If you've not been into it before, you might worry about what happens during a therapy session.
So here's an example of how you might typically tackle a common problem, in the hope it helps sheds some light on the process.
Suppose you make an appointment to discuss an office problem. "My boss gives me orders, and when I ask a question, he yells," you say. "It's gotten to the point where I'm shaking just at the thought of talking to him. What do I do to fix this?"
The thing is, I can't tell you how to fix it straight off. I know what works for me, but not what works for you. You are a unique human being with your own style, character and circumstances.
Yes, you're a special snowflake!
So what I have to do, is to get to you know you really well, and reasonably quickly. (Because you're paying me and you don't want to be hanging around for weeks on end)
So what are the steps to figure it out?
#1 I ask, "Tell me about the last three times your boss yelled." We examine the situations in detail so I can see exactly what's going on. At the end of this, I have a better idea of your feelings, your personal style, your boss' personal style and so on.
#2 As a boss is an authority figure, I then look to see how you handle authority figures generally. So I ask, "How do you fight with your mum?" I might also ask about your dad, your teacher at school, your older sibs, former bosses - whatever works.
#3 At this point, I have a good idea of who you are, and of your personal style. The next step is to see if you already have successes in this area. So I ask you, "Have you ever been in a word fight and turned it around?"
#4 We now have lots of information about you and the situation, so now we look at general principles of how issues like your are resolved by other people. Generally, this involves me explaining theories and examples.
#5 Now we pick through everything, and we decide on an approach that a) suits your style and situation, and b) that has some good evidence for working with others.
And at this point, we go on to practice (modeling, we call it) in a safe space, and then we work up to you going out solo.
As you can see, most of it isn't rocket science but it does take a bit of work, especially when it comes to steps 4 and 5 which are often where clients get the most benefit.
I hope this helps, and if you're looking for a counselling psychologist working online for stress and depression management, you know how to contact me. I work online via Skype and Messenger. My current charges are RM100 or US$30 over Paypal.
Monday, February 12, 2018
"I've got a problem with my boss, so why do you want to know about my mum?" Short answer: 'cause you're a special snowflake. Yes, really!
Sunday, February 4, 2018
On Saturday I left a bag of tangerines and pineapple at the hawker centre. When I went back the next morning, the man at the stall said, “Yes. No. Oh, I threw it away.”
I said, “You threw away perfectly fresh fruit? Come on, you know that’s not true.”
I knew he’d eaten it. He knew he was lying.
So he said, “I will compensate you” and I said, “Man, it’s just fruit. Forget it. But don’t lie to me next time, okay?”
I bought my breakfast as usual and replaced the fruit but I was thinking about it on the way home, and I believe this is symptomatic of something else.
When someone leaves perishables, you keep them for a few hours. That’s only fair. But if at the end of that day nobody comes, you don’t chuck out perfectly beautiful, nicely wrapped tangerines and pineapple. That would be a waste. You eat them.
Okay, they were commercially wrapped so you could keep them up to three days. So maybe he could have put them in the fridge and kept them an extra day. But hey, it’s not a gold watch. It’s not money. It’s just bloody fruit.
So why didn’t he just say, “Oops, when you didn’t come back, I ate them”?
I think it’s because people are so stressed at the moment that they yell for nothing at all. It’s not uncommon to see people screaming at staff for bringing the wrong drink or the wrong dish. All that aggro has created a situation where people lie automatically, just to avoid a scolding.
Sunday, January 21, 2018
One of the things I find fascinating about psychology is that it’s a field riddled with controversy.
|“If it’s quackery, why is it working for me?”|
The definition of psychology is that it is the scientific study of the human mind and its functions, especially those affecting behaviour in a given context. However, when you don’t have universal agreement on the definition of basic terms like normal and healthy, then you’re going to have a lot of fights over what’s proper.
As psychology is constantly evolving, there are a lot of discredited theories. That’s okay because we’re all learning. (Go the end of the article for a list - Freud is on it!)
To make it more complicated, there are con artists working in the mental health field.
Mental health attracts con artists for many reasons, including:
Scared=Easy Target: Desperate people don’t think clearly so they are easy to fool$$$ Fast Money: Desperate people will part with money quickly, hoping that paying over hard earned cash will magically help them find a ‘fix’Power Opportunity: It’s easy to influence frightened people. Cons and nuts find that being The Guru is an easy way to power.
From what I’m hearing, many of the ones here in Malaysia call themselves ‘Dr’, talk a lot about the unconscious, and the really cheeky ones run urine and blood tests - all at extortionate prices.
I’ve blogged before about how to avoid those. Today I’m focusing on a sensible question I’ve been asked, “If it’s quackery, why is it working for me?”
The answer isn’t a simple one but here are some points to consider.
#1 How much time do you spend on your mental health?
If the answer is, “Erm.... dunno. Minutes a month.” then you have to consider that spending a whole hour every week on identifying your issues is helpful all by itself.
Sometimes, all you need is to focus on what’s up and you can find the solution for yourself.
#2 Being upset means you don’t think straight
For most of us, thinking about a problem goes like, “Oh hell, I’m upset. Why am I feeling so bad? This sucks. I hate this.” And on and on and on for hours.
This is not helpful.
Sometimes just sitting down with a person who can help you focus on unraveling your thoughts is enough to clear the fog.
#3 Empathy goes a long way
When I said earlier that psychology is full of controversy, Freud springs to mind. Some of his theories were absolutely insane, yet he did some excellent work.
If you read his books and papers, it’s very easy to see why he was effective: he was genuinely interested in people and he was a kind, thoughtful man.
Sometimes, just having an understanding ear is enough to help.
This of course begs another question: “So if I see a quack who has good intentions, an empathetic attitude, and I’m willing to spend the time, what’s the problem?
|A wacko quack can cause real damage|
Just this: a wacko quack can cause real damage.
Think about it in terms of fixing a car. If you see blue smoke coming out of the engine, you can take it to a cowboy mechanic and one of two things happens: you strike lucky and it’s fixed, or you pay your money and you end up with a vehicle that blows up.
It’s the same with mental health.
Want to find a pro? Quacks make up fake associations so the best thing is to ask about qualifications. Look for someone who has a basic Bachelor’s degree in psychology as well as a Masters in a mental health field that includes several hundred hours of supervised practical clinical work.
Want to work with me? Click to see qualifications and how I work. 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 email@example.com for an appointment.
If you’re curious why rubbish is increasingly popular, you can read a classic like Carl Sagan’s Demon-Haunted World or check out Prof Patrick Grim who's one my favourites, or throw the terms pseudoscience into Amazon to see a list of current publications. It’s an awesome field, and worth taking a look at.
Curious what psychological theories are considered nonsense by insiders? Here’s a paper you’ll love. (Skip straight to page 518 for the list.) Pseudosciences included:
o Jungian sand tray therapy for treatment of adolescent and adult disorders
o Neuro-Linguistic Programming (NLP) for treatment of mental/behavioral disorders
o Rage reduction therapy for depression
o Freudian dream analysis for treatment of mental/behavioral disorders
Sunday, January 14, 2018
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.
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.
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 firstname.lastname@example.org for an appointment.
Wednesday, January 10, 2018
#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 email@example.com
Tuesday, December 26, 2017
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 firstname.lastname@example.org.
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.