Free agony aunt service for November 2016

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!

Ellen

Ready to be your best self and live your best life? Message me today via email ellen.whyte@gmail.com or WhatsApp: +44 7514 408143 for your free 15-minute consultation.

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

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.

 

Seen your doctor and not sure if you want to pop a pill or go for therapy? Click here

Now, about avoiding those crooks.

Psychiatrists are medical doctors specialising in mental health, so they do medical tests.

 

Therapists, counsellors, and psychologists are not medical doctors, so we do not do medical tests. 

 

(Disclaimer: yes, some therapists have PhDs and are called doctor but they're not medical doctors. And some medical doctors do not become psychiatrists but become therapists instead - but it's super rare! As rare as albino crocodiles.)

 

A therapist, counsellor or psychologist will never do pee or other medical tests. If we think you need it, 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! 

Still hesitating about your options? Click here to read about Self-help vs. Professional Help: Knowing When to Call In the Mental Health Expert 

And if you've come to a decision and you want a therapist, reach out and text me.  

 

Visualisation, Meditation, And Mindfulness In Therapy

We build happiness, step by step

This is a 4 min read, so sit back and relax, okay?

 

If we haven't met yet, I'm Ellen Whyte, BSc Psych (Hons), MCouns (Dist), a psychotherapist with 10 years of experience helping clients across 20+ countries navigate life's challenges and thrive. 

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 it here 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.

Ready to be the best you and live your best life? Message me today via email ellen.whyte@gmail.com or WhatsApp: +44 7514 408143 for your free 15-minute consultation. 

Settling Anxiety With Ginger Tea - With A Caution For Pregnancy

When Anxiety Gives You Butterflies: Why a Simple Tip Supports Proper Therapy

Last Saturday I went to a workshop on Social Anxiety Disorder run by the renowned anxiety researcher Michael Eysenck. It was a great experience, and the talk got me thinking about something I should probably share.

If you know me, you'll know that I'm not into alternative medicine or treatment of any kind. Twenty-five years in Asia haven't converted me to believing in acupuncture, reiki, and so on.

The Link Between Anxiety and Your Stomach

When clients tell me they're stressed, the symptoms often start in the gut, the famous "butterflies" or, if you’re really stressed, "bats." 

Have a cuppa! Courtesy Wikipedia

Since therapy needs to address your condition head-on, I always start with evidence-based psychological tools. But for an immediate, non-medicinal boost, I often advise clients to start the day with a simple glass of ginger tea.

I'm talking about a slice of the fresh root or some powdered ginger, not the crystal-flavored products from the shops! Here’s why this small act can support your therapy:

Ginger contains oils that fight nausea. Some studies have found it effective against tummy upsets caused by travel sickness, operations, and chemo. (Equally, other studies find it's as effective as a placebo, so the idea that it works is controversial.)

What tips the balance for me is that ginger tea is a traditional, familiar drink. For many of my international clients, it's something grandma used to give them. This positive association with comfort is important because I'm looking to help people feel better right now, so they can engage with the deeper work of therapy. When anxiety gives you butterflies, try a cup of ginger tea and see if it helps settle that.

Important Caveats (This Is Not a Cure)

I am not saying you should drink this stuff all day long! Ginger acts as a mild laxative, and anything with active ingredients comes with warnings. Ginger is generally rated as safe, but it also has some blood-thinning properties. If you have medical issues or are pregnant, you must talk to your doctor first!

My advice to drink ginger tea is a low-stakes, physical coping mechanism that supports proper psychological therapy. It is never a replacement for actually addressing the condition that causes the anxiety.

As for the second thing I recommend, check out why I think visualisation, meditation, and mindfulness can be useful in therapy.

Want to manage anxiety, depression, relationships, or simply be the best you living your best life? I can help you turbocharge change! Message me today via email ellen.whyte@gmail.com or WhatsApp: +44 7514 408143 for your free 15-minute consultation.

Simple Tip To Turbocharge Gratitude Journaling; Uncover Your Hidden Inner Needs

Gratitude journaling can be a useful tool if you're depressed but it's also useful if you want to understand yourself a bit better.

The idea of keeping a gratitude journal isn't new but it's becoming popular again thanks to the positive psychology movement. The idea is a really good one based on the precept that when you're depressed, you're more likely to notice negative events than positive ones.

Think about it: when you're down, you notice the traffic jam and not that the sun's shining, that you've had a good cup of coffee, that someone's put a newspaper out for you to read etc etc.

Keeping a note of the good stuff can therefore help you focus on the positive and that helps pull you out of the blues.

But there's another useful side to the journaling, and you don't have to keep endless notes either. Understanding exactly what makes you happy, can reveal needs and values that you may not realise you had.

For example, a few years ago I realised I was grateful when a friend called me to tell me a seminar time had changed. When I analysed it, I realised I was happy because it made me feel part of the group. Until that exercise, I hadn't realised that belonging to that group was particularly important to me.

So if you're curious about knowing yourself better, just complete this sentence: yesterday XXX happened. It made me feel great because it made me think YYY.

And enjoy the revelations! 

Ready to turbocharge change and be the best you? Message me today via email ellen.whyte@gmail.com or WhatsApp: +44 7514 408143 for your free 15-minute consultation. 

Some Notes About Free Therapy

"Where to get free therapy?" someone messaged me recently.  "Would you recommend?"  The short answer is yes, but with caveats. 

If you can't afford to pay and the government hospitals have super long waiting lists, you might look to a charity or non-profit group.  

However, before you pick up the phone to schedule an appointment, you should ask two questions.

Must Ask Question #1 Are They Selling Or Promoting Something?

"Deception of woman, with self-portrait" Witkiewicz, 1927

You'll have heard of cults that focus on lost, depressed or upset people because they are vulnerable.  They sell psychological services in order to engage, convert and exploit.

While those are extreme cases, there's a subtler problem that comes with some groups.

For example, suppose you're in an unhappy marriage. You look to someone to discuss this and you find an NGO (non-governmental organisation) that will talk to you for free.

So you pop along and then the conversation runs along the lines of, "How can we help you save your marriage?" because the centre is run by people who don't believe in divorce or who want to keep divorce rates down. Whatever you say, they'll tell you to stay in the marriage, even if it hurts you.

Or the conversation runs along the lines of, "How shall we get you that divorce?" because the group believes marriage is an institution that legalises domestic slavery of women. Whatever you say, they'll advise you to break up, even if it hurts you.

Either way, that's not good.

When you seek help, you should have someone work with you to formulate goals that make you happy. 

(Note: I'm talking about voluntary contexts here.  I'm not covering situations like court directed anger management or talking terrorists into stopping bombing people!)

A proper session should start with, "What is the issue you want help with?" and then the conversation should map out all your options, just to make sure you know what they are. Then you formulate your goal and you get help making a plan for you to reach that.

So, how do you spot groups with agendas? Read their promo pamphlets to see what their ideals are. Also check their social media feeds to see what kind of comments they make. Ask your circle of friends if they have personal experiences.  Put it all together and if you don't get a good vibe, try somewhere else. 

Of course, if you have a particular belief system that you want to work with, you might want to look for a group that agree with you. That's entirely up to you.

Must Ask Question #2 How Professional Are They?
Sometimes all you need is a nice person who listens to you and who is sensible. There are loads of charities who offer this service and they're awesome.  

Some specialise in particular issues, and over the years their volunteers become experts in their field. You can have a wonderful experience with such people and it's truly valuable.

However, therapy is more than listening.  Therapy is the treatment of mental or psychological disorders by psychological means.

What does that mean?  Well, it involves understanding the principles of human development and psychology as well as assessing mental health issues, and being able to apply the various treatment strategies that are known to create change effectively.

That kind of training is not something you pick up over a two day workshop or by watching a YouTube video.  It's also not something you can pick up just by listening to people for many years.  It requires formal training.

I've written about safe ways to find professionals in developing countries before.  But when you're searching through free services, you can get a grip on what's what by asking the simple question, "What are your formal qualifications?"  A pro has a suitable degree from a college or university as well as practical experience. 

I'm Ellen Whyte, BSc Psych (Hons), MCouns (Dist) which means I have a Bachelor's with Honours in Psychology and a Master's with Distinction in Counselling.  I'm a level 7 psychotherapist with 10 years of experience helping clients across 20+ countries navigate life's challenges and thrive.

Ready to heal and turbocharge change so you can be your best you? 

Message me today via email ellen.whyte@gmail.com or WhatsApp: +44 7514 408143 for your free 15-minute consultation.

Have a great weekend!

 

 

 

Is Online Therapy For You? Some Of The More Unusual Reasons People Opt For Online Services

When it comes to online services people tend to focus on the fact that it cuts out travel, and that’s it’s discrete - or that sitting down with someone tends to make for better communication than video conferencing.

However, working online can offer some special benefits. Here’s are three that I value.

#1 If you’ve been raped and your country will jail or punish you for it

You may have seen the cases in the news like that of Alicia Gali, the Australian woman who was raped by three men after they drugged her drink. When Gali told the police, they arrested and jailed her - because United Arab Emirates law states that rape victims are guilty of illicit sex, which is illegal.

The UAE isn’t the only country with that kind of law, so if you’re living in that situation, reaching out to someone overseas online can be a sensible idea.

#2 When you need little support boosts

Face-to-face sessions are an hour. With online therapy, you have flexibility. Some of my clients book 30 minute calls. These work well if there's an ongoing crisis or if you need top up boosts but not a whole session.

These can be set up in advance, or you fire off a quick email or WhatsApp and we set it up as soon as we both can, usually in 24 or 48 hours. Working online means flexibility.

When there's a massive cultural gap...

#3 When you are out of your culture

Twenty years ago when I moved to Malaysia, I went to see a therapist to say, “I’ve just moved here from Europe, I just got married, I’ve just changed careers, and that’s all been okay but now my parents are splitting up because my dad has a mistress. Help me!” He said, “Your mum should accept your father having a second wife.”

Enough said, right? Complete mic drop. Therapy's no good if it misses the cultural plot twists in your story.

When there's a massive cultural gap...

Bottom line: If you’re far away from home, as a digital nomad, expat, or foreign student then online therapy is for you.

Am I the therapist for you? I am Scottish-Dutch, married to an American, lived and worked in Europe for 25 years and in South East Asia for the other 25 years, so I can think in West and East.

When family fireworks, expat whirlwinds, or those 'wait, is that normal here?' moments have you reeling (Malaysia to Middle East, I've got the miles), contact me. We'll sort it, with a side of proper perspective—and probably a giggle or two as well.

Message me today via email ellen.whyte@gmail.com or WhatsApp: +44 7514 408143 for your free 15-minute consultation.