Wednesday, August 12, 2015

Anxiety, Parenting and Acceptance Commitment Therapy by Dr Nga Tran Consultant Psychiatrist and ACT Therapist

Being a parent is probably the most important role your life. It is frequently a time of great joy, love, wonder and gratitude. From the images you would have seen and books you may have read, it certainly seems like these emotions are the ones that will be most prominent.

However it is also common to feel other emotions that perhaps you may think you are not supposed to feel.

Feeling down, sad, depressed, guilty, overwhelmed or anxious are also very common for parents.

Anxiety is a normal emotion that is vital in protecting us from danger. When we perceive a threat our body reacts with physiological changes including the release of large amounts of adrenaline and an increased heart and breathing rate. These changes prepare the body to fight or take flight from the threat. If you think about how fragile and defenceless a child is, then it makes perfect survival sense for the mother to be constantly on the alert for threats to its wellbeing.

Our brains are still wired like this to detect bears and tigers that may harm our children, or poisons in the environment that may make them ill. You may feel restless, fidgety and constantly on edge. Your sleep and appetite may be affected. You may find yourself constantly thinking ahead to plan and organise to shield off any potential problems. You may constantly look for the perfect response to every situation. So many “what if” and potentially catastrophic scenarios run through your mind that you may not be able to make any decisions at all. You may feel guilty and your mind may tell you that you are not a good mum, that you should know what to do, that everyone else except you can handle the situation.

You may respond to these emotions in a way that makes the problem get bigger rather than smaller, such as withdrawing from your family and friends, stop doing the things that normally give you pleasure, work harder in setting rules and schedules in order to get a sense that you can control the danger.

These strategies work well when there is a tiger outside about to eat your child. But when the source of danger is diffuse and cannot be eliminated, such as worrying thoughts, these strategies actually teach you that you need to worry harder and exert more routine and control. And the potential sources of worry are endless, so a vicious cycle is set up. Reading multiple parenting books and websites can often increase the doubts that perhaps you are not doing things right and that you need to work harder.

This is not because you are in any way abnormal. This is just how your brain, and most of our brains, work. For a combination of reasons that may include your usual thinking style, the ways of coping you have observed around you, past experiences, your current situation, responses of others, and the temperament of your child, you have inadvertently found yourself in this vicious cycle.

ACT (Acceptance and Commitment Therapy) is a modern form of CBT (Cognitive Behaviour Therapy) that is very effective for anxiety.

ACT helps you to become aware of your anxious thoughts and emotions, not as automatic cues of danger but as events occurring in your mind and body. In that way you don’t have to automatically react to your thoughts and emotions, but be able to step back from them and see them for what they are. This frees you up to act in a way that is more in keeping with how you want to be as a parent and as a person. It allows you to experience your unique child as he or she really is from moment to moment, a concept known as mindfulness. In this way you can notice all the subtle cues that your child uses to communicate. This more than any set rules or routine, forms the basis of the sort of interaction and care that will allow you and your child to thrive together.

An added benefit is that you can apply this to all other areas of your life on an ongoing basis. So ACT is so much more than a treatment for depression or anxiety. You gain a whole set of skills that help you to live a richer and more vital life, and can dip into this tool box time and time again throughout your life.

Dr Nga Tran
Consultant Psychiatrist/ACT Therapist
Brisbane ACT Centre
7 Marie Street, Milton 4064
Ph 3193 1072, Fax 3193 1073

Saturday, May 9, 2015

Parenting tip on why unconditional love for our children is so important.

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Giving our children unconditional love is one thing, and making sure that they perceive it as unconditional love is another.

Giving our children unconditional love is so important as it will teach our children that they are significant no matter what.  Once they have a stable and strong sense of "significance" or self, they will then have a good foundation from which to build strong relationships with self and others, and succeed better at life.

Wednesday, April 22, 2015

The 5 Love Languages by Dr Gary Chapman

One of the books that I often recommend is the 5 love languages. Essentially, it is the "language of connection".  If you want to "connect" with someone and build a good foundation for your relationship, you need to do the following....

1 Spending quality time with each other
2 Acts of service ie doing things for each other
3 Physical touch ie hugging, kissing or holding hands
4 Word of affirmation ie telling how much you appreciate each other or praising your partner
5 Gift giving ie to buy gifts for them

Available on our Self Help Amazon bookstore.

Sunday, March 1, 2015

"My child has been diagnosed with Austism/Asperger's, so now what?" Workshop for parents.

Venue:  Priority Health Medical Centre Shop145 Orion Shopping Centre
             1 Main St Springfield Central 4300
             Seminar Room

Time:  Tuesday 7 April 2015

Sunday, February 15, 2015

How does one measure one's significance?

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What is significance?

How significant do you feel?

From 0-10, 0=worthlessness and 10=I am very significant or important, how would you rate yourself?

Most of us measure our significance through our
  • Achievement
  • Wealth which really comes back to achievement
  • Looks
  • Likeability and how much we can be of service to others which is a form of achievement 

But is this the best way to measure one's significance taking into account that looks, wealth and achievement can be fleeting at times.

Try to measure one's significance through authenticity and growth in addition to the above, as through authenticity and growth, we will have a more stable perception of significance and self worth.

Once our perception of significance is improved, we will see the world in a more positive way.

Wednesday, December 24, 2014

Merry Christmas

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Merry Christmas and a Happy New Year to all our readers and to your families. We thank you for your support in 2014 and hope that life will bring you much joy and happiness.  We look forward to sharing more ideas with you in 2015!

Tuesday, October 7, 2014

Chronic pain and how to manage it

Chronic pain can have a significant impact on both our physical and emotional well being.

My simple approach to treating chronic pain is as follows...
  1. Treat the cause if you can eg a severe bulging disc with severe nerve impingement.
  2. Treat the pain with non pharmacological methods such as heat, ice, TENS, improving core muscles, massage and physiotherapy.
  3. Treat the pain with  pharmacological methods with analgesics such as heat rub, capsicum spray, anti-inflamatory gels, panadol, anti-inflamatories and less ideally narcotics and possibly steroid injection into an inflamed tissue.
  4. Increase the threshold to pain by improving mood, treating depression and anxiety and improving coping skills.
Chronic pain is not easy to treat and often require a multidisciplinary approach.  Ask your Doctor about whether you are eligible for a Care Plan and possibly a Team Care Arrangement to access up to 5 Medicare subsidised visits to an Allied Health Professional such as a Physiotherapist.

Thursday, July 17, 2014

One way to explain the relationship between Anxiety and Depression

  • Anxiety is good if you can manage it well.......Most high achiever have anxious traits.
  • If one cannot manage anxiety, one tends to alternate between avoid and blame.
  • Over time, with avoidance and blame, it leads to powerless, hopelessness and then....
  • This can then lead to depressed mood.
  • When one is very depressed, anxiety tends to lessen due to lack of care factor.
  • However, if one has lost care factor, one also loses meaning and purpose leading to more depressed mood.
  • One can argue that depression is "end stage" anxiety.

Wednesday, December 18, 2013

"Vinny's Toolbox" to help with Depression and Anxiety

What is "Vinny's Toolbox".....

Let's face it, we all have problems and in actual fact, if one day we have no problems, then this will become our "new" problem as we will get bored and have no more meaning and purpose.  So, in order to thrive, be resilient and not get stressed and depressed, one needs to know "how to solve problems".

This is where we consider using the "Vinny's Toolbox".

First of all, stop and define WHAT the problem ACTUALLY is.  Try to see the problem for what it is, not worse than what it is. When we are stressed, we tend to catastrophize and see things worse than it actually is.  Try to perceive rather than judge.

Then consider which of the 4 following tools to use....

  1. Run and Avoid.  This is a very important tool and in actual fact, if we don't have it, we will probably die an early death.  For example, if we see a snake in our path....Avoid!  If there is a bushfire nearby....Avoid!  However, most people use this tool inappropriately.  They avoid when they shouldn't avoid.  If you have a problem with your husband or wife, probably avoidance is not going to solve your problem.  So the key is to use the right tool for the right situation or problem.  If you need to put a screw in the wall, you would not use a hammer would you?
  2. The opposite of run and avoid is to Fight, Show aggression, Blame, and Frustration.  This is a very useful tool especially if you are in danger and you cannot avoid.  Blame and anger helps to give us that burst of energy in order to get ourselves out of that danger.  It is best used for your enemies and not for your family and friends.  Aggression leads to "counter" defensiveness and escalates into more aggression.  Aggression destroys relationship so remember, this tool is not for your family, friends or people who you need a continual relationship with.
  3. Best way to understand the usefulness of the 3rd tool is to ask yourself this question.  If you made $1 Million this year, the taxman is going to send you a tax bill for $300000.  What tool would you use for this problem.  ?Run and avoid ?Show aggression with the taxman or simply Accept and glad that you have made a lot of money.  In all sincerity, I would love to have a tax bill of $300000.  Again, some of us use this tool inappropriately.  For example, if our children is failing in their school work, should we just let that go and accept?  Maybe not.....
  4. The last tool is where most of us also lack and that is Assertiveness.  The problem is that most of us don't know the subtle difference between Assertiveness and Aggression.  One of the best way  to differentiate this is to ask yourself if there is blame or anger in your emotion.  Assertiveness with blame will come across as Aggression.  Examples of assertiveness and aggression are outlined below.....
"We need to talk or else it is over" = Aggression

"We need to talk" in a demanding voice = Can still come across as aggression as it implies that we need to talk, I don't really care whether you want to talk or not but I want to talk.

"I understand that you don't really want to talk about it and at the same time, this is very important for me and us, so do you think we can put aside sometime today to talk about it in order to solve this issue together? = Assertiveness.  Assertiveness has no blame and accepts that both conflicting ideas can coexist hence the word "and".

(Be careful not to use the word "but" after a validation e.g. I understand that you don't really want to talk but I want to talk.).......  So take away the "but"!

Imagine saying things like "You are a great singer artist but you don't have the right image for it".

In essence, if one predominantly uses the "avoidance and blame" tools....High risk of depression as chronic avoidance and blame teaches us powerlessness, and powerlessness leads to hopelessness, and hopelessness leads to depression. 

If one uses acceptance and assertive skills predominantly....This is "resilience".  The great news is that these can be taught and learnt!

Please share it to those who might benefit from this.