Why are so psychologists so expensive?

Anecdotally, we know that the cost of private psychological support is one of the barriers to people reaching out and seeking individual therapy. The Australian Psychological Society (or the APS), which is the peak body representing psychologists in Australia, has set their recommended fee for the 2021/2022 financial year at $267 for a 45-60 minute consultation. We know this is a LOT of money for most people!

When you multiply this rate by a few sessions per day, times a few days per week, over most weeks of the year, you’ll likely come out with an astronomically large estimated sum of what your Psychologist might earn per year.

However, there are a few myths and misconceptions about this figure. You might be surprised by the breakdown, and it might provide extra information about why individual session rates are so high.

Firstly, the session fee you pay is often split between your individual Psychologist and the practice they work for. Sometimes this fee is as high as 50%. The practice’s split goes to all the running costs of operating a practice – the costs of renting or owning office space, relevant bills (such as electricity, water, internet, etc.), maintaining the materials and resources for therapy (such as furniture, pens, paper, computers, whiteboards), paying for the right to use a variety of standardised mental health assessments, other salaries of administration and cleaning staff, and relevant insurances and taxes.

The other part of the session fee split your Psychologist receives. Most psychologists working in a private practice operate as ‘sole traders’ – that is, they get are not an employee but a contractor who gets paid a fixed rate per session, and they operate as their own ‘business’ and pay their own business expenses from this fee. At least 35% of their split would go to paying Tax, and your Psychologist is most likely also contributing to their own superannuation (another 10%). 

Psychologists must complete a minimum of 6 years of training. Clinical Psychologist must complete a 4 year undergraduate Bachelor degree, a 2 year Masters degree, and then two years of full time supervised practice. Psychologists, therefore, often graduate with tens of thousands of dollars of HELP/HECS debt (or student loans), which must also be paid out of that fee at tax time (usually at %2-%7 of income). 

Your Psychologist would also then have a range of expenses – including their own insurances, their own professional development costs, their own registration and professional membership fees. These are all required to remain legally practising, and are often in the thousands of dollars per year. 

Your Psychologist also only gets paid if they have a session. This session rate must cover their time for outside of session work, such as keeping notes, contacting other relevant health professionals, planning treatment, and writing progress reports. As contractors, Psychologists don’t usually get paid leave, so their session fees must also cover their expenses when not working, and taking holidays, study leave, or sick/carers leave. Taking time off work is important for all people, and your Psychologist can’t be practicing effectively if they don’t take their 4 weeks annual leave. 

Now, the point of this article isn’t to present Psychologists are under-privileged, or hard-done by!  Psychologist’s incomes are usually above the Australian average. All the Psychologists I know love their jobs and would do it regardless of what they are paid. However, hopefully this article has provided some more insight into the reasons that contribute to high individual therapy costs. 

Ultimately, yes – psychologists are expensive. So, what can you do if the cost is an issue for you? Please still reach out for help! You and your mental health are worth it. Here are some suggestions to make therapy more affordable:

-       Seek therapy later in the year: you can never time when a crisis might happen, and it’s almost impossible to plan when you might need mental health support. But if you’ve been putting off therapy, think about booking sessions later in the calendar year. This might be of use for two reasons. Firstly, you can get 20 therapy sessions with a Medicare rebate each calendar year. There’s less of a chance you’ll run out if you start later in the year; you’ll be able to have sessions more frequently, and you’ll be able to ‘refresh’ your session limit in January – possibly creating the situation of 40 Medicare rebated sessions in close succession. Secondly, you will have a higher likelihood of hitting your Medicare Safety Net – this is an monetary amount that, if you exceed in spending out of pocket on health expenses each year, the Medicare rebate becomes a percentage of what you’ve paid out of pocket (rather than a set amount). This can mean you get almost the entire session (sometimes up to 80%) back from Medicare.

-       Speak to your therapist: some psychologists have space in their caseload for bulk-billed or reduced fee clients. Your psychologist might be able to make a plan with you whilst you struggle financially – many will want you to continue in therapy. Don’t just drop off – by raising your financial concerns with your therapist, they may be able to offer support (such as reduced fees) or by referring you to a lower-cost service. 

-       Look for online therapy courses: there are more and more online mental health courses being developed. ‘This Way Up’ is a great example of evidence-based, online mental health support which is much more affordable than individual sessions. Your GP or Psychologist will be able to point you in the right direction. 

-       Look for group therapy: group therapy can be another effective way to get face-to-face mental health support, without the costs of individual sessions. Often you get the added benefit of hearing from and meeting people with similar struggles to your own, and hearing what has worked for them.

-       See if you’re eligible for any public or not-for-profit mental health support: if you are under the age of 25 you may be eligible for treatment through Headspace. If you have acute, chronic mental health conditions, you may be able to be referred through your local community mental health team (usually based at your local hospital). Often there are not-for-profits that provide specific mental health support for people within certain populations – such as those with disabilities (through NDIS), those who are Victims of Crime (through Victims Services), those who have recently had a child, those who have an Eating Disorder, or co-occurring medical condition (such as cancer).

-       See if your local university has a clinic: many universities have a low-cost psychological clinic, usually staffed by Provisionally or Generally Registered Psychologists completing their specialist training through a Masters degree. They offer reduced fee individual and group therapy, and comprehensive psychometric assessment. 

Reclaiming your power to choose

Helplessness, hopelessness, and feeling “stuck” are painful emotions that frequently arise when people’s mental health is suffering. They are often reported in people experiencing depression and anxiety. They can, however, also be felt by any of us, at any time, particularly when we feel that life is not the way we want it to be. 

Whilst we cannot always avoid painful, stressful, or even traumatic events, it’s important to recognise that many of us have a lot more power to shape our lives at any given point in time than we probably recognise.

It’s absolutely true that there will always be things we cannot control. Feelings of powerlessness can arise because we find ourselves in situations where we simply don’t have the capacity, skills, or ability to change the things that we wish we could. And these incidences can be incredibly painful, distressing, or debilitating. These may be times when we are simply trying to survive the best way we know how, and anything beyond that feels impossible. 

And at other times, when we feel helpless or hopeless it’s not because we don’t have any power or choice, it’s because we aren’t recognising our choices. We are caught up in all the things we cannot change, rather than focusing on the things that we can!

These tips may be helpful to reflect on, particularly if you find yourself feeling low, stuck, unfulfilled, helpless, or struggling to connect with hope.

1.     Recognise that we nearly always have some element of choice. It’s simply that all choices have consequences, and sometimes we don’t want to face those consequences. So, we instead tell ourselves that we don’t have a choice. Sometimes this can make us feel relieved as it absolves us of the responsibility to make any changes we might feel anxious about. The problem is that we may also feel resentful, angry, frustrated, or helpless if we feel we have no choice or control. In reality, there are very few things we have no choice at all over- it’s simply that the consequences or disadvantages may outweigh the benefit at that moment in time. Acknowledging the facts as they are, and then focusing on the choices that do lie within our control can be much more empowering!

2.     Remind ourselves there is often no way not to choose. Far from having no choice, it’s often the opposite- we can’t avoid choosing! Our actions often represent the choices we have made, whether consciously or not. Each day we are uncertain about a decision and thus delay taking action, we are actually choosing for things to stay the same. This can be scary, but it can also empower us to ask ourselves “If I can’t avoid choosing, what do I choose for today? Even if we agree to re-evaluate the next day whether our choice is still the same.

3.     Remember our choices lie in our behaviours. Recognise that in most situations, we cannot control the situation, other people, or even our own thoughts or feelings! The one thing we can normally choose, however, is our own actions and how we respond. Sometimes our responses may be automatic, but once we become aware of them, we give ourselves the opportunity to choose to act differently the next time. Focusing our attention on our own behaviours instantly increases our sense of empowerment and can propel ourselves to act in ways which move us closer towards the kind of life we want for ourselves!

4.     Adopt an attitude of flexibility rather than rigid adherence to rules, expectations, or “shoulds”. Feeling stuck often correlates to a perception that we have to automatically follow rules that we, or others, have set for us. Who says we have to keep doing the things we do? We’re bombarded by advice all the time about how to be the perfect human, partner, parent, child, employee, friend, or any other role we may fulfil! We’re often drowning under the weight of responsibilities and living up to all these expectations! If following a certain rule is working for you, keep doing it! If it’s not, give yourself permission to let it go. And if you do decide something is important enough for you to do, instead of telling yourself you have to do it or have no choice, try connecting with the reasons why it’s important. Then you can tell yourself “I choose to do this because it matters to me”.

5.     Recognise that making choices which result in change can be sudden or gradual. Sometimes change results from taking an enormous leap of faith, but more commonly it is something that results from tiny consistent actions every day. So, pause, reflect, and ask yourself where does your power lie? What choices can you make in the midst of all the things you may not be able to change? And what’s holding you back from taking that first step? One step at a time is what gets any of us to where we want to be! And if it’s more a choice about notdoing something, own that choice and let go of the guilt! It’s your choice to make.

6.     Recognise that no one else will or can change your life for you. If you are not feeling fulfilled, only you can really change that. Others can support you, guide you, or hold you if you fall. But no one else can actually do it for you! You are the one steering your ship. You are the one, moment by moment, who is crafting your own existence. No matter how hard it may feel, no matter how many barriers there may be, any of us has the capacity to change our own lives. We can be courageous! We can be willing to tolerate uncertainty and risk! We can let go of doing things that no longer serve us! We can choose to accept ourselves unconditionally, regardless of the things we do or don’t do! We can choose to let go of judgements and guilt and move towards our own authentic self, regardless of what that looks like. Whenever you feel ready, it can be time to pause, reflect, and reclaim your ability to choose!

Compare and Despair

Do you ever find yourself comparing yourself to others then feeling worse about yourself? We might compare our possessions, career, partners, looks, character traits and financial status. For example, we might check out other people’s lives and successes and then feel like a failure. We might also feel jealous of other people’s successes.  

This pattern of thinking is called compare and despair, which is an unhelpful thinking style that every person tends to engage in from time to time. Unhelpful thinking styles can also become automatic habits that individuals may not realise they are engaging in. This becomes problematic when these thoughts cause an increase in anxiety and decrease in mood. When this happens regularly and consistently this may have a detrimental impact on an individual’s social, academic, occupational and personal life. It is common in anxiety disorders and depressive disorders that an individual’s symptoms may be maintained by unhelpful thinking styles such as compare and despair. 

Comparing ourselves to others is a natural tendency for humans to engage across the life span. As social beings, it allows us to evaluate ourselves through reference to other people and things. It becomes more problematic however when we focus only on the good and positive aspects in others and become upset when we compare ourselves negatively against them. 

If you are somebody who may notice yourself having thoughts involving comparing and despairing from time to time, there are ways in which we can begin to become more critical and analytical of our thoughts. This can help us determine whether the thought is realistic and fair which may alleviate some distress that the thought caused. It can be helpful to write the thought down, then ask yourself:

Am I doing that ‘compare and despair’ thing? What would be a more balanced and helpful way of looking at it?

It is also important to be mindful of when we are stressed or tired as we may be more prone to engaging in unhelpful thinking styles such as compare and despair. This can be managed by maintaining self-care strategies particularly during times of stress which may include, exercise, relaxation activities, stress relieving techniques and mindfulness. 

When we begin to pay more attention to this pattern of thinking we can get better at stopping it in its tracks!

A positive view of ‘negative’ emotions

Do you categorise emotions as ‘good/positive’ or ‘bad/negative’?  Emotions that are generally labelled as ‘positive’ include love, contentment, joy, happiness, curiosity, excitement and gratitude, while emotions such as fear, sadness, guilt, anger, jealousy, loneliness, disappointment and rejection, are often labelled as ‘negative’. 

We are commonly taught throughout our lives that pleasant emotions are ‘good’, and unpleasant or uncomfortable emotions are ‘bad’. This labelling encourages us to struggle with the ‘bad’ emotions, so that when we experience difficult feelings, we may be tempted to try to avoid or control them. Of course, this is also completely normal and natural, as none of us like to experience things that make us uncomfortable or feel painful, and our instinct is to minimise them. Unfortunately, this struggle tends to give these difficult, unpleasant emotions more attention, increased power over us, and higher impact on our lives.

Importantly, there is nothing inherently ‘bad’ about difficult emotions. They don’t hurt us, and are an important part of our human experience. We can’t be in a perpetual state of ‘happiness’ or ‘positive’ emotions. Emotional pain is inevitable. It is completely normal to continually shift between a range of emotions, depending on the context. For example, building relationships with others, keeping fit and healthy, pursuing a career, while all meaningful and fulfilling, will also entail difficult and challenging emotional times. Sadness when losing something or someone you care about, while painful, is appropriate and an important reflection of your level of care. 

How you respond to uncomfortable or challenging emotions is an important component of how you experience your life. If you try and avoid any emotions that feel painful or uncomfortable, you will constantly be struggling with, and fighting, perfectly normal emotions. This means putting your energy into battles that don’t contribute to your longer-term fulfilment. 

So, perhaps a ‘good, happy life’ is not reflected in only experiencing ‘positive emotions’, but is better defined by it being meaningful and fulfilling - even though this means experiencing, and embracing, a wide range of emotions. Not just the ones that feel good.

If you find it difficult to live with the more challenging emotions, and find yourself trying to avoid or control unpleasant feelings, here are some thoughts about learning to let go of that struggle and accept your full emotional experience:

·      Notice and identify your emotion(s). Try and name what you are feeling. Be as specific as you can. Be curious and observe your emotion(s).

·      Notice any body sensations that may be associated with particular emotions, and where you might be feeling them.

·      Acknowledge and accept your emotions. Don’t try to change or avoid them.

·      Be self-compassionate about your emotions. Be kind to yourself, and accept that whatever you are feeling is natural and understandable. Don't judge yourself for what you are feeling.

·      Take meaningful action. When you have processed what you are feeling, bring your focus back to the world around you. Move forward in a way that is consistent with what is important to you, and how you want to be.

·      Compare your emotions to the weather!

Don’t let your emotions stop you from getting on with what is important to you.

Emotions of all different shades come and go and are always changing, just like the weather. When you are hoping for a sunny day, but it rains instead, what do you do? You can struggle against it, complain, say it isn’t fair, label it as ‘bad’, or give up on the day and hide in your bed. But the weather will not respond in any way, and your life is unlikely to be improved by any of this. Alternatively, you can acknowledge and accept that the weather is raining, even though it is not what you wanted, and adjust to the facts. You can still get on with your day – you can even get out into the rain and be active if you choose! In the same way, you can observe your changing emotions, and if you experience emotions that you don’t like, or that are not what you hope for, you can gently acknowledge and accept that they are there. You can still get on with whatever is important to you, without trying to change or avoid your difficult emotions.

Note: Of course, if you have difficult emotions that you feel stuck with for a longer period of time, or you don’t feel safe, reach out for additional support and help from a professional. 

How to re-charge your battery for more energy

Low energy or fatigue can be a symptom or side effect of several mental health conditions, including depression, anxiety, trauma, and grief to name a few. I’m often having discussions with clients about the ways in which they might be able to ‘recharge’ their battery to gain more energy. During these conversations, I’ll usually use the comparison between my mobile phone battery and my car battery.

In order to recharge my phone battery, I need to plug it in. It often needs to sit somewhere connected to the socket, and not be used. If I use my phone too much or for too long before charging it, then it will eventually turn off.

However, when I think about my car battery, it’s a different story. My car needs to be driven regularly in order for it to remain charged. I’ll never forget the morning I tried to start my car after two weeks of annual leave – it made that half-hearted ‘click click click’ noise as I turned the key. It wouldn’t start and I had to borrow a neighbour’s car before calling NRMA later that evening. Although I felt refreshed from two weeks off, my car had been impacted by not being driven daily like it used to be. 

Our human ‘batteries’ can be similar to both – there is more than one way we can recharge.  

I think we’re all familiar with how to recharge in the ‘phone battery’ sense. Often this looks like firstly stopping and, secondly ‘plugging in’. We always need to think about and plan for breaks in our work, study, or regular routines. On a day-to-day basis this might look like stepping away from the desk for lunch outside, setting a timer for a regular study break when doing homework, or doing a few minutes of mindfulness. On a week-to-week basis it might look like having one morning set aside to sleep in, or ordering take-away one evening so you don’t have to cook, and switching off work emails on the weekend. Over the year, this looks like booking in and taking regular annual leave, getting out of the city on long-weekends and school holidays, having an ‘off season’ in sport or having a mid-semester break. 

Once we’ve paused, what ‘plugging in’ looks like is different person to person. Some might recharge with time alone, enjoying solitude and quiet, others enjoy socialising and conversation and being around others. Some like switching off their brains with social media or reality TV, whilst others like puzzles and books and podcasts. And don’t forget all the usual self-care that we know and love – baths, music, candles, chocolates, cooking, dancing, art, face-masks, online-shopping, hugs. Find out what helps you feel replenished when you’ve been drained. 

However, what we also know is that sometimes our energy fits under the ‘use it or lose it’ category. It’s like our car battery – we gain energy from being active and doing things.

Depression, in particular, can create a pretty vicious cycle of low energy, leading to inactivity, leading to negative thoughts and feelings, leading to hopelessness, which ultimately ‘feeds’ the Depression Voice and the exhaustion, fatigue, and tiredness it brings. 

A common factor of many mental health treatments is what we call ‘behavioural activation’. To put it simply, the aim is to get moving. The Depression Voice can be very convincing to us – telling you that in order to feel better you need to sleep more, do less, conserve energy, see less people… This may provide temporary relief, but not long-term benefit. 

It’s counter-intuitive, but often we find that being more active (even in the face of tiredness or depression!) can increase our energy levels. 

Much like your car - adding in some light movement or activity each day or week can play a huge role in sustaining our ‘batteries’ and creating more energy. Slowly and progressively adding in events, activities, or plans to a daily or weekly routine can decrease exhaustion. In regards to sleep, sometimes less is more! Oversleeping or irregular sleeping (such as day time napping) may contribute to lethargy. Day-to-day this might look like setting an alarm and getting out of bed when it goes off, parking slightly further away from your front door, or getting off the bus one stop early. Week-to-week it might look like writing lists of things to do when you’re bored, or committing to at least 1 social event each weekend. Over the year it might look like joining a social sports team or club, setting an exercise goal, or reducing overall time spent in bed.

Any activity (whether it be something as small as making the bed or brushing your teeth, or as big as planning to run a 5k, 10k, 21k, 42km race) also has the added bonus on helping us feel productive and in control. We give the Depression Voice less to focus on when we can reflect on the big and small things we’ve done that day, week, or month. Motivation also usually comes from momentum, and adding in small activities can increase the motivational flow. As the saying goes, from small things, big things grow!

So when we notice tiredness in our bodies, we need to ask ourselves – is it my ‘phone’ battery that’s low, or is it my ‘car’ battery that’s low. Sometimes to recharge we need to stop and plug in to our energy source. At other times we need to start the ignition and get the wheels moving.

(Note – there are many physical and medical conditions which can contribute to low energy, and may need to be addressed first or ruled out prior to mental health treatment. Your GP is always the best person to discuss this with!). 

Work/Life Boundaries When Working From Home

The Covid-19 Pandemic has had an enormous effect on the entire world. When it comes to people’s professional lives, there have been big impacts for most- both practically and psychologically. Some people have had to navigate job losses or work being put on hold, whereas others have had to continue working face-to-face knowing there is a risk to them and their loved ones. And a large percentage of other people may be somewhere in between– working from home whilst continuing to juggle their jobs and normal responsibilities.

One of the biggest challenges with working from home (aside from the obvious strain on the millions of parents trying to home-school children whilst still juggling their careers!) is that there is far less separation between work and life outside of it. There is no longer a natural transition (i.e., commute) which provides time to shift gears. There’s no longer two distinct environments where those parts of a person’s life take place. And there is often far less structure around working hours versus personal time. All of these things can have an impact, both good and bad.

There may be some parts of working from home you really enjoy. For example, the flexibility to do a load of washing, exercise, or cook meals in between getting your work done rather than having to do it all in the evening. Or the time and money saved commuting to another location. Or less rushing to get out the door in the morning. Or less pressure to look a certain way or to maintain interactions with colleagues that are stressful for you. 

On the other hand, working from home may leave you feeling isolated and flat, or struggling to be present and enjoy other areas of life because you’re always thinking about work or even doing work at times you would normally have switched off. 

If you notice work and home have merged in a way that’s not benefitting you, the following tips may help!

1.     Start the day well. Without a commute many people are using that time to sleep in. Then rolling out of bed and straight into work calls, emails, or meetings. This can leave you feeling unfocused, frazzled, or unfulfilled. Without the pressure to get up as early it can also mean staying up later at night rather than sticking to a good sleep routine. Is this really helpful? And if not, what might it be like to still prioritise your previous sleep schedule, and instead reflect on how that extra time in the morning could be spent in a more meaningful way? Perhaps taking the time to make a delicious breakfast and eat it mindfully rather than scoffing down some toast whilst tapping away at your laptop? Or savouring a cup of tea or coffee outside or in front of a window whilst observing nature?  Perhaps a calming or energising meditation? Or having extra hugs or snuggles with loved ones without rushing? Or starting the day with some exercise such as a walk outside in the fresh air? Or perhaps simply using the extra time to set some clear goals and priorities for the day ahead to leave you feeling confident and in control of what to focus on.

2.     Get dressed and put a little effort into looking somewhat professional. Many people have been enjoying the comfort of wearing track pants or pyjamas all day. I get the appeal! I’m a massive fan of dressing comfortably when at home! And at the same time, even if you’re not going to see anyone else it can give a boost to your mood, confidence, energy, or drive to still “get ready” for the working day in a similar way to how you would if going to your workplace. It also makes it easier at the end of the day to transition back to relaxation by changing back into pyjamas or loungewear as a signal you have switched off from work!

3.     Set boundaries on working hours. Many of us have probably found that when working from home we can slip into the mindset that the work can be done at any time of the day, and as a result there’s far less structure around our “working hours”. It’s easy to start procrastinating or thinking “I’ll do it tonight”. But this means the same amount of work may now be spread over longer hours or creeping into weekends, and it may mean we’re left with very little time to be fully present in our personal lives without the work looming over us! 

4.     Set mini boundaries throughout the day around parent versus work-mode. If you’re juggling home-schooling or caring for kids it’s understandable you may feel you’ve no choice but to catch up on your work in the evening when they’re asleep. This is really tough as it leaves you no downtime or means your sleep patterns get pushed back which can sap your energy and make everything harder! If this is the case, try to reflect on whether trying to juggle both things simultaneously is causing things to take twice as long due to continuous interruptions. If so, try setting mini boundaries around when you’re in parent-mode versus work-mode and aim to be 100% focused on each role during that time. It may mean lowering your expectations around parenting and allowing a bit more TV when you’re in work mode, or alternatively taking a bit more time to set them up with independent activities before you commence work, but it can pay off if it means they then let you work uninterrupted for a longer block. And prioritising undivided connection with them early on in the day (and in small doses throughout!) can reap massive rewards in helping them feel secure enough to play more independently rather than trying to meet that need for connection through vying for your attention all day long. And if you really cannot get all your work done whilst also parenting during the day, it might be time to think about whether it’s possible to take a bit of leave to recharge, or to speak to your manager about reducing your workload or the expectations placed upon you? They may not even realise you’re struggling unless you speak up, and they may be understanding if you raise things!

5.     Try to have a dedicated workspace. If you’re fortunate enough to have a study/home office, try to only check emails and make phone calls in that space. If not, try to still set aside a specific working area, and set boundaries on only doing work in that one place. This helps stop the association of thinking about work no matter where you are in your home, and prevents you from being constantly pulled back into work whilst trying to engage in other activities!

6.     Transition at the end of the working day. Once you’ve finished work it’s important to create a transitional period to help you switch from work mode to home mode. If you go straight from working at your computer to jumping into home-based tasks or family life it’s likely your mind will still be on work and it will be harder to stop thinking about all the things that have happened that day or that are still hanging over you. It can help to take a few minutes to reflect and jot down any unfinished tasks or priorities for the next day to get them out of your head. This helps let go feeling the need to remember them. Next, it could help to engage in a transitional activity. If you previously commuted, you probably had activities you naturally did which helped you unwind and transition from work to home. Maybe it was listening to music or podcasts, calling a friend, looking out the window as you passed familiar landmarks, or reading a book on the train. Or perhaps you went to the gym or stopped by the shops on the way home to grab dinner. Whatever you used to do it can help to now think about a way to create a new ritual to repeat each day to signal to your brain that you’re entering a different mental space. It could be exercising, taking a hot shower, changing clothes, meditating, a simple breathing exercise, or any of the things you used to do like calling someone or listening to music. It doesn’t have to take long. The power will come from making it a ritual through daily repetition!

7.     Reflect on your worth and how precious and valuable your time is. It’s easy to feel like you have no choice other than giving so much of your life to work. Is this really true or have you simply slipped into some habits, let your boundaries slide, or stopped valuing yourself or your time? Could some simple tweaks and knowing your own worth help you to feel more confident setting whatever boundaries need to be made. Reminding yourself of what really matters to you is so important, as it allows you to consciously choose where to focus your attention. And whatever you love to do or experience outside of work, that is every bit as important as being productive. A meaningful life requires balance. Let go of the guilt. You deserve it!

Mind Reading

Do you ever find yourself assuming you know what others might be thinking? Or that you know the rationale behind their behaviour? For example, you might be talking to someone and have the thought “they don’t want to be here talking to me”, “they think I’m stupid”. Another example might be if your boss asks to speak to you and the thoughts that might happen are “they don’t think I’m good enough to do this job” or “they’re angry about something I did”. 

This pattern of thinking is called mind-reading, which is an unhelpful thinking style that every person tends to engage in from time to time. Unhelpful thinking styles can also become automatic habits that individuals may not realise they are engaging in. This becomes problematic when these thoughts cause an increase in anxiety and decrease in mood. When this happens regularly and consistently this may have a detrimental impact on an individual’s social, academic, occupational and personal life. It is common in anxiety disorders and depressive disorders that an individual’s symptoms may be maintained by unhelpful thinking styles such as mind-reading. 

Mind-reading occurs when we believe we know what someone else is thinking, usually about us. We might jump to conclusions about a person or situations due to our prediction of what they’re thinking. Often times, these conclusions are a reflection of how we think about ourselves, e.g. “I think I’m boring to talk to”, “I think I’m bad at my job, I always do things wrong”. Because we believe these things to be true about ourselves, we might jump to the conclusion that others think these things about us too. 

If you are somebody who may notice yourself having thoughts involving mind-reading from time to time, there are ways in which we can begin to become more critical and analytical of our thoughts. This can help us determine whether the thought is realistic and fair which may alleviate some distress that the thought caused. It can be helpful to write the thought down, then ask yourself:

Am I assuming I know what others are thinking? What’s the evidence? Those are my own thoughts, not theirs. Is there another, more balanced way of looking at it?

It is also important to be mindful of when we are stressed or tired as we may be more prone to engaging in unhelpful thinking styles such as mind-reading. This can be managed by maintaining self-care strategies particularly during times of stress which may include, exercise, relaxation activities, stress relieving techniques and mindfulness. 

When we begin to pay more attention to this pattern of thinking we can get better at stopping it in its tracks!

Co-Regulation Throughout the Lifespan

When a baby is first born, most of us recognise it doesn’t yet have the skills to regulate its own emotions. Whether it is frightened, upset, tired, or frustrated, it normally requires a caregiver to step in and provide comfort, nurturing, and a sense of safety before it can start to calm down and relax. This process is called co-regulation. The caregiver’s presence, attunement, and soothing actions help the baby to regulate. And the process is often reciprocal. When the baby is distressed the caregiver often also experiences a rise in emotional intensity themselves, and as their responsiveness helps the baby to calm down, often the parent’s own feelings change or reduce in intensity too! 

As babies grow into toddlers, and toddlers grow into children, and children grow into teenagers, and teenagers grow into adults, our expectations often change. We start to presume that the individual should no longer need this help. That they should be able to regulate their own feelings, calm themselves when angry or scared, soothe themselves when hurt or upset, and to master the way they react to difficult feelings. And to some extent this does makes sense! Most of us do gain independence as we mature. We become better at handling big feelings. Our brains develop, and the rational part becomes more able to balance out the raw emotions that often fuel dysregulated behaviours. But what if these expectations do still at times exceed our capacity? What if all of us sometimes need a little help?

No matter the age, if one person is unable to self-regulate, they may require another person to provide a sense of calmness or safety that allows them to feed off of this to de-escalate. Emotional dysregulation involves activation of our sympathetic nervous systems- our fight/flight response – and if we are unable to self-regulate because these physical changes are so overwhelming, it’s often critical that we can mirror or draw upon another’s state of physical calmness. We can’t fight fire with fire as far as emotions go. We need the opposite to bring us back down.

Co-Regulation in the Early Years

If you’re the parent of an infant or toddler co-regulation is a really important concept that can help make parenting so much easier!

·      Because babies lack the capacity to understand or express things verbally, non-verbal cues are particularly important. Gentle tone of voice, eye-contact, soothing repetition of words or sounds, physical comfort, feeding, rocking, cuddling, baby massage, softly singing, or holding them close to your body can all be helpful things to try. Co-regulation involves attunement and observing their responses, and then adapting your response accordingly. If they are overstimulated you might notice them avoiding eye contact and thrashing around. In this case trying to gaze intently at them might make things worse. At other times if they’re feeling scared or lonely and are seeking connection, lovingly gazing into their eyes as you gently coo might be exactly what they need!

·      With a toddler or pre-schooler, it’s important to remember that co-regulation is a precursor to self-regulation. Teaching them to manage big feelings requires you to assist them in this process! Instead of joining them in their chaos, they need you to be the calmness to their storms. By simply being with them and gently validating their feelings you can help them to de-escalate from meltdowns far more effectively than if you try to reason with their emotionally overwhelmed little brains! Helping them put words to their experiences can be really beneficial, but often in this age group offering hugs or affection, remaining patient and calm, and helping them to ride things out is critical. And after you’ve acknowledged and validated their feelings, distraction can also be a very handy tool to help them ride things out! One of the joys of this age group is that they tend to live in the moment, so helping them shift their focus can often enable them to move on pretty quickly!

Co-Regulation in Older Kids and Teens

·      As children grow-up they can sometimes seem mature beyond their years. They can demonstrate such insight, awareness and intellect it’s easy to forget their brains are still a long way away from being fully developed. Language can become more important in helping them to regulate, but it’s often still important to draw upon the idea of helping their nervous systems calm down first. Having a soothing voice, offering hugs or physical affection, active listening without judgement, or offering to go on a walk to help them cool down can all go a long way!

·      As part of this, the biggest strength a parent can utilise is awareness of their own emotions and continuing to work on self-regulating so that they can be that stable base for their child to turn to for support. Remaining calm, warm, empathetic, and attuned are life-skills that require ongoing practice, and they are invaluable when parenting any age group. Perhaps this means regularly practicing breathing exercises, or scheduling in mini-mindfulness breaks to ask yourself how you’re coping and acknowledge any feelings you may be trying to suppress? Perhaps it means sticking to an exercise schedule, or prioritising sleep, or finding the time for hobbies or interests away from parenting which help you feel calm. Or perhaps it’s finding your own therapist to hear and understand how frustrating or overwhelming parenting or other life stresses can be.

·      Another thing to perhaps reflect on is how as our expectations for children grow, we sometimes lose our empathy and compassion if they aren’t responding the way we believe they should. The same parent that may have had mountains of patience for their baby or toddler can find themselves directing a lot of blame and criticism towards their older child. This blame and criticism is often what fuels the fires of conflict and maintains a pattern where the young person can become quick to anger, refuse parental assistance or advice, or turn away from seeking support when they’re upset. If they’re already struggling with self-regulation it’s vital they don’t miss out on the benefits of co-regulation too! Don’t let your hurt or anger bubble over if your child pushes you away. Instead see it as communication that they may be feeling uncertain as to whether they will get the kind of emotional support they need. Ask yourself if you’ve been blaming them for not self-regulating in a way that makes it hard for them to co-regulate with you? Are your expectations realistic and fair? Do you as a parent yell or snap at them, yet get angry or punish them for these same behaviours? 

Co-Regulation in Adulthood

·      I doubt there’s many of us that can truly say we’re always able to regulate without the assistance of another person. All of us have times when we feel overwhelmed, upset, angry, or scared; and despite our best efforts to soothe ourselves, may find that turning towards another is what really helps. That time you had a difficult day at work and your partner gave you a hug or validated your experience may be an example. The time you phoned your mum or dad and heard their loving voice and felt a sense of comfort may be another. Or that time you went out with a friend and just being around them helped you to feel better. Or when you looked at a colleague during a work meeting and made eye-contact that reassured you, or you spoke to a manager who calmly helped you to problem-solve something you were stressed about. These could all be examples of co-regulation in action. 

·      So, reflecting on adult relationships through this lens can be really interesting. Particularly when it comes to romantic partnerships. Do you tend to soothe and comfort one another, or do you tend to escalate dysregulation in one another? What happens when one of you finds yourself in a fight/flight state of anxiety, anger or distress? Does the other one help to soothe and comfort until the threat has passed, or do they get frustrated or angry with the other for “over-reacting” - leading to escalation of conflict, or distance in the relationship which over time erodes the feeling of safety? Do you both turn towards self-regulation versus co-regulation in equal amounts, or is there a mismatch which is fuelling conflict? If one of you has a tendency to self-regulate whereas the other has a tendency to reach out and try to connect when they’re struggling how does this play out between you? 

·      If you notice a partner, friend, or loved one is struggling emotionally, how can you aid the process of enabling them to co-regulate? Perhaps focusing on active listening and a calm, gentle, demeanour? Or physically connecting through a hug, eye contact, squeeze of the hand or shoulder? Or if you’re the one who needs to co-regulate, can you begin to recognise this and name it? For example, telling someone “I’m really struggling to calm myself down, could you sit with me, or give me a hug until I feel better”?

·      Both self-regulation and co-regulation are important in our relationships. And arguably it’s impossible for co-regulation to occur unless at least one person is skilled enough at self-regulation to provide the starting point for the reciprocal benefits to occur. So, if your goal is to help someone in your life manage their emotions: whether that’s a child, partner, family member, or friend, then strengthening your awareness and repertoire of helpful responses to your own emotions could be a wonderful place to start! 

How do I make the "right" decision?

A question that I’ve often heard in therapy is ‘but how do I make the right decision?’. I’ve seen many people (and even noticed myself!) stuck in indecision because we don’t want to make the wrong decision. We put off deciding or acting with the hope that the answer will become clear - and sometimes it does, and sometimes it doesn’t. Sometimes we even put off making a decision for long enough that we don’t have to make it anymore – the moment has passed, someone else has decided, or our choices narrowed to one.

Indecisiveness, in many ways, makes sense! Humans have a strong drive to avoid pain and seek pleasure – that is, we want to avoid disappointment, failure, rejection, stress, sadness etc. All these feelings are often labelled as or accompany the ‘wrong’ decision. ‘Wrong’ decisions, if able to be reversed, take time and effort to ‘un-do’, and if they can’t be reversed we can sometimes be left with regret. 

However, indecision is really frustrating! We can spend lots of our resources going around and around in our minds – our time, our emotional energy, sometimes even money. It can also lead to feeling ‘stuck’ or ‘trapped’ at times, or even just a sense confusion or of lack of fulfilment and purpose.

This blog won’t give you the answers to the question that you’re struggling with right now, but it may help you explore your indecisiveness more. When struggling with indecisiveness, we can:

1.     Explore all possible options

Sometimes our brains don’t work as well as we think they do. They are fallible - we’re often prone to thinking errors, thought distortions, or heuristics (a word basically meaning brain ‘shortcuts’) which lead us to not see the ‘full’ picture or evaluate risk and reward poorly.

I often get clients to write down all possible outcomes or options to their decision or dilemma, no matter how unlikely it might be. When we force our brain to explore all possible options we might come up with other solutions we didn’t initially consider. Seeing multiple options written down on a page can also remind us that we aren’t as stuck as we think we are – we have options! I often then get clients to give each option two % ratings (from 0-100) – a % for how preferential each option is to me and a % for how likely they objectively think each situation is. This allows us to engage both the rational part of our mind and the emotional part of our mind in tandem, creating our ‘wise’ mind.

2.     It’s often not as simple as the one ‘right’ decision (make a pros and cons list!)

We often have to move away from black and white thinking with decision making – it’s often less rigid than one decision is 100% ‘right’ and one or more are 100% ‘wrong’. We can switch up our language to asking ourselves what is the ‘next best’ thing for me to do? We can think about what is the easiest option, the most helpful option, the most challenging option, the most costly option, the most risky – all of these words move us away from right vs. wrong. 

Making a pros and cons list isn’t ground-breaking advice, but it can also assist us in moving away from thinking about decisions as ‘right’ or ‘wrong’ and can move us towards thinking what are the possible benefits and possible consequences of every option (knowing that all options will have pros and cons). 

3.     Look at what’s important to me

Evaluating our core personal values and goals can be a helpful way to assist in decision making. Ask yourself – ‘what am I working towards and how can I get there?’ It might be a financial, relational, travel, emotional/psychological, career or educational goal. Which option moves me closer towards that goal? Asking ourselves ‘what do I value?’ can be equally important. Sometimes our goals and available decisions don’t always align, or sometimes our possible choices might even contradict with our goals. By knowing your own values you might gain more clarity about how to come to a decision. It can be reassuring to know that even if the outcome of the decision doesn’t work out, you made that decision based on a core value. For example, perhaps you value ‘growth’ and so you take a new job that’s very challenging – knowing that it aligns with your value to grow can assist in pushing through the learning curve and self-doubt. Maybe you value ‘connection’ and so you decide to spend Friday nights of your HSC spending time with friends – perhaps your results don’t end up being ‘perfect’ but instead of leaning towards telling yourself ‘I should’ve studied more’ you can remind yourself of the benefit of your friendships. 

4.     Examine underlying causes 

What’s contributing to this indecisiveness? Yes, decisions are can be tricky to make, but sometimes there are other factors that are confounding our ability to make decisions. Perfectionism means we’re often less tolerant of perceived failures, we set the bar very high for ourselves to not ‘fail’, and we have unrealistic expectations of success. Depression, anxiety, stress and trauma often drives ‘worst case scenario’ thinking so that we are unable to accurately weigh up realistic and probable options. People pleasing can often disconnect us from our true self (meaning that we don’t know or are unware of our core values), and make us more likely to try and make decisions based on other people’s wants or expectations. Avoidance of discomfort can mean we often let other people take responsibility for our decisions so that we don’t have to feel fear or regret, but can reduce our autonomy and independence. Fear of change and the unknown might mean we take the ‘safe’ and familiar option rather than pushing ourselves into new challenges and environments. Procrastination or lack of planning might mean we don’t give ourselves enough time to make informed or considered decisions, and increase stressful, last minute decision making. 

5.     Take action!

Inaction contributes to indecisiveness because we aren’t gaining more information. When we takes steps, even small ones, towards making a decision we get feedback about that decision making process. Maybe it’s as small as writing down a list of options, drafting a pros/cons list, sending a text message, researching online, speaking to someone else. Make sure your action is leading you forward, rather than just leading you back around the indecisiveness merry-go-round. 

Unhelpful Thinking Styles

Do you ever find yourself feeling like nothing good ever happens to you? Or do you find yourself ruminating on all the possibly bad things that happened in a given situation? For example, focusing on all the things that could’ve been done better after a job interview or feeling we failed a test due to not being able to answer some of the questions. Another example is that we might feel like we have the worst luck.  

This pattern of thinking is called ‘mental filter’, which is an unhelpful thinking style that every person tends to engage in from time to time. Unhelpful thinking styles can also become automatic habits that individuals may not realise they are engaging in. This becomes problematic when these thoughts cause an increase in anxiety and decrease in mood. When this happens regularly and consistently this may have a detrimental impact on an individual’s social, academic, occupational and personal life. It is common in anxiety disorders and depressive disorders that an individual’s symptoms may be maintained by unhelpful thinking styles such as ‘mental filter’. 

Mental filter occurs when we notice only what the filter allows or wants us to notice, and we dismiss anything that doesn’t ‘fit’. Like looking through ‘gloomy specs’ or only catching the negative stuff in our ‘kitchen strainers’ whilst anything more positive or realistic is dismissed. When we are engaging in mental filter it is likely we would be seeing our glass a being half empty rather than half full in any situation. 

If you are somebody who may notice yourself wearing ‘gloomy specs’ from time to time, there are ways in which we can begin to become more critical and analytical of our thoughts. This can help us determine whether the thought is realistic and fair which may alleviate some distress that the thought caused. It can be helpful to write the thought down, then ask yourself:

Am I only noticing the bad stuff? Am I filtering out the positives? Am I wearing those ‘gloomy specs’? What would be more realistic?

It is also important to be mindful of when we are stressed or tired as we may be more prone to engaging in unhelpful thinking styles such as mental filter. This can be managed by maintaining self-care strategies particularly during times of stress which may include, exercise, relaxation activities, stress relieving techniques and mindfulness. 

When we begin to pay more attention to this pattern of thinking we can get better at stopping it in its tracks!

Mini-mindful moments you can take without needing an app, a dark room, or your eyes closed!

The benefits of mindfulness, even brief practices, are well documented. Mindfulness training can lead to less emotional exhaustion and more job satisfaction (Hulsheger et al, 2013), can increase our tolerance of distress (Verplanken & Fisher, 2014), can reduce sub-clinical symptoms of depression, anxiety, and stress (Schreiner & Malcolm, 2012), can reduce impairments in working memory due to stress (Banks, Welhaf & Srour, 2015), can reduce anger and increase attentional control (Rodrigues Vega et al, 2013), and can even increase connectivity in the brain (Kilpatrick et al, 2011). 

However, there are lots of misconceptions about mindfulness. We can often confuse it with meditation and think we need to be completely ‘zen’ to give it a go, we need a youtube video or app to guide us through, we need to be lying down or have our eyes closed, we should be able to totally clear our mind, and we need to be doing it for 10 minutes or more. 

Mindfulness at it’s core is about being aware of the present moment, with a curious, non-judgemental attitude. 

Maybe even sitting down for 5 minutes of guided mindfulness is too tricky for you right now – that’s okay! There are a myriad of mini-mindful moments that present across the day, every day.

Here are 10 examples of mini-mindful moments (some not lasting more than 60 seconds) which you might want to embrace:

1.     When you sit down at the end of a day at work/school

This might be in the car, on the bus, or on the train. Maybe it’s not until you get home and take a seat on the couch. Pause for one moment, even just one breath. Notice the shape or your steering wheel, the hum of the bus, the movement of the train carriage. Try and shift your thoughts away from what you just did at work, or what you’re going to cook for dinner. Perhaps it’s even just taking a few seconds before you put your key in the door – catch yourself and pause. 

2.     In the shower

Our minds love to wander in the shower! And this can be a great time of processing, planning, perhaps even creativity! Practice ‘watching’ your thoughts – like cars on a highway, or leaves on a stream – just passing you by. Or maybe just notice the sound of the water as it falls, if you can hear individual drips or the hum of the pipes. Notice the feeling of the pressure on your shoulders or scalp. Notice the way different parts of your body have a different temperature. Look at the droplets forming on the tiles or glass, the patterns they make. 

3.     When you brush your teeth

Notice the taste of the toothpaste as it hits your tongue and then moves around your mouth. Notice the foaminess increase. Perhaps the zing of the mint – does your mouth change temperature. Maybe even try and focus in on each tooth as you brush it – the feeling of the bristles on your gum. Maybe notice the sounds you can pick up on as you brush each tooth. 

4.     Whilst you eat a snack or 5. Before you eat your lunch

Take a second to pause before eating (maybe even take a seat!). Notice the colour and shape of your food – any light or shadows. Notice the smell of your food. Notice the feeling in your belly – ask yourself ‘how hungry am I?’. Then, take a small bite and chew slowly – notice the texture and taste of the food. Bring as much attention as you can to each bite. 

6.     Before you take a sip of your morning tea or coffee

Another moment to pause before doing something that is pretty easy to do on ‘autopilot’. This can also be a very sensory experience – can you tune into the swirls of steam rising from your hot drink? Take a moment to notice the smell of the drink, or try and describe the exact colour of your tea or coffee. Maybe notice if there are any reflections on the surface, or patterns in the foam. 

7.     When you first wake up

This might the hardest mini-moment – we’re groggy, tired, confused, or reluctant when we first wake up! Maybe try and pause for even 10 seconds before reaching for your phone or turning of your alarm. Maybe you want to keep your eyes closed and tune into as many different sounds as you can – your alarm, any birds, traffic outside, wind or rain, the movements of anyone around you. Maybe you want try and grasp onto the last remnants of your dreams. You might even want to choose an intention or affirmation for the day, or create some mindful space to focus on a particular personal core value. Ask yourself – how do I want today to go?

8.     When you’re stopped at the traffic lights

Sometimes this is one of the moments where, depending on how our day is going, we can feel stressed, agitated, frustrated, annoyed. Maybe in this moment you might want to tune into the sensations of that feeling in your body and observe it – the tapping of your fingers on the steering wheel or gear stick, the feeling of your foot on the break pedal, the tension in your stomach or shoulders. Or maybe you just want to notice the colour of the car in front of you, a pedestrian on a footpath near your, maybe look up at the colour of the sky or the movement of a tree. 

9.     When waiting for the kettle to boil (the microwave to finish, the sink to fill up, the hot water to come through, etc).

This can be a moment where we reach for our phone, or start ruminating on a particular situation, or impatiently wait. There’s often many moments in the day where we have to momentarily wait for something, and impatience can make those 30 seconds feel like it’s dragging on and on. Perhaps use that forced waiting time as an opportunity to pause – what’s going on in my body right now? How is my day going? What is going on in my head right now? Take a take few deep breaths? Can I take a second to remember my intention for the day? Can I try and recall a gratitude?

10.  Before you go to sleep 

Your last pause for the day. This might be reflective space – what did I do well today? What worked well for me? What moments do I want to remember or what do I need to let go of? Maybe just focus on counting your in-breaths and out-breaths. Tune into the rise and fall of your belly or chest. Maybe notice the feeling of your body in bed – the feeling of the sheets against your skin, where your limbs press into the mattress, your head against the pillow. Maybe noticing any tension in your body – where specifically you feel it and if you can release certain muscles. 

Healthy Personal Boundaries

Having healthy boundaries with others is important for nearly all aspects of your life, often affecting your sense of identity and emotional wellbeing. 

Boundaries in relationships refer to the guidelines and limits that we want for ourselves in relation to others. Healthy boundaries enable you to both limit others by saying “no” to them when appropriate, and to be able to have close and intimate relationships with others. It is this balance between recognising and asserting needs, and opening up to others, which provides for healthy boundaries and maintains your identity and self-esteem.

One way to visualise the need for having healthy boundaries, is as a form of self-care leading to self-respect. Viewing it this way can help to empower you to set healthy boundaries and avoid feeling guilt for doing so. Thinking in these terms also makes it clear that being able to show kindness to yourself is an important building block in establishing healthy boundaries – if you can’t be compassionate to yourself, it is very difficult to identify and assert your needs.

Healthy personal boundaries, and living in line with your values, can also be an important factor in defining your identity, self-respect and sense of autonomy. Having appropriate boundaries can give you a sense of control and safety through having clarity about what you do and don’t want, and what you consider yourself to be responsible for. 

Boundaries are often defined as being rigid, or loose, with healthy boundaries often considered as falling somewhere in between these. Some typically defining features of each of these boundary types include:

Rigid boundaries

·      Keep people at a distance: avoid close or intimate relationships

·      Protective of their personal information

·      Not expressing needs and wants

·      Reluctant to ask for help

Loose boundaries

·      Highly involved in the problems of others and feel responsible for others’ happiness

·      Rely on others’ opinions for how they feel (weak sense of identity)

·      Allow others to make decisions for them. Inability to take responsibility

·      Share an inappropriate amount of personal information

·      Reluctant to say “no” to others, and so are susceptible to disrespect or abuse

Healthy boundaries 

·      Ability to maintain their values regardless of others

·      High self-esteem and self respect: trust and value own opinions

·      Understand and communicate needs and wants. Take responsibility for themselves

·      Assertive: able to say “yes” and “no” to others, and accept being told “no” by others

·      Can separate needs, thoughts and feelings from those of others

·      Has equal responsibility and power in relationships

Of course, everyone has their own unique set of boundaries that they are comfortable with, as healthy boundaries are based on your values, or the things that are meaningful or important to you. 

You may also have very different boundaries depending on the setting and type of relationship, such as romantic relationships, family, friends, co-workers or manager, as these relationships are based on different levels of closeness, trust and values. Importantly, several different types of boundaries apply within each of these relationships, each of which are equally important. These may include boundaries concerning physical, emotional, intellectual, time-based, financial and sexual aspects.

When we do not have boundaries that work for us, we can end up feeling resentful, disappointed, angry, exhausted, time-poor, dependent or isolated, and experiencing poor quality and high conflict relationships with others. Our self-esteem and self-respect are also likely to suffer.

So, if boundaries are important to taking care of ourselves, and most of us would agree that they wouldn’t want their boundaries violated, why can it be so difficult to set and maintain healthy boundaries? Generally this is driven by the very powerful motivations of fear (of rejection, abandonment or confrontation) or feelings of guilt.

Further complicating the picture is the fact that we only have our internal barometer to know when there may have been a breach of our boundaries. However, one way to start tuning into when your boundaries may have been violated, is to notice when you come away from an interaction feeling drained, anxious, resentful, or angry, or if you find yourself complaining about the situation afterwards.

Ideas for setting healthy personal boundaries

·      Think about a specific relationship where you struggle with setting healthy boundaries

·      Consider whether your boundaries are too rigid or loose (or if something else is going on), and which areas (e.g. emotional, physical, intellectual, time, sexual, financial/possessions) are problematic

·      Reflect on what you want from/value in the relationship, and how your life might be different if you adjust your boundaries

·      Set boundaries based on your identified values – depending on the boundary problem, this may involve opening up more and being more vulnerable, or setting limits, for example

·      Take time to identify and understand your healthy personal boundaries, and work through any emotions that come up 

·      Communicate your boundaries clearly and calmly to the other person: State what the boundary is, say what you need, and why it is important

·      Be clear, brief, calm, firm and respectful

·      Use “I” statements – focus on yourself and your needs

·      Do not over-explain, justify or apologise for your boundary setting

Learning to set healthy personal boundaries will take practice, and you may feel awkward, selfish, guilty, and even afraid, at first. Start small until you feel more empowered. If you are taking responsibility for your behaviour and communicating in a respectful and clear manner, you are not responsible for the other person’s reaction to your boundary setting. Be determined and remember that you have the right to take care of yourself and have self-respect. Surround yourself with people who will support your efforts, and respect your choices. 

Always respect the boundaries others have set for themselves.

Managing Disappointment

Disappointment is a natural emotion that arises whenever something we have been hoping for, expecting, or looking forward to, doesn’t happen. It can arise in response to all sorts of situations and can range from being fleeting and mild to us feeling absolute devastated, crushed, or hopeless.

As we have recently faced another lockdown, it’s an emotion many of us are probably familiar with right now. Holidays, eating out, parties, and social gatherings have all been cancelled or put-on hold. We’ve been unable to see loved ones we may have planned to spend time with. Maybe struggling to think of how to fill our time when so many things are off limits. Of course, disappointment has shown up! 

It would be so easy for disappointment to grow, to fester, to start to eat away at our existence.  But It doesn’t have to be that way. Disappointment is hard, but if you’re experiencing it for any reason, the following may be a helpful place to start!

1.     Acknowledge and validate the feelings that arise. There is nothing wrong with the feeling itself. In fact, it’s often helpful for us to tune into and honour our feelings. Disappointment is a natural emotion that alerts us to the fact that something we have been hoping for hasn’t happened. A goal, dream, or wish, has remained unfulfilled. It makes sense that we feel pain in response to this!

2.     Open up to make room for the feelings. Painful as it is, trying to ignore, suppress, or shut down what we’re feeling is rarely a helpful long-term strategy. Instead, it can be helpful to try and make room for the feelings to be there. Practice acceptance and know that this feeling will pass. It really hurts right now, but it will not last forever.

3.     Practice self-compassion and compassion for others. Disappointment is painful, particularly if it’s intense. This is a time when we need to be kind to ourselves and those around us. We are all doing the best we can and sometimes things are out of our control, no matter how hard we try. Blaming ourselves or others for things that occur is often fruitless. Instead, we can try holding ourselves with kindness and compassion. We can also try to maintain empathy for others and recognise that they too are doing the best they can with the emotional resources, skills, or knowledge at their disposal.

4.     Ask ourselves what do we really need in response to the feeling? Do we need to express it; perhaps cry, vent, or seek comfort from others? Do we need quiet time alone to reflect on what’s happening? Do we need to shift our focus to something engaging, joyful, fun, or soothing?

5.     Watch our thinking. Let go of criticisms, judgements, and blame. “Shoulds” and “if onlys”. These things are likely to just trigger more painful emotions such as frustration, resentment, anger, and bitterness. Spending lots of time dwelling on the past or getting caught up in worries about the future is rarely beneficial. Keep an eye out for black and white thinking or over-generalising. Thoughts like “Nothing EVER goes my way” or “Things will NEVER get better”. Or I’m “ALWAYS going to feel this way” can catch us all out at times. Not only are these thoughts not accurate, but the impact of getting hooked by them is likely to make things feel a whole lot worse.

6.     Get some perspective. This doesn’t mean invalidating your feelings of disappointment by dismissing them or telling yourself you shouldn’t be feeling them, but it does mean reflecting on whether your mind is amplifying the situation by filtering out any positives. It can sometimes be helpful to consider alternative ways of viewing things. Trying to practice gratitude for the things we have rather than focusing on those we don’t. 

7.     Search for the silver linings. Are there any upsides to the situation? How can you take what life has given you and try to find a way to make use of the situation to better your life, circumstances, or wellbeing? 

8.     Have hope and set goals for the future. Make new plans, daydream, focus on things to look forward to. Sure, there’s always a chance disappointment may arise again if those plans change, but there’s also a chance things will work out! Sometimes the anticipation of something good to come can bring about excitement, purpose, or hope that makes disappointment much easier to manage. We cannot change reality as it is right now, but maybe we can keep working towards imagining and building the future we want to live!

Unhelpful Thinking Styles

Do you ever find yourself thinking that the worst possible thing might happen in a situation? Some examples are, “If I fail this exam, I will never pass school, and I will be a total failure in life” or “If me and my partner break up, I’ll never be able to find someone again”. 

This pattern of thinking is called catastrophising, which is an unhelpful thinking style that every person tends to engage in from time to time. Unhelpful thinking styles can also become automatic habits that individuals may not realise they are engaging in. This becomes problematic when these thoughts cause an increase in anxiety and decrease in mood. When this happens regularly and consistently this may have a detrimental impact on an individual’s social, academic, occupational and personal life. It is common in anxiety disorders and depressive disorders that an individual’s symptoms may be maintained by unhelpful thinking styles such as catastrophising. 

Catastrophising occurs when we imagine and believe that the worst possible thing will happen in a situation when in reality it may be a smaller problem and the catastrophic outcome may be unlikely. These thoughts may occur in response to an ambiguous situation, a situation we hold strong value for and situations we fear. 

If you are somebody who may notice a catastrophic thought from time to time, there are ways in which we can begin to become more critical and analytical of our thoughts. This can help us determine whether the thought is realistic and fair which may alleviate some distress that the thought caused. It can be helpful to write the thought down, then ask yourself:

Ok, thinking that the worst possible thing will definitely happen isn’t really helpful right now. What is most likely to happen? 

It is also important to be mindful of when we are stressed or tired as we may be more prone to engaging in unhelpful thinking styles such as catastrophising. This can be managed by maintaining self-care strategies particularly during times of stress which may include, exercise, relaxation activities, stress relieving techniques and mindfulness. 

When we begin to pay more attention to this pattern of thinking we can get better at stopping it in its tracks!

Empathy - how and why to foster it

Empathy is a word that we seem to be hearing more and more these days, in a multitude of contexts. It’s focused on by neuroscientists, business leaders, educationalists, and political activists, and has a high profile on social and traditional media. With increased awareness of empathy, both in terms of its value and the effect of its lack, I increasingly see people who are questioning their level of empathy. This is a complex concern, but perhaps a response could be that we should all be aiming to increase our empathy in healthy ways.

So, what is empathy? 

Simply put, empathy is being able to put yourself in someone else’s position, particularly in terms of what they are feeling or experiencing. It means to understand someone else’s feelings and perspectives and to have this influence our actions. Of course this is often more difficult when other people feel and think differently from yourself. 

Increasing our empathy

How can we increase our empathic potential, improving both the quality of the lives of the people around us, and our own lives? Happily, our empathy is determined both by a genetic component and an environmental component, meaning that what we experience also shapes how empathic we are. This means that we can continue to develop and strengthen our empathy skills throughout our lives. 

Some ways that you can begin this process include:

·       Be curious. Endlessly! Be particularly curious about people you don’t know – strangers, or people you see, but don’t usually interact with. The person next to you on the bus, the person at work you don’t normally speak with, or the person assisting you in the café/shop. Ask questions, and try to understand strangers’ worlds and learn about lives, perspectives and experiences that are different from your own. Find out about their worries, dreams and passions. You can also follow people who are different to you on social media – with an open mind - to hear what they have to say. 

·       Listen fully (and respectfully) to others. This means being fully present and not interrupting. Try to be open to others’ emotions, needs, perspectives and ideas, even if you don’t agree with them. 

·       Reveal your own feelings and make yourself vulnerable. Empathy is built on an exchange of authentic information about feelings, beliefs and experiences. Opening yourself up and sharing is as important as listening.

·       Observe other people’s nonverbal communication. Notice their body language, tome of voice and facial expressions, and when these change during a conversation.

·       Take time to imagine “walking in someone else’s shoes”, or actually try experiencing someone else’s reality. Go somewhere where you are in the minority, or find other ways to experience what it is like to be out of your comfort zone. Notice how it feels.

·       Practice random acts of kindness. When the opportunity presents itself, do a small kind act to benefit others in some way, either without them knowing, or without expecting anything in return. Notice when others do the same for you.

·       Notice labels and look for individuality and commonality. We often use labels that set people apart on the basis of social status, religion, race or other criteria, leading to prejudice. Be aware of these labels or biases and search for what you may have in common with people, rather than what sets you apart. Notice the individual, not the label.

·       Purposefully empathise with people who seem like adversaries in some way because of their beliefs. For example, if you believe in global warming or a particular approach to education, try to understand the thinking of someone who doesn’t share your view, without judgement. This is a powerful way to begin a process of communication, and perhaps change or cooperation.

Why does it matter?

Healthy and expanded levels of empathy have been associated with numerous benefits. Connecting with others’ worlds can play an important role in many aspects of life. 

Empathy…

• Allows us to better understand and relate to others, enabling the creation of deeper emotional connections, including intimacy and trust, with others. This can result in more successful marriages and better work relationships and effectiveness.

• Encourages helping behaviours and makes it hard to ignore another’s suffering. Acts of kindness and altruism improve social order and cooperation, increase forgiveness and while increasing our mental wellbeing.

• Can help us to understand ourselves and our emotional world, and increase emotional regulation, when it is at healthy levels. It can change the way we see ourselves and how others see and respond to us.

• Leads to better and more resilient parenting.

• Can contribute to humanity’s compassion, allowing us to meet global challenges

• Helps maintain connection, social order and cooperation. 

Of course, it should be noted that high levels of empathy are associated with significant concern for the wellbeing and happiness of others. While this can be positive, it can also lead to feelings of overwhelm, emotional burnout, anxiety or alienation. Healthy empathy requires self-awareness and balance, so that the needs of others can be understood and taken into account, without sacrificing your own emotions and needs. Being empathic with yourself, and practising self-compassion, is also an important part of emotional intelligence and mental wellbeing.

Mental Health During Winter

It’s fairly common to struggle a little bit more during the cooler months - even though winters in Australia (particularly on the coast) are much more mild compared to the Northern Hemisphere. It’s important to recognise and be aware of the ways that shifts and changes, even in the season, can play a role in our mental health. In the same way that we might make preparations or adjustments in our homes or our wardrobes with the new season, we might need to be aware of ways to prepare for and adjust our mental health routines.

Why might we struggle more during winter?

There are so many reasons why we might struggle more during the winter months! It’s generally colder, of course! And depending on where you live, it may be much, much colder. Anecdotally, what we know is that it’s harder to feel motivated to get out of bed or get outside when it’s cooler. Leaving the warmth of your bed or contemplating heading outside is much less enticing than whe it’s sunny and warm outside. We might have to use much more of our motivational energy to do things which in summer or spring are more effortless; like getting ready for the day, having a shower, walking to the bus stop, getting to work or school, going to the shops. If we find those activities take up a little more energy, then it’s understandable that we have less left over other pursuits and activities.

It’s also darker earlier in winter! It’s often dark by the time we’re home from school, uni, or work – and this can feel like a real shock after having many daylight hours left in summer at that time. This after-work time is often when we get our ‘optional’ activities in – such as going to the gym, going for a walk or run, organising to see friends or family. So, during winter, these are often harder due to the dark – it might feel less safe, you might be restricted from driving, or you might simply feel more of a desire to be inside at home!

For these reasons, we might get less sunlight leading to lower vitamin D levels. We might exercise less. We might have big routine changes. We might do less – see less friends, exercise less, spend more time at home, want to sleep more. Our regular hobbies or interests might be more difficult to do – such as outdoor swimming, or getting to the beach. 

Whilst inactivity is often a symptom of depression, it’s also a really significant contributing factor. When we do less, we feel less good about ourselves, we give ourselves less of an opportunity to feel productive or connected, and so we’re likely feel worse (which feeds back into wanting to do less!).  

In it’s most extreme form, you might suffer from Seasonal Affective Disorder (aka SAD). Seasonal Affective Disorder is most commonly understood as a cluster of symptoms most like Depression (but may include Anxious features) that occurs around seasonal changes, particularly winter. 

What can I do about it?

Remember to have self-compassion – as mentioned, everyone tends to struggle more during winter! It’s a very human thing to do. Remember there are some animals that hibernate for most of the winter months – it’s quite possibly an evolutionary, biological drive to want to do less around this time of year. Engage in self-compassion exercises to reduce self-criticism about what we do and how we look over these months. It’s important to not have rigid expectations about what we can achieve our how we’ll feel all year round. 

Recognise that everything passes – quite literally, the seasons always change! In the same way that winter seems to just ‘arrive’ each year unexpectedly, it will also pass as well. Days will get longer and things will get warmer. It can be helpful to remind yourself that even if you’re struggling now, things always change. 

Pin point what contributes to your mental wellbeing – if you are struggling, try and work out what has contributed to the shift. Perhaps use an experimental approach, a bit like after an elimination diet, by adding in different routine changes or activities one at a time to see what makes you feel better. You might discover that it’s the lack of exercise that’s been making things worse, or lack of sunlight, or less socialising, or maybe your diet has changed. Once you’ve recognised what’s contributing, you can…

Think about how to make reasonable adjustments – in the same way that we wear different clothes in winter, we might need to make different adjustments to our routines or self-care strategies. Perhaps you need to exercise differently (move to an indoor gym class as opposed to a morning run outside?), or eat different foods, or find a different way to connect with people or get places. Maybe it’s about having self-compassion for staying in more. Or getting up earlier to catch the sunlight, or eating outdoors at work to get more Vitamin D intake. Little shifts and changes can make a big differences to getting through the season. 

Speak to a health professional – this might include a psychologist, but it might also include your GP or a nutritionist. There are often biological factors which contribute to lessened mental wellbeing in Winter – getting advice on if other therapies (such as light therapy or vitamin supplements) might be helpful for you is essential.

The Invisible Epidemic

Eating disorders are serious mental illnesses with severe consequences to a person’s physical and psychological wellbeing. Anorexia has the highest mortality rate of any illness, with around 450 people expected to die each year in Australia from the illness. This is partly due to the physical complications that arise from the illness, and partly from the increased risk of suicide that accompanies it. Similarly, Bulimia Nervosa comes with the risk of sudden death from cardiac complications, and a risk of suicide that is also far greater than in the general population. Binge Eating Disorder, and OSFED (Other Specified Feeding and Eating Disorder) are no less of a threat to a person’s psychological and physical wellbeing either. Any disordered eating behaviours can place massive strain on a person’s physical health and symptoms such as anxiety, depression, social withdrawal, impaired concentration, overwhelming guilt, shame, and fear are well-recognised symptoms of eating disorders that can accompany them all.

What is particularly dangerous in today’s society is our weight bias in the way we view our own and other people’s bodies. In Australian culture, thinness is highly praised and valued, whereas being in a larger body is often discriminated against, either overtly, or in more subtle ways. Maybe people don’t always say it out loud, but due to the relentless social conditioning most of us have been subjected to, when people see someone in a larger body there is often an unconscious perception that they are inferior to slimmer peers, that it is their fault, or that they are “unhealthy” or “lack willpower”. Weight bias transcends many aspects of our culture, and what is particularly frightening is how it impacts children and teens who have internalised these messages that their own body is not good enough if it doesn’t match unrealistic ideals. 

All of this is particularly relevant in how we view young people with disordered eating. The dangers of weight biases are that many parents, young people themselves, and even professionals can underestimate how unwell a child or adolescent is if their body doesn’t look completely emaciated. It is not uncommon for parents to notice their child has started skipping meals, cutting out entire food groups, engaging in intense diet or exercise routines, refusing to eat family meals, or focusing intensely on food or health-related behaviours at the expense of engaging in other areas of life. It is also not uncommon that if the child is noticeably underweight it gets labelled as an eating disorder and treated as such, but if the child is of average or even above average weight it gets dismissed as a phase, no big deal, or perhaps even a good thing that “they’re taking better care of themselves”. This disturbing trend means many vulnerable children and teens do not getting the help they need, simply because of biases that exist in our culture, or how the genetic shape or size they were born with fits into that. 

Research shows us that the physical damage that amounts from disordered eating behaviours is not lessened simply because someone starts off at a higher weight. Similarly, the psychological consequences of starvation still result when any body is undernourished regardless of its size. Teenagers with eating disorders and average or larger bodies are often secretly trapped in a cycle of feeling so ashamed of their body that they restrict what they eat, which triggers physiological and psychological mechanisms that result in binge eating. This in turn either keeps their weight the same, or sometimes leads to metabolic changes that push their weight even higher. Yet if these behaviours come to light it is often the bingeing that is judged as being the issue (and often believed to be something they can just stop) rather than anyone seeing that it is the restriction and self-starvation that is the real problem. And yet if their weight were lower, would this still be the case or would the restriction itself be noticed and seen as the most alarming part?

If we imagine a teenager’s natural body shape were to fall into the 90th percentile (which some naturally will because that’s how percentile’s work!) and they lost a large amount of weight, they may become significantly underweight for their natural shape and size and yet viewed as being “healthier”. Whereas someone who is naturally smaller could lose far less weight yet instantly be recognised as unwell simply because their body was smaller to begin with. And part of the cycle of what triggers the body image dissatisfaction or keeps eating disorders going may be that teenagers in larger bodies report feeling judged whenever they eat certain foods, whereas in smaller peers nobody pays attention to what they eat. Furthermore, when a larger child begins to diet and restrict their food intake, they may be praised for the same behaviours that would trigger concern or intervention in a smaller peer or sibling.

So, what can we do about this harmful pattern?

1.     Educate ourselves on all of the mechanisms that go into determining our shape and size. Understand how much of this is due to genetics, and also the physical changes that result if we restrict or undereat.  Our bodies work hard to maintain the weight, shape, or size that it feels is right for us. Being in a larger body should not be seen as a flaw, it is part of human diversity. It is also not possible for most people to significantly change their natural size or shape in the long-term without significant consequences to their psychological or physical wellbeing.

2.     If you have a child or teenager and you notice any dieting behaviours, ask yourself honestly whether your own weight-bias may be clouding your opinions of what’s going on. If they were a different shape or size would you respond differently? It’s important to see the behaviours for what they are, without letting ingrained fears your child “should” be a certain shape or size get in the way.

3.     Reflect on how food is spoken about within the home – how does labelling foods as “good” or “bad” or “healthy” or “junk” impact your child or teen’s perceptions of these foods and of themselves if they enjoy or eat them?

4.     Actively encourage behaviours which increase psychological and physical wellbeing such as sleep, seeing friends, eating a balanced diet from all food groups and moving their bodies for enjoyment or because it helps them feel strong or energised, rather than to change their weight or shape. 

5.     Take a firm stance against behaviours which are damaging. Unless there is a clear medical reason explained by a doctor who is aware of their own weight-bias, no teenager needs to diet no matter what their natural shape or size. See a weight-neutral dietitian if you have concerns about how to help your child or teen nourish their body in a way that fosters true wellbeing.

6.     Be aware of what your teen is viewing on social media. Are they continuously exposed to material which reinforces weight biases and social stigma? Heavily filtered pictures or videos? “Fitspo” sites? Material which perpetuates a narrow and unrealistic view of what a healthy, natural body really looks like? If so, navigate boundaries around social media usage, or talk openly with them about how they feel about themselves when they view these things. Discuss how they can block certain things from their feed and fill it up with more body positive (or non-body-related!) material instead.

7.     Be aware of your own anxiety and how this impacts your behaviours. If you have struggled with body acceptance or felt stigmatised because of your own weight or shape, is it possible your desire to protect your child from similar pain is causing you to buy into cultural messages that they “should” be a different size to what they naturally are? If so, how does this change your behaviour around food or around them?

8.     Be mindful of over-focusing on being “healthy”. In a vulnerable teen who is not comfortable in their own skin there can be a fine line between encouraging behaviours that genuinely increase their wellbeing, and inadvertently sending messages that fuel patterns of guilt, shame, or disordered eating thoughts and behaviours!

9.     If you’re concerned they may have an eating disorder get help early. Eating disorders are complex and often difficult to treat. And they are potentially fatal. The best defence is early intervention before the behaviours become more ingrained or their physical health deteriorates further.

10.  Let go of your own guilt. There is no evidence to suggest parents are to blame for a young person’s eating disorder. Many teens will not develop eating disorders regardless of what messages they are exposed to, and many more will for reasons we may never fully understand. Eating disorders have many complex factors that intertwine to determine whether someone develops one. There is no one proven “cause”. Let go of guilt and instead focus on helping your child learn to love and accept themselves whatever body they are in!

Depression in Men

1 in 8 men will experience depression at some point in their life. It is often said that men do not get appropriate diagnosis and treatment for mental health issues because they do not present to their doctor for such issues. While this may be true in some cases, a recent study from the University of Adelaide showed that men with depressive symptoms do in fact engage with their GP, and those with more significant depressive symptoms engage more frequently than men with low-average symptoms. This suggests that, while men are apparently presenting with significant depression, how they are presenting is somehow not being readily identified as depression. The problem of linking the symptoms of depression in men, to identifying their depression, could be for a number of reasons. However, some important (and overlapping) factors are likely to be at play here:

1.    Men’s experiences of depression seem to be different from women’s.

2.    Men’s depression may be characterised by externalising or physical symptoms, such as substance abuse, anger, or risk-taking.

3.    Men are less likely to recognise and identify their depression. Men are more likely to notice and mention their physical symptoms (e.g. tiredness, headaches, weight loss/gain) or behavioural changes (e.g. anger).

4.    Men may communicate differently. They may be reluctant to talk about their symptoms, be unlikely to volunteer information, and downplay the signs and symptoms of depression. However, when they do communicate about their experience, it may be to describe feelings or irritability or anger, rather than saying they feel sad or emotional.

Given these unique characteristics, it is perhaps even more important that there is more general awareness of what depression might look like in men. A good starting point, however, is what depression typically looks like. Someone who is significantly depressed is likely to have symptoms such as:

·       Feelings of sadness, hopelessness or emptiness

·       Extreme tiredness

·       Difficulty sleeping, or sleeping too much

·       Loss of pleasure from activities that were usually enjoyed

Significantly depressed mood is also experienced for most of the day on most days, and the loss of interest or pleasure will encompass nearly all activities, for a period of at least 2 weeks.

In addition to these symptoms, men might experience other signs and behaviours of depression that may not be typically identified as reflecting underlying depression. These additional signs are often characterised by externalising behaviour, due to unhealthy coping strategies that are most typically used by men, and include:

·       Behaviour that is distracting or escapist, such working all the time, or spending a lot of time on sports or video games. Such behaviours can indicate an attempt to avoid difficult feelings and/or relationships.

·       Physical symptoms, such as headaches, stomach problems or chronic pain.

·       Misuse of alcohol or drugs.

·       Irritability, anger, or aggression. This could include violent or abusive (including controlling) behaviour.

·       Withdrawal and isolation from others. 

·       Loss of interest in work, family, sex, going out, sport or other interests.

·       Risk-taking behaviour.

While men, like women, may develop depression for a range of reasons, there are specific factors that might elevate their risk of depression. These include:

·       Problems with physical health, relationships or work

·       Changed living circumstances, such as might be caused by a separation or divorce

·       Pregnancy and/or the arrival of a baby

·       Being, or feeling, socially isolated

·       Using alcohol and/or drugs

Why is all of this important?

By knowing what the risk factors are for men developing depression, and being aware of the specific signs and behaviours that may reflect underlying depression in men, it is more likely that men and those around them will accurately identify mental health concerns, and appropriate treatment may be accessed. 

While many men may find it difficult to ask for help when experiencing symptoms of depression, accessing treatment is important. Ignoring, suppressing or managing depression with unhealthy coping behaviours, generally leads to the symptoms getting worse and the man, and those around him, suffering greatly. It can be devastating in all areas of a man’s life, including his health, career, and relationships. 

It is also notable that men are more likely to complete suicide when significantly depressed, although women attempt suicide more often. This is because men are more likely to use a more lethal method, may act more impulsively, and generally do not alert others to the risk (for example by talking about their suicidal thoughts).

Being aware of the risk factors, signs and behaviours of significant depression in men, having the courage and strength to ask for help, or encouraging and supporting a man you care about to do so, is important and can lead to significant change and improvements in wellbeing. There are many effective treatments available for depression, including medication and psychotherapy. If you or someone close to you thinks you may be depressed, a good starting point is to talk to your GP.

Why Am I Feeling So Angry?

Anger is a powerful emotion – when it’s out of control and acted upon, it can cause intense ruptures and hurt in relationships. We can do things we regret. However, it also propels us towards action – to fight for what we want and what we believe in, and push for change in ourselves and the world around us. It can be very protective. 

Anger (like any other emotion) isn’t inherently ‘bad’ or ‘good’ – it’s simply another way our body and our mind processes and reacts to the world around us, giving us information about life and tools to engage with it.

Increased feelings of anger (experienced in a mild form such as being more irritable or frustrated, all the way through to periods of intense rage) is a common symptom of a few mental health diagnoses or conditions. Anger is famously one of the ‘five stages of grief’. It is listed in the Diagnostic and Statistical Manual (DSM) as a symptom of Depressive Episode. It is a common reaction to trauma, significant change, or prolonged stress. The physiological effects of Anxiety Disorders can produce increased agitation and make us feel ‘on edge’. Sleep deprivation (as a result of Insomnia or another condition) reduces our regulatory capacity and can give us a ‘shorter fuse’, make us more reactive and susceptible to anger. 

Noticing our own anger can be a helpful barometer for how we’re going. Because of how physiological an anger response can be (increased heart rate, sweating, shaking, increase in body temperature, raised voice, clenched fists, muscle tensing, racing thoughts, ruminating, flushed face…) it can sometimes be easier to pick up than other symptoms. It can be tricky to admit that we’re struggling with anger, but raising it with your Psychologist, a doctor, or a friend or family member can be a good starting point. 

‘The Anger Iceberg’ is a model I often cover in therapy with clients who report struggling with anger. The Anger Iceberg is a concept from the Gottman Institute (a well regarded organisation from the US that produces research and clinical resources regarding healthy relationships). It’s a pretty simple concept that suggests that, like an iceberg, anger has two parts – the part we can see and the part we can’t. 

Our experiences and expressions of anger – being frustrated, irritable, annoyed, pissed off, enraged – are the tip of the iceberg (the part above the water). But below this emotion, there’s a lot more going on below the surface; anger is just the part that comes out or ‘spills over’. 

This is because anger is often a secondary emotion – it is a response or product of another emotion. Some examples of secondary emotions – I might feel happy when I cancel plans, and then feel guilty that I felt happy. I might feel worried about meeting someone new, and then feel frustrated at my worry. I might feel scared about flying on aeroplanes, and then feel embarrassed at my fear. 

When we look ‘under the water’ into the hidden part of the anger iceberg, we often see that anger is a split-second, subconscious response to a range of other feelings, thoughts, and experiences. But because anger is such a powerful emotion, we often don’t notice what is first driving it. All we can focus on is the frustration or outrage!

The part of the iceberg that is unseen, or the experiences that drive anger, might be a range of feelings or thoughts; 

• feelings such as sadness, grief, loss, confusion, loneliness, guilt, shame, pain, hurt, fear, insecurity, stress, numbness, jealousy, or vulnerability

• thoughts, such as “I’m being ignored”, “I don’t have control”, “I’m not being heard”, “I’m unsafe”, “I’m exposed”, “I’m stuck”, “I don’t know what to do”, “I’m disrespected”, “I’m trapped”, “I’m excluded or abandoned”, “I’m not supported”

The thoughts and feelings that drive anger can be triggered by a range of experiences: isolation, injustice, powerlessness, overwhelm, changes or transitions. As mentioned above, trauma and mental health conditions, along with simple physiological states (hunger, tiredness, stress, being under the influence of substances) all make us more susceptible to reacting with anger, or even using anger as a coping mechanism. 

Therefore, part of addressing anger is understanding what is driving it. We might need to ask ourselves; what’s below the surface here?

Often it’s best to do this self-reflecting when we’re in a cool, calm headspace. Anger can impact our ability to use our pre-frontal cortex, which is involved in reflective thought, so it’s hard to truthfully answer this question in the heat of the moment! If you’re noticing yourself getting more irritable or angry, plan some time when you’re alone or with a trusted person to reflect on the circumstances in which you often feel that way; look for patterns or common themes; ask yourself what deep parts of yourself might be being triggered?

I work with many teenagers and their parents. Both being an adolescent and parenting an adolescent can be ripe for anger! Teenagers are often angry at their parents; parents are often angry at their children. When we delve deeper here, we often see that frustration comes when parents feel like they’re not being listened to, and this transition from being respected by their children to ignored feels incredibly isolating. Often parents are deeply worried about their children, and this drives their frustration with their choices or decisions. Likewise, teenagers often feel micro-managed by their parents – simple comments such as “have you cleaned your room?” or “where are you going?” can trigger anger because they create a feeling of being mistrusted or undervalued. Often arguments can be softened (perhaps even avoided!) if we learn to identify what’s below the frustration and communicate those feelings or thoughts instead. 

There are many strategies that can be used to address chronic, acute, or harmful anger. Common examples including ‘time outs’, deep breathing, exercise, or cold water. It’s important to address your anger if you recognise that it’s starting to impact others or yourself. However, strategies to address anger work best if we can identify the exact root emotions contributing to the anger in the first place!

Do you think to avoid your feelings?

This might sound like a strange question, but many people describe themselves as spending a lot of time thinking about things in great detail. This isn’t necessarily a problem in itself, as for some people reflecting, analysing, planning, and problem-solving can be major strengths that serve them well in many areas of life. At other times though, this tendency to spend a lot of time inside our heads “thinking” about things can be less helpful. It can sometimes take us away from actually experiencing life, and often serves a function of helping us to avoid “doing” or “feeling” instead when those things feel uncomfortable!

Difficulty identifying feelings is also surprisingly common. Many people may find it challenging to accurately work out exactly what they are feeling. Most of us have a good sense of whether we’re feeling “good” or “bad” or even whether we’re angry, happy, or sad, but once we start exploring the subtle nuances between different feelings it gets a lot more challenging!

For example, it can be really hard to work out whether what we’re feeling is resentment? Or perhaps frustration? Or rejection? Or irritation? or betrayal? Or any other number of closely related yet slightly different emotions.

What often makes the process particularly hard is that for most of us, avoidance of painful or unpleasant feelings is a strategy we may use in order to cope, to function, or to get things done. Sometimes it comes from a history of trauma, or from being told we “shouldn’t” feel what we feel, or from beliefs that emotions are unhelpful and only hold us back in life. Sometimes we simply tell ourselves we’re too busy to stop and reflect on our feelings, or that it’s a waste of time! But by avoiding our feelings we miss out on valuable information and shut down opportunities to connect with what matters to us on a deeper level.

At times it’s obvious to us, or to others, that we are engaging in avoidance of our feelings. For example, we might assert we’re fine when we’re clearly not, or we might engage in strategies like comfort eating, drinking, binge-watching Netflix, or avoiding tasks that trigger anxiety or stress. Many of these times we are well aware that we are trying to distract ourselves from the emotions we don’t want to feel.

A more subtle form of avoidance, however, can be staying in a “thinking” space rather than connecting with our emotions or the physical manifestations of them. So maybe we are really good at identifying cognitively “I’m angry”, “lonely”, or “stressed” and yet we find it really hard to actually turn towards feeling these feelings. To actually notice and make room for the emotions in our body. Afterall, to move towards those feelings requires immense courage in allowing ourselves to be vulnerable to the pain that often shows up.

So instead, we ask “Why do I feel this way?” “What’s wrong with me?” “Why won’t these feelings ever go away?” Or we vent to others about our problems yet never feel a sense of anything being resolved. We may analyse our feelings from a cognitive space, looking to rationalise our experiences or search for answers in the hope we will suddenly stop feeling what we feel. But sometimes it’s not that easy. Even if we intellectually know why we feel the way we do, it doesn’t always change the feelings themselves. 

Or perhaps we engage in all these mental strategies like worrying, planning, predicting, preparing and analysing – All sneaky ways of keeping us in a cognitive space so that we don’t need to actually feel what we don’t want to feel!

If you suspect you “think“ your feelings rather than actually feeling them, or you rationalise or analyse your way through life, or perhaps avoid all kinds of uncomfortable internal experiences through other means of distraction, the following may be helpful!

1. Start when you’re relatively calm and start small. There’s no need to launch into 30-minute meditations unless you truly see the benefit or have practiced it before! Instead, you could try pausing and simply checking in with yourself and asking yourself “what am I feeling right now?”. 

2. The next step could be that instead of simply labelling it, try to allow yourself the space to notice how that feeling feels in your body. What do you notice about your posture, heart rate, facial expressions, sense of lightness or heaviness, sensations in your tummy or muscles etc?

3. Remind yourself it’s ok to feel whatever you’re feeling. Your feelings make sense in the context of your life and whatever shows up shows up. There are no “wrong” feelings.

4. If uncomfortable feelings are there, notice that even as those feelings are present you are still in control of your body. You can stretch, push your feet into the floor, take some deep breaths and ground yourself in the moment without needing to push those feelings away.

5. Spend time noticing how emotions are like waves that rise in intensity, and come down by themselves, even if we “do nothing”. This requires some practice as the temptation is often to act upon the emotion or do something to get rid of it. But just like a wave is often highest right before it breaks, sometimes our emotions also reach a peak before dissipating shortly afterwards. Especially if we allow them to be there, accept them willingly, and do not try to suppress them. No feeling lasts forever, and if the same ones keep showing up, approach them with curiosity. Perhaps there is a message they’re trying to tell you that you’re busy ignoring by shutting them down?

6.  If you notice you have a tendency to over-analyse, worry, plan, or prepare, next time you spot yourself doing it simply pause. See if you can identify what you’re feeling in that exact moment. Is there a sense of discomfort you’re trying to escape from? If so see if you can name it, observe what it’s like, and make room for it.

7.  If you notice a really strong urge to avoid uncomfortable feelings by engaging in unhelpful behaviours just STOP. 

   Stop. 

   Take a step back. 

   Observe what’s happening both inside and outside of yourself. 

   Proceed Mindfully. 

   This is a great skill from DBT that enables us to pause and notice what’s happening, and then choose to how to respond rather than just reacting. It won’t come naturally at first, but over time it can become much easier! 

8. When you’re calm, ask yourself whether the actions you often engage in to avoid feeling your feelings really move you closer towards the life you want for yourself? Do they really “work” in the long-term to add value to your life, or does the avoidance come with consequences to you that make life more difficult or keep you stuck?

9. Know that you’re not alone and its human to try to escape pain. We all do it! It’s not a sign you’re weak or defective in some way, it’s your brain’s way of trying to protect you! Emotional pain can be just as unbearable as physical pain when it is intense. It takes courage to open yourself up to the vulnerability that comes with feeling your feelings!

10.  Practice self-compassion! Acknowledge the pain that shows up sometimes. It is a moment of suffering, and it’s the very essence of humanity to feel in this way. Can you hold yourself gently and be kind to yourself in these moments of pain? What do you most need to hear in these moments and can you try saying it to yourself? Again, it may feel weird and unnatural at first, but over time, responding to your own pain and discomfort with kindness, nurturing, and self-love can make these feelings a lot more bearable than kicking yourself when you’re down by invalidating your own feelings or trying to pretend they’re not happening!

None of these steps are easy, but through practicing openness, acceptance, and compassion for ourselves no matter what feelings show up, we can learn to stop fearing our emotions. Instead we can see them as powerful allies that can enrich our lives, open us up to a full range of experiences, and connect us to a deeper understanding of ourselves in a way that cannot always be achieved through “thinking” our feelings rather than simply feeling them!