Psychologist versus Psychiatrist: Who should I see?

Okay, I’m totally going to put my foot in it here and offend someone I’m sure but I assure both professions that I mean no harm. I am a psychologist but I work closely with many psychiatrists and have a great deal of respect for the work that they do. Let me explain quickly what the difference is between psychologists and psychiatrists and compare the training of these professionals.

Psychiatrist: Is a medical doctor and in Australia this means they have studied a minimum six year Medical Degree. Then, in addition to this they have studied a specialised program in psychiatry beyond their hospital internship. They are highly qualified as you can tell. They can prescribe medication and for the most part hold a predominantly medical perspective of your mental health. I’m not saying that they discount psychological and psychosocial factors, they just specialise in the medical field and so they bring this philosophy to their conceptualisation of you.

Psychologist: A psychologist has completed a minimum of an undergraduate degree of four years and two years of at work training before they can become registered. Some psychologists (including myself) have completed an additional 2 years of postgraduate Masters degrees in a specific area such as clinical psychology, educational psychology, or counselling psychology. These specialisations don’t necessarily dictate the type of practice they have adopted though their training likely influences their philosophies and conceptualizations of you (and therefore also your treatment).  

So… The sorts of things you may want to ask yourself are;

Do I want a pharmacological  treatment approach to my issue I am facing (do I want to take medication?)? If so, then a psychiatrist is your best choice but it may not be your first choice. Many psychiatric illnesses can be treated with psychotherapy alone and in other cases a combination of psychotherapy and medication are a better option than just medication alone.

Do I want a diagnosis? Is so, a psychiatrist again is the practitioner you need to see to get a formal diagnosis. This said, psychologists are well trained in the DSM (diagnostic manual) and can provide you with insight and a plethora of information without formal diagnosis. Their diagnostic conceptualisation of you ultimately often guides them in their treatment approach.

What type of therapy do I need? There are lots of different therapeutic approaches. Some demonstrated as being more beneficial for certain issues people are facing. You may have heard of some. If not, check here for some examples…. Some therapists have specific additional training (beyond university) in certain treatment modalities. Find out this info…

What does the presentations does the therapist have a particular interest in? If you have an eating disorder for example, find a therapist who states they have an interest in this area. If you have been given a possible BPD diagnosis, you might like to find a practitioner with an interest in personality disorders (me for example :o))… Practitioners with particular interests keep up to date with the latest research in their area of interest and so are likely well equipped to help you with what you are dealing with.Psychology today is a great website to search for practitioners.

Now, throw all of this information on the sidelines for a minute and I’m going to tell you the single biggest contributing factor to your improvement in your mental health. What do you think it is??

Okay, well, I’m here to tell you that it is not the practitioner’s training. It is also not the type of therapeutic model they adopt. It is also not the number of years they have studied. Research has demonstrated repeatedly that the single biggest factor to your improvements in therapy is the quality of your relationship with your therapist. That’s right!!! The quality of the rapport that you have with your therapist.

So…. Research your therapist choice. Read what they have written, check out their blogs, look at their website, check out their profile photo, arrange a brief phone call, stalk them on facebook (LOL). All of the above. This will give you more knowledge than any letters they have by their name whether they are the right therapist to help you.

Peace and happy journeying….

If you’ve liked what you read here and think I may be a good fit for you, you are welcome to send me an email or call me with any questions you may have.

1% Pledge

I am so proud to announce this news…

As this new financial year begins, my business has partnered with Reachout Australia to donate 1% of our annual income to this cause.

For those of you who don't know, ReachOut is Australia’s leading online mental health organisation for young people and their parents. It offers practical support, tools and tips help young people get through anything from everyday issues to tough times. #reachout 

https://about.au.reachout.com/

For anyone with a business, have you considered joining the 1% tribe? ☺️☺️

If you have a suggested charity Tristan Abba Psychologist can support next financial year please comment below.

A Unique Opportunity to Work on Ourselves

Much of the world has been seemingly placed on pause at the moment. Many people have been placed in challenging situations regarding their employment or inability to access the services they previously required. In my practice I have been witnessing significant decline in many people’s mental health over the past fortnight due to circumstances being taken out of their control. So how do we adopt an attitude of resilience at this time and focus on the things that are within our control rather than being overwhelmed by that which is not? Here are some tips I am sharing with my clients at the moment…

First is to focus on our thinking. I am prone to a bit of catastrophic thinking, I’ll happily admit to this. How’s yours right now? Are you able to call yourself on your own BS you have playing in your head about the world around you? Do your thoughts end in doom and gloom for yourself, your family, your life? If so, now is the perfect time to change this.

Stop.

Breathe… (now more slowly and deeply, twice if not three times)…

Step back from social media, the news, people with pervasively pessimistic opinions.

Ask yourself these questions: “What evidence do I actually have that this catastrophic end I am imagining is going to eventuate? (feeling like something is true doesn’t mean for a second that it is - you’re feelings are NOT always reliable assessors of reality). What evidence can I find to suggest that it actually might not happen? What would someone older/ wiser/ kinder say to me if I shared my fears with them?”

These questions can help give us some perspective on our thinking always with the goal of bringing us back to the present.

Second is to focus in on our selves and ways we can improve. You have the time right now to do this. I know, you’re kids are climbing the walls and have completed their online school work by 840 am but if you really want to, you can make the time (a lot of other activities are no longer options at the moment, right? How can you take advantage of this time). Self-work is non-negotiable for many mental health professionals. It’s like brushing your teeth for psychologists. Without reflection on ourselves we stagnate and become unhelpful to our clients.

Making your self improvement a non-negotiable part of your week validates your growth and evolution as a human being. Now is a great time to do this, particularly in Australia where all online counselling (phone and video based psychology sessions) are open to the public and are wholly bulk billed under a MHCP. This is an amazing time if you have ever been interested in doing counselling with a professional that may have been out of your reach financially in the past. Reach out to someone who specialises in something you are struggling with and see if they are offering this service - you are no longer limited to people in your home town. Check out psychology today to find someone;

https://www.psychologytoday.com/au/counselling

Amazing!

Alternatively, the NY Public Library released a free App this past fortnight with 300,000 of its books available to read for free to the world. 300,000!!! Search away for self development opportunities. The app is called SimplyE.

Third is to focus on RAP. I say this again and again but Responsibilities, Achievements, Pleasures. There are some incredible resources becoming available to the world currently online for fun and entertaining activities, learning opportunities and growth. Use this global pause to lay down new routines for yourself that will serve your future self well. This is your only responsibility to yourself at this time. Create new habits in mindful activities - reading, meditation, puzzles, gardening, art….

Be kind to yourself. Now as always…

How to Process Emotions

Many of the people I meet in my practice want to stop being affected negatively by past events or experiences. But what does this really take? One answer, is the processing of emotions that are attached to the memories. So I thought I would take a brief look here at what ‘processing’ really looks like.

There are many forms of psychotherapy out there. In my Gold Coast psychology practice, I adopt an individually tailored approach that adopts aspects from several of the alphabet soup collection of evidence-based therapies. You may have heard of some of them; Cognitive Behaviour Therapy (CBT), Acceptance & Commitment Therapy (ACT), Dialectical Behaviour Therapy (DBT), Motivational Interviewing (MI) and Eye Movement Desensitisation & Reprocessing (EMDR). The reason I mention these is that regardless of what therapeutic modality we adopt to build new skills, the underlying ‘processing of emotions’ remains a necessary component of our healing and runs as an undercurrent throughout your psychology sessions.

This is what emotional processing looks like in step by step form. You don’t need a therapist to do this, though a helpful and non-judgmental person may help you along the way for reflection and encouragement.

1)      Notice: Pay attention to your emotional state when either recalling a past memory or in-the-moment when your emotions are triggered. Take a deep breath. Feel. Don’t think. Feel. Notice what is happening. Bring your attention to your present experience as much as you can.

2)      Name it/ them: State what you feel. “I am sad” “I feel angry”. If you can’t pinpoint a word, try an emotion wheel like this one (I’ve left it big so you can print it out for the fridge if you like).

3)      Feel it: Stay with the feeling, even if it is hard. Notice what it feels like in your body. Stick with it through your discomfort. These are only feelings.  

4)      Relax into it: Take a few deep breaths. Notice if the feeling changes or shifts. DON’T JUDGE YOUR EXPERIENCE. Notice how your mind may try to take you out of it.

That’s it… Processing your emotions is one of the simplest yet most challenging things we face psychologically as overthinking human beings. Research indicates that the more skilled you are at doing this though, the less intra-personal (within yourself) and interpersonal (with others) conflicts you will face.

Keeping a journal can help to take this experience further or help you to deeper understand yourself. It can also help you see patterns in your thinking-feeling relationship and what triggers pop up frequently in your life.

Moving your body can be a really helpful way to process some of the physiological energy that emotions create. Dancing, yoga, running etc. Express the emotional state you are feeling. There are healthy ways to express all of the human emotions that don’t involve harming yourself or anyone else in any way.

Take care everyone and be kind to yourself. If you want some practice processing emotions, drop in to our Burleigh Heads psychology clinic or email me directly for more information.  

Note: If you’re reading this and are experiencing suicidal thoughts and have not practiced something like this before, I urge you not to, and instead call Lifeline (131114) or the Acute Care Team (1300 MH CALL) if you do not feel safe.

Likewise, if this practice becomes too overwhelming, I encourage you to enlist the help of a mental health professional for support. Don’t judge yourself. It’s just a practice like any new skill.

Coping with Anxiety and Stress this Bushfire Season

In the midst of Australia battling some of the worst bush fires it has ever seen, it has been impossible to avoid the media coverage of the events unfolding around our country. The click bait links to red skies, Armageddon like visions of people stranded on beaches and singed koalas been fed water by firefighters are unmissable. This all taking place not all that far from my home in the Gold Coast. It made me begin to wonder the cumulative effect of this on our anxiety and stress levels. It’s interesting also in the context of this new year time, when people have come off the back of depleted nervous systems following a week of excessive booze, unbalanced meal plans and dealing with Auntie Sherryl’s opportune comments over Xmas. At a time when anxiety is already potentially heightened from people’s own self-development expectations as a new year looms.

I notice the public riled up. Angry and blaming towards a government head as he is the easiest target to cast fear driven shame. Climate change becomes a daily conversation and everyone is an expert it seems. Now, before I give you some functional psychological strategies for this time of our lives, here are some ways you might be making your anxiety and stress worse this fire season.

1.       Trying to force people to agree with your climate change perspectives

2.       Avoiding everyone who seems anxious or distressed

3.       Surrounding yourself with solely anxious or distressed people

4.       Quickly borrowing solutions to the fire crisis from people you follow on social media or ‘experts’

5.       You act as though the apocalyptic view of Australia portrayed on histrionic media stations is actually true

6.       Using all of your energy to focus on raising others from their naivety and ignore your own needs and your family

7.       Focussing more on Scomo’s behaviours around people instead of your own

8.       Venting to others without first calming yourself down to a rational level

9.       Over-functioning for Australia or your immediate surroundings when you feel frustrated

10.   Convincing yourself that the Prime Minister must change in order for you to calm down

All of these are stop gap measures to relieve our anxiety or stress. But they do little to increase our capacity to endure and tolerate these experiences. These actions make us sensitive to dramatic news stories and distract us from being our best, more logical calm selves.

On the opposite spectrum, here are the opposite of these behaviours. People who manage these are more likely to be calmer as a population during challenging times.

1.       They develop their own balanced opinions on this situation over time instead of borrowing them from others

2.       They respond based on the facts rather than their (or others’) imagination

3.       They can be around climate change sceptics and Greta alike and feel able to think for themselves

4.       They try to self-regulate before asking to be reassured

5.       They can be flexible in their thinking around the fires, climate change, and yes, even Scomo

6.       They focus on managing themselves rather than changing others

7.       They accept that anxiety is a natural part of real psychological growth

Please take care fellow Australians whether you are immediately affected by the bush fires or not. Although I don't want to minimise the travesty of this fire season, I don’t think it is helpful to magnify it. This is not the end of our beautiful sunburnt country. There will no doubt be significant change from it. And I only hope that learnings will come to people with power from this experience. Right now, much is out of our control yet our reactions, our anxiety in the face of these situations can be helped.

I have no professional training on climate change, fire fighting, politics and indeed, the Apocalypse. Although reading between my satirical lines you may find a personal opinion on these matters, my intention was not to push one. I have the deepest respect for the firefighters working in their roles and the greatest of sympathy to those who have lost lives, loved ones, or their homes in these blazes.

The counselling room...

Image courtesy of Upsplash

‘In the Psychologist counselling room, you aren’t defined by your past.

You aren’t defined by your past actions.

In this room your thoughts and feelings are legitimate and valuable. These are what will define you.’

Don't Let This Thought Ruin Your Day

Photo courtesy of Pixabay

Okay, the truth is that there are so many specific thoughts that could be potential culprits here but I wanted a catchy headline so apologies for misleading you. But… What if i could give you a list of the most common general thoughts that trip up everyone at some time or another and leave us feeling angry, shameful, stressed or depressed? Then if you can recognise that you are thinking (or are about to think) one of these, you are empowered to stop this thought ruining your day by coming up with a more reasonable, kind, or self-empowering thought. Wouldn’t that be great!?

The thoughts I’m talking about here psychologists refer to as Cognitive Distortions (Cognitive=thought, Distortion=misleading). Now I must admit, when I was learning this stuff back in second year Cognitive Psychology, I never liked the term Cognitive Distortion much so let’s just call them Brain Farts. It’s kind of apt, it’s less technical, and, well, it sounds funnier…

Believe it or not, brain farts are there to protect you. They provide an immediate go-to thought in new, challenging or stressful situations when your prefrontal cortex (the part of your brain best adept at complex thought processing) isn’t engaged. Doesn’t make sense? You’re thinking, ‘in challenging situations, my prefrontal lobes are totally active and that’s how I solve the problem’. And yes, you’re correct. At the end of your challenging situation this is often the case but at the acute, beginning point of challenge or stress, your brain is in survival mode where you need to react to survive. Thinking and considering various options doesn’t help when you are faced with an angry moose (moose are really angry creatures I learnt recently). When faced with an angry moose, you need to react in order to survive and your brain knows this, so it generally shuts out your complex / creative thinking prefrontal cortex and instead relies on tried and tested automatic algorithms of thought that were designed many evolutionary years ago to get you out of danger. Unfortunately, it is these same algorithms that can sometimes seep into your consciousness at times when you don’t need them (i.e., non-moose situations). And this is how the evolution of brain farts (cognitive distortions) has transpired.

Image courtesy of Squarespace

From here on,  I’m going to use one, single common situation here that could very well occur in your day to help you to see how each of these brain farts (BF) can accidentally emerge (pardon the pun). The hypothetical scenario we’re going to imagine is when another driver pulls in front of us quickly but we didn’t see them because we were texting or checking our phone. With this, we will explore the various ways we might cognitively react to this experience.

Brain Fart #1: ‘all drivers are such idiots’ ‘everyone in this city drives like shit’ OR, ‘it’s not safe to drive on the roads ever anymore’ ‘I’m always nearly having crashes’

In these examples, we are Overgeneralising by using one (or a few) experiences to generalise extensively. Look for the words always or never in your thoughts. Overgeneralising often leaves us feeling negative towards others or if it involves self-blame, negative towards ourselves.

Brain Fart #2: ‘It must have been an Asian/ white / male/ female/ young/ old / sportscar/ truck drivers’ (you choose the stereotype you most often fall back on).

Here we are Jumping to Conclusions. We didn’t see the other driver. Sure it explains the event and displaces blame from ourselves but it can also create misplaced anger and ongoing unnecessary resentment to certain people (or types of people) in this case. Not a happy way to start your day.

Brain Fart #3: ‘OMFG, i nearly crashed and if i did i would have to call mum and OMG I wouldn’t have a car and how will i get to work and i’ll lose my job but i don’t have the money to fix the car and i’ll have to borrow money from somewhere or i’ll lose my job and then i’ll become destitute and then i’ll won’t be able to pay my rent and i’ll have to … etc etc’ OR ‘i’m never going to drive again because it’s just too risky’

Okay, you get where I’m going with this. This is called Catastrophising and it is the hallmark of anxious thinking destined to increase your stress levels and ruin your day. As soon as you start thinking ‘what if…’, pull yourself up

Brain Fart #4 & #5: ‘I’m such an idiot, I shouldn’t have been texting’ OR ‘what an idiot, he should have been watching where he was going, what is he, blind?!’

These are both examples of two common TFs; Labelling and Should Statements. Labelling is really useful for fight/ flight situations when we need a quick solution. With time, a reasoned approach to this scenario might be that both drivers were in some ways at fault but in an emotion-fuelled moment, the brain will often resort to ‘us vs them’ logic and attribute blame wherever it is most in a habit of doing, leaving us occasionally feeling better in the case of self-righteous indignation but often worse in the longer term.

Shoulds, oughts, musts, are all telltale words to look out for in your thoughts. They’re absolute rules there for our brain to provide quick solutions but often leave us feeling negative, rigid, or shameful.

Brain Fart #6: ‘They cut me of because they didn’t like me’ ‘That truck driver must have cut me off because I have such a lame looking car’ ‘people have no respect for older drivers’

Here is an example of personalisation or taking responsibility for things that are not (solely in this case) our fault. In the scenario described, there are many possible reasons why the other driver cut you off. Personalisation of the event is possible though often improbable where a more simple explanations is more likely. The other driver didn’t see you, or simply misjudged their lane change perhaps?... Maybe they’re just having a bad day, maybe they’re trying to get their wife in labour to emergency? Who knows but more often than not, it has nothing specifically to do with you. Personalisation emerges frequently in people with more fragile sense of selves or lower self esteem. Be mindful of thoughts that involve self-blame and take a moment to analyse these.

Brain Fart #7: ‘All male/ female/ young/ old/ Asian/ white/ truck/ sportscar/ Holden/ Ford drivers are bad drivers’

This is called ‘All or Nothing’ or Dichotomous Thinking. It’s fraught with danger because there are no absolutes in this amazing world we live in. We all make mistakes and there are plenty of white/ asian/ male/ female/ young/ old/ truck/ sportscar/ Holden/ Ford drivers out there with all sorts of grey degrees of driving skills, right? Worse yet, if you are applying dichotomous thinking to yourself such as in ‘if i’m not perfect i’m a failure’, it is toxic! Allowing more shades of grey into your mind will enable you more cognitive peace.

TF #9: ‘I’m so angry now because of that driver!’

Final Brain Fart for this scenario is probably the most common because it is so easy for us to fall into the trap of. In this example, we are straight-out Blaming someone else for the way that we feel. ‘BUT IT’S THEIR FAULT!’, I hear you yell. Well, even if it was wholly their fault and you weren’t texting and even if they cut you off on purpose and even if they flicked you the bird as they did it and they yelled out “lame car” to you, here’s the clicker, and I say this to almost every one of my clients;

You, and only you, are responsible solely for the way that you feel.

So own this responsibility. Change your thoughts and your feelings can follow or accept your feelings and watch them pass. Either way, don’t blame them on someone else. This will only leave you feeling disempowered and definitely ruin your day.

If you want more information about brain farts or more diverse scenarios where they might be applying to your life, search Cognitive Distortions (brain farts might not come up with what you’re looking for). I covered some common ones here but there are many others including Magnification, Minimisation, & Emotional Reasoning. The point of knowing this information is bringing aware to your own cognitive tendencies and over time practicing new and more helpful self-talk to replace them.

Take care people and be kind to yourself, always.

Oh, and don’t text and drive…