Thursday, August 25, 2016

Social Anxiety Series Part II: Breathing and How to Regulate It

photo credit

There are a number of techniques and treatment to help us cope with social anxiety. For instance, breathing is very important, obviously, it keeps us alive. However, if our breathing becomes uncontrolled it could lead to physiological changes in our body that may increase anxiety. So the key is to monitor your breathing rate and pattern.

Like for example, you are in a social situation and suddenly you feel dizzy, your vision becomes blurred and you experience light headedness. This may be a result of over breathing which cause an oxygen reduction in some parts of the brain.

Accordingly, over breathing for a longer period of time may make you lose energy and makes you feel exhausted. And that is why when you experience anxiety, you feel dizzy, you experience hot flashes or sweat because when you feel anxious, you started to breathe fast.

So how do we regulate our breathing? There are two kinds of breathing, one is chest breathing and the other is stomach breathing. So the way to determine how you are breathing is to put your hand on your collar bone and the other hand on your stomach and take a deep breathe. If your stomach expands with less collar bone movement, you are breathing through your nose which is a good sign that your breathing is helpful. However if there is more chest movement, it means that you are breathing through your mouth, and this kind of breathing is usually related to  anxiety.

How you breathe is the key so here are ways to help you control your breathing.

1. You can sit comfortably on a chair with your legs apart or you can do a yoga sitting position on the floor. Make sure that you are comfortable in your position.

2. When your shoulders, chest and jaws are relaxed, slowly breathe in through your nose.

3. Relax and breathe in and expand your waist so your stomach inflates. (you can place your dominant hand over your stomach to check if it inflates when you breathe in.)

4. Breathe naturally. Avoid deep breathing.

5. Breathe out through your mouth and release the air from your chest.

6. Maintain breathing low and slow and focus on the movement of your stomach.

You can use this technique whenever you feel symptoms of anxiety to positively cope with it. However, it may take a while to get use to it.  So practice until it becomes your second nature. Till next time and I hope you find this post helpful.

Thursday, July 28, 2016

Social Anxiety Series Part 1: How to Identify Unhealthy Thinking Styles

It is sad that anxiety is keeping you from doing things you would have love to do.
It is common to feel shy and anxious in social situations.  For most people they would overcome these uncomfortable reactions and would proceed to accomplished the task and go through with it. But others cope with it by avoiding the situation which would distract their daily lives and hinder them from doing the things they want to do.

Take note though that social anxiety is not being able to feel all the emotional, mental and physiological discomfort but the number of times you avoid social situations because you don't want to experience the way it makes you feel . You suddenly began to hide from anyone or stay away from situations because  even the thought of it makes you feel anxious, makes your heart beats faster, makes your palms sweaty, your breathing becomes irregular and you become light headed and feel like fainting. These reactions would make it impossible for you to function effectively.

These are the common signs of Social Anxiety 

  • Palpitations - your heart beats so fast in social situations or when you are doing an act.
  • Shaking and your  breathing  becomes short and you feel like choking.
  • You feel the tightness in your chest and it makes you want to vomit.
  • Hot flashes and you feel like you are going to faint
  • Numbness and your throat and mouth becomes dry
  • Blushing and may feel hypersensitive to criticism and what others thinks
  • Avoid social contact and reluctant to involve in social situation in fear of doing or saying something wrong.
  • Avoid social performance.
There is a general assumption that people and situation cause the way we feel. We have the tendency to think that the way we feel is based on the what people do and what certain situations we are in. But there is what we call a thinking-feeling connection which means that our thoughts actually influenced the way we feel. There are different kinds of automatic thoughts;  Neutral thoughtI will make a presentation in the class today.”   Positive thoughtI can do it.” And the Negative thoughtI am going to fail and everyone will laugh at me.” These negative thoughts will often lead to feelings of anxiety and cause you to suffer emotionally. This is what we also call “unhealthy thinking styles” these thoughts often becomes a default thinking mechanism which makes it impossible for us to process “healthy” thinking. 

Accordingly, our thoughts create different emotions, so it is important to recognize what you are telling yourself or what were you thinking and how it makes you feel before or during an action. 

There are different kinds of unhealthy thinking styles for example:

·         The Mental Filter - this is when you only think of one situation that could happen and ignore any other possible outcome.

·         The Shouding and Musting - These are not always unhealthy thinking. But if you find yourselves making unreasonable efforts to achieve the expectations you make to yourselves and others, this will cause pressure and anxiety.

·         Jumping to Conclusions – this is where we assume or make prediction about the worst that can happen. For example: I am going to fail, people will laugh at me. I am going to say something stupid, people will not talk to me and think I am weird, and a lot more.

·         Overgeneralization - this is when you gather all negative assumptions and apply it to your present and future situations.  For instance, if you tell yourself ‘I will never be good at…, I will always fail, or everyone will think I am not smart enough… 

·         Personalization – this is when you blame yourself every time something bad happens or you think will happen.

·         Labeling – this is when you identify and behave yourself according to the global notion that categorizes or classifies people. For example, when you say ‘I am a shy person, I will never do well in a crowd, I am not a good public speaker or I am always the clumsy one. These types of unhealthy thinking will somehow create a self-fulfilling prophecy which often leads to anxiety and stop you from making progress.

·         Catastrophizing – this is where the “blow out of proportion” phrase comes in. It is when you think that something bad, awful or embarrassing will happen before the action actually happens. This will lead to fear and anxiety and will often lead to avoidance.

·         Emotional Reasoning – this is when your perception of the situation is based on how you feel towards it. For instance, when the only proof something bad is going to happen is because you feel bad about it or when you make a conclusion that it is true base on your emotions and feelings. For example, when you tell yourself  I feel like I am going to make a mistake , I feel that my skills are not good enough…etc.

·         Black and White Thinking – This is when you think that you can either passed or fail. And there is nothing else you can do about it.

·         Magnification and Minimization – This is when you compare you performance based on the thought that others are great and your performance doesn’t matter. You have the tendency to magnify the accomplishments of other people and then you think less of yourself.

So, how do we identify "unhealthy" thinking styles and what can we do about it.

#1 Identify your feelings - Do you feel tense, anxious, panicky, uneasy, nervous, scared, exited, calm, euphoric? and the list goes on. In this case, common feelings associated with social anxiety are only mentioned.

#2 Identify your automatic thoughts – it is common for people to have "unhealthy" thinking style and a lot of them have overcome it by adapting positive coping skills. These are examples of unhealthy thoughts  "I am going to fail", "people are going to think I am stupid", "I will look foolish" , "I have always failed, so why is this different"  and so on.

#3 Remember thoughts are not feelings – you may say “I feel nervous” when you are actually thinking 'people will laugh at me if you make a mistake.' Also, you are probably thinking that people are expecting you to perform well therefore, you feel anxious or tense. Often times it is difficult to determine feeling from thinking. The key is to identify what you tell yourself and how you feel about it.

#4 Identify feelings from thoughts – doing an exercise on making a connection between your thoughts and feeling can be helpful. You can write a journal about different situations where you usually feel tense or anxious, what are the statements (unhealthy thinking) you often tell yourself and then determine how it makes you feel.   For example, you are going to make a class presentation (situation). Then you tell yourself, “My teacher is very strict, I am going to make mistakes and fail (unhealthy thinking) you feel anxious, nervous and scared (feelings) then your heart started to beat fast, you start to sweat and feel like you are going to faint (physiological reaction).

#5 Create alternative thoughts – once you identify the cycle, go back to what you tell yourself/ unhealthy thinking and replace it with positive alternative thoughts.

For example you can tell yourself…
  • This is my first time, when I am done, I would be happy I did what I can.
  • I feel anxious but I will focus on my performance, the feelings I have now will be gone once I am done.
  • I will do what I have to do and whatever that result is, there is always something I can do about it if not, I can let go and move on.
  • What I feel right now is part of the process, once I get used to it, the feelings will slowly go away.
  • I am focus on what I can do at the moment.
So those are the tips you can do on your way to overcome social anxiety. Please stay tune for more coping strategies and techniques. If you have any questions or suggestions please feel free to leave a comment or send me a message.

Wednesday, July 13, 2016

How To Overcome Test Anxiety


Settling in for the new school year can be challenging. Aside from adjusting to new professors and thinking about how to even pass every requirement, taking the test can be one of the difficult task one has to complete. Test Anxiety is one of the common issues a student encounters and it is one of the academic dilemma students face every school year.

Most often students complain that they don't have much time, apparently the "too many things to do too little time" is the oratorical statement when it comes to school and time management. However, students can best benefit from time management, study skills and helpful techniques to create a low anxiety stress resistance academic lifestyle.


TIME MANAGEMENT TIPS

  1.  Prioritize - Identify your goals and your engagements and rank them base on their importance.
  2. Work on a system - Develop a 24 hours time tracking system so you have a full view of what your    daily task will look like.
  3. Study Priority List - Create a weekly study priority list base on your test timetable . Mark down chapters that you need to study and set your timing when you are most efficient. Study the topics you find difficult to the ones that you find easier.
  4. The "Hit List" - Create a list of daily study task so you can tick it off once you complete them.
  5. Divide your task into chunks so you don't get overwhelm and by dividing it into steps you will find it easier to accomplish it.
  6. Create a yearly Calendar and note down all the test you need to take and the requirements you need to comply so you have an overall idea of what to accomplished first.
  7. Create a Weekly Study log which includes the specific date you need to take the exam or complete a requirement and prioritize them in your study time table. 
  8. Time Limit -  set a time limit when you study. That way you don't find yourself lingering around instead of focusing on the task you need to do.
  9. Do not procrastinate.

STUDY SKILLS

  1. Organize your school materials that way you don't waste your time looking for them when you instead needed to study. Organize school handouts or syllabus in specific folders and tag them, if you must so that it is convenient for you to retrieve it.
  2. Set up a study space where you most feel efficient and productive. Stay away from the things that distracts you and take only what you need to help you study. 
  3. Put your phone on stealth mode and turn off you social media tabs if you need to.
  4. Refresh yourself before you start to study and make sure you hydrate yourself every so often.
  5. Use study tools to help you achieve productivity. Use highlighters to emphasize important details and use the dictionary to check the words you are not familiar with.
  6. Do not memorize information. Read and understand what it means and how it applies to your daily life, the community, or other people's lives. If you are a visual person, you can draw mind maps or illustrate them in the best way beneficial to you.
  7. Use social media to connect with other people and ask them what they think about the topic that you are studying. But make sure you don't linger too much and find yourself doing things not totally related to what you are studying. So again, focus.
  8. Highlight the phrases or concepts you don't understand and formulate questions you can ask your teacher to clarify it and get another view point.
  9. Ask yourself how relevant is the topic to you and why not.
  10. Relax, take a deep breath, take a short walk and begin again.

POSITIVE SELF TALK

Here are example of positive self talk excerpt from Saint Louis University Student Success Center to replace the negative talk you often tell yourself.

  • "I failed the course last semester, but I can now use my study/math skills to pass this course."
  • "I went blank on the last test, but I now know how to reduce test anxiety."
  • "I know that with hard work, I will pass math."
  • "I prepared for this test and will do the best I can."
  • "I feel good about myself and my abilities. I am not going to worry about that difficult problem. I'm going to use all my test time and check for careless errors. Even if I don't get the grade I want on this test, it is not the end of the world." 
So I hope you find these tips useful. Good luck to a productive school year ahead. For more questions and feedback please comment below or send me a message.

Monday, July 11, 2016

Me Before You Decoded


Recently, I have come across a debate on the movie that has swept our feet into an ecstasy of love, chemistry and romance in its 21st century plot. And while I too gush over the hormone induced thrill of its twist I noticed that there is something missing, and no I am not talking about the morals of assisted suicide or  the rights to decide when to end life no not even going there not at all. But while the cheerful and bubbly Louisa Clark at the found herself going for her dreams, I mourn for the lost hope. Then I wonder, if only and if only mental health have been given a little role will it end differently?

While I can't speak for everybody, it is but understandable that often times the cheapest end to  life for a person that has become angry, moody, bitter and disabled would seem a better option as opposed to preserving a life which would only cost so much more than living a lifestyle of an average person. But what about the person's rights to a positive, productive and encouraging life? or is it ending life the convenient option?

Stephen Hawking once said, "I have noticed even people who claim everything is predestined, and that we can do nothing to change it, look before they cross the road." the point taken is, there is always something we can do about it. And this doesn't just include people who are confined to a wheelchair for the rest of their lives but for anyone who succumb to a life threatening experience or the trauma of surviving everyday and the important of mental health care. Living a positive and a life full of hope is still an option and We Can Do Something About it.

Monday, October 12, 2015

Mental Health Awareness 2015: Dignity in Mental Health


The 10th of October was World Mental Health Awareness Day and the Graduate School of Psychology Assumption University of Thailand was happy to take  part along with the student volunteers to raise awareness about the importance of mental health and our responsibility as psychology students and counselors to help decrease stigma about seeking mental health support on this year's theme "Dignity in Mental Health."


In connection to this, we set up a booth at The Assumption University Bangna Campus to raise awareness among the undergraduate students and assist them with free testing and interactive activities.


This year it is also the aim of the world health organization to stop the stigma and that people with mental health condition can be able to live with dignity as well as provide them with sufficient support. The aim is to be able to provide healthcare professionals with appropriate and adequate training to be able to respond to every need.


Every year, the Graduate School of Psychology, Assumption University of Thailand helps create public awareness and reaches out to the younger generation so they can be informed about the importance of mental healthcare and to seek support when needed. 


Qualified volunteers assisted the students as well as some of the staff take free testing on stress, happiness and provided them with information and follow up assistance should there be any questions regarding the result of the test.


There was also a movie presentation about suicide prevention, body image and depression as well as information on how and where to seek help. We also hand out bookmarks with positive affirmation and useful school supplies to serve as positive reinforcements for their participation.


The students also took part in interactive activities such as writing positive affirmation and sharing it on our "what makes you happy" board. They also took part in our survey as well as come by the booth to ask and talk about mental health related issues and how can they, as young people be able to help raise awareness.


We were also graced with the presence of distinguished psychology professors and counselors from the student affairs who also provided us with more information regarding possible collaboration, workshops and symposiums which would benefit the students.


All in all, we are very happy for the positive outcome of the event. The students as well as some of the staff from Assumption University of Thailand Bangna Campus welcome the team with warmth and although the students were busy with their exams, some of them came by to show their support.


The team had a wonderful experience reaching out to the public, providing information about the importance of mental health and by showing that as future counselors we are prepared to take part on the band of mental health professionals help stop stigma and assure that people with mental health condition will be provided with appropriate support and too live with dignity. Job well done team! your effort and service are so much appreciated as well as to our professors and adviser who gave their support to make this event possible. 

“Life is a kaleidoscope. Turn your head a different angle and see it a whole new way.”
–Anonymous

Sunday, June 21, 2015

Reflection: Group Therapy Workshop



“Some of the most comforting words in the universe are “me too.” That moment when you find out that your struggle is also someone else’s struggle that you are not alone, and that others have been down the same road.”

Putting your wall down and telling strangers your struggles can be very intimidating. But suffering in silence and thinking that you may be the only one in the world who has to go through a difficult time can be even more severe.. Therefore group therapy offers a support network, where people of different backgrounds and personality come together to share and offer feedback to a common issue everyone is going through in a group.  Therefore, by talking about their experiences and sharing their feelings about it, people tends to bond towards the group hence finding support where they all gain strength through sharing.

However, I have noticed that for most of the members in a group, it is easy to assume the counselor's seat and to give advice rather than sharing their own feelings. So the challenge is how, as a facilitator can we encourage sharing among the group and avoid "group bonding" towards one person; which would rather make that one person thinks that he is the only one struggling, making that person feels that his private self has been violated which would often result to that person not wanting to share again.

Well, I am very new to the profession and to be honest, I still have so much yet to learn when it comes to the various kinds of counseling. But in particular, I believe that in group therapy, sharing is the support, rather than giving advice.

So, what is group therapy?

Accordingly, group therapy is where people come together to talk about issues that concerns them. It is a safe place where everyone shares and learn to interact with each other. It is where people freely shares, listens to each other and provide feedback. It is also where one learn so many ways on how to cope with difficulties by learning different ways how to cope with it. Therefore, it is very important that people in the group shares common issues and to openly discuss.

So my initial thoughts was, what is the role of the facilitator? what are the common challenges a facilitator faces while keeping the group together and be able to maintain a safe place for everyone. While there is no limit to the setting, there must be some kind of a goal so that each individual in the group can benefit from it as well as it can move on as a group, towards a common goal which to be able to find healing and yet again, support.

Well, it was my first time to actually come to a group therapy workshop. And my goal was, as a beginning Counselor, I wanted to know how to be able to facilitate the group as effectively as I can as well as know the role I am going to take in the group.

"Partly because I do trust the group, I can usually be quite loose and relaxed in a group even from the first. That's overstating it somewhat, for I always feel a little anxiety, perhaps, when a group starts, but, by and large, I feel, 'I don't have any ideas what's going to happen, but I think what's going to happen will be all right,' and I think I tend to communicate non-verbally that, 'Well, none of us seems to know what's going to happen, but it doesn't seem to be something to worry about.'" I believe that my relaxation and lack of any desire to guide may have a freeing influence on others."

And so my further study lead me to an article by Carl R. Rogers, where he sited 13 points to keep in mind when facilitating a group such as: Group Acceptance, Individual Acceptance, Emphatic Understanding, Operating in terms of feelings, Confrontation and feedback, Expression of my own problems, Avoidance of Planning and "Gimmicks", Avoidance of Interpretative or Process Comments, Physical movement and Contact, Trust in the therapeutic Potentiality of the Group, Being Aware of your own faults, Special Problems and  Non-Facilitative  Behavior.These key concept will help the facilitator become aware of the role he plays in the group therapy and his share of influence.

Therefore, it is noted that the role of the facilitator is to support and encourage self expression among the members. He is to assure that there is mutual trust and emotional safety within the group environment. The facilitator in all ways must display active and empathy skills and be able to use his counseling skills to facilitate should there be important issues or key themes to be addressed in the group. Importantly, the facilitator must ensure to help the group transition smoothly from an open process group to the psycho-educational part of the session.

In conclusion, as a facilitator, one must be willing to allow a member to participate or not to participate in a group. Every member should feel that they at some point can withdraw personal participation and not be coerced. Doing so, it will allow members to most likely open up on the next sessions knowing that they are not force to do or say something that they are not ready to express. It is also important for the facilitator to allow silence and observed if there is a presence of unexpressed pain or resistance. Also, we have to accept every statement at their face value and avoid judgement, that we are willing to believe what the person is saying rather than trying to "psycho-analyze" what it really means. The key is not to control the group and what happens within it but to assure that there is a sense of trust, and respect.

I still strongly believe that each one and every therapist, beginner or expert, unite to one solitary goal. And that is to provide an honest therapeutic environment where each individual finds healing and comfort in embracing being one with others. To let every member know that they are not alone and there are others who they can walk side by side with.

Thursday, June 18, 2015

Summary & Reflection: Workshop on Effective Communication Skills for Beginning Counselors


“Fie, fie upon her! There's language in her eye, her cheek, her lip. Nay, her foot speaks; her wanton spirits look out at every joint and motive of her body.”  William Shakespear

 In today's society where everyone want to be heard, we at some point have forgotten how significant it is to listen with the purpose to understand. To pass our message across, we often find ourselves profusely talking, to eagerly share because we have too much information and we wanted to be heard. But as a counselor, a neophyte to the professional like myself, there is that strong need to learn the trade of being an active listener, to seek to understand rather than to be understood. So, by learning to decipher Nonverbal Communication Skills, it will somehow bridge the communication gap which we have often overlooked.

Non Verbal Communication is define as sending messages in various ways without using verbal codes or words. These are unconscious, unintentional or intentional gestures which are displayed as body language. As a beginning counselor, it is therefore very important to distinguish body languages in your clients as well as being aware of the messages that you also convey. Non Verbal Communication can be displayed as: paralanguage (sounds), smell, word choice or syntax, posture, intonation, dress, gesture, proximity, eye contact, vocal nuance, glance, volume, touch.

So what is the role of Nonverbal Communication Skills in the counselling practice? Dr. Maria Bella Bamforth, keynote Lecturer on Effective Communication Skills in Counseling stressed that in a study done on the Effectiveness of Spoken Communication  by Albert Mehrabian (UCLA), the meaning of the language consisted are derived of 7% spoken words, 30% paralinguistic and 55% facial expression and other body language. Julius Fast, author of Body language pointed out that, “We all, in one way or another, send our little messages out to the world... And rarely do we send our messages consciously. We act out our state of being with nonverbal body language. We lift one eyebrow for disbelief. We rub our noses for puzzlement. We clasp our arms to isolate ourselves or to protect ourselves. We shrug our shoulders for indifference, wink one eye for intimacy, tap our fingers for impatience, slap our foreheads for forgetfulness. The gestures are numerous, and while some are deliberate... there are some, such as rubbing our noses for puzzlement or clasping our arms to protect ourselves, that are mostly unconscious.”

One of the key point on good communication skill is active listening. By observing nonverbal communication skills a counselor can assess the reaction of the client to her words or actions. Also on her Lecture, Dr. Maria Bella Bamforth, keynote speaker on Effective Communication Skills, pointed out the importance of active listening. Active listening wherein a person is motivated to listen with intent and purpose. She further discuss that active listening requires that the listener focus on the words and the feeling of the speaker, use feedback to verify understanding and pay attention to the various meaning conveyed in the message. It is also important that the listener talk less, understand and analyze what is being said, must not be preoccupied with her own thoughts, able to control prejudices and keeps pace with the speaker.

Key Communication Skills for Counselor

Develop Rapport - It is very important to develop and build trust in clients so that an effective line of communication will be achieve and that issues will be discuss as soon as possible. 

Ask Appropriate Questions - In your conversation with the client. It is very important to use open-ended questions to encourage a wide range of possible answers. 

Reflect the clients feeling - This is when the counselor reflects back the feelings of the client. It can be attain by validating the clients words. A counselor can ask questions such as, "You feel that you are under valued in your job..." etc. 

Paraphrase Clients Words - Summarize the clients words in a clear and direct form. This is to show that you are keeping pace with your client and you seek affirmation that you have understood the client.

Use "Encouragers" - This is where the counselors uses verbal or nonverbal cues to encourage the client to continue talking. You can repeat keywords, use facial expressions or verbal affirmations.

Clarify Mixed Messages - This is where the counselor re-affirms, restate and paraphrase the client's words to clarify. *Clarifiers are often use to ensure that messages are understood both by the counselor and the clients.

Lead and Focus: In a conversation, it is very easy to get lost in so many topics and issues. The role of the counselor is to focus and direct client to issues which needs to be prioritize and be address as soon as possible.

Summarize - At the end of the session, it is important for the counselor to give a brief summary of what took place in the conversation. Review what the client have said and express in the conversation so that both the client and the counselor can move on.

To add, I as an aspiring counselor also learned the importance of Nonverbal Communications such as: Facial Expressions, Eye Accessing Cues, posture and gestures. The counselor will have more understanding of the message within the conversation through observing nonverbal communication clues. For example, the most "articulate" expression of body language is the eye movement. Accordingly one can tell so much about the person by looking through their eyes, after all, it is the window to the soul. 

Giving importance to Behavioral Responses is the fundamental factor to an effective communication. It is when your thoughts ceases, to welcome the thoughts of others. I once read a quote that says, "just once, when I say oh, I'm fine. I wan't someone to look me in the eye and say, Okay. now tell the truth." Our communication system has somehow overloaded, in fact, there are more ways than one means of communication; even which our text have also been replaced with emoticons which implies varied ways of how one feels. Voltaire once said, "one great use of words is to hide our thoughts.” As an aspiring counselor, I feel that there is so much for me to learn in terms of the technicalities of being an effective listener. But really, the challenge is how do we show our clients that we understand, that we feel that gap in their shoes, to just look them in the eye and tell them, "tell me about it"  without even saying a single world.