In it he discussed the terms mental illness and mental injury.
He spoke about the way we perceive accidents involving physical injury compared to accidents that involve mental impacts.
A PHYSICAL INJURY
He gave a scenario where you are walking down the street and someone runs up to you and slashes your arm. You are hurt and bleeding but you are not sick. Apart from the injury to your arm you are otherwise healthy. No one blames you for being slashed. After all, that is victim blaming, something we are increasingly aware of and seek to avoid doing.
COMPARE THIS TO A MENTAL INJURY
But someone who is suffering from a mental injury is not given the same respect. If you developed PTSD as a result of this random attack you would be described as being mentally ill. This implies that there is something wrong with you, rather than there being something wrong with the people around you or your environment. In the case of the slashed arm, something is wrong with the person who randomly decided to slash your arm.
Suddenly you are being victim blamed. But isn’t that something we try to avoid doing these days?
PHYSICAL INJURIES BUT MENTAL ILLNESS
If you have arthritis in your knee but are otherwise healthy, you just have arthritis in your knee.
If you have anxiety about social situations but are otherwise healthy, you are mentally ill.
Using the term mentally ill suggests there is something wrong with you as a person. The connotation drawn from that term is that you have something wrong with you and you are ill.
Why is there such a difference between physical ailments and psychological ailments?
WHAT COUNSELLOR’S STUDY IN THEIR BACHELOR DEGREES
Luke’s comments reminded me of the rationale behind the subjects I studied in my counselling degree. We not only studied counselling, but also psychology (to better understand behaviour) and sociology (to better understand the environment). We were always taught that we needed to understand the context of a person’s environment and the impact of the people around them to understand what was happening to them.
A HORRIBLE WAY FOR YOU TO BE TREATED
If you walk into my practice room and I just see you as mentally ill, then that implies I just see you as being wrong, at fault.
If I see you as being the cause of your suffering then I don’t look further than you. I pathologise your suffering. I look for dysfunction in you and set out to correct it.
THE WAY I TREAT YOU
But that is not what I do.
Instead, I see your suffering as the result of an injury that has resulted in a completely normal reaction to abnormal circumstances. Sometimes there is more than one injury. Sometimes the injury keeps happening again and again, or has in the past happened again and again.
I look at your environment, including the people in that environment. I look to see how that impacts on you and your suffering.
I believe every person who walks through my door is someone who has been injured as a result of abnormal circumstances. I see you as being a healthy individual who is coping as best you can with a wound.
Interestingly the Greek word for wound is trauma.
Makes sense doesn’t it.
NEED HELP WITH YOUR MENTAL INJURY?
If you would like to talk to me about how I can help you with your mental injury, please contact me on 0409396608 or nan@plentifullifecounselling.com.au
If you would like to learn more, I write a regular newsletter with interesting information, tips, information on courses, and the occasional freebie. At the moment I have a free mindfulness meditation for anyone who signs up to my newsletter. This meditation offers a way to safely explore your feelings and learn to be okay with them. If you would like to subscribe please click on the link here: http://eepurl.com/g8Jpiz
RUOK day is not only about reminding you that you have the power to help others, but also a reminder to seek help is you are not OK.
Helping others is not just the preserve of those of us who specialise in mental health. We all can help others.
Today I am going to talk about how to ask others if they are OK.
Then I am going to talk about how you can get help if you are not OK.
Most people will not ask for help. Such help seeking is pretty taboo in our society. Have you ever been taught even the basics of a foreign language? If you have you will no doubt have started with how to greet another person. Hello. I am xxx. How are you? And you will not doubt have been taught the response: I am well thankyou.
This is the hidden message of our culture. Don’t tell others how you are feeling!
I am sure you have met people who will avoid any discussions that are hard. These are the people who will avoid responding to your tentative words reaching out for help. Or who will respond with comments designed to stop the conversation.
If you are in that position, don’t give up. Later in this blog I will talk about what you can do to be heard.
WHAT SHOULD I BE LOOKING FOR IN THOSE AROUND ME TO INDICATE I NEED TO ASK RUOK?
Because of the taboos in our society on reaching out to others, it is unlikely a person who needs help will tell you – unless you ask.
The following are times in a person’s life when they might need a little bit of extra help:
• When a relationship has ended or there are difficulties in that relationship.
• When the person is going through stressful times, or there has been an increase in the stress in their life.
• When there are financial difficulties.
• When there are major changes in the person’s life either at home or work.
• When someone/thing they care about has been lost.
• When there is a major health issue.
• Any time you notice someone is struggling.
SIGNS A PERSON IS STRUGGLING
• Things they are saying, especially if they are different:
o They may not be making any sense when they talk, as though they are confused.
o They may tell you they can’t cope or feel things are out of control.
o They may criticise others or themselves.
o You may get the impression they are feeling trapped or in emotional pain.
o They may tell you they feel lonely or are a burden to others.
• Things they are doing that may be different:
o They may seem to lack energy or be unmotivated
o They may be unable to switch off
o There may be changes in how much and when they sleep, exercise or eat.
o They may appear uninterested in their appearance. This may extend to their home.
o They may no longer be interested in the things they used to enjoy doing.
WHAT DO I DO IF I THINK SOMEONE IS STRUGGLING
If you think someone is struggling then this is the time to consider asking them if they are okay.
Before you do this it is a good idea to consider how or if you might have that conversation with this person.
If you ask the wrong way, and are not prepared for a helpful conversation, you may not help the person. If you feel you are not able to ask, maybe finding another person to ask may be helpful. This is not saying you are not going to be any good at it, but maybe the situation the other person is in , or the relationship you have with them may impact any conversation you may have.
The other person needs to feel they can trust you, or they will not open up to you. So it is wise to consider whether you have been trustworthy in your relationship with that person.
If you feel the other person can’t trust you, you may still be able to reach out to them. In this situation it is best to acknowledge the past. Maybe you could try saying something like:
“I know I haven’t been very trustworthy in the past, but I am concerned about you and I care that you may not be feeling okay.”
If your previous conversations with this person have not involved you listening very well, you can maybe try saying:
“I know I haven’t listened to you very well I the past, but I am concerned that you may not be okay and I want to listen and hear you and support you.”
HOW TO PREPARE TO ASK RUOK
First step is to be ready:
• Ask yourself if you are in the right headspace to listen.
• Ask yourself if you are willing to really listen to the other person.
• Make sure you have the time to have this conversation. It is no good asking someone if they are okay and then rushing off because you have to be somewhere else.
Second step is to be prepared:
• Acknowledge that you are not there to “fix” the other person. You are there to listen. It is okay if you don’t have any answers to their difficulties.
• Don’t rush the other person or fire off questions at them. Be prepared to sit quietly and non judgementally with the other person and allow them the space to process their thoughts and express what they want. When you are trying to survive you spend a lot of time pushing down emotions so you can get through the day. It may take time for the other person to feel able to speak about something that they are feeling very emotional about. It is helpful to bear in mind that it is often embarrassing to discuss problems.
Last step is to choose your moment carefully:
• Find somewhere private and comfortable. A busy place with little privacy is not going to be very conducive to expressing vulnerable thoughts.
• Is this a good time for them to talk? If they are busy and stressed, they are not likely to be willing to take the time out to express how they are feeling.
• You may need to choose another time if they are too busy to talk.
• Consider the way you talk. It is often less threatening when you are sitting side by side doing nothing that requires concentration, or when walking. Being side by side is less confronting than being face to face.
The last point on being side by side highlights the value of being with the other person and doing something together. This is a great time for a conversation where the other person is likely to feel comfortable and able to talk.
IMPORTANT TO CONSIDER
You may be ready to reach out to the other person. But they may not be ready to talk.
Don’t give up. The fact you reached out and expressed your concern will not be lost on the other person. It may be that when they are ready to talk they wil reach out to you.
It is better to have asked than not to have asked. If you ask and they say no, at least you asked. If you don’t ask you will never know if you gave up a wonderful opportunity to reach out to someone in need.
NOW TO ASK – R U OK?
Have a casual conservation.
Start by saying something about what has prompted you to ask.
Examples include:
• You have been quiet lately, how are things going for you?
• I haven’t seen you much lately, is everything going okay for you?
• You’ve seemed really stressed lately, do you want to chat about something?
Now listen and don’t jump in with your own stories.
THEY DON’T WANT TO TALK TO ME – WHAT DO I DO?
Just because you reach out to another person does not guarantee they will talk to you.
It may be the wrong time for them to talk. You could try asking them if it would be okay to check in with them again.
They may feel no one cares and may need to process you request before they are willing to accept you invitation to chat.
Maybe they would feel more comfortable talking to someone else.
You reaching out may lead to them reflecting on their need to talk and they may be willing to talk to or someone else at another time.
THEY DO WANT TO TALK TO ME – WHAT DO I DO?
They welcome your question and tell you about their problem.
So what do you do?
• Remember we talked about you being there to listen, not solve problems.
• Listen.
• Don’t rush to judgement. Have an open mind.
• Give them space to talk. If they pause, don’t rush to fill the silence. Silence is great. Allow the silences and trust the person will talk when ready.
• Ask questions that are open ended, that is that don’t require yes or no answers.
• Ask them to explain the things they say. Don’t assume you understand what they are saying or the impact it has on them. Do this by asking questions that allow space for them to answer in many words. No questions that just require a yes/no. They shut down the conversation.
• Every so often repeat back what you have heard them say and ask if you understood it properly. This give them a chance to correct any misunderstandings and sends the message that you are listening.
I HAVE LISTENED AND THEY HAVE TOLD ME ABOUT THEIR PROBLEM – NOW WHAT DO I DO?
It is at this point you can encourage them to explore what they might be able to do to help themselves.
This may involve someone they can seek help from. It may instead involve spending time together brainstorming ideas on what they may be able to do to change their situation.
Maybe they might see their doctor, talk to a family member, talk to a close friend they trust, see a counsellor.
They may have encountered difficulties in the past and been able to solve them. What did they do back then? Is this something that may work now?
You can also ask them if there is anything they need from you.
CONVERSATION OVER – NOW WHAT?
Once the conversation is over there is still one thing you need to do.
That is to check in with the person at another time.
Let them know you haven’t forgotten them and are still willing to support them.
This allows you to communicate to them that someone cares.
It allows them to feel less isolated.
It may be the encouragement they need to do something about their situation.
It can support them until they are ready to reach out for professional help.
I THINK THEY ARE AT RISK OF SUICIDE – WHAT DO I DO?
If you are concerned the other person is suicidal don’t be afraid to ask.
It can be as simple as “are you thinking about killing yourself?”
Asking will not plant the idea in the other person’s mind. If they are suicidal they already have that idea. If they are not suicidal your asking will not suddenly make them suicidal.
If they answer YES this is what is important for you to do.
Do not leave them alone. Keeping them safe is important.
Get professional help.
While you stay with them:
Keep listening to them.
Find out if there is someone they trust who can help them.
Not all people who are suicidal will actually kill themselves. You can ask if they have a plan and the equipment needed to carry it out.
Unless you feel they are in immediate danger (in which case you will dial 000) try the following:
• Call a crisis support line together.
LIFELINE: 13 11 14
SUICIDE CALL BACK SERVICE 1300 659 467
who provide immediate support and advice
• Visit an emergency department together.
• Take them to a place they feel safe where they will not be alone.
HOW DO I GET HELP IF I AM NOT OK?
Reach out to someone you feel comfortable talking to.
If someone reaches out to you, be willing to accept that offer of help.
If you urgently need to talk to someone, or you are feeling suicidal, LIFELINE 13 11 14 is a good starting point.
You can also ring the SUICIDE CALL BACK SERVICE 1300 659 467
For longer term help counselling can be very helpful.
If you would like to talk to me about how I can help you when you are not okay, please contact me on 0409396608 or nan@plentifullifecounselling.com.au
If you would like to learn more, I write a regular newsletter with interesting information, tips, information on courses, and the occasional freebie. At the moment I have a free mindfulness meditation for anyone who signs up to my newsletter. This meditation offers a way to safely explore your feelings and learn to be okay with them. If you would like to subscribe please click on the link here: http://eepurl.com/g8Jpiz
RUOK.ORG.AU IS A GREAT SOURCE OF ADVICE ON HOW TO ASK RUOK
Would you be horrified if I told you that some childhood stress will shorten your life expectancy by 10-20 years?
Maybe you would struggle to believe that. For generations adults have told themselves that children are resilient and get over things. But do they?
Extensive research has shown that some types of childhood stress have exactly this impact on life expectancy. This stress is referred to as toxic stress.
These types of childhood stress are called adverse childhood experiences. There is an acronym for that – ACE.
ACEs
High ACE scores have been linked in research to premature death, a large number of health conditions including mental health problems, heart disease, and lung cancer.
The types of stress included in ACEs include physical and emotional abuse, neglect, household dysfunction, parents struggling with substance abuse or mental health issues, sexual abuse just to name a few.
The truth is childhood trauma is not something you “get over” or “grow out of”.
CHILDREN’S BRAINS ARE IMPACTED BY ACEs
The repeated stress of ACEs has well observed impacts on the way the brain develops. These impacts are observable across the person’s lifetime.
ACEs were described in the 1990s and have been the subject of much research since then. The original researchers noted that ACEs are very common, in all strata of society. A person from a middle class or high socio-economic level is just as likely to have experienced ACEs as a child from an impoverished background.
IMPACTS OF ACEs
Other findings are that high ACE scores are consistent with poor adult life outcomes including significantly higher risk of heart disease, diabetes, obesity, depression, substance abuse, mental health issues, suicide, smoking, poor academic achievement, homelessness, incarceration, being a victim of domestic violence, unemployment and early death.
That is quite horrifying. But how do stressful things that happen to children impact on adulthood? The answer is toxic stress. Toxic stress in a child is stress that leads to frequent, prolonged and excessive activation of the body’s stress response systems. This has a negative impact on the child’s developing brain, immune system, metabolic regulation and cardiovascular system. It has been described as overrevving the body over a long period of time so that it wears out and problems develop.
WHEN STRESS IS A PROBLEM FOR CHILDREN
Children will experience stress. It is part of life. Where it becomes a problem is where there is no supportive adult or adults present to cushion the impact of the stress. For example, research has shown that during crises in the life of a family, the children of the family will be less impacted by the stress if their parents are able to cope well and support their children.
WHAT ARE ACEs?
Initially ACEs were classified as:
• Neglect
• Physical abuse
• Emotional abuse
• Sexual abuse
• Domestic or family violence
• A parent with mental health issues
• A parent with substance abuse issues
• A parent in prison
• Lack of attunement between parent and child
Over time there has been a broadening of what is considered to be an ACE to include:
• Homelessness
• Natural disasters
• War
• Being a refugee
• Violence in the community
• Racism
• Chronic poverty
• And so on.
TRAUMA, ACEs AND TOXIC STRESS
Trauma is a large part of ACEs and toxic stress. Trauma is generally considered to be any stressful experience where there is great adversity or terror and the emotional responses to those experiences. This involves toxic stress and is a major part of any ACE.
HOW CHILDREN REACT TO TRAUMA
In children, trauma will often play out in behaviours where the child withdraws or acts out. Some children will develop ADHD type behaviours. Others may become aggressive and pick fights with other children. Some may withdraw and even self harm. Bullying behaviours are sometimes the result of trauma.
The child who steals cars, breaks into homes, vandalises things ifs often a child who is suffering from ACEs.
It is important to recognise the acting out behaviour of children as likely due to trauma.
Many years ago I worked in a shop and caught a boy stealing. He was only 12 and had started this destructive behaviour after his father had left his marriage. The boy was so broken and miserable. It broke my heart to see his pain.
WHAT HAPPENS IN ADULTHOOD?
ACE affected children grow into adulthood. It is important to consider that if you are ACE affected you are not irreparably damaged. You can get help.
It is important to see a Trauma trained therapist. Working with trauma is a highly specialised field. It is important to find out what experience a prospective therapist has in the trauma field.
WHAT THERAPY SHOULD I SEEK OUT?
Therapy to heal the impact of ACE is not a 10 session solution. The impacts on your brain have taken a long time to form and they need a long time to change. Brain growth slows over the age of 26 and you need to grow many new neural pathways. So expect these changes to take a long time.
Much of trauma is stored in the areas of the brain and body that cannot be consciously accessed. For this reason, talk only therapies are not very effective in healing trauma.
Finding a therapist who works with different approaches such as, to name a few, somatic approaches, art therapy, expressive therapies, EMDR, EFT as well as some talk therapy is important. In Australia the Blue Knot Foundation and its guidelines are the gold standard for trauma therapists. A good trauma therapist will have completed training with them.
HOW LONG DOES THERAPY TAKE?
Expect to spend a long time working on your trauma. I recommend you come to work on a problem. This may take regular sessions over a number of months. The sessions will be frequent at first and decrease in frequency as time goes on. You work on a particular aspect of your trauma, then allow time for that healing to consolidate.
You may take a break from therapy while that consolidation takes place. At some time in the future you will feel the need to seek therapy for another aspect of your trauma. You may go back to the same therapist or find a new one.
HOW I CAN HELP
I am a trauma trained therapist, have received training through the Blue Knot Foundation and I adhere to their guidelines. I also have extensive experience working with trauma affected individuals. All the therapies listed above are used by me in my work.
If you would like to talk to me about how I can help you with your ACEs and their impacts, please contact me on 0409396608 or nan@plentifullifecounselling.com.au
If you would like to learn more, I write a regular newsletter with interesting information, tips, information on courses, and the occasional freebie. At the moment I have a free mindfulness meditation for anyone who signs up to my newsletter. This meditation offers a way to safely explore your feelings and learn to be okay with them. If you would like to subscribe please click on the link here: http://eepurl.com/g8Jpiz
There are those times in life when you get so anxious you can’t think straight and find yourself saying and doing things that you wish you hadn’t.
Or there are those times when you are overwhelmed by intense emotions and can’t function, or worse still react in a way you don’t want to.
What do you do?
In the long term, counselling to find the root cause of the problems and defuse them is great.
But what do you do in the short term?
Learn how to identify the signs you are getting anxious or your emotions are intensifying. You need to be able to identify them before they get out of control.
When you feel those early signs practice grounding to help you gain control of them.
6 ways to practice grounding are:
Tune into your Body. Feel your feet on the ground. Pressing your toes into the floor will help make that connection. Look at your shoes. What size are they? What do they look like?
Engage your senses. put on a favourite shirt, smell essential oils, make yourself a warm drink, go outside and feel the wind on your body or gaze at a tree or clouds.
Self-soothe. find an object connects you to something solid outside yourself. This may be a rock, a soft toy, a tree to hug. You might find taking a shower or a bath helps.
Observe. look around you. What can you see? Choose an object and describe it in detail. What colour is it? What is its texture? What about the play of shadow and light in the object? What shape is it?
Breathe deep to the bottom of your chest. Practice 4-7-8 breathing. Breathe in for 4, hold for 7 then breathe out through pursed lips for 8. This is a wonderful way of engaging your Polyvagal Nerve and calming yourself.
Distract yourself. Look around the room. Find all the red objects. Find all the objects with right angles. Count backwards from 100 by 5s. Anything that focuses your attention somewhere else.
Everyone has moments when it is hard to maintain control over intense emotions or anxiety. If you learn how to spot those moments and stop them before they are out of control then you are on the path to having more control over your life.
If you would like to talk to me about how I can help you with the long term healing of your anxiety and overwhelming emotions, please contact me on 0409396608 or nan@plentifullifecounselling.com.au
If you would like to learn more, I write a regular newsletter with interesting information, tips, information on courses, and the occasional freebie. At the moment I have a free mindfulness meditation for anyone who signs up to my newsletter. This meditation offers a way to safely explore your feelings and learn to be okay with them. If you would like to subscribe please click on the link here: http://eepurl.com/g8Jpiz
