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Treating Trauma With Eye Movement Desensitisation and Reprocessing (EMDR)

Treating Trauma With Eye Movement Desensitisation and Reprocessing (EMDR)

Fear resulting from psychological trauma can be extremely deep-seated. The distress, feelings of helplessness and constant flashback of traumatic events can turn one’s world upside down, causing major problems with daily activities and quality of life. It may be easy for someone to say, “Well, why can’t you just get over it?” But in reality, we need to recognise that it is much easier said than done. In order to help people move past their traumatic experiences, researchers and psychologists have worked tirelessly, creating various therapeutic methods and tweaking them to achieve the optimal recovery outcome. In regards to the treatment of post-traumatic stress disorder (PTSD), you may be familiar with an approach known as Dialectical Behavioural Therapy. In this article, we’ll be introducing you to an alternative psychotherapy technique, also known as Eye Movement Desensitisation and Reprocessing (EMDR).

Developed by Francine Shapiro in 1987, EMDR therapy is an empirically validated treatment for trauma and other negative life experiences. While it is also increasingly applied for the treatment of other mental health conditions such as depression, anxiety or panic attacks, researchers have not found EMDR to be as effective as with trauma-related conditions. As its name suggests, EMDR isn’t all about talk therapy or medications. In a different vein from cognitive behavioural therapy, EMDR doesn’t focus on altering a client’s thought patterns or behaviours. Instead, it relies on one’s own rapid, rhythmic eye movements, allowing the brain to process memories and resume its natural healing process. 

What is the Basis of EMDR Therapy?

EMDR is fundamentally based on the Adaptive Information Processing (AIP) Model. A key tenet of this model is that the symptoms of PTSD are manifested due to memories that are dysfunctionally stored or not fully processed. Memories of disturbing experiences often string along negative emotions, thoughts, beliefs and even physical sensations that were associated with them at the time of occurrence. This can bring about a multitude of unpleasant symptoms that can be exceptionally detrimental to one’s mental health. 

When one is exposed to stress or trauma, the body’s automatic response would be to activate its Sympathetic Nervous System (SNS). As an adaptive system, it controls our natural fight, flight or freeze instincts, which is critical in ensuring our survival. When the SNS is activated, the individual will undergo physical alterations such as increased heart and breathing rates, decreased blood flow to the digestive system and constricted blood vessels. In addition, hormone levels including those of adrenaline and cortisol will increase dramatically, causing hypervigilance. However, for someone who is under constant stress from traumatic flashbacks, the over-stimulation of the SNS will be greatly damaging to this person’s physical health. As such, EMDR therapy aims to process memories such that the experience is remembered, but the fight, flight or freeze response is eased. 

At this juncture, you may be wondering how clinician-directed eye movements could possibly alleviate trauma-induced stress. EMDR therapy involves guiding the client towards reliving triggering experiences in short phases while the clinician directs his eye movements. During the process, the client will be tasked to focus on trauma-related imagery and the relevant sensations. The clinician will then simultaneously move their finger across the client’s field of view, with each phase lasting approximately 20 to 30 seconds. This will then be repeated a couple of times. At some point, other forms of rhythmic left-right stimulation (for example, listening to tones that go back and forth between the left and right sides of your head) will also be incorporated into the therapeutic process. As distressing as it sounds, the process in fact allows for the vividness and emotional triggers of the memory to be reduced over time. When the client’s attention is diverted as they recall the traumatic event, this makes the exposure to negative thoughts and memories less upsetting, hence limiting a strong psychological response. After attending several EMDR therapy sessions (depending on the individual), the impact of the traumatic event is believed to be significantly reduced. 

How is EMDR Structured? 

Generally speaking, EMDR takes on an eight-phase approach. 

Stage 1: History Taking and Treatment Planning

For a start, the clinician will work hand-in-hand with the client to identify the traumatic experiences which require attention. Should the client have a problematic childhood, the initial stage of EMDR may focus on resolving childhood traumas before moving on to resolve adult onset stressors. Identifying targets for EMDR treatment is also crucial – this means looking further into the client’s past memories, their current emotional triggers, as well as what they hope to achieve by the end of the treatment phase.

Stage 2: Preparation

In this phase, the clinician introduces the client to a few emotion-coping strategies to ensure that the client is well able to manage their emotional distress whenever a trigger is brought up. It is important that the client is able to deal with overwhelming emotions even between EMDR sessions in daily life. The clinician may also familiarise the client with the eye movements or bilateral stimulations. 

Stage 3: Assessment

The clinician will then identify and assess the specific traumatic memories that need to be tackled. This also involves analysing the associated emotions and sensations triggered by the memories. 

Stages 4 to 7: Treatment Process

These intermediate stages focus on the process of desensitisation, installation, a body scan, and seeking closure. The client is asked to concentrate on the trauma-related imagery and memory while engaged in the directed eye movements or other bilateral stimulation. After each set of stimulation, the client will be asked to clear their mind and report what they feel, think, and the sensations they experience. Depending on the individual, the clinician may have the client refocus on the same memory, or move on to another. This process is repeated until the client reports no distress. 

Installation is where the clinician works with the client to increase the strength of positive cognition. This means focusing on the preferred positive beliefs, rather than negative ones. For example, an individual dealing with trauma arising from childhood domestic abuse may start off with a negative belief of “I am weak and powerless”. Installation aims to change that belief into one of “I am now in control.” Of course, EMDR does not force one to believe in something that is inappropriate or unsuitable for the situation. In the example brought up, allowing the client to realise that positive belief could mean encouraging them to take on self-defence training, or other skills that can provide them with a greater sense of security and control. 

A body scan is used in order to check for any residual somatic response that is linked to event-related tension or stress. Should any undesirable bodily sensations be present, the clinician will then target them specifically in subsequent sets. 

Stage 8: Evaluation

The next EMDR session begins with this phase. This stage is mainly for the re-evaluation of the client’s plight. More importantly, this step is to ensure that the necessary progress is made and to review the client’s psychological state. Further review will be carried out, and the relevant changes will be made to provide the optimal treatment effect. 

Although EMDR may be a relatively new technique as compared to other forms of therapy, it is nonetheless an extensively researched method proven to alleviate the stress symptoms of trauma survivors and other individuals who have had distressing life experiences. If you think that EMDR therapy is right for you, do seek help from a mental health professional.


References:

  1. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing (Accessed 18/03/2021)
  2. https://www.emdr.com/what-is-emdr/ (Accessed 18/03/2021)
  3. https://www.emdria.org/about-emdr-therapy/ (Accessed 19/03/2021)
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467776/ (Accessed 20/03/2021)
  5. https://anxietyreleaseapp.com/what-is-bilateral-stimulation/ (Accessed 20/03/2021)
  6. https://hornsveldpsychologenpraktijk.files.wordpress.com/2019/01/full-8-phase-explanation.pdf (Accessed 20/03/2021)
Suicide Risks for Persons with Addictions

Suicide Risks for Persons with Addictions

Written by: Juliana Pang, Therapist

Caregivers with a family member affected by addiction problems are often exhausted, drained dry of their empathy and compassionate capacities.

They recount countless cycles of suspended hope followed by just as many broken promises as they watch the affected person return time and again to their compulsive addiction despite a seemingly obvious trail of destruction behind them.

Caregivers learn to cope with the endless demands on their energies by blending the words uttered by the affected persons as a cocktail of lies, manipulation and attention-seeking antics to get what they want.  In time, the cries for help from the affected person turn into cries for help by the boy who cried wolf and eventually fading into indistinguishable white noise.

Professor Lisa Firestone of the Glendon Association observes that there is a natural tendency for caregivers to minimise any suicide expressions in general.  Responses such as, “Well, his past attempts weren’t serious.” or “He is just manipulating to get something.” are commonly observed.  There is also a general tendency to not want the expressions to be true.  In the case of addicts, words such as “I want to die” or “I am going to end my life” no longer convey the same meaning or gravity of their sense of desperation.

Why should we want to pay attention to an addict’s cry for help?

In Singapore, we lose 1.1 lives every day to suicide.  It is still the leading cause of death for youths aged 10 to 29.  While direct correlation evidence is still being researched on, studies in America have shown that more than 90% of people who kill themselves suffer from depression have a substance abuse disorder or both. Suicidality and addiction share a high concordance relationship.

When we overlay the statistics with a physiological lens, we note that both groups of persons have been observed in studies to have a dysfunctional hypothalamic-pituitary-adrenal (HPA) axis which essentially controls our body’s response to stress.

In a person with a normal functioning HPA axis, on the reception of a stressor, the hypothalamus in our brain instructs the secretion of the corticotropin-releasing factor (CRF) and vasopressin to stimulate our pituitary glands to produce the adrenocorticotropic hormone (ACTH).  The ACTH, in turn, stimulates glucocorticoid synthesis and release (commonly referred to as cortisol) from the adrenal glands.  This chain reaction provides a person the increased energy to handle the stress event and to do so without suffering from the pain and fatigue.  When the stress event is gone, the body produces a negative feedback loop which then brings the body system back to homeostasis.

In a person exposed to a persistent or extreme level of stress, or in a person who frequently activates the HPA axis through substance use, the body starts to blunt the sensitivity of the HPA axis and blunt cell receptivity to cortisol in its efforts to return to and maintain homeostasis.  This alteration to the sensitivity of the HPA axis affects our ability to tolerate physical and mental stresses and creates a need for a much bigger stimulus to activate the HPA axis (which may mean higher dosage of substance use); and when the HPA axis does react, produces a much bigger and exaggerated response (which may translate to more aggressive behaviours).

What Does This Mean In Practical Terms?

Many suicidal persons described having a voice in their head which is constantly there; telling them how much they need to seek fulfilment and comfort by reaching for the desired stimulus, whether it be a substance or a behaviour, of which one is killing themselves.  Their mind starts to command them to constantly plan, to seek out and to take actions to soothe the unbearable lack that they are feeling.  Eventually, the voice in the head goes from coaxing and persuading to being more intensive and aggressive towards the self to take immediate drastic actions.

The relief of death, a final refuge, becomes alluring and pleasurable and the fear of dying eventually transforms into the fear of not dying and becoming the loser, disappointment, and burden that they already believe themselves to be to their caregivers.  This dual push towards drastic action and the need for an ever-increasing amount of substance in addicts leads to an increase in the risk level of suicidality.

What Can We Look Out For?

How then does the caregiver separate the wheat from the chaff amid the chaos that addiction has already wrought onto the family system to detect the risks of suicidality?

Below are some, though not exclusive, common markers to look out for. It is particularly useful to note changes in the content of the affected person’s expressions and any escalation or sudden extinction of intensity.

  • Mood
    • Intense Emotional Outbursts
    • Extreme Isolation or Withdrawal
    • The feeling of Being a Misfit in Every Way
  • Speech
    • Hopelessness
    • Helplessness
    • Worthlessness
  • Behaviour
    • Researching or Procuring Means of Suicide.
    • Self-Harm, Including Risky Substance Use or Behaviours.
    • Planning of Affairs.
  • Presence of Trigger Events
    • Loss of Primary Relationship.
    • Physical or Mental Health Conditions That Debilitate.
    • Abuse or Trauma Events.
What Can Caregivers Do On Observing The Signs?

Ask the Suicide Questions:

  • In the past few weeks, have you ever wished that you were dead?
  • In the past few weeks, have you felt that you or your family would be better off if you were dead?
  • In the past week, have you made plans about killing yourself?
  • Have you tried to kill yourself?

If the answers are yes to any or to all the questions, caregivers are encouraged to take the following first steps:

  • Be empathetic towards the suicidal wish.
    • The objective is not to agree with the act of suicide but to understand what has happened to lead the affected person to the conclusion that suicide is the only solution.
  • Find a genuine connection with the affected person.
    • However difficult that person might have been in your life, express what this person means to you personally and how the loss of this person would affect you.
  • Make a safety plan.
    • Ask the affected person to agree to not take or delay any action to harm themselves until they get to or you get them to professional help.

In these situations, working with professional therapists can help the affected person build up their sense of self, adjust unhelpful beliefs towards the whole life experience, reignite their sense of being a valued part of humanity and community, develop skills to cope with life’s stresses and build a treatment and recovery plan for any inter-connected problems such as their addiction problems.

Professor Lisa Firestone observes that suicidal persons are generally ambivalent: a part of them wants to die but a part of them wants to live as well.  There is often a process of the dividing up of the self within the person, between an aspect which is life affirming and engaging with the outer world; and the anti-self, which is self-critical, self-hating and ultimately suicidal.  The key to recovery is to connect with and help strengthen that part of them that wants to keep on living.


1 Glendon.org. 2021. Understanding & Preventing Suicide – DVD « The Glendon Association. [online] Available at: https://www.glendon.org/product-post/understanding-preventing-suicide-dvd0/

2 Sos.org.sg. 2021. Suicide Facts and Figures | Samaritans of Singapore (SOS). [online] Available at: https://www.sos.org.sg/learn-about-suicide/quick-facts

3 Addiction Center. 2021. Addiction and Suicide – Addiction Center. [online] Available at: https://www.addictioncenter.com/addiction/addiction-and-suicide/

4 Goeders, N., 2003. The impact of stress on addiction. European Neuropsychopharmacology, 13.

5 Glendon.org. 2021. Understanding & Preventing Suicide – DVD « The Glendon Association. [online] Available at: https://www.glendon.org/product-post/understanding-preventing-suicide-dvd0/

6 Dazzi, T., Gribble, R., Wessely, S., & Fear, N. (2014). Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychological Medicine, 44(16), 3361-3363. doi:10.1017/S0033291714001299

7 Glendon.org. 2021. Dynamics of Suicide: An Interview with Dr. Israel Orbach « The Glendon Association. [online] Available at: https://www.glendon.org/product-post/dynamics-of-suicide-an-interview-with-israel-orbach/

8 Glendon.org. 2021. Understanding & Preventing Suicide – DVD « The Glendon Association. [online] Available at: https://www.glendon.org/product-post/understanding-preventing-suicide-dvd0/

9 Glendon.org. 2021. Firestone, R.W. – The “inner voice” and suicide « The Glendon Association. [online] Available at: https://www.glendon.org/resource/firestone-r-w-the-inner-voice-and-suicide/

Photo by Francisco Moreno on Unsplash

Stress – What It Really Is & How To Manage It.

Stress – What It Really Is & How To Manage It.

Stress is something we can never escape from, be it good (eustress) or bad (distress). From the small, tedious daily hassles to long-term occurrences that weigh on your mind, stress can impact us in different ways, and the experience varies for everyone. Just as how different individuals have differing levels of pain tolerance, the same applies for stress.

Stress comes in many forms, but they can be largely categorised under ‘environmental’ (e.g noise), ‘social’ (e.g family demands, friendship conflicts), ‘physiological’ (e.g sleep disturbance) and ‘cognitive’ stressors (e.g low self-esteem, high expectations of oneself). While a certain level of stress may be necessary to provide motivation and encourage positive growth, excessive and unhealthy levels of stress especially in the long-term may cause undesirable mental and physical health consequences:

Psychological Impacts Physical Impacts
Mood swings Disrupted sleep patterns / insomnia
Undue anxiety or fear Hyperventilating
Difficulty concentrating / forgetfulness High blood pressure
Disorientation Nervous behaviours such as teeth grinding or nail biting
Increased frustration and irritability Nausea
A racing mind / constant worrying Poor eating / digestive upsets
Poor decision-making processes Increased heart rate / rapid breathing
Low self-esteem Sweating / sweaty palms
Sense of helplessness Muscle tension
Apathy Restlessness / fatigue

 

When stress becomes chronic, physical health consequences can definitely worsen, and an individual may also develop depression or anxiety disorders. As such, while there is no one-size-fits-all, this article aims to provide useful tips and suggestions on how you can better manage your stress levels, and to avoid being overwhelmed and giving in to chronic stress.

To guide us along, there are two main types of stress-coping mechanisms – ‘Problem-focused’ and ‘Emotion-focused’ coping. These are possibly the most basic approaches to healthy stress-coping, and aim to reduce or eliminate the causes of stress, apart from merely alleviating its symptoms. 

Problem-focused Coping

Problem-focused coping is where action is taken to clarify and resolve the stressor directly, and hence addresses the demands of a given situation. An example of this method of coping is when a student who is worried over an upcoming examination copes by attending more review sessions and reading up on her course materials diligently. This serves to reduce her anxiety and increase her confidence to excel in her examination. A problem-focused mechanism is primarily used when one appraises a stressor to be within his capacity to change, and hence makes the appropriate adjustments and alterations to cope with the impending demands. As such, it is also important to learn how to identify the root cause of the direct stressor before responding to it accordingly. 

Emotion-focused Coping

Emotion-focused coping may be a concept that you find familiar. Unlike problem-focused coping, emotion-focused coping involves making efforts to regulate your emotional response to a stressor. This means identifying your feelings, focusing and working through them. According to Folkman and Lazarus (1980), such a mechanism can be extremely helpful especially when you need to work through your emotions before you can think clearly enough to act rationally. Emotion-focused coping can be done in various forms such as:

  • Venting or talking to a friend / close oneWhenever you feel stressed or overwhelmed, bottling up may not be the best way around. Talking to others about what’s bothering you could bring great relief, and perhaps they could also provide you with the constructive feedback or encouragement that you need.  Physical affection, such as hand-holding and hugs can help combat stress too. Just as how others may come to you whenever they need support, don’t be afraid to lean into your social circle and find comfort in your friends. Of course, do also remember to be mindful of your friends’ emotions and needs while you’re busy venting!

 

  • Journaling
    In this digital age, perhaps Journaling may come across as a rather old-fashioned way of coping with your emotions. Many a time, people would rather distract themselves and destress by playing mobile games or browsing through social media as and when they are feeling stressed. Although those can be a possible methods of destressing, the beauty of journaling shines through when you give yourself some time to reflect and balance yourself by creating your very own safe space. Writing in a journal can help you clear your mind by releasing any pent-up feelings, to let go of negative thoughts, as well as to enhance your self-awareness as you write about your progress.

 

  • Meditation
    Practising mindful meditation is an effective strategy to combat stress, for it can help you eliminate the stream of jumbled thoughts that are contributing to your heightened stress levels. Studies have shown that training in mindfulness can potentially increase your awareness of your thoughts, emotions, and maladaptive ways of responding to stress, therefore allowing one to cope with stress in a healthier and more effective way (Bishop et al, 2004, in Shapiro et al, 2005). With guided meditations that can easily be found online, all you need to do is to set aside some time for some mental self-care.

 

  • Reframing the situation and finding meaning in it
    When we are stressed, we often only focus on the bad and how much we dread a particular situation. However, it can be helpful to look on the bright side and to find the benefit and meaning in a stressful event. By doing so, we can make these experiences a little more tolerable, as well as to grow and build resilience as we go along.

 

Other Means of Coping with Stress

Last but not least, pay more attention to your diet and nutrition intake. For some of you, caffeine is a must-have on a daily basis, with some people having four to five cups of coffee per day. However, when you combine stress with the artificial boost in stress hormones from caffeine, this creates a significantly compounded effect. While caffeine can be particularly effective in providing you with the short-term energy boost and increased alertness, it can potentially heighten stress levels in the long-term. As such, it is always good to consume it in moderation and to be mindful of your caffeine intake. In addition, you may want to consume foods rich in vitamin B, which can help to reduce stress responses in your body.  

As previously mentioned, everyone experiences life events in their own unique way, and a strategy that works for you may not for others. With that said, we hope this article has helped you to understand the various ways to combat stress better, and that you find the strategy best suited for you. However, if you ever find yourself struggling to cope with stressful life events, do reach out to one of our psychotherapists or counsellors for help.


References:

  1. Zimbardo, P. G., Johnson, R. L., & McCann, V. (2017). Psychology: Core Concepts (8th ed.). Pearson. (Accessed 25/11/2020)
  2. Shapiro, S.L., Astin, J.A., Bishop, S.R., & Cordova, M. (2005). Mindfulness-based stress reduction for health care professionals: results from a randomised trial. International Journal of Stress Management, 12 (2), 164-176. (Accessed 25/11/2020)
  3. https://dictionary.apa.org/problem-focused-coping (Accessed 25/11/2020)
  4. Photo by Tim Gouw on Unsplash
What Are Anxiety Disorders and How Do They Affect Us?

What Are Anxiety Disorders and How Do They Affect Us?

We are no strangers to feelings of anxiety – at certain stages of our lives or in particular situations, we would have experienced anxiousness and worry with relation to our careers, studies, relationships and even our environment. However, anxiety levels may go beyond the healthy norm for some people, and may instead develop into anxiety disorders that may have a debilitating effect on their lives. According to the American Psychology Association (APA), an individual who suffers from an anxiety disorder is described to have “recurring intrusive thoughts or concerns”, where the duration and severity in which the individual experiences anxiety could be blown out of proportion to the original stressor, resulting in undesirable tension and other physical alterations. In this article, we will be exploring a few types of anxiety disorders as well as how they can manifest within us.

 

Generalised Anxiety Disorder (GAD)

Generalised Anxiety Disorder is a psychological issue characterised by persistent and pervasive feelings of anxiety without any known external cause. People who are diagnosed with GAD tend to feel anxious on most days for at least six months, and could be plagued by worry over several factors such as social interactions, personal health and wellbeing, and their everyday routine tasks. For example, an individual with GAD may find himself experiencing headaches, cold sweats, increased irritability and frequent feelings of “free-floating” anxiety. Others may also experience muscle tension, sleep disruptions or having difficulty concentrating. Often, the sense of anxiety may seemingly come from nowhere and last for long periods of time, therefore interfering with daily activities and various life circumstances.  

 

Panic Disorder

In contrast, Panic Disorders are characterised by the random occurrence of panic attacks that have no obvious connection with events that are co-occurring in the person’s present experience. This means that panic attacks could occur at any time, even when someone is casually enjoying a meal. Of course, panic attacks could also be brought on by a particular trigger in the environment, such as a much-feared object or situation. Some individuals have reported that panic attacks feel frighteningly similar to a heart attack, especially with the rapid increase in heart palpitations, and the accompanying shortness of breath. Other symptoms also include trembling, sweating, and feelings of being out of control. With these panic attacks bringing on sudden periods of intense fear and anxiety, it can be exceptionally terrifying when these attacks reach their peak within mere minutes. However, a notable difference between a panic disorder and GAD is that an individual diagnosed with panic disorder is usually free of anxiety in between panic attacks.  

 

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder is a disorder marked by patterns of persistent and unwanted thoughts and behaviours. Obsessions are recurrent thoughts, urges or mental images that cause anxiety. On the other hand, compulsions are the repetitive behaviours that a person feels the urge to do in response to an obsessive thought or image. One common example often exhibited in films is where an individual has an obsessive fear of germs. This person may avoid shaking hands with strangers, avoid using public restrooms or feel the urge to wash their hands way too frequently. However, OCD isn’t purely limited to feelings of anxiety due to germs. OCD can manifest in other ways as well, such as wanting things to be symmetrical or in perfect order, repeatedly checking on things (“Did I leave my stove on?”), or the compulsive counting of objects or possessions. While everyone double-checks their things and has their own habits, people with OCD generally cannot control their thoughts and behaviours, even if they are recognised to be rather excessive. They can spend at least 1 hour a day on these thoughts and behaviours, and will only feel the much-needed brief sense of relief from their anxiety when they perform their rituals. As such, OCD can be exceptionally debilitating to one’s mental health.

 

Social Anxiety Disorder

Persons with Social Anxiety Disorder, or SAD, experience high levels of anxiety and fear under particular or all social situations, depending on the severity of their condition. They are often afraid of being subjected to judgement, humiliation or rejection in public, causing them to feel embarrassed. As such, individuals with SAD may feel extra self-conscious and stressed out, and try to avoid social situations where they might be placed at the centre of attention.

 

Phobic Disorders

A phobia involves a pathological fear of a specific object or a situation. This means that one may experience intense anxiety upon encountering their fears and will take active steps to avoid the feared object. Phobias may centre on heights(acrophobia), birds (ornithophobia), crowds and open spaces(agoraphobia), and many others. People with agoraphobia, in particular, may struggle to be themselves in public spaces, for they think that it would be difficult to leave in the event they have panic-like reactions or other embarrassing symptoms. In severe cases, agoraphobia can cause one to be housebound. 

 

Options for the treatment of anxiety disorders include medication from a psychiatrist and therapy with a psychologist, psychotherapist or counsellor, and anxiety disorders can be treated with either one or both methods. While medication does not cure anxiety completely, it helps to relieve its symptoms, allowing the individual to cope better. Psychotherapy methods such as Cognitive Behavioural Therapy can be particularly effective as well, for it aims to help victims of anxiety disorders change their way of thinking, behaving, and their way of reacting to certain anxiety-causing stimuli. 

 

It is important for us to recognise that seeking treatment for anxiety disorders is crucial, especially if it hinders or interferes with our daily life. While one may choose to adopt the “I can handle it myself” attitude – perhaps due to any pre-existing stigma or societal expectations –  we need to acknowledge that we will ultimately be worse off if we do not seek help early. Don’t struggle alone, talk to us about ways to manage your anxiety and find the support you need.

 


References:

  1. https://www.apa.org/topics/anxiety (Accessed 03/12/2020)
  2. https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml (Accessed 03/12/2020)
  3. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml (Accessed 03/12/2020)
Photo by engin akyurt on Unsplash
Managing Anxiety And Depression During Festivities (especially during the COVID season)

Managing Anxiety And Depression During Festivities (especially during the COVID season)

Written by Jane Low, Senior Psychologist

Christmas is a time of giving, peace and joy. It is also a time to celebrate traditions where family and friends gather, feasting on Christmas goodies and exchanging presents. There are scents, sights and sounds that are familiar to Christmas time where individuals can form a strong attachment with. Therefore, such festivities may likely trigger strong memories and feelings within some of us. The feelings of loss, people being away from us, losing contact with others are examples of bittersweet memories that one can have during festivities like Christmas. 

A past memory can also trigger different memories and they can become potentially difficult to process. Some may experience sadness when remembering a lost loved one, while others may feel anxious to attend social gatherings.

Living in a pandemic, things have slowed down considerably, and feelings of loneliness have intensified because of a lack of stimulation in our environments as well as physical interactions with others. In sum, we have been inside our own cocoons. A quieter Christmas this year may also mean a heightened sense of loneliness, anxiety and depression. Here are some ways to cope with some of these unpleasant feelings you may experience during this festive season. 

Legitimising those feelings

Recognise and acknowledge that you may experience some unpleasant feelings such as anxiety and sadness this Christmas. Take the time and show some kindness to yourself. Take your time to feel some of these things that are missing in your life. You can write those thoughts and feelings down in a journal or confide in a trustworthy family member or a close friend. If you find it difficult to cope with these feelings and feel overwhelmed, please make an appointment and talk to a health professional (e.g. psychologist or counsellor) about what you are going through.

Reflecting on your values

Connecting with your values can help you to achieve some meaning and purpose in life. Think about what makes your life worthwhile and the values that matter most to you. Some questions to ponder: how do we want to be as a person, what do we want to stand for, and how do we want to connect to the environment around us. For some, feeling positive emotions and being optimistic are important, while for others, engaging in enjoyable and pleasurable activities (e.g. playing the guitar) are meaningful to them. Other individuals may also focus on social relationships with others and some may derive their sense of satisfaction by celebrating their personal accomplishments. When you navigate through life with your values, you will not only experience great inner strength and joy, but you will also have a meaning and purpose which will help you to tide through life’s challenges. 

Maintaining a healthy lifestyle

Looking after yourself physically also helps you to look after yourself mentally which will benefit your overall wellbeing. A good night’s sleep and keeping a balanced diet are both equally important. Having at least eight hours of sleep every night and consuming a diet filled with fruits and vegetables can be helpful for your body. Additionally, exercising at least thirty minutes a day also helps to keep your mind active, leading to a healthier body. Do also, keep yourself hydrated with plenty of water. All these help maintain a healthy lifestyle. 

In closing, try not to dwell on things that have not worked out. As we live in unprecedented times, things can easily interrupt our daily routines. Focus on smaller and more manageable tasks and when you do achieve them, remember to celebrate your small victories! Here is an anonymous quote that I saw at a doctor’s clinic waiting area: “Life is too short to wake up with regrets – so love the people who treat you right, forget about those who don’t believe everything happens for a reason. If you get a chance, take it. If it changes your life, let it. Nobody said life would be easy. They just promised it would most likely be worth it.”

 


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