Tuesday, November 8, 2022

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

Stress can mess with your memory
Stress can mess with your memory

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

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

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

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

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

Understand social media

First, fear and drama sell

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

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

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

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

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

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

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

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

Putting it together

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

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

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

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

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

I'd start by asking questions:

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


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

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

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

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

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

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

Image by Tumisu from Pixabay

Wednesday, October 26, 2022

I Think Of Depression As Spots

Figuring out what's wrong is the first step

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

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

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

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

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

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

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

Image by Arek Socha from Pixabay

Saturday, October 15, 2022

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

Target, senior executive office snoopervisor
Target, senior executive office snoopervisor

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


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

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

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

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

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

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

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


Tuesday, October 4, 2022

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

Ellen Whyte, Quality Affordable Therapy

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

new logo Ellen Whyte


Friday, September 2, 2022

Visa Worries, An Expat Therapist Shares Personal Coping Tips

Passport and stamp image

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Image by jacqueline macou from Pixabay

Wednesday, August 24, 2022

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

Girl with finger on her lips

Is it okay for you and your friend to see the same therapist? What about partners, exes, cousins and so on? This has come up a few times recently and it’s a great question. 
 
There isn’t a standard answer because there are no rules. 
 
You may think that there can be no overlap but that isn't possible. We live and work in the community.
 
Mental health practitioners who work in companies see people who work together and who live in their neighbourhood, just like those who work in a local hospital, so it's a very common issue.
 
Mental health practitioners can see members of the same family, people who work together, sleep together, who know each other on social media etc etc. 
 
What’s key is 1) confidentiality and 2) neutrality. 
 
Confidentiality. Some therapists share their notes in their office with colleagues or staff. I work alone and I prefer to maintain strict confidentiality. 
 
If you see me, I talk to you and to you only. Between sessions, I forget I know you. 
 
If your best friend, cousin, work colleague, or neighbour also sees me, I act as if I don’t know you in therapy sessions. In fact, I won’t even confirm or deny that you’re my client if anyone asks. 
 
So, I won’t talk but if you and your friend want to discuss your sessions, that’s your decision. You know what’s good for you.
 
Neutrality. The therapist helps the client reach their goals. That’s the job in a nutshell. In the session, it’s all about you. 
 
But with cross connections, I often hear the same story from different perspectives. Like if there’s a product launch, I may hear about the event management side from one client and from the product side from another. 
 
Confidentiality means that I can’t let information I hear in one session bleed over into another.
What’s said in a session, stays in that session.
 
This can be tricky when secrets are involved. 
 
For example, client X owns a restaurant chain and client Y works as a chef. Client X tells me that the chain will be firing 10% of all staff. In another session, client Y hopes for a big bonus and plans a long holiday. 
 
Confidentiality means I can’t talk out of session. So when client Y is talking away about holidays, I have to shut off and not warn them the company is actually in trouble. Which is awesome confidentiality but poor client Y, right? 
 
When it comes to dating, divorce and so on, secrets and confidentiality can really complicate matters.
 
So, I have this approach for taking on new clients:
If you know each other, that’s fine by me. Work colleagues, cousins, neighbours… it’s all fine.
If you think the relationship is very close and you’re thinking about neutrality or confidentiality, tell me and we talk it over. 
 
Generally speaking, if you are happy together and want help for two different things, like one wants to talk about anxiety and the other wants to talk about career happiness, I’m fine with that. 
 
If you’re close family or in a relationship and both of you want individual sessions to talk about your relationship, that may be tricky.
With two new clients, especially those living together, I usually suggest they see a family or couples therapist.
If one is an existing client and the one is new to me, I usually suggest the new one sees someone else. It’s just easier.
Should that not be an option for some reason, we can discuss it. Depending on what’s going on, I may say yes or no. 
 
(Note: if you have options, like lots of other professionals around, I usually say no. If you have few options, like you’re LGBTQ in the Middle East, or poly in the West, then I may say yes)
 
Of course, this is when all the info is out there and up front. 
 
Sometimes relationships aren’t clear at the beginning or they change. 
 
For example, I learn once we have started sessions that client A is the ex that client B is telling me about, or that client Q works in the same company as client P. Sometimes, client J is delighted with a new friend and I discover the new hottie is my client L.
 
Usually, it’s all good. I listen, hold the session and then forget until the next time.
 
The one curiously tricky situation is when I discover that two clients who I thought were individual one-off clients are actually partners. 
 
If I’m lucky, they tell me in session and then we can talk it over. But if they don’t, and I don’t know if they know their partner is in therapy, it’s an issue because I can’t ask without breaking confidentiality. But that’s a discussion for another day 😊

Image by Pretty Sleepy Art from Pixabay

Tuesday, July 12, 2022

Expat Life: Staying Sane During Visa Application And Renewal

Digital nomading sounds so glam. Working on your laptop by a sunny pool, in December, freshly squeezed guava juice at your side. What could be nicer?

While it's lovely to travel, working abroad also means endless paperwork for visas. I'm doing ours at the moment, and so it's at the top of my mind.

Here are some thoughts on how to stay sane during this challenging time.

Image of passport and stamp

Stress #1 Control, Agency and Importance
The visa directs where you live and for how long, so it's important. 

You have very little control over when or whether it's granted. As human beings don't do well with helplessness, this will be a primary stressor.

Mental Health Tip: Acknowledge that feeling stressed because you are helpless and uncertain is actually a sensible reaction. Breathe through it. Practice self-care.

Practical: You're doing this for a reason, so treat it like a project and set goals for success and failure. Do you want the visa because it looks good on the CV? Because of the income you make? Some other reason?

Whatever it is, put a value on it and figure out how much effort you are willing to spend to get it. Then make a failure target so that you know when to walk away.

For example, "Getting the visa means an international credit on my CV and will net me $1500 a month more in income for two years. I'm willing to invest one month and $5000. If there's no positive by date X or they ask for more money, I walk."

Stress #2 Backup plan
There are usually options, so make a list of alternative destinations and jobs. Maybe you stay home, go home, or try another country.

Most importantly, make sure you work out a timeline! You don't want to be stuck in one country with paperwork that's running out, or having trouble with the revenue stream, on top of being unsure of where you're going.

Stress #3 Confusion and Conflict
Visa bureaucracy typically involves several government departments, all of whom have different agendas. They likely don't talk to each other. If you've applying for a new visa, you may spend all your time dealing with people who are as new to this as you are.

Mental Health Tip: Acknowledge that feeling stressed because you are helpless and uncertain is actually a sensible reaction. Breathe through it.

Mental Health Tip: remember why you're doing this! See the stress as partial payment for what you're going to get out of it when you succeed.

Stress #4 Time Budget
Be certain you have a time budget set aside. As it typically takes several dozen hours of labour of which collecting documents is the simplest part, treat this like a major project with milestones.

Practical: devoting a block of time regularly can be more useful than jumping to respond. Me, I do my paperwork in a one morning block, and devote a whole day to visiting a department. If I finish early, I treat myself to time off and pat myself on the back.

Stress #5: Follow The Basics
Eat properly, get decent sleep, eliminate small stresses and exercise. Yes, obvious, but without veggy, protein and sleep your body can't work. So be certain you don't sabotage your health.

Mental Health Tip: I get off social media and reread favourite books. The lack of notifications lower my overall alert level and the old favourites are a throwback to old comfortable times.  Try it and see!

Stress #6: Rope in Friends
A problem shared is a problem halved, but apart from the emotional support, talking to a local friend will help remind you why you like to stay.

If you're looking for tips, chat to someone from your own country who recently and successfully managed the process. If you're lucky, there may be a shortcut or two you didn't know about.  

Mental Health Tip: remember the points of stress #1 Control, Agency and Importance

I speak from the heart. This is my fifth country, and I'm in the middle of applying for my fifteenth? Eighteenth? Gazzilionth visa. I used to work visas for expat engineers in other countries too, so all in all, I've processed more than a hundred visas over 30 years.

The biggest takeaway is that I've learned that all countries are hostile to expats. You can have politicians moaning they need workers, or raving about luring you in with special promotional paperwork, but it's not them doing the actual visa processing.  

So try not to talk it personally. Decide if it's for you, and if it is, go do it.   

Finally, if you need mental health support, book a session with me. I'm nice and affordable as I live in a developing nation. And I'll know what you're talking about.

Saturday, May 14, 2022

Do You Qualify For A Discount? And Are Discounts Racist? Talking About Mental Health Costs And Discounting Frameworks

 

Pile of money

Remember how last October I decided not to increase my rates? Well, it seems to be causing some confusion. It also caused a fight, and therefore I'm doing some thinking.

Let me explain, and tell me what you think.

In my therapy work, I am based at home and online, so I pass on these savings to clients. As I'm in Malaysia where living is cheaper than in Europe, I'm very affordable, charging just US$35 per session.  

In addition, I offer a discount rate to clients in Malaysia. Why? Because Malaysia is a developing nation, and a lot of the people, especially young people, are quite poor.

As I've said before, I'm okay with working a little harder in order to give the people in my community a little bit of a break.

So I charge a local rate of RM110. (correct in Nov 2022)

From time to time I've had people living in first world nations asking for discounts and saying they can get third parties to pay the local rate.  The answer is no.

I'm willing to work a little harder to help my community, but there's a limit. Even my top rate, US$35, makes me significantly cheaper than my peers. 

I also need to earn my living, pay back for the 7 years tuition that is needed to enter work as a therapist, and prepare to look after myself in old age when I can no longer work. 

Some four or five years ago, before I had two separate rates, clients picked the payment method that worked for them. But my pricing structure has changed, so that no longer applies. I now have a two-tier system.

It is also true that some of my younger local clients who started with me while in college in Malaysia and then moved abroad kept the low rate. I closed one eye and let them stay on this as a courtesy because emigration is expensive and mentally challenging. 

And yes, I've also let a few families overseas in trouble in cheap.

Most people are okay with this. However, others misunderstand or resent this flexibility. I got some very nasty responses from one individual recently.

Hence the thinking.

Discounting is always controversial because it's natural to love a discount and to feel bad when you don't get one. Even so, charging different rates is common in mental health practice, mainly because so many can't afford the service but need it.

Typically, practitioners use means testing, where they offer a discount depending on your income. Mostly, they ask to see wage slips. 

I refuse to do this for several reasons. 

I find it intrusive. I don't need to know what you make, and I certainly don't want to get into how you spend your money. For all I know, you're making peanuts and have a rich relative who pays your bills. Or you earn a bomb, and are keeping your huge family. It's none of my business.

Also, as many people link income and personal worth, it may hurt or worry to discuss this topic. I won't do that to my clients. 

As for asking to see wages slips - OMG, that says you don't even trust people to be honest! I'm so not going there. I actually make a point of invoicing after the session, to show I trust my clients.  

I don't say means testing is wrong. But given the issues, it's not for me.

So, is my system of discounting based on geographical location racist? 

It's not racist because I don't ask people about race, but it's probably something 'ist'. Locationist, maybe? My thinking is based on local salaries and local purchasing power. I think that's practical, and although it's not foolproof or ideal, it's the best I can come up with. 

No, I don't want to apply special rates to various countries based on average income. I'm happy to help my community but I'm not a saint. I am running a business, not an NGO. Also, practically speaking, I'm not going to research other economies every time I get a client from a country that's new to me, either.

So there you go. That's my thinking. If I'm wrong, tell me how and why, and I will reconsider.

As for now, I love what I do, but I don't want to fight about money. So here are my rules, clearly and concisely.  

If you're living in Malaysia, you get the local rate. If you're not, you don't. No exceptions.

I'm putting my foot down, establishing my boundaries 😊

Will I adjust my rates for the clients abroad who get a low rate out of courtesy? 

I'm in several minds about this. 

Part of me says that they should not be affected because I'm annoyed by the rantings of some entitled twit. 

But another part of me says that really, if they're now established in first world countries, they should move to the other structure. Maybe I'm a bit too soft there?

I won't make a hasty decision. I'm going to sleep on it. And if you have an opinion, please do share. I'd like the insight.

Update: when people migrate, I'm taking it case by case. As there are no universal moral rules, I'm not going to break my head trying to make them. 25th November 2022

Tuesday, May 10, 2022

Shock, Trauma, PTSD - The Basics Without A Lot Of Technical Waffle

 

Random image to signify stress
Malaysia is a very safe country to live in. We have no wars, no terrorist attacks, and no riots. This is terrific but as a client pointed out last week, it also means that many of us don't really understand how shock/trauma/PTSD works. So I am writing this piece at their request, in the hope that it helps promote understanding.

Story One: Kim

When Kim was small, his mother would beat him every time she didn't score an A at school. His mum would make him wait while she got the rotan.

Today Kim is a grown man with a job in HR. Her colleagues like him, he has lots of friends, but Kim has a secret.

He jokes that he has shares in Foodpanda because he never cooks. Secretly, he doesn’t cook because when he enters a kitchen, his breath catches in his throat, his palms sweat, and he feels sick. 

Story Two: Nora

Nora is a police officer. Three months ago, she was part of a team that investigated a missing man. The family claimed he'd gone off for an outstation job, but the neighbours reported a lot of fights.

Her team was suspicious, so they looked into it. They found the man's body hidden in a patch of rough ground near his family home.

Nora was physically sick when she first saw the body. Then she was okay again.

During the rest of the investigation, the family confessed that they'd beaten and tortured the victim. Nora wrote up her reports, consulted with the prosecutor, and moved on to the next case.

But somehow, this incident has stuck with her. Three months later, she still has bad dreams. She feels disconnected from her family. Sometimes, she catches herself looking at her cousins and wondering if they are secretly judging her.

Also, she can no longer enjoy her favourite Netflix cop show. Whenever on screen they go into an interrogation room, she remembers how normal that family looked as they told her how they'd killed their son.  

What do Kim and Nora say?

Both Kim and Nora worry that they're going crazy. Kim can't figure out what his beef is with kitchens. He thinks he might have kitchen phobia, or a cooking phobia. Nora thinks that police work is tough and maybe she just isn't cut out to be a cop. Both are embarrassed, and so they don't tell anyone about their secret.

What's really going on?

Kim and Nora suffer from shock or trauma. 

Kim suffered from repeated trauma when he was small. His mum often made him wait in the kitchen, and little Kim learned to associate the stove with being beaten. He forgot exactly how it all hung together because more than ten years have gone by, but the body remembers. When Kim sees a stove, his mind goes straight back to the trauma of being beaten.

Nora witnessed a tragedy, a family who actually killed a loved one. Seeing the body and hearing the story over and over again from the family, and writing the report, and discussing it with her colleagues, has traumatised her.

In her shock, Nora wonders if the whole world is secretly nasty and dangerous. And every time she sees something that triggers her memory, like an interview room on TV, she's reminded of the past and traumatised all over again. 

Shock, Trauma, and Posttraumatic Stress Disorder (PTSD)

Experts argue over distinctions and exact definitions are different in various countries. You can get into that if you like it's not necessary for grasping the basics.

What you should know is this. Shock or trauma is upsetting. If you are frightened, angry or scared when it happens, that's a healthy reaction. If someone beats you, or you see a crime, you should have emotions!

In a lot of cases, time will heal. Many of us cry, have a few bad nights, and then the emotions fade and vanish.

But for others, these thoughts and feelings stick around. Sometimes they last for years. Sometimes they actually get worse over time.

What it is not

It's not because people are weak, silly, or being dramatic.

Saying that is victim blaming which is mean.

Note: for the Kims in this world, they are often told, "Oh well, everyone is beaten and they're okay with it." No, they're not. Violence is never healthy.

Why exactly does it happen?

That depends on the model you follow. Me, I think it's not one-size-fits-all. There are several models that work well, but none are universal. Again, I don't think it's important outside of the profession.

Give me a list of possible trauma events

Childhood physical abuse and violence

Being the target of sexual violence

Being the target of a crime

Witnessing a crime

Being in or witnessing a war or terrorist attack

Physical assault

Being in or witnessing an accident

Being threatened with a weapon

 

When should we look for help?

If you've had a recent shock, talk it through and be kind to yourself. If you're having flashbacks, trouble sleeping, crying jags, or overwhelming feelings after a month, have a chat with a mental health professional. If it's been more than three months, definitely go.

Note: when you do see one of us, we'll help you figure out if it's anxiety, shock, depression, PTSD or a combination, okay? So don't worry.

How do we fix it?

First, we talk it through and figure out how your experiences affect you today. Then we figure out triggers and we help you learn new thinking and behaviour. Useful approaches include cognitive behavioural therapy and exposure therapy. <- you can google these

We do this very gently and we avoid reliving the experience. In the past, people thought bringing emotions to the surface was healing. Now we know that it can be as traumatising as the original experience. So we are very, very careful.  

Note: as a client, you have total power to say stop, to call for a pause, and to put in boundaries. In fact, it's part of the process.

My friend has trauma/shock/PTSD, what do I do?

On TV it's all about hugging and being there but frankly, everyone has different needs.

So my best advice is that you wait until you two are talking quietly together, and you ask, "What do you want me to do?" Then listen.

I hope this helps. If you need to talk to a mental health pro, PM me.