Friday, March 15, 2019

Want help with stress and depression but are freaked at talking to a psychologist? Here's what to expect in the first session

Hi, good to see you again. If you want to ask questions or comment, email me. Alternatively, find me on Facebook Monday to Thursday. Warning: I love cats!


I work with clients who are looking to manage stress and depression. As I live in Malaysia, I work with clients who live in my time zone: it runs roughly from Hong Kong and Australia to Saudi Arabia and the Emirates.

In our part of the world, there's a stigma about consulting mental health professionals, and so it can be a bit nerve wracking to reach out. Therefore, I thought I'd explain what happens in the first two sessions. You know, to take the fear out of the equation.

This first time we talk, we chat for about 20 mins. It's a free consultation so we can check that we can work together. Because we're talking over a video link, we start off by checking that the connection is stable. Then you tell me what kind of support you're looking for.  If I can help, and if we get along, we make an appointment for the first session.

The first session is where we explore the issues.  Depression and stress come in various forms, and they hit people differently. Also, there are several good therapy approaches.  So in this session we figure out what's going on and how we're going to work.

First, we talk about your overall background, like what you do, how old you are, and so on.

Then we look at what stressful events you've gone though in the last year. Like, have you moved house, changed jobs, had a health scare, had a baby, changed your lifestyle etcetera.

Then we look at your mental health, paying particular attention to common symptoms of depression. Like, how is your concentration, what's your appetite like, how are you sleeping, do you feel unusual sadness, have unreasonable flashes of anger.

Finally, we look at your support system. That involves a chat about how you get along with your friends, family, and colleagues.

At this point, we should have a reasonable idea of what's going on. I put together an overview, and we have a chat about goals and the approaches we might use to reach them.

At this point you'll be tired, so we set a bit of homework, simple things to get you started, and then we call it a day.

The first session covers a lot of ground, and takes about 90 minutes. But after that, sessions take about an hour.

So, I hope you find this useful. If you are looking for help, send me an email to happy@lepak.com and we'll set up an appointment. 

Monday, February 25, 2019

How to say the N-word

Years ago, the day after I'd moved house, a neighbour came up to me and said, "We're having a street meeting." I was still unpacking, I was tired, and so I said something casual about maybe looking in. He replied, "Oh, but I already told them you'd come." And then he added, "All the ladies are bringing something. You can cook something from your country."

Awkward, right?

One of the greatest challenges we face socially, is saying no. It can be quite difficult, especially if you're dealing with people you don't know well.

Many of us are worried about saying no because we wonder "what people might think". We worry that they'll think we're disagreeable, difficult or selfish. It's especially hard if you're female, or in a place that puts a lot of value on conforming.

There are several ways to address this.  My favourite, is to get some perspective. That's where you tell your story in the third person, describing just the events as if it's happened to other people. Then, give the fictional you advice.

Like with the story I just told. Telling it in the third person, that story would go like this:
Mia has just moved house. She's exhausted.
John comes round and says, "We're having a party!"
Mia replies, "Thanks. I'm too tired to go out, but I hope you have a good time."
John says, "But I said you'd come. Oh, and you should bring food, too."
QUESTION: what advice would you give to Mia?
Put this way, we'd be likely to tell Mia to skip the party and forget about it. Because John is being inconsiderate.

Perspective works because we tend to give very good practical advice to others, whereas we're often much too hard on ourselves. With perspective, you take away some of the personal elements; it helps you see clearly.

Once you've gained your perspective, you practice - or model, as we say in the trade.

What you do is write down what you think they will say, and your ideal answer. Then you run through it. The idea is that you get to practice in a safe space, and anticipate some of the issues that might crop up.

With saying no in the type of scenario I just described, you might be faced with responses like:
"But it won't be the same if you're not there!"
"We're depending on you to bring the cake/stew/whatever."
"Everyone is expecting you!"
"If you don't go, you'll ruin it!"

If you're faced with this live, that kind of pressure heaps up - because of that need to be nice and agreeable. However, if you get perspective and model, you'll see it for what it is: emotional blackmail. 

When you get that kind of response, you may be tempted to argue or justify. Don't do that! Stick to what matters: you were asked, you declined - and that's the end of it. Do not get drawn in to discussion. Just say, "No."

You can also use some non-defensive and assertive language. These are expressions that will help you cut down on arguments and that will help you draw personal boundaries. Here's a list.

Practice non-defensive responding phrases:
Oh?
Oh, I see.
That's interesting.
I'm sorry you feel that way THEN STOP TALKING
Thank you for your opinion. I'll take that on board. THEN STOP TALKING
I'm sorry you're hurt/upset/disappointed THEN STOP TALKING
I'm sorry you don't approve. THEN STOP TALKING
You're certainly entitled to your opinion THEN STOP TALKING
Let's do this some other time, when you're calmer. THEN STOP TALKING
Let me think about that. THEN STOP TALKING

Add in assertive phrases:
That is very hurtful
I don't appreciate it when you call me INSERT PHRASE HERE
When you speak that way, you hurt me
You agreed to hear me out.
Name calling and screaming won't get us anywhere.
It's not okay for you to talk to me that way.
I won't talk to you when you are yelling at me.
I won't stay if you speak to me this way
I won't stay when you are scaring me.

TOP TIP: if the person is abusive or threatening, WALK AWAY!

Saying no can be difficult, but doing so will cut your stress load. So, have a go, and if you are looking for professional help, send me an email. The first 20 minutes are free.

Monday, February 18, 2019

When life becomes too stressful, step two of Ellen's road tested coping strategies: socialising and support

Last week I talked about how 2018 was a crisis year for me - which meant I got to road test standard coping techniques.  I'm sharing my experiences with you, in the hope that you find it useful.

Note: I started making a video, but Swooner came in and threw up and now it's raining. I'm taking it as a Sign to Wait For Tomorrow.

Last week was about organizing and minimizing; today is about socializing and support.

We are social creatures and we need to feel connected. However, being around people when you are over-stressed, is tricky.

Stress affects your emotions. You may be a little too quick to anger, or cry, or to see the negative side of a neutral or positive comment… 

Also, people who know you are in mid-crisis tend to ask questions, like, "How are you?" and "You poor thing. How are you coping?"

They mean to be kind, but it their questions can lead to you reliving the trauma that comes with crisis, instead of taking a break from it.

Plus, if you are lucky enough to have lots of friends, you may end up having the same conversation over and over. I become impatient when tired, and so I find this issue particularly difficult.

Then, there's 'advice'.  This is very popular, and it's well meant. Friends don't like to see you suffer, and so they tell you how they cope or think they'd cope, and they frame it as "you should" or "have you done this?"

However, even if it's good stuff, unasked for advice can come across as second-guessing or auditing.  Too much unasked for advice can have you questioning yourself and your coping strategies, thus further racking up the stress.

In short, being with people, even when they try to be helpful, might add to your stress in a time of crisis.

So, how do you manage it?

The first thing I do is to limit my socializing. 

I draw back completely from social media. Stress affects my temper, and with cross cultural text communication being a challenge, I think it's best to take a break.

Next, I only speak about the crisis to my family and my closest friends. I can say anything to them, and they are sane, sensible and supportive.

I also connect with people who've been through the same crisis experience. Sometimes, just sharing with someone who's been there and done that is a relief. 

At the same time, I up my face to face socializing. I lunch with writers, researchers, lawyers and academics, colleagues and acquaintances who don't know about my personal life. It's a great way to switch off from my troubles while giving me fresh things to think about.

Also, I have some pub buddies who are perfectly happy to talk about this that and the other, without treading on sore topics. We call it 'decompression' and it's lovely.

By carefully curating my social interaction, I get the best out of my support system and I cut down on the negatives. I think the concept is an important part of managing stress but the details of your approach have to be tailored to your personal experience.

If you want more details, take a look at the post on Support System Mapping. It's sensible, not psychology, but it's very, very useful!

Next time, we'll talk about saying no and setting boundaries.

Thank you for listening, and do leave a comment and come and talk to me here. And if you have an issue you want to discuss with a mental health professional, do contact me via email at happy@lepak.com. The first 20 minutes are free.

Monday, February 11, 2019

When life becomes too stressful...Step One of Ellen's road tested strategies

I specialise in stress and depression, and as it happens, 2018 gave me an opportunity to road-test techniques and approaches. Over the next few weeks, I'm going to share what I did, how it worked for me, and hopefully, it will help you too.

If you don't know me, let me start by explaining that these last 12 months have not been easy.

Last February our best friend died in a shock smash and in March my husband Tom broke an arm and a leg. 

Tom was at home for three months, and helpless, poor soul.  During his convalescence, I was helping our friend's widow deal with the kind of red tape a sudden death generates. Also, there were some difficult family matters that cropped up. The year culminated with my estranged father's death in December.

I really thought we could get some peace, and then Guido, our wonderful cat, disappeared.

Recognising the signs of stress and burnout, I took the best part of six weeks off work. Now I'm back, and I'd like to share.

When life becomes too stressful...

Everyone is stressed nowadays. We all seem to be pushed to the max. Current advice tends to focus on coping, and this typically involves learning a stress relieving exercise such as visualising. I love that kind of exercise because it's a basic skill that will 'push up your Zen', as a friend calls it.

However, when your life is too stressful, you can't just whap on a Band-Aid like visualisation. Stress is a signal that you are over loading. It's okay for a very short time, but if you keep pushing yourself, you're going to damage your health.

Stress is a signal that you need to change your life.  

So, here's my first tip: when life becomes too complex, simplify.

Back in April, when I found myself running around 24/7 and too busy really to sleep properly, I stepped back and took a good look at how I was spending my time. This isn't psychology, it's practical time management, but it's a step towards good mental health:

Note down how you spend your time. Then, rationalise.

I have three jobs: counselling psychologist, columnist, and author. My other tasks were red tape for my friend's estate and some small projects I had on the go.

When I laid it all out, I realised that I was very organised about my work, but that I had allowed the red tape to take over.

What I was doing wrong: I was treating every bit of paperwork as an emergency. It wasn't. Taking phone calls and texts at all times of day, and prioritising whatever had to be done, meant I was ducking in and out of that task and stressing myself several times a week.

How I fixed it:  I accepted all the texts, forms, letters and so on, but I put them aside and dealt with it all on Thursday mornings.

What I was doing wrong:  Also, I had lost sight of what I am contracted to do and what work I take on as a favour.

How I fixed it: The small projects were mentoring work. As they were favours, I was at liberty to make my own rules. I informed the people involved that life had thrown me a couple of curve balls and that I would be available but only at certain times. Then I scheduled blocks of time weeks in advance.

What that did. By pushing those jobs into solid blocks, I lowered my stress level and was able to use the rest of my time more productively.

In addition, I changed some of my routines at home. I ordered groceries online to be delivered every Saturday so I could avoid going shopping. That's been a bit hit and miss, but overall, it's been useful.

Also, I dumped every single clothing item that needs ironing. Now I wear only pure cotton that goes in the dryer and can be hung up or folded, and miracle material blouses that are wash and shake dry. That has been a life saver and I seriously recommend everyone in the world adopt this!

As first steps, these moves really helped me. Next time I'd like to talk about socialising and support.

Want to discuss this? Come and talk to me here.

Tuesday, January 1, 2019

A little bit about me

A friend suggested I tell you a bit about myself, so here is a little of my career background. Here's a short video. If you prefer to read, the transcript is below.


I went to university in Scotland, graduating with a Bachelors in Psychology with honours that included two years business and computing.

Afterwards, I went to Spain, where my family lived, and worked there for a year. At this point, the manager for our family business in Indonesia left. I went to take over the administration for 8 engineers who were writing technical manuals at $60 an hour. I saw an opportunity for expansion, and landed us some contracts for design and development. In three years, I was able to expand the business to 20 engineers at an average of $70 per hour.

I went back to Spain to help out with a family crisis. That’s when I met Tom, my husband. He’s an academic, an Information Technology specialist. When he got a job in Malaysia, I needed a career that would give me some flexibility. I started creating content for newspapers and magazines.

I syndicated and sold over 3000 features and columns to clients in 12 countries. I also worked locally for newspapers like The Star, the Malaysian national daily, and magazines like Malaysia Womens Weekly, Her World and Cleo.

A few years ago, I went back to psychology and took a Masters. It included three internships.

First, I was with Dresser-Rand, a Siemens company. Working with engineers again, the focus was on industrial psychology as well as helping clients with stress, work life balance, and problem solving techniques.

Then I went to APU, Asia Pacific University. Working with teachers and students from more than 105 countries, we focused on stress, relocation depression, and cross-cultural communication.

Finally, I spent time with AWAM, All Womens Action Malaysia, a feminist NGO with a crisis centre that supports victims of domestic violence, rape, incest, sexual harassment and divorce.

I graduated three years ago, with a Masters in Counselling, passing with distinction, and set up a business, working online through video link.

I specialise in teaching techniques to manage stress and depression, working with clients in Malaysia, Cambodia, Vietnam, Hong Kong and Australia.

As for this year, Tom and I are writing journal papers, which I thoroughly enjoy. Also, I plan to expand my client base to Thailand and Indonesia. I still write feel-good columns for The Star, and I write novels – because I like to be busy.

So, that’s me. If you’re looking for mental health support, write to me at happy@lepak.com and we’ll set up an appointment over Skype, Whatsapp or Messenger. The first 20 minutes are free.










Wednesday, December 19, 2018

"HELP! Am I ruining Christmas?"


A friend of mine sent me a note, with a suggestion I talk about this here because it’s such a common problem.

"HELP! Am I ruining Christmas?"
"HELP! Am I ruining Christmas?"

Ellen,

I have always spent every holiday with my family. This year, I’m not going back for Christmas.

I’ve run out of leave and so I can’t take any extra days. Also, work has been hell and I’m just exhausted.

Instead of flying home, I’m staying in town and driving twenty minutes to my fiancĂ©e’s family for a quiet dinner.

Mum said she understands but I have this awful guilty feeling. Am I ruining Christmas?


Okay, you know your circumstances are dictating a very sensible decision and your mum agrees, so where’s the guilt coming from?

I suspect that this is a stress reaction inspired by change. You’ve always gone home and now you’re not. That’s a little unsettling. Also, you’re tired and that tends to lead to gloomy thoughts where you perceive things in the most negative way possible.

I think you need to step back and look at the big picture. Before this, you were a single lady and going home was natural. Now you’re engaged, your life’s changing. This is the start of the holiday juggle; the bit where you and your future husband will plan to see both your families over the year’s holidays.

I think a chat with mum, something along the lines of, “I’ll be getting married soon, and I’m dreading having to parcel out our holiday time” will help. She had to do the same and can probably give you some sensible advice. Communicate openly, and you’ll feel a lot better.

Also, do consider that Chinese New Year is coming up in six weeks time and that both Wesak and Gawai fall over a long weekends as well. So, there are plenty of holidays coming up. 

Merry Christmas!

Sunday, December 2, 2018

Is there a connection between sleep quality and mood for new mums?

Hi there, here's my latest venture in YouTubing. If you prefer the read, the text is below.


A new study in The Journal of Behavioral Medicine in July this year looked into the connection between sleep quality and post-natal depression and anxiety. As it wasn't reported in the mass media, I thought you might be interested.

The importance of a good night's sleep is only common sense. The thing is, sometimes common sense proves to be wrong. So, it's sensible to run scientific studies, just to see what's what.

For this one, researchers from 4 universities in the US interviewed 116 ladies who'd given birth six months earlier. They assessed them for depression and for anxiety. They also asked an awful lot of questions about factors that might be important such as their age, their employment status and so on.

When they adjusted for all the differences, the numbers showed that there is a clear link between poor sleep and depression and anxiety symptoms.

What does it mean?

We know from other studies mood problems can make it hard for mums and babies to bond. That's a problem because good strong bonds are important for healthy development. 

Now, other studies show that postnatal depression and anxiety are quite common. Roughly one in ten mummies get to one or the other. If you're unlucky, you get both.

So, when doctors talk to new mums, this new study tells us that the conversation needs to include a chat about sleep quality. Mums who are okay but who aren't sleeping well need to be given a heads-up that it may lead to mood issues. Because forewarned is forearmed.

As for new mums who report having mood issues, we're saying, focusing on sleep quality should be part of the package.  That means talking to a mental health professional about cognitive behavioural therapy, relaxation techniques like visualisation and other systems that can help improve sleep quality.

The study is by no means perfect, no study ever is, but it's nicely structured and thoughtful, so I think it's worth checking out. I've left a link to the journal article below and in the video description.

Poor sleep quality increases symptoms of depression and anxiety in postpartum women
https://cds.psych.ucla.edu/documents/Okun2018_Article_PoorSleepQualityIncreasesSympt.pdf

And if you want to check out visualisation, check out my related videos on my YouTube channel
Introduction to Visualisation on YouTube
Relaxing Beach Visualisation on YouTube
Or my blog post that includes the transcript

I hope you found this useful. Do leave a comment to share your thoughts. Also, please, if you are hit by post-natal depression or anxiety, get help, okay? Don't just suffer, reach out. Also, get some quality sleep.