Transcranial magnetic stimulation (TMS) uses a targeted pulsed magnetic field, similar to what is used in an MRI (magnetic resonance imaging) machine. While the patient is awake and alert, NeuroStar TMS Therapy stimulates areas of the brain that are underactive in depression.2
NeuroStar TMS Therapy is an in-office treatment that takes 37 minutes, is performed while the patient sits in a chair, and is administered five days a week, for up to four to six weeks.
Simple steps for NeuroStar TMS Therapy:
Step One: The patient reclines comfortably in the treatment chair, awake and alert
Step Two: A small curved device containing the magnetic coil rests lightly on the patient’s head
Step Three: The device delivers focused magnetic stimulation directly to the target areas of the brain
Step Four: The patient can immediately resume normal activities
During treatment, the patient hears a clicking sound and feels a tapping sensation on the head. The most common side effect is generally mild-to-moderate pain or discomfort at or near the treatment area during the session. When this occurs it is temporary, and typically occurs only during the first week of treatment.
There are no effects on alertness or understanding; patients being treated with NeuroStar TMS Therapy can drive themselves to and from their treatment sessions. Above information is taken from: https://neurostar.com/neurostar-tms-depression-treatment/
As I mentioned in my first article, the phrase,”reverse roles” was very much what I heard at my first psychodrama workshop. As this was uttered by the group leader, two people on the stage switched places and began playing the opposite role.
“This is it! “, I thought as I began to think of how I could use it in my work. Get people to reverse roles and voila! Well I was sorely mistaken those many years ago. As I began to explore this fascinating form of group work I discovered several techniques that are used in Psychodrama. Here are two key techniques used and an example of how I used them.
Here the Protagonist says a few words in the role of a particular ‘character’ or entity in their drama. The Auxiliary then says these lines to the Protagonist who is in the complimentary role.
In this technique, objects and people are used to represent the scenario the Protagonist wishes to explore.
A Drama using Role Reversal and Concretization
Ken is aged 19, and has a serious problem with drugs and alcohol which he has managed to stop, after going to the alcohol treatment centre. He had just come out of drug rehab in the United Kingdom and was brought to my practice by his concerned father. His father had tried very hard to help him over the years and has now brought Ken to us at Promises. Ken is worried about going out for dinner with his Father and a family Friend, whom we shall call Andy, because he might be tempted to drink again.
I encourage him to enact a scene at dinner with his father and Andy, playing out what he expects to happen. He sets out the chairs and chooses two people in the group to be his Father and Andy. As he greets the two older men rather lethargically, his shoulders slouch and he speaks in a flat voice.
Reversing roles, Ken now plays the part of Andy. He perks up now, smiling and full of energy. ‘Andy’ says, “The last time I saw you Ken, you were a small boy. My how you’ve grown!” Playing the role of his tempter, he urges Ken to “have a drink now as a real man” holding a glass towards him.
Back to being himself after another role reversal Ken’s face reddens and he clenches his fists in agitation. He speaks to me as the Director, saying that he is afraid he might have a relapse. I immediately ask him to take on the role of his father.
As his father, he sits with his arms crossed and says through clenched teeth, “It’s okay, you don’t have to drink. I don’t want to cause a relapse.” As himself, Ken is at a loss for words. I ask the other audience members to do some modeling and try different responses in the role of Ken as he watches.
Ken cheers up as he sees the other group members rising to the occasion. Everyone is animated as they get a chance to act the part and try to tell Andy off. There is much laughter and hilarity as people do and say whatever they think might work. A sort of role training session is underway.
Ken is noticeably inspired by the group and he chooses one response. He stands tall with a cheeky smile and says to Andy, “I’m not drinking today, and I wonder why you are so determined to force alcohol on me!” In role reversal as Andy, he changes the subject and backs down, no longer the magnanimous host. The drama ends. Ken is no longer a deflated doomsday worry wart. Instead he is positive about going out for dinner and knows what he can do later that night at dinner. The group has come to his aid and I once again marvel at the magic of Psychodrama.
In future articles, I shall illustrate more psychodrama techniques with dramas I have directed. It continues to be a privilege to be allowed into the lives of group members and I am continually amazed at the transformations that happen.
At Promises Healthcare, we are committed to helping you through your journey to recovery. Discover a new life and find renewed hope. If you or someone you know needs mental health support, please contact our clinic for inquiries and consultations.
This is a series of article about the Action Method of Psychodrama by Sharmini Winslow.
“Reverse roles!”, the group leader shouted, and two people switched roles on stage and began enacting the opposite part. I was in the middle of my first Psychodrama workshop and all seemed chaotic and yet pleasantly therapeutic. What was going on? My desire to explore psychodrama had brought me here to a large room with a group leader and several very friendly people. Soon I was learning the ropes and I tried to make sense of things. 7 years later, I am still held captive by the magic of psychodrama.
Often people ask me,”what is Psychodrama?”, and I ask if they have 10 minutes to listen. It is a therapeutic action method that usually is done in groups. So here is a short description that will suffice for now.
Psychodrama, is the brainchild of Dr J.L. Moreno. It comes from two words, Psycho and drama. Psycho (not like in the movie where someone slashes you in the shower with a knife), is derived from the word ‘psyche’ which means the mental or psychological structure of a person. Drama refers to the enactment or action that happens in the session.
There are 5 instruments in Psychodrama
In the group, the therapist or group leader takes on this role and keeps the action flowing and gives structure to what evolves on the stage.
This can be any space set aside for the enactments to occur. In a group, the stage is the space apart from where group members are seated. Moreno built a stage in New York specifically for psychodrama which had the audience seated at a different level. I had the privilege of directing a drama on the original stage.
These are the group members who are not involved in the drama but who act as witnesses and can respond to the action on stage as a normal audience would, often yelling encouragement to the protagonist.
This is the person who represents the main concerns of the group. Usually chosen by the group, the Protagonist gets to put into action a concern, a challenge or an event that they would like to have turned out differently. In psychodrama, past, future and present can coexist in the Here and Now.
The Auxiliary or sometimes called the Auxiliary Ego is the group member chosen to be a certain element or person in the drama, for example the protagonist’s Sister or maybe their addiction.
Each session has a warm up, an enactment phase and time for sharing. In the sharing segment, group members get to share something about their own lives that is connected to the drama.
So in Psychodrama the protagonist’s inner world gets “‘concretized” or made real, and the Director helps the Protagonist explore and work spontaneously to create new ways of being that are more helpful in living with whatever challenge was enacted. New perspectives are discovered; insights and conclusions made that bring healing and newness. The Protagonist and group members experience the wonder of being spontaneous and are positively energized!
*Psychodrama is used in group sessions run by Sharmini as part of her practice at Promises.
At Promises Healthcare, we are committed to helping you through your journey to recovery. Discover a new life and find renewed hope. Please contact our clinic today if you or someone you know needs mental health support.
Have you ever wondered why it’s so tough to stick to your new year’s resolutions? According to Statistics Brain Research Institute, only 9.2% of Americans feel like they have achieved their resolutions in the past year. Here are some strategies from psychologist and behaviour change expert, Dr Paul Marciano, and the American Psychological Association to help you with sticking to your resolutions this year.
Set realistic resolutions
Most of us are guilty of making impractical resolutions that we can’t keep. For example, we aim to exercise more regularly, from barely going to the gym once a week, to aiming for seven days. Instead of setting unrealistic resolutions, you can try starting with something that’s small, practical and within your abilities. Rather than aiming for seven days of exercise, you could start with three or four. Josh Klapow, an Alabama-based clinical psychologist says, “It is far better to succeed at a smaller, more manageable resolution than to fail at a larger, loftier one.”
Bad habits develop over time. Similarly, it also takes time to substitute bad habits for good ones. When making resolutions, we often overestimate ourselves and try to re-evaluate our lives. We have to accept that development is rarely consistent and aim to change one behaviour at a time. Hence, having the patience to work through on resolution at a time will help you stick to them.
Talk about your goals
Having support from your social group is vital. Sharing your goals with friends and family increases the chances of success. Rather than trying to achieve your goal alone, you could join a fitness class at a gym, join a support group to quit smoking, or even just have someone to check in on your progress (accountability partner). Having social support and people to share successes and failures will make the process less daunting.
Resilience is vital in achieving your resolutions. When you slip-up and get discouraged, it is important to remember that it’s impossible to achieve perfection. Just because you were busy and didn’t manage to go for your gym classes doesn’t mean that you have failed and should give up your goal to be fit. What is critical is to bounce back from your mistakes and continue to work towards your goal. According to founder of MoneyCrashers, Andrew Schrage, it is useful to set targets throughout the year, so that you can keep yourself in check and your momentum going.
When you’re feeling overpowered when trying to achieve your resolutions, it is important to remember people who can listen and care for you. Seeking professional help can reinforce your resilience and manage stress stemming from your resolution. For example, a psychologist can suggest ways for you to fine-tune your goals to make them more achievable.
Make your resolutions more precise
Dr. Marciano recommends setting specific, measurable, achievable, relevant and time-bound (SMART) goals. Instead of just setting a goal to lose weight, you should be more specific and aim for a particular weight or body-fat percentage goal, or allocate a time every day to go for a run.
Track your development
Reflecting on your starting point and the developments you have made creates feedback loops. This allows you to track improvements during your endeavour and it will be an incentive to continue. It also enables you to reflect and adjust your strategies accordingly when you’re declining or when you’re not improving as much.
Set aside time for your goals
Allocate time for your resolutions and make them a priority by putting them on your schedule. This way, you won’t have the excuse of not being able to find the time to complete something. If you’re trying to get fit, block out certain hours of the day to complete your run or schedule certain fitness classes into your calendar. Treating your fitness classes or runs as though they are scheduled appointments can help you stick to them.
At Promises Healthcare, we are committed to help you through your journey to recovery. Discover a new life and find renewed hope. If you or someone you know needs mental health support, please contact our clinic for inquiries and consultations.
Amongst lawyers, one of the leading causes given for mid-career abandonment is burnout. Promises Healthcare partnered with the Law Society of Singapore for a two hour professional development seminar aimed at addressing this issue by providing legal professionals with practical stress management strategies.
The President of the Law Society, Mr. Gregory Vijayendran, delivered the opening address to an eager crowd stating, ‘Burnout is one of the elephants in the room that we (legal professionals) need to address…Today we will talk about it.’
Dr. Munidasa Winslow, Executive Director and Consultant Psychiatrist at Promises Healthcare, shared an engaging and thoughtful presentation. He outlined why lawyers are so prone to burnout, how they can identify the early warning signs, and how to prevent burnout. Dr. Winslow also spoke about how lawyers in the areas of family and criminal law can develop compassion fatigue and suffer from vicarious traumatization.
Mr. Paul Seah, Senior Partner at Tan Kok Quan Partnership, presented ten key points on how lawyers can create work-life balance. He touched on generational differences, particularly among millennials and senior lawyers, and encouraged young professionals to identify their priorities and set their boundaries firmly to avoid burnout.
Here are some key takeaways from the seminar:
Burnout is a serious problem that can lead to adverse physical and mental health and has a detrimental impact on families, relationships, friendships, and careers.
Whilst stress is a part of everyday life, high levels of chronic stress will lead to exhaustion and burnout.
Prevent burnout by engaging in active self-care on a daily basis.
Being willing to seek help is not a weakness but a sign of strength, self-respect, and professionalism.
The responsibility for preventing burnout falls on individuals as well as the organization in which they work. Individual changes should be supported by changes in workplace culture led by senior management.
Contact Promises Healthcare if you or your organization would like to learn more about navigating professional burnout and managing stress. We provide individual training, employee assistance programs, as well as workshops and seminars for groups.