Book Review: How (Not) to Do it All: Energise Your Life By Dr Emma Short

Out January 2023

Dr Emma Short is a British medical doctor specialising in histopathology and she has a PhD in cancer genetics.  

While Dr Short is the principal author, she has included chapters written by friends and colleagues.

What I like:

Written for a general audience, this book is very accessible, with simple, clear writing and tips for effective change outlined in the text, in boxes, and then also in personal stories.  

There's nothing new here, but the advice is sensible, aiming at helping readers make minor changes that add up to significant impact.

Dr Short's expertise shines through in the first part of the book. I especially loved the section that explain why exercise reduces inflammation and why this is important for overall health. It's the best description I've read in ages.

The chapter that discusses how we are pushed into over-achieving is excellent as well. Basic but thorough and very simple to digest.

What I don't like:

Some of the psychological theories referenced were debunked decades ago.

For example, the section on the value of socialising has sensible observations and practical advice but references and quotes Maslow's theory.  Unfortunately, Maslow's work was based on personal observations. Studies have repeatedly discredited most of his theory. It's hugely problematic.

Similarly, there are references to personality research that could do with clarifying, updating and revising.

There's plenty of evidence-based theory to back up the advice, so I'm at a loss why that wasn't used. This issue detracts from the overall authority of the publication.

Summary: most of this book is an excellent practical read, but it includes debunked theory.

How (Not) to Do it All: Energise Your Life
By Dr Emma Short 
ISBN     9781914595387

Publication date: January 2023

162 pages

Price £9.99

Buy Link Parthian Books

Can't Find Your Keys? Think You're Losing Your Mind? Don't Panic! It May Be Simple Stress

Stress can mess with your memory

When your memory is shot, you might worry you have an attention disorder. However, it's important not to jump to conclusions.

Daphne can't remember a phone number two minutes after hearing it. She also keeps losing her keys. When she goes to the shops, she has to take a list with her because otherwise she buys everything except for the thing she went out to buy.

Daphne is convinced she has ADD/ADHD. Her attention is messed up, right? And from seeing TikTok videos, she knows that attention disorders are sometimes overlooked.

Social media is terrific for raising awareness. It's also helping people open up and talk about mental health, removing the stigma that has haunted so many of us.

However, social media has some negatives that can sabotage good information.

Understand social media

First, fear and drama sell

It's much easier to attract likes by posting about doom, disaster, struggle and anger than it is to tell a simple story about reasonable people coming together to implement reasonable solutions.

Second, information online has to be bite-sized to be popular.

That's a problem because mental health tends to be complicated. You can't condense a 120 minute Tarantino film into a 22 second summary without losing something.

Third, there is often no quality control, no expert review.  

Sometimes that's okay, especially if it's simple stuff, but with the penchant for fear and drama and the condensing, you can get some very poor-quality information trending.

In the first half of 2022 TikTok was hot on attention disorders. But did you know that poor memory is also linked to depression and anxiety?

Research shows that certain kinds of depression can come with poor memory. Also, certain types of anxiety interfere with memory making. It's not one size fits all, though. There are lots of people with depression who have an excellent memory and the same goes for lots of people with anxiety.

However, studies show that when you combine anxiety and depression, the combination typically wreaks merry hell with memory. And the thing is, you don't need to have severe anxiety or severe depression. It can be as simple as a bit of low mood and a punch of life stress.

Putting it together

So, where does this leave Daphne who keeps losing her keys and being stranded in the supermarket aisle?

Given mental health is complicated, I'd suggest she not look for a quick or easy fix. Like the tailors say, measure twice and cut once. Spend a lot of time figuring out exactly what is going on, and only when you're certain, look at management and treatment options.  

If Daphne has the funds and the access, she can go and see a psychiatrist, a medical doctor who specializes in mental health issues. She will have a long chat with Daphne and based on that, will then decide on the proper assessments to figure out what's going on.

This will likely take several hours and two or even three visits. At the end of that, she'll probably have a pretty good diagnosis at which point she can make informed decisions.

If Daphne can't manage that, she might see a mental health practitioner like me.

I'd start by asking questions:

• Tell me about your memory this week
• Tell me about your memory last year
• Tell me about your memory when you were a kid
• Do you have a family history of attention disorders, anxiety, depression or other issues?
• Are you on any medication? Because some meds mess with your mood and memory
• Are you menopausal? Yup, that can do it, too
• Been in any fights? Played rugby? Been in a car accident? Your basic physical trauma questions
• Have you recently had food poisoning? Because gut health is linked to mood and memory
• What kind of work do you do? Because certain chemicals like paint and insecticide… yes, you guessed it! Have an effect on mood and memory!
• What does your family doctor say about your physical health? Because certain physical issues like wonky thyroids can have an effect on mood and memory
• What's been going on in the last 12 months? Because too much change can have an effect on mood and memory. People don't always remember what's going on, so I have a 50+ item list to kick off with
• How's your sleep? Because sleep deprivation is a killer, literally, and it messes up mental health
• Do you overthink things? Do you ever get short of breath? Do you come out in rashes? Because I'm checking for anxiety
• When you were a kid, did you self-harm? Were you bulimic? Because people sometimes don't know they've a history of stress or anxiety and these issues can be related to anxiety
• What are your hobbies? Are you enjoying them at the moment? Because I'm checking for depression and low mood, both of which can impact on memory
• What's your family like? And tell me about your friendship groups. Connections matter. We're social creatures
• How much happiness is there in your week? I'm looking at daily patterns

As I'm not a medical doctor, I cannot diagnose. But at the end of an hour, I should be able to tell you if I think you need to see a doctor.

Also, I will be able to tell you if I think you have anxiety, depression, both or perhaps something else like a form of PTSD or whether you should consult an expert to see if you have an attention disorder.

Speaking personally, I'm fairly conservative when it comes to medication. As mental health is always tricky, I think it's safest to go for talk therapy first and if that doesn't work, to see about other methods to manage. Assuming of course that you're not in a crisis of some kind.

Surprisingly often, classic therapy approaches for managing anxiety and low mood are enough to bring about significant changes for anyone suffering from too much life stress.

Also, it can't hurt you and if we put in solid goals to make sure we can track progress, it's generally speaking a good first option.

I hope you find this interesting and informative. Thanks for reading!

Image by Tumisu from Pixabay

I Think Of Depression As Spots

I think of depression as spots. When you have spots, the first thing is to figure out what they are. 

Maybe you have an allergy to a new washing powder. Maybe you are allergic to something you ate the night before. 

Maybe you have dengue or chickenpox or shingles. It could be acne. Maybe it's boils. 

Or a mosquito bit you. Or perhaps a cobra fanged you. It may be a perfectly simple heat rash.

Figuring out what's causing it will lead you to the appropriate action. There's no point in changing your washing powder if you are allergic to eggs or have chickenpox.

Depression is the same. There are lots of different causes and that's why there are various approaches for managing it. There's not one-size-fits-all.

So if you have spots, or rather depression, and you can't immediately tell why and what to do about it, either talk to a psychiatrist, a medical doctor who specializes in mental health, or talk to a therapist like me. We'll have a chat, and figure it out together. 

Image by Arek Socha from Pixabay

Why I Offer A Free 15 Min Chat To Potential Therapy Clients

Target, senior executive office snoopervisor

I offer a free 15 min chat to potential therapy clients for three reasons: 

1) we talk online, so we need to make sure the tech works for us,

2) you tell me very briefly what your goals are, so we can decide if it's something we can deal with in therapy (because amazingly, I'm not a super genius who is trained in everything!). Also, what if you don't like me?, and

3) so I can tell you how confidentiality works, including emergency care, etc etc.

I do this because many people have never spoken to a mental health professional. This way, you get the intro quickly and easily. It helps you make better decisions.

Yes, it costs me time which is money. But so what? It's 15 minutes. I consider it a bit of public service.  

If you ask me, it should be an industry standard.  It's on my list of Laws To Implement when I become Mistress of the Galaxy :-)

A bit nervous and wondering what a first session is like? Read this post 

I'm Rebranding! And A Word About The Politics Of Mental Health Practice

I'm rebranding!  I'm the same person in the same place doing the same thing, but I'm changing my logo, website, blog and titles. The rebrand is because we are currently living in Malaysia, but we plan to move to the UK in late 2023.

Why rebrand? Politics! I think you'll find this interesting, so I'll explain.

Psychiatrists are medical doctors who specialize in mental health. Everyone else in mental health, therapists, psychologists, counsellors and so on, are not medical doctors.

While countries agree on legal definition of psychiatrist, they disagree on how to define other titles.

Sooooo, in some countries you can call yourself whatever you like. BUT in other countries, titles are 'owned' by professional associations. If that sounds weird, consider it's the same for certain kinds of engineers, architects and so on.

Here's where the politics come in. Mental health associations that own titles are usually exclusive, meaning they work to keep people out. They typically only take local people or people from a very small number of schools.

Practically speaking, if you work in mental health, your nationality restricts where you can join and the school you go to also restricts who you can join.

For example, in Malaysia, the title 'Kaunselor' is controlled by an association we call the Lembaga. They only accept people with Malaysian degrees.  So you can have a Master's degree in Counselling from Oxford in the UK and not be accepted.

Other titles in Malaysia are not controlled, BUT associations typically don't let foreigners join as full members.

Also, membership is not automatic. You can live locally or even be a local, have local qualifications and still be rejected. It's just like a club.

Note: this is not to criticize Malaysia. Every other country does the same. Mental health is in many ways just like the cartel. (If I am mysteriously killed tomorrow, you'll know why!)

So, as I am British, I am not a good fit for local professional associations. That's why I joined the British Association for Counselling and Psychotherapy. They are the UK version of the Lembaga.

But it left me with a dilemma. In the UK I am a registered counsellor and psychotherapist. But I can't be a Kaunselor in Malaysia.

As we planned to live in Malaysia forever, I branded my work to be in line with local norms and guidelines. On the advice of friends in the profession, I call myself a counselling psychologist. I have qualifications in psychology and counselling, so that works here.

But now we're leaving for the UK in the end of 2023. And guess what? In the UK, the title of counselling psychologist is controlled by an association I'm not a member of! ?? Sod's law, right?

So, I am changing from 'counselling psychologist' to 'counsellor and psychotherapist'. I'm adding in coaching because I've been taking extra courses and planned to add this to my business anyway in 2023.

The rebranding won't happen overnight as it's a big job but I do already have my new logos. Tell me what you think?

Visa Worries, An Expat Therapist Shares Personal Coping Tips

So about our Talent Visa woes: there’s no change yet, but there have been some questions. Next week we lose our permission to work after 25+ years here in Malaysia, unless someone at immigration wields a stamp. The questions have been mostly, “Why aren’t you going nuts?!”

I’d love to say it’s because I’m the greatest mental health therapist in the entire world, and my calm is entirely due to my using my knowledge about depression, anxiety etc to flow through this. Yeah, I should lie like a rug and say Hire Me! 😊

Truth is, the job does help but it’s also partly experience and personality.

The experience says that this is a tough time, but there have been worse times. Nobody is dead. Nobody is bankrupt. Nobody is at death’s door. So the reality is that there is inconvenience and annoyance, but no tragedy. I find that a massive comfort.

Next, from my work: when you’re in a tight spot, look to your rock. Your rock is whatever it is that gives you safety. This can be religion, a place, money etc etc.

For me it’s money in the bank. I believe that money makes you free. My personal minimum target is if you can do nothing in terms of revenue making for a year and still be okay, that makes you pretty much bullet-proof. I’ve got that, so I’m blessed.

Next, it’s working out what absolutely needs to be done. For me that’s Tom who needs another operation at the end of the year, and moving the cats abroad. Everything else is nice but not necessary. I can abandon my books, my things, everything. It’s just stuff. Only Tom and the cats matter. I can arrange their needs, no matter what.  That is a comfort.

As for the rock, a safety margin of cash, I’ve even got a plan for that. If it all goes pear-shaped in 8 days, I get on a bus, move to a nearby country, set up temporarily and keep working while I arrange for the next big move. Inconvenient, but with my work being entirely portable, it really isn’t a big deal.  

What cements is all is choosing to be happy every day. I know what gives me the feels: petting Target, playing with Tic Tac and Inkie, making very nice dinners and sharing them with Tom while watching old films.

So every single day I set aside time to pet and play then I cook and we watch black and white films. Those moments of happiness are mine. They can’t ever be taken away. They’re locked in my mind and they run through the fabric of my life.   

And finally, I think personality has a lot to do with calm. It’s tough times but I’m the type who breathes through and keeps moving forward. It’s useful for me and my job, but I get it can be super annoying.

With all the drama, I’ve had several mates this week exclaim, “How can you sit there and be so calm!!!!!!!!!!” and advising, “Call immigration! Call the Talent people again!! Write in the newspaper!!! Do something!!!!!!!!!”

I really appreciate that love. It’s heaven to know so many people care. But when you’re anxious, action appears to be useful. Reality is that everything that can be done, has been done. And now we just have to wait and see. 

Update 14 November 2022: we got it!  Five years. But we think the writing is on the wall for foreigners in Malaysia, so we plan to move to the UK in 2023. As I work online, it will be business as usual :-)

Image by jacqueline macou from Pixabay

Is It Okay For You And Your Friend To See The Same Therapist? What About Partners, Exes, Cousins And So On? Talking About Confidentiality And Neutrality

Is it okay for you and your friend to see the same therapist? What about partners, exes, cousins and so on? This has come up a few times recently and it’s a great question. 

 

There isn’t a standard answer because there are no rules. 

 

You may think that there can be no overlap but that isn't possible. We live and work in the community.

 

Mental health practitioners who work in companies see people who work together and who live in their neighbourhood, just like those who work in a local hospital, so it's a very common issue.

 

Mental health practitioners can see members of the same family, people who work together, sleep together, who know each other on social media etc etc. 

 

What’s key is 1) confidentiality and 2) neutrality. 

 

Confidentiality. Some therapists share their notes in their office with colleagues or staff. I work alone and I prefer to maintain strict confidentiality. 

 

If you see me, I talk to you and to you only. Between sessions, I forget I know you. 

 

If your best friend, cousin, work colleague, or neighbour also sees me, I act as if I don’t know you in therapy sessions. In fact, I won’t even confirm or deny that you’re my client if anyone asks. 

 

So, I won’t talk but if you and your friend want to discuss your sessions, that’s your decision. You know what’s good for you.

 

Neutrality. The therapist helps the client reach their goals. That’s the job in a nutshell. In the session, it’s all about you. 

 

But with cross connections, I often hear the same story from different perspectives. Like if there’s a product launch, I may hear about the event management side from one client and from the product side from another. 

 

Confidentiality means that I can’t let information I hear in one session bleed over into another.

What’s said in a session, stays in that session.

 

This can be tricky when secrets are involved. 

 

For example, client X owns a restaurant chain and client Y works as a chef. Client X tells me that the chain will be firing 10% of all staff. In another session, client Y hopes for a big bonus and plans a long holiday. 

 

Confidentiality means I can’t talk out of session. So when client Y is talking away about holidays, I have to shut off and not warn them the company is actually in trouble. Which is awesome confidentiality but poor client Y, right? 

 

When it comes to dating, divorce and so on, secrets and confidentiality can really complicate matters.

 

So, I have this approach for taking on new clients:

If you know each other, that’s fine by me. Work colleagues, cousins, neighbours… it’s all fine.

If you think the relationship is very close and you’re thinking about neutrality or confidentiality, tell me and we talk it over. 

 

Generally speaking, if you are happy together and want help for two different things, like one wants to talk about anxiety and the other wants to talk about career happiness, I’m fine with that. 

 

If you’re close family or in a relationship and both of you want individual sessions to talk about your relationship, that may be tricky.

With two new clients, especially those living together, I usually suggest they see a family or couples therapist.

If one is an existing client and the one is new to me, I usually suggest the new one sees someone else. It’s just easier.

Should that not be an option for some reason, we can discuss it. Depending on what’s going on, I may say yes or no. 

 

(Note: if you have options, like lots of other professionals around, I usually say no. If you have few options, like you’re LGBTQ in the Middle East, or poly in the West, then I may say yes)

 

Of course, this is when all the info is out there and up front. 

 

Sometimes relationships aren’t clear at the beginning or they change. 

 

For example, I learn once we have started sessions that client A is the ex that client B is telling me about, or that client Q works in the same company as client P. Sometimes, client J is delighted with a new friend and I discover the new hottie is my client L.

 

Usually, it’s all good. I listen, hold the session and then forget until the next time.

 

The one curiously tricky situation is when I discover that two clients who I thought were individual one-off clients are actually partners. 

 

If I’m lucky, they tell me in session and then we can talk it over. But if they don’t, and I don’t know if they know their partner is in therapy, it’s an issue because I can’t ask without breaking confidentiality. But that’s a discussion for another day

Image by Pretty Sleepy Art from Pixabay