All the rage

https://youtu.be/6JVDj2rEOas

All the Rage is a feature film about Dr. John Sarno and others who are pioneering mind body approaches to treating chronic illness.

This film is to be shown in Melbourne at Cinema Nova Carlton on Sunday September 3rd 2017 at 6.30pm. You can listen to local practitioners and find out about local resources.

For bookings contact rosehoey@gmail.com

Learn to use Dementia Care Mapping – new course in Melbourne November 2016

We are holding a new Learn to use dementia Care Mapping course to be held on November 28-30 in Eltham, Victoria. This course is an introduction to DCM and licenses you to use this powerful tool in your own workplace to improve quality of life for people living with dementia in residential and day care settings.

The cost of the course is $1375 incGST. You will be provided with all materials, lunch and refreshment breaks.

To register contact Bernie McCarthy at bernie@mccarthypsychology.com.au or on 0408 145 819.

The course is provided under license from Bradford University, UK by BMAC Education.

Express your feelings?

I once had a client who said when I asked what feelings he felt, “I don’t seem to have feelings”. This dismayed him and his eyes began to fill up. Slowly it dawned on him that he did indeed have feelings and that he experienced them so rarely that he thought he had no feelings at all. This was normal for him.

On the other hand I have also had clients who seem to have so much feeling that they come in weeping or angry and have difficulty talking without exploding in tears or rage. Usually it is tears as we are not all that comfortable to express rage in front of others.

Feelings are an important dimension of being human and they are present in all of us. If we are biologically human we have feelings. I am sometimes asked, “But if I have feelings, tell me what they are because I can’t feel them?” Examples of feelings include love, sadness, anger, rage, gratitude, guilt, grief, and anxiety.

How we experience our feelings can vary from person to person. In some households you may find that there is so much feeling expressed that it seems chaotic and out of control, even unpredictable. This brings us to a distinction. There is a difference between EXPRESSING and EXPERIENCING.

Expressing is when we do or say something with our feelings, i.e., Cry when we are sad, or hit or shout when we are angry. This becomes aggression. Anger is the feeling and aggression is the action or words. Experiencing on the other hand is when we have the physical experience of the feeling inside our bodies, without expressing it.

To help understand feelings better here we can identify three parts to a feeling. There is the COGNITIVE label or thought that goes with a feeling, i.e., we know we are angry and recognise it.

The second part is the physical experience of the feeling in our body. This is slightly different for each feeling. Sadness, feels heavy, comes into our chests and causes us to fill up with tears and crying so our nose runs and we have tears. Anger on the other hand is hot and it rises from our stomachs into our chest and up our spine into our shoulders and arms, We form fists and clench. We feel stronger and breather faster in readiness for action.

Anxiety is different again. In anxiety we have a sense of something coming from above and pushing down, raised heart rate in palpitations, dry mouth, shakes, tight chest causing sighing, increased need to go to the toilet to pee, and muscle tension in various body areas. Anxiety can also go to our gastro-intestinal tract, causing pain, nausea and bloating. If anxiety becomes chronic the muscles can become stuck in a tense state causing significant pain. Third, anxiety can affect our senses so we have temporary visual problems, hearing difficulty, or a sense of feeling drifty or in some cases blank out altogether for brief periods, leaving us with no memory for parts of conversations. Other words for anxiety include stress and tension.

The third part of a feeling is the IMPULSE. This is an urge we have to act in a way that releases the rising energy generated by the physical and cognitive parts of the feeling. This may be the impulse to cry, to hit, to shout, to hug, to walk up close to someone you love, look them in the eyes and tell them you love them.

When a feeling is experienced it is all internal, not communicated to others and is not expressed. All feelings can be experienced without expressing them.

When a feeling is expressed it is discharged or exploded out and others can see it or hear it in the actions that we have the urge to do or words we want to say.

An example is anger. This is the feeling. It is internal to the person and is experienced as heat rising like a volcano. As described above it causes a rising sense of strength and the impulse is to strike out, to grab, to throttle or to kick. We rarely give expression to this impulse so most of the time people around us are safe. However, some people have trouble containing the impulse to act and they express the feeling in aggressive or even violent actions, i.e., road rage.

Some households have a lot of expressed emotion flying around. They shout at each other, swearing and calling each other names when they feel anger toward each other. These are rarely emotionally safe places to grow up. Children form defensive shells around themselves, learn how to handle feelings and intimacy from watching their parents and other adults and do the same themselves. They are often punished for it by the very parents they are modelling.

Couples can sometimes engage in expressing feelings to each other and this can be destructive if it is done in the heat of the feeling and without respectful concern for the emotional safety of the other person.

Expressing feelings is not as healthy for us as experiencing the feelings, knowing what they are and understanding the meaning of the feeling for us. This is all internal and only then does it lead to external actions toward other such as raising a concern, sharing thoughts and having a discussion together to reach an understanding of an issue that concerns you both.

For example, people will say to me, “But what do I do with it once I experience it?” The answer is understand it. If a couple are angry with each other and discharge their anger by shouting and calling each other names, swearing at each other or making statements about their past behaviour in anger or rage, the feeling is expressed but is this helpful? Not likely. The most likely result is that there is increased distance between the people and they do not communicate easily. There is silence and hurt. This can create loneliness and isolation.

The other alternative may be if both parties notice they feel angry, experience it internally, understand why they feel angry, understand the importance that the other person’s actions or words have had for them and only then once the feeling is understood, they engage with the other person to share their thoughts and that they have felt angry.

This is much more emotionally safe for each person. Words are not said in anger and people are not hurt intentionally because the love we have for the person is also felt alongside the anger. It is true that we can experience more than one emotion at a time. I have had clients say to me, “If I get angry that means I don’t love them anymore.” We can feel angry at the people we love most in the world.

Experiencing feelings first is more emotionally safe, better for relationships and better for us individually than expressing emotion without the experience.

See what feelings you can recognize in yourself. Monitor your own inner emotional life more closely by noticing what changes in your body when you have interactions with others. How do you feel when you are waiting for your partner to come home? Love? Anger? Sadness? Joy? Gratitude? All of the above? Nothing?

Expressing or discharging emotions does not communicate feelings and create understanding. Rather it pushes people away and creates hurt and loneliness.

Experiencing feelings enables us to create intimacy and closeness with others that is respectful, safe, and enjoyable. It also enables us to be productive in our work because our energy is available for creativity and effort. Finally it enables us to experience pleasure and enjoyment in our lives.

 

I was at a funeral last year and it struck me that sadness

I was at a funeral last year and it struck me that it is acceptable to cry at a funeral if you were close to the person because the person was important to you. But if the person was not particularly close and you still feel like crying you may find yourself thinking that it is not OK because you were not close enough to them to justify feeling so overwhelmed and sad.

I am interested in the fact that we put such restrictions on when and how much we can feel sad. Only if we are close enough, only if the loss was big enough to justify it etc.

This flies in the face of the fact that sadness is just that. Sadness. It is the normal and natural feeling we have when we feel loss of something valuable to us, perhaps loved. There may be many reasons we feel sadness come up in us at a funeral of someone we were not particularly close to. It may be that it touches off memories of someone we were close to in the past. Or it may be that we saw someone else crying and that was enough to trigger our own sadness. Or it may be that we are feeling loss in some other area of our lives, other than loss of someone by death, i.e., loss of a job or moving to a new town and feeling sad about losing the old town. Having an argument with your spouse can make you feel sad about the distance it creates so you find yourself crying.

It is important here to distinguish between reasons we cry. We cry because we are sad. But we also cry because we feel overwhelmed by strong feeling such as anger and so we discharge it by crying it out, as if the tears wash the feeling away. It can seem like a relief afterward but this relief is due to the fact that we were becoming anxious/tense about the feeling becoming so intense. We felt overwhelmed and so cried to get rid of it. This is not as healthy as the tears from sadness.

Sadness does not have a calendar to it so as with all feelings, it doesn’t know that the death was a long time ago. It just knows that you feel sad right now.

You do not need to have a good reason to feel sad. Your psyche knows you feel sad so you will feel sad and then once the sadness has been felt in its entirety you will find the insight comes that helps you understand what it was about.

Emotions do not have reasons. The reasons come afterward to help us make sense of the feeling.

So sadness is a valuable emotion. It tells us how much we have valued something or someone we have now lost. This is important in loving relationships that we can know how much we have loved those we lose in death. Sadness tells us how much we love.

Gratitude is an old fashioned word we don’t hear much in everyday conversation

Gratitude is an old fashioned word that we don’t hear much in everyday conversation these days. Yet, it is the oil that greases the wheels of human relationships and makes us able to get on with each other so much more smoothly than we do without it.

Gratitude is simply thankfulness. I have noticed in some relationships people do not express gratitude for anything others do, but accept the kindness or thoughtfulness of others as if it is just a given, something to take for granted, that is always there. Some even seem to expect kindness and thoughtfulness and become annoyed when it is not readily available, but do not express gratitude for it when it is offered.

Being thankful is a way of recognising that what someone has done for us has been noticed and we are better for it. It recognises that the other person is important and offers them this recognition as a way to say, “I see what you do for me”. In effect this is like saying, “I see you and I value you”.

Close relationships are built on a capacity to accept another person in your life and allow them to affect you emotionally and psychologically.

Gratitude is a way to recognise that the other person has done something that has a beneficial effect on us, and we welcome this closeness. We welcome them into our lives.

Expressing gratitude for what others do for us is also a recognition that we are not islands, self-sufficient to ourselves, but need others and rely on others for much in our lives. These acts of gratitude may be for simple acts such as that someone has cooked a meal for us, or offered to drive us somewhere, or folded our clothes for us, or asked us if we would like a cup of tea/coffee.

Being grateful is a way of recognising the other person’s thoughtfulness, valuing it and letting them know that you understand you are better off because of them.

Often in long-term relationships it can easily slip into an acceptance that the other person in the relationship does what they will do and will continue doing what they do, and that we don’t have to keep thanking them for it. However, this can lead to the kindness, thoughtfulness and generosity of others becoming invisible and not being valued by either party. The solution is gratitude.

The type of gratitude I have in mind is regular small thanks for regular small things. Each time someone does something for you thank them for it. Thanks for making breakfast. Thanks for taking the bins out. Thanks for listening to me rant on. Thanks for tea. Thanks for doing that for me.

Thanks for reading.

 

 

 

 

Feeling is not doing

We are often afraid of our anger, that feeling anger means we should be guilty. But what have you done by feeling it? Nothing. Feeling is not doing.

We frequently get feeling and acting mixed up as though feeling angry means we have been aggressive. Let’s get a few things straight. Anger is a feeling and aggression is an action or words. One is interior (anger), and the other is exterior (aggression).

The feelings we have are a normal part of being a human being. They are a physiological response we have to experience and so are an integral part of relating with other people, the world around us and our own inner experience.

Take for example, the sadness we have when we lose a person we love in death. This is a normal reaction and not something pathological. We grieve because we have lost someone we loved. The grief is an indicator of the depth of love in us for that person. In this way sadness is to be welcomed because as painful as it is, it is never the last word. Love is.

Often when we have lost someone in death there is also anger toward the loved person. So we feel sadness and anger and love, all mixed in or one after the other in close succession. This can be confusing and cause guilt in us as if we are being unfaithful to the person by being angry with them. We feel what we feel – no judgment. It just is. if you feel angry about them leaving you in death or for any other reason then that is what you feel. Once you feel it deeply enough you can get to the bottom of why you feel angry. Just give yourself enough time to feel all of it without loading it up with judgments.

Keep it simple. Feelings are OK because they are a natural process we experience as much as breathing is a natural process. Feelings are like our emotional skin to the world.

If we let feelings be themselves, feelings will come and go. I often hear people say (as a justification for not crying) “If I start I won’t stop”. This is not sadness talking, it is anxiety. Anxiety that you will be out of control if you let yourself feel sad. So we avoid it. This has the makings of depression if we sit on our feelings and won’t let them be felt.

This brings me to my last point. Experiencing is not expressing. This is the difference between anger and aggression. Anger is an experience, and aggression is an expression of the angry feeling. I am encouraging you to experience rather than express your anger or whatever other feelings you have

Notice in yourself how you relate with your own feelings. How much anxiety do you have about experiencing (not expressing) your feelings? Give yourself close attention so you notice the physical experiences that make up your feelings. This means practicing self-monitoring, or self-observation. If you don’t do it naturally, you may have to learn to do it by practicing is regularly, daily and just notice your inner sensations. What do I feel right now?

 

Take

Psychotherapy at McCarthy Psychology Centre

People who may benefit from therapy with Bernie McCarthy may present with the following conditions:

  • Anxiety (panic, agoraphobia, OCD, generalised worry, phobias, Post Traumatic Stress Disorder)
  • Depression
  • Medically unexplained symptoms (MUS) including chest pain, back pain, jaw pain, headaches and migraines, skin conditions including psoriasis and exzema, reflux and bowel disturbance
  • Eating disorders
  • Personality disorders
  • Fibromyalgia
  • Chronic fatigue
  • Transient cognitive disturbances such visual blurring, going blank, mental confusion
  • Relationship distress and life changes
  • Grief
  • Many of the above conditions will present with co-morbid depression/ anxiety.

For more information on the approach Bernie uses in therapy please click on the link here.

AGE

13years +

FEES

First session is a trial therapy of two hours – fee is $280.00 (out of pocket $155.50). Subsequent sessions 50-60 mins – fee is $195.00 (out of pocket $70.50). A low fee is charged for patients on government benefits and pensions and in some circumstances bulkbilling is appropriate. Discuss this with Bernie McCarthy

Medicare rebates under Better Outcomes for Mental Health program

AVAILABLE:

Monday to Friday 8am to 6pm

CONTACT FOR APPOINTMENTS

For appointments call 0408 145 819. The link above will take you to the page for details of location, fees, and Medicare rebates.

 

DSM-V is here – beware fad diagnoses

Professor Emeritus Allen Frances MD, the distinguished US psychiatrist was Chair of the DSM-IV and writes in Psychology Today of his concern about the quality of changes made in DSM-V to mental disorder diagnostic categories and criteria that have been recently released in the new edition of the Diagnostic and Statistical Manual of Mental Disorders (5th edition).

He lists ten worst changes urging readers not to adopt these diagnoses in their work:

1) Disruptive Mood Dysregulation Disorder: DSM 5 will turn temper tantrums into a mental disorder- a puzzling decision based on the work of only one research group. We have no idea whatever how this untested new diagnosis will play out in real life practice settings, but my fear is that it will exacerbate, not relieve, the already excessive and inappropriate use of medication in young children. During the past two decades, child psychiatry has already provoked three fads- a tripling of Attention Deficit Disorder, a more than twenty-times increase in Autistic Disorder, and a forty-times increase in childhood Bipolar Disorder. The field should have felt chastened by this sorry track record and should engage itself now in the crucial task of educating practitioners and the public about the difficulty of accurately diagnosing children and the risks of over- medicating them. DSM 5 should not be adding a new disorder likely to result in a new fad and even more inappropriate medication use in vulnerable children.

2) Normal grief will become Major Depressive Disorder, thus medicalizing and trivializing our expectable and necessary emotional reactions to the loss of a loved one and substituting pills and superficial medical rituals for the deep consolations of family, friends, religion, and the resiliency that comes with time and the acceptance of the limitations of life.

3) The everyday forgetting characteristic of old age will now be misdiagnosed as Minor Neurocognitive Disorder, creating a huge false positive population of people who are not at special risk for dementia. Since there is no effective treatment for this ‘condition’ (or for dementia), the label provides absolutely no benefit (while creating great anxiety) even for those at true risk for later developing dementia. It is a dead loss for the many who will be mislabeled.

4) DSM 5 will likely trigger a fad of Adult Attention Deficit Disorder leading to widespread misuse of stimulant drugs for performance enhancement and recreation and contributing to the already large illegal secondary market in diverted prescription drugs.

5) Excessive eating 12 times in 3 months is no longer just a manifestation of gluttony and the easy availability of really great tasting food. DSM 5 has instead turned it into a psychiatric illness called Binge Eating Disorder.

6) The changes in the DSM 5 definition of Autism will result in lowered rates- 10% according to estimates by the DSM 5 work group, perhaps 50% according to outside research groups. This reduction can be seen as beneficial in the sense that the diagnosis of Autism will be more accurate and specific- but advocates understandably fear a disruption in needed school services. Here the DSM 5 problem is not so much a bad decision, but the misleading promises that it will have no impact on rates of disorder or of service delivery. School services should be tied more to educational need, less to a controversial psychiatric diagnosis created for clinical (not educational) purposes and whose rate is so sensitive to small changes in definition and assessment.

7) First time substance abusers will be lumped in definitionally in with hard core addicts despite their very different treatment needs and prognosis and the stigma this will cause.

8) DSM 5 has created a slippery slope by introducing the concept of Behavioral Addictions that eventually can spread to make a mental disorder of everything we like to do a lot. Watch out for careless overdiagnosis of internet and sex addiction and the development of lucrative treatment programs to exploit these new markets.

9) DSM 5 obscures the already fuzzy boundary been Generalized Anxiety Disorder and the worries of everyday life. Small changes in definition can create millions of anxious new ‘patients’ and expand the already widespread practice of inappropriately prescribing addicting anti-anxiety medications.

10) DSM 5 has opened the gate even further to the already existing problem of misdiagnosis of PTSD in forensic settings.

Allen Frances hopes that DSM-5 will not result in increases in diagnoses that make normal behaviour into something pathological, for instance normal grief into Major Depressive Disorder.

Let’s hope we have some balance in the way it is adopted. However, knowing the human condition we will have excesses by practitioners keen to make a buck out of fads and treatment programs for what was once normal behaviour.

The longer I am a psychologist the wider the range of “normal” gets. DSM-5 seems to narrow it and make some normal behaviour into pathological.