Grief: After the 10 year mark

When you experience deep loss, your world goes into a bubble where time stands still. You seem to lose future planning and the past is too unbearable to fully reflect on. People don't always realise this but it is often after time has lapsed and things resume into mundane rituals, where life goes on,

that a person in grief struggles the most. In my belief, this is because you start to realise that this is it, finality sinks in and there is a gap and emptiness which only others who have experienced loss may even begin to understand.

Somehow, with some time and care, you integrate this loss into your world view. You make peace with the pain and emptiness and almost get used to having this as a part of you. You develop rituals and strategies, you talk or you block it out, you form a new relationship with your lost loved one and start to anticipate the days that are going to be harder than others. I always say to people who have just experienced loss that the first year is the hardest. That is not to say it will be ok after a year, no, more like in that year you will experience all the 'firsts'. The first birthday, anniversary, milestone, breakdown without their support, happy occasions, longest time without speaking etc etc. You start to form coping skills and ways of dealing with this loss without losing control completely. There are times where the grief feels as fresh as it did that first day but you learn that these times are normal and a new part of your life that you adapt to.

As the years go by, things happen and 'firsts' continue. You wake up one day and struggle to fathom how you have made it through for this long. You may even feel guilty and panic because you can't remember their voice or need an answer for a question which only they can provide. The loss is relived again and again in big and small ways but you keep moving. You wonder how your life would have turned out if they were still here. You wonder what they would say about your current predicament and you listen when people tell you your loved one would be proud of you. In your heart you know they would because you have carried on despite times when you ached to join them and relieve the emptiness and pain, if only to see them one last time.

Today, for me, it has been 11 years. I know my grief well. Time has provided understanding and new grief. Loss has come in various forms and in some cases, completely unrelated to my biggest loss. I still feel stuck in a weird unknowing. I hold on to my memories as if they happened yesturday. Interestingly they are more centred around me than my mother. I reflect on this regularly and for me, I think it is because my loss has gone in two ways. I lost the person I loved most in the world, my primary attachment figure and the only person who has been there in almost every way from the beginning. But 11 years ago I lost something else, just as precious. I lost a part of myself. I lost my sense of identity in a way. I lost my safety net, my unconditional love and answers to questions I will forever need the answers to. I lost my faith and I lost a sense of belonging. People will tell you that you are loved, that you are not alone and that they will always be there for you. I personally don't know where I would be today without those people. The truth is though, those declarations can bring on an even greater sense of emptiness and loneliness because you still feel alone but people don't get it. They don't understand how you can feel alone when you are loved, how you can feel empty when you have people there to support you and believe in you.

At the end of the day, you can feel alone. It takes understanding that there are different types of being 'alone'. There is no filling this gap because the cause of the loneliness of grief is more like a severing of a part of yourself that you will never get back and will have to learn to accept and live with. We may never shake this. We may always feel like we are missing some big element of ourselves. We may try to fill this in destructive ways, we may project this onto other people in our lives and expect them to fill roles and gaps that they will never be able to fill. We may think we are ok with our loss and realise abruptly that we are not when we start blubbering like a baby when something triggers our grief (the movie 'Stepmom' is a good example for me). A dear friend said to me once, the pain doesn't lesson, is just becomes less frequent. I love that. It may not hold true for everyone but for me, it hit home.

Grief is a part of life and we will all experience this at some point. I don't want to give people the impression that there is a time limit and you will 'move on' and things will be better in time. The truth is though, in some ways you do move on and things are better but in other ways it can feel harder and more confronting. Grief works in phases like the tides. We all have different triggers, we all had different hopes and dreams and we all need things at different times and in different ways. One common thread I believe is that we learn how to make this a part of our new selves. We find ways to carry on, feel love, take risks and cherish memories. Perhaps the memories are of happier times without the loved one, that is ok too. The best thing to do however, is to find a way to keep your loved one in your life despite them not being in it. This is called a 'continuous bond' in grief theory. You will never replace them, thus they will need to be present in a different way. Whether you talk to them, talk about them, cry for them, laugh at them, learn from them or live in their honour, keeping them as a part of you will help the finality of the situation seem less daunting.

For all those people who have been dealing with loss, I am writing this with you in mind and heart. You are a survivor and it is no easy feat this carrying on business.
Be kind to yourself
XXX
Paula          

Overwhelm is like Stress with a Twist

Lately I have been surrounded by overwhelm. In my personal life, with my clients and with people around me. It has got the cogs turning because it is not like your common anxiety or stress where we seem to fixate on certain things or events, stressful issues and such the like. Overwhelm is something quite chaotic and disorganised and seems to prevent any focus or control, despite being triggered by stressful events and issues in our lives.

The problem with being overwhelmed is that it seems to create an extreme loss of control with many people, thus perpetuating the feelings of hopelessness and frustration. Even the idea of asking for help may seem too much to bare as many people have no idea how to articulate their problems, focus on the main concerns or make sense of reactions. Have you ever felt as though you are just going to explode, want to scream, burst into tears, bang your head a few times? This is often the nasty side effect of being overwhelmed.

People feel overwhelmed in many different and diverse situations and for many different reasons. It can come about from the stress of your present life: too many tasks at work, bills to pay, kids to take care of, being time poor and unable to fit everything you would like to do into you day/week/month/year. Perhaps thinking of the future brings overwhelm: you see your dreams slipping away, the reality of your life does not match your desired hopes and goals, people you love may leave you, kids may grow up, jobs may end etc etc. There is also the past to worry about: unresolved issues rearing their heads in your present life, regrets, past hurt, failed relationships, mistakes or poor choices, anger you are unable to let go. Perhaps it is a bit of all of these things.

We have a saying in the West, 'if it doesn't rain it pours' and it is a well versed saying in many households when your fridge decides to break when you have just taken a loan out for a car. You have been struggling with relationship issues and get fired from your job. I know for myself, everything seems to run out at the same time, when I am at my most broke! The world is a stressful place and you do not need an anxiety disorder to feel the crippling effects of modern day life as people with past histories and future plans.

Unfortunately, when we get into a state of being extremely overwhelmed, this seems to be when we are least effective in problem solving. We struggle to create distance from our troubles and feelings and new stress keeps flooding in. We may even be taking on board the stress of the people around us, worrying about a world of things that are out of our control, pressured and strained from the things we need to get done and we become out of touch with our own needs. This is when people start to shut down and ignore their bodies, their impulses, their rationality and the offers for any form of help. It becomes a state of survival in my experience and can start to effect our ability to take care of ourselves and sometimes others. We often pick up illnesses during this time and I always say 'it is your body telling you to slow down'.

There may not be a way to ease the load you are bogged down with. This I am well aware of. So what do you do?

Think of an emergency room on a Saturday night. So many people are coming in with immediate concerns, injury's, instability and crisis. How do you help everyone with a limited amount of staff and resources? They call it 'Triage'. People are systematically put in a hierarchy of severity. It is understood that every person is important and every case is an emergency but within this realm there are cases that require a faster response than others. These systems sound cold, you may say. Wouldn't it be great if everyone could be helped upon arrival, given immediate care and priority. The same could be said about your own overwhelm, wouldn't it be ideal if you could address every one of your issues immediately and tackle each task simultaneously. For that you would need something short of super human powers - it is not possible to be superman!

We need to take a leaf out of the triage book and step aside from the chaos and our feelings for a minute. Create distance and clear our heads. In whatever way suits you, it is good to put things down objectively and out of your head and onto paper/chalk board/verbally/in a drawing or diagram. I like mind maps personally but that is simply my preference. I also use highlighters because my brain likes colour and finds it easier to separate and organise with different colours. Get all your worries, tasks and concerns and even your feelings if you would like, onto something you can visualise clearly. At this point the objective is not to do anything with them. Just get them out there and in a different format from thought (cognition). Our brains are amazing and we have so much coming in and being processed, it is not hard to see that we get caught up from time to time. Give your brain a break and use your other senses.

You may be surprised to see that problems that seem enormous in your head can fit neatly onto a corner of paper, in point form even. This in itself may be helpful because it allows you to 'forget' your troubles or 'to do list' a bit as it is down on paper (or somewhere) and you can go back to it later. This is a great thing to do on a Friday before you leave work, if you have things to catch up on the next week. Put them in a 'to do List' so that you may allow yourself to 'forget them' over the weekend. As you keep thinking of them, add them to the list or keep another list on you and leave the other one at work. It is a great feeling when you can start crossing things off the list too, but that is up to you :)

Once all your overwhelm is put down on paper etc, start the process of 'triage' and identify your most pressing issues and concerns. Be flexible, circumstances are always changing. If there are things you are worried about but have no control over, such as you mum having an operation the following week or you sent in an application for something and are awaiting results, acknowledge that these concerns are creating stress but there is nothing you can do about them right now. Work out what needs to be tackled first, what cannot be tackled by you, what are your responsibilities and most importantly, what are not. We are social creatures and this has many pro's but the downside is we care deeply about our loved ones or about other people as humans. If you work in my industry and listen to the problems of other people whilst developing relationships with people (even therapeutic ones), you are going to empathise with them and care about their lives. It is a very hard thing to step back and let people make mistakes, return to old habits that are more than likely going to have the same outcome, take risks that could be detrimental etc. It is hard not to feel sadness and pain for people, to feel angry on their behalf or to feel a sense of wanting to 'fix' things.

The bottom line is that we can only hold people's hands through their hardship. We are not nor should be responsible for other people's lives. We have responsibilities to them (particularly children). We can give people knowledge, tools, guidance, support and love, but we cannot control their lives or their perspectives. Everyone is different and that is a good thing. It is time to let go, cut yourself some slack and take the control back in your own lives. Once you have a clear idea of your
overwhelm, then you may start to have more of an idea of what you need and what change needs to occur. Don't beat yourself up about things that are out of your control or capability, you have a right to have limits, to feel what you feel and to say no to things that are too much for you. You also have skills and knowledge, you have survived this world your whole life, you are a fighter! It is normal to struggle from time to time, take action and create some distance so that there is space for other things that can bring you joy.

You can do it
XXXX
Paula

Raising Happy Children

With so many of my peers entering the world of parenthood, I have been pondering a blog around 'children and attachment' for quite some time now. To attempt to move away from fancy words and theory's I want to try and explain and discuss 'raising happy and well adjusted children'. I have been working with children in various settings for about 5 years or so now and have worked with a range of cultures and ages. My current job as a family worker unfortunately exposes me to the 'not so happy' children in the community and it is from this growing knowledge that I felt it may be helpful to a few people out there to explore this very broad topic with me. For those who are not parents, perhaps you may start to look at your own childhoods...

No child is born 'evil' or 'bad'. Despite many people out their believing otherwise, the very tough home truth is that children are a product of learning or circumstance. This is something I believe with my whole heart and if no other message goes through, let it be this one! If you were told something awful like that as a child...it is not true. Simple. What isn't simple, however, is understanding why children develop behavioural problems, or behave in ways that are associated with our idea's of 'bad'. I thought the best way to go about this would be to explain some of those fancy phrases or terms such as 'attachment', 'emotional regulation' and 'development' in a way that is easy to comprehend and apply to your own lives.

DEVELOPMENT

I will start with development as most people know about this to some degree - if for no other reason but because we have all progressed through early development ourselves and continue to develop throughout our lives. When development is mentioned in relation to children, it is about how a child is growing, learning and reaching milestones specific to a rough age group. Theorists such as Freud and Erikson (the 2 that spring to mind the most for me) and many others have attempted to create comprehensive 'stages of development'. I wont go into what their theories are in this forum but I will discuss this concept of developmental stages a bit as it can become a great source of stress for parents, particularly if your child is said to be 'delayed' or 'immature' for their age.  

There are many theories but none of them are absolute and rigid. These milestones are meant to act as a guide. Children should start to teethe, walk, talk, make associations etc around certain ages. Some children advance in some areas and take longer to develop in others. This is normal. Your child is unique and special and should be assessed as an individual, the same as adults. Some areas require more effort and support than others on the part of parents and educators. Children are often put through assessments at school in their early years in order to assess for readiness to move up to the next grade or level. Ideally this is done in order to support the child, not to criticise and pass judgement. That said, many people do feel judged and finding out your child is behind can be quite confronting for parents. For the most part,delays in development are not an indicator of disability, slowness, lack of intelligence or underlying issues. Often it is about being flexible and understanding that your little nipper is constantly learning and their brains are still developing. Children are each exposed to different stimuli, experiences and learning opportunities and the rate at which this learning takes place is going to differ slightly for each child.

When to be concerned:

With everything, it is always good to consult with a professional if you notice areas of struggle or delay that are worrying or substantially different from other children their age. Keep talking to your Doctor and keep yourself informed about what milestones to expect from what ages so that you are able to align your expectations with your child's capability. When professionals assess a child for abuse, often these developmental stages act as a guide for abnormal behaviour. An example would be a child who is being abused may regress or halt development in certain areas like speech. Teachers should hopefully pay attention when children who are, for example, 3 years old and have not started forming words or sentences yet.

EMOTIONAL REGULATION

This is something that you may actually know about on a basic level. We need to teach children about emotions and appropriate ways of expressing them. This is something most parents do naturally. Emotions are learnt through modelling (children watching you and your emotions) as well as through validation, which is when you reinforce their emotional experiencing by acknowledging their feelings. If you try and hide emotions from children it can actually be more harmful than protective because young children are more in tune with their intuition and senses than with thoughts and reasoning. They will pick up on your emotions and react to them. Being appropriately transparent is a great way to teach your children about different emotions and take away the fear surrounding the more negative emotions such as anger and sadness, I want to stress that you do not need to be transparent about your problems and the reasons you are feeling a certain way, adult problems should not burden children. What you should do, however, is explain that you have an adult problem and it is making you feel sad or angry or frustrated. If you are crying, explain to the child that you are crying because you are feeling sad etc. It is a parents job to familiarise and support children through their emotional experiencing so that they can feel comfortable in their reactions and do not feel guilty or ashamed of 'how they feel'. I find it is easier to teach children about emotions like you would shapes, colours, the alphabet and other common lessons. Associate emotions with colour and ask children to match different emotions to the colours they think represent the emotion. There are many lovely activities to help you with this but the best way is to lead by example.

What happens when a child's emotions are not regulated?

Due to the sheer enormity of child abuse and mental illness, this is an area that is strongly backed up by research although the negative effects of insufficient emotional regulation have been known to many frameworks of psychotherapy and psychology for years. Within child abuse literature and laws, neglect has been proven to be just as harmful, if not more harmful in some cases, than physical abuse. The reason is due to this regulation of emotions and attachment (which I will chat about shortly). Neglect is not simply about not playing with your children or not giving your children constant attention. It is about failure to help them develop and learn, failure to build up their strengths, failure to validate them as human beings and failure to normalise their experiences and teach them that feeling emotions is normal and not to be ashamed of. Safety is not only about a physical environment. Children need to feel like they can make mistakes and will still be loved and accepted. They need to be able to have trust in the people caring for them and they need to be able to ask questions and learn how to manage their feelings appropriately so as not to harm themselves or others in any way.
Going back to my initial statement of children not being born bad or evil, this is a prime example. Children do not have the mental capacity and ability to process their feelings and articulate their needs like adults can. That does not mean they do not feel the same emotions, it means they often are unable to understand them. Children who behave in challenging ways are often acting out their emotions due to a lack of a better outlet or guidance. They are attempting to get their needs met. Discipline and structure are important here, not in terms of punishment, but in terms of safety and boundaries. When you punish a child for expressing their emotions inappropriately, it is important to spend some time teaching the child more appropriate and healthy ways to react without shunning the emotion itself. ALL EMOTIONS ARE IMPORTANT and serve a purpose.
If a child has never been taught how to understand their emotions they will struggle in life to various degrees. The child may go on to develop low self-esteem, mental illness such as anxiety, depression and in extreme cases, more serious mental illnesses such as Borderline Personality Disorder. They will most likely struggle to have healthy relationships and may struggle to handle stress in life. As they have not been taught that certain feelings are normal in certain situations, they will have to work all of this out for themselves along the way. This will mean that they will struggle to feel confident in their reactions and may feel out of control and easily overwhelmed. A good example of a child not having their emotions regulated is when the primary caregiver has mental illness, lets say depression, and struggle to feel their own positive emotions such as joy and excitement and thus are unable to model these to their child. The child may race home with a gold star only to be met with a half hearted smile. The child may become confused and mistake this reaction for a mistake in their own feelings 'this gold star is not something to be excited about'. That lesson will be learnt and the child will be left with confusion. Later in life the child may go on to find that they are unable to recognise joy and excitement.

ATTACHMENT

This ties into both development and emotional regulation and stems from 'Bowlby's Theory of Attachment'. It is about the relationships and emotional bonds
that are formed  between people. Children will form an attachment to their primary care giver, usually the mother figure. This is different to other relationships of friendship and romantic attraction/love. It is a deep relationship requiring trust and a sense of belonging where the person creates a bond that is extremely influential to their sense of being in the world. The earliest attachments in childhood are the most important and impact behaviour, self-esteem and self reliance and have a lasting impact throughout the child's life. To have a secure attachment, your child will learn that you love them unconditionally and will be dependable and reliable. Again, many parents do this naturally by meeting the infant's needs, accepting the child's mistakes, spending quality time with the child, creating structure and safety and routine in the child's life, teaching the child continuously, being patient, showing and expressing love and guiding the child through challenges.

When the attachment is not secure: 

This can happen for a number of reasons, namely, it happens when a primary care-giver is not consistent or does not create this bond effectively with the child. Inherently, it happens when the child's needs do not get met (physical, emotional and other). If the child continuously receives mixed messages, they will become confused and will not feel secure. This happens when a parent is abusive and the child is never sure how the parent will react. It can also happen when a child is neglected or left to fend for themselves in some way. It also happens when the child's emotions are not regulated. Not having this security can lead to a range of issues down the track for example they may be unable to form healthy relationships, either becoming too dependent or too avoidant, unable to feel secure in a range of areas within their life. Thus this impacts self-esteem and confidence. Some people may go on to suffer from various forms of mental illness, similar to a lack of emotional regulation.

Some final words:

As a parent it is your job to teach your child how to believe in their own ability and experiencing. It is important to take care of yourself so that you may take care of your child. The best way to teach a child is to lead by example. I hope this has not created fear in new parents, it is not meant to frighten and scare, rather to inform. Love your children, treat children like children and don't expect children to deal with adult issues. Children learn best through play and through modelling so remember, live by example and do not use your children to meet your needs, it should be the other way around. There are no rule books and formula's, you will mess up more than once and that's ok. It is how you handle the mistakes that count in the end. Dr Phil always says 'it takes a hundred atta boy's to make up for one criticism. Never call your child names like stupid, useless, bad, hopeless etc, they will believe you and take this on board. Always punish the behaviour not the person. Your behaviour is naughty not you are naughty. Take time to explain why you are angry or upset with them, let's get rid of the 'because I said so' and replace it with a solid response 'mummy wants to keep you safe and so the answer is no'. Encourage questioning and exploration and encourage tolerance and love!

Those are my thoughts and I encourage you all to keep learning about this and find ways that work for you and your family.

XXX
Paula

The Power of Memories

There are a few ideas that have been milling around my head lately and it has been hard to channel some of them under a neat heading. I wanted to talk about happiness, regret, meaning, identity and other very interesting and relevant topics. It dawned on me how memories embrace all those topics and many more. Instead of spending time talking about why and how we create memories, I thought I would talk about the impact and influence they have in all of our lives in different ways.

When I say the word 'memory', what comes to mind? Do you think of some memories that you have? Have you recalled positive or negative memories? Does thinking about memories make you feel a certain way like happy or sad or nostalgic? Are the memories happy but the feeling you have looking back at them leave you with a sense of loss or longing?

I would make an educated guess that this will depend on the mood you are in when reading this as well as what you are needing or going through in the present. The reason I infer this is because memories are a tool we unconsciously use to inform us and help us find and create meaning in our lives. At times we use our memories consciously, esp when making decisions or working out whether to trust someone or something. If you are like me, you might store a few things in the memory bank to bring up later (this is an important aspect of counselling too). Unfortunately, however, we often tend to remember things in a limited way, mainly based on our feelings at the time of the memory. For instance you could be on the most amazing holiday with all the trimmings but look back on the whole experience negatively because of a single fight you had with your travelling partner. This, to me, is what makes this topic one of great curiosity and interest.

So many of us are trying to put things behind us. How many times have we heard the phrases 'what's done is done' or 'better left in the past' etc. In the Western way of being, we have a nasty habit of sweeping so much under the rug, refusing to sit with uncomfortable feelings and pushing one another to move on and move up so to speak. The problem with this is that the memory may have been stored away, conversations surrounding it may now be limited if not non-existent and there may seem to be a belief of 'out of sight, out of mind'; but lets face it, if it were that simple we would all be very well-adjusted, fearless and perhaps even reckless. We may even learn how to forgive ourselves a bit more readily.

I have never, in all my days, met a problem that someone is very emotionally connected to, that is easy to forget and move on from. You may be thinking that I am crazy to say this so absolutely, that there are people who don't let things get to them and of whom don't seem to dwell on their issues much at all. This is something that is very misleading I believe and it tends to create unrealistic expectations of ourselves and of others. If there is one thing I have learnt it's that people are complex and unpredictable. Try as you may, block a memory from your life that has been extremely influential and powerful in defining who you are, you will start to find it creeping in to other areas of your life. Perhaps some people have heard of a term 'dissociation'? Loosely, this is when we mentally distance ourselves from a problem. We all do it to some degree, daydreaming is a common example, where you get lost in thought and are not in touch with your surroundings for a brief time. Dissociation can be a defence mechanism, particularly in situations of abuse or extreme distress. Often our minds work out a way to compartmentalise information in order for us to protect ourselves. Something like recalling abuse is something that can be intensely overwhelming for people and if safety is not created in some way - even in our minds - there is the potential to become re-traumatised. Many adults have no memories at all about their abuse as children, particularly sexual abuse. When small memories start to emerge, often in the form of nightmares and flashbacks, it can be incredibly distressing and confusing.
It also begs the question, how much information has been stored out of our awareness as we have journey'd through life's challenges? I also start to think of transference and how certain things can get triggered off in our lives without us even realising it (due to associations we are continuously making - linking the past to the present). How many of our stored memories are important and still need to be processed in some way? I am sure there are many, big and small. This is what makes us complex and unpredictable, this is one of the elements that make us human.

But memories are not all negative. The problem is though that we seem to remember the negative ones with a lot more clarity and willingness to understand. My best guess: Regret. I will admit, I put regret up there with guilt and remorse and spend a lot of time trying to avoid these emotions. Unfortunately, just the conscious avoidance of them gives them power over my life. Regret is a tricky one because no matter how hard we try, we cannot have the gift of hindsight until, well, in hindsight. All we have power over is our reactions but even then, if we are not in sync with our experiences and not accepting of ourselves, controlling our reactions may feel like a pipe dream.

Understanding yourself better really is the key here. Not in a 'magic formula' kind of way but rather as a realistic tool to find acceptance and compassion for all things 'you'. Memories shape and define us. We learn from mistakes, whether we repeat the mistakes or not. At times, we pick and choose elements from our past experiences to ground us, to remind us that we belong, to validate us as members of something greater than ourselves. Even immediate memories such as calling a friend in a time of need can help you to remember that you are not alone. Alternatively the memory of trying to get help and not receiving it can make you feel even more alone. Scientists are probably more comfortable with the terms 'cause and effect'. As we navigate through our lives and accumulate experiences, we have the choice to learn and grow. The first step is to look at yourself, with all your flaws, weaknesses and mistakes, and see someone who is not so unlike everyone else. Even if you were to be perfect, perfect means different things to different people.

You cannot change the past. I often say to people who are caught in a spiral of regret: Look back at this time, what you knew, how old you were, what you were feeling, faced with and the time in your life when the experience occurred...Given the place you were in and the ability you had at the time, would you have been able to do things much differently? Sure, you would most likely react better if given this problem now, esp after time and hindsight to think about it, but it is important to remember that we do the best we can given the circumstances. Beating yourself up is a punishment not fitting of the crime. Emotions such as regret, guilt and remorse are guides to us, helping us to be conscientious and loving towards others. Fixating on negative emotions prevents us from learning and maturing.

Remember this: there are just as many good memories as there are bad, we just need to open ourselves up to embracing them.

XXX
Paula

Post Natal Depression and Baby Blues

Today I thought I would create a bit of awareness around Post Natal Depression (PND) or Post Partum Depression. In a simple way, this is when a new mum becomes depressed for longer than 2 weeks after giving birth. This disorder has the same severe or prolonged symptoms of Clinical Depression that lasts more than a week or two and interferes with the ability to function on a daily basis. 

PND can interfere with the relationship between mum and baby in terms of bonding and attachment. It can put relationship strains on the parents and PND can be extremely distressing for the new mum.

This is different from the Baby Blues - NB.
Getting the 'Baby Blues' is very common. 50-80% of women have this experience and it usually lasts a week or two after giving birth. Symptoms include mood swings, tearfulness, anxiety and difficulty sleeping aside from the baby. Baby Blues are thought to be linked with the stresses of pregnancy and hormonal changes. The treatment for this is usually rest and support.

There are 2 types of recognised forms of PND - Melancholic and Non- Melancholic.

Melancholic is rarer and has a distinct genetic or biological basis, thus unfortunately you are predisposed to PND and will most likely require medication in your treatment plan. It is characterised by slowed cognitive processes (thinking), poor concentration and psychomotor disturbances (agitation or slowing of movements); on top of the depression symptoms.

Non - Melancholic is more common and is linked with certain risk factors in your social environment. The depression can still be severe but this form of PND responds to psychological and therapeutic treatment and approaches. This is the PND I would like to chat about today.

There is a focus on fears and the concerns are often about the well - being of the baby or feelings of inadequacy as a parent.
Symptoms of PND can include:
Loss of enjoyment in usual activities
Loss of self - esteem and confidence
Loss of appetite and weight
Broken sleep (irrespective of baby)
Sense of helplessness and of being a failure
Wish not to be alive
Suicidal ideation (thoughts of suicide)
Panic attacks
Loss of libido (sex drive)
Fears of baby or partners' well-being or safety

Risk factors for developing PND can include anxiety during pregnancy, stressful life events during pregnancy, low levels of social support, low socio-economic status or obstetric complications. Risk factors mean that there is an increased risk of developing PND; it is NB to note not everyone with these risk factors will go on to develop PND.

The negative effects of PND can be frightening for people suffering from this disorder as well as for their families. Often the mum will struggle to bond with her baby and may not feel any gratification for her role as a mother. Tasks in her life may be too hard to manage at this time, particularly to do with the baby. Thus the new mum may feel isolated, guilty, helpless and hopeless and these feelings are constantly being reinforced by her inability to tend for and love her baby.
The risk for substance abuse increases with PND as does the suicide risk. Some mums start to have intrusive thoughts of accidental or intentional harm towards the baby. NB it is very rare for a non psychotic woman to commit infanticide but these thoughts can be extremely distressing nevertheless.

Depression will effect a mothers's ability to interact appropriately with her child. She may not respond to her baby's cues or she may be negative, hostile or disengaged. The outcome will be a lower cognitive function and emotional development in the child. In lay-mans' terms a child needs to learn about feelings, behaviours and feel validated and supported in order to develop and grow with confidence and stability. If the child is not being responded to or is receiving mixed messages about how to feel, the child will not feel secure in their own reactions and will not learn to understand their own emotions easily. This is bound to create problems later in life. Perhaps some of you are thinking that your own needs may have not been met as a child....

Breast feeding can be difficult for women suffering from PND.

Medication is not a popular choice for PND, particularly because women are breastfeeding and do not want to taint their breast milk. Side effects are not yet known in this regard and the argument lies between the side effects of medication and the negative effects of PND on the child's development. Something to think about.

The common form of treatment is psychotherapy using psychological approaches. The two approaches that are proven to be effective are Interpersonal Therapy and Cognitive Behavioural Therapy. In my personal opinion, it is important to find a person, group or approach that feels right for you. If you would like to treat this asap and are time limited, money limited or a person who does not like talking about their problems, a more manualised approach like Cognitive Behavioural Therapy (CBT) or Interpersonal Therapy (IPT) may suit you. Both approaches go for a number of weeks (12 - 20 on average, CBT can be less) and the skills you learn can be incorporated into your life outside of therapy. Other forms of therapy are less structured and more open ended, often with a person - centred base. My best advice would be to take into account what you would feel comfortable, talk to your GP about options and shop around for a therapist that works for you.

It is always important to feel comfortable and trusting of your therapist. You should work with them to find the best treatment for you. Your unique problems and commitments should be taken into account and you should feel comfortable enough to say when things are not working for you. Sometimes bringing your baby with you to the sessions may be helpful and the therapist can gain an idea of your interaction styles with your baby. You should NOT feel judged, this is important. If you are suffering from PND you are doing enough judging for yourself, you do not need to add to this.

It is important to understand Post Natal Depression so that we can be understanding of ourselves and of others, should we come across this disorder. We are only human after all and no person is immune to life's hardships in one way or the other. Lets support one another!

Hope this isn't too wordy and academic, hard to casually give the facts as we know them :)

Take care
XXXX
Paula

Reference:
Treatment of postpartum depression: clinical, psychological and pharmacological options

Elizabeth Fitelson,1 Sarah Kim,4 Allison Scott Baker,3 and Kristin Leight

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3039003/

How do you help someone who doesn't want to be helped?

Unfortunately you don't.

One of the hardest challenges I face as a counsellor is to learn how to respect client readiness. It is so easy to see patterns and problems when you are looking at someone else. It is so easy to think of the solutions for other people, isn't it. The simplicity ends when the solutions are our own and the problems are ours.

The best way to help someone is to try to understand them. When I say understand them, I do not mean through your own eyes. You need to find empathy for that person and try and imagine yourself in their shoes. We are all guilty of being quick to blame to some extent. We want to find something other than ourselves to take the heat, or even more powerful, something other than our loved ones. Having a loved one who is struggling in some way can be torturous for some people, particularly if the behaviour of the loved one is self destructive.

When I think of readiness and admitting to problems, I often think of training I did at Lifeline in regards to addictions. How many families have been effected by alcoholism or drug addiction. I say families because it is often very much a shared demon - addiction. Often family members are at a loss as to how to help and what to do, living in fear that their loved one is in danger and at risk on a daily basis. One thing I learned in the training was that the person/addict has to reach rock bottom. This can be anything from almost dying to losing a job or letting someone down. It is unique for each person as to what constitutes 'rock bottom' but the underlying principle is that the person feels like they have reached their lowest point and decide to make a change.

I wanted to bring that notion of rock bottom up because I think it has merit in all problems and issues in our personal lives. I do not feel that you have to reach rock bottom per se'. I do, however, feel that you have to reach a point where you are tired of living a certain way and you must decide to make the change. That is when readiness for help has been reached. In saying that, it leads back to the issue of trying to help someone who has not reached a point of readiness to accept help. This is a tough one because I do not feel a passive approach of saying and doing nothing is the answer when someone you know is at risk.

The thing to focus on is what YOU feel is ok and what you feel is not. All you are able to control is your own actions and your own boundaries. It is important that you maintain these boundaries so as not to become fixated on things that you cannot change. Many people give so much more of themselves, when helping a loved one, then the loved one is prepared to give themselves. If this is happening, if you are working harder than the person you are trying to help, lasting change and growth is not occurring for the other person. In fact, you are creating dependency and enabling maladaptive behaviour (lack of responsibility), probably without ever intending to. It is NOT your responsibility to save your loved one - hard lesson - but you do have responsibilities to them. One of them is to alert the person to your concern and investigate options available to them for help and resources. Give your loved one tools to help themselves rather than you taking that responsibility on board yourself  - it's a lose lose if you try to be a carer and uphold your original relationship to the person.

If you or your loved one reach this point of readiness by yourself/themself, when the changes happen there will be a sense of empowerment. A sense of strength and independence and what is called 'autonomy'. This is where lasting lessons take place, that help a person learn skills so as to face problems more constructively in the future. There is nothing harder than watching someone go down a path of destruction and feeling powerless to stop it. Often we feel angry and hurt and frustrated etc too. All you can do is your best and encourage the person to seek help. Try to think of the person separately from the problem and remember, we all lose our way at times. Knowledge is power, seek to understand.

Big hug
XX
Paula

Dreams and Nightmares

I have been wanting to write a bit about dreams for a while but in all honesty, this topic is so vast and so interesting, I have been wondering how to do this blog justice.

I'll start by talking about my own passion for dreams and why I find this element of our existence so fascinating. When I lost my mother I was 17 years old. Unbeknownst to me at the time and despite what I truly believed, I was still very much a child in so many ways. It is that tricky age where you are developed enough to have reason and knowledge, but where most teenagers are lacking is emotional intelligence to an extent. I would have been unable to process the trauma that was inflicted on me and due to this overwhelm I seemed to be able to put it deep inside and carry on with things.

This sounds terrible and I had therapy for a year which always seemed to come back to my guilt about this reaction to losing the most important attachment figure in my life. Over the course of therapy I began to relay my dreams. I was going through typical grief processes during the dead of night, during my REM sleep, go figure! The brain is a marvellous organ isn't it. During my Honours year in Psychology I chose to do my thesis  on this very thing, using a narrative perspective and methodology (not analysing meaning like Freud would have, but looking at our world view and personal stories and how dreams have been influential in grief when losing a parent). I realised just how powerful dreams can be, not just for me, but for others, whilst doing my research and interviewing my sample of participant's.

When we are able to recall and interpret our own dreams, we are inherently learning a great deal about ourselves. Many people believe different things. Analysts may believe that dreams are a channel between our conscious and unconscious, depicting our drives, wishes and fears. Spiritual people may believe our dreams hold messages, omens, guidance, visitations from the dead or our ancestors. Jung believed that every person, object, feeling etc is a representation of a part of ourselves (very simplistically). Many people have seen or owned a dream book with various interpretations and meanings for different dream symbols (for example dreaming of death can mean a new beginning or change). Dreams have fascinated people for centuries and it is not hard to see why. The exciting fact: We all Dream! Not everyone is able to recall their dreams, this does not mean they are not dreaming.

So what happens when we experience nightmares? We know children commonly have nightmares but it is not unusual for adults to be woken up by the terror of a bad dream. It is impossible to box these nightmares into a neat category because there are many different reasons why adults may experience nightmares. The obvious reason that most people are aware of is trauma. When something traumatic has happened to you or someone close to you it is not uncommon to relive this event in your dreams, play out different scenario's (what could have happened), relive the fear, anger, remorse etc etc. This is one of the symptoms of Post Traumatic Stress Disorder (PTSD) and can be crippling when these nightmares are recurring. A common reason for nightmares however, is stress and anxiety. Our brains are attempting to organise feelings, information, experience and thoughts and some believe that this is done in the form of a story - in order for us to make sense of this information.

Please note: Other reasons for nightmares could be a reaction to medication and if you have started a new medication and are suffering from persistent nightmares, it is always a good idea to chat to your GP about this. Also, if your nightmares are regular and have started to have an effect on your daily functioning and you are finding you are struggling from lack of sleep, anxiety or you have found you are unable to separate your dreams from reality on a regular basis, please also chat to your GP about what steps to take to get some help for this. There are many treatments available to help you.

My message today is about 'paying attention'. Our conscious state and awareness is often described as the tip of the iceberg in regards to what is going on underneath the surface. We are constantly being flooded with information, influences, stimulation, reactions and all those things that make us social beings who are a part of a culture and society. The down side is that our organic experiences, the ones that are true to how we really feel, uninfluenced by others, are often so stifled that we are unaware of them altogether. Dreams allow us a forum to be, feel, act, think and interact in ways that are unburdened by boundaries and social structure. Our dreams are gateways to our inner processes in my belief and nightmares can be the same.

If you are struggling to recall your dreams it may be a good idea to start consciously making an effort to remember them. A common tip for this is to keep a journal next to your bed and to jot down feelings and thoughts the minute you wake up. Even leaving it for a few minutes may make you forget (it is incredible how quickly the details can leave you). If you are able to recall the dream, write it down immediately or speak it out loud. In other words, consciously put it in your memory bank. The next step is to attempt to find meaning and make sense of your dream/nightmare. There are so many different ways to do this and it is your choice as an individual to decide what works for you.

 For me, I focus on the lingering feelings of the dream. Often I am left wondering why certain people are in my dream, why something so mundane is having such an effect on me or why the dream made so much sense at the time but when thinking about it, nothing really seems to tie in. It is in these moments of confusion that I turn from the story and characters so to speak and check in with my own experience as I am recalling the dream. Was I afraid, angry, hurt, sad, peaceful, panicked, joyous, hopeful....? Once I have found feeling that fit for me, I start to think through what the relevance of other elements of the dream may mean. Last night I had a nightmare where I was walking a long the usual route I take my dog and I overheard a brutal murder, torture in fact, of a young woman. In the dream I knew what was happening despite not seeing any of this happening. I knew I needed to get away quickly and call the police but I was absolutely terrified that I had been seen and would be captured and the same would happen to me. Needless to say I woke with a start and could not shake the fear or the imagery. My own method for dealing with this is to try and allow this whole thing to play out but with the outcome I consciously choose (doesn't always work but it helps more than trying to think of other things when your brain feels so engrossed with the nightmare).

I worked out that the feeling that stood out for me the most was fear. I have managed to relate this to areas of my life as well as think about the amount of crime novels and TV programmes I have been watching lately (I go through phases). My actual fear is not about being tortured of course, but perhaps looking at some of the themes of the story may be helpful. Freedom, free will, self sacrifice or lack their of in my case in this dream, moral obligation, survival (you get the drift). Once you see themes that feel right starting to emerge, you are then able to ask yourself some questions like 'are there any other areas of my life where I have felt like I have to put my self first to survive, or am I feeling like my freedom is limited, do I need space?' For me I am struggling with the dark side of humanity - an occupational hazard I suppose - people are not always what they seem. So there are many interpretations and the process of listening to yourself, questioning your own processes and finding resolutions that fit for you may aid you in whatever life journey you are currently on. Dreams help us to find meaning, to understand ourselves and to organise information. They allow us to explore without limits and learn and grow!

I urge you all to make use of this tool, to listen and to love!

Sweet dreams XXX
Paula

Overreacting? Perhaps it may be transference.

Do you ever have one of those days where you feel as if you may explode with anger, frustration and emotion all at the same time? I have recently experienced this and have managed to figure out a few things which I thought would inspire a blog on the topic of transference.

Anyone who has studied any field in the mental health profession will be good friends with this term. Transference has been around in my industry since the days of Freud and I will attempt to give a brief explanation of what it is before I go on. In simplistic terms transference happens when you react to something in your life based not on the incident itself but on things that are being triggered off for you from your past. This is not a conscious process and the emotion you feel towards the current situation can feel very relevant to that particular situation. I may not be making much sense so here is an example I have made up:
Say you get into a fight with your partner because they have not been approving of your choice of outfit. For someone with no emotional connection it may not be a big deal at all, in fact some may even laugh it off. But imagine that as a child your mother would criticise everything you wore and call you fat and ugly. You spend your life trying to gain your mother's approval, trying to better yourself and become preoccupied with how you look. So when your partner says that outfit doesn't look great, you absolutely explode. After the rage you find yourself feeling extremely upset and hurt and can't seem to let it go.

At the time it may feel like a completely valid reaction, the anger is there and so is the hurt. Y
ou value your partners' opinion and feel horrible about the situation. In time however you may start to question why it all feels so intense and wonder why you are unable to move on from it. As I mentioned the past with your mother, it is easy to make the connection that this is stemming from the experiences you had with her and your partner has triggered the past hurt and anger you previously experienced.

Life is not all neat and tidy and transparent however, and it is not always easy to recognise transference (even as therapists - with ourselves and for our clients). I want to share a valuable lesson I learnt whilst doing my placement. I had a very wise supervisor and this is one of my most treasured and most used lessons:

We all react in one way or another to situations. Even the feeling of not caring is a reaction. To be moved or influenced by someone is normal. I will often feel things for my clients such as sadness for their situation, pain for them, anger towards people who have wronged them, compassion, intrigue, frustration etc. A certain amount of these emotions are good and are what make me empathic and human. It is when we have extreme reactions that we need to start paying attention to our own transference and processes. Extremes on both sides, either we react really strongly and are more than moved by something, it effects us; or conversely we are not moved at all and may be bored, complacent, numb or such the like. My supervisor pointed out to me that these extreme reactions are often not about the other person at all but rather about something being triggered off within me - transference. Thus by paying attention to the level of reaction towards something we experience, we are able to recognise our own triggers and start to think about where they are coming from.

Why am I telling you this you may wonder? 

You may just find yourself in a situation where you feel almost combustive with emotion and instead of being able to calm down, you just get more and more worked up. It is in these moments where I urge you to start looking within and asking yourself some questions. In my own situation, after a day of what felt like extreme anxiety and negativity, it took recognising that this was a case of transference but having to sleep on it and perhaps dream (I suspect that is what happened although I do not recall the dream at all) or reflect on it, for the answers to come. Often when the answer feels right there is a sense of relief. Many people, myself included, experience this in a very physical and real way, even if it is fleeting. As counsellors we are taught in certain therapy frameworks to look out for this sign of relief and help the client to recognise that they have tapped into something meaningful. In my own situation I felt as if a giant weight had been lifted and as I told my partner about the experience and the tears and emotion was able to flow freely, I was able to find relief and understanding and move on from my extreme reaction.

Unfortunately recognising and exploring transference can be difficult and even painful. It is important to be patient and kind to yourself. I find it is really helpful to explore with someone else, muse out loud or write things down. Move out of your head and into your experiencing and body so to speak. Pay attention to how you are feeling and look at yourself with curiosity and compassion. We all have our demons and skeletons and need to navigate through them sometimes. Awareness brings about more control and understanding.

Happy sailing :)
XX
Paula

When I 'listen to my gut' am I really listening to the internalised voices of my past?

I have been giving a lot of thought lately to family patterns and how much we are influenced by our upbringing. The 'nature/nurture' argument has been around for decades but this particular concept often gets my cogs turning.

Sometimes, as I watch all my peers start having kids of their own, I feel a bit frightened for them. The reason for this is because I often still feel like I don't know nearly enough to feel prepared for the responsibility of caring for another little human being. Somewhere along the line (and I have noticed much of this happens a bit after the birth, not immediately) instincts kick in and new mothers seem to have a deeper knowing when it comes to their children. Where does this come from?

The black and white answer can be that you learn how to be a mum (or dad) throughout your life. You learn from all of your own experiences, primarily from your own parental figures. Other influences include modelling other significant relationships, learning from teachers, coaches and tutors, learning from your peers and learning through play. Another viewpoint can be looking at the nature side of things and ones instincts. Humans have very little instincts when compared to our animal folk. Much of our behaviour is learned. Many of us are being signalled by our 'instincts' regularly but do not pay attention. The saying 'trust your gut' is a good example of this. But is 'your gut' really just an amalgamation of all the voices of your past, namely your parents, that have been internalised over the years?

In phenomenology or experiential psychology, Ernest Spinelli* explains that we are all unique individuals who may share common experiences, but our perception and experience of these common experiences will differ between each individual. The reason for this is the 'meaning' we place on that experience. This meaning is influenced by all the different experiences in our lives such as our upbringing, values, principles, past experience, culture, religion, education, personality type etc etc. So if we think of how everything in our life is influenced by the meaning we create due to our past experiences, parenthood should be no different right? That can be a very frightening concept for some people. Many people are terrified of passing on negative legacy's left by their own parents, and sadly, many people do continue to pass this on.

It is not uncommon for people who suffered the hands of abuse to go on to becoming abusers themselves. I do not have any solid answer for this, nor will I attempt to stereotype and generalise. What I am intending to highlight is the power 'nurture' seems to have, even over 'nature' in some instances. Let me give an example: A child that has been put down, criticised and neglected growing up will often find it very difficult to believe in themself. The voices of primary attachment figures have become embedded in this child and after years of conditioning and being led to believe they are not worthy, intelligent or special, the child will grow up and believe those voices to be their own. It can often take a lot of therapeutic work to undo this pattern of thinking and to differentiate the persons' own self from the conditioning others have placed on them. It is no wonder that when someone has been shown abuse instead of encouragement and love, it is not easy for that person to learn how to show encouragement and love themselves.

I want to be clear that I do not mean impossible when I say 'not easy'. Sometimes our bad experiences show us how we do NOT want to behave or live. In psychology they may use the terms 'repeat or resist' when it comes to our parental influences. As individuals we have a choice, we can simulate behaviours as we have learnt them or we can resist them and change or break the patterns. Resisting and changing patterns can create a lot of conflict and can make people feel very unstable. Sometimes we need other people to help us, to reassure us and to validate our decisions so as to feel less alone. I say less alone because when we resist our familial patterns we are often challenging our values and our world view as we knew them, taking us away from that sense of belonging. Many people who have been abused will have unresolved issues/hurt/pain/anger etc and this can make one feel very out of control, particularly when it comes to personal choices and what I have been referring to as 'resistance'.

Breaking patterns and creating change happens best when we are aware of our patterns and of ourselves (as much as possible). Referring to phenomenology again, in regards to making any decision, the best way to secure the best possible outcome is to put all the cards on the table, giving each card equal footing. Once you have all your cards (elements of the problem) in front of you and you are able to look at the problem from all angles, the answer can then be seen more clearly. In other words, in order for you to break a cycle or a pattern, you need to understand the cycle and the pattern as it stands, from all angles. You may be afraid that you will become violent and abusive like your father and feel this is something you have no control over. The truth is, you may, but you have the choice not to. You may need to open up some old wounds in order for you to understand your past experiences and the present fears, but once you start to separate the abuse from who you are as an individual, to realise that you do have a choice and control, that is when you are able to allow change to occur. The choice lies in your actions now, in the present and in your own motivation to be who you would like to be. The 'nature' side of you, the essence of you is not fundamentally bad. No one is born evil, no one is a bad seed! We are shaped by our nurturing, our environment and by our need to survive. We cannot change our experiences but we CAN change our reactions to them. Sometimes it just takes a bit of work.

I like to believe that 'my gut' is a mixture of my instincts and my upbringing. As a counsellor I am learning to value the power of listening to my body, listening to those voices, to those feelings that creep in unexpectedly, to those waves of emotion that come out of the blue. often, when I pay attention, I am given many clues about a particular situation and once or twice my instincts have kept me safe. My message today is to listen to your gut and if something does not feel right, pay attention :) You can break those cycles if you so wish to :)

XXX
Paula

*Spinelli, E. (2005). The Interpreted World: an introduction to phenomenological psychology (2nd Ed).

        SAGE Publications: London, UK.

How important is our profession?

I have just joined LinkedIn and I must say I am having fun with it! What I love seeing is how positive everyone is about themselves and the differing lines of work people have chosen. I am no fool, of course everyone is positive, this is an online CV and professional networking site after all! But it lulls one into a false sense of security, as you notch up all the 'wonderful' things you are capable of, the amazing experience you have gained, the great characteristics and skills you have to offer, you are forced into being really complimentary about yourself :)

But, like any external gratification, it is often not a true reflection of how you really feel about yourself...which is sad I think. Unless you have manipulated the truth somewhat, most of the things we put in CV's are true. Why then, is it so very hard to give ourselves a big pat on the back?

As I am launched into the crazy, demoralising world of job seeking (yet again), I feel less and less positive about myself. Each rejection letter cuts a blow with the words 'thank you for your recent application but unfortunately....'. The worst part is when they tell you you do not have enough experience! Of course I don't, I have spent 6 years studying and heaps of volunteer work to become a professional! Rant over. I have started to reflect on this stressful time I am gong through and it has made me think about the idea of 'meaning and purpose' and how much we rely on our status, our profession, our income etc in order to determine how we feel about ourselves and others.

When you meet someone for the first time, give it 10 minutes and you are asked or do the asking 'so, what is it you do?' This can give chills down the spine of the unemployed! It can also give people a really good starting point for conversation, a peep hole into the world of the other and an idea as to what type of people they are (dare I say it). This brings me to the point of this topic of 'how important is our profession?' We seem to define success with what we do rather than who we are. When trying to sell yourself to potential employers we mask the uncertainty and attempt to appear self assured, driven, ambitious, reliable etc etc, the list goes on. When we get the sack, rejected in some way, told off, pressured, criticised and put down in the work place, it very seldom feels like 'water off a duck's back', we take it personally. I have read many articles on bullying in the workplace and how many people are so reliant on their jobs due to the precarious market, that they persevere, bite tongues and push forward. The result: illness. So many people are having breakdowns, suffering from stress, back ache, low self esteem and depression and on the extreme, heart problems and high blood pressure. 

Feminists have been fighting for house wives to be given the same respect as professionals. Why are people still ashamed of staying at home and looking after their children, the house and other non-career orientated things? Why do we feel so shaken when we are unable to find work (and I don't mean on a purely financial level)? What are these aspects of professional life that make certain people better than others, men better than women?

All I know is that we all need to feel needed and purposeful. On my side I would add that I need to feel independent and self sufficient. I want people to know that I have worked hard and the status of 'unemployed' does not seem to reflect me correctly. Something is skewed in this perspective, I know that much. There are so many areas of life at which to excel and make a difference. That older person you had a chat to while walking the dog, perhaps you made their day. The compliment you paid to a friend, perhaps you got them out of a really miserable mood. The lesson you taught your child, perhaps it will define something really huge in their lives one day. You just never know and one thing I do know, we all have our successes!

 Perhaps next time you are putting together your CV or writing a cover letter or talking yourself up in an interview, give yourself a pat on the back. You are more than job experience and fancy titles, you are a well rounded person with many complex aspects that make up who you are. You have been influential to many people, even some you don't know. You have more than your profession to offer and although we all need money to survive, it is important to make the most out of our unique gifts. Be pro-active and take the bull by the horns, your biggest advocate is you!

Best of luck

Paula XXXX

Why is 'change' just so damn hard?!

What is it about the word ‘change’ that seems to provoke anxiety in the very strongest of us humans? Good or bad, the very nature of change can create a whirlwind of experiencing in us, often in a very difficult way.

I use the word ‘change’ quite loosely of course, but truth be told, even the smallest elements of change can create huge and influential effects. Take growing older for instance. This is not some cataclysmic shock, it is not a devastation or natural disaster and it is not something anyone one of us can avoid. It is one of the few things society can label ‘normal’. We all age, every year, every day, every second. The process of aging differs in each of us on a micro level but on a macro level, we all run through the hands of time, maturing physically and biologically, developing, growing, wrinkling and evolving. But during the differing life stages, the change can feel enormous and there is a  certain amount of hardship as we say goodbye to each phase and hello to the new one.

This gets me thinking about something my supervisor on my counselling placement taught me in regards to decisions making. Many clients came to see me due to an inability to commit to a decision. I couldn’t quite grasp how living in this limbo was the chosen path, keeping a foot in both doors, keeping both options open but reaping the benefits of neither...we all do it, myself included, what is the gain? The words of wisdom: To make a decision means a severing of another. Powerful stuff, let me break it down further. When we make a decision, chose a meal, pick a partner, take a path, choose particular words, we are inherently shutting off various other options. It is this ‘severing’ of options which can leave us in doubt, fearing the wrong decisions, fearing regret, error, remorse etc. Decisions are an element of change, we commit to a choice at the sacrifice of other choices so to speak...not easy. Change is similar I believe. When we make changes, however small, we are severing a part of ourselves in a way, we are abandoning the familiar and heading into the unknown.

Sometimes change is thrust upon us in a way that is traumatic. Death is one of those things, either to others or our own mortality. The greater the personal the loss, the more resistant to change we seem to become. Looking at aging again as this ties in with the idea of our own mortality, how many of you have felt saddened at the loss of your childhood innocence? I often look back at the times of blissful ignorance and wonder if I was better off just not knowing the realities of the world. I think about how I used to play, how I used to get excited, how I used to dream and I feel a great deal of loss that this time in my life will never be repeated. Change is not just about external circumstances and occurrences’ that happen to you, the most difficult changes are often the ones that happen under the conscious, within us and on levels we can only muse about. Sometimes you can look back and realise your beliefs have evolved, your values have changed, your thoughts are different and your needs have varied. When we do not embrace our internal changes and most importantly our evolving needs, how are we supposed to adapt and get our needs met? If we continue to remain in our old habits and routines, asking for the same type of help, soothing ourselves in the same way, seeking people out that help us in the same ways, we are ignoring and resisting our own evolution and conflicts may start to arise within us.

Something many people may have heard is:

You cannot change the past but you CAN change your reactions and attitude towards it.

Change can be so traumatic and difficult that people can become ill, develop disorders such as adjustment disorder, depression, anxiety etc. People can miss opportunities, shut themselves off, have sleep disturbances, fail to progress towards their potential and a variety of other examples in this resistance to change. We all deal with change is our own ways but I think most people will agree that whatever the way, it is never easy. Something as natural and unavoidable as change is one of the most powerful elements of life in my opinion. It can have the power to make or break you and we have very little control over much of it (and it’s outcomes). The best we can do is become aware of ourselves. Learn to recognise how you handle change and how you have been changing over your life. Learn to find the inner strength to cope, creating ways to feel a sense of security and safety that is relevant to you. One thing I am trying to do for myself is to seek out the real me. The part of me that has been at the core throughout my life, my essence or character if you will. This, I believe is something that evolves and is influenced on one level but at the organic level it is me, my soul, my foundation, my epicentre so to speak. I am learning to ground myself in the present, to be with myself in the here and now and to separate all my over thinking from my actual experiencing. This is a work in progress but I like to believe that in this ever changing world, the essence of me will always be just that...ME J

ANZAC Day, lets think about PTSD and trauma

In Australia, we are celebrating all the people who have fought in wars, protected our borders and done service for the country. There is a big march in the city, they had a dawn service and veterans from far and wide take part in this coming together, this appreciation, the memories....

So as I reflect on the members of my own family who fought in the war (like my grandfather) or became a nurse in the war (like my grandmother), I often think about the mental scars these men and women are left to face in the aftermath. The nightmares they have seen, the lives they have taken, the friends and comrades they have lost, the casualties, the fear and the survival. No-one can ever truly imagine what these people have gone through, what people are continuing to go through in the likes of Afghanistan, South Korea, Iraq, Somalia, Syria etc.

It was also thanks to soldiers and military men passed that we are able to understand something called PTSD (Post Traumatic Stress Disorder). It was only after so many men were coming back from war and started to develop common symptoms, that the governments and the world of mental health started to accept that there are links between what had occurred at war and these symptoms. As you can imagine, this was no easy journey, to admit that PTSD was a real side effect of war would be for governments to accept liability, to be responsible for changes and treatment. We can also thank these soldiers and their trauma for the developments in psychotherapy and psychology that move beyond psycho-analysis and the days of Freud and his long - term therapy which had been the dominant means of treatment for mental health issues. When these soldiers started to return home after the likes of WWII and Vietnam, long - term psychoanalysis, which entails delving into childhood and working through deep set issues, was no longer viable. Something was needed to treat the mass of soldiers and military men for what was now emerging as PTSD, something which was now being acknowledged as a response to trauma (not embedded in childhood). As the likes of Carl Rogers and his Person Centred Therapy started to gain popularity, so too did our growing understanding of the human condition. Questions were being asked, theories were being challenged and when you look at all the different modalities and frameworks employed today, we have to give thanks to these men and women who suffered to make this possible for us all. I say us all because psychotherapy and psychological fields are now available to masses of people with a variety of presenting problems, it is good to acknowledge that it was not always this way.

PTSD can effect everybody, not just soldiers in the war. This disorder is due to the residual effects of a past trauma or trauma's. It is thanks to these soldiers that a very comprehensive list of symptoms has now been developed and associated with PTSD. Some of these symptoms include nightmares and sleep disturbances, hyper-vigilance (being extremely alert), racing heart, anxiety, depressive symptoms, inability to do certain activities that were otherwise easy for you, anger, confusion, panic attacks etc. There are many symptoms and changes that occur when people suffer PTSD and it is often overlooked or misdiagnosed through lack of awareness or due to a very late onset. It is not unusual for people to develop PTSD after a substantial period of time has lapsed since the trauma, sometimes even years. This makes it difficult for people and practitioners to often make the link between symptoms and PTSD.

Trauma does not always have to be about war, death, terrible accidents or personal injury. People can get traumatised by someone else's trauma or potential trauma. This is called 'vicarious trauma'. For instance witnessing an accident, almost being in an accident and wondering what could have been or having something happen to someone close to you. We are beautiful creatures, human beings, most of us equipped with a very special tool called empathy. Unfortunately by being able to empathise with others, imagine yourself in their shoes so to speak, we are also vulnerable to imagining people's pain, fear and panic. Thus it is important to be mindful of how you are being affected, to be kind to others and yourselves and to be aware of what PTSD is all about. It is also important to spare a thought for all those brave men and women who have had to live with trauma and put their lives on the line for the safety and protection of their country and it's people.

Thank you to all the ANZAC's!
Paula

Stress! How do you get a handle on it?

Stress is such a society friendly word isn't it? I mean, there is no shame in saying it, whatever age you are and whatever sex you are, we all seem to get 'stressed'. So why is it so very hard to just 'stress-less?'

Let me start by chatting a bit about stress a bit. We tend to use it when we are feeling things such as 'overwhelmed, frustrated, panicked, pressured, annoyed, and confused'. We may also start using it when we start getting illnesses or pain that cannot be explained away by tests and doctors, such as upset tummies, back ache, headaches, skin irritations and rashes, insomnia or sleep disturbances and changes in diet or appetite.

Stress is used to tell someone to calm down and don't worry "Don't stress, we can make another plan" or "No worries, thanks anyway". It is used to highlight a point "I would like to stress the importance of xyz". It is used in such a variety of ways and by such a wide amount of people that it is no wonder we often feel bogged down by stress and silently suffer symptoms that may be worse than the society friendly label suggests. So am I asking you to become stressed about your stress, absolutely not. I want to open the doors to a deeper understanding of how you cope with stress, how you experience it and I will offer a few of my own stress busting strategies at the end.

Lets take a closer look at you and your life.
How do you cope with the challenges life seems to throw your way?
How many of you have found that your stress comes and goes, some days you feel better equipped to deal with stress than others?
How many of you have started to feel stressed for 'no reason'?
How many of you tend to be alerted to your stress when you put your neck out or you start to get nausea and stomach troubles?
How many times do we start blaming things or people around us because we 'just don't need this right now!'?

We all experience our stress in different ways, unique to our own way of life and coping style. Stress can often be misleading and perhaps what you have been experiencing may very well be anxiety. But without throwing labels around and self diagnosing yourself (not a good idea), ask yourself what area's are the most challenging for you. Do you have trouble with thoughts that seem to endlessly go around and around in your head? Do you find you are always worrying about something? Have you been really hard on yourself lately? Check in with your body, does anything stand out, any pain, discomfort, tightness, etc? How have you been sleeping lately? When was the last time you did something enjoyable? How have you made it through when you have been struggling? If you are aware of your stress, lets break that down, what is it that makes you aware of your own stress? What was it that alerted you?
We tend to say that we are stressed without really thinking about it. Perhaps being overworked, lacking patience and having deadlines is simply a neon light of stress warnings for you, but it is more than that. Think about it.....
For me, I tend to have a very short fuse and get annoyed very easily. I seem to worry about so many things that are completely out of my control. I am often very emotional and can cry at the drop of a hat (sad adverts, a moving song, a TV show etc). I get horrible back pain and neck pain and my hands flair up with eczema. I can usually fall asleep but find I wake up a lot during the night and toss and turn in the early hours of the morning. I get really fatigued and run down and when it gets bad, I get stomach troubles. As life needs to go on, I often forget to notice all these symptoms until I feel completely overwhelmed by them and by this stage I feel quite helpless and get really annoyed and angry with the whole situation. Any of this sound familiar? I urge you to think about your own paragraph here :)

Once you start having more of a handle on your own symptoms of stress, of your problem areas and of your coping style (because yes, you have actually been coping, even if it doesn't feel like it), you are able to realise that you have a particular way of dealing with stress and it is up to you whether it is working for you or not, or if some of it is working but there are areas you would like to change or improve. The body is a very clever creation and believe it or not, is acting in a protective way towards you. When we do not listen to our own inner needs, when we don't slow down and take care of our selves, our bodies seem to start forcing us to do that. We get ill, feel pain, get fatigued, throw up etc, and the common element here is that with all these symptoms, you are forced to pay attention. In many cases you are forced to physically slow down and rest. How many of us, however, pop some pills and push on anyway (I myself am guilty of this)?

Lets get pro-active instead of becoming inactive!

Stress and anxiety is not unlike fear in many ways. Both fear and stress accelerate your heart rate in a response to adrenalin or the fight or flight response many of you will have heard of. As your heart rate increases, your body goes into survival mode and starts to react in ways that inherently are built to protect you. The big trick here sounds so very simplistic but it is to slow that heart rate right down and relax the nervous system.
HOW you may ask? When you are in the midst of your stress, at work, looking after the kids, running errands, cleaning the house, being a friend, cooking dinner, planning for the future, struggling financially, job hunting....you name it, we have a lot to be stressful about in this fast paced, rather difficult world we live in. It is not always realistic to go on a spa retreat, take a tropical holiday or get a full body massage!
My strategy is to work with your breath. When you hear the old tip of taking ten deep breathes, it is not all a bunch of rubbish. There is huge merit in this technique. There are many different ways to work with your breath and it is about finding the method that works for you. The basic principle is mindfulness. Getting your head out of your worrying, rumination of thoughts and fears and into the present. Finding that relationship with your body and taking steps to slow down that heart rate and calm that nervous system.

This can be as simple as doing a small meditation where you sit or lie comfortably, close your eyes if you want to and take some deep, long breathes where you imagine the air coming into your body and as you release your breath, you imagine a releasing of stress and emotion. I like to imagine sending breath to different areas of my body, such as my back or neck when it is sore, or my tummy when it is upset. Yoga is a great way of working with your breath as well as incorporating stretches that open up your chest, groin, back etc and strengthen your core.

Listen to Bob Marley! perhaps my favourite strategy to suggest because it is just so do-able! The beat of this reggae is similar to the beat of a slow, calm heart. Pop some Bob on in the car or on your phone to have easy access and focus on the music for a while. Let the music get that heart beat of yours to slow down :)

Exercise. This releases endorphins, gets you in the moment, works with your breath and gets that blood flowing. Hard to worry about things when you are playing sport, working up a sweat or trying to breathe! There is more and more research being done on the benefits of exercise, particularly with depression and anxiety! It's not all about looking good at the beach!

Do something that makes you happy, at the very least once a week!

Start a journal or start sketching/drawing/painting. Try this as free association, working with whatever comes to mind in the moment. You may surprise yourself with what crops up and it is a great way to learn about your inner self as well as to release some pent up stress! You don't need to be an artist or an author, this is just for you!

Talk about it! Lets support each other and ask for support ourselves. So many people battle with stress and anxiety, it is not something that needs to be kept in the dark. Lets share our methods, tools, experiences and help each other to feel less overwhelmed and more hopeful!

Eat for health! Give your body lots of fuel to cope with the day! Make super foods your friend and start getting creative with food! My favourite new additions at the moment are ginger and ground up linseed! Taking care of the basics, the physiological needs, is vital for good mental health!

And lastly, if you find you are not coping, nothing is working and you need some help, be proactive in this area too. There are many great therapies and treatments out there to help you. It is always helpful to ask yourself what type of help you are needing when choosing a form of therapy. I am happy to give some examples and options if anyone would like to send me a message or comment (here or on my Facebook page www.facebook.com/counsellingcounsel).

Hope this helps
Paula

Is my Grief 'Normal'?

YES!

There is NO strict set of rules, set time frame or particularly approved way of being when it comes to grief. In other words, there is no 'normal' way to grieve in my opinion. It is important to be mindful of your own process. If you have been battling to function for an extended period of time, it may be useful to see a counsellor or join a group to help you learn how to cope with your grief and regain some control over your functioning. I always recommend seeing your GP if you are not sure what to do or how to get some help.

Every person will deal with loss in their own unique way. The person, pet or even non-living thing or aspect of self that has been lost will be significant to the bereaved in different and personal ways. Our relationships are complex and cannot be given a formula or a one-size fits all mentality, so too is our grief. Think of the last movie you saw. Many other people will have seen the same movie too. Some people will enjoy it and others won't. Most people will have a view of the movie based on their unique outlook coupled with past experience, how they relate to characters, what effects moved them etc. You get my point. Grief is the same. There will always be commonalities between people who are grieving and theories are formulated based on these commonalities. We can establish that there are similarities in how people of different age groups grieve, of how men and women grieve and in how various cultures grieve. The circumstances of the loss will also affect the way people grieve. These similarities are important because they can make us feel less alone, less afraid and perhaps less judgemental of ourselves.

Comparing our grief to others can also be harmful. Many people have a stereotypical view of grief and loss. Some examples I have come across are that people are tearful and cry all the time; people are unable to enjoy themselves and mope around wearing black; that people do not want to talk about the deceased or that people are 'strong' because they are not crying. There are many more and I am sure each culture, family or social group will hold varying stereotypes. The reason I call this harmful is because people have very little control over how they react to loss. Literature shows that grief is all encompassing and can effect us on almost every level (physical, emotional, spiritual, social etc). Many people find they feel a lot of guilt and/or regret whilst grieving. By setting these stereotypes of grief, society has found a way to add to this guilt by creating judgement towards people who are not grieving in a way that is deemed 'appropriate'.

My message today is to attempt to move away from these stereotypes and to share what I feel is the most important lesson I have learn't in regards to grief: There is no right or wrong way to grieve and there is no clear definition of 'normal'. If you are unable to cry, that's alright. If you cry all the time, that's alright. If you need to be around things that remind you of your loved one, that's alright. If you need a complete change and to create distance from your memories, that's alright. If you want to talk, that's alright. If you can't talk, or don't want to, that's alright. If you feel angry, that's alright. If you feel happy despite your loss, that's alright. Whatever and however you are reacting is how you as an individual are coping. You are doing what you need to do to get through this loss.

As I said above, grief can effect us on all levels and some people will have more trouble than others in certain areas. Some common features of grief are loss of appetite and inability to sleep or stay asleep. Many people become very run down and pick up illnesses at this time due to a reduced immune system.There are biological reasons for this, I won't get into this here but I urge people to read further on this topic if there is an interest. Taking care of yourself may not seem important when you are bereaved but if these symptoms persist perhaps it would be helpful to see your GP and talk about options to help you, particularly with the physical symptoms. Lack of food and sleep can impair our reasoning and can make things feel a lot worse.

If you have any thoughts of suicide or self harm please know that there are people there to help and numbers you can call. Don't suffer in silence. Listen to your body and be kind to yourself. Things will never be the same but you CAN learn to find ways of living with your loss. Time will give you perspective and there is support out there. Try to find someone in your life who can listen to you and allow you to work through your pain in your own unique way. Remember too that some people in your life may not be able to help you and that does not mean that you are doing anything wrong or that you do not deserve help; it means that some people are unable to help you due to their own unique circumstances or abilities.

Hang in there!
Paula