The Purple Vault

By Claire Welshe

A clear blue sky beamed through my window the day I learned that I would never again see purple rain, at least not in the flesh. The flesh of megastars such as Prince, it seemed, was just as susceptible to mortal vulnerabilities as the rest of us. We are all human. We will all suffer the same fate, eventually. My clear blue sky day suddenly seemed a little cloudy.

Human beings are geared to strive for survival. When our bodies become dehydrated, we feel thirsty and seek out water in order to stay alive. When threatened, we feel fear and our bodies divert blood to our muscles to ensure we can fight or run, so we can survive. So a reminder that no-one is immune from life’s inevitable demise can often be very unsettling. We are neurologically hard-wired to avoid threats to our existence yet on some level we all know that at some point, even our best efforts will be futile. My cloudy day was now looking distinctly rainy.

There is some speculation that Prince had advance warning that his days were numbered. On the weekend before his death, he reportedly proclaimed to his enamoured fans “Wait a few days before you waste your prayers on me.” If indeed this was an ominous foreshadowing of his death, then the way in which he derived his resilience in the face of such adversity is something that we can all learn from.

As more and more snippets of his last few days are released to the public, it seems that the “artist formerly known as Prince” lived his last days loyal to his lifelong passion for music, his values surrounding creative expression and his devotion to philanthropic projects he deeply believed in, despite, or perhaps because, he knew that he didn’t have much time left. His last moments were reportedly spent in his home recording studio, actively contributing to what is now believed to be an actual physical vault of up to 2,000 unreleased songs and videos in the basement of his Paisley Park estate in Minneapolis, enough to continue to release one album per year until well past my lifetime. He created a rainbow to follow the rain. To follow the purple rain.

If you were told you had only one year, one week or even one day to live, how would you make each moment matter? What would you want your “vault” of memories to contain? How would you change the way you live today? What is stopping you from living that life, right now?

Acceptance and Commitment Therapy (ACT) can help support clients deal with the difficult thoughts and emotions that inevitably arise when facing a life limiting illness, helping them identify valued directions for their remaining time on earth and supporting them as they take committed action towards adding to the “vault” we will all leave behind. Research shows that distilling and focussing on what is most important during the end stage of life as part of a broader ACT intervention can help manage distress and improve quality of life during this very difficult time.

The Brisbane ACT Centre now offers a home visiting service by Claire Welshe, mental health occupational therapist, for those who are unable to access the Brisbane ACT Centre due to poor health or other restrictions. Contact us today to make an appointment.

1. Ann D. Rost, Kelly Wilson, Erin Buchanan, Mikaela J. Hildebrandt, David Mutch, Improving Psychological Adjustment Among Late-Stage Ovarian Cancer Patients: Examining the Role of Avoidance in Treatment, Cognitive and Behavioral Practice, Volume 19, Issue 4, November 2012, Pages 508-517, ISSN 1077-7229, http://dx.doi.org/10.1016/j.cbpra.2012.01.003.

(http://www.sciencedirect.com/science/article/pii/S1077722912000132)

2. Feros DL1, Lane L, Ciarrochi J, Blackledge JT, Acceptance and Commitment Therapy (ACT) for improving the lives of cancer patients: a preliminary study, Psychooncology. 2013 Feb;22(2):459-64. doi: 10.1002/pon.2083. Epub 2011 Oct 6.

What Makes a Good Therapist? 10 Traits Explored!

This is the second in the Brisbane ACT Centre’s two part series on finding a psychology practitioner that’s perfect for you. In our first post we looked at choosing a therapist, now we move onto the qualities and actions of effective therapists – what makes a great psychologist?

A terrific, publicly available paper published by the American Psychological Association suggests that there are fourteen qualities and actions of effective therapists based on theory, policy, and research evidence. These traits aren’t exhaustive, but they give you a good picture of what makes a psychologist effective. Therapy, like all skills coaching, can be subtle and complex, and what’s easiest isn’t always the best treatment for you.

In the APA paper there are 14 qualities and actions that make for an effective therapist, here’s 10 of our favourites:

1. Effective therapists have sophisticated interpersonal skills, they’re sensitive to your emotional state, and are able to communicate well with warmth and acceptance. Do you find your therapist warm and easy to communicate with?

2. Effective psychologists creates trust with their clients – their clients feel understood and believe the therapist is capable of helping them. It’s critical that you feel that you can trust your therapist if you’re going to work well together.

3. Good therapists are capable of creating what’s called the ‘Therapist Alliance’, which means they can create a therapeutic bond around the goals and tasks of the therapy. The atmosphere is collaborative and purposeful. Looks for therapists that create this relationship solidly, and early in therapy.

4. The fourth quality is complex, being a therapist’s ability to give an acceptable and adaptive explanation for a client’s distress. An explanation for distress can be a useful tool in treatment, and it’s important that clients resonate with it. The explanation (in therapy) is however only a tool, a means by which the client can overcome his or her difficulties. Biological explanations, while common, aren’t based on solid science and actually worsen self-stigma, increase hopelessness and decrease useful behaviour change. Understanding that suffering is human, and that we all get entangled in our own ways, decreases stigma and increases optimism/engagement/ flexibility. Hunting for “causes” is often less important than directly learning to handle difficult emotions and change our behaviours. Human problems aren’t simple, often with multiple causes that can’t be easily untangled. Fixating too much on the cause of problems can be very unproductive. The underlying ACT model provides meaningful, helpful explanations of distress which increase engagement, self-compassion and action.

5. The therapist has a treatment plan consistent with the explanation, which makes sense to the client. If a client feels understood and accepts that a treatment plan will be effective they’ll stick better to it. Look for good, clear treatment plans with your psychologist.

6. The effective therapist monitors client progressin an authentic way. It’s crucial that a psychologist measures how their clients are going so that progress is clear. Look for psychologists that use appropriate scales, discussing their purpose clearly, and that pay attention to progress monitoring tools, tailoring their approach to results.

7. A flexible approach is key to good therapy and counselling. It’s important for psychologists to be able to adapt their approach when it isn’t working or if progress is too slow. The psychologist is open to new information, tests their hypotheses and most importantly is willing to be wrong.

8. Effective psychologists don’t avoid difficult or painful areas, and in fact uses difficult areas to most effectively help their clients. Often we can be avoidant of painful thoughts and feelings. Good therapists pick up on when their clients are avoiding a tough topic and can gently explore these difficult areas in a professional and helpful way. It might be uncomfortable for the client, but ultimately is a critical quality of an effective therapist.

9. The effective therapist communicates hope and optimism. This is relatively easy for clients progressing well, however, those with severe and/or chronic problems perhaps need this even more. ACT therapists love working with clients who have failed other approaches – they know well what doesn’t work, and are keen to try something new! Effective therapists acknowledge struggles and yet engender hope that the client can and will get unstuck.

10. Psychology is a field that is growing quickly, there is stronger research being done constantly that helps us understand how best to treat our clients. Effective therapists keep up with the best possible research related to their clients. Look for therapists that are committed to staying on the cutting edge of psychological science.

Those are 10 traits that make a therapist effective at treating their patients. You can check out the full paper here if you like for all fourteen of the traits. Therapy can be a fantastic investment in health and happiness, and it’s important to choose a therapist who will be effective at helping you achieve your goals. If you’re starting with a new psychologist, or on the lookout for one, you can use these 10 traits to figure out if they’ll be effective at helping you.

3 Steps To Finding the Right Psychologist For You

This is the first in the Brisbane ACT Centre’s two part series on finding a psychology practitioner that’s perfect for you. In this post we look at how to look for psychologists and choose between therapists. In the next segment we’ll explore what research shows makes for a great psychologist.

A wealth of clinical studies finds that psychotherapy is highly effective, and more and more modern research shows that therapy is at least as effective for treating depression and anxiety in the short term as antidepressants – without common side-effects. And psychotherapy is clearly more effective for treating depression and anxiety over the longer term.

There’s a huge number of skilled and qualified psychologists in Brisbane, so how do you choose the one that’s right for you? You’ll be working together with the psychologist that you choose, so it’s important to find someone that will be effective and the right fit for you.

Word of mouth

For many people finding the right therapist starts by asking for recommendations from friends, family and their doctor. Asking people you know for a recommendation is a great way to find a capable therapist.

However some people won’t be comfortable asking friends and family for a psychologist recommendation, which is completely fine. Your own search for a psychological professional can be a very private journey.

You may also want to do some personal research instead of asking for a recommendation to choose the person that’s just the right fit for you. After doing some research you can discuss your options with your doctor, friends or family.

Research

Use your favourite search engine to find websites for psychologists close to you. Look for the practical information that you’ll need, like how close the psychologists office is to your home or workplace, or if the hours are convenient for you.

Read how the psychologist describes themselves and their career, looking for clues along the way about if they’d be a good fit for you. Overall you should be trying to figure out if this is someone that you can be comfortable with. If the psychologist has a video talking about their work then use that as a way to figure out how comfortable you’d be working with them.

Commitment to Understanding Modern Therapeutic Approaches

Behind the scenes the science of psychology is fractured, many psychologists rely on old and outdated therapeutic approaches that have been superseded by much more modern, evidence based approaches. It’s a good idea to look for a therapist that shows a commitment to learning, growing and being on the cutting edge of modern psychological science.

There are many schools of valid psychological science, we personally endorse Acceptance and Commitment Therapy (although we’re a bit biased!) because it’s an incredibly well researched and evidenced based approach to therapy. There are however lots of other schools of thought to explore, and provided the therapist shows that they’re committed to staying current in psychological research you’ll know you’re in good hands.

Summing Up

To summarize the first step to finding the right therapist for you are to ask friends and family (if you’d like a personal recommendation) and discuss with your doctor. Research the necessary practical information around locations, schedules and fees. Just as importantly research the more intangible information around how comfortable you would be with the therapist. And finally look to make sure that the therapist is committed to delivering the best possible treatment with the most modern and effective approaches.

Next week in part 2 in the series we’ll look at the characteristics that make an effective therapist according to scientific research. While you’re looking for the right psychologist for you take a look at our team at the Brisbane ACT Centre. Our entire team are hand picked for their warmth, professionalism and rigorous commitment to staying on top of the most effective forms of therapy.

Acceptance – Getting Comfortable with the Uncomfortable

By Michelle Carroll-Walden

Can you recall the last time you had a pebble in your shoe?

You knew it was there, but you were too busy to be bothered.

Maybe you were running late for the bus or trying to enjoy the view. But each time you took a step you were reminded of how uncomfortable it was. And not feeling comfortable is not acceptable. So you decided to stop what you were doing and get rid of the offending culprit… that annoying little pebble.

But what if that pebble can’t be so easily tossed?

What if you can’t stop to get it out because you’ll miss the bus? Or worse still, you just can’t find it in your shoe. So you have to put up with it all day, knowing it is there and there is nothing you can do. How uncomfortable. How unbearable.

Sometimes our thoughts or feelings are a lot like that annoying little pebble. They can be painful, irritating, uncomfortable, and even unbearable. We can choose to ignore our thoughts. We can distract ourselves with social media or shopping and it seems ok for a while. But just like the annoying pebble in your shoe, those uncomfortable thoughts or feelings will not go away. And as that pebble starts to dig in, we may even take drastic action to rid ourselves of it. We may avoid friends, family, or activities we enjoy. We may even try to lose ourselves in addictions, such as drinking, drugs or gambling. Despite our best efforts those uncomfortable thoughts or feelings will always remain. But unlike the annoying little pebble they cannot be so easily tossed away. And trying so hard to get rid of them can cost us so much in terms of living! These costs can range from direct health impacts, to huge credit card debts, to pushing away the very people we most love and care about.

So what’s the answer?

It’s about learning to get comfortable with the uncomfortable! It’s about a willingness to let the pebble stay in your shoe. It’s about not struggling with it so much, or pushing it away so hard. It’s about not allowing our stories, our thoughts, our uncomfortable sensations, to consume us. It’s about becoming aware that they are there but not letting them to take us away from the view – of what really matters most to us in life – the very things which may well bring up those difficult thoughts and feelings.

Of course acceptance isn’t as simple as tossing out a pebble. It’s a tricky skill – but a skill we can quickly learn, and gradually improve upon day by day. And what are the costs of continuing to struggle? What are you missing out on? Who are you pushing away?

Could you be willing to leave the pebble in your shoe and learn to sit with the discomfort, in kindness and self-compassion, if it means you get to enjoy the view?

Ten things you can do to deal with depression

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So you find these dark periods are here again. You may try many things which help somewhat but depression keeps coming around. You don’t want it, and you don’t like it. But when it is here anyway, here are some tips which may help:

1. Allow yourself to feel the way you feel.

Society and social media would have you believe that something is wrong with you if you feel depressed. Of course these feelings are unpleasant and you don’t have to like them, but they are normal, common and occur to everyone to various degrees. Feeling depressed is unpleasant enough, but in addition you may feel guilty, angry, sad or anxious about being depressed. Just being ok about whatever you feel can lessen these secondary emotions.

2. Become aware of your thoughts and don’t take them all as gospel.

Taking your thoughts at face value would be like heeding every piece of advice and advertisement you hear on the radio. It’s more useful to know you are listening to the radio and hearing an advertisement. You have thoughts but your thoughts are not you. Many of our thoughts are automatic and just pop up, and may not be that helpful. Seeing your thoughts for what they are gives you a chance to decide which ones to pay attention to.

3. Put your efforts towards changing your actions rather than your thoughts and feelings.

We have the idea that we need sort out our thoughts and feelings first before we can make changes to our lives. The research shows that it is the other way around, that the only part you can control are your actions . Your thoughts and feelings will likely change if you engage in different actions.

4. Bring your attention to the present moment.

When you have lots of difficult thoughts and feelings, they can demand all your attention so that you go about your day in on auto-pilot. Expand your awareness to include what there is right here and now, using your five senses, and notice small details with openness and curiosity. So you may notice feeling sad, as well as apprehensive as well as doubtful, as well as hear birds, see trees, taste your sandwich, see your friend’s face……

5. Set time aside to practice mindfulness.

There is nothing magical about mindfulness. It is paying attention in a purposeful and open way. It is a skill that needs repeated practice, like running or swimming. You can practice mindfulness doing every day activities such as having a cup of coffee, brushing your teeth, washing dishes, walking and driving. There are many great apps available with audio guides to assist you, including “Smiling Mind” and “ACT Companion”.

6. Connect with what is important to you.

Sometimes being depressed is so unwanted that you spend all your efforts trying to feel better, thereby behaving in ways that are at odds with what is important to you. You may value meaningful relationships, nature, learning, or helping others. Find opportunities to put these values into actions. The things you care deeply about are often on the flip side of what causes you pain or distress. You may feel guilty about withdrawing from your family or not turning up to work – the flip side of that may be because you value connection and contribution.

7. Take lots of small steps repeatedly to build helpful habits.

Make changes in your behaviour in the direction of what you value, no matter how small that seems. Lots of small actions in the right direction will be more helpful than setting big unrealistic goals, then feeling overwhelmed and guilty when you don’t do them. Build helpful habits over time that will help you handle depression in the future when it comes around again. Some of the most helpful habits are exercise, healthy eating and meaningful relationships, and they all take time and repeated actions.

8. Be grateful for what you do have, do something for others.

Life can be extremely challenging at times, but in the midst of that we can usually find things that we can be grateful for ways to help others. Research shows that actively fostering gratitude and compassion can counteract depression, and that doing something for others boosts the giver’s happiness even more than the receiver’s.

9. Cut yourself some slack and be kind to yourself.

Many of us find it easy to be kind to others, but find it hard to cut ourselves some slack. When you beat yourself up about something, imagine how you would react if you were listening to a friend telling you their struggles, and see if you can give yourself the kindness you would give to a friend.

10. Seek professional help if you are struggling.

This can include a whole range of allied health and medical professionals. However be aware of quick fixes or grand promises. There is a role for prescription medications from your GP or psychiatrist. However the evidence is that for mild to moderate depression, there are many other treatment options that work better than or as well as medication. They include exercise, relaxation techniques, and a whole range of psychological treatments including cognitive behaviour therapy and mindfulness-based therapies such as Acceptance and Commitment Therapy. The advantage of the non-drug treatments are that you have skills you can use throughout your life, and without the side effects. In the end it is about respecting your preference and helping you be aware of all your options, and if required, using medications in the safest possible way while minimising side effects.

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The Struggle with Sleeplessness

One of the key tools that the world’s foremost sleep coaches at the Sleep School use is acceptance and commitment therapy, or ACT. Guy Meadows nicely described ACT as “a revolutionary research-based psychological tool that recognises that it is our struggle or reaction to pain and suffering that actually makes them worse.” ACT promotes mental flexibility, openness and curiosity, so rather than struggling against negative thoughts and feelings, we learn to observe, accept and then let them go.

So how does this relate to chronic insomnia?

Research and clinical experience points to the struggle with sleeplessness is the critical process instigating and sustaining insomnia. Older approaches such as traditional cognitive behaviour therapy sometimes focus on getting rid of symptoms associated with poor sleep. Trying to block out or challenge certain thoughts, or remove anxious feelings. When it comes to the struggle with sleeping (as with anxiety, sadness, and so many other struggles), the thoughts and feelings end up coming back stronger, in greater numbers and with more frequency. Your energy is inadvertently put into trying to get rid of what you don’t want, rather than into what you do want, which is to sleep.

What if a sleep expert found he couldn’t sleep?

In the introduction to his fantastic “Sleep Book” Guy Meadows recounts when the thought popped into his head “what if I became an insomniac to?” Finding himself sleep sleepless, unable to switch off, his mind bringing up more and more worrisome thoughts, “I’m the guy who helps other people to sleep and now I can’t!” While his body wound up the tension, anxiety, urgency… Deep breathing, muscle relaxation, trying to clear the mind, all backfiring. Eventually falling asleep in the early hours of the morning. And the following day those thoughts showing up with even more urgency. He struggled to think back to what he used to do to get to sleep… nothing! Struggling with thoughts and feelings about sleep entangled and prevented. ACT skills are fantastic in this area.

How will we know this is working for you?

Is what you really want less worries about sleep, less agitation in the body, or simply more sleep? Is the quickest way to that battles with the mind, struggles with the body, or opening up to whatever thoughts and feelings are happening, letting them come and go as they will if we can but only actively let them, letting your body do its thing. Guy’s program helps his English clients discover how the struggle to sleep actually prevents sleep, learned through experience what they cannot change, through active coaching how to open up to those thoughts and feelings, to build a new sleeping pattern, and connect this with deeply held values for their personal and broader lives. We can’t take you to London, but we can train you in the skills to help sleep soundly, and live fully.