Repeated Patterns in Life: Schema therapy

• Posted by: miyukiphd

• (Originally posted) December 18, 2018

I previously wrote about the differences between counselors and psychologists in my blog, but we psychologists consider the problems the person is having, their roots, the wishes of the client, etc. From among the effective therapies, use the one that is likely to be more effective. Last time, I talked about cognitive behavioral therapy and mindfulness, but this time I would like to introduce schema therapy.

Do you find it difficult to live or do you find yourself repeating the same negative experiences? It may be due to schema.

I don't think many people have ever heard of the word schema. Schemas are rough guidelines, frameworks, and frameworks created based on childhood experiences that guide the way we see, feel, and respond to things. In our daily lives, it is very important to understand huge amounts of information at the moment and take action quickly in order to survive. I talked about stereotypes before, but if stereotypes are a rough way of looking at certain things or people, schemas are even rougher frames used to understand ourselves, others, and the world. please. Schema therapy is used with a variety of patients, but it is said to be particularly effective for people who experienced complex trauma (*see below) in early childhood.

According to schema therapy developed by Dr. Young, there are 18 maladaptive schemas (please note that the Schema Therapy has a more recent development, but I focus here on the original theory). For example, let's say that there is a client who was severely neglected by their parents as a child, and they have the schema of having no one to rely on emotionally when they needs it (emotional deprivation). Depending on their innate nature, that person may confide all their feelings and thoughts to others and try to get them to understand, or on the other hand, they may not want to let others down, or they may feel uncomfortable about personal matters. may not be clear at all. In either case, they are unable to maintain a sense of distance from others, and as a result, they maintain the schema that there is no one they can rely on mentally (emotional deprivation). One of the things I am most interested in in psychology is "memory and learning." When we learn things, we sometimes learn consciously (like multiplication), but we also learn many things unconsciously. And things that we have learned unconsciously, such as schemas, will remain in our subconscious as long as we do not pay attention to them, and will continue to exert their power, continuing the same negative chain. While mindfulness and cognitive behavioral therapy look at problems in the here and now, schemas look back and dig into problems in the past as well as the present. Then, we bring into our consciousness the schemas that are contributing to the negative chain that continues today, and change our behavior. If you find it difficult to live or are experiencing the same negative experiences over and over again, why not try schema therapy?

*Complex trauma refers to repeatedly experiencing severe trauma. Moreover, the trauma is not caused by natural phenomena such as earthquakes, but is characterized by man-made disasters and interpersonal disasters. For example, being repeatedly verbally abused or emotionally harassed by a parent, being physically abused or physically or emotionally neglected, being sexually abused, or being exposed to domestic violence. In contrast, simple trauma refers to trauma that has been experienced once. With simple trauma, you can remember details such as when and where, but with complex trauma, because of the continuity of the experience, it is difficult to separate and recall each experience. It is believed that complex trauma plays a major role in schema formation.

What is the significance and meaning of life?

• miyukiphd

• (Originally Posted) March 2, 2019

This time I would like to write about a topic that I often thought about when I was a teenager. This may seem like a dark subject, but I'm looking at it more philosophically than psychologically. However, if you are a little worried about depression, you can skip this topic.

I think I was a realistic child, not a typical child, from an early age. I liked Andersen and Grimm's fairy tales more than Disney, which idealized cruel and sad scenes, and I liked biographies and true stories of people living in different eras and countries more than Fantasy, and I always wanted to know the truth. I liked Anne Frank's diary better than the story of a princess being wooed by a prince.

Then, when I became a teenager (13 years old), I realized something. The fact that there is no answer to the question of why I am here, and the fact that I cannot find an answer to the question of what is the significance and meaning of my life, which happens to exist. I was very shocked. While the other kids talked about their idols, their own hairstyles and clothes, the opposite sex they like, their dreams for the future, etc., they chimed in, silently continuing to search for answers to such unanswerable questions. Philosophy was not taught at the public junior and senior high schools I attended, and there were no adults around me with whom I could seriously talk about such matters. At that time (the 1980s) there was no internet, and I identified myself with the main characters depicted in various literature who were troubled by the same questions that transcended eras and countries. However, throughout my teens and twenties, I had fun with friends of my age and had personal goals, so my existential crisis never affected my mental health. I believed that if I found a purpose in my life and achieved self-actualization, my existential crisis would be resolved.

And recently I watched a documentary about the death of a 97-year-old philosopher (Dr. Herbert Fingerett). In this short documentary clip, the philosopher talks about the essential question of philosophy: ``Is there meaning or purpose to life?'' Now, in this world without his wife, who has been by his side for 70 years, he says that he accepts that there are things he cannot easily do alone as an old man, and he says that a life of just waiting for death is truly empty and lonely. On the other hand, even though he wrote in his book that there is no need to fear death in theory because it means nothing, he is now facing death and it has a very personal meaning for him. He says that he still has a desire to remain in this world. It stems from the fact that he regrets not noticing (for example, looking at the trees growing in his garden with gratitude) during his glorious days when he achieved so much. Maybe it's just a matter of attachment to the world. Either way, in the end he said he could never answer this question. He said that there are no answers anywhere, so he just exists as he is.

What I interpreted from this is not to question the significance or meaning of life (because there is no answer), but rather to be swayed by such things, it is more realistic to have compassion and gratitude for the things that exist right now, including yourself. Does that mean it is meaningful? As I believed, by moving toward your goals, you may feel happier and have fewer regrets. But I feel like I'm only seeing one side of life. It's like an idealized Disney fantasy without the cruel and sad scenes. In other words, while we can create meaning and purpose in our lives by accomplishing what we have planned, the cruel and sad fact is that there are things in life that are unclear, unanswerable, and beyond our control. In other words, all we can do is recognize and accept that there are things in the world for which there are no answers, be grateful for the things and people who coexist with us, accept ourselves as we are at each moment, and exist as ourselves.

Invisible Pressure and Identity

 

·        by miyukiphd

 ·        (Originally posted) October 10, 2018

Stereotype is our over-generalised and over-simplified beliefs and it allows us to take a cognitive shortcut to comprehend our experience quickly to prepare our decision and behaviour. So, stereotyping sounds very effective to survive (e.g., smoke = danger = evacuate etc.). However, stereotypes can also generate prejudice and discrimination. Regardless of our ages, we are exposed to invisible stereotypes (e.g., age, sex, race, physical features etc.) in our society. This experience is not always positive, and I would like to talk about how stereotype can affect our identities.

When I was living in Japan, I was never scared of public speech. Rather, I liked to talk in public, as it was part of my growing up via my childhood hobbies of the piano, drama, student council, and sports. Because of my behavioural tendency, I was always labelled as an “active, tomboy, and/or social” child and, even after my teenage where I chose to be less “extraverted”, no one thought I was “shy”. However, since living in Australia, my strengths and limitations have changed, and accordingly, how others perceived me has changed, too. For example, because of the language and cultural barrier, I am no longer able to offer the breadth of conversational topics in English. In addition, the definition of “social” is very different between countries. Furthermore, I started being perceived as an Asian (and Japanese if they know my nationality) woman, rather than “me”.  Because of these factors, people I met in Australia tend to see me as “shy” and “introverted”. And funnily enough, once people started seeing me in this way, I started questioning myself if I am shy and behaving like a shy person! These experiences made me rethink my identity. It is easily imagined that this type of experience is happening to everyone, especially those who are social figures. Also, children are not exempt from this.

I have two sons, and I provided the opportunities for them to freely choose their toys, clothes, shoes etc. within healthy boundaries when they were little. I did not want to decide what were appropriate things for boys to have, just as I did not like my mother to always choose pretty dresses for me. Both of my sons tended to choose gender neutral or feminine toys, such as teddy bears, a pram for toy dolls, kitchen items, balls, puzzles, and their favourite colour was pink. Both of my son had a female best friend up until Prep Year. However, once they started Year One, they both told me “I don’t like those toys and I like playing with boys”. I asked my sons separately, “what makes you think in this way?”. Surprisingly, both answered confidently, “because I am a boy!”. My sons changed their preferences according to their perceived appropriateness for their identities. There is a three-year gap between my sons, but they reached their own conclusion at the same age – of course, this does not mean that everyone starts feeling this invisible pressure at this age. This could be also partly due to apparent differences between boys and girls at Primary School – uniforms, hair style, choices of extra-curricular activities and so on. I remember that my younger son still (secretly) loved his soft toys on his bed until Year Two, and we had to hide these when his friends were visiting our place.

The influence of this “invisible pressure” on our identities exists. This pressure is derived from stereotype and social expectations – also see “Ought Self”. Even if a stereotype does not entail any negatives (i.e., boys like cars more than soft toys), it can cause emotional pain if your genuine self does not fit the “stereotype”. The pressure to fit into a stereotype is invisible and thus challenging. So, I would recommend you to mindfully observe your emotions and whether such “invisible pressure” causes you any distress. If it does, changing your behaviour until it is more closely aligned with your genuine self is the first step. We cannot change stereotype or social expectations of others, but we can change our behaviour. I choose my behaviour mindfully to maintain my genuine self. 

To be what you want to be

·       by miyukiphd

·      (Originally posted) August 8, 2018

Psychology

According to Self-Discrepancy Theory (Higgins, 1987; Tangney, et al., 1998), there are four different Selves: Ideal Self (what you want to be); Real Self (what you see who you are); Ought Self (what you believe you ought to be); and Feared Self (what you are fearful to be). Ideal Self can be based on your ambition, goals, and/or traits that you like (to have). Whereas Ought Self is who you are expected to be, and the expectations are those from your parents, peers, and the society you live in. When your Real Self is far from your Ideal Self or Ought Self, and when your Real Self is close to your Feared Self, depression / anxiety will be experienced. That is, discrepancy between these Selves creates emotional distress, including self-esteem issues.

What is your Ideal Self? Can you tell the difference between Ideal Self and Ought Self? Where is your Feared Self coming from?

I always wanted to be an independent person (financially, physically, and mentally). This Ideal Self may have been developed because not only I witnessed sexual inequality in previous generations, but I also always felt my Real Self (an active and independent person) is different from traditional (Japanese) women (Ought Self). Whenever I was directly and indirectly asked to be a typical girl (Ought Self), I felt uncomfortable expressing myself (Real Self) due to fear of rejection. Ought Self had particularly strong influence in my teenage and the early 20s, as I was a so-called perfectionist (see my previous blog on Perfectionism). My Ought Self had power over my Ideal Self, and my Real Self believed that I needed to aspire to be the Ought Self. Of course, this made me feel as if I was living in someone else’s life. Perfectionism would be partly learned from society, but it would mostly be from your upbringing. If a child perceives that s/he is not accepted unconditionally by his/her parents, s/he becomes more conscious about others’ approval. I often see similar struggle in my clients who have gender / sexuality that does not match with social expectation (i.e., LGBTIA).

Ought Self does not exist in me anymore, making me feel satisfied with who I am now. I found my Real Self that is very similar to my Ideal Self – I achieved this partly by living in overseas, but more so by finding my own identity.

How about your journey to discover yourself? Are you the person who you want to be?

If not, what is stopping you from becoming the person you want to be? Are you still overpowered by your Ought Self?

Not Good at Intimate Relationships

·        by miyukiphd

·        (Originally posted) June 8, 2018

The profession I finally chose was a Clinical Psychologist. I was originally thinking of becoming a researcher (in the field of cognition and memory), and it still intrigues me how I ended up as a clinical psychologist! As my interest has been memory, I see many clients with a history of trauma whose memory is heavily affected by their experiences. However, I also enjoy seeing clients who present with common issues such as the direction of their career or intimate relationship. I believe that the attempt to resolve these common issues is a necessary pathway to discovering true self and happiness.

People naturally desire to be loved and seek approval from others (we are social animals!) to different degrees and finding an eternal love may even be a purpose in life for some people. So, I see many clients whose intimate relationship issues are causing them significant distress. The issues could be current boy/girlfriend, marriage, ex-partners, or even future partners. What most surprised me was the frequency of affairs that I come across. With my logical view, I could say “you need to finish the current one before going to the next”, but an affair is not always short-term nor simple, and my logic does not work.

For example, imagine someone who is married to a person who is successful and kind. S/he has a good and successful job and beautiful children. They have many common friends and they look very happy. But my client told me that s/he cannot express what s/he wants or cannot attain what s/he wants from their partner. An affair can be the person who could fulfil the void instantly – fulfil only the missing piece. Although continuing the affair creates great guilt and shame, it does not seem that easy for my client to end the relationship. My client knows that s/he cannot / should not continue this unhealthy relationship, which brought her/him in to therapy. Most of them do not know what to do – continue or cease one of the relationships.

What do you think I would tell them?

Firstly, I would not tell my client what (not) to do, nor criticise what s/he has done. My opinion, ethical or social measurement is not helpful. Psychology is different from legal advice. Instead, I start with exploring my client’s relationship history, including the relationship with his/her parents, friends and partners. Of which, parents are the first attachment figures, and it is very important for me to understand the origin of my client’s relationship issues.

The emotional bond, or attachment is formed in different forms: Secure; Anxious Ambivalent (or Preoccupied); Avoidant (or Dismissing); and Disorganised (or Fearful Avoidant) styles. These styles are differentiated by the level of approach (from approach to avoid the attachment figure) and the level of fear (from fearful to not fearful). For example, if a baby develops secure attachment with their caregiver, then s/he would approach when distressed without fear; whereas a baby with anxious ambivalent attachment will approach but will be fearful of rejection (see more about attachment styles). So, understanding what kind of attachment they learned is important. Learning is not only direct learning, and we also learn from our observation. So, I also ask my client how his/her parents expressed their love / affection to each other, which became my client’s role model. Furthermore, exploring their coping in relationship issues is also necessary. This is because as no one partner would fulfil our needs completely, all the time, we attempt to fill the gap in different ways. For instance, an individual may focus on something more controllable than one’s relationship issues (e.g., work) and avoid facing the issues. These coping styles are stored in our implicit memory, and we are not always aware of our default coping styles, which may be unhelpful to our intimate relationships.

 Are you surprised that I don’t answer their questions nor talk about morality? I don’t give my clients answers that influence their lives. Instead, I help them to bring their implicit definition of love (attachment) and coping to awareness. This also helps my clients see the patterns of their relationships. Therapy can be emotionally draining, as we will have to get in touch with the past pain, but this also deepens emotional (not intellectual) understanding of their life patterns, which results in a new, healthy perception.

I will then teach my clients healthy coping (e.g., communication, emotion regulation etc.). After their past pain is healed, my clients are ready to make good decisions. It is always my pleasure to see my clients is improving their intimate relationship with the newly acquired secure attachment and healthy coping.

Happiness

·        by miyukiphd

 ·        (Originally posted) April 13, 2018

Many clients have told me that they are not feeling happy, even though they have achieved a lot in their lives like having a good job, a house, a car, and so on. Happiness and psychological wellbeing are something that everyone is inherently striving for.

But what is happiness and how can we achieve it? Why are some people unhappy regardless of their achievements?

In the process of psychological treatment, setting treatment goals is an essential part in the early stage of treatment. Indeed, “to be happy” is one of the most common treatment goals. For the pursuit of happiness it is very important to know what happiness actually involves. For example, if you think it is merely positive emotions, you may try to achieve happiness by inducing positive emotions, but they do not last forever. Emotions are a fleeting and momentary experience.

So, what do you think happiness is?

There are many theories that have contributed to our current understanding and the definitions of happiness. For example, Dr Abraham Maslow theorised our needs in his hierarchy of needs – five needs are divided into basic (or deficiency) needs such as physiological, safety, love and esteem, and growth needs (self-actualization). The basic needs are those that all of us strive for if not achieved. Self-actualization, on the other hand, is not something that everyone achieves or strives for.

The five-stage model includes, from lower to higher level:

1. Biological and Physiological needs– air, food, drink, shelter, warmth, sex, sleep.

2. Safety needs– protection from elements, security, order, law, stability, freedom from fear.

3. Love and belongingness needs– friendship, intimacy, affection and love, – from work group, family, friends, and romantic relationships.

4. Esteem needs– achievement, mastery, independence, status, dominance, prestige, self-respect, and respect from others.

5. Self-Actualization needs– realizing personal potential, self-fulfillment, seeking personal growth and peak experiences.

How are these needs and happiness related?

Even if you meet your lower basic needs, like physiological and safety needs, for instance by having a good job, it does not meet all of your basic needs. One way of achieving happiness is to understand which of your needs are unmet. Dr Maslow also stated that peak experiences, where an individual feels more whole, alive, self-sufficient and yet part of the world, more aware of truth, justice, harmony, goodness, and so on, provide us with profound moments of love, understanding, happiness, or rapture. Self-actualizing people are believed to have many such peak experiences.

Dr Martin Seligman, the father of Positive Psychology, has also been researching happiness and what it entails. According to Dr Seligman, there are five components that need to be considered for the pursuit of happiness.

Five Components Involved in Happiness

• PLEASURE – POSITIVE EMOTIONS

This is where you lead a life of pleasure, maximizing positive emotions while minimizing negative emotions.

• ENGAGEMENT – FLOW

This is where you are engaged in activities that allow you to be in flow. According to Dr Seligman, you need to identify your strengths that are deeply characteristic of yourself, and learn how to practice them. When you are in flow, you concentrate your undivided attention on activities that are moderately challenging to you. When you are in flow, it may seem that your sense of self vanishes and time stops.

• RELATIONSHIPS

Positive relationships are believed to be important to support the other four components of wellbeing.

• PURPOSE – MEANING IN YOUR LIFE

An individual living with meaning is said to belong and serve something that is bigger than him/herself, for example family, community.

• ACCOMPLISHMENT

This is about the pursuit of success, winning, achievement, and mastery, both as end-goals and as processes. Dr Seligman argues that many people would pursue accomplishment for its own sake, even when it is devoid of positive emotions or meaning.

3 Things You Can Do Right Now to Boost Your Happiness

To boost happiness in your life, there are certain habits and behaviours you can start working on right now.

• DO MORE OF WHAT YOU LOVE

Increase flow in your life. Think about when you lost track of time and were absorbed in the present moment e.g., when listening to music, swimming, talking to your friend, etc. and engage in these activities more.

• DEVELOP MEANINGFUL RELATIONSHIPS

Research shows that it is not about the number of relationship you have, but the quality of relationship you have. An appropriate level of self-disclosure is essential in meaningful relationships – interpersonal skills training such as communication skills including sending and receiving verbal and nonverbal messages would help you to improve your relationships.

• FIND PURPOSE IN YOUR LIFE

Know your values, things that are very important to you, and your strengths and put them in practice today!

These are not mutually exclusive and they influence each other. That is, if you have a meaningful relationship, accomplishment, and purpose in your life, you would experience more positive emotions and flow moments, which ultimately increases your sense of happiness. 

Furusato (a place to belong)

·       by miyukiphd

·        (Originally posted) February 8, 2018

Furusato is a very familiar concept to Japanese people. Furusato does not mean merely a place where we grew up (hometown), but a place that feels safe and the place where we created a history with our family, extended family and friends to whom we can connect deeply.

While moving around during childhood does not always have negative effects, adults who don’t have Furusato may have to make extra efforts to establish a place they belong to and sustainable and meaningful connections with others.  More specifically, some clients of mine reported that they had moved around every 2 years in childhood – “I had to say good-bye to friends of two years and then had to fit in to new peers (but knew I will have to leave in two years anyway)”. Those children grow up into adulthood with beliefs, such as “I don’t fit in” and may keep searching for their perfect place.

I heard that indigenous Australian people feel sick if they are away from their homeland for a long time. So, they have to go back to their homeland regularly. In Japan, it is customary for most people go back to their Furusato twice a year to reconnect with their family and their land of origin. There seems to be many similarities between indigenous Australians and Japanese in terms of respect to our ancestors / history / land.

Do you have a place you can call “Furusato”? Where is it? What kind of emotions come up when you think of events, things, people, and/or places related to your Furusato?

It has been over 17 years since I moved to Australia, but Tokyo is still my Furusato where I have many fond memories, family and friends. My family has lived in the same place in Tokyo for over 60 years now. Australia is such a wonderful county, yet my Furusato is Tokyo, which provides me with a sense of safety and connection to my ancestors, my family and friends who know my childhood. Having people who share old memories is an important contributor to a sense of safety and belonging.

What I found after having lived overseas for a long time is that there is no perfect place anywhere.  I have seen refugees who had come to Australia to secure their safety. Some of them told me that they would like to go back if possible, as they are losing their identity and feeling empty in a safe country. But, most of them can’t go back to their Furusato.

Perhaps not many people live in their Furusato forever. There may be many who live outside of their Furusato happily. These people may have made their new place Furusato, or they go back to their Furusato regularly to recharge their sense of belonging.

Do you have Furusato and a sense of belonging?

Learning from Grief

·        by miyukiphd

 ·  (Originally posted) November 19, 2017

All living creatures including human beings are given finite time, and someday, we will face the loss of a loved one. I have seen clients who lost their loved one in different ways. The loss can cause many different emotional and practical consequences. For example, the realisation of eternal loss of future with the deceased would cause sadness, emptiness and despair. Other emotions, such as guilt and loss of identity may also be experienced, depending on the nature of the relationship with the deceased. Some factors – the complexity of the relationship with the deceased, the young age of deceased / person left behind, and the way they died (sudden, unexpected, brutal etc.) such as suicide – may make the process of grief more complex. The loss of a child is recognised as one of the most difficult losses of all. How a parent may feel after losing a child is beyond my imagination. Of course, the loss is not limited to humans and it could be the loss of your family pet. Different losses bring us different challenges and meanings, resulting in different types and intensity of emotions. So, we need to take our own pace and time to go through a grief processes.

Have you ever lost your special person? What was it like for you?

We experience intense emotions when we face events that are unexpected and unexplainable with our pre-existing belief system. A psychological illness may result if you are carried away by or avoid your intense emotions. It is important to accept your emotions as they are without judgment (=mindfulness). Emotions will eventually subside as you process the experience of the loss. The process may also involve recognition and acceptance of your own limited time in life, too.

Some clients told me that they have to be sad to show their deep love to the deceased, interfering with their recovery. These clients prohibit themselves from feeling joy or feel guilty. The process of grief does not mean that you forget the deceased, but you find a way of living your remaining life with the memories and a new knowledge of limited life. And, it is okay for anyone to feel joy again even after the loss of a loved one.

The last day with your loved one will definitely come. This is not a negative thought or a threat, but a truth that we tend to avoid thinking about. But the strong joy of connecting with our loved ones in daily life will follow once you accept our fatality and limited time we have to share. My sense of happiness and appreciation of connections with families / friends have increased since the experience of losses, too.

Do you live mindfully, as if it is one of your precious days? Do you express your love and appreciation to your important people?

“Next time” may never exist, and the only thing we have for sure is “now”.

Mindfulness

·       by miyukiphd

·      (Originally Posted) November 18, 2017

It is believed that our thoughts go to the past when we are depressed and to the future when we are anxious. For example, depressed clients tend to show regrets and rumination (thinking about negative things that happened in the past over and over), while anxious clients tend to show ‘what if’ thoughts, worrying about things that have not happened yet. Either way, they miss experiencing joy in the present moment, as they see ‘now’ through their ‘past’ and/or ‘future’ lenses.

Have you heard the word, ‘Mindfulness’?

It is based on a concept from Buddhism, and mindfulness has been widely recognised for its therapeutic effectiveness for depression, anxiety, insomnia, stress, and more. The effectiveness has been reported in accumulated research findings, as mindfulness seems to activate a part of brain that plays a role in emotion regulation.

Mindfulness is a way of paying attention to our internal (e.g., breath, bodily sensations, thoughts, emotions), or external (e.g., visual, smell, sounds, taste food, touch objects) experiences in the present moment with certain attitudes:  non-judgment, curiosity, and open-minded. I believe that mindfulness is more like a way of being, experiencing our lives full-heartedly without judgment. Mindfulness allows us to experience our lives fully. For instance, imagine you see snow for the first time. You are looking up to the sky with snowflakes continuously falling down. You feel a cold and wet sensation on your face, head, and body, as the snowflakes land on you. You notice your thoughts (there is lots of snow), emotions (excitement), and behaviour (collect snow on your palms and taste snow). There is no judgment (e.g., it is dirty to consume snow, and I should not behave childishly).

I have met many people from different ethnic backgrounds, and I still believe Japanese is one of the most mindful cultures. We traditionally practice mindfulness seasonally if not every day. These customs include viewing of ‘cherry blossom in Spring’, ‘fireworks in Summer’, or ‘coloured leaves in Autumn’, and listening to ‘summer bells to cool us down’ and ‘a temple bell at the New Year’s Eve night’.  We also have many seasonal foods/drinks to taste the ‘season’. Martial arts, flower arrangement, calligraphy, tea ceremonies, and even cleaning are used to practice mindfulness in Japan. Mindfulness is part of Japanese traditional culture and a way of living albeit Japanese people may not recognise it.

Mental health illness can be worsened by our own judgment. For example, you may think “I am useless” and ruminate about negative feedback from your boss over and over after you made a mistake at work. This may lead to insomnia and depression, as these judgments can create negative emotions and bodily sensations (see my blog on CBT). If you use mindfulness, you see your mistake, and notice your emotions (e.g., upset, down), bodily sensations (e.g., heavy) without judgment. You just notice these – these are valid reactions. Instead of judging your own mistakes, you just notice your experiences. If you cannot stop judging yourself, then you notice it, too. “I notice that I am judging my mistakes by thinking I am useless”. Whenever your thoughts / emotions / bodily sensations come back to you, you notice them, while bringing your attention back to your present moment. Eventually, these thoughts / emotions / bodily sensations will pass.

It is impossible to change the past or predict our future perfectly; what we have is the present moment. Our experiences are momentum and will pass – then there would be more space for you to do something for the better.

Some individuals experience more intense emotions than others. Mindfulness is not only for those with mental illness. Mindfulness can enrich our lives by bringing our attention back to the present moment – a cliché “yesterday is history, tomorrow is a mystery, and today is a gift. That’s why we call it present”.

There are many mindfulness (guided meditation) APPs, You Tube clips and more available. Or you can simply start being mindful of what you do (walking, eating, having a shower etc.). 

Perfectionism

·       by miyukiphd

·      (Originally posted) October 17, 2017

Have you heard something called “Perfectionism”?

This is one of the most common conditions seen among my clients. Perfectionists seek unrelenting standards and suffer psychologically due to a sense of pressure they create themselves. This is because a perfectionist’s self-worth depends on (1) comparison with others, (2) achievement, and (3) approval from others.

It is a good recipe for psychological suffering! Perfectionists are more likely to develop anxiety and depression.

Perfectionists tend to believe (subconsciously) “I have to be (better and) perfect”. In addition, they assume (1) we are all the same (strengths/weaknesses), (2) the results are up to us, (3) our own judgement is not reliable and we have to rely on others’ approval, and (4) self-worth is measurable on a universal scale. As a result, they will be anxious/angry/sad when they don’t live up to their unrelenting standards. Also perfectionists may have high standards not only for themselves, but also for others and their environments, and people around them may feel exhausted. It is also common that they lose coherent identity, as they adapt their needs/wants/behaviour to gain approval from others.

It is not uncommon for young individuals in their teens to compare with their peers and to have unstable self-worth, depending on peers’ approval due to their still-developing identity. However, if this continues throughout adulthood, you may be a perfectionist! Then how come some people become pathological perfectionists? What can we do about it?

Psychological conditions are derived from environment, our natural temperament/psychological make-ups, and biological factors (genetics, physical traits etc.). In particular, I would like to focus on ‘environmental factors’ here. Have you grown up, being compared with someone and/or having parents who emphasised outcomes, which made you believe that you cannot be yourself to be understood and accepted? One of children’s basic needs is feeling loved. If a child does not feel loved, this causes great stress to the child. We have different coping styles (depending on environment, temperament, biological factors), some children develop a belief that “they have to improve themselves and be perfect to be loved/accepted”. Eventually, perfectionistic thoughts and behaviours become automatic – yet this is a vicious cycle of maintaining the belief “I am worthless”, as their unrelenting standards are simply unachievable.

Self-acceptance is a key for treating perfectionism – knowing and accepting one’s strengths and limitations. If we know and accept our genuine self, we soon realise how silly it is to compare ourselves with others. It is like comparing  cats and lions. Cats can’t be lions and they don’t have to be!

Do you know your genuine self? We develop our identity during childhood through to young adulthood by learning our strengths, limitations, values, and ambitions. Self-accepting adults would adjust their goals to more realistic yet still challenging ones if their initial ambition was too far to reach. Those individuals would not only achieve their goals, but also deepen their self-knowledge in the process. They can also allow themselves to be vulnerable (Good Resource, Brene Brown’s Ted Talk on the Power of Vulnerability: https://www.ted.com/talks/brene_brown_on_vulnerability).

I will introduce self-acceptance and identity in more depth in another blog article, but if you think you are a perfectionist, you could weaken your perfectionism by identifying your perfectionistic thoughts and behaviour by using cognitive behaviour therapy (CBT, see my blog article on CBT).

Clinical Psychology: Cognitive Behavioural Therapy

 ·       by miyukiphd

·       (Originally posted) October 17, 2017

Psychology is a relatively new discipline and psychology has various sub-disciplines – e.g., cognitive psychology, organisational psychology, clinical psychology and so on. Clinical Psychology is my specialised area of psychology and it researches and treats different mental health conditions and maladaptive behaviours that interfere with everyday life. One of the reasons I chose clinical psychology over all other kinds was because clinical psychology applies to many people (i.e., many applications). Clinical psychologists who work in clinical settings are mainly treating clients with mental health conditions and/or maladaptive behaviour using psychotherapy.

Firstly, based on clients’ self-reported symptoms and assessment, clinical psychologists achieve a diagnosis (e.g., depression) and/or a case formulation (identify origin, triggers, reactions/coping, and maintaining factors). Then, with their clients’ agreement, clinical psychologists attempt to achieve clients’ treatment goals using psychotherapy, and its effects are derived from research findings.  It is our role to inform and treat our clients with the most effective psychotherapy based on guidelines of psychotherapy (or updated research findings) and ethics – unless there is a good reason not to use (e.g., the client tried the first line of therapy previously yet did not find it useful, requesting a different approach). To become a clinical psychologist in Australia, we need to study at university for at least 6 years (a Bachelor’s degree with honours then a Master’s degree) followed by 1.5 to 2 year supervised practice. And this is not the end of our learning, and we are required to take at least 30 hour continuing personal development every year. Regular peer supervision, self-reflection and self-care are musts for us!

There are various kinds of psychotherapy, and of all, Cognitive Behavioural Therapy (CBT) has found its effectiveness in research for over 50 years. CBT has been used for depression, anxiety (Panic Disorder, OCD, etc.), and eating disorders etc. In general, I guess people try to change how they ‘feel’ when they are feeling sad, angry, and/or scared. The attempt may be done by harmful ways, such as suppression and/or avoidance by drugs/alcohol etc.

On the other hand, CBT is based on an assumption that ‘a situation is not a cause of our emotions, but our thoughts (also see as our belief, perception, or cognition, how we interpret the situation) are the cause’. In addition, ‘our psychological conditions are led by our cognition, leading to our emotions and behaviour. These three factors are believed to interact and maintain our psychological conditions’. Thus, CBT proposes that we may not be able to change the situation (trigger), but we can change our interpretation of the situation and how we react (behaviour), which would ultimately change how we feel.

Does the same situation result in different emotions, depending on our interpretation? For example, if you imagine that you are invited to a theme park with a lot of rides for free, what would you feel? Would you be feeling excited? Or scared? The first emotion (excitement) may be derived from your interpretation, “I love rides and it is going to be a great day!”, while the second emotion (scared) may be from “I hate rides. I would feel sick and embarrass myself.” Behaviour would be different – the first person may prepare for the day, researching the theme park, while the second person may be thinking about a good excuse not to go. As in this example, it is easily seen how CBT’s assumption is so omnipresent. In short, CBT supports the view that a situation (trigger) leads to our automatic thoughts, leading to our emotions and behaviour (as well as physical sensations).

We develop our belief system, depending on our experience (environment), genetics and temperament. We sometimes develop distorted beliefs and these beliefs become our habitual thinking pattern. They are called automatic thoughts, which our brains create instantly, like a knee-jerk reaction. The first step in CBT is to identify clients’ automatic thoughts and unhelpful behaviour. Then, my clients and I work on creating more helpful thoughts and behaviour to create change.

I hope that you could identify your unhelpful, distorted automatic thoughts and unhelpful behaviour to improve your wellbeing! 

Welcome to my blog

 ·       by miyukiphd

·       (originally posted) September 11, 2017

I developed the personality of ‘a listener’ at a young age and I have been utilising it for my professional role in more recent years. There are several reasons why I decided to start this blog. The main reason is based on the fact that there are thousands of people who are not seeing a psychologist due to the social stigma attached to mental illness and misconception of treatment. To be honest, I did not know much about clinical psychology before studying psychology at university – my initial interest was cognition and memory (i.e., human consciousness). Nowadays, I see more and more clients who lost their loved ones from suicide. Furthermore, because of my special interest being trauma, I see many trauma survivors and many of them have been suffering silently for decades. These people told me that they found it ‘shameful’ to have (admit) a mental illness and they had never thought of sharing their suffering with others. This may be due to a lack of empathic carers/parents in their lives, and they could not imagine sharing their feelings with others. Or simply, they have been blaming themselves for what happened to them and who they are now. Even if they have empathic carers/families, unless they accept their mental health issues, I will never see them. Insight and motivation of clients are the important factors in achieving good outcomes in psychological treatment.

So, I am hoping for such people to gain accurate information of psychology/mental health and will then visit their local psychological clinic, which will ultimately improve their quality of life (I hope!). Also, even if you don’t have mental health issues, I believe that understanding your psyche would improve your life, like it did for me.

Online psychological therapy or answers to your questions are not offered at this moment. I hope you enjoy my blog!