Make your Marriage Last from the Start

 

Have noticed the appearance and increase in the idea of pre-wedding counselling or preparation recently?  You might have thought that couple counselling is only for couples who have problems. Alternatively you may be riding the crest of a loving wave happily preparing to spend the rest of your life with your beloved. However it is worth taking a closer look at pre-marriage Counselling.

Couples now have to contend with increasing demands that can affect their relationship such as balancing dual careers, childcare, finances and friends. Within this context it is not surprising that many couples that start off with positive intent can find themselves getting into bad habits and stuck patterns that can eat away at the relationship and become harder to fix when more entrenched. Added to this is a lack of traditional support as families live further away and Iead increasingly disparate lives. It is a sad fact that half of marriages end in divorce and it is estimated that only half of those that survive are happy ones. Although statistics on civil partnerships are less readily known early indications unfortunately suggest it is just as difficult to make these work. 

Pre wedding counselling acknowledges the reality of the challenges couples face in making their relationship work. Indeed a good skills based approach has been shown the reduce the chances of divorce by as much as 30% and lead to a happier marriage. It can also help which pre wedding stress. Therefore, it would appear that the idea of pre wedding or civil ceremony counselling might be worth considering to give your relationship the best chance of success.  After all it is one of the most important events in your life. Pre wedding counselling is available at Lotus Therapeutics with a qualified and registered Family Therapist who will get to know you as a couple including your strengths and limitations. You will then be offered a skills based approach to help supplement your existing strengths and help to prepare you for whatever life has to throw at you. 

Lotus also has Couple Counselling service for established couples who are either experiencing difficulties or also want to give their marriage a greater chance of success.

How Lying & Keeping Secrets Affects our Health

“The most common lie is that which one lies to himself; lying to others is relatively an exception” – Friedrich Nietzsche.

There are many reasons why a person might start to tell lies. It may be that they have something to gain from it, or that they are protecting someone who might be hurt by the truth- or, that they are ashamed or feel guilty about something.  They may not want to worry those around them if the truth turns out to be negative, such as finding out the results of hospital tests for example.  Alternatively, it could be a white lie, such as “I am too tired to go out tonight" to avoid conflict or please others.

According to Harvard psychologist William Pollack, Ph.D, telling lies and keeping secrets can actually be bad for your health. Of course, we all know that certain lies need to be told and certain secrets must be kept. We just have to make sure we know when to lie or when to tell the truth.

When to do which

Tell the truth if:

·      Someone asks you outright – if you lie to someone directly, chances are that if they find out you will have damaged the trust within that relationship. Your friend, relative or partner will always remember it and never be sure whether you’re telling the truth or not in the future.

·      It’s making you tense and anxious – If you’re keeping a secret or have begun to tell lies and it’s making you nervous, tense and wound up, it’s better to come clean and put yourself (and everyone around you) out of their misery.

·      The situation isn’t too bad yet – If you can see things getting worse it’s good to come clean, especially if you think there might be ways to solve the problem or solutions that can be thought of behind the reason you lied/kept a secret.

Keep the secret or continue lying if:

·      It’s not your secret – Telling someone else’s secret might lead to gossip as well as breaking that person’s trust. Also, that person might have decided they want to sort it out themselves, and so you will shame them by getting there first. If it’s not your business it’s better not to trouble with it and support their decision in whether or not to tell.

·      You intend to tell it within days – Sometimes “Now just isn’t the right time”, and that’s okay. These things are better dealt with if everyone is in a good mood and ready to talk deeply about an issue.

So How do Lies and Secrets Affect my Health?

1.    Telling lies or keeping secrets is prone to making you anxious and on edge. Having something on your mind all the time isn’t good for you, especially if it’s linked to danger, e.g. someone finding out and exposing you, or the worry of others getting hurt etc. This makes us begin a “fight or flight” response, in which adrenaline is constantly in our bodies, which can be damaging long term and cause illnesses such as Irritable Bowel Syndrome (IBS).

2.    Telling lies or keeping secrets distract you from your daily routine – you are more likely to make mistakes, forget things, and make physical activities seem more difficult.

3.    Sometimes the secret itself is something you should be talking about. Having a “Big secret” can be very taxing if you have no one you feel you can tell, and therefore are not getting the appropriate support from family and friends. If you need someone to talk to but feel you have nowhere to turn, you might be better off talking to a therapist, calling a helpline such as the Samaritans 08457 90 90 90,  or asking for help on an internet forum.

Try and do what’s best for yourself and the people you love. This might involve making a difficult choice or coming clean about something.  Whether you choose to lie or tell the truth, keep the secret or reveal it, think about whether or not it is justified, and if the good consequences outweigh the bad.

 

Anti Depressants- do they really work?

“Pain could be killed. Sadness could not, but the drugs did shut its mouth for a time.”  Colson Whitehead, Zone One

There is currently a debate around whether Anti depressants are being overused for treating Depression and if there is really a strong enough evidence base for them.

Statistics show that at least 1 in 10 people in the UK suffer from depression, it’s prevalence being slightly higher in women, with 1 in 20 of sufferers being as a result of clinical depression.  Anti depressant prescriptions in the UK have increased by 9.6% in 2011, to 46 million prescriptions and continue to rise.

There is no question that most people with Depression report a reduction in their symptoms though research shows that improvement appears to be due to psychological factors, i.e., the placebo effect.  Evidence is currently inconclusive about how much the Placebo effect is involved. We could ask, how much of the effectiveness of medication is due to the active ingredients and the non Placebo effect?

From my own experiences of working with hundreds of clients with Depression, both Clinical (i.e. from a chemical Serotonin imbalance) and ‘Reactive’ (as a result of a response to an event or stressor), Anti Depressants do have their place.  Many initially report an improvement using Anti Depressants though often, alone they aren’t enough to resolve the underlying factors that cause it in the first place and that help maintain it.  For instance, taking a pill when experiencing work stress may buffer against some of the negative emotional effects though unless the underlying triggers are addressed, things may not change long term. With some clients, Anti Depressants have little effect or in some cases, cause a worsening of symptoms as a result of unpleasant side effects.

Dr Ian Reid, Professor of Psychiatry at the University of Aberdeen, says "Antidepressants are but one element available in the treatment of depression, not a panacea,"…they can have harmful side effects, and they certainly don't help everyone with the disorder. But they are not overprescribed. Careless reportage has demonised them in the public eye, adding to the stigmatisation of mental illness, and erecting unnecessary barriers to effective care." 

The National Institute for Health and Clinical Excellence (NICE) guidelines doesn’t promote the use of Anti depressants as a first port of call for treating moderate depression though instead advocates talking therapies such as CBT (Cognitive Behavioural Therapy) and Interpersonal Therapy initially. Often however, long NHS waiting lists prevent individuals accessing services.  GP’s only option then is to prescribe medication to patients when there are few alternatives available.

Posing my question at the beginning, is there enough evidence to support the widespread use of Anti Depressants; one might argue, if it makes people feel better, why worry about how that happens? Perhaps the individual’s belief in the pill as well as the scientific base causes the improvement.  Often, the therapeutic benefit of talking about our problems and expressing our feelings to a professional such as a GP is part of the healing effect;  ‘It’s good to talk’ as BT says.

The promotion of medication alone however, dismisses the wider implications of creating a culture of ‘pill popping’ rather than addressing underlying causes and socioeconomic factors.   We should be asking why has depression become endemic, not only in the UK but worldwide and how can we change it? In our modern ‘quick fix’ society, we are prone to avoiding the real issues when we need to take a move in the direction of change and start doing something differently. 

Men and Depression: The Internal Conflict

“Depression is rage spread thin” - George Santayana

Depression affects 6 million men every year in America alone.  Reasons for depression that men have reported include: trouble in an important relationship, unemployment, pregnancy or childbirth, separation/divorce, retirement, and work stress.

There is a lot of pressure upon men in our society to maintain a sense of “masculinity” and being a “real man”. Sometimes this means that when a man feels desperate, lonely or depressed – he will hide his feelings and keep things bottled up. Because of this, men are three times more likely to commit suicide than women (statistic from the Royal College of Psychiatrists).

There is a common misconception that women are the more body conscious, the more emotional and the more soulful of the sexes – but this is not true. A man may look into the mirror and hate his appearance, doubting himself for not being muscular enough, for being short, not having much chest hair etc. Similarly, men feel the same emotional range as women and can also suffer from depression or anxiety. They just tend to keep it much more hidden.

If you think you know a man who is suffering with depression, be sensitive about it. He may not want to admit to himself or you that he is out of his depth. Men traditionally see themselves as having a lot of responsibility; earn the wage, be the protector, be man of the house. And when they start to struggle they see it as a failure. A crisis of masculinity, if you like.

Things you need to know and look for concerning Male Depression:

·         Coping Mechanisms – Male coping mechanisms differ a lot from female coping strategies. A man might throw himself into an activity, focussing a lot on work or sport to avoid dealing with his problems or distract himself. Also, the man in question might resort to impulsive strategies such as alcohol or drugs to cope with the feelings they are experiencing.

·         Downplaying signs or symptoms – Men are much more likely to ignore or justify the feelings they are experiencing than females.

·         Reluctance to discuss things – Men probably wont want to discuss they feelings with anyone, let alone a mental health professional. It’s better to reach out to your man in a caring, casual way when encouraging to seek help, e.g. “It’s probably nothing darling, but it might be worth just popping to see Dr Smith in case he has any suggestions” than “You are depressed and I’m taking you to see a Psychiatrist on Monday!”.

·         Emotions – Men are likely to feel anger, violence or frustration rather than sadness when they are depressed.

·         Physical vs Emotional – Males are likely to report feelings of physical pain such as headaches, backaches, dizziness, chest and joint pain rather than emotional discomfort.

If you think that your partner, son, brother, father or male friend is suffering from depression, try to encourage them to seek help from a Doctor or Psychotherapist without pressuring them or making a big “fuss” about it. The Royal College of Psychiatrists offers helpful information here:

http://www.rcpsych.ac.uk/expertadvice/problems/depression/mendepression.aspx

 

From Angry to Assertive in 10 Steps

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“Holding on to anger is like grasping a hot coal with the intent of throwing it at someone else; you are the one who gets burned." Buddha

It’s National Anger Awareness week this week- an opportunity for us to increase our understanding of and get more savvy with ways of managing our anger.  In my experience as a Therapist, Anger is one of the most misunderstood emotions; either one to be feared or revered- allowing a gain or loss of control over situations. 

Due to faulty conditioning as children and living in a culture of suppression, rather than expression of feelings, anger can often become a toxic rather than empowering emotion.  We characterize it with the person that loses control at the wheel, the man who beats his wife- it is bad to have anger we say as it can do so much harm.  I always say to my clients that every emotion is a valid one and anger can be more positive than most if channeled in the right way.

For example, if none of us felt any anger, would we ever fight injustice or stand up and be counted?  I doubt it.  The problems come when we choose to repress our feelings and allow them to fester until they transform into something else that can do harm.  The solution? Quite simply, learn to be assertive and say it like it is! 

Being assertive or congruent with your feelings may feel foreign to you at the moment.  Though, it can be learned, like any skill and you may be assertive in some situations more than others.  Think back to times at work or in your personal life when you exhibited more assertive behaviour, what was the difference?  Perhaps there is a certain context such as with your partner where you struggle with being assertive. To begin with, try these steps for learning new ways of changing your communication:

1.    Create some space around the argument before mentally scripting what you need to say using positive language: “I want to clear the air between us and discuss this..”

2.    Use 1^st Person Language and own your point of view- “I feel…”

3.    Get out of the Blame/Shame game: Remember, you have choices as to how you feel, no one can make you angry!

4.    Be specific on what triggered your anger and the degree of it- slightly annoyed- rage?

5.    Acknowledge your part in the situation- own responsibility for anything you did- remember this is a strength, not a weakness.

6.    At the same time, avoid self put-downs or criticisms.  Backing down from an argument in order to please only gets you into the passive role.

7.    Get out of Mind reading what the other person is thinking or feeling.  You need to have evidence based on fact not assumptions!

8.    Focus on the Behaviour, not the person.  i.e. “That was a selfish thing that you did.” rather than “You’re a selfish/angry person.”  

9.    Offer a positive for changing the behaviour- i.e. “We will be able to feel more able to communicate in future and get our needs met.”  

10. Finally, always use Assertive rather than passive or aggressive language: “I feel”, “I would like”, “In my opinion..” 

Remember, assertiveness also encompasses your voice tonality, body language and posture- this is supposed to be 55% of how we communicate so it is key to how others receive your communication, not just the words.

If you feel anger is something that is controlling your life, take a look at the beating anger website or consider speaking to a Therapist in confidence. 

How to Change Your Reality in 4 Steps

“Reality is merely is merely an illusion, although a very persistent one"  Albert Einstein

The way we perceive the world is a guide to how we navigate our way through it via out filters of experience- our map.  You see, ‘reality’ as we see it is only an edited version of the ‘real thing’- the territory.  Most of us operate as if our map that we hold in our minds is the reality that everyone else uses.  We then make assumptions and deletions based on our perceptions, resulting in stress and conflict as we learn that others don’t think the same way!

We create a very limited view of the world which often leaves us feeling without choice, stressed and unhappy that others aren’t doing it right. Or, we feel we seem to be getting it wrong (depending on what our model says) !  The question I often ask my clients is, ‘would you like to change this view’?  Most of them say yes of course though with a having a map comes a certain amount of investment in that view of the world and a fear of what might happen if I change it?

As a therapist, I aim to challenge the ‘reality’ of a person’s experience whilst respecting their model of the world as being theirs and unique.  I do not wish to trample on what has been their foundation for years of experience though perhaps offer them a different perspective from a third person’s point of view.  This in itself can be liberating.

To begin shifting your reality, work through the following steps to begin editing your experiences:

1.    Bring a stressful or negative memory or thought to mind- make sure you make it as powerful as possible- sense and connect with the colours, feelings, sounds again.

2.    Check in with yourself- would it be okay to let go of any unpleasant feelings associated with it? If ‘no’ then ask yourself ‘what is the positive purpose of keeping it?  i.e. so you don’t do it again or so you can ‘punish’ that person or yourself? Be curious.

3.    Next, notice how you think about the thought or memory you’re accessing then:

a.    If you’re associated (in it), dissociate (see yourself in it like a movie)

b.    Turn it black and white if it is in colour.

c.     If it is in 3D, make the memory flat like you’re seeing it on a screen.

d.    Shrink it down in size until you have it about the size of a postcard, flat and black and white in front of you.

e.    Reach out in your mind, screw it up and throw it away or burn it.

4.    Test it- Think about the memory now and see how you feel about it now?  If it feels better, you’re finished.  If there is no change, try altering the other submodalities such as making the sound different or quieter or adding a funny soundtrack to the image or memory.  Using humour is very powerful for changing our perceptions of things.  Try it next time you are scared of something or anticipating an event like doing a presentation- imagine the most ridiculous thing or a commentary by someone who makes you laugh and see how it feels. Feel free to play with it, after all, it’s your reality!

Tips for Breaking the Worry Cycle

“Do not worry if you have built your castles in the air. They are where they should be. Now put the foundations under them.” - Henry David Thoreau

Worry can be mentally and emotionally exhausting. Your kids haven’t been abducted, you’re happily married and a month ahead on the rent – so what’s the problem? Why can’t we stop worrying?

We worry about everything and nothing. Most worriers are aware that there is no logic in the act of worrying – it is shutting it off which proves to be the problem! And it can be exhausting.

Dr. Walter Cavert did a study of the things we worry about. He discovered that:


40 % of the things we worry about never happen,

30 % of our worries concern the past,
12 % of our worries are needless worries about our health,
10 % of our worries are insignificant or petty (things that will really not make much of a difference in our lives one way or another).

We have spent 92 % of our emotional energies over things that won’t happen or things we can’t change.
 

Identifying why you worry is a suitable starting point to dealing with this cycle. For some it might be physical; they have had too much sugar or caffeine (it is surprising how much of a difference this can make!) or they haven’t worked out at the gym in a while and feel a bit restless. Or it could be mental, like stress or dysfunctional thought patterns.

Getting to the root of the worry is essential in breaking the worry cycle. Find out what is triggering the anxieties, and avoid those triggers. But how do we figure out what they are? The problem is, worries don’t always have a reason. It could simply be the fact that everything is going so well which makes a person nervous as they are expecting it to change! Sometimes, worrying about something can be reassuring, as if it might solve the problem when the problem isn’t even there yet. Confused? Us too.

The trick is: Just sit back and relax. Take a minute to laugh at yourself – worrying about things that don’t exist or running too many 'what if' thoughts? Try mixing up the associations with the worry- imagine it being like a movie or a comic strip where you can put a funny soundtrack to it or canned laughter. Do whatever makes it light hearted or silly and see what happens!

Avoid the caffeine if you can. It’ll increase your awareness and that fretful part of your brain will be kicked into overdrive.

Try and figure out if you can take any action against what’s worrying you. Chances are it’s something so miniscule and irrelevant that when you moan about it to someone, they’ll tell you to “find some real problems”. But if there really is something, you DO have a bill due soon – think about ways in which you can deal with that. And if it’s all under control and you worry anyway? STOP. Cue the laughter. 

A useful process to follow is to write down all your ‘worries’ and write down all possible solutions to each problem.  Don’t analyse, just brainstorm. Then go back and assess which ones are the best and the pros and cons of each.  Next, decide on the most practical solution.  This helps engage the rational side of your brain and enables you to see the worry from another perspective.  If you struggle with this exercise, think about what advice you would give a friend if they had the same issue, or ask another for some ideas for solutions.  Lastly, ask yourself what is the first step to changing this? Take action and remember to review your progress. 

Life is too short. Kick back, put your feet up, and enjoy the ride. Worrying will get you nowhere and it won’t allow you to have fun. Relax and take some time to think about what’s good in your life. Break the cycle today.

World Mental Health Day- Depression: A Global Crisis

“Even for me life had its gleams of sunshine.” - Charlotte Bronte, Jane Eyre.

On the 10^th of October 2012, we are celebrating the 20th Anniversary of World Mental Health Day!

World Mental Health Day aims to increase the awareness of the public about mental health issues. The day readily opens discussions of various mental disorders; many people don't know what they are or how to get the support they need – World Mental Health Day hopes to change that.

This year's theme is depression. Depression is a serious mental illness affecting over 350 million people world wide, of all cultures and ages. The World Mental Health Survey conducted in 17 different countries discovered that (on average) a shocking 1 in 20 people reported having an episode of depression in the previous year. A study conducted by the European Depression Association (EDA) of 7000 people found that 1 in 10 of them had taken time off work because they were depressed. 1 in 4 confessed they did not tell their employer.

It seems that not only does the general public not realise the seriousness and frequency of depression, they also do not realise what can be done to help and maybe even view it as something to hide or be ashamed of.

This is not the case; Depression is a very serious condition which is often gets out of your control. It is not your fault you feel this way, and you mustn't blame yourself. Depression consists of symptoms such as persistant sadness and low mood, a possible change in diet, trouble sleeping, fatigue, agitation, feelings of worthlessness and poor concentration. It can make life very difficult.

So what can help? 

Cognitive behavioural therapy has proven it's benefits time and time again, as it offers treatment which teaches lasting life skills which can be applied and used in every day life. It looks at how you can change any negative thoughts or patterns that you have in your life, and often helps you to learn how to deal with emotional problems effectively. It can teach you to step out of your automatic thoughts.

Mindfulness is often taught as therapy for depression. It involves learning how to live in the moment and focus on the beautiful tiny features of every single day – be it the smell of that coffee or the sight of the morning sky. By paying attention to the little wonders around you, and not just noticing them but really appreciating them, it can help to ease depression because we realise all the good, special things we have in the world and how lucky we really are. It can be a transformative experience.

World Mental Health Day hopes that by rasing awareness of depression and ways to deal with it, we can collectively improve the general wellbeing and quality of life for people worldwide. For more information, visit the Mental Health Foundation website.