Sunday, May 21, 2023

Love Burns Out: What to Do When Your Parents Don't Like You


This feels odd to write about, although it's not exactly a secret. I am sharing some personal history and thoughts that might be useful if you struggle with family relationships.

I am an oops baby. In the 60s, premarital sex was considered a sin, and people who were caught in a pregnancy "did the right thing."

My parents married because they got pregnant with me. They said they loved me, but they made it clear, loudly and often, that they would not have tied the knot if they had a choice.

In childhood, I felt guilty. I also felt responsible.

My parents didn't do this on purpose. They thought treating kids like adults was empowering. Messed up, right? But that was a different time. Back then people didn't know a lot about mental health.

As it was, my parents worked hard. We had excellent schools, birthday parties, and books galore. Everything we needed and more.

But they were not a good match. They had different needs, values, cultures, and languages. Over time, they became angry and deeply resentful. They drank too much.

Abuse image

My mum would work herself into a rage and say the most awful nasty things she could think of.  A barrage of emotional abuse. My dad would shrug and act the martyr. The next day, they'd pretend nothing had happened.

I tried to talk about it. It did no good. My dad would moan and complain he was only there for the good of the family. My mum used rage, cold silence, and denial.  

When I was younger this went on behind closed doors. By my late teens, this went on in public too. 

I built my own life and moved away. Back then, people didn't talk about low contact, but that's what it was.

In the late 90s, my parents' marriage imploded. There was lots of drama.

My father went off with a mistress. That's a whole other story that I won't get into. My mother and I started talking.

It was tricky; she would blow up often, but we got to know each other better.

By the time my father died, my mum and I were talking several times a week. I visited regularly.

But the last year or so has been difficult. The rage came back. And the silent treatment.

When I visited last summer, I walked on eggshells. I worried about her health, especially dementia, but her memory is fine, and she knows what she's doing. She has regular excellent medical care. This time, it's not booze.

In January, she instigated a fight, not with me, but with someone else. Then she screamed at me.

It took me straight back to the awful years where she'd rip me to shreds and I had no choice but to take it. This time I told her I would no longer accept this. She cut me off.

Four months of silent treatment, but on her birthday, she picked up the phone and acted as if nothing had happened.

I didn't want to call again. But family, you know?

When I rang a week later, I got a tirade of abuse. She told me I was to stay out of her life forever. This time I just said, "OK."

So, where's the message?
I'm fine. Actually, better than fine. I have good friends, I'm married to my best friend, and I have a thriving business. I am very happy with my life.

If you're from a difficult family, you can be happy too. Here are some thoughts.

Families are messy

Many people are stuck in relationships they don't want, with kids they didn't want either. It sours them. They take out their anger on everyone around them.

Kids take it when they're small, they have no choice, but they leave when they're adult.

In Malaysia, 1 out of 3 older people are not supported by or are abandoned by their kids. (read here and here). In the UK, 1 out of 5 families are affected by estrangement. (read here) In the USA, it's 1 family in 4. (read here)

Being disliked or resented by your parents and deciding you want some distance is common.

You can build a happy life for yourself

Learn a skill, earn money, and move out. You need not go far. Just have your own life with people who love you.

There is no formula

Life is rarely black and white, and there are seldom easy choices. There are no rules and no simple fixes.

Most of us with difficult families go through times when we connect and times when we don't. And that's okay.

You will have regrets

Kids yearn for their parents to love them. When that love is not there, or conditional, or coloured by resentment, most of us bend over backwards, hoping to fix our relationships.

Some of the things we do work. Some of them hurt or cost us, but we're willing to pay the price. And sometimes we look back and say, "doh!"

I don't regret trying to connect, but I do regret those annual visits. I wish I'd spent that time with people who love me.

Love burns out

Once you've been through a few abuse cycles, emotions change. The sadness, anger, and other feelings are overwhelming when you're young. But as you mature, they fade. Eventually, you stop caring.

It's a form of self-protection. Why embrace people who hurt you repeatedly?

So if you're worried about this, please know it's a common reaction.

Estrangement is not always permanent

We tend to think in absolutes. While estrangement can be permanent, it can also be temporary, lasting months or years.


I don't plan to reach out. But I'm not saying never. I'm moving country this year, and so I'm busy.

For now I'm okay with zero contact for the foreseeable future.

People will judge

Those from happy families won't get it. They have no idea what it's like to grow up with toxic parents.

There will also be people who know they are a problem in their own families and who seek to normalize abuse.

When you feel judged, maybe you want to engage. Or maybe not.

I suggest this: other people aren't living your life. You are! Think and do what suits you best.

I should also mention silence, but that's for the next post. This one is long enough!

Get help

Toxic Parents by Susan Forward
Back in the 80s and 90s, abuse and estrangement were taboo. The first book I ever read about it blew me away and gave me hope: "Toxic Parents" by Susan Forward.  

There are lots of insightful helpful books out there these days.

I suggest you read widely, lean in with friends, and use therapy as a safe space to sort out an approach that works for you.

It worked for me.

If you want some support, you know how to find me.

Image by John Hain on Pixabay

Thursday, May 4, 2023

Have Depression And Think You Shouldn't Be In A Relationship? Check Out Ethical Depression

"I can't have a relationship because I have regular periods of depression. It's not fair to others."

I hear this sentiment often. I don't agree with it, and here's why.

Tax and accounts professionals work crazy hours every April and December. Should they swear off relationships?
Academics who take PhDs are unbearable - for more than a year! Should they exit all relationships before starting?
Doctors, lawyers, police, nurses, and other professionals disappear at the oddest times to deal with emergencies, and they typically work extra over holidays. Should they stay single?

Of course they should not. And neither should you.

Depression Fuels Negative Thinking

A Dementor, pic courtesy of Karen Roe from Bury St Edmunds, Suffolk, UK
Don't listen to the depression dementors

Depression is a mental health issue because it affects perception. Typically, depression removes the joy from life and focuses on the negative.

Depression is like living with Dementors.

So while the sentiment appears to come from care, I think the idea that you have to go through life alone and without the joys of partnership is really depression talking.

Depression is sneaky. It whispers that you're no good, can't be good, won't be good, don't deserve happiness. 

It's nasty, and it's insidious. Don't listen to it.

Bet you're thinking that living with depression is still a challenge. You'd be right. So here's an idea for you: ethical depression.

Being Ethical About Depression = Practical Depression Management

Planning for when your dips hit helps you through periods of depression. If you work up a system, you can navigate the worst of it, reducing the burden on you and your loved ones.

To help yourself, you need to do some prep.

  • Know your patterns
  • Know your triggers
  • Know what self-care routine you need to maintain your best health
  • Map out your support network
  • Have a detailed plan for managing your dips
  • Set up rules of thumb that help you identify an emergency
  • Have an emergency plan

Basically, this is all the stuff you will have put together with your therapist.

With the basics in place, you need to add two things:

Be responsible for your behaviour. Depression is a mental health issue but as adults we are responsible for our actions.

So, if you're angry when you're dipping, learn new behaviour. If you know there are periods when medication helps, figure that when/what/how and do it.
Communicate with your partner. Loving partners often hope to manage our troubles for us, which is simply not possible. So you'll need to have a series of conversations.

This is tricky because a) each episode of depression will be slightly different, b) your circumstances change over time, and c) it takes time and experience to discover what your partner is happy to do, and d) your partner's situation will change too.

Example: at 20, if you're at university and sharing a flat with roomies, managing depression differs completely from when you're 38, managing a team, and parenting a kid or furries.

Then, when you're 60, and retiring from a career and coming to terms with being older, periods of depression can really hit your identity and relationships, and managing it is different again.

Talk and Keep Talking

If you treat your depression like a business client who needs to be managed, you'll find it easier to deal with.

Know what you need, and discuss your thoughts and needs with your partner regularly. Do this while you're in a good space for maximum effect.

After every dip, have a post-mortem and update your thoughts on what's going on, and see if you need to make any changes.


Love Image by John Hain from Pixabay
You deserve love and companionship
Depression can be a bugger to deal with, especially if you have deep dips, but don't let it define you. Nobody is perfect. Everyone has issues. So go get out there, and be happy.

PS, should you need help, hire me! I'm sensible, practical, very private and affordable. Also, I work online internationally.

Photo credit:
Love, by John Hain from Pixabay
A Dementor, pic courtesy of Karen Roe from Bury St Edmunds, Suffolk, UK

Sunday, April 2, 2023

"May I See My Therapy Notes?" A Surprisingly Controversial Topic (And Yes, I Share – Or Take None At All If You Prefer)

Sharing therapy notes empowers clients
Empowerment is key

You're pouring your heart out and the therapist takes a note. Immediately you wonder what they've written down.

So, can you see your notes?

With me, yes. In the free 15 min chat, I ask if you want notes or not. If you say yes, I always share notes with you. We're working together, right?

I believe in empowerment and transparency. So, if I think it's important enough to note down, then we're talking it over, and you need to see it.

It's your life we're talking about.

I believe refusing to share notes damages trust and infantilises clients. However, sharing notes with clients is controversial. In fact, note taking itself is also a hot topic.

What Therapy Notes Are For

Mental health practitioners take notes in different ways. One common style is to note how a client acts, including emotions they show, plus the therapist's hypotheses of what is going on, action taken, progress over time, or thoughts about the session.

Notes are useful to track work and effective change. When therapists have dozens of clients, you can't expect us to remember every detail without a prompt.

Also, if staff move about, having notes mean clients don't have to start all over again with every therapist change.

In hospitals, NGOs, and companies where practitioners have bosses, several people will access and use notes. They use them to extract data, to check on how your therapist is working, and more. That's a problem, which I'll discuss in a second.

Not Sharing Notes Is Common

Hospitals and companies are typically defensive, and they're known for withholding records from their patients and clients. 

It's not just therapy notes; the fight for us to see our own medical notes has been ongoing for decades. It's why so many countries have had to actively legislate to allow us access. And even then, there are lots of arguments about it - like this piece discusses so nicely

As early mental health practitioners were typically also medical doctors, and many therapists work in clinics, I suspect that this issue has a strong historical legacy. Whether it is or not, many therapists refuse to share notes with clients, even although in a recent study 94% of 85 clients polled said they found it useful.

I'm hearing more colleagues talk about this, so hopefully the norm will switch to transparency and empowerment being the norm. 

And if I may suggest a hint to further the revolution: if clients refuse to work with therapist who won't share, that change will come sooner.  Money always talks 😊

When Therapy Notes Hurt Clients or Are Dangerous

Another issue is that notes can hurt clients - and I'm not thinking about my awful spelling and brute approach to grammar, either.

Seriously, notes can hurt and even kill if they are seen by a third party. Here are some simple examples I come across regularly.

  • Zul is from a poor family. He shares a laptop with three sibs. If they saw his notes and learned he was depressed, they would worry.  Worrying them would burden him and impact on his mental health.
  • Fiona is exiting a violent marriage, and her husband snoops. If he sees her therapy notes, he'll beat her into hospital or an early grave.
  • Shan is an atheist in a country where that is illegal. If people saw his therapy notes, he'd be fined, flogged and jailed as part of his 're-education'.
  • Jenn had a miscarriage and she's devastated. But if her evil ex finds out, he'll accuse her of having an abortion. As those are illegal in her country, Jenn would go to trial and if wrongfully convicted, jail.
  • Mandy and Ken are discussing an abortion in a country where that's illegal. Being discovered even thinking about it means being fired and ostracised. If they we're to decide to do it and travel to a safe place, being discovered would mean jail.
  • Rob is gay in a country where that is illegal. If anyone saw his notes, he would be executed.
  • Farah is having an affair. Adultery is illegal in her country. If she's discovered, it means flogging, fines and jail.
  • Dave likes his privacy. He simply doesn't want a record of his mental health journey.
  • Karen doesn't want anyone to know she's in therapy because her organisation believes seeing a therapist means you're unstable or weak. If people knew, she'd never be promoted. She might even be fired.

The world is a nasty place, and we can't be Pollyanas. Therapy is a safe space, and that comes with obligations.

Leaks, Data Selling and Other Privacy and Security Issues

While organisations typically document everything for many good reasons, it's also a massive problem because too many are lousy at keeping records safe. 

They are targets for hacking, and sometimes unhappy staff leak or sell patient data. Here are a few articles about recent issues - in the USAthe UK and Australia.

Organisations themselves also choose to make money by selling client data. There are a tonne of scandals, like this one where the NHS gave information to Google which wasn't the first time either, as the same issue came up in the USA in 2019.    

As for health apps that track exercise, periods, and mental health, they are built to extract, package, and sell information. It's a huge industry, as this piece and this piece explain. 

If you're okay with selling your information, that's great. But if you are private or think it may put you in danger, it pays to be careful.

I am a private practitioner. Therefore, I make my own guidelines. My primary focus is healing in a private setting. 

I do my own paperwork. Nobody knows who my clients are. I keep client notes offline, and not on a server. I have firewalls. I do everything I can to keep notes safe.

As many of my clients are vulnerable, I offer a No Notes option

I'll ask before we start if you want notes. You can say yes or no - and I don't need a reason. It's your session and your choice. And if you start off wanting notes and then change your mind, that's okay too.

My view is this: it's your session and your life, so you pick. 

I hope you found this interesting. Be safe and if you need a therapist, you know how to find me. Thank you for reading!

Image by John Hain from Pixabay

Tuesday, March 28, 2023

I'm ageing – and I'm appalled

She looked me over and said, "What a relief! We've been looking for an older counsellor. The students need a mother figure. You'll be an excellent addition to the team."

It was a dagger in my heart. As I was desperate for the job, I put on my best poker face and smiled. But afterwards I rushed to the loo and gazed in the mirror. I looked same as always. Nicer than usual, actually. I had lipstick on. And I'd brushed my hair.

"You're not so old," I muttered as I examined my face, searching for crow's feet.

That was eight years ago. Today I don't need to peer in the mirror to see lines. Actually, I do because I have to wear glasses now, but what I meant to say was that the fine lines have deepened. You can see them quite clearly from across the room, thank you very much. Also, the sprinkling of grey hair has expanded, dominating my fringe.

It's undeniable. I'm getting old. And for the record, I am not happy about it.

I'm not the only one. With declining fertility rates and increasing longevity, we have more old people than ever before. And like me, many are absolutely refusing to recognize the truth of their mirror.

Thanks to the collective hissy fit and rejection of reality, age is now the focus of a massive global positivity drive. Sixty is the new forty!

Well, on the inside I'm 32 but my back doesn't agree. The dratted thing packed in twice last year. The eyes aren't doing so hot either. I now have computer, book, and TV glasses. It's completely ridiculous. When I put on my computer glasses the other day and picked up a novel, I thought for a moment I'd gone blind.

While this does not happen to 32-year-olds, the adage that you're only as old as you feel now has scientific backing.  

A 2021 study of 2253 people by researchers of the Universities of Montpellier, France and Michigan, USA confirmed it: people who feel younger than their age, have a younger biological age.

It's weird, isn't it? I'm not into woo-woo, and so I was skeptical. But other work supports the idea.

A whole bunch of biomarkers, nicknamed "deep aging clocks", that include MRI brain scans and blood chemical analysis can assess and predict biological aging accurately.

In fact, some very clever people have been monitoring changes in DNA, so-called "epigenetic clocks", too.

And the consensus so far is this: while your actual age is important, your biological age is affected directly by the age you feel yourself to be on the inside.  

So it's probably excellent news that my internal mirror is a few decades behind. However, repressing reality isn't going so well for me.

When I set foot in the wet market, I'm 'auntied' mercilessly. Only the chicken butcher and the veggy bloke still call me sister.  Mind you, this may be because I'm a foot taller than both of them and have a steely glare, even at 7AM.

My mind keeps flashing back to when I was a teen.  I was taking a tube somewhere. London, perhaps, or maybe it was Madrid. Anyway, I stood up for an older gentleman, minding my manners and offering the cotton-top my seat.  

He glared, grumped, "I'm not THAT OLD!" and stomped off. I was mortified. Also miffed because a slick bloke slid into my spot and refused to move on the basis of, "Use it or lose it."

Well, my chickens have come home to roost. I can't go near the MRT now without some super civic kid smiling and acting helpful.  

While I'm horrified, my mate Michelle is making hay. She went off to get her booster jab and called me, cackling with triumph, from the health center.

"It's busy, with queues everywhere," she announced. "But guess what? There's an auntie line!"

"You haven't!" I said in awed horror.

"Have so," she cast back triumphantly. "They gave me a chair and they did my paperwork for me. All I had to do was sign and stick my arm out."

I've tried not to let that influence me. But the other day, when I was in the bank, bored out of my mind and looking at my number, 3128, I snuck a peek at the helpdesk.

Yes, I admit it freely. If there had been a clear sign to an auntie VIP pass, I may have caved. However, I wasn't wearing my glasses. And now they've replaced the sweet knowledgeable lady with a fiendishly complicated machine that's unhelpful in three languages, I couldn't be bothered to investigate. So, I waited my turn.

But I fear my denial will be vanquished by my loathing of queues. The next time I go, if I remember to think about it, I'm going to see about the auntie line.

As for the machine, if it tries to defeat me with its endless unfathomable questions, I will have to hope that the grey fringe and crow's feet prompt some helpful Gen-Z to jump in and rescue me.

Ageing sucks. But if it allows me to skip queues, I am willing to concede there are upsides.

Ellen Whyte is a British-registered counsellor and psychotherapist who loves to laugh and has a soft spot for cats. She founded an online practice in 2016, and works with clients in 20+ countries.

Wednesday, March 1, 2023

Is ChatGPT a good therapist?

Tom and I have been playing with the ChatGPT bot for some months now. It's a remarkable tool that mimics a human conversationalist. 

I'm a huge fan of AI and of science fiction, (I loved Hal from 2001: A Space Odyssey by Arthur C Clarke!) and although this is not a medical tool, I was curious how good it is at figuring out common mental health issues. 

After all, there are forums like Reddit and MumsNet where people ask for advice, right? And some of that can be pretty good.

So here goes!

Setting Up The ChatGPT Test

All clients are unique but there are some quite typical first approaches that I see over and over again. For this venture I made up three very common texts that potential clients might send me. They are entirely invented but reflect real life quite well.

I have then described how I would start the first session. Finally, I have put it to ChatGPT and shared its answer.

My comments on pros and cons are at the end.

Sad brain by John Hain
Sad brain by John Hain

Meet "Client A"

I am crying a lot. I'm also misery eating. I have low energy. And I'm sleeping too much. What's wrong and how do I feel better?

Ellen's Approach

This is a simple question by a person who is familiar with mental health discussions. They talk in terms of psychological symptoms.

I would suspect low mood, possibly depression, and I would ask questions to see what was going on.

As part of my first free 15 minutes discussion I ask, "How is your overall health, has a doctor checked you over? Did you have a thyroid test?" This is because physical health and mental health are linked. Thyroids in particular can cause havoc if they're wonky. You can read more about that in this post.

Assuming the client has a clean bill of health from their doctor, we dive into the background so we get a big picture overview. 

Over about an hour, we work through a depression inventory and various discussions that include:

How are you sleeping? If you don't sleep well you become ill. If you don't sleep at all, you die. So this is hugely important. Sometimes depression comes from sleep deprivation due to construction, a partner who snores, or new baby in the family that cries at night.

What are your personal relationships like with partner, family, boss? Note: a client claiming simply, "I have a lovely relationship" doesn't cut it because abused people tend to make excuses for cruel treatment. I want details! 

Also, have you had any changes recently,  like a move, a promotion, an exam? All change is stressful, and there may be a reason someone is down, like maybe they moved jobs and are missing old friends or perhaps there's a longer commute that's upsetting them.

Have you had any shocks recently, like a minor car accident or been cheated by an internet scam? I have a stress discussion that covers 50+ common stressors. 

Once we have the big picture, we start with happiness scheduling or behavioural activation for depression, and we have a chat to see if you want to talk to a doctor about medication. If you do, I give you a list of suggested basic questions to ask

Then, in the second session, we look at bigger picture work that tackles possible triggers and we model how you can change how you work/behave/think. This is basic therapy work, the stuff you see in the films. 

I can use different techniques, Interpersonal, Adlerian, Client Centred or Existentialist. What we pick depends on the situations you face and how you think. Frankly, it's not important. We're helping you, not writing an academic paper.  

As we move along, we use the list of symptoms you're showing from session 1 to keep an eye on how you're doing.

ChatGPT's Approach

ChatGPT logo

I typed in, "Can you think like a therapist and suggest a diagnosis and a therapy approach?"


Based on your symptoms, it's possible that you may be experiencing depression. Depression is a common mental health condition that can cause feelings of sadness, hopelessness, and loss of interest in activities that you once enjoyed.

As for therapy approach, cognitive-behavioral therapy (CBT) and/or interpersonal therapy (IPT) may be helpful in addressing the negative thoughts and behaviors that are contributing to your depression. In CBT, you would work with a therapist to identify and challenge negative thoughts, and learn new skills for coping with difficult emotions. IPT focuses on improving relationships and communication skills, which can be particularly helpful if interpersonal conflicts are contributing to your depression.

It's also important to seek support from a healthcare professional, who can provide an accurate diagnosis and recommend treatment options such as medication, if necessary. Additionally, practicing self-care strategies such as mindfulness, exercise, and healthy eating habits can also be helpful in managing depression symptoms.

Remember, seeking help is a sign of strength, and there is no shame in asking for support when you are struggling

Meet "Client B"

I feel heaty. I have aches. I don't sleep right. And at work, I can't perform. What's wrong with me?

Ellen's Approach

My immediate first thought is that 'heaty' signals that this is a person who either thinks in a Chinese language, or that they come from a Chinese educational background. As I have written before, Cultural filters affect how we think about depression and anxiety. There are journal links on that at the end of the piece.

I would proceed exactly the same way as "Client A".

ChatGPT's Approach

ChatGPT logo
I typed in, "Can you think like a therapist and suggest a diagnosis and a therapy approach?"


It's difficult to determine exactly what may be wrong without more information, but your symptoms could be indicative of a number of health issues. Here are a few possibilities:

Dehydration: Dehydration can lead to a feeling of being "heaty," body aches, poor sleep, and reduced performance. Be sure to drink enough fluids throughout the day, especially if you are sweating due to physical activity or warm weather.

Viral or bacterial infection: A viral or bacterial infection, such as the flu, may cause similar symptoms. If your symptoms persist, you should consult a doctor to rule out any serious illness.

Stress or anxiety: Stress or anxiety can also lead to body aches, poor sleep, and reduced performance. If you are experiencing a lot of stress at work or in your personal life, it may be helpful to speak with a therapist or counselor.

Poor sleep hygiene: Poor sleep hygiene can lead to aches, poor sleep, and reduced performance. Try to establish a consistent sleep schedule and create a relaxing bedtime routine to help improve your sleep.

Overall, it's important to take care of your physical and mental health. If your symptoms persist, it's best to consult a medical professional for further evaluation and treatment

Meet "Client C"

Information dump = upset client
Information dump = upset

I have a new job and the people don't like me. They don't ask me for lunch. In my last job I was bullied. I think I am unlikeable. I do try, I smile, I say hello, but it doesn't work. My last boss said I am abrupt. But I don't think I am. I am a friendly person. I asked them for lunch but they made excuses. I am crying a lot. I'm also misery eating. I'm upset often. Maybe I'm overthinking this. They're colleagues not friends. My work is good. I was just given a bonus. Is there something wrong with me? Should I quit?

This information dump style is super common when a person is upset. Typically something has triggered them and they come to therapy out of sheer desperation for a fix. As they can't figure out what's going on, they don't know what is pertinent information and what is not. 

The best thing is to ask a lot of questions and to get as much information as possible.

First point: don't quit! Making decisions when you're upset is seldom wise. So hold your horses while we try and figure out what's going on. If necessary, take a day's leave.

My immediate thoughts about what may be going on:
This could be a form of depression, anxiety or social anxiety, or a mix of these.

This could be a stress reaction by a person who grew up in an abusive environment. People who grow up with dysfunctional, abusive, toxic or neglectful families tend to have poor models when growing up. As a result they don't have a lot of practice at healthy or regular socialising. So when they go into the world, they can stumble.

This could be a person who is on the spectrum, so they miss social cues. 

It could be a stress reaction or even PTSD-c brought on by long-term bullying in the previous job or school or both.

The client may actually be the victim of bullying and gaslighting. So that opens up possibilities:

If this is someone coming from a group culture, it could a close-knit team being nasty to a newcomer. (It's not just criminal gangs who bully newcomers!)

It may also be sexism, racism, class or religious friction, e.g. a female Indian Hindu welder working in an all male Christian owned business in Wales. 

Or it may be a hierarchy or power play. This is very likely if the person is working in a start-up or company that is scaling up from a tiny team. I would ask about job titles here too just in case the client is HR/legal or a consultant or trainer. In companies such people can be bullied and gaslit by staff who feel threatened because they see the person as having power over them. This is especially true for women working in male dominated organisations. <- yes, patriarchy!

I'd check for lots of detail and refine ideas as we go along.

After all this, I'd make suggestions about what may be happening and ask for input from the client. Then we'd take it from there.

Therapy approaches depend on what I hear. 

If it's depression, we set about dealing with it in the same way as for Clients A and B. 

As depression and anxiety often come together, it may be both.

If you have a form of anxiety, we start with big picture stuff where we talk over the physical parts of anxiety and then the psychological parts. Then we work on helping you manage your anxiety with a mix of CBT and mindfulness and plain old distraction (a behaviour technique). 

I may teach you basic visualisation, that's relaxation without the heavy lifting of meditation.  And if your sleep is off, we talk about sleep hygiene. (I haven't written that post yet, I will! In the meantime, try this one from WebMd

Again, in the second session, we also look at bigger picture work that tackles possible triggers and we model how you can change how you work/behave/think. If the same thing happens over and over, we may use a mix of CBT and tweaks so that you have a system that works for your regular triggers.

In addition, we go for plain therapy using Interpersonal, Adlerian, Client Centred or Existentialist.

For simple life stress without depression and anxiety, we talk it out big picture style. I also talk you through some of the techniques above if we think it will be helpful to you. 

If there's bullying or abuse going on, we talk about how power and control works. We may also talk about group culture, hierarchies, sexism, and discrimination. <- yes, all that juicy stuff you're not allowed to talk about in the pub is what we talk about in sessions!

We figure out what's going on in your life and what kinds of choices you can make. This will take several sessions. We may also talk about Toxic Forgiveness and the type of bullying where 'friends' hold an 'intervention'.

If you have had a big fright or been bullied a long time, we may discuss PTSD and PTSD-c. I use a multi pronged approach to this that combines simple anxiety and depression approaches to start with, followed by talking it out.

When you're ready, we do the classic exposure ladder where you very, very slowly unlearn your fear reactions and practice newer, happier, reactions. And I also talk to you about whether you want to see a medical doctor for medication. 

Finally, if we think you're on the spectrum, that's not something I'm trained for so we'd see who you could consult to get a proper opinion.

ChatGPT's Approach

ChatGPT logo
I typed in, "Can you think like a therapist and suggest a diagnosis and a therapy approach?"


It sounds like you are struggling with feelings of rejection and low self-worth at your new job. Based on your description, it's possible that you may be experiencing symptoms of social anxiety, which can manifest as fear of negative evaluation, self-consciousness, and avoidance of social situations.

As for therapy approach, cognitive-behavioral therapy (CBT) may be helpful in addressing the negative thoughts and behaviors that are contributing to your distress. In CBT, you would work with a therapist to identify and challenge negative thoughts, and learn new skills for coping with anxiety and social situations.

In addition to therapy, it may also be helpful to seek out support from a trusted friend or family member, and to practice self-care strategies such as mindfulness, exercise, and healthy eating habits.

It's important to remember that your worth is not defined by the opinions of others, and that it's possible to improve social skills and build positive relationships over time. It may be worth discussing your concerns with a supervisor or HR representative to see if there are any workplace policies or resources available to support your social integration. And as for quitting, it's ultimately your decision, but it may be helpful to explore other options before making a final choice

Ellen vs ChatGPT; The Verdict

Clearly I'm a super duper genius and the ChatGPT is no Hal 9000. :-) Seriously,  the bot is really a sophisticated search tool that cuts and pastes information from the Internet.

HAL 9000 from 2001: A Space Odyssey by Arthur C Clarke
HAL 9000

It did fine with Client A because that person was using very precise vocabulary in a very careful way. It wasn't so hot with Client B. That suggests the bot isn't very multicultural.

But the way it handled Client C was a bit of a mess. Also, it did not take into account an area of danger.

If Client C is being bullied and gaslit, then CBT and mindfulness will be dangerous. You should never accept or ignore maltreatment.

In addition, if it is not bullying but shyness or cross-cultural issues that's causing this, then it's important to note that HR works for the company, not the staff. 

Although HR individuals can be wonderful and helpful, I'd be careful about being open about feeling disliked. It can backfire easily.

Finally, the bot talked about self-esteem. While there may be a case to make, I agree with the positive psychology movement that self-esteem is a barometer of overall mental health rather then an end onto itself. It's a different point of view, and I suspect that the bot thinks of it in the old-fashioned Maslow way. I need to blog about this too! Coming soon, promise.

My take is that if you already know what's up, and you talk to ChatGPT in exactly the right way, it's useful. If you don't, you'll get incomplete advice. You may also miss out on a bigger view or be given a direction that is ultimately harmful. 

In conclusion, here's an apt quote from a Slate article

auto-generated content is associated with low-quality journalism, and that’s precisely what Google has tried to suppress in its search results. “Before this GPT conversation, Google was doubling down on content quality and what they call EEAT: experience, expertise, authority, and trust,” explained Lily Ray, senior SEO director at Amsive Digital and author of the SISTRIX report. “They want to know who created the content—they want to know that person’s an expert or has a lot of experience. They want to be able to trust that person—trust the brand, trust a website.”

If you want to play with ChatGPT, click here. And if you want to talk to me about your mental health, you know how to find me!

Some related journal papers: here's one about how Han Chinese talk in terms of physical symptoms compared to Europeans, and here is a discussion of typical South East Asian approaches to talking about health, including mental health.
Tom is an information technology and computer science academic and he is writing his own paper. I will link to that in the future.

Creating new post…

Image by John Hain from Pixabay

Friday, February 24, 2023

Book Review: The Practice of Belonging

The Practice of Belonging: Six Lessons from Vibrant Communities to Combat Loneliness, Foster Diversity, and Cultivate Caring Relationships
Paperback - April 4, 2023
by Lisa Kentgen PhD

Community values and practices are always a hot topic but with the pandemic, more people than ever are talking about how we connect, where our communities work and where they don't. Finding solutions for issues is a challenge, and so I was curious to read this book.

Lisa Kentgen is a psychologist with a Ph.D. in clinical psychology who works in academia and in clinical settings. It's a wonderful combination because this book marries solid research to practical application and provides lovely insight.

This is one of the best books I've read recently. The chapter on how caring transforms on a personal and community basis alone is worth a seminar.

I loved the personal anecdotes and the reflections on dealing with differences. The first gave me a vivid impression of communities I don't know personally. The second are food for self-improvement. Also, as The Practice of Belonging covers a variety of approaches and attitudes, it is a lovely multicultural read. That was simply a joy!

As I read it, I found myself wondering how it would work in my community, in Malaysia, and at home, in the UK. For example, the chapter on hospitality talks about connecting but it's a topic that is also deeply connected to architecture, gender roles, and food security. So will need to read that again to get the most out of it.

What I liked: The simple language, broad approach plus discreet references. The combination makes for an easy read but if you want to chase down original sources, you can.

What I wasn't fond of: nothing. This was an excellent book.

Definitely five stars. Highly recommended.