Internet addiction and young people – Gaming, gambling and porn at a click

How can we spend so much of our ever-diminishing sense of available time looking at what people are eating for breakfast?  Why do so many people want to know which cake best represents their life? What is it about the internet that gets to us?  When you consider that amount of time you lose when you are on the internet, it is not hard to imagine how some people might fall completely for its Pokemon-hunting, stock-trading and hilarious-cat-video charms.

In short, researchers are starting to believe that it’s novelty that keeps us clicking.  Scientists  believe that humans have an important primitive drive to seek out new things – new foods, new people and new adventures.  Our dopamine-fueled reward circuit in our brain affects much of what we do.  Primitively, it would drive us to seek out food, bonding, and mates for reproduction.  These drives are especially strong in teenagers and young adults.  New or novel foods and new possible mates are healthier for our species.  The internet provides many more novel experiences than any previous generation of humans have been exposed to in a lifetime and so appeals to out primitive brains very effectively.  We just seem driven to keep clicking through all the internet has to offer.

Since the first psychological studies about internet usage started to emerge in the late ‘90s, much effort has been spent trying to define what might be an addiction or problematic usage and what could be considered normal internet use.  Given that the internet is in most people’s homes and workplaces, most of us seem to manage it well and, indeed, benefit from the many wonderful ways it lets us interact with information, images, art, or communication.

The internet influences all of us in different ways.

Some, especially teens and young adults, can struggle to manage their use of the internet and get their lives completely out of balance to the point where it interferes with their relationships, work, school and health. While it is not yet listed in the Diagnostic and Statistical Manual (http://www.dsm5.org/Pages/Default.aspx) , there is a lot of evidence that problematic internet use works much like an addiction.  Some problematic internet use may be specific – gaming, porn, gambling or stock trading – or a general over use of the internet where a person demonstrates a preference or a reliance on virtual rather than face to face interpersonal communication.

Brain studies are really getting interesting and they are showing us that internet use can certainly look like other addictions in the brain.  They appear to support the hypothesis about the roles of the brain’s reward circuit and the way that dopamine and opiates are released in the brain.  During the teen years, our brain is very plastic and capable of learning much.  It is also seeking more pleasures and novelties as it accommodates the need for our species to survive.

Teens also don’t have a fully developed frontal lobe system that we require to override primitive urges.

Teens still need monitoring and help to solve problems.  They also need to know when their internet use is becoming a problem whether that be gaming, gambling or pornography.

There are many documented positives about internet gaming, but when the addiction is internet gaming, psychologists like to consider the all the possible contributing factors, including what might be going on in the young person’s family?  What is the young person chasing and getting from internet gaming that they are not getting in other places – companionship, respect, accomplishment, do they get to be a hero at home?

Internet gambling in young people can actually be strongly linked to their gaming….remember everything is just a click away.  Many online games give prizes (like “skins”) that can then be gambled on other sites for more game advantage or even money.

When it comes to internet porn, because it appeals to primitive sexual drives, young brains can be wired in certain ways as they learn both how “to do” sex and also “what turns them on”.  The images on the internet are so much faster to access and so much more novel than the girls at school.  Young people can click through millions of novel images very quickly and, if a certain set of images stop satisfying them, they are only a click away from something that is more intense and more exciting.  The concern is that many may be rewiring their brain to prefer sex with the internet to sex with real people and there are a large number of erectile dysfunction issues that are now being attributed to internet porn.  The good news is these can be treated and people can return to healthy functioning quite quickly.  However, those who started using internet porn at an earlier age, take longer to respond to treatment.

One of the problems we have in treating internet addictions is that it is really not realistic to have people go completely cold turkey or absolutely abstain from internet use.

We might want someone to upload their homework on the net or research for that assignment, but we don’t want them accessing pron or gaming sites.  In that way, it’s a little like compulsive eating.  We don’t want people to abstain from food, we want them to make better food choices.  However, the brain changes that can accompany internet addictions can make it hard for people to make these better choices on their own.  The other thing that separates the novelty offered by the internet to that provided by food is that we can keep binging on the internet.

With food we eventually get full or sick, even with illicit substances that make us feel good we might eventually pass out, but with the internet we can keep clicking.

Psychologically and socially, the internet is often used for escape. You can get lost in all sorts of amazing ways.  Time just disappears.

The internet can also seem to compensate for any deficits you think you have.  Some find it much easier to ‘speak’ to others on the internet rather than face to face.

When you are lonely, feel like you’re not worthwhile, or if you are suicidal, there are many kind people who will respond to you in all hours of the day or night from anywhere in the world.  Some of the kind people are well-intentioned.  Some are trying to meet their own needs and not all are well-intentioned!  We need to watch for young people using the internet in ways that might put them at risk as they try to compensate or escape problems.

When it comes to internet addictions, there are many ways that psychologists can help people to recover and the earlier treatment is sought, the better.  A good psychologist will examine the social factors, the psychological factors and the possible brain changes and individualise a treatment plan. CBT can be used to monitor peoples thoughts and beliefs about their use , work out which thought go with urges to use the internet and work out coping skills if a person in avoiding problems by spending time on the net.

It also helps to ……

  • First, remember that most young people will manage their internet use well and benefit from its many advantages.
  • Generally, have conversations with your young people about what they are doing on the internet – especially if they are asking for your credit card often or is you notice a significant change in their outlook. Most schools have capacities to monitor young people’s use of the internet provided at schools. However, internet accessed by phone is not something schools can monitor. It helps to have an agreement with a young person about how you will monitor them.
  • Educate young people and use the consequences that will get their attention – the idea that they may be on the way to erectile dysfunction will certainly be attention grabbing, but not in a “do it and you’ll go blind” kind of way – explain the science to them. Explain the healthy use of porn, that safe sex practices are underrepresented in porn and that porn is out of context of all-important relationships.  Make sure that the internet is not the young person’s primary source of education about sex.
  • Encourage healthy off-screen life and relationships. Devote time together, unplugged.
  • Ensure your young person has a range of stress management options. Stress can add to the further drive to seek stimulation from the internet.  Teach and make available other ways to manage stress.  Meditation keeps looking better and better with each new research article I read as it works on helping our frontal or more-adult parts of the brain strengthen to be able to manage urges.
  • If all of this seems too confronting, talk to other parents and educators about how they have these conversations with young people and how they monitor internet use.
  • If you see signs of addiction, get in early. If someone is truly addicted, there will very likely definitely be a quarrel when you mention time away from the internet.  Your GP can help with a referral to an appropriate psychologist and kids help line and parent help line can be useful in times of distress.

Can confidence actually come from a “Certificate of Participation”?

Wouldn’t it be handy if you could go and get some confidence in a jar?

I don’t think confidence is available in jar form as yet.  I’m also not entirely sure that confidence necessarily comes from a “certificate of participation, either, but I can see where people are coming from when they try this.  I think they just need to think a little more about the concept and perhaps understand the psychological science behind it so that they can modify the “Certificate of Participation” scheme they plan so that it actually assists in building confidence.

When people speak about confidence, I think they generally mean that a person has strength in the belief that they will be able to do something.  In psychology, we call this self-efficacy – the idea that we have capabilities and we have a strong belief in those capabilities.

The concept of self-efficacy has been pivotal in psychology.  In the 1970s, psychology was very behavioural.  We believed that things happened because an individual was rewarded for it and things didn’t happen or happened less often because they were punished.  It was Albert Bandura in the late 1970s who started to write about the idea that success had something to do with reward and failure, but it also had a lot to do with whether we had a strong belief in our capabilities.

If I don’t think I can do something, then I may be disinclined to even start and if I do start and I have low self-efficacy, it won’t take much for me to give up if I hit an obstacle or feel like I’m failing.

According to Bandura’s theory of self-efficacy,  our expectation for our individual self-efficacy or how well we think we can do something comes from four places:

 1.  Performance accomplishments – our own personal experiences from having tried something before. If we have repeated successes, our expectations that we can do the task are high.  If we have failures, especially at the beginning of trying something, then our belief about our ability is lowered.  If mishaps occur early, people can give up.  If mishaps occur after some success, the negative impact of occasional failure is reduced.  So there are patterns of timing and a pattern of experience that are important to the development of self-efficacy.  We need to plan for success early if we are teaching someone something that is difficult – start with baby steps that increase the chance that they will be successful early, then throw in a few more difficult challenges between the successes.  Once we establish self efficacy, it can generalise to other areas.

2.  Vicarious experience – seeing other people try and have success or try and fail can affect our level of self efficacy. Having positive models can help.

3.  Verbal persuasion – telling people to “give it a go” and that “you can do it” might help, but it can also backfire if we are not careful.

We need to do more than tell people what to do – if we want to persuade someone to attempt something we need to also arrange conditions to help them perform, because if we persuade them and they continue to fail the their efficacy and the effects of our persuasion will both drop.

Also, a person’s own self talk or inner dialogue about their abilities can persuade or dissuade them.  If a person tells themselves that “I got this Certificate of Participation because I wasn’t good enough to win”, that conversation is likely to be one that erodes their sense of self-efficacy.  If they tell themselves that the certificate is a genuine representation of effort, it may have a different outcome on their efficacy.

4.  Physiological states – difficult and stressful situations get us emotionally aroused. If people feel really anxious, they are less likely to expect success. Helping people to manage their emotional arousal can help.  Tricking them to manage their emotional arousal can have worsening consequences.  How a person experiences and makes meaning of their anxiety or stress will affect their motivation to try. Giving deceptive feedback is unhelpful because we need reliability and durability across time.

Bandura also explained that efficacy has a profound effect on personal development because it affects the challenges people choose to undertake, how much effort they expend, how long they persevere in the face of obstacles and whether they are motivated or demoralised by failure .  If a person sees themselves as having a strong sense of coping, it reduces their vulnerability to stress in difficult times and strengthens their resilience.

 

We need to give young people lots of opportunities.  We need to make sure that we model the behaviour we would like to see them do.  We need to verbally encourage but not without setting it up so that they can achieve some success.  We need to understand how it is they are thinking about their own abilities and, if some of those thoughts appear inaccurate or unhelpful, we need to help them to challenge those thoughts.  We also need to help them to manage their anxious arousal with techniques to self calm and soothe.  We also need to celebrate and make sure they take notice of their own successes, too.  We want them to take the right message away from their attempts.

If you can wrap up all of those helpful and motivating aspects of self-efficacy into a “Certificate of Participation”, then go right ahead!  If not, please refrain.

 

For more information about Shona Innes you can always check out www.shonainnespsychology.com.

 

Shame: Coaching versus criticism

What secrets do you keep about yourself?  What are you ashamed about?

Shame is the feeling that arises when we think about ourselves as being “bad”, or “wrong”, or “broken”.  Shame is a negative evaluation of the self – different from guilt which is a negative evaluation of our actions or behaviour. Guilt is where we wish we hadn’t done something.  Shame is much more about an attack on our “selves” rather than a regret about our behaviour. Shame is much more closely linked to being self-critical.

Of course, like all feelings, shame serves a function.  It helps to guide us and treat others in certain ways.  However, we need to be sure that we don’t magnify our shame, nor avoid it completely.

Shame is something we hide so it’s hard to find out a lot about it.  In my practice over the years, I have seen shame go hand in hand with depression, social anxiety, substance use, self injury and gambling.

We all have thoughts and it’s when we go looking at people’s thinking patterns that we can often see the patterns on their mood and behaviour. The stuff we say inside our head has a huge impact on our mood and our behaviour. Some people are a little more visual in their thoughts than others, but most report having an ongoing commentary in their heads – thoughts that guide, notice, and trigger certain feelings in us. These same thoughts can also judge us.  Some people are really high in self criticism.  Their thoughts about themselves are pretty toxic.  Self critical thoughts and shame have a close relationship. Shame and self criticism can make it hard to take risks, learn and make mistakes.

It can be easy for people to get stuck in a cycle where they try to avoid their feelings about themselves that they distract themselves with something that ultimately serves to make them feel worse about themselves.

Shame can be a very painful experience and it may stop people connecting with others.  Because it can be a painful experience and often linked to fear, many people tend to isolate or attempt to remove the bad feelings or run away from the bad emotions like shame. If left unchecked, shame can develop into self hatred.

Shame, like other feelings, has a variety of origins – essentially anything that has us judging ourselves harshly will likely impact on feelings of shame.  Of course, we all need to get feedback on our behaviour.  As we grow up, we rely less on adults to remind us how to behave or what to do in certain situations and we start to internalise the rules for ourselves. The way we are disciplined as children can speak to this harsh treatment of ourselves.  If we have hard harsh, strict and critical discipline, we can internalise this harshness and it can be easy for us to experience shame in response to a range of triggers. Typically, adolescence is a time where we start to notice our internal judge.

It’s easy to get stuck in a cycle of shame.

Sometimes, it can feel like, if we are just more critical of ourselves, we could be lovable or a better person and so some people can continue to elevate their standards and get harsher on themselves in order to make themselves more lovable or acceptable.

Of course, as soon as we make strict rules for ourselves, it is easier to break them.  So essentially, self criticism can spiral – we make a bad choice and break one of our rules, we feel bad and vow to make the rules for ourselves tighter and stricter, making them easier to break again.

How can we help people with overbearing feelings of shame and harsh self-criticism?  Here are a few ideas to contemplate:

  1. To break the cycle or intervene with shame, we first need to help people to tune into their criticism – to become aware of the judgments and rules they live by in their own heads. Self criticism can become something that is done so often over a life span it can become automatic – sometimes we don’t even notice our negative self talk.  If we can’t notice them, then it can be hard to actively do something about them.  Perhaps keep a journal or just tune in mindfully from time to time – especially when you are in the middle of experiencing the feeling of shame.
  1. It can then help for us to develop some distance from our criticizing thoughts – to play around with hearing them in a different voice or notice that they are just thoughts, not Laws. We need to help people work out different ways to respond to their self criticism.
  1. We can learn to deal with shame and self criticism by focusing on what is really important to us and our values. Some of the most self-critical people that I have met have been amongst the kindest in the way they respond to others.  It’s like they have different rules or Laws for themselves than for others and they just cannot even begin to think about the idea of being a little more compassionate or friendly to themselves.
  1. If you are going to have an internal conscience or guide for your behaviour, what would you look for? What aspects would you look for in a good coach?  Are your thoughts being that person?  Maybe, it’s time to recruit a new coach?
  1. Try to treat yourself as kindly as you treat others – it can be like learning a totally new skill and can feel very foreign for some. Ask yourself, “would I say this about my friend?”  If the answer is “no”, then let the thought go.

 

Why we need attachments – from birth and especially after trauma

For a long time now we have known that people need people.

In the 1930’s, Harry Harlow conducted studies with baby rhesus monkeys.  He made surrogate monkey mothers out of wire and wood and some he covered with cloth.  The babies had a preference for the soft covered monkeys, even if the wire monkeys held the bottle of food.  The babies clung to the cloth mother.  Babies raised with just a wire mother had troubles with digesting their food and frequently suffered diarrhoea.  Baby monkeys were braver in the presence of a surrogate and would huddle in fear without them. Harlow concluded that contact comfort was essential to the development of psychological and physical health and lack of contact can be psychologically distressing.

Another important researcher of this era was John Bowlby.  He studied maternal deprivation and sought to understand the problems experienced by infants and children raised in institutions.  Prior to this research, institutions were large and busy places where children were fed, but the atmosphere tended to be clinical rather than warm. He suggested that babies need physical contact and emotional attachments to others in order to survive and that they cry and cling to make and maintain important survival connections.  If an infant has regular, steady contact with a reliable and caring attachment figure, they are likely to develop a secure attachment.

If there was trouble with early attachment, the child grew up with a different attachment style – insecure in their attachments – either constantly anxious about attachments and needing to check or expect abandonment, or avoidant of attachments altogether.

Attachment theory is starting to make a re-emergence as a way of understanding human behaviour, especially in terms of how others are in interpersonal relationships and now how well people deal with trauma.  We usually seek attachments when we are unwell or tired or under threat.  The way we go about doing this and the success we have in feeling soothed by others may well be influenced by our early experiences.

Move ahead from psychology history to now, the early 2010s, and we find that contact with people is important not just in infancy, but throughout life.

Professor Richard Bryant is one of the world’s foremost researchers in Post Traumatic Stress Disorder. I was fortunate enough to hear him speak at a recent congress.   His group has studied trauma in laboratory settings and also in those people affected by many of Australia’s natural disasters.  Some of the information they use has come through from the terrible bushfires of 2009 and is providing important information about attachments styles and how well people recover from traumatic circumstances.

In the laboratory studies, the team have used the cold pressor test.  A test where people are asked to put their hand into icy cold water, a stressful situation, and they measure various stress responses in their body.  Some who did the test were asked to think about a person they really loved during the test and others were asked to think about something else.  The group that were primed to think about their loved ones, showed lower stress responses in the test.

However, when they assessed the participants for their attachment style, they found that those who were avoidant in their attachment style reacted differently.  When those with an avoidant attachment style were asked to think about their loved one, there was no protective effect of doing so during the cold pressor stress.  Individuals with secure attachment seemed to benefit from thinking about loved ones more than those who had a pattern of avoidant attachment.

Based on these studies, you can see why researchers are speculating that attachment can affect how we learn about and deal with fear.

Then, beyond the lab and in the real world, Richard Bryant’s team looked at distress following real world disaster.  The team have followed those who survived the Ash Wednesday bush fires.  They have done some follow up with those children who were separated from their families when the fire came through and those who were with their families.  It seems that those children who were separated during the fire experienced more long term distressing effects, avoidance, numbing and arousal.  So, it seems it does not have to be long term separation from an attachment figure (like in an institution or care facility) for there to be an impact on long term trauma.

After Black Saturday in 2009, the team followed up with survivors again and looked at their social maps.  Social maps indicate the connections and friendships that people have to each other – who is friends with whom.  When they looked closely at the maps it indicated that the social connections people had correlated with how much trauma they experienced.  The more connections people had to other people, the less trauma they had and the connections seemed especially healthy if they were reciprocal rather than just one way.

A large proportion of our population have an insecure attachment style and not all of these respond to trauma in distressing ways.  Clearly, there are lots of other strategies that people use to get by, but this research confirms the importance of our early attachment and our need for people.  Secure attachment is obviously a priority for many with their infant and children.   To me, this research also suggests that it is wise to ensure that children who are separated from parents during fearful events are reunited quickly and that communities that have experienced trauma get support to continue to network.  Also, it seems important that those who go through trauma alone are given chances to work on building and maintaining reciprocal relationships.

Why teenagers (and young adults) still need parenting

The human brain is a very complex piece of living “equipment”.  The brain is constantly working, changing and updating.  It’s potential is truly amazing and if you have watched and delighted in how children grow and become more clever over time, then you will know exactly what I mean.

The brain develops from a mass of very special interconnected cells, to an amazing organised network of information, sensory, emotional superhighways, but this doesn’t happen overnight.  As a child grows, the networks in the brain are developing.  Networks that are not used get pruned off. With pruning comes efficiency,  information pathways don’t have as many options when unused sections of highway are pruned so thinking and processing information becomes more streamlined.  Everything becomes less of an effort as things begin to become disentangled. With fewer pathways to choose from, messages can flow more smoothly and our brains can become much more efficient.

Further, those superhighways that are most efficient, get an extra special coating on them called myelin.  Myelin adds a layer of protection to the highways so that information has less places that it can leak away off the paths.  The neural pathways become insulated so that fewer messages can escape.  Different parts of the brain get myelinated at different rates.

We currently understand that it takes about 25 years for a brain to complete the bulk of it’s mylenation and pruning program (sometimes a few years faster in girls than in boys).

It takes about 25 years (with females perhaps more likely taking about 23), for our brain to be efficiently “grow-up.  Yes – 25!  Not 16 when we learn to drive, or 18 when we vote or even 21 when we celebrate the “key to the door”…but 25.

Motor vehicle insurers do their research. They know and motor vehicle insurance policy prices reflect that things begin to settle in the brain at 25.

The last part of the brain to be fully mylineated in the prefrontal cortex.  Located in the very front and top places of the brain, the prefrontal cortex is the thinking part of the brain and the part of the brain that helps us pay attention, prioritize, weigh up risks and inhibit or put the breaks on certain behaviours or urges.  These “executive function” tasks can all be done by teens at a younger age, but become most efficient in the early to mid 20s.

So, it makes sense that despite teenagers approaching the same size as adults and having strength, they still need an adult to assist them with the jobs that the cortex does – helping to regulate the urges and think things through before taking action.  Essentially, teens and young adults can still really benefit from having a fully developed cortex working in conjunction with their developing cortex.

When we step back from the biology of the brain and consider the psychology, it makes sense that the growth of the brain and the psychological jobs of adolescence aligns and go hand in hand.  The psychological jobs of the teen years is all about beginning to separate out from parents and family and starting to form an identity of your own.  It is not unusual for teens to really experiment with who they are – trying on different outlooks – they may become vegan, change their hair colour, adopt a certain political or fashion statement, become passionate about things locally or globally.  Young adults eventually start selecting clearer pathways for their future.

It can definitely help to have parents or support people who are aware of the major brain changes and psychological tasks of the teen years.

In adolescents, new cells grow in the brain…especially int he very social parts of the brain. So, during the teen years, the young person has to learn to battle between their desire to fit in socially and their sensible, logical part of their brain.

Also with adolescents comes the growth spurt and, of course, the hormone spurt.  Bodies become bigger, stronger and change shape.  It is not uncommon for teens to take more risks, especially when they are in the presence of other teens or people that they find very attractive.

Teens need parents to help regulate or scaffold them through this development so they can maximise social interactions and still pay attention to other important things – like school work, chores, driving or other tasks of day to day living.  Just because they can reach the pedals of the car, doesn’t mean they are completely brain ready for the task of driving.  It makes sense that learner drivers are mandated to have another adult driver (supposedly, another fully developed cortex) in the car with them and that they are limited to the number of same-ages friends they can have as passengers.  The battle between their social brain and their developing cortex can sometimes have them paying too much attention to what’s going on inside the car and not enough to what is happening outside the car.

It’s important to remember that whilst the period of adolescence is perhaps more perilous that other period of development, most teens will come through it and be perfectly okay!

Also, remember that adolescents is a long period.  All of these jobs about helping a  young person regulate themselves do not get done all at the same time.  It’s more of a day to day thing.

The ultimate strategy in parenting a teen is that of “finding the middle path”.  Helping teens balance their urges, especially the social ones, with the “have to”s of life.  Reminding them of the things they need to attend to, weigh up pros and cons and balance our risk and reward.  I think it also helps parents of teens and young adults to stay true to their own life values whilst recognizing that teens and young adults are in the process of developing their own, perhaps different values.  Our values help us to guide our own decision making. Through the process of the rapidly developing brain and psychological changes prior to adulthood, teens and young adults will develop their own value system that will guide them through their own adult journey.

 

 

 

Why we love to worry (especially about children) and why we shouldn’t

Worries are those thoughts we have where we predict the future – but not in a good way.  We predict that something bad is going to happen and because our brain is thinking about something bad or threatening, the rest of our body can get worked up, too.  So, we can start to feel quite ill and uptight as our body changes from a relaxed position, with all its parts working steadily in combination, to a position where it is ready for battle danger– tense, not digesting, breathing rapidly, heart beat rising and our brain not thinking clearly.

Indeed, some people do get “worried sick”.

Usually, worries take the form of “what if…..” thinking.  “What if”….then insert something pretty terrible here.  For parents, who worry about their children, the worries may be “what if they are abducted”, “what if they get in with a wrong crowd”, “what if I’m parenting wrong”, “what if all of that screen time is causing them brain damage?”…there are so many possible negative “what ifs” and some people can generate lots of them.

Despite how awful people feel when they worry, some people find it hard to stop worrying.  Worrying can become chronic and severely interfere with the lives of people making it hard for them to think at work or school, causing sleep problems and getting in the way of relationships.  When worry is clinically significant, psychologists and mental health professionals may refer to it a Generalised Anxiety Disorder or GAD.

People who regularly worry can find it very hard to still their minds.  Often, it can be very difficult to convince them to let go of their worries.  It can take concerned friends and family members, or even psychologists, a lot of effort to convince someone to work on reducing their worry.

Despite knowing that their worries are causing them excess distress, some people love their worries very much.

From my experience of working with those who worry, there are three good reasons why people can fall in love with their worry.

  • Reason 1 – worry feels like problem solving.

Worry is about predicting the future in a negative way and it almost feels that to some people, if they just worry about a predicted problem, they may be able to sort it out.  However, worry is very different to problem solving.  Good problem solving is about identifying a problem, weighing up possible solutions and then carefully analysing the pros and cons of each solution until you pick the best solution and try it.  Worry tends not to be this organised and it rarely arrives at a satisfying outcome.  Often, people who worry think about a future problem and then get stuck in their thoughts at that most troubling point – kind of like watching a scary movie but getting it stuck in the most frightening part.  It means that the body is tense and the brain is not thinking as clearly as when it is relaxed and logical.  If you find yourself worrying about something you’d like to fix, stop the worry stream and grab a pen and paper.  Write the problem down clearly, generate a range of possible solutions and pick the best one to implement.

  • Reason 2 – some people think that worry prepares them to outsmart danger

Some people believe that, if they worry, they will be able to predict all bad options and therefore be able to outsmart or out-think any danger – like worry is preparing us for dangers ahead.  Worry certainly does prepare the body for danger or threat, but usually this is well before our body needs to be in threat mode. Worry also has the ability to make us over-estimate the chances of a bad things happening in the future so we can get all het up about something that has a very low chance of ever happening.

In threat mode our body is prepared to run, fight or freeze.  When there is a threat our bodies will automatically kick into the fight and flight response.  The fight and flight response does not need to be kept in a “half on” position in order to work.  We can be totally relaxed, swinging in a hammock by a relaxing pool and our body will still take care of us by switching into fight and flight if a threat arrives at that moment.  Turning on fight and flight and getting ourselves upset ahead of time with worry, only helps to wear us out by getting out body prepared before we need to take any physical action or when we may never actually need to take action.  It’s like worry makes us travel forward in time like some sort of really awful time machine to visit only the troubling places and not the joyful ones.  It can help people who worry to try to practice strategies that help them stay “in the moment”, mindful and relaxed.

  • Reason 3 – some people believe that by worrying about someone they are loving them

For some people, it feels that by worrying about someone, they might be putting a protective shield around them.  But worry does not allow us to have super-human abilities. To worry about someone is not the same as loving them. In fact, too much worry can make us uptight in the presence of others.  It can lead us to nag them and hassle them and it can definitely bring the mood down in a household.  If you love someone, isn’t it better to wish them joy and wonderment in life’s adventures rather than to constantly remind them of all the negative outcomes you anticipate for their future?  It’s better to just love your special people and share acts of love rather than to worry about them.

So, if you catch yourself worrying, perhaps ask yourself whether you are really having a good time and whether you really think it will change the outcomes for anyone that you love.

If you think you need some extra help to get out of the habit or pattern of chronic worry, your General Practitioner can refer you to a psychologist if she or he thinks that is the best path for you.

oh, and if you are noticing that someone little in your life is starting to worry, perhaps you could share “Worries are Like Clouds” with them.

Change – What to do when people don’t want to change their behaviour

How many psychologists does it take to change a light bulb?

One, but the light bulb has got to want to change!

How do we help someone change?  If a person wants to change, then the process can seem a bit easier.  But what happens when a person is reluctant to change a habit or behaviour that is unhealthy, dangerous, illegal or causes ongoing problems with their friendships or relationships.  For instance, what if we want them to change or give up drinking, smoking, eating the wrong foods, or gambling?

For a long time now, since the 1980’s psychologists have been using a model developed by Prochaska and DiClemente (1986) called the “Stages of Change” model.  This model was first discussed in relation to giving up substance addictions, but has since been applied to a wide range of behaviours that people may want to change.   Psychologists don’t use the model in a rigid way to pigeon-hole people, but more as a framework for helping people and assessing their willingness to participate in treatment.

In the “Stages of Change” model, there are five stages:

  1. A pre-contemplative stage – usually, the person who is pre-contemplative is not even thinking about changing. A person who is pre-contemplative about change will not usually attend for treatment or help. They may be forced to undertake treatment because someone else makes them – as part of a deal within a relationship, because they “have to” do it to satisfy some requirement to move forward on work or study, or because they legally need to do it.

A lot of young people I see are pre-contemplative. They might have been brought to see me by their parents or because school has said they need to come or because they have had brushes with the Law and have been told to seek treatment by a Court.

  1. A contemplative stage – in the contemplative stage, a person is thinking about change, but has not made any firm commitment. It might be that they “kind of” know they should make s change, but they haven’t gotten around to it.  They know that there’s something they need to change
  2. A preparation stage – in the preparation stage, a person might be planning to take some action. They might be ready to try something or “give it a go”.
  3. An action stage – during the action phase, the person is actually taking the steps to make change – they might be going for treatment, getting to the gym, or staying alcohol free – but they are working towards their goal of change
  4. A maintenance stage – in this stage, a person has changed their behaviour and is in the process of sustaining that change.

At any of these stages, things can happen and the person finds they are back in the old habit.  We call this a “lapse”.  People can lapse at any stage and might return to any of the earlier stages.

The important thing about understanding where people are at with regard to their change is that different stages call for different strategies – each stage of change needs a bit of a different approach.

If someone is not even thinking about change (pre-contemplative), then we can demand change and police it – but that doesn’t always work or might not always be an option.  It can be more helpful, sometimes, to provide a person with information about the behaviour that requires change, but we have to be careful that we don’t load the information with too many “have to” messages.  If we want to bring about authentic motivation for change, it’s best that the person arrive at their own reasons to change – being too bossy or domineering can lock a person in to the “anti” or “opposite” position.

Rather than waste resources on telling them how to change if they are pre-contemplative, it can be more useful to focus on making sure they understand exactly what the risks of their behaviours might be.  We need to provide this information is a collaborative way.  Anger and scare tactics can rebound sometimes.  In the case of alcohol, for instance, rather than tell a pre-contemplative teen that should not drink,  we might give a person information about how much is a standard drink, the health and legal effects of alcohol, look at how much and how often they are drinking and let them arrive at their own conclusion.

If they are still not ready to change or they are not ready to even think about it, then it is important that we give them the information they need to stay safe.  We call this “harm minimisation” – if they are going to keep doing it, how can they do so safely?  For instance, if a teen is going to continue to drink alcohol after being presented with all of the risks about it (for them and others), then talking to them about, for example,  staying close to good friends, making sure they don’t take their car, or pre-arranging safe lifts home becomes really important.

If a person is contemplating a change, this can be a good time to have them weigh up the pros and cons of change – what are all the good things about changing, what are all the good things about not changing, and also what might be not so good about change and what might be not so good about no change.

If a person is preparing for action we can help them set their goals and introduce them to various strategies for change.  For a young person wanting to stay sober and not use alcohol, we might teach them refusal skills so they know how to say “no” to offers and deal with any anticipated ridicule that may occur if they say “no”.

There is some new research emerging from here in Queensland that is looking at the importance of helping people visualise their goals rather than just talking about them.  Functional Imagery Training helps people visualise their goals and incorporate lots of senses in their images – the sights, sounds, smells of achieving change – and then to share their vision with us.

If a person has a lapse while they are trying to make change, it’s really important that we help them reflect and learn about the things that happened that made it easy for them to fall back into old ways.  We don’t want them to give up, “throw the baby out with the bath water” and go back to their old ways.  We like to look closely at it so we can learn and make plans for next time.  Again, we can’t do this properly if we are being too police-y or judgemental.

There’s much more to be gained by working collaboratively with a person who needs to change than by just adding more judgement.

Maybe it’s time to change how you think about others making change??

Getting kids to eat their vegetables

Have you ever wondered why we eat the food that we eat?  In an age where, despite knowing the health risk, we still have large proportions of us who are overweight and, sadly, a large number of children who are overweight, too.

Usually, humans eat for three main reasons:

  1. We eat because we are hungry. Our body needs to keep us on an even keel and it makes us hungry when we start to be deprived of energy.  This is homeostatic eating – keeping the things in our body in some sort of balance.
  2. We eat because it is a certain time of the day or because we usually have food in a certain situation. This is called cue-elicited or learned eating.  We might always eat around 6 o’clock at night.  We might always come home after school or work and stand at the fridge and choose a snack.  Certain things outside of us, like the time of day or who we are with or certain weather might trigger us to eat because we have learned to do so over time.
  3. We eat because things taste delicious or are appealing to us in some way. When we eat because something is really palatable, we call this hedonic eating.

Hedonic eating is usually what drives us the eat foods that are not particularly healthy for us, but they taste mighty good.  Because unhealthy foods taste so good, we are prepared to work harder for them.  In most cases, unhealthy food has a higher reward value.  However, not everyone is equally affected by the reward value of certain foods.  Researchers call this, reward sensitivity.  Different children (and adults) will be more sensitive to the reward value of some foods and, the thing is, that reward sensitivity is related to weight.  High reward sensitivity children (and grown-ups) prefer high sugary and fatty food and beverages and these tend to be the kids who are prone to eating too many unhealthy foods.

So, the challenge is – how do we make healthy foods more rewarding? How do we make children like healthy foods more?  Despite knowing that we should eat healthier foods, the consumption of vegetables is far below recommended guidelines.

I’ve just been to a conference where I met some researchers from Belgium.  They have been busy trying to find out ways that we can help kids like their veggies more.

We already know that children’s eating habits are affected by:

  • their preferences for food (and their reward sensitivity)
  • their genes
  • the food that their parents’ consume
  • the way that their parents offer them food
  • and the availability and accessibility of food children can choose from in the home

….But can we change the foods that children like?

Researchers  took a list of vegetables and had children in an early childhood centre determine which vegetable they liked the least.  They voted, hands-down, for chicory.  So armed with the ultimate unlikable vegetable, they set about seeing whether they could change children’s minds about eating it.

So, every second day for a couple of weeks, they repeatedly offered the children a bowl of chicory.  They divided the children into three groups. One group was just given the opportunity to have the chicory each time.  The second group was given a social reward – they were told that the researcher would be really proud of them if they tried it.  The third group was given a sticker each time they ate some of the chicory.  It’s important to note that the researchers weren’t rewarding them for the amounts that they ate (because we do not want to encourage children to override their own internal systems to tell them when they are full and that could result in overeating), just that they tried it.  They also measured how much chicory the children tried each time.

Expecting to find that the children who were rewarded to perhaps have eaten the most chicory, the researchers found that, after a couple of weeks of presenting chicory every second day, all of the groups had started to eat more chicory – whether they had a reward for it, or not.  They all increased their consumption over time.  But, AMAZINGLY, the children all started to report that they liked chicory more over the course of time.

The thing seems to be, that in getting little folk to eat something they screw their noses up at and say that they don’t like, there is no need to make a song and dance about it.

Rewarding tasting a new food, either with a social reward or a little present, was no different to just exposing them to the food reasonably often.  Try just repeatedly making vegetables an option for them.  Of course, don’t offer veggies at the same time as you offer the lollies, chips and ice-cream because these highly hedonic foods will likely always win, but don’t get out of the habit of serving it up to them and see what happens over time.

As a psychologist, it’s always affirming when you get the new information that confirms what you have done as you’ve been making it up as you’ve gone along as a parent.  When my children were younger, we used to have a weekly “try something new night” where we would offer something that they may not have had before.  The kids never had to eat all of it, but it was offered for them to taste.  It was a bit of a weekly adventure trying foods from different cultures or from different plants.

Perhaps you can experiment at your place? …..but remember, the secret does not lie in the bribes or threats, just in a little bit on offer, often, over time.

Getting activated:  What does Elizabeth’s wading pool have to do with happiness?

At various times in our lives, for a variety of reasons, we can get too busy, too sick, too tired, too sore, too “I-can’t-be-bothered” or even, concerningly, too depressed to do the day to day pleasant things that are ever-so-important to a happy mood.

When people stop doing the things that they normally do – perhaps because they are re unwell, because they’ve had a big fright, or perhaps they are not getting along well with others – it can be quite easy for them to withdraw from the people and responsibilities around them.

They say ‘no’ to invitations, they stay in bed longer or they may retreat into a mindless activity. They can even stop doing the day to day things we all do to look after ourselves, shower, eat well or move our bodies. They can also start to skew their thinking and only notice negative things.

The longer a person stays in a downward spiral of withdrawal, the less likely it is that they are going to bump into someone who tells them a funny story, see someone who is smiling at them or do something that makes them feel good.  The chances of them having a pleasant day or even a pleasant moment can start to erode away.

Before too long, they can be stuck in a negative mood vortex, where they don’t expect nice things to happen, they don’t get out and about where the chances of nice things happening are greater and so they fail to access the things that are needed to keep a mood buoyant.

They can move from upset to sad, terrified, depressed and lonely.  Their felt energy can deplete and sadly, they can lose hope. It can be harder for them to extract joy out of things that are normally joyful for them. Psychologists and mental health professionals call this anhedonia and it is often a symptom of a Major Depressive Episode.

With young children, parents are usually pretty quick to pick up when they are not their usual selves.  Other times it can be a little harder to notice and there are a few key times in a life span where we really need to watch withdrawal:

  • the teen years – it is normal for adolescents to spend longer times in their room (or the bathroom) alone, but if they skip meals, say ‘no’ to things they would usually love, have fewer invitations or friends over, then it’s worth a conversation.
  • when people live alone
  • the elderly
  • the grieving
  • those with chronic illness or pain.

How can we help?

Essentially, we need to help people who have withdrawn to get what psychologists call, “behaviourally activated”.  Sometimes, behavioural activation is no easy task.

When I think about behavioural activation, I often think about when I was a little girl and I would play with my friend, Elizabeth and our siblings in Elizabeth’s round, blue wading-pool.  We played a game where we would all try to go round and round in the same direction as fast as we could and then someone would yell the magic word (which may have been something like “bottom” or “fart”) and we would stop running and we would lie back and float around in the vortex we made.  Then, we made up another game, which was very similar.  We’d go round and round and then someone would say “the word”, but this time we would have to try to go in the opposite direction.  It would usually see us all falling over in fits of giggles as the water forced us over, but if we held our ground and worked one step at a time, we could actually get the water moving in the opposite direction pretty quickly.

This is what it can feel like when you have been inactive physically, socially and emotionally for a lengthy period of time.  Getting started on things again can feel like you’re going the wrong way in the little blue pool.

However, if you keep going often and persistently enough, you can turn the vortex around and have it go the other way – spiraling on towards more happiness.

So, we need to help people avoid being withdrawn.  It can be as simple as:

  • planning something pleasant to do each day – a short walk, a soak in a bath, some time with nature…it doesn’t have to be expensive and activities planned will vary from person to person
  • using a calendar or diary and making sure there is some social activity and some physical activity – it doesn’t need to be long, the hardest part is just getting going. If they turn up, they don’t need to stay for too long, but they do need to move against the force.
  • get back to the senses – make a list of your favourite things to see, hear, smell, touch, taste and do.
  • get back to doing something that you are good at – be that crosswords, drawing, music, growing a plant. We feel better when we feel a sense of mastery over something.
  • volunteer to help someone or something else.

It’s much better to catch a withdrawn and negative spiral of decline as early as you can.  The first few moments of effort will be hard, but before long, the water in the little blue pool will go the other way…the way that means more sweet moments and maybe even giggles or laughter.

The new website for my practice is ready to launch – click here

Questions psychologists get asked at parties – barriers to accessing psychology?

When people casually enquire into what you do for a living and I tell them I’m a Clinical and Forensic Psychologist, I get a range of responses.  I’m proud of my title and my profession.  It represents a lot of hard work.  However, telling people what I do can, sometimes, change the mood of a conversation.

There are a range of questions that I’ve come to expect that can follow and I think the questions that people ask me when they meet me at functions, formal and informal, are important for everybody to know.  Without proper answers to some of these questions, people may perceive barriers that may prevent them from seeking help from a psychologist if they or one of their family members ever needed help.

So, let’s see what I can do to talk down some of these barriers….

  • Are you reading my mind?

Many people don’t know what psychologists do and how they differ from psychics, psychiatrists or even counsellors.  Each of these kinds of jobs involves assisting others in some ways.  Psychologists study human behaviour using scientifically supported ways.  Psychologists do not claim to have psychic powers or gifts pertaining to peoples’ souls or minds.  Unlike counsellors, psychologist in Australia have to go through a long and rigorous process to be registered to practice and this registration offers a range of protection for clients that are written in National Law.  Unethical or dangerous practices can lead to de-registration. Unlike psychiatrists, who are medically trained, psychologists in Australia cannot prescribe medication, but many psychologists will work in conjunction with psychiatrists to care for their clients.

  • How is talking to someone supposed to help? 

Whilst listening is essential to the practice of good psychology, psychologists do a lot more than just listen and talk.   A psychologist can offer a listening ear with the added bonus of years of training about what accumulated years of research can tell us how to assist.

One of the things that can stop people from accessing help, is the idea that they are a burden to others – so much of a burden that other people won’t be able to cope with their distress.  One of the advantages of seeing a registered psychologist is that these are people who should know how to take care of themselves when client’s present with heavy burdens so that the client’s issues are dealt with professionally and not too personally.

  • Aren’t psychologists attracted to the field because they have their own issues?

The pathway to becoming a registered psychologist in Australia is a long one with no less than six years of closely monitored and regulated training required for basic general registration.  Some people may choose to study psychology after they have had an interesting personal experience or because they themselves found a psychologist assisted them when they needed it – much in the same way, people might choose to study and practice medicine or nursing after being inspired by the care they received in a hospital.

However, I believe that a large majority of people are drawn to the profession of psychology because they are interested in human behaviour and want to help people to solve difficulties in their lives.  If a psychologist in training has issues that might impair their ability to practice, they should be given this feedback as part of their training.

The very desire to help others needs to be carefully titrated through psychological supervision and formal self-reflection.

It’s not just in the choosing of the profession, but in the maintenance of the profession that psychologists need to reflect on their own issues.  Just because a person is a registered health professional, does not protect them from ever getting a mental health issues themselves.  Self-care is critical and all psychologists should practice with plans in place to keep them as healthy as they can be.

  • “That work must be so very hard – how do you manage it?”

Yes, the practice of psychology can be challenging, but a professional  psychologist will always take steps to manage any stress or burden.

Indeed, self-care is one of our greatest professional responsibilities.

A failure to take steps to take care of ourselves can lead to compassion fatigue, burn out, and even breeches of important ethical boundaries.  Our psychology registration board considers it mandatory that psychologists take care of themselves and stipulates that we regularly consult our peers about our work to ease stress and to open our eyes to possible blind spots, share new theories and skills and think about issues in different ways using different frameworks.

  • Is it always the parents’ fault?

One of the things you learn very early when you study psychology is that human behaviour is very complex.  Parenting is obviously an essential part of anybody’s upbringing, but there are also many other aspects of a person’s sense of wellbeing, especially as we get older – biology, thought patterns, other relationships, peers, health, community just to name a few and then all of the combinations of these variables, too.  Of course, in cases of obvious parental abuse and neglect, parenting factors stand out loud and clear, but there are amazing stories of those who have suffered great atrocities at the hands of their parents, yet have gone on to live happy and fulfilled lives.  We would love to study these people more, but they rarely present for help.

I hate to think parents might avoid bringing a child for psychological help because they are concerned they will get “blamed”, but I suspect this might be the case sometimes.

Psychologists are there to assist and promote well being and safety and address the factors that might be triggering, maintaining or exacerbating a problem.  If a person has issues that have to do with parenting, then they will be assisted appropriately.

….

Summing up, this is how I try to answer the questions I get asked at parties…without ruining the mood of the function or event.  I hope my answers can assist in reducing any barriers that people might have to seeking out a psychologist if they need to see one.