Category: Psychology in practice

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Life in General Managing stress Psychology in practice

Cognitive-Behaviour (Behavior) Therapy: Very effective for stress and Anxiety!

If you are suffering from study pressure, exam stress, or general stress or anxiety….

Cognitive-behaviour (behavior) therapy, or CBT has been to be extremely effective. It is called an evidence-based treatment approach as large, well-controlled studies have proved its effectiveness – both here and overseas.

How does it work?

We all have a stream of thoughts going through our minds every moment of our waking lives. We are continuously having an internal dialogue with ourselves (some of us have this conversation out loud sometimes which can cause other people to look at us funny!).

These thoughts that we have are not necessarily reflecting the truth about things – they are merely our own “take” on life, and can be right, wrong, accurate or inaccurate.

Unfortunately, though, we tend to regard our thoughts as true, and as our thought affect our emotions, we can start to feel very bad – based only on our unreliable thoughts!

For example: if you always anticipate that awful things could happen in the future – your thoughts are often starting with “what  if”…you will undoubtedly feel anxious a great deal of the time!

People usually only dwell on the negative possibilities – like failing (if you are a student) or getting caught in a lift (if you are claustrophobic). Not many people have anxiety about winning the lottery!

CBT helps individuals recognise and alter unhelpful and innacurate thinking patterns so that they can begin to live happier and more mindful lives, free from debilitating anxiety and depression.

If you would like to experience CBT, please contact us!

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Life in General Psychology in practice

Thinking about going for some psychotherapy, counselling or coaching in South Africa?

Will your sessions be paid for by your medical aid?

 

When prospective clients contact my Cape Town based psychology practice for the first time, we invariable bring up the topic of  medical aid payment. For clients on medical aids, the question I get gets asked is – “will my psychotherapy treatment be covered by my medical aid”?

 

There are a number of aspects to this that you will need to clarify  before a definite answer can be given, for example:

1. Is the psychologist, counsellor or coach registered with the Health Professions’ Council and with the Board of Healthcare Funders (BHF)?

Only professionally registered psychologists and psychological counsellors can claim from medical aids.

 

2. Is the registered psychologist, counsellor or coach charging medical aid (BHF) rates?

 

3. Does the psychologist or counsellor require you to pay upfront for your sessions and then for you to claim back the fee from your medical aid, or are they prepared to submit directly to the medical aid on your behalf?

 

4. Do you have sufficient funds in your medical aid account to cover number of psychology sessions required?

Each medical aid has its own benefit structure – some have a savings component for all out of hospital medical treatment, with psychology and psychotherapy treatment coming out of this “pot”, while other medical aids have  a set annual  “ceiling” for psychotherapy (this is the annual amount that is “allowed”, once this is exceeded the member has to pay for their psychology sessions themselves). Some medical aid plans, on the other hand are a combination of these two – there is a ceiling for claims but then once a certain amount has been spent on medical expenses above that ceiling, medical aid benefits again kick in.

In order to find out this information, you could contact your medical aid and quote the code 86205 which is the BHF code used for an hour of psychotherapy (which is the usual length for an individual psychology session)

 

5. Is the diagnostic code the psychologist will be using covered by your medical aid?

For some time the BHF have required health care practitioners to provide diagnostic codes for the treatments and procedures that are undertaken. This is also the case for psychologists. The coding system that is currently used is the ICD 10. When you visit your psychologist for the first time, he/she will do an informal or a formal assessment of your concern or problem, and will be required to note a diagnosis on the statement that is sent to your medical aid.

Some medical aids restrict benefits to particular problems or disorders and may sometimes, therefore, refuse to pay for certain types of issues.  Sometimes, too, medical aids may restrict benefits to certain categories of psychologists, depending on their scope of practice.

This will be a subject for a future post!

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Life in General Maintaining Healthy Relationships Psychology in practice

Cape Town Clinical Psychologist discusses: Your 2012 Resolutions – think relationships!

Most people (even those who don’t believe in New Year’s resolutions) are thinking about what they would like to change during 2012. Most focus, however, on themselves – their health and their behaviour (for example, deciding to quit smoking or embark on an exercise regime).

In my clinical psychology practice, however, I advise my clients to think more broadly about this issue – to think about their relationships.

 I therefore invite you to consider the current health of your relationships with:

1) Your partner/spouse, children and your family:

Ask yourself the following questions, for example…

Is your relationship as good as it can be? Are you able to be honest and authenitc with your spouse? Do you practise a way of interacting with your intimate partner which is respectful and considerate? When you asgue, do you do so in a constructive way, without resorting to “below the belt” tactics such as name-calling? (If there are problems in our intimate relationship it is invariably the case that the partner is blamed for this state of affairs. It is crucial that we each start by changing our own steps in our relationship dance!)

Are your relationhips with your children and your extended family as good as they could be? If you were to die tomorrow, have you told them how you feel about them or do you have “unfinished business”?  Is your will up to date?

2) Your friends and co-workers:

Are you sufficiently supportive and “there” for your friends and co-workers? Are you reliable, dependable and empathic?

3) Your community and environment:

Are you involved in community and volunteer activities? Do you consider your environment and recycle, for example?

4) Your pets

If your pets were able to rate you in terms of how well you meet their needs, what grade would you get? If you have a dog, do you walk him/her every day?

 

I am sure there are many more examples out there in the same vein and I would  be happy to receive your comments in this regard!

Of course, making resolutions is the easy part, like any form of behaviour change sticking to them consistently is a much more difficult thing and a topic in its own right for another post!

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Health and Happiness Managing stress Mindfulness Psychology in practice

Why is it easier to be anxious and depressed rather than happy and relaxed?

It appears that we can blame it on evolution!

 

Why is it so difficult to stop our minds drifting to unpleasant and anxiety-provoking topics? Often this happens in the middle of the night, especially to insomniacs who often find that their thoughts prevent them from getting back to sleep.

Well, evolutionary psychologists put it down to the way in which our brains are wired, says Ronald Siegel in his article entitled “West meets East” in the September/October edition of Psychotherapy Networker (in which he discussed the link between psychotherapy and Eastern spiritual practices, such as mindfulness).

The arguement goes that the human beings of today have survived through natural selection only because, through thousands of years, they are the ones who were constantly on the lookout for danger and needed to be extremely adept at anticipating possible risks and life-threatening situations. So anxiety and fear kept you alive whilst happiness and complacency got you killed.

So, although the world has changed a great deal since the days of our cavemen ancestors, our physiology and the wiring of our brains have remained more or less the same, causing us to react to (usually) benign life events, such as traffic snarl-ups and work pressure, asif they were of the magnitude of a tiger hiding in the shadows, waiting to pounce.

So if we are wired for anxiety and stress, what can be done about it?

First it is necessary to develop an awareness of the problem. Then with the help of cognitive-behavioural techniques (CBT), relaxation training and mindfulness techniques it is possible to gain control of one’s thoughts and to calm down the mind. It is important to take on board that one’s thoughts are merely a product of one’s mind and are not necessarily accurate. It is quite possible to substitute more balanced thoughts for thoughts that lead to anxiety, stress and depression. This will help to calm the mind, paving the way for a more measured, focused and appreciative approach to life, including one’s relationships.

And this can only lead to an inhanced feeling of happiness and contentment!

Categories
Health and Happiness Life in General Managing stress Mindfulness Psychology in practice

If you are a student are you starting to feel stressed about the upcoming exams? Stress management is actually pretty straightforward!

Yesterday I conducted a stress management workshop for a group of Grade 11 and 12 learners. They were saying that they are feeling a great deal of stress and pressure at this stage because of their work-load and the thought of the upcoming exams.

I wish I could talk to all other learners and students out there about the importance of keeping their thoughts focused and not to dwell on the possibility that they might not do well! I use the analogy of the trapeze artist on the high-wire. If he/she allows him/herself to think that they might fall, this will probably happen (it becomes a self-fulfilling prophecy).

It is therefore crucial for students to monitor their thinking and alter their thoughts if they notice themselves becoming negative.  A pattern of “what-if ” thinking, for example “What if I can’t answer the questions in the paper and I fail” should therefore be banished and replaced by thoughts such as “I will do the best I can”. These ideas come from Cognitive Behaviour Therapy (CBT). “What-if””thinking, if not controlled, can lead to runaway feelings of anxiety and stress.

I also spoke to the students about the importance of practicing relaxation and mindfulness exercises to help with focus and to calm the mind. It is also essential to pay attention to one’s body and health at times of pressure and stress – to eat well, exercise and to get sufficient sleep.

By keeping your stress levels in a zone that is optimal for you by doing the above, you will be well prepared, physically and psychologically, for the road ahead. All you will need to add to this recipe for success is a great deal of focused study!

Please contact me if you have any questions about the above or any other aspect of stress management.

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Maintaining Healthy Relationships Psychology in practice

Cape Town Psychologist on: Relationships in Couples – Can you do something to save your relationship?

I have a number of very distressed partners coming to see me for couples counselling at present, at my psychology practice in Wynberg. They either come together (usually one partner brings along a reluctant other half) or on their own because their partner refuses to come.
What can you as an individual do to improve your relationship?

1. Hone your communication and anger management skills

As it takes two people to maintain a destructive arguement, you can make the decision to communicate your needs clearly and to fight fair. If you find you are not able to break the negative cycle you may need to consult someone like a psychologist or psychotherapist to help you master the necessary mind-set and skills.

2. Take personal responsibility for your own actions.

Of course your partner behaves in a way that infuriates you. However, you can make the choice not to react in a negative and destructive way. It is important to find ways that work for you.

3. Accept that constant nagging and criticism will not heal your relationship.

In order to change your interaction pattern into something positive you will need to start focusing on what is good about your partner and to reinforce that. This is hard but necessary. Remember Gottman’s 5:1 ratio – good relationships are characterised by communication that consists of a ratio of approximately five positive, constructive comments to one negative comment.

I suggest you make a start and make some positive changes now before it is too late for your relationship to recover!

For any comments or queries, please contact us.

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Life in General Maintaining Healthy Relationships Managing stress Psychology in practice

Couples in toxic relationships – why do some of us persevere with destructive relationships?

When you know if your heart of hearts that your intimate relationship has become a major source of stress and unhappiness in your life , why don’t you break it off?

All your friends and family are giving you a consistent message that you would be better off without your current partner, why do you steadfastly resist their advice?

In my Cape Town psychology practice I often get clients who find themselves stuck in this position – they often feel desperate – they love their partner but he/she drives them crazy. They have often been in a destructive relationship for a long time and are feeling at the end of their tether.

Why won’t they admit that their relationship is doing them psychological harm, end it and move on with their lives?

The reasons people stay in toxic relationships are often complex and driven by largely unconscious factors such as:

 

1. The comfort of the familiar

In many cases there is the feeling that the bad relationship is comfortable in a sense, because it is known and predictable.

2. Needing to be needed

Clients often reveal a fear that their current relationship may be their last – that they will not find anyone else if they break off  their current relationship. There is a fear of being alone forever.

3. Trying to avoid “bad” feelings

Ending a relationship usually precipitates a sense of loss and mourning, with associated feelings of sadness (and even misery), anxiety, panic, and sometimes may trigger depression. Avoidance is a natural and normal tendency in the circumstances. However, we all need to face such feelings if we want to transform our lives for the better.

3. Poor self-esteem

Some individuals believe that they are not deserving of a caring, supportive relationship and of a happy, fulfilled life. There are, of course, always a number of unique, complex reasons for such an outlook. Often the underpinnings are to be found in the person’s early life experiences.

4. Not being able to say “no” or get their needs met

Clients caught up in toxic relationships often report that they feel unable to insist that their own needs get acknowledged – they often nag their partner to change but to no avail. They are in many cases locked into a co-dependent, enabling dynamic with their parnter where they feel helpless to change things for the better.

5. Believing one’s partner must/will change

Often I will hear “If only my partner were to realise the error of his/her ways and change for the better, our relationship would be good”.

This is a normal, but unfortunately, misguided belief!

It is crucial to accept that we can only change ourselves, if we become more strategic and positive in our interactions with our partners, our relationships have a chance to transform. However, if the other person in the relationship is not motivated to similarly change for the better, you may be doing yourself a big favour if you decide that enough is enough and to move on with your life!

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Life in General Maintaining Healthy Relationships Managing stress Psychology in practice

Cape Town Couple Counselling:Couples becoming parents – be prepared!

 

 

If you are currently pregnant (or that your partner is pregnant), or you have just become a parent for the first time, it is an exciting and challenging time!

 

Newby moms and dads have a great deal to adjust to, so it is important to start the process as soon as you get the news!

So what can you do to make this journey as happy and smooth as possible and  how can you help your partner prepare for this new, exciting stage in your relationship?

1. Communicate, communicate! From the first

moment you find out that you are pregnant, begin to talk to your partner about the implications and ramifications for yourselves as individuals and also as a couple.  Becoming a parent and co-parenting with your spouse or partner presents many and varied challenges – to talk about and explore these beforehand will stand you in good stead for when the baby arrives.

2.  Operate as a team and be there for each other. Ask your partner what he/she needs from you at the various stages of the pregnancy and after the birth. A strong, mutually supportive relationship at this stage will ensure that when the baby arrives, an immediate family bond is established, which becomes a strong foundation for the future.

3. Look out for signs of emotional distress in your partner. Pre- and post-partum depression and anxiety is quite common and mostly goes unrecognised. Although emotion fluctuations are normal in pregnancy and post-delivery because of strong hormonal fluctuations,  if you notice that your partner seems depressed and/or anxious for

days on end, if she has trouble sleeping and stops doing her usually daily activities, it is important that you encourage her to go for counselling.

4. Make sure you are prepared for the delivery (both practically and psychologically).

Whether you opt for a natural birth or for a caesarian section, be aware that things don’t always go according to plan, so it is important not to get too invested in one option as circumstances may dictate a different scenario entirely.

5. Get support from outside.

The first weeks as new parents will be a roller-coaster ride! Make sure you have adequate family and/or friends around for support, as well as nursing/breastfeeding/medical backup.

 

If you have any questions, please do not hesitate to contact me.

Categories
Life in General Managing stress Psychology in practice

Exam stress can be beaten! Develop a strategic approach to your exam preparation if you want to do well!

Doing well in your exams is not only a function of working hard – many bright and dedicated students bet owerwhelmed by anxiety and stress during exams, causing them to  “hit a blank”  at the critical moment.

How good are you at managing your stress?

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Life in General Managing stress Mindfulness Psychology in practice Talking Points in Psychology and Psychotherapy

Mindfulness, psychology, psychotherapy and neuroscience is proving that you can, in fact, teach an old dog new tricks!

It goes without saying that, in the 21st Century, the majority of psychologists and psychotherapists believe that individuals are all capable of making positive changes to their lives, no matter how old they (or we) may be, that change is possible right up to the moment that we take our last breath.

(This was not always the case. Freud, for example, believed that human development was complete after adolescence).

The great news is that increasingly detailed knowledge of the structure and workings of the brain from the exciting and rapidly developing field of neuroscience seem to back up this view. Neuroscientists speak

about “neuroplasticity” of the brain, meaning that our brains are

“a work in progress”, no matter what how old we are and that we are capable of  by doing and thinking in different ways, people are able to change old, counterproductive patterns of behaviour and ways of relating to partners, children and the world in general.

How can this be achieved?

First, old, dysfunctional patterns need to be interrupted and changed. This invariably happens in all forms of successful psychotherapy.

Second, the person needs to be trained to focus their attention in a conscious, purposeful way

Third,  a psychotherapist will help the client identify and then start to practise, new , more positive and healthy habits and patterns of behaviour, forming new neural networks in the brain. (see Pat Ogden, Sensorimotor Psychotherapy, Susan Aposhyan:Body-Mind Psychotherapy).

 

I see it as most encouraging that the new findings coming fromthe field of  neuroscience  provide scientific support to our work as psychologists and psychotherapists, and that psychologists utilising many different approaches, from Positive Psychology to Cognitive-Behavioural Therapy (CBT), all have the above, central elements in common!

 

Reference: Psychotherapy Networker, March/April 2011