shame, with less pain.

    Phenomenological experience

    • With shame, people tend to shrink and feel worthless, powerless and small
    • With guilt, people tend to feel tense, remorseful, and regretful

    Operation of “self.”

    • With shame, the self becomes split into an “observing self” and an “observer self.”
    • With guilt, a unified self remains intact

    Impact on “self.”

    • With shame, the self becomes impaired by a global devaluation (because of the focus of evaluation on the self)
    • With guilt, the self is unimpaired by a global devaluation (because the focus of the evaluation is on the specific behaviour)

    Concern vis-a-vis the “other.”

    • With shame, one becomes concerned with an internalised others’ evaluation of the self.
    • With guilt, one becomes concerned with the effect that their specific behaviour has had on others.

    Counterfactual processes

    • With shame, one tries to mentally undo the undesirable aspects of the self that have become apparent through denial, defensiveness, blaming others or aggression.
    • With guilt, one tries to mentally undo the undesirable aspects of their behaviour through being moral, caring, socially responsible and constructive.

    Motivational features

    • With shame, the desire is to hide, escape, or strike back
    • With guilt, the desire is to confess, apologise, or repair

    How to measure Shame and Guilt

    I challenge you to take the Test of Self-Conscious Affect (TOSCA Version 3) to determine if you are more prone to shame, guilt or blaming others across work and social situations.

    When I took it, my results were:

    “I seldom blame others.”

    “I use guilt self-talk an average amount.”

    and

    “I use shame self-talk an average amount.”

    It was nice to see that I do not blame others when I realise that I have made a mistake and am often accountable and responsible for my actions. However, it does seem that I tend to punish myself too much following a transgression. But what do these findings mean for real life?

    The TOSCA has been used widely in studies on shame and guilt since 1989. It defines guilt as a more adaptive response to a situation where the focus is on the desire to repair or right the specific wrong caused. Conversely, shame is a less adaptive response where the attention is on a global negative self-evaluation without any reparation generally being taken.

    Research Findings on Shame and Guilt

    Research findings using the TOSCA have found that “Shame and guilt have important and quite different implications for interpersonal relationships.” For example, based on 12 years of research, Tangney and Dearing (2002) have found that:

    Individuals who are prone to shame:

    • They are more likely to blame others for adverse events through humiliating others, bullying, and violence.
    • They are more likely to experience bitterness, resentment and a seething kind of anger and hostility towards others and the world. They are also inclined to express their anger in aggressive and non-constructive ways, particularly in close interpersonal relationships. The shame-anger dynamic may help explain what occurs in many domestic violence incidents.
    • They are less likely to be empathetic, as the global self-focus of shame impedes sensitivity and impairs connection.
    • They are more likely to be vulnerable to a range of psychological difficulties through internalising the shame, including depression, low self-worth, self-loathing, eating disorders, and addiction.
    • They are more likely to be suspended from high school, use illicit drugs, engage in unsafe sex practices, abuse their spouses and attempt suicide (when individuals were first assessed in fifth grade and then followed up on years later).

    Individuals who are prone to guilt:

    • They are more likely to understand, empathise and connect with others.
    • They are more likely to accept responsibility for their transgressions.
    • They are less likely to be angry, hostile and aggressive. Conversely, people who feel guilty and angry are more likely to express what they feel assertively and constructively.
    • They are less likely to experience psychopathology as long as the guilt is “shame-free.”
    • They are more likely to apply to college, engage in community service, begin drinking alcohol at a later age, and use birth control (when individuals were first assessed in fifth grade and then followed up on years later). They were also less likely to try heroin, drive while intoxicated, and be arrested or convicted of a crime.

    Is guilt always a helpful emotion?

    No. Two maladaptive forms of guilt (Kim, Thibodeau & Jorgensen, 2011) have been correlated with depressive symptoms to a similar degree to what shame is. These are contextual-maladaptive guilt, which involves an “exaggerated responsibility for uncontrollable events,” and generalised guilt, which involves “free-floating guilt that is unrelated to any specific context” (Kim, Thibodeau & Jorgensen, 2011). This excessive or inappropriate guilt would not be helpful to experience regularly.

    What Can We Do?

    A. Manage guilt effectively

    With guilt, the steps for dealing with the emotion are pretty straightforward:

    1. Has a transgression occurred where you have not lived up to your own (or an internalised other’s) moral standards?
    2. Can you make up for this transgression in any way?
    • By taking responsibility for your action?
    • By fixing the mistake and cleaning up the mess?
    • By genuinely apologising and showing remorse for your actions?
    • By understanding and empathising with the person if you hurt them?

    3. How can you learn from the mistake so that you are less likely to repeat the same transgression in the future?

    4. What plan can you put in place so that you are less likely to repeat the same transgression in the future?

    If you feel guilty for having a particular thought, please understand that we cannot control what ideas pop into our consciousness. What we can control is how we interpret or respond to the ideas that do arise. Considering that we have at least 10,000 thoughts a day, it is implausible that all of these thoughts will be positive, happy, kind, pro-social thoughts.

    No transgression has occurred if it is just a thought, and there is no need to feel guilty, no matter how antisocial, nasty, sinful or taboo these thoughts may seem. A court of law can never charge you for impure thoughts. You do not need to put yourselves on trial either. Even psychologically healthy people have weird or unsettling ideas, as evidenced by this list of common intrusive thoughts (Purdon & Clark, 1992). Our actions define our character and how others see us, not our internal monologue. The above steps only need to be worked through when your efforts do not live up to the person you would like to be.

    Once you have worked through these steps, there are no additional benefits that you can achieve by continuing to feel guilty, punishing yourself for your transgression, or not forgiving yourself for your actions. Everyone makes mistakes. We must utilise guilt as an indicator that we have not been living consistently with our most important values and then practice these steps to get back on track.

    If you continue to feel guilty after this, try to accept your feelings and make room for the emotional experience. Then try to change your focus to whatever is most important to you in the present moment. For example, it could be the sport or computer game you are playing or connecting with others if you are out socialising. By asking yourself, “What’s Most Important Right Now?” it becomes a lot easier to get out of a cycle of ruminating about what you have done and feeling guilty for it.

    B. Encourage parents, teachers, bosses, managers, coaches, and mentors to help others to learn from their behavioural mistakes so that they can improve and maintain a positive sense of self, rather than criticising who they are or shaming them for doing something wrong

    We must educate people in these roles about the differences between shame and guilt and let them know that even if using shame seems to be effective in changing behaviour in the short term, it can have devastating long-term consequences. It can damage your relationship with the person and their mental health and behaviour.

    Shaming children is especially dangerous and shows them that their love, worth and approval is conditional. As a result of being shamed, children will eventually give up, become rebellious, try to be perfect, or subjugate their own needs and please others to maintain their fragile sense of being loveable, good enough or worthy.

    Once people become knowledgeable about focusing on the specific behaviour rather than the person as a whole, it can enhance their sensitivity and effectiveness in all relationships.

    C. Develop a Growth Mindset

    I have previously spoken about mindsets, as researched by Carol Dweck. When examining the difference between shame and guilt, I noticed the similarities between shame and a fixed mindset and guilt and a growth mindset.

    Both guilt and a growth mindset are focused on improving following setbacks, rather than remaining stuck, giving up or blaming someone else for your shortcomings. In addition, research indicates that you can cultivate a growth mindset over time.

    The similarities between guilt and a growth mindset suggest that it is also possible to change from being more shame-prone to being more guilt-prone. As you become more guilt-prone, you will begin to learn from your experiences and continue to grow without being held back by the transgressions that you have made in the past.

    D. Embrace your imperfections, allow yourself to be vulnerable, and share your feelings of shame with those that have earned the right to hear your story

    In “The Gifts of Imperfection’, Brene Brown defines shame as the following:

    “shame is the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging.”

    Brene Brown

    Brene has found that shame needs the three ingredients of secrecy, silence, and judgment for it to grow and spiral out of control in our lives. She also believes that we all experience shame to some degree and that even though we are afraid to talk about what we are ashamed of, it is actually by talking about our shame that we are least likely to be controlled by it.

    “If we want to live and love with our whole hearts, and if we want to engage with the world from a place of worthiness, we have to talk about the things that get in the way — especially shame, fear and vulnerability”

    Brene Brown

    How to become more shame Resilient (Brown, 2010):

    1. Understand shame.
    2. Recognise what triggers shame for you, both externally (e.g., other people’s critical messages) and internally (e.g., your unrealistic expectations).
    3. Check to see if these criticisms or expectations are realistic or accurate.
    4. Realise that being imperfect does not mean the same as being inadequate or unworthy of love.
    5. Reach out to people who have earned the right to hear your shame experiences.
    6. Talk about what makes you feel ashamed and whatever else you may be feeling about the experience.
    7. Ask for the type of support that you need from them. It could be some kind words or reassurance. It could be something they can do for you (even if it is turn up and listen). It could be some hand-holding, back rubbing, or a hug. Or it could be some quality time, something to cheer you up, or a fun outing to help you change focus and move on.

    Once our previously shameful experiences are out in the open, we begin to own our story and realise that we are loveable and worthy, just the way we are. Although it is easier to experience this if our closest relationships provide us with unconditional acceptance, love, and belonging, we only need one person we can open to for shame to reduce and improve. If there is no one in your life that you would feel comfortable talking to about your shame, then a psychologist you feel safe with can help.

    Dr Damon Ashworth

    Clinical Psychologist

  • Do You Love Your Loved Ones How They Want to be Loved?

    Do You Love Your Loved Ones How They Want to be Loved?

    Where do we go wrong?

    One of the saddest things I see time and time again in my work as a Clinical Psychologist is partners who both love each other and try their best to show this to each other, yet neither of them feels loved and appreciated.

    The same thing also happens frequently within families, either between parents and their children or between siblings.

    In the excellent book, ‘Thanks for the Feedback: The Science and Art of Receiving Feedback Well’ by Douglas Stone and Sheila Heen, they highlight nicely why this often occurs:

    Firstly, we are aware of our thoughts, feelings and intentions behind whatever actions we do. The other person is not. All they can see is what we say, how we say it, and our behaviour or body language. Our body language influences approximately 55% of how others interpret what we say to them, with 38% being how we say it and only 7% what we say (Mehrabian,1971). Worse still, these non-verbal cues are generally out of our awareness, meaning we don’t see what they see either.

    Secondly, no matter how precisely we choose our words or actions, we cannot fully control how our message will be taken in and interpreted by the other person. Someone understands what we say based on their past experiences, core beliefs about others or our role (partner, sibling, parent or child), and their expectations and assumptions of what we are like or how we should be. Therefore, it creates biases before we have even opened our mouths and affects how they are impacted by what we do and say.

    Lastly, suppose we make a mistake or an error or upset someone. In that case, we will usually attribute it to the context or situational factors rather than seeing it as something to do with our character (e.g. “I didn’t wash the dishes because I was running late for work”). Conversely, When others make a mistake or upset us, we often attribute it to a personality characteristic or an unchangeable flaw (e.g. “you didn’t wash the dishes because you are lazy and disrespectful”). What happens next is that we usually criticise their character, which they rightly become defensive over, and they try to explain the context, which we tell them is just an excuse. When the other person criticises our character, the opposite happens, and we wonder how they can be so cruel and unforgiving (making other judgments about their character and personality). It’s no wonder that relationships are so tricky!

    What can we do?

    1. Develop Active Listening Skills

    Rather than assume the intent of others based on how they made us feel, it is much better to try and understand their perspective first and show this understanding through the skills of active listening, including:

    • clarifying: asking for more information on what they were talking about
    • “what did you mean by…?”,
    • “Can you elaborate further on …?”
    • paraphrasing: repeating back what was said to you in another way
    • them: “it’s like 100 degrees outside!”
    • you: “it’s so hot!”
    • reflecting: showing that you understand how they felt
    • them: “I had nothing to do all weekend!”
    • you: “you must have been bored!”
    • summarising: especially if someone has been speaking for a few minutes on a topic
    • them: multiple stories about the various things that have gone wrong for them recently
    • you: “sounds like you’ve had a rough week!”

    Some people will get annoyed if you don’t fully understand them or what they are feeling at the moment. Still, even this is an excellent opportunity to learn more about the other person and to get better attuned with how they think and feel from now on. Most people will appreciate the effort.

    2. Follow the Three Principles of Humanistic Psychology

    Carl Rogers was a Humanistic Psychologist who believed that only three elements were essential for promoting growth and well-being in others. These were:

    • Unconditional Positive Regard: No matter what the other person does or doesn’t do, it is essential to separate the person from their actions and continue to see the person positively. As a parent or a partner, it is more than okay not to accept or tolerate certain behaviours, but we need to show that we are unhappy with the behaviour rather than who they are. If it is someone that we love, our love for them should not diminish, because we can still see that they are a good person who sometimes does the wrong thing. If they can feel this, it will help them learn right from wrong going forward, rather than feeling like they have to be a certain way to be loved.
    • Empathic Attunement: It is essential to see the world in the way the other person does and understand how they view the particular situation and feel about it. If we can show this to them in a way that they feel it, they will know that we get it and will develop greater trust in opening up to us about other things as we advance. They will also feel less alone and isolated and be more responsive if we suggest potential ways to help them out of a predicament. Without understanding first, any advice you give usually falls flat and is not taken on at best or is seen as uncaring and interfering at worst.
    • Congruency: It is essential to ensure that what we are expressing is consistent with how we feel (in a way appropriate to the other person or audience). A parent who is upset at something that has happened in their life may not want to burden a child with their problems. However, it is still better to say, “Mummy is a little upset, but she is going to be okay” rather than “nothing, everything is fine” when a child asks, “what’s wrong mummy?” because they have accurately picked up on how you are feeling. Telling them something that is not congruent with how you feel will only confuse them and potentially make them doubt how their perception is going forward. The more congruent we are, the more trustworthy we are to others, and the less they have to worry about resentment building up or you keeping things from them.

    3. Practice Effective Communication

    As part of Dialectical Behavioural Therapy (DBT), Marsha Linehan teaches interpersonal effectiveness skills. She says that if we want to get an objective met when communicating, try the following four steps:

    D — Describe the situation, and stick to facts, not judgments

    (e.g.” When you are 30 minutes late”, not “When you are rude and don’t care!”).

    E — Explain how you feel

    (Emotions — e.g. “I feel hurt and upset!”. Not opinions — e.g. “I feel like you don’t care at all!”)

    A — Ask for what you need or would prefer

    (Behaviours — e.g. “I would prefer that if you are late next time that you either try to leave a bit earlier or text or call to let me know that you are running late”. Not feelings — e.g. “I would prefer if you cared about and loved me like you say you do”).

    R — Reinforce the potential benefits to them, you and the relationship if they could do what you have asked

    (e.g. “Then you won’t need to rush as much, you’ll be safer on the road getting here, I won’t worry as much, we won’t end up fighting, and we’ll be able to enjoy a great night out together!”).

    You might be sceptical, but it really can work, and it does become more comfortable with practice.

    4. Avoid the Four Horseman of the Apocalypse

    John Gottman, the legendary relationship researcher, claims that he can successfully predict with a 91% accuracy which couples will get divorced in the future after observing them for only five minutes. He says that if you want to avoid a later break-up (the apocalypse), it is essential to prevent the following four things (the four horsemen) that can significantly erode the goodwill of a relationship over time. These are:

    • Criticism: While it is essential to be able to make a complaint about a specific behaviour in a relationship (e.g. “you left the toilet seat up again”), a criticism about who the person is will never be helpful (e.g. “you’re such a slob!”).
    • Contempt: This includes anything that communicates disgust, resentment or looking down upon the other. Contempt may be spoken through hostile humour such as sarcasm, cynicism or name-calling, or displayed through behaviours such as eye-rolling, sneering or mocking laughter with the head tilted back. Building a culture of mutual respect and appreciation is the antidote to this.
    • Defensiveness: This is usually in response to criticisms or contempt, and each partner then feels that they are right and the other is wrong, and the argument becomes about who will win. When each partner is trying to win an argument and blame the other, the relationship suffers in the end. It’s much better to take responsibility for your part and then work towards what will be best for both of you going forward.
    • Stonewalling: Eventually, after escalating conflict, one partner tries to tune out the other partner, disengaging from the communication or the relationship emotionally while remaining physically present. Stonewalling is done more by males than females and is a way to calm themselves down when feeling overwhelmed and flooded. The result on the other partner is escalating distress, much like a baby who is suddenly unable to interact with their mother in the Stillface Experiment:

    Let your partner know that you are overwhelmed and need a 20-minute break. Then, tell them that you will be back and happy to continue the discussion once you feel calmer. Doing this is a much more effective way than just shutting off or shutting out the other person. It also leads to both of you feeling more in control and less distressed.

    5. Find Out Their Primary and Secondary Love Languages

    People often express their love to others in the way they would most want, rather than showing their love in how their partner, child, parent, or sibling would wish them to.

    For example, many fathers will try to show their love to their children by working hard, making lots of money, and providing financial security and stability for their future. But, conversely, the child often wants to spend some time with their dad, play at the park, kick the football, or play video games together.

    The most confusing scenario to me is males, who tend to be more visual than females, sending explicit pictures of themselves to a female they are pursuing. I think they do this because they would like to receive a graphic image from the female. However, they assume that the women would want the same. It is considered a crime if you do this in public without prior consent and not through a phone.

    Meanwhile, females, usually more sentimental than males, may prefer some flowers or a lovely card with a thoughtful handwritten message. Still, men don’t understand this because it’s typically not something they would ever want to receive. Therefore they don’t see the point. Big mistake!

    Understanding the five love languages, written about by Gary Chapman in various books, becomes very handy.

    When trying to show someone that you care, the first step is to determine which love languages seem to mean the most to them. A questionnaire exists on the website http://www.5lovelanguages.com that you could ask the other person to complete if you are unsure what they value most and want to understand them better.

    The next step is to disregard what you would want from them and do what you think will make them the happiest, based on their love language preferences:

    Words of Affirmation:

    • DO: Give them compliments, encouraging words, written cards or letters
    • DON’T: Give them undue criticism or emotionally harsh words

    Quality Time:

    • DO: Give them your undivided attention, have one-on-one conversations without interruptions, do things together, take trips together, sit and talk.
    • DON’T: Spend too much time with friends or groups (even if it’s together), neglect them or have long gaps of time between catch-ups and check-ins.

    Gifts:

    • DO: Give gifts, give time, remember special occasions, give small tokens of appreciation or love — show that you have put in the effort or thought in choosing.
    • DON’T: Forget special events or anniversaries, or buy meaningless, generic or thoughtless gifts that show that you haven’t put in time or effort in choosing

    Acts of Service:

    • DO: Assist with chores, make a checklist together, tick something off their to-do list, fix something, ask “How can I help?” or “What can I do?”
    • DON’T: Overcommit to tasks that you won’t be able to complete, forget to follow through on something you have promised to do, fail to help.

    Physical Touch:

    • DO: Sit close, hug, touch
    • DON’T: Withhold affection or threaten to do so, neglect, physically hit or abuse

    By loving those we love in the way they want to be loved, there is a much higher chance that we will feel loved and appreciated, and our relationships will likely improve. Seeing that relationship warmth is the number one predictor of long-term health and happiness, making small changes in how we listen to, talk to, and care for others could go a long way to improving the overall quality of our lives.

    Dr Damon Ashworth

    Clinical Psychologist

  • 25 Ideas That Could Change Your Life

    25 Ideas That Could Change Your Life

    1. KAIZEN

    A Japanese term meaning “improvement”.

    I think of Kaizen as ‘continuous improvement’ or “continual change for the better, one small step at a time”, as this is how I first heard of the term.

    Many successful Japanese manufacturing companies in automobiles and technology have used this exact approach to obtain massive success over time.

    What could you achieve if you just focused on taking one small step in the right direction today and then another one every day after that?

    2. BE THE CHANGE YOU WANT TO SEE…

    Gandhi did not say, “Be the change you want to see in the world,” even though people attribute this quote to him. What he said was this:

    “We but mirror the world. All the tendencies present in the outer world are to be found in the world of our body. If we could change ourselves, the tendencies in the world would also change. As a man changes his own nature, so does the attitude of the world change towards him. This is the divine mystery supreme. A wonderful thing it is and the source of our happiness. We need not wait to see what others do.”

    Mahatma Gandhi

    3. BE HERE NOW

    If we are fully present in the moment and aware of what is going on both internally and externally, we choose what we decide to do.

    If you do not feel present, meditate, ground yourself, get outside, move and connect with your five senses in the moment and the world around you.

    “Awareness is all about restoring your freedom to choose what you want instead of what your past imposes on you.”

    Deepak Chopra

    4. CHOICES DEFINE YOUR LEGACY

    It is a lengthy process of choices becoming actions, actions becoming habits, and your habits informing your character and ultimate legacy. A Mr Wiseman first said a quote like this in 1856. It tells us that whatever we sow, we must later reap.

    Therefore, it is essential to engage in positive actions before what we do becomes habitual. Gambling, smoking and binge drinking all start as choices. But the more engrained something is, the harder it is to stop. If we choose to engage in healthy activities enough, they too can become automatic for us.

    “Neurons that fire together, wire together.”

    Donald Hebb

    5. LIFE WASN’T MEANT TO BE EASY

    We often don’t appreciate things that fall into our lap, and we tend to value things much more when we put in some hard work to get them. Even people who build their own IKEA furniture think these items are worth more than those who do not.

    I know I’d be more proud of the $3 million I built up through hard work than the equivalent amount of money won through a lottery. How about you?

    “Anything in life worth having is worth working for.”

    Andrew Carnegie

    6. THE MAGIC HAPPENS OUTSIDE YOUR COMFORT ZONE

    “Move out of your comfort zone. You can only grow if you are willing to feel awkward and uncomfortable when you try something new.”

    Brian Tracy

    So many people want a comfortable life and therefore stick to what feels safe. But, unfortunately, if you are not willing to feel uncomfortable, your life will only get smaller over time.

    When you first step out of your comfort zone, it will be scary; you will feel awkward and even feel unsafe. But is it really, or does it just feel threatening because it is new? If at this moment, you run back to what you are used to, you won’t grow. However, if you persist through the initial pain, it will only get more comfortable in time, and your comfort zone will continue to expand and grow.

    7. RETHINK WHAT IT MEANS TO BE FREE

    What does freedom mean to you?

    You are doing whatever your parents, school, bosses, or government wants you to do? UMM NO. That is called compliance.

    You are rebelling against everything and doing the exact opposite of what your parents, school, bosses and government tell you to do? STILL NO. That is called counterpliance. Your actions are still being defined by what others tell you to do. Plus, it doesn’t always work out too well for you.

    You are just living for the moment and indulging in all of your passions and pleasures whenever you want because YOLO, right? NOPE. Hedonism may feel great for a night but not for a lifetime. It can also have nasty side effects if you aren’t careful, including weight gain, disease, debt, dissatisfaction, and even death.

    True freedom must come from making the choice that is likely to be the best for you in the long term, even if it denies you that last alcoholic drink or dessert or the fun that happens after 2 am. You might want the added snooze time in the mornings, but If you can’t get yourself to do things that are difficult or painful in the short term but beneficial in the long run, you can never honestly be free in the future. As a former NAVY SEAL famously said:

    “Discipline equals freedom.”

    Jocko Willink

    8. GETTING STARTED IS ALWAYS THE HARDEST PART

    “The secret of getting ahead is getting started”

    Mark Twain

    In a book that I once read (the Willpower Instinct, I think), I came across a 10-minute rule that I found surprisingly helpful. If you are not sure if you are up for doing something, give it a go for 10 minutes, and if after 10 minutes you still don’t feel up to it, stop. I tried it a few times by going to the gym, and usually, once I get there and get into it, I’m fine, but my brain often tries to tell me that I am too tired before I go.

    The 10-minute strategy seems to work because it is much easier to get our brains to do something for 10 minutes than for a considerable chunk of time. It is because it requires much less energy when we are forecasting our capacity to do the task. In addition, human brains are cognitive misers, which means they are always trying to “help” by conserving energy. So if you want to get started or you feel tired, think small.

    9. THE FIRST DRAFT OF ANYTHING IS TRASH

    “Don’t get discouraged because there’s a lot of mechanical work to writing. There is, and you can’t get out of it. I rewrote the first part of A Farewell to Arms at least fifty times. You’ve got to work it over. The first draft of anything is shit. When you first start to write you get all the kick and the reader gets none, but after you learn to work it’s your object to convey everything to the reader so that he remembers it not as a story he had read but something that happened to himself.”

    Ernest Hemingway

    This quote is fantastic because people often think they need to produce a masterpiece the first time they try or do something. However, if one of the most famous authors of all time made horrible first drafts, why should we expect more on ours? The solution is to focus on the process, not the outcome, and produce a draft before editing, reviewing, or criticising what you have done.

    10. DON’T PUT THINGS OFF UNTIL LATER

    “If something takes less than 2 minutes to do, don’t write it down or add it to your to do list — do it now.”

    David Allen, Getting Things Done

    Most people have so much stuff to do at any time that it is challenging to ever get their to-do list down to zero. It causes anxiety and stress for many people. However, the key is to have an excellent system to manage everything that comes in so that you don’t have to keep worrying and thinking about everything you need to do. Getting things done (GTD) is one such system. And the two-minute rule from GTD says that small tasks should never go on your to-do list if you can get them done now. This rule alone means that my email inbox rarely has any unopened or unreplied emails.

    11. BE YOURSELF; EVERYONE ELSE IS TAKEN

    Some believe that Oscar Wilde first said this, but the fascinating quote investigator website said they could not find it in any of his writings. However, Keith Craft noted something similar in announcing that we all have a unique fingerprint, and we can, therefore, “leave a unique imprint that no one else can leave.”

    “To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment.”

    Ralph Waldo Emerson

    12. WE REGRET THE THINGS WE DON’T DO MORE THAN THE THINGS WE DO

    We tend to think about what we may lose if we take a risk when deciding the future. However, when reflecting on the past, we regret what we missed by not taking a chance. The question then becomes, do we:

    1. Play it safe, and not put ourselves out there because people may judge or criticise us for giving something a go and not succeeding? Or
    2. Criticise others for being brave enough to try something? Or
    3. Throw caution to the wind and give it our best shot, knowing that we will learn and grow more from mistakes and setbacks than we ever would have by sitting back and criticising others?

    “It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

    Theodore Roosevelt

    13. FEEL THE FEAR AND DO IT ANYWAY!

    Susan Jeffers was my hero back when I read her top-selling self-help book. I couldn’t believe that I didn’t have to get rid of my fear before I tried to act courageously.

    The Confidence Gap by Russ Harris then further highlighted to me that the actions tend to come before the feeling of confidence, not the other way around.

    Fear was designed to keep us safe as a hunter-gatherer but holds us back more in modern-day life than it helps us sometimes. So instead, we need to assess the actual level of risk whenever we feel fear and go for it if the situation feels scary but is pretty safe. It could be horror movies, roller coaster rides, plane flights, or public speaking.

    “The only thing we have to fear is fear itself.”

    Franklin Delano Roosevelt, inaugural address, 1932

    14. WYSIATI

    “What you see is all there is.”

    Daniel Kahneman

    How you are thinking and feeling in the moment is very much influenced by how you are thinking and feeling. If you feel on top of the world, you are likely to be feeling happy, thinking positively about yourself, others, the world and your future. Anything may feel possible. Then the next week, you have a setback or get sick, and you start to feel depressed and hopeless and think negatively about yourself, others, the world and your future. Of course, both can’t be true if they are only a week apart. It’s therefore essential to understand the power of WYSIATI.

    Don’t think too big picture if you feel flat and down, and try not to do your weekly shop when you’re too hungry. The choices you’ll make once you’ve picked up a bit and have eaten something are likely to be very different.

    15. MEMENTO MORI

    “Remember that you have to die.”

    Latin phrase

    In many cultures worldwide and throughout history, acknowledging our mortality through prayer, meditation, reflection, ceremony, or celebration is more common than in atheistic or modern-day Western life.

    The phrase memento mori helped people consider the transient nature of earthly life, our goods and our pursuits and enabled them to become humble and clarify what was important to them.

    16. THINGS FADE; ALTERNATIVES EXCLUDE

    Two things that are inevitable in life are:

    1. no matter what we do, time passes and things erode over time (also known as the second law of thermodynamics), and

    2. if we go down one path, we cannot go down another track simultaneously.

    “Decisions are difficult for many reasons, some reaching down into the very socket of our being. John Gardner, in his novel Grendel, tells of a wise man who sums up his meditations on life’s mysteries in two simple but terrible postulates: “Things fade: alternatives exclude.” […] Decision invariably involves renunciation: for every yes there must be a no, each decision eliminating or killing other options (the root of the word decide means “slay,” as in homicide or suicide).”

    Irvin Yalom (1991). Love’s executioner. p. 10. Penguin Books.

    17. PARKINSON’S LAW

    Have you ever wondered how you get way more work done on some days when you are super busy? Then on quiet days, you don’t have much work to do but struggle to get it all done. The reason for this is Parkinson’s law:

    “Work expands so as to fill the time available for its completion.”

    The Stock–Sanford corollary to Parkinson’s rule is better, in my opinion, and it is something I used a lot when studying at uni:

    “If you wait until the last minute, it only takes a minute to do.”

    If productivity is what you are going for, give yourself a closer deadline and someone to hold you accountable if you don’t meet it, and voila, productivity and efficiency improve!

    18. THE IMPORTANCE OF MEANING AND PURPOSE

    “He who has a why to live for can bear almost any how.”

    Friedrich Nietzsche

    Nietzsche was a nihilist, which meant that he didn’t think the world had any meaning in it. Irvin Yalom said that even if the world is meaningless overall, it is still essential for us to find personally meaningful things individually or as a group. Viktor Frankl showed that in the concentration camps in WWII, those with some higher purpose beyond the camps were the ones who could manage to survive the horrible atrocities they faced every day.

    What’s personally meaningful to you? Where could you find purpose?

    19. DON’T LISTEN TO THE DOUBTERS

    “Impossibility is not a fact — it’s an opinion.”

    Muhammed Ali

    Think of anyone who has done something groundbreaking or is still trying to do something pioneering today — Henry Ford, Walt Disney, Steve Jobs, Barack Obama, Richard Branson, Elon Musk, Bill Gates. I wonder how many people told them to give up, grow up, stop being deluded, or think realistically? I’d say most of them.

    Just because someone hasn’t done something doesn’t necessarily mean you can’t do it. Otherwise, we wouldn’t have had the massive amount of progression that we have had over the past 200 years.

    20. CLARIFY YOUR VALUES AND MAKE DECISIONS BASED ON THESE

    “(Some people spend) their lives doing work they detest to make money they don’t want to buy things they don’t need in order to impress people they dislike.”

    Emile Gauvreau

    Don’t fall into the trap of thinking that your life has to be a certain way just because everyone else is doing something a certain way and telling you that you should too.

    By clarifying your values first and building your hierarchy, you can see if what you are currently doing is consistent with what is essential. If not, what changes could you make that you’d be willing to make to help you start heading in the right direction? The earlier you make these changes, or at least concrete plans to make them, the higher chance you will be happy with the path you are on.

    21. RELATIONSHIP WARMTH IS THE NUMBER ONE PREDICTOR OF LONG-TERM HEALTH AND HAPPINESS

    “Love people, use things. The opposite never works.”

    Joshua Fields Millburn & Ryan Nicodemus, The Minimalists

    The minimalist movement has picked up in the last 20 years in response to most of us in the Western world having way too much stuff and realising that it doesn’t make us any happier. If anything, it causes us more stress. Clothing used to be a scarce and valuable thing. Now wardrobes and houses are overflowing, and storage facilities are popping up everywhere to help clear some space.

    What if we just bought fewer things and focused more on what matters: our connections with the important people in our lives. Robert Waldinger, director of the Harvard Study of Adult Development, found that in the end, close relationships are more critical to our health and happiness than anything else.

    22. OCCAM’S RAZOR

    “Given several possible explanations about something, the simplest one is probably right.”

    Is the dog above trying to read, or is it merely sniffing the book?

    Occam’s razor is why conspiracy theories are never likely to be true. Think about the moon landing, or 9/11, or the Illuminati, flat earth theories, or any other conspiracy out there. For the conspiracy plot to be accurate, so many added levels are needed. Even people keeping the scheme a secret for years without anyone turning themselves in or trying to make money out of it is unlikely. So it’s much simpler and more likely that there is no conspiracy.

    You can also apply Occam’s razor to losing weight, sleeping well, getting stronger, or improving any skill. Some people have complicated theories, but usually, the answer lies in relatively simple explanations. Doing too much or complicating things beyond what is necessary often backfires.

    Reduce things back to the bare essentials, and see what happens.

    23. LAW OF DIMINISHING RETURNS

    The law of diminishing returns says that each time we do something to receive a benefit, the benefit will be less and less.

    Let’s say you order this massive stack of pancakes in the picture above. The first pancake may taste amazing, and the pleasure received is a 9 out of 10. After that, each bite is likely to be slightly less enjoyable than the bite before. Finally, if you somehow managed to get through the whole stack, the last taste might only be a 1 out of 10 on the pleasure scale.

    However, a month later, your next pancake might reach 9 out of 10 on the pleasure scale again.

    The solution is to wait for long enough between doing the same thing twice so that you enjoy it just as much the next time.

    “Variety is the very spice of life, that gives it all its flavour.”

    William Cowper

    24. BE KIND

    “If you’re kind, people may accuse you of selfish, ulterior motives. Be kind anyway.”

    Mother Teresa

    If you know why you are doing something, try not to worry about what others think. People who do not understand why you are doing what you are doing will see it from their point of view.

    If they could only do what you are doing by getting something in return, they will assume you have the same intention. But being kind is a reward within itself. If you can give just for the sake of it, do it. You can thank me later.

    25. DESIGN YOUR OWN LIFE

    “When you grow up you tend to get told the world is the way it is and (you should) just live your life inside the world. Try not to bash into the walls too much. Try to have a nice family, have fun, save a little money. That’s a very limited life. Life can be much broader once you discover one simple fact: Everything around you that you call life was made up by people that were no smarter than you and you can change it, you can influence it, you can build your own things that other people can use. Once you learn that, you’ll never be the same again”.

    Steve Jobs

    As far as I see the world, we only have one life to live. We can spend it doing what others expect of us, or we can spend it doing what is suitable for us. We can blame everyone else for how things turn out, or we can go our own way.

    Regardless of what you decide, time passes, and eventually, you will either feel that you made the most of what you had or accumulate regrets. I try to live my life in a way where I learn from my past mistakes, and make choices that I hopefully won’t regret in the future. What about you?

    Dr Damon Ashworth

    Clinical Psychologist

  • What if Being a Therapist is Unhealthy?

    What if Being a Therapist is Unhealthy?

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

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

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

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

    Photo by SHVETS production on Pexels.com

    An Unhealthy Trap?

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

    Gabor Mate

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

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

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

    But what are the personal consequences for me?

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

    What do I need?

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

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

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

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

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

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

    Is it possible to find a healthy balance?

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

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

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

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

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

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

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

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

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

    Dr Damon Ashworth

    Clinical psychologist

  • The Importance of Sleep for Good Mental Health

    The Importance of Sleep for Good Mental Health

    Sleep difficulties are a feature of nearly every mental health difficulty, including depression, anxiety, trauma, substance use issues, bipolar disorder and psychosis or schizophrenia. Take Depression for example. Up to 90% of individuals with Depression have sleep difficulties, and two out of every three have significant enough sleep problems to also have a diagnosis of Insomnia.

    alarm clock analogue bed bedroom

    Worse still, Insomnia does not tend to go away on its own without appropriate treatment. This is because once people start to sleep poorly, they tend to develop ways of thinking and behaving around sleep that make their problems worse over the long run.

    Fortunately, there is a treatment out there that can improve your sleep. It’s called Cognitive Behavioural Therapy for Insomnia (CBT-I), which directly targets these unhelpful thoughts and behaviours around sleep.

    CBT-I is an effective treatment for insomnia, with many studies showing it to be similar to sleeping pills at improving sleep in the short-term, and much more effective than sleeping pills at improving sleep in the long-term.

    Research shows that CBT-I consistently reduces the time taken to get to sleep, decreases the amount of time spent awake during the night, and improves sleep quality and efficiency, with improvements persisting after treatment finishes. This is unlike sleeping pills, which typically lead to sleep difficulties coming back once people with insomnia stop taking them.

    Sleeping pills are also not recommended for use beyond 2-4 weeks at a time, because they stop working after a while and people need to take bigger doses over time to get the same effects. Sometimes doctors prescribe them more because they think they will work faster for patients, but even one session of CBT-I has been shown to make a significant difference to one’s sleep at night!

    beach during sunset

    CBT for Insomnia consists of four main components:

    1. Psychoeducation: This provides people with helpful information around sleep, including homeostatic pressure, circadian rhythms, hyper-arousal and sleep hygiene recommendations. Sleep hygiene means having a comfortable bedroom environment, minimising light exposure before bed, exercising during the day, minimising caffeine and alcohol and doing things to wind down or manage worries before bed.
    1. Sleep scheduling: This provides people with helpful information on when they should be going to bed at night, the time they should be arising from bed in the morning, and the ideal amount of time that they should be in bed for each night. Stimulus control and sleep restriction are the two main interventions included in sleep scheduling, and both are scientifically supported for improving sleep quality and sleep efficiency if done properly.
    1. Relaxation techniques: Because hyper-arousal plays a huge role in Insomnia, it is important to help people develop strategies to quieten the mind and calm the body, during the day, before bed and in bed. Relaxation techniques can include imagery training, meditation, biofeedback training, deep and slow breathing and progressive muscle relaxation.
    1. Cognitive Therapy: This provides people with the skills to challenge their unhelpful or unrealistic beliefs about sleep. A lot of individuals with Insomnia attribute all of their tiredness, mood difficulties or poor performance at work to their sleep difficulties, and this puts too much pressure on them to get a good night’s sleep. It is therefore important to get them to see the other factors that may contribute to how they feel during the day, present them with data that challenges their fears, and help them to develop realistic expectations about their sleep.

    In Vanuatu, there is currently only one psychologist located at the Mind Care Unit in Port Vila who is trained in CBT-I. Please come down to receive this effective treatment if you or a family member is struggling with poor sleep. Until then, there are other sleep strategies that you can try:

    orange cat sleeping on white bed

    BEST SLEEP INTERVENTIONS OVERALL

    In 2017, Dr Damon Ashworth, Clinical Psychologist and Sleep Researcher, ran 26 two-week experiments on his sleep to determine which interventions were most helpful for him.

    He gave each intervention a score out of 100, based on how effective he found the strategy (25 points), how easy it was to apply and use the strategy (25 points), and how much scientific evidence there was that showed that this strategy could improve sleep (50 points).

    Here are all of the sleep interventions he tested, ranked from best to worst based on their overall score out of 100:

    palm trees at night

    High Distinction

    1. Stimulus control = 85/100
    2. Winding down before sleep = 85/100
    3. Sleep restriction = 81/100
    4. Relaxation strategies pre-sleep = 81/100

    photo of a man sitting under the tree

    Distinction

    1. Meditation = 77/100
    2. No alcohol = 75/100
    3. Wearing blue-light blocking glasses before sleep = 75/100
    4. Listening to music in the evening = 73/100
    5. Yoga/Pilates = 72/100
    6. Constructive worry or writing down plans = 71/100

    white teddy bear with opened book photo

    Credit

    1. Avoiding TV before bed = 69/100
    2. Melatonin = 68/100
    3. Aromatherapy = 68/100
    4. Sauna or hot bath in the evening = 68/100
    5. Morning sunlight = 65/100
    6. Reading or listening to audiobooks pre-sleep = 63/100
    7. Exercise during the day = 61/100

    black ceramic tea cup on brown surface

    Pass

    1. No caffeine = 58/100
    2. Food that helps sleep = 57/100
    3. Controlling temperature = 57/100
    4. Massage in the afternoon = 57/100
    5. Comfort of sleep surface = 56/100
    6. Sleeping alone = 53/100
    7. Creativity in the evening = 52/100

    Sleep Recommendations

    (Stepanski & Wyatt, 2003)
    1. Decrease time in bed – Sleep efficiency is a better predictor of satisfaction with sleep and daytime mood than total sleep time. So if you only get 7 hours of sleep per night, spend 7.5 hours of time in bed. This will allow for better sleep over time.
    2. Regular bedtime and arising time – Reducing variability in your sleep can make a huge difference in how long it takes you to get to sleep, how restful a sleep you have, and how refreshed you feel in the morning. Have a set bedtime, and whenever you feel sleepy around this time, go to bed. Then set an alarm so that you can wake up at the same time each day. If you want to sleep in on weekends, allow yourself no more than one hour later than you usually wake up. Following this regardless of how much sleep you get helps to strengthen your circadian rhythms and build up your homeostatic pressure to ensure better sleep over time.
    3. Exercise – Vigorous exercise prior to bedtime is actually unhelpful for sleep, but expending more energy during the day is likely to lead to better quality sleep at night. The earlier in the day it is done, the greater the effect it will have.
    4. Less caffeine and alcohol – Minimise these substances where possible, especially within 4 hours of bedtime as they both have significant effects on sleep quality. Alcohol can reduce worries and result in getting to sleep quicker, but results in poorer sleep quality in the second half of the night. Alcohol can also can lead to more snoring due to the loosening of the throat muscles. Caffeine boosts cortisol levels, a.k.a. stress, and results in less deep sleep and more awakenings.
    5. Do not try to sleep – It is something that has to come on naturally. The harder you try to get to sleep, the less likely you will be able to, as trying activates the autonomic nervous system, which also increase how stressed you feel. The more you allow yourself to relax, the more likely sleep is.
    6. Do not keep looking at your phone or alarm clock during the night – If your alarm is set, then there is no need to know the time in bed. This will only increase performance anxiety if you look and see that you have not slept for very long. Put it in a draw, cover it with a shirt, or face it the other way.
    7. Keep naps short – Napping during the day reduces your pressure for sleep by the time you get into bed at night. If you have to nap, keep it less than 30 minutes so that you don’t go into a deep sleep, and do it before 4pm so that sleep pressure can build up again by the time you go to bed that night.
    8. Engage in relaxing activities before bed – Just like waking up, going to sleep is a transitional process. Don’t expect that your mind will shut off immediately as soon as you get into bed. Whatever it is, do something relaxing as a pre-bed routine. Watch some T.V., read a book, listen to some music, have a hot bath, practice yoga, mindfulness or relaxation techniques. Then maintain that relaxed state in bed and allow sleep to come.
    9. Use the bedroom only for sleep and sex – This means no reading, eating, internet surfing, game playing, phones, T.V., planning, worrying etc. in bed. Want bed = sleep.
    10. Make worry list before bed – To prevent your mind from racing in bed, reflect on the day about 2 hours before you want to sleep, write down any worries, concerns or problems you may have, create a to-do-list, or plan for the day ahead. Then if thoughts come up in bed, remind yourself that you have already sorted them out or that they can wait until tomorrow.
    11. Leave the bed if awake – Sometimes no matter what we try, you may find yourself awake in bed. If you do not fall to sleep within what feels like 20 minutes, get up, go to another room, and do something relaxing until you are sleepy before returning to bed. Over time, this will recondition the bed with sleepiness rather than frustration and allow you to fall asleep quickly. If you are worried that you may never sleep if this was the case, give it a try for a week. It may be the most difficult recommendation to follow initially, but it produces long-lasting results quickly.

    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

  • 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    (Therapeutic Alliance = 30% of overall outcome variance)

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

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

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

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

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

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

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

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

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

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

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

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

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

    Dr Damon Ashworth

    Clinical Psychologist