Sunday, January 14, 2018

I Can't Pay For Therapy; How About Working With A Student Therapist?


This was written in response to a chat with a friend :-)

If you can’t afford therapy, one option is to work with a student therapist. There are pros and cons, so here’s a short list of things to take into account when you make your choices.

Pros
Students tend to be open to exploring options. That can be good if standard therapy approaches haven’t worked for you.

Students need hours, so they tend to favour long sessions. That’s good if you have issues that need lots of time to address.

It’s free. As students aren’t qualified, they can’t charge. At least, that’s the rule of thumb in Malaysia. I am hearing of other countries where students charge money; I find that very difficult in terms of ethics. See my next points.

Cons
Your student therapist is still learning, and that has implications. It’s just like asking a student doctor to give you an injection or medical exam; sometimes they’re terrific and sometimes they’re a bit clumsy.

As you’re not dealing with a fully qualified person, your sessions are not private. Your student therapist will be talking about your case with her supervisor, her tutor back at school, and then the examiner will see the notes as well.  In my school, we were also asked to present cases we were working on in class. In addition, your case may be evaluated by a licensing board.

All this checking and double checking is to make sure everything is being done right.

Should you be worried? Usually student therapists are pretty good about anonymising information and destroying notes after. But to be certain, ask for details. 

When students do their practice hours, everything needs to be documented and checked. This is to prevent fraud. This means contact hours are face-to-face sessions held in the supervisor’s place of work. This has implications for you because when the student therapist has completed her hours, she leaves. To prevent your sessions from halting abruptly, ask your student therapist how she will plan for this.

If you want online therapy, this may be difficult: students typically don’t work online or across borders because of the way hours need to be supervised and documented.

I knew when I was studying that I wanted to work online so I planned specially for it. I took an extra course in online therapy. On top of that, I also did an extra project, working online with overseas clients. Throughout, I leveraged my Masters Degree supervisors to make sure I was on the right track and I had an overseas teacher as well.  If you want to work online with a student, just ask how she’s getting her supervisors to work with her.

Note: I’m in Malaysia and I write from a local perspective. As countries have their own laws governing licensing and practice, you may have different or additional issues to deal with.

My advice: if you’re in doubt about a mental health provider or service, ask your family doctor to direct you to the proper organisations in your country. Mental health practitioners know it’s a minefield for the general public to find good quality help, and they tend to be generous about helping you find someone proper.

Want to work with me? I work online via Skype and Messenger and from home, so I can keep prices down. I charge US$30/RM100 per session. The first twenty minutes where we see if we can work together are free. Email me at happy@lepak.com for an appointment.


Wednesday, January 10, 2018

"Why is therapy never cheap?" - and why I'm only charging US$30 per session


One question pops up fairly often, "Why is therapy never cheap?" So here are some thoughts.

#1 We’re slow to start. It takes about seven years of school, Bachelors plus Masters, and apart from the classes, you need to spend roughly 1000 hours on unpaid internships that include some 300 therapy hours. Getting that done takes a year, sometimes more. So getting to the point where we can work costs a bomb.

#2 We do a lot of stuff you don’t see. You talk for an hour, but the second you leave, we’re writing up session notes. Then, before we talk next time, we read through the notes to prepare. While it varies, for every hour we talk, I tend to spend an hour on notes and prep.

#3 We're always studying. Every job involves constant learning but psychology is particularly intensive. I do constant journal sweeps as well as reading new publications, attending lectures and taking short courses. It costs money to stay current.

So there you go. As it is, I'm very affordable at RM100/US$30 per session. I'm keeping costs down by working online, and I have other revenue streams. Also, living in Malaysia means my cost of living isn't as high as in some other countries. Even so, it's not good ROI on my education investment. Frankly, the second the economy comes up again, so are my prices.  

Want to ask me about online therapy? Write to me at happy@lepak.com

Tuesday, December 26, 2017

What is it like to cut a toxic relative out of your life? A personal perspective


I’ve thought about writing about this topic more than once, and I’ve always chickened out. However, I was asked the other day for tips about coping with toxic people, including toxic family, and having had second, third and fourth thoughts, I’ve decided to go for it.

A few years ago I was making a phone call. I was intending to arrange a night out. A drink followed by dinner. I was feeling dreadful: churning stomach, sweaty hands, and headache alive and hammering.

I didn’t have the flu. It was pure nerves.

I was standing there and that’s when it hit me. I looked at myself and thought, “This is ridiculous. I’m not doing it anymore.”

I made a decision on the spot that I was cutting that person out of my life. It wasn’t easy, and despite the apparent circumstances, it wasn’t a sudden one either. Our relationship had deteriorated over a period of years.

I’d tried to fix it several times but it was like talking to a brick wall. No matter how I tried, the barrage of lies, put downs, mind games and a whole load of other absolute poisonous crap that I won’t discuss here went on and on and on.

I’d kept going because I kept thinking that it would change, that it would get better.

But it didn’t and so I said, “Enough.”

Not making that call was huge for me. The moment I made that decision I felt absolutely awful. It’s hard to describe but it was a sense of failure, of utmost misery.

But you know what?  I also felt huge relief.

I cried buckets, pure guilt, and then I got sensible. I thought it through and planned for the fall-out.

First, I had to cut ties. I worked out what I wanted to say the next time we spoke, and I practiced and practiced so I’d get it all out in one go, without being drawn into long debates.

I don’t remember the exact words but I was very brief and impersonal. It went something like, “We’ve not connected for a long time. Our meetings upset me. It is best for me to step back.”

The conversation took place over the phone and it took less than a minute. Afterwards I went through more a barrage of those same conflicting emotions but at that point the relief loomed larger than the rest.

Then when the news spread, I tackled the issues one by one.

My close family and friends understood as they’d seen for themselves what led up to it.  Apart from, “We’re here if you want to talk” they were kind enough to leave me to it. And when I got myself together, I did do a bit of talking. Still do, sometimes. I don’t think I could have done it without them and I’m forever grateful.

It was the people I didn’t know well who were a pain in the bum. I learned to cut off the well meaning ones by saying, “This is a private family matter I prefer not to discuss.” 

The few who persisted got shorter shrift. “Mind your own business and I’ll mind one” caused some red faces but I don’t regret it. Busybodies who want to second-guess and arm chair moralise are best kept at arm’s length.

The most difficult thing was that some more distant family and friends complained. I had some very difficult conversations with them but I realised very quickly that they were mainly bitching out of fear.

I’m afraid this is very common in these situations: if one person in a group is targeted, the rest of the herd is grateful because it means they feel safe. Once you realise what’s behind the, “Why can’t we just go back to the way we used to be?” it’s easier to stick to your guns.

So, am I happier?  Was it the right decision? 

I do feel grief over What Might Have Been. And sometimes I play that, “What if I’d said this instead of that?” But on balance it was right to walk away. For me the answer is yes. Cutting out that toxic relative was the best decision for me.

Is it right for you? I don’t know. What I would say is this: think it over. Wave a magic wand and ask, “What would life be like if...?” and think it through.

As this is my blog, and I’m a counselling psychologist, I’d say that if you need to, it can help to talk it all through with someone like me. 

If you don’t talk to me, and are looking for another professional, my advice would be to  pick someone who has experience of abuse and domestic violence cases. People who’ve been up at the sharp end tend to be better at talking through all the possibilities of dealing with toxic relationships. 

Also, avoid therapists who are committed to ‘saving’ relationships. You want someone who wants the best for you, not someone who wants you to live according to a pattern they think is nice.  

And having said all that, Happy New Year. May 2018 bring you health, happiness and lots of laughter.

Want to schedule an appointment? I work online via Skype and Messenger. Send me an email at happy@lepak.com.

Wednesday, December 13, 2017

“How to deal with people who keep bugging you...” Tips for when social media friends are a pain in the bum


This was written as a response to a Facebook post asking what you'd like me to blog about. The question was, “how to deal with people who keep bugging you ie they don't know boundaries?

Social media is great for keeping in touch, and making new friends, but unfortunately, it also opens the floodgates to unwanted contact. The two things that top the list include unsolicited advice and repeated PMs or requests for private chatting. Note: I'm not including PMs that ask for a contact, referral, or other very specific help or information. Those are always okay.

For me, the factors pushing both behaviours is similar. 

I see giving an unsolicited opinion once is okay, as it can be very hard to see if someone is just moaning about an issue because it happens to be on their mind or whether they are asking for help. Asking someone to chat when you've not met and you haven't had long public conversations on their timeline, well, I wouldn't do it myself but assuming it's polite and not a dick pic, I suppose there's no harm in it. 

However, it's only okay if the friend stops when you don't reply or fob them off with an "I'm busy" or equal non-response.

A person who is genuinely interested in your advice or who wants to chat in order to get to know you better will come back to you. If they don't, you should move on. This is why I think a second push is a no-no.

Still, suppose your friend goes for it again.  If you think they're basically okay but just not getting it, you have to be completely straightforward. The message has to be utterly plain, so they can't mistake it. After all, the subtle stuff has already passed them by.

For random unwelcome advice, you might say, “This is not something I wish to discuss further.”

If you have a health problem that's brought out the crazies, a friend who is expert at fielding these recommends, you preface it with a graceful, “Thank you for your kindness. I have a detailed treatment plan I am comfortable with.”

For persistent chat requests, I use this standard phrase, “If you have a specific question, or need a contact, do PM me, but I just don't have the time for random chitchat.”

It can be difficult to have to be this blunt but it means you can invite an “okay, I get it” in return, and it's all good again. With this option, you make it possible to keep your friend. I'm all in favour of this, because relationships are to be treasured.
However, if that person has a hissy fit, or keeps bugging you, that’s different.

I could beat around the bush here and be super sweet about it, but let’s talk turkey. There might be many underlying causes fueling this annoying persistence, and none are flattering.
·    They are self-centred/entitled and can't see their opinions/attentions are unwelcome.
·        They are selling something and hope to bully you into buying.
·        They are advocates/evangelists, meaning they are bullies intent on shoving their opinions onto you.
·        They are abusive and this is an attempt to control you by wearing you down.

In all these cases, I think it’s acceptable to cut them off. I do.

Clearly it will be more difficult if this person is close to you. However, there really is no reason why you should put up with bad behaviour.

Friends respect boundaries.

Tuesday, November 21, 2017

Oh, Oh! When You're Not As Clever As You Think


Long time, no see!  I’ve been busier than the proverbial bees and so haven’t had the time to blog.

However, apart from the private clients and the novel writing, I’m also back into research. I’ll tell you more about it in a few months. In the meantime, I thought you’d be interested in this nugget.

Do you ever find yourself super irritated by people who wax lyrical on complex topics they know absolutely nothing about? If yes, then read on....

The Man In The Pub is a classic. He’s the one who tells you how to fix the national budget, lower your blood pressure, dump your difficult boss, and he’ll have a sure fire fix your love life too - whether you ask him or not! The thing about him is that he's just ordinary but he thinks he's a genius.

Curiously, the Man In The Pub phenomenon is becoming more and more common. Just look around and you’ll hear people talking very confidently about statins, food additives, allergies - and they do it while admitting they barely passed their high school chemistry and biology exams, never mind taking a hard science course of any kind at college.

Question: why do these people think they understand complex topics when their ‘research’ consists of reading a couple of Facebook posts based on a magazine article that was shared by friends?

First, there’s the Dunning-Kruger effect. It says that when you lack skills, you come to the wrong conclusions. Then, because you don’t know what you’re doing, you can’t tell you’ve made a mistake. So you go about, thinking you’ve got it nailed, when actually you don’t. What you do have is a case of illusory superiority. Ouch, right? (Want to read the papers, check out the references below)

And here’s the bit I’m interested in... I think the reason we’re all becoming The Man In The Pub is because we have the illusion that we’re always connected and always learning. Our smartphones and our Google make us think that we’re soaking up smarts. 

We feel empowered, which is lovely, but we’re not actually learning that much. While we might be a bit better about finding out quickly where Bangui is, or who was fighting at Flodden back in 1513, no amount of Googling is a substitute for serious study. That's common sense, right? If all you had to do was Smartphone away, we’d all have a couple of dozen PhDs by now.

Given we're living in the Internet age, we’re all suffering from the Dunning-Kruger effect at least a little bit. And the problem is that it can make life awfully difficult. (I’ll write more about that later, as this is getting a bit long.)

It got me thinking, what’s a quick self-check to see if you might be falling into this?

I suggest this: the next time you talk about a complex topic, like medicine or space exploration, ask yourself what kind of knowledge you would need to be a world renowned expert. Could you be a surgeon on the basis of your marketing degree?  Would NASA ask you to take charge of the Space Station because you have a masters in psychology? If the answer is probably not, watch yourself.

Crushing, right? And I was so certain I could do Robert M. Lightfoot Jr's job! But hey, better than being The Man In The Pub. 

Check it out these papers:

Dunning, D. (2011). 5 The Dunning-Kruger Effect: On Being Ignorant of One's Own Ignorance. Advances in experimental social psychology, 44, 247.
 
Kruger, J., & Dunning, D. (1999). Unskilled and unaware of it: how difficulties in recognizing one's own incompetence lead to inflated self-assessments. Journal of personality and social psychology, 77(6), 1121.
 

Thursday, October 12, 2017

I am safe to come out to - celebrating Coming Out Day in the USA

Today is National Coming Out Day in the USA, a time dedicated to raising awareness of civil rights for the Lesbian, Gay, Bisexual and Transgender community.

If you don't know me personally, this seems a good day to say that I am a safe person to come out to.

If you're in a country where being LGBT is a crime, and you're looking for a therapist for managing depression and stress, please know you can talk to me secretly and safely.

Contact me via email at happy@lepak.com

Tuesday, October 3, 2017

Are you being sexually harassed online? Here's what to do.

Online sexual harassment is common and I’m fed up of people who think we should suck it up or ignore this incredibly wicked and damaging behaviour.

If you are a victim, here are some tips for reporting effectively.

We’re going to do this in three stages: documenting, reporting and support.

Preparation
Thanks to Stevenpb from Pixabay
1. Take screenshots of each and every incident.

2. Note the time and date.

3. Take a screenshot of the perpetrator’s personal details. Be sure to capture all their pages, from their education to their contact list.

4. Write a coherent detailed report of what happened and when, complete with all your screenshots. If you find anything is missing, now is the time to go back and collect evidence.

5. When your report is complete, report each comment to Facebook, LinkedIn, Twitter etc. Each comment is a report, so note down when you report them, and add that information to your report. Yes, take a screenshot!

6. Block the user who is harassing you. From this moment on, you can’t see him or her anymore, so once you’ve done this, you won’t be able to add to your report, okay? So make double sure you have everything you need before this step.

Reporting
Contact MyCERT, the Malaysian cyber security people. Note, this works if there is a Malaysian connection: for example, you can use them if you are in Malaysia, the perpetrator is in Malaysia, or the company he or she works for is Malaysian.

If there is no Malaysian connection at all, contact whoever is responsible for cyber crimes in your own community.

My advice is to phone and then email MyCERT. Ask for an incidence report number. Add this to your overall report.

Once you’ve lodged your MyCERT report, you can consider these further options.

A. Take the information to the police. If you aim to take this to court, or you think the person attacking you will turn up at your house/office one day, you need to alert the police.
If you don’t intend to go to court, and don't anticipate other dangers, then this step may or may not be worth it.

On the one hand, the police should know what’s going on. For all we know, the person harassing you is already a person of interest in other crimes. This may or may not include stalking, domestic violence, criminal intimidation and so on. If that is so, the police really need to hear from you.

On the other, the police tend to be understaffed when it comes to tech crime experts. My view is that a reasonable compromise is to go and see them and ask if they’d like a formal report. Policing should be a community effort, and so reasonable adults should be able to talk reasonably.

B. Inform the company the perpetrator works for that you have filed an official complaint.

In my view this is incredibly important. If someone is happy to sexually harass you online, you can bet your boots they’re doing it at work too.

We all know how hard it is to make a formal complaint at work about harassment. It is vital that management has a heads-up so they can make informed decisions.

Also, if it were my company, I would want to know that my people were disgracing my name online.

However, it's up to you to decide if you want to do this. If you feel uncomfortable, you might also talk to a lawyer and have her do it for you.

Me, I'm the direct kind. I would write directly to the CEO and let her send it to whoever needs to deal with it within her own system. For a very large company, I might also copy my note to HR. And if I weren't seeing a response, I would send it to their corporate communications department. Believe me, if you want a response, the media people will be screaming the second they get your email.

C. You may decide not to report it further.

Reporting means getting more people involved, more talking and there is no doubt that many people just can't cope with that kind of pressure.

If that's you, then make your report to MyCERT and the social media it happened on and leave it. I know I'll get slammed for this but let me tell you: if it's going to make you ill, then don't force yourself to be a hero. Just keep reporting; that's good enough. The more of us who report, the better. And your information may bolster someone else's case.

If you decide to tackle these bullies, good for you! Yes, it's a drain but the more of us who step up, the easier it becomes for others to speak up. So go for it, but do make sure that you manage the stress that goes along with this kind of case.

Support
You can expect some fallout for reporting. First, there are invariably ignorant and hurtful comments online from people who blame you for being the victim of this crime. It’s up to you whether you choose to educate them or remove them from your friends list.

Second, you may also face harassment from the perpetrator’s pals who hope to frighten you off. After all, you’re spoiling their nasty little game by shining a light on them. This can get very nasty, from having them put out fake news about you, to direct physical threats of violence. If you're worried, talk to the police and your lawyer. In case of extra harassment, document and report.

Finally, when you report your case may go nowhere. However, if someone decent becomes involved, they will follow up. That can mean telling your story over and over again. That is in itself stressful because it's like having the wound poked at repeatedly, plus there's bound to be questioning of your motives, person etc.

To cope with the overall stress, my advice is to gather your support network. Identify friends, colleagues and acquaintances who can help you long-term, short-term and in specific instances. Make a list!

Also, spend twenty minutes a day focusing on destressing. That should have a twin focus:

1. Doing something fun that you like (talking to your cat, watching silly films on YouTube) and,

2. Working of physical stress either by running or by hitting something very hard to get rid of the anger (tennis, squash, kickboxing - whatever works)

You might also enlist the help of a professional like me to help you manage this difficult time.

I’m a counselling psychologist and I work online over Skype, Facetime and Messenger. Contact me through happy@lepak.com.

And finally, don’t blame yourself! Put the blame where it is: on the nasty minds who get their kicks from attacking others.

Good luck!