Friday, December 30, 2016

When Happiness Is Sabotaged By Too Many Choices

We're told that having lots of choices make us happy.  It seems that it should because people have different tastes. However, turns out that this isn't quite true.

Check out this TED talk by Barry Schwartz, who presents the conclusions of various studies that explain how too many choices make us doubt ourselves and can cause a kind of mental paralysis.

Saturday, December 24, 2016

Suffering From Weltschmerz? A Tip To Cheer You Up!

Hell in a wheelbarrow, courtesy Thomas Staub pixabay
Hell in a wheelbarrow, courtesy Thomas Staub pixabay

Do you feel that the world is a mean place, filled with wicked people, lazy youths and altogether heading for hell in a hand basket?  

If so, read on for some discussion of what might be going on, and tips for managing the issue.

Weltschmerz meaning world-pain in German was coined by Johann Paul Friedrich Richter, a German author who wrote fun, upbeat romances in the late 18th century.  

Known by his pen name, Jean Paul, he suggested that our wishes about a perfect world can never actually come true, hence our pain when reality falls short of our expectations.

Jean Paul by Heinrich Pfenninge
Jean Paul by Heinrich Pfenninger

Weltschmerz is also used in the context of the kind of anxious depression we feel when we contemplate the ills of the world. 

At present, this type of reaction is the subject of some research and so far the leading impression is that connectivity is at least partly to blame.

So how does that work?

Many opinion makers point out that depression has risen at the same time as the internet has become generally available. They say we are swamped with information, a lot of it is pretty negative, and that this is one of the things that makes us more prone to depression. 

However, is this really new?

Many people point at the media as highlighting bad stuff that's happening. However, in the 1700s, newspapers were popular, especially the yellow press that relied on scandal mongering.Nasty news back then was just as hot as it is now.

I think this points to our human nature. Positive news attracts very few readers; horrific news is extremely popular. As news agencies are companies that rely on sales, they focus on death, war, torture, rape, cruelty and so on. (Although some add in the odd cute kitten to mitigate all the negative stuff.)

While the type of news we see has stayed constant over time, it's true that we have the capability to see more bad news today than ever before. I watch "on the hour" headlines from several live news feeds and read the top stories of twenty or so newspapers and magazines every day. 

That's a lot of bad news.

However, many people don't watch the news, don't read newspapers and get their information from social networks instead. They are not in touch with world events at all, and sometimes not even local ones.

It may be that the other things about being connected, the pressure to keep up with the Jones's, bullying, and so on, are factors, however, these pressures aren't new either and I'm not convinced they're very much different now than they were pre-internet.

I think there are two more important phenomena at work. 

Gumibears, courtesy Ronile, Pixabay

First, we are increasingly lonely.  Our homes are smaller, so we live alone or in small family units rather than with three or even four generations. 

Few of us can afford to live near our work, so we tend to live further away from our friends and relatives than ever before. 

We also work more hours than we used to, have fewer days off, and commuting means even less time with loved ones.   

This type of isolation leads to increased stress and depression.

Second, we underestimate our own changing sophistication. 

When we're young, we tend to be naive and more optimistic because bad situations are new to us. Of course, the more experience we have, the more we become aware that happy endings aren't always the rule.  

This means that when we are mature, we understand that victims won't always leave their abusive partners, that rape victims are blamed because others choose to attack them, ... and on and on it goes.

However, we confuse our own increased wisdom with moral decline in the world.  We think, "This didn't happen twenty years ago," instead of, "Twenty years ago I would have thought differently about this."

Put it all together and you have a pretty powerful negative punch, with or without connectivity.

If you suffer from Weltschmertz, simply understanding what you're feeling, what your personal triggers are, and how you can uplift your spirits with simple exercises like uncovering your own inner needs as well as pleasure scheduling will help. 

However, there is another very simple realisation that helps me when I'm having dark thoughts:

In the Book of Isaiah, written around 700BC, the author wrote, "How the faithful city has become a whore! Everyone loves a bribe and runs after gifts. They do not defend the orphan, and the widow’s cause does not come before them."

Horace reads before Maecenas, by Fyodor Bronnikov
Horace, a Roman poet working around 20BC, wrote in Book III of Odes, "Viler than grandsires, sires beget Ourselves, yet baser, soon to curse The world with offspring baser yet."

Look throughout history and you'll find similar examples of older people moaning that the world used to be terrific and is now horrible.

I take that as a very good sign. If people have been moaning about how wicked everyone is for thousands of years, we're probably looking at thousands more years of the same thing.

So when I'm inclined to think, "The world is becoming awful" I say to myself "It's my increased wisdom saying that, and I'm just having a Horace moment."  It works for me.  Hope it works for you!

Thursday, December 15, 2016

How To Survive Christmas

It's confession time: Christmas has lousy associations for me and New Year is even worse.  I do survive them but the ways I use are a mix of conventional and unusual. So I thought I'd share.
Punch you for Christmas
Thanks WeKnowMemes

First, for those of you who know me, you might wonder how come it's even an issue, seeing I live in South East Asia.

Well, although Malaysia has oodles of non-Christians, and we have at least four New Year type holidays that I can think of, there's no getting away from the fact that the holidays are big here - especially in shopping centers, pubs and on TV. 

Also, people like to party! Our local supermarket was playing Jingle Bells last month, and the hairdresser was at it before Thanksgiving. 

I find it all a bit much sometimes, but it needn't be all depressing all the time. Here's what I find works for me.

1. Accept That You're Allowed To Hate The Holidays - And Maybe Make A Game Of It

The world is happy and you're not. That's okay. It's nothing to feel guilty about. Unless you live in a place where fun is dictated by law, you can feel however you like.

However, it helps to separate what you feel from how you want others to feel. I enjoy watching people be happy and I recognise I don't need to feel the same. I find this cheers me up.

Also, when you're down, any problems that crop up seem much more major than they really are. This is a classic issue that comes with depression. If you can recognise that, it makes being down about the holidays easier to live with.

I have a fairly dark sense of humour at times, so I not only recognise when my world is distorted, I make a game out of it.

Like yesterday I had several computer problems that meant I couldn't get my work done. The courier didn't turn up, an interview was cancelled... it just went on and on.  

Usually that stuff doesn't bother me but with the holidays coming up, I was just doom and gloom. Then, when my smallest cat threw up all over the laundry I'd just done, I began tallying up Bad Things That Happened Today and was able to laugh about it.

2. Feel Free Not To Join In

If you don't like the holidays, you don't have to pretend to celebrate them. When you get party invites say you're busy or you have a prior date if you want to be polite.

I find that with friends it's easier to be open and say, "This time has bad associations for me so I don't celebrate." The advantage of this is that you don't have to repeat yourself every year.

There are also people who refuse to accept a no to their invitations.  "I hear you don't celebrate but you simply must come to my house. I insist!" 

Remember, it's okay to say no but it's controlling not to accept no. Feel free to give them a cold stare and to icily refuse.

3. Don't Celebrate The Holidays; Celebrate Having A Day Off

As we have days off work, this is the perfect time to do stuff you normally wouldn't do. Spend the days baking, taking fencing lessons, trekking in the wilderness. Basically, do something you love and treat yourself kindly.

Also, if you're in a place like Malaysia, there are plenty of shops that are open and not celebrating. This may be the perfect time to go and eat a Chinese dum sum buffet or to find a place that does the world's best Bak Kut Teh.

4. Arrange for Marathon Film Fests, Junk Food And Sleep

The holidays consist of a limited number of days. You can totally avoid the period by switching off your phone and social media, stocking up on films and going totally bear-like.

The Terminator

I like to watch all the Jaws films (yes, even that 3rd one!) and then all the Predators, and then Terminator 1 and II (III was a disaster and IV was just arrrrggghhh!). 

Add in all the original Robocop films and you have two or three days of film heaven. Roll into bed and have Technicolor dreams about sharks eating you up, afterwards.

Note: junk food is salty so stock up on loads of water, and make ice cubes if you like it frosty.

5. When You Really Are A Mess

If this is a time when someone close to you died, or you can't see your kids, or some other serious issue, then you need to be practical and make yourself a rescue plan.

If there's a friend who's willing to be on stand-by, arrange for that support. You know yourself so anticipate what you may need and when. Then ask if your friend is willing or able to back you up. If necessary, work it like a team.

If you don't want to talk to a friend, then jot down the numbers of the many charity hotlines that remain open at this time of year. Don't be ashamed to call them up; it's what they do that's fantastic.

Think you're really not safe?  Then go talk to your doctor and ask to see a psychiatrist. Seriously, don't suffer. It's not useful to be miserable and it's preventable. Get the help you deserve.

This is very much unlike my usual posts so do tell me what you think. 

Also, Merry Christmas! Remember, it's only a few days and then it will be over.

Wednesday, November 30, 2016

"Dear Ellen, life's perfect so why am I in tears at the least little thing?"

Feet over a ledge

Dear Ellen,

I've got a new job that I love, a new apartment that's just beautiful and I've finally met someone I think is The One. So why am I in tears at the least little thing? I feel like I'm on the edge of a cliff, about to fall off. I should be happy. 

Am I insane?


Dear So Not Crazy,

Moving house is considered one of the most stressful life events. There's all the hassle of packing and moving, which is physically demanding, plus there's the symbolic burden of ending one life and starting another.

On top of that, you have a new job.  Again, while this is wildly exciting, it means new routines, new and possibly unknown expectations, working with new people, and possibly some extra hours while you're trying to orient yourself.

Plus, in your private life you have found love.  Possibly The Love. While that's wonderful, it's also scary. There's all the pressure of wondering if it's really the partner you want to spend the rest of your life with, and all the other changes that will inspire, balanced against the fear of whether you're going to be disappointed again.

Stress is not about bad things happening to you, it's simply a reaction to change.  

That means that positive change is stressful. And my dear you're piling up change as if it's going out of fashion!  It's not at all surprising that you're uptight.

From what you say, the tears and that cliff feeling are probably just an effect of your life changes.  However, to be safe, do pop into your family doctor and ask for a quick checkup.

When you're declared perfectly healthy, pay attention to your stress. Make sure you eat properly, get your full 7 to 8 hours sleep, and keep your body moving so that it stays exercised. 

In addition, note your stress, know where it comes from, and spend some time relaxing.  A massage, a trip to the hairdresser, or a nice long movie marathon curled up with that lovely new partner - whatever makes you happily tranquil.

This letter is part of the November 2016 free agony aunt column service. As it's the last day of the month, it's the last issue.   

Friday, November 25, 2016

What is cognitive behavioural therapy (CBT) and does it help manage depression?

CBT theory says there's a relationship between thoughts and behaviour.  For example, let's say you scream and run every time you see a wasp. You run so wildly, that you've banged into walls.

Suppose that you want the change the behaviour?  Suppose you want to stop screaming and running every time you see a wasp?

With CBT you would see how your thinking links to your behaviour. You'd sit with a therapist and look at the last few times you saw a wasp. You'd figure out exactly what you were thinking and feeling.

Suppose this leads you the discovery that you think all wasps sting.  With the help of your therapist, you would focus on changing your thinking. Instead of seeing the wasp as a wild beast that's gunning for you, you might change that thinking to acknowledging that wasps are nature's most effective insecticides.

Yup, wasps eat aphids and blackfly, the insects that eat crops, fruit, flowers and other plants. If you have a few wasps around, you don't need nasty chemicals to control garden pests.

You work then work out a plan with your therapist to identify your trigger points and to change your thinking patterns. Over time, you will learn to look at a wasp and instead of screaming and running off, you'll say, "Hello, beautiful wasp! Please eat up all my aphids!"

So, what does that have to do with depression? 

If your depression is a reaction to your personal fears and stressors, then CBT can be a real help.  For example, many of us suffer from all kinds of doom and gloom thoughts that we know aren't necessarily true but that suck all the joy out of our real life successes. 

Like the man who just got a good annual review and a bonus but who can't enjoy it because he secretly thinks his boss hates him, that he will be fired, and that he will end up unemployed because he's a failure. 

Or the woman who gets As in her continuous assessments while doing her degree but worries herself into a depression by convincing herself that she will fail the exam, fail the course, and end up working as a part time street sweeper.

If your depression comes from that kind of 'faulty thinking' then a few sessions with a therapist and some CBT can be very effective.

The thing about depression is that we tend to talk about it as if it's a problem that can be clearly defined and that has clearly visible causes.  But that's not true.

Depression manifests in different forms. 

Some people feel sad, some feel blank, and some cycle between the two. You have people who sleep a lot when they're depressed and others who can't sleep. 

For some it's something that hits hard and vanishes just as quickly. For others it creeps up like a fog, lingers, and then slowly vanishes.  (There are other symptoms too, but this is a blog post so we'll keep it short.)

Also, it appears that depression can come from all kinds of situations. Some reasons include having a faulty thyroid, or that it is an effect of medicine taken for various conditions. For that reason, you should read this first: Feeling depressed? What you should do before seeing a therapist...and a tip on avoiding crooks

Target, my cat, who always makes me happy

As for others causes of depression, well, we're fairly certain that sometimes it is a reaction to an emotional shock. 

Some scientists think some depression may be a result of issues with brain chemicals not working as they should while others suggest it's a consequence of the immune system not working as it should when fighting inflammation.

So the bottom line is that when you are looking at all the different ways there are to manage depression, you have to start by figuring out what the root cause of it is. Once you know why you're depressed, you can see what treatment options are available.

Me, I work with perfectly normal people who are under a lot of stress and who need a bit of mental plumbing.  I like CBT and I tend to mix it up with positive psychology because I think the two work well together.

If you're suffering a lot, and you want a little extra help from an antidepressant, then you should also see a psychiatrist. You can read about that here: "I'm depressed. Should I pop a pill, go for therapy, or both?"

I think the real problem isn't with whether CBT works or not but at the way people tend to look for help when they're depressed. 

If you're depressed, don't start off by looking at solutions, like "I want CBT" or "I won't take pills".  Instead, identify root causes and then see what's on the table in terms of treatments. 

Because if the root cause is your thyroid, then talking isn't going to work.

Monday, November 21, 2016

"Dear Ellen, I'm sick and tired of my boss yelling at me..."

Angry man cartoon

Dear Ellen,

I've got a problem with my boss. He comes in at 1030am, has a long lunch, comes back at 4pm and at 5 he's telling me what he wants me to do. And he wants everything done the same day. Last week I worked until 9 twice! I got home after 10 when my kids were in bed. I'm staff so I don't get overttime. I get in at 8am. Also, he's yelling at me. If he can't find something, it's my fault. If a client is upset, it's my fault. Everything is my fault! I'm sick and tired of him and I want to quit. But jobs aren't easy to get. Also, I have a degree but not more. What should I do?

Question: Who do you work for and what's your job title? What are your office hours? How long have you been working there? Do you have a list of KPIs? How are you doing on those? What did your last performance review say? Is this boss new or have you worked together a while?

(Redacted) Medium sized local company, accounts management
9-5 Mon-Fri
8 years working there
Yes, I have KPIs. Last year got a bonus. This year on track.
Same boss 4 years.

PS has the job changed in the last year?

PPS Is your company laying people off?

Dear Sick and Tired,

Okay, my first thought was that your boss might have been yelling because he's hoping you'll leave and he won't have to pay compensation. Clearly that's not the case.

Sometimes bosses yell because their staff are lazy or don't do their jobs. It's a lousy way to manage people but not all managers are professional. 

Just in case, let's look at you.

As you have been there for a significant time, you've been doing a good job for some years now. If you hadn't, the company would have replaced you. 

Also, you got a bonus last year, so you were definitely doing something right back then!  The job hasn't changed, so it seems logical that you're still hitting the spot.

At present,
1. You are in on time and he is not.
2. He's too disorganised to give you a proper period of time to get things done.
3. This means you have to work unreasonably long hours, and
4. He behaves unprofessionally, shouting at you

First things first. You don't need to put up with a disorganised man who yells. I'm going to make a few suggestions, just to list your broad options.

Your company is medium sized, so you might look to transfer internally. Speak to human resources about this, or scout positions among your peers. 

You can also try to fix this situation. Standard advice is to log everything and then approach human resources to talk to your manager and resolve this. The idea here is that they are a neutral third party who can settle this according to company protocol.

It may work. It may also backfire if your boss is the kind who thinks that talking to HR is sneaking or tattling. You know your company culture, so you can tell if this is a good approach.

If you go that route and it doesn't work, you have two options: explore a hostile work environment claim, and/or leave.

You can simply quit. Yes, the job market is lousy but all you need is one job, right? So you can write up your CV and start talking to headhunters. Believe me, companies are always out looking for someone who has experience!

What I've said so far is all standard safe advice. I would add this: you seem to have liked your boss in the past.  So, if you want to give this man one more chance, you can take the straightforward route and talk to him.

Note: this only works if he's a reasonable human being. If he's not, then it's probably not worth it.  You know him, so you decide.

If you do talk to him in an open manner, you need to do some prep.

First, put yourself into your boss' space.  As the economy sucks, my bet is that the company is having cash flow trouble. I'm guessing your boss's boss is hammering at him. So your boss then turns around and yells at you. It's unprofessional but very common.

I also bet that your boss doesn't even realise that he's pushing you too far. You've been taking it without protest, and now his bad manners have become a habit. 

To fix this you have to let him know he has to change his ways, but you should be circumspect and remind him that you're part of his team, and that he can lean on you - without the shouting!

For your prep, write down your work tasks for the last month, and tick off what you've done. If you've done extra work, make a note of that.

On a separate piece of paper, write down the last three times he yelled at you.  Don't be too long about it, just note the day, time and a single sentence about the occasion.

Now you need to go and talk to him. Pick a time when he's calm, and when you can reasonably go straight home or out afterwards. So just before lunch or just before the end of the day.

Take the note of the work you've done, but leave the note about the shouting on your desk.

I'm a straightforward person so I'd get straight to the point with something like this:

"Boss, I've been working for you for four years now. It's been interesting and fulfilling but recently I've been feeling unhappy. I looked at my KPIs and my work sheet, and I think I'm doing my job but I feel I can't do anything right anymore."

If it opens a dialogue, as it should, show him your work sheet.  Ask, "Is there anything else I can do?  I know jobs aren't static so if there's something different I should be doing, please tell me." Then negotiate what he wants you to do.

He should know that he's been a prat for asking you to work late, but you should remind him that you start at 8AM and a 12 hour working day is unreasonable. 

State the problem. "Boss, I work for you Monday to Friday from X till Y.  I do have a private life and a family.  I had to work X extra hours on Wednesday and Thursday last week, which meant I didn't see my kids."

State the solution. "I finish work at 6PM so it would be helpful if you give me my tasks at 5PM the day before.  That way I can think and plan, and be more efficient. Also, it means I can see my kids."

You also need to address the yelling, "You know how on Monday when X and then you Y?" Keep it brief and impersonal. If he says it was a one off, add, "Well, boss, there was also..."

Practice saying, "If I make a mistake, then tell me. But please don't shout at me. It makes me uncomfortable."  If he tries to blow it off, just insist, "It makes me uncomfortable."  He should then get the message.

Clearly the three issues can come up in any order. You should rehearse it to yourself thoroughly first. Imagine what he might say, and what you might say.

Stay calm and professional!

Also, about the degree. Speak to HR on ways you can upgrade your CV. It may simply be a matter of taking on certain tasks, or taking up various bits of in-house training. 

You might go back to school but frankly it's a lot of extra time and money, which you may not see back, so think very carefully before you go that route.

Good luck and tell me how it goes!

This letter is part of the free agony aunt service I'm offering November 2016. If you have a question, contact me!

Saturday, November 19, 2016

"Dear Ellen, my bf just got engaged to someone else..."

Dear Ellen,

I'm in college, and I've been dating my classmate A for six months. We can't tell his family, because they want him to marry B. They think we're just friends.

Last weekend they told me they've set a wedding date for next year. They invited me to the engagement party!

I'm crushed. A says he loves me but B is from a rich family they do business with so he can't say no. What do I do? 

Dear Crushed,

I read this and thought, oh my gosh what have you gotten yourself in to?

Good men value and respect women. A hides you as if you're a dirty little secret.

A also plans to exploit another young woman for her family connections and money. The term for that is gold digger.

Good people are honest with the world. A shows one face to the world and another to you. From your letter he's pretending that this is all happening out of his control. What rubbish! 

He has known he is going to commit to this other girl for some time now. Do you have any idea how many lies he must have told to his family and to that poor girl and her family for them to agree to the engagement?

Forget A. He's not worth your time. Exit now.

Exit sign

You're a talented young woman, about to get a degree and embark on a successful career. You have a lot to be proud of. You should be with a man who is proud of you, too. One who is excited to be with you and who sees your happiness as important as his own. Someone honest and decent.

I'm concerned about the reasons you fell into this relationship. There are loads of good men who'd thank their lucky stars to be with you, so why did you go for a horror like A?

I'm going to make a stab in the dark and suggest you suffer from low self esteem. If so, you need to find out what caused this and work to correct it. 

Your college counsellor will help you with this. Invest in six to eight sessions working out what went wrong, and set about making sure you don't fall in the same trap again. Therapy in college is free, so take advantage.

Also, I suggest that you spend your final months at college studying hard and playing hard. Go on lots of different dates but don't go steady with anyone. You're too vulnerable at present and I'm worried you'll fall for another A.

Finally, if you have an open relationship with your parents, you might also talk to your mum and dad about this. Your parents will have seen lots of people making this and other mistakes and leaning on them for support might be helpful. If you're not sure how they'd take it, talk it through with the counsellor.

Good luck, and I hope to hear very soon that you've graduated and are happy again.

This is part of the free agony aunt service for November 2016. Do write in!

Wednesday, November 16, 2016

"How long does therapy take? Do I have to spend months and years at it?"

Watch in sand

Never visited a therapist and a bit nervous about reaching out? Don't worry, you're not alone! 

With the stigma of seeking help being a strong one in lots of places, it can be difficult to discover what therapy involves. 
So I thought I’d explain exactly how I work, and hope it sheds some light on what goes on with the virtual couch.

If you watch television, perhaps you recall that Tony Soprano went once a week for all 7 seasons and Monk went twice a week for 8 seasons.  
Although both Tony and Monk suffered from anxiety, they chatted about life, with mental health practitioners Jennifer Melfi and Neven Bell contributing insight and support.

The people in the films are practicing classic therapy, the kind that was pioneered by Freud in the beginning of the 20th century.  Their sessions are about delving into the deep inner you. I have a few clients who look for that type of support and it can be very helpful. However, the cost of a weekly session for life adds up.

Most of my clients want to make effective positive changes in their lives but they don't want to spend years doing it. And that's what I love to do.

Put simply, Melfi and Bell are big picture philosophical whereas I'm more mental plumber.

It works like this: we pick apart how you're thinking and behaving right now. Then we formulate our goal, working out how you'd like to function ideally. Once we have that, I help you map out a step by step approach so that you can reach your goal.

Although the approach is simple enough, making specific positive changes in your life requires consistent attention and effort. It's like going to the gym: just buying a membership doesn't do much - you have to put in the work.

How much work will depend entirely on the scope of the issue you want to work on and how much effort you put into doing your homework (Yes, there's homework!)

There's no hard and fast rule but after we've had our first proper session, I will give you an estimate of how long I think it will take to get you to your goal.

As this is probably a big vague and frustrating, let me ramble on about some options.

The Typical "Fix Me" Client
Kim Regular puts aside 15 minutes to chat, so we can test the connection and whether we can work together. This is free.

If they sign up, we have a first session. This tends to be a bit longer than an hour because I have to ask lots of background questions. But it's charged as one session, even if we end up talking for 90 minutes.

After this, we have a weekly session for two to three months. During the sessions, we work towards the goal and review progress and hiccoughs. Each session lasts about an hour.

As the end of this time, Kim Regular should be seeing some good progress. Once they are happy and confident that they're on the right track, they go it alone for a fortnight. We check in again, and if all's well, we agree to text each other at the end of a month (free).

In 2019, my typical client had 11 sessions. 

Super Secret One Off Sessions For Senior Executives, aka Consigliere Service
If you like Mafia stories, you'll know that the consigliere is the member of a Mafia family who serves as an adviser to the leader and resolves disputes within the family.  

I have a handful of senior executive clients who book a session every now and again, typically if they're managing a big work transition like a new contract, an expansion into a new market, or sticky management issue. 

As our sessions are secret, they can talk it all through, get some perspective and nobody ever knows about it. 

So, if you're looking for support, know you have options.
Crisis Counselling
Some of my clients are adult survivors of trauma such as emotional abuse, physical abuse, incest, rape and violent crime. If this is you and the acts took place in the past, then please do reach out.
However, if you are in an ongoing crisis and have just now been attacked, then online therapy isn’t a good first choice. 
You are better off going to a hospital or crisis centre where you have medical and legal professionals to support you.
Having said that: if you’re in a place where reporting will land you in jail, or if you are an expat and stuck with professionals where you don’t speak the language, then do contact me. 
I’m not promising to take you on as a client but I’d rather you reach out to someone than cope alone.

If you are in Malaysia, and you need help in a crisis, then you can always reach out to AWAM and WAO.   
These are feminist NGOS but they talk to men too. If you're not sure or shy, just call them up and have a brief chat. They're good people.
Hope that helps!
Image by annca from Pixabay

Monday, November 14, 2016

"Dear Ellen, what do I do about workplace bullying?"

Want to ask your opinion on office politics. HR not very keen to take action towards the players which create very negative energy. Where the staff can ridiculous fellow colleagues publicly & without any punishment. If you are in my position, what would you do?

Thanks for writing in!  Let’s deal with this in two parts: first, what is bullying and where does it come from and second, why your company isn’t dealing with it.
Bullied girl
From Rebeccadevitt0 at Pixabat

Bullying takes many forms but classic systems include these behaviours:
·        Spreading nasty rumours about someone
·        Laughing, jeering and humiliating someone
·        Nasty name calling
·        Yelling at someone, especially in public
·        Not inviting someone to a meeting they should be at
·        Not sharing pertinent information with someone so that they can’t do their jobs properly

Bullying is often a learned behaviour. Kids who go to a school where teachers allow bullies to run wild, will become bullies themselves. Some do so after being victims while others take to it without being victims.

Offices are exactly the same. I’ve seen happy workplaces turn into hells because of one new senior manager coming in and establishing a bully climate. It’s as if bullying is somehow infectious.

Hierarchies are involved too. Studies show that places with a strong top-down hierarchy are more likely to have a bully climate than places that are egalitarian. Let’s face it: the more power a boss has over staff, the more likely abuse is going to take place.

Note: you may want to look at Hofstede’s work here and examine the Power Distance scores for different communities. Power Distance is a form of measuring how top down a hierarchy is. 
Malaysia scores 100 compared to India at 77, Iceland at 30 and New Zealand at 22.  So in Malaysia, bosses have lots of power over staff, and this is why we have so many little Napoleons.

I don’t know what you do or what your position is in your company, so I’m going to talk about what can be done and who might be taking the action. Please read it and decide where you fit in.

So, how do you make changes?

Suppose you’re dealing with someone who has only recently started bullying. To affect change, you need to make a list of bullying behaviours, call the bully up on them and explain what the proper behaviour should be.

For example, “Jane, on Wednesday at the weekly meeting, you interrupted Sue. This is not acceptable. We don’t interrupt others. You then laughed at her. This is not acceptable. We do not laugh at others. You then made a nasty remark about her work. This is not acceptable. We promote constructive criticism.”

Then you need to set boundaries and a timeline for improvement. In my experience, a bully can’t be fixed with a single chat or sending them off to a workshop. They will simply give you the nod, and then go straight back to their usual behaviour.

Why is this? Here’s a list:
·        They may not know how to change
·        They may not know exactly what behaviour is okay and what is not
·        They may find bullying rewarding in terms of achieving goals, and they don’t want to give it up
·        They may enjoy bullying because it gives them a sense of power, and they don’t want to give it up
·        They may think that they can defy you

Bullies also often run in packs, so they have plenty of peer support to keep up their unwanted behaviour.

If you want change, you need to provide re-training, supervision that assesses the change, and a timeframe.  Clearly, if the change is not made within the timeframe, you have to let that person go. In other words, the person who demands the change must also have the power of sanctions.

Who does the training?

If the bullying is a consequence of learning, and simply bad communication and/or leadership style, then you can work with someone with common sense who is a good teacher and mentor.

You must have a proper plan in place, though, that includes pinpointing problem behaviour, outlining goal behaviour, describing how you will affect the change, and a timeline for making the changes.

However, if the bullying is a lifelong habit, then you may have a problem.  You see, children from dysfunctional and abusive families are often bullies. 
If this is the case with your people, then you need to address the underlying issues. In such families, cruelty, violence and abuse are commonplace. As you might think, this is serious business and you need a qualified therapist to tackle that.

If you are a multinational, you should have properly qualified people on call who can help. If not, you need to find someone and it will require a budget. I’m going to suggest that you don’t do it in-house. 
People need to be able to talk freely about very personal, very painful things in their past. They can’t do so if that person is someone they have to work with or see in the office.

Now the second part of the question: why isn’t your company doing something about the bullying?

When bullies invade the workplace, people who are good at their job simply leave and go and work elsewhere. Those who stay become less effective because of the poisonous atmosphere. In other words: bullies are very bad for business.

So why do companies allow bullies to flourish?

Some do so because they’re not interested in people. If the bullies contribute to the bottom line, the company doesn’t care how they do it. They don’t care about high employee turnover, either. If this is your company, I suggest you leave and find nicer people to work with.

Some won’t confront bullies because they’re afraid. Bullies work by intimidating people (remember the list of how they work?) and sometimes even senior people are too scared to stand up to them. That’s a problem.

If you think the place is worth saving, and you have some standing in the company, you need to create a team atmosphere. Build a core of good people who support one another. Then work to deal with bullying by documenting and reporting.

Some don’t tackle it because they’re not good at their jobs. Senior managers are human, and they’re not all in their jobs because they’re capable. If this is the case in your company, you need to document and report.

How do you document? Document incidents together with times, dates and witnesses. Tip: you might use the list of bullying behaviours at the top of this response. Put it all together in a report and go and see the manager responsible (or HR depending on how your company works).

When you report, do not take the bully with you!  Do not take victims with you!  As bullies intimidate victims, and victims are often horribly humiliated by the whole situation, you need to talk quietly, openly and rationally about the situation with someone who has the power and authority to address the issue.

Good luck and let me know what happens.

Have a question?  During November 2016 I'm offering a free agony aunt service. Email me!  

Friday, November 11, 2016

"Dear Ellen, My friend doesn't make sense..."

SOS Courtesy of Geralt on Pixabay

Note: this is a transcript of a private Facebook discussion that I'm putting here with permission of the person I was talking to. I removed all the information that might identify the people involved. 

Hi Ellen

I need to ask your opinion on this issue I have with a friend. I'm just clueless on how to help her. I'm not close to her but her recent live videos on fb has been disturbing. So my other 2 friends and I feel like helping. Her family doesn't know what to do. So your advice, I'll pass it on to her mom n dad.

The videos don't make sense. It disturbs everyone who cares I guess. And for some it's like a live drama. At first we saw as funny n we kinda laughed about it coz it doesn't make sense.

She got dumped so at first we thought all this was her own way of getting attention.

But recently it's weirder. Just a few days ago a company was circulating her ic and statement about her wandering around. Carrying luggage n keep waiting for someone n she doesn't carry money.

She posted a video where a restaurant didn't allow her to eat if she didn't pay first. And security was there. Also she was at a shopping mall and security didn't allow her in. She is running around saying that a man has been caught under black magic and went off with an Indonesian girl that looks like her.

So we aren't sure what's going on as her family have no idea how to get her back. That's the complicated part. Her parents ask my friends and I to help bring her back. As we have never dealt with such a thing before... not sure how to approach her.

I believe she needs counseling or therapy.

I’m so sorry to hear this. If your friend is irrational, meaning she's not living in the real world, she needs to see a psychiatrist, a medical doctor who specialises in mental health problems.

There are a range of conditions that can cause this kind of behaviour, and very often it needs some kind of medical treatment to get someone back on track again. Counselling or therapy is something that will come later.

Hopefully you can get her to listen to you. If so, you need to go to a public hospital, in KL the University Hospital is excellent, as an emergency patient. They will assess her and make suggestions about treatment.

Do be careful.  Delusions are very frightening, and your friend is likely going to be scared. Be gentle talking her into going for assessment.

If she won't go, there's a problem because we can't just force adults to do things. If she isn't seeing she needs care, then her family might consult a lawyer to see what the proper procedure is.

Alternatively, and this would be my first move, I would go to your local police station.  Speak to whoever is in charge and ask what normally happens.

The reason I suggest the police is because I once had neighbours who had a son who was mentally ill. He went off his meds, and got into trouble.  The police came round to pick him up and take him to hospital, to the psychiatric unit.

The police were super nice, very gentle, and awfully good about the whole procedure. The university hospital was excellent too. They kept him in a few days, until the meds kicked in, and then released him.

Also, let me make a few discrete calls to find out what others recommend. (I made some phone calls here)

Good news!  Apparently University Malaya Hospital might be able to help too.  Your friend’s parents need to call the direct line, explain what's going on and take it from there.

Do let me know what happens, please. I hope she's safe and gets proper treatment.

Have a question?  During November 2016 I'm offering a free agony aunt service. Email me! 

Tuesday, November 8, 2016

"Dear Ellen, I caught my son with his hands down his pants..."

Apple in wire

"I caught my son with his hands down his pants. He's 5 yo. How do I stop him? I feel so guilty that he's doing this."

Kids aren't my field but I'm going to answer this on the basis of developmental psychology.

First of all, what do you remember from when you're five? My bet is not very much.

When we are little, we're more about doing than thinking. Kids explore and do what they enjoy. It's why they clamour for ice-cream, back scratches or a million other things. Your little boy discovered that touching his willy is pleasurable, so he does so.

You say you feel guilty and at a guess, I'm thinking you're attributing all kinds of labels that apply to adults who have mental health problems like exhibitionism. The thing is, your little son is not an adult. He's five years old, innocent and he has no idea about our taboos and shibboleths.

Most little boys and girls do play with themselves, bouncing on bicycles, rubbing up against things. Typical ages for this run from 2 to 6 years old. Ask other mums and you'll hear plenty of stories. Normally it's just a phase and they grow out of it.

Note: in some cases, the phase turns into an obsession. It's unusual and it can be rooted in boredom as well as anxiety and depression. If this happens, you should have a chat with someone who specialises in child psychology. Again, it's not a sign of moral depravity but rather a comfort seeking response because of something else going on. So it's nothing to be ashamed about but you might seek some help.

From your note I have the impression your boy isn't obsessed. However, when this is part of normal development, it's a good opportunity to explain about privacy. "Sweetie, that part of you is private. Like you go to the bathroom for pee-pee, touching that part of you is not for everyone to see."

That will help him learn about limits in a safe and natural way, and it will help you talk him out of touching himself when you've a house full of visitors.

In the meantime, try not to stress or shout from frustration. Little kids aren't complex thinkers but they are ace at emotion. So he'll see you're upset and not really understand why. He'll also feel bad about himself and for a little one that's a heartbreaking experience.

Also, avoid well-meaning others butting in with frightening tales like, "Your hands will fall off!" Scare tactics are damaging and must be avoided. 

Now, about you. You say you feel guilty and that worries me.

Mums are under tremendous pressure. From what I see, you're supposed to sing while hypnobirthing, breastfeed for umpteen years, and then raise a clean-eating kid who gets straight As from pre-kindy onwards. And in your spare time you're to be a sexy, nurturing kitchen and bedroom goddess.

Please take a moment to stand back and recognise this is a load of bollocks. You're a loving mum and you're raising a boy while holding down a job. That's not easy. Take a break and realise what impossible standards are about. Be kind to yourself and enjoy watching your little boy grow up.

Have a question?  During November 2016 I'm offering a free agony aunt service. Email me!

Image by engin akyurt from Pixabay

Sunday, November 6, 2016

"Dear Ellen, if he wants kids and I don't, should we marry?"

Baby feet

Hi Ellen, Saw your post. Question: if he wants kids and I don't, should we marry?

Man, that's a good one! Since the development of reliable birth control in the 1950s, some people have opted out of having children. I’m very grateful we have such choices. However, when couples are on opposite sides of this question, it’s a problem.

Women are often told that we have a mothering instinct that will somehow kick in when we need it. This leads people to say, "Just get married and you'll change your mind." You're Malaysian, so my bet is that this will be very familiar!

However, from what I see, parents don't always love their kids. There are plenty of women who have them because of social pressures and who then discover that they don't actually like them. Men find themselves in exactly the same position!

Parents who are less than enthusiastic about their offspring often do the decent thing and do their best to give their kids a good start in life. They might build good relationships too as the kids grow older. But some mums and dads walk away, which is why our orphanages shelter kids who have one or two living parents. That is a disaster for the kids.

You're thinking ahead so kudos for that! The bottom line is that the question of kids is a deal breaker. If one partner wants them and the other not, you both risk lifelong regret. 

Should you go off and search for someone who more closely shares your needs? I'd say that depends.

You say you don't want kids, and I think you should explore what exactly you mean by this.

If you don't like babies or children, and the idea of spending years living with them is just horrendous, then you're probably not going to be a good mum or much fun to be around if you cave and have them. I’ve seen people in this situation, and it’s unhappy to say the least.  Some of these situations have ended with the mums leaving the relationship and the fathers becoming single dads.

But if you actually quite like babies and kids, and you don't want them because you’d rather have a career, then you can do a deal with your man. It means you carrying the child and having it, and then it will be you earning the salary and working long hours while he takes a career break and rushes around with dirty nappies, cooking dinner, organising school busses and so on. I know of several families who have done this, and it’s worked out happily.

I suggest you have several long talks with your man and see where you both stand. Think it through from all perspectives, perhaps starting off with these basic viewpoints:

1. What happens if you have kids and you maintain the common social roles where you’re the primary caregiver? How do you feel? What will life be like for you individually and together?

2. What happens if you don't have kids? How do you feel? What will life be like for you individually and together?

3. What if you have them but he is the primary caregiver? How do you feel? What will life be like for you individually and together?

Once you have your needs worked out, you can both make an informed decision.

Thanks for writing in and hope this helps.

Have a question?  During November 2016 I'm offering a free agony aunt service. Email me!

Photo courtesy of Frank Beckerde on Pixabay

Friday, November 4, 2016

Free agony aunt service for November 2016

SOS Hand
This image courtesy of Gerd Altmann on pixabay
Over November 2016, I'd like to offer a free agony aunt service. You can email me, and I'll post your letter and my reply on this blog.  I'll give you a pseudonym so nobody will know who you are!

My strengths are stress, depression and relocation, but if you have an issue with a different focus, I will do my best to answer.

Have a wonderful weekend!

happy AT

Tuesday, November 1, 2016

Feeling depressed? What You Should Do Before Seeing A Therapist...And A Tip On Avoiding Crooks

Blue lady
If you call me up, one of the first things I’ll ask you is if you’ve had a medical checkup recently.  If you haven’t, I’ll suggest you see your family doctor. Why?  Because depression can be a side effect of a medical issue.

Almost everyone I know is feeling stressed these days. The economy is bad, money is tight and most people are trying to fit a job, a family, and a personal life into too few hours.

It makes sense therefore to put down any feelings of depression to stress, anxiety and other problems.  However, depression can have its roots in medical issues.  Take a look at this list:

#1 Depression can be a side-effect of taking medicines used to treat acne, asthma, high blood pressure, HIV and other conditions. Even some birth control systems are linked to depression now. 

#2 Depression can be the result of pain, even low-level pain. Exactly how this works is unclear, but if you have had an accident, have back pain, arthritis or some other condition that hurts, be aware that it can have a mental health effect too.

#3 When your thyroid, a gland in your neck, isn’t working properly, you may feel tired and depressed. Other symptoms can include constipation, rough hair and skin, muscle pain, problems with your weight and feeling the cold. It’s easily diagnosed and treated by your doctor.

#4 Although the links are uncertain, there is some evidence that diabetes, heart disease, arthritis, kidney disease, HIV/AIDS, lupus, and multiple sclerosis (MS) may put you at greater risk of depression. 

#5 If you’re on a diet, or you have diarrhea, you may be missing nutrients and this can lead to depression. Chugging supplements may not be the best solution, either.

Supposing you do go and see your doctor and you discover a medical issue, does that mean you don’t need to see a therapist?  As usual, the answer is maybe.

Take the thyroid problem, which is quite common. For some people, taking the meds to fix their thyroid means their depression about their micromanaging boss, their hassles with Great Aunt Judy and their angst ridden teenage son suddenly become manageable.

They did have stresses in their lives, but they find the thyroid malfunction has been sapping their usual bounce and confidence.  Once that’s fixed, they’re good to go.

Others find that when the thyroid is fixed, they still need help to cope with the boss, the aunt and the teenager. So they need the meds and a therapist to help them make effective changes.

The bottom line is this: every person is different, every case is different so the idea is that you get as much information as you can so that you can make an informed decision and take the action that works out best for you.

Now, about avoiding those crooks.

If you go and see a psychiatrist, she is also a medical doctor, so she can do tests to check for medical issues. 
Therapists, counsellors, psychologists are usually not medical doctors, so we suggest you go and see your regular doctor. There’s no need to be fancy - just go and see someone sensible, tell them you’re depressed and ask them to check if there’s maybe a medical cause.

Crooks will demand you do in-house pee tests (and some really cheeky beggars hire nurses to do blood tests!) and while they’re gleefully adding charges to your bill, they talk grandiosely about your results. Super nasty ones then sell you supplements too, promising amazing results.

In short, seeing your family doctor before you see a therapist is sensible and if you see a psychiatrist, you’re in safe hands too. But if a non-medical doctor wants to do medical tests, my advice is don’t walk - RUN!

Friday, October 7, 2016

Visualisation, Meditation, And Mindfulness In Therapy

Happy Stones

This is a long one, so grab a cup of coffee, okay?

Most people who see me come out of desperation.  They’re depressed, anxious and stressed.  
To complicate matters, many suffer from guilt. They think that it’s “weak” to ask for help or that they’ve somehow brought their troubles onto themselves. 

Let me say right away that I think it’s perfectly sensible to ask for help.  After all, when your car isn’t right, you talk to a mechanic.  If your shoe’s leaking, you talk to a cobbler. So when you’re not yourself, why not ask a therapist for an opinion?  Sensible, right?  Right!

So once we get that out of the way, we start discussing what’s going on. Although it varies from case to case, a typical assessment with me takes about two hours and includes:
·        A suicide inventory
·        A depression inventory
·        A stress inventory
·        A discussion on sleep history
·        A discussion of personal health
·        A discussion of family health
·        A discussion about your attitudes and needs from therapy

At the end of it, I will give you a quick overview of my first impressions.  Then I go off and analyse everything in detail.  I spend a couple of days drawing up a personal plan for you that explains where you are, identifies your goals, and that sets out in detail the steps that have to be taken to get to your goals.

On paper that all sounds okay but in practice it means that between your emailing me to say, “Help!  I need you, NOW!” and actually getting down to getting a plan in place takes time.

Not nice when you’re already stressed!

So when we talk the first time, I often teach a simple relaxation technique called visualisation. It’s designed to help get you started into managing your stress and depression easily and quickly.

What is visualisation?
Visualisation is about forming a mental image. I ask clients to remember a time when they were particularly calm or happy.  We discuss that incidence, and then rebuild the scene, complete with scents, sounds, textures and actions.

They close their eyes, and we talk ourselves into the scene. I usually make a tape and send it to them, so that they can start off listening to it.  Over time, they become practiced and can pull up the image effortlessly when they feel stressed.

Visualisation is not the same as mindfulness or meditation. Visualisation is just about recreating a mental image of a time and place.

Mindfulness is about focusing on the now, opening your sense, and acknowledging and accepting your feelings and thoughts.

Meditation is like mindfulness, but it’s more focussed on a specific goal, like building compassion. Often it comes with prescribed systems of thought.

Mystic mumbojumbo
Now, as I said last time, I’m an evidence-based practitioner so you may be wondering why I’m promoting a technique like visualisation that appears to come straight from the mystic.

I’ve always been interested in how meditation and prayer affect the mind. In fact, I have a certificate in clinical hypnotherapy, something I picked up hoping to discover more about the process. 

Unfortunately the course I took didn’t work out too well.  I was hoping to learn about modern research such as the magnetic resonance imaging (MRI) studies by people like Sara Lazar from Harvard University. Sadly, what we got was mostly gobbledegook and pseudoscience.

You’d think from all the press about how wonderful mindfulness is that there’s some good studies out there validating the claims made every day in articles.  However, that is not the case.

I’m not going to bore you with a laundry list, but here are my three top concerns about current literature on the subject.

1. Too small. Many studies that promote meditation and mindfulness are very small, typically with less than 30 people. This means that meaningful statistical analysis of results is extremely difficult.

2. No control groups. There are too many studies without control groups. In a proper study, half the people would use meditation or mindfulness and the other half not. It’s the best way to rate effectiveness.

3. Bad design. A lot of studies don’t actually study the effects of mindfulness or meditation.

Cognitive Behavioural Therapy (CBT) is a standard technique used for depression management. CBT involves analysing patterns of thoughts and behaviour. The idea is that you have beliefs that influence your thoughts and these prompt action.

Put in a nutshell, CBT works like this:

When you come in for therapy you’re like this
Belief: wasps are dangerous,
Thought when you see a wasp: this dangerous beast will sting me,
Behaviour: run away.

With therapy you change this to
Belief: wasps are nature’s most effective guardians, killing off pests,
Thought when you see a wasp: this is a beautiful and useful animal,
Behaviour: say “Awwwwww, cute!” and admire the wasp.

I ought to be shot for reducing CBT in this way, but for our purposes, it’s good enough.  You can read a proper article about how CBT works here

From what I see, many studies investigating the use of meditation and mindfulness use plain old CBT and throw in a bit of meditation. The study then says it’s testing the meditation and mindfulness - ignoring the possibility that it’s good old-fashioned therapy that’s working and the rest is just glam and glitter.

Having said that, there are a few studies that are well designed, and well conducted, that hint at some promising ideas.

One of these is the Harvard study I mentioned earlier.  You can read ithere but basically the study looked at two groups, one that took a Mindfulness-Based Stress Reduction course and one that didn’t.  MRIs showed that the group who took the course ended up boosting grey matter concentration in their hippocampus, an area of the brain that’s associated with emotional control. 

Another good study (read it here) comparing 22 people who practised meditation and 22 people as the control group found similar results.

There are a few more, but really not enough to say there’s rock solid evidence, However, it’s interesting and I’m curious about further work in this area. After all, emotional control is central to managing depression and stress.

Dangers of meditation and mindfulness
You might ask why I don’t just chuck in mindfulness on top of CBT and be done with it. The problem is that other studies have found that meditation and mindfulness can be dangerous and that some practitioners say that it’s often misrepresented or misunderstood.  You can read about that here and here

This makes perfect sense to me. You see, depression and stress tend to cause cognitive biases, a fancy way of saying that it messes with your mind.

People who are depressed and stressed typically focus more on the negative rather than the positive. You’ve seen this yourself: when nine good things happen, someone who is down focuses on the one thing that went wrong.

Another by-product is feeling that you’re somehow secretly a bad person.  Also, many people feel there’s a devil on their shoulder, whispering that everyone hates them.

As you might expect, when you ask someone who’s already feeling bad to focus on the “true inner you” for an hour you’re not going to have them coming back to you and saying, “I’m a wonderful human being and I love all my precious flaws”.  What you’re much more likely to get is a self hating wreck who’s just remembered every mistake they’ve ever made in their lives. Possibly a suicidal wreck.

This effect is well discussed in rumination studies. You can read an overview of that here.

Another concern I have about mindfulness and meditation is that if you’re studying the kind that leads to distancing yourself, you might miss the opportunity for analysing and understanding your emotions and therefore miss the opportunity to manage them better. I haven’t seen good studies on this, but it’s something I worry about.

So what’s the bottom line?
Generally speaking, I see Buddhists and Hindus in Malaysia work rather carefully with this subject. Those who are devout do talk about the different types of systems, and they discuss methods that should be avoided if you’re stressed or depressed. Frankly, I don’t know enough about the ins and outs of it to comment at that level of detail.

While I’m interested in mindfulness and meditation, as I’ve said before, I’m an atheist so the prayer part of certain meditation systems pass me by.  I’m also not a spiritual person.  I tend to be practical. I’m telling you this because you should know my limitations.

So if you’re not yourself, I would err on the side of caution and suggest you avoid any kind of meditation or mindfulness that encourages rumination.

However, I think that a little short visualisation of a pleasant scene or image can’t do any harm. It’s the equivalent of looking at a sunset, or of eating an ice-cream.

Finally, there’s a cross-cultural element at work here. For my clients who come from the Middle East and Asia, visualisation is familiar and comforting. It also comes naturally, so it’s already part of their mental health toolbox.

For me, therapy is about helping people make effective change to reach their goals.  It should be safe and as painless as possible.   
However, it’s not always easy to make decisions about approaches. That is why I discuss the pros and cons with clients whom I think will benefit before we get into it. Then I let them decide what they want to do.

What do you think?

Image by Alexandra_Koch from Pixabay