Breaking that Depressive Thinking with CBT Part 1 : Procrastination- Depression Cycle

In the first of a series of posts about how depressive and pessimistic thinking can cause major issues in life, today I look at procrastination and how it fuels depression and vice versa. Procrastination can be defined as that invisible wall in front of you, stopping you moving on and using effective methods for beating depressive thinking. Incredibly, in 2010, the APA, in its annual Stress in America report, failed to identify procrastination as a major factor in why people do not follow through on programmes designed to beat stress and pressure. This is even more incredible when survey participants recognised a lack of willpower in healthy lifestyle changes. Most said that this willpower was diminished due to lack of energy and confidence and once one was increased, the other increased too. I think you can see the pattern. In this post, I would like to show that depression and procrastination go hand in hand and need to be tackled simultaneously.

What is procrastination ?

Business people define procrastination as the delaying of deadlines. However, a more serious form is the putting off of personally relevant activities for change. This can have a devastating effect on life and our view of it and ourselves. Procrastination is a process or a series of steps employed to avoid facing fears, situations, possible failure and even possible success. Put simply it is an automatic habit of putting off a timely and relevant activity to another day, month or some undefined time in the future. These timely and relevant activities are replaced with easier or simpler tasks. The link with depression comes when you put off making those necessary changes that might pull you out of depression, often with the thought that you are too weak to face the issues or fears. When depressed, you may view getting started on these changes as overwhelming or impossible or even hopeless. But we must remember that depression and procrastination have overlapping features:

  • Both make you feel uncomfortable at the thought of taking relevant action, making it more likely that we will put off changes.
  • Both contain elements of rumination and reanalysis, dwelling on depressive thoughts or substituting needed action for “pleasure” activities.
  • Both have us engaging in self-talk such as “why bother?”

 Cognitive, Emotional and Behavioral Aspects

The cognitive aspect of procrastination is well-known. There is always some form of justification found for delaying the pain and the dysfunctional thinking that conditions might be better at some later date.  You may tell yourself that dealing with depression is something that can be done later when more inspiration is there or that you are under too much stress to deal with it now. This way we can easily con ourselves into thinking that we are making a planning decision. Procrastination gives us false optimism that things will  eventually be right enough to tackle activities. Linked with depression, it holds nothing but false pessimism such as ” I can’t do that” or “I don’t have the energy”. Talking like this means you are stuck in the procrastination-depression cycle of thinking. To change this, you have to change the way you organise your thinking. If you have the energy to think depressing thoughts, you also have enough to think proactively. You can also define timescales. For example, tell yourself, you will undertake that activity at at certain time in the day, for example 3pm (but then it has to be done). This makes the task definable and manageable and you can stop procrastination taking over.

The best way to get yourself out of the cycle is to challenge the inner critic who is fuelling your thinking. Simply do the opposite of what the inner critic tells you. For example : You have to face a task that you have been putting off and you have no desire to do it but you know you have to. The inner critic might convince you that it is ok to sit and read the newspaper or watch tv or do anything else instead. You can still do this but challenging means first the task and then the newspaper and tv.

What are the emotional aspects of procrastination? Well, it plays on our mood for sure, especially when we beat ourselves up for delaying a task which in turn, gives us discomfort.  When depression is involved, those thoughts and discomfort are magnified out of all proportion and more things get pushed aside. We often believe that our happiness and depression is conditional on feeling good. This is what is known as a contingency procrastination cycle where we make our ability to do things and move on conditional to how we are feeling. If you are depressed and apply this, this ability will never reappear. Accepting this will allow you to give yourself the tolerance that you need to start. You may not feel better straight away but surely later as a by-product of taking action. It is often useful to look at the consequences of doing something against the consequences of not doing something, which are often greater.

Behavioral diversions are a key aspect of procrastination in the fact that we tend to replace needed action with something less pressing. These are generally worthless, time-wasting activities that side-track us from doing what we need to do. Some fine examples of these are napping, quarrelling, watching hours of tv and ruminating. When depression is added, these activities seem even more appealing. Hard as it is, activity is a great remedy for depression (and procrastination). The result of delaying and endless time-wasting can promote hopelessness and stress.

Help yourself out of Depression and Procrastination

1. “Just Do It” :  When we are depressed we tend to isolate ourselves from friends and society in general. This also includes many of the activities we take for granted in our daily lives. This, to the extreme can mean lonliness and isolation. Getting back into these daily activities can be difficult and overwhelming. Robert Heller, Florida psychologist believes that breaking the pattern of behavior associated with the isolation is key to recovery. He advocates a “Just do it” approach. He suggests keeping a daily log of the things you do and to gradually add activities, regardless of whether you feel you want to do them. By reviewing this regularly, one can see gaps where activities can be placed like, saying hello to someone, approaching a friend or shopping every day for an item instead of once a week.

2. Increase Activity : People often believe that once they start to pull out of depression, they will start to catch-up on the activities they have stopped doing. Unfortunately, this is usually a case of shutting the door after the horse has bolted. Research tells us that the very things that have been neglected during depressive spirals are the things that will get us out of it. However, procrastination often takes over but will graded exposure to activities, it can be overcome. I often ask my clients to name a small thing they are prepared to do in the week between sessions and commit to it. This can be started of in a small way and gradually increased.

3. Paradoxical Thinking: If we convince ourselves that by delaying a task, we will feel better, we will repeat that habit over and over. It relieves the stress we are feeling at that moment and procrastination brings reward. Convincing yourself that procrastination will bring rewards is paradoxical thinking. It will bring exactly the opposite of what you hoped. Keeping contact with friends and family when depressed helps the depression in the long run but momentarily it seems better to stay away. Another example of this kind of thinking is when we tell ourselves that we cannot undertake anything until we feel inspired..can you see the chicken-egg theory here? This cycle can be broken by reversing the reward system you have set up for yourself. For example, you could reward yourself every time you resist the impulse to procrastinate. If you must work in the garden but want to watch tv, work for an hour in the garden and reward yourself by watching tv. Reward yourself with something pleasurable each time you avoid procrastination.

Dr. Nicholas Jenner is a Counseling psychologist in private practice working with individuals,couples,  groups and companies globally. Online therapy is, in my experience, effective for treating a number of major conditions. Are you having issues that you need to talk through? I have a range of plans that can help you get the help you need.  Online Therapy details : Here …… Take advantage of the “online therapy” tester. Try the first three sessions for free. Contact me for more details.

Getting Started with Online Therapy…Easy as 1,2,3

Getting the help you need is easier than you think. Starting online therapy means communication with your therapist….not a secretary…..not a form…..no sitting in a waiting room….no trips into town…. a simple process.  Here is how it works:

 

Make that appointment: You may have been feeling that life is becoming more difficult. Work is getting on top of you or there are problems in the family. You may just have days where nothing seems to function or you may be worried or anxious about aspects of your life. Maybe even going through major life changes. You know you need to talk to someone but making that decision is difficult. However, it is an important first step……Can it be easier than this?

Simply contact me via email or phone and arrange a convenient time for a free, no obligation initial 60 minute session via video conference or phone.

During your first consultation, you will have the opportunity to present your issues in a comfortable, positive but realistic atmosphere. I realise how difficult it might have been for you to come this far.

Your first appointment with me is primarily an information-gathering session . I need to learn a lot about you and your history in a short amount of time in order to properly evaluate your concerns and arrive at a possible diagnosis. Since diagnosis often helps guide treatment, it’s an important part of the process. Your story is indeed your own and a very personal one at that. Despite what you may have read, a person is not simply a diagnosis. Nor do professionals look at people who come to them that way. They look at each and every person as a unique individual who is in pain and needs help. I will place a lot of emphasis on your current issues because they are usually the ones that can have an immediate effect but these usually hide deeper problems which I will also like to find out about. Many people will leave their first session alternately feeling: relieved, horrified, peaceful, even more anxious, and hopeful, or any combination of these feelings and more. However, most who continue find the process of therapy rewarding and enriching.

Where do you go from here? At the end of the initial consultation, we will discuss my diagnosis and your options. This diagnosis might be a tentative one if the issues presented are complicated or information is lacking.Once we’ve completed the free initial consultation, therapy focuses in on your goals and what brings you to counseling. The therapy hour is your space to safely explore themes, issues, and experiences that are important to you.  My approach to therapy is collaborative, in that, I do not assume that I know what is best for you or how we should get there.  I support you in moving in the direction you want to live.  The first session gives me an idea of where we need to go and this continues to evolve as we work together.

I have a range of affordable monthly plans that cover all budgets. This can be done via video, phone or if preferred, via mail.

More details   Here

Facts and Myths about Suicide.

Look at these startling facts about suicide rates: Source WHO:

  • Every year, almost one million people die from suicide; a “global” mortality rate of 16 per 100,000, or one death every 40 seconds.
  • In the last 45 years suicide rates have increased by 60% worldwide. Suicide is among the three leading causes of death among those aged 15-44 years in some countries, and the second leading cause of death in the 10-24 years age group; these figures do not include suicide attempts which are up to 20 times more frequent than completed suicide.
  • Suicide worldwide is estimated to represent 1.8% of the total global burden of disease in 1998, and 2.4% in countries with market and former socialist economies in 2020.
  • Although traditionally suicide rates have been highest among the male elderly, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of countries, in both developed and developing countries.
  • Mental disorders (particularly depression and alcohol use disorders) are a major risk factor for suicide in Europe and North America; however, in Asian countries impulsiveness plays an important role. Suicide is complex with psychological, social, biological, cultural and environmental factors involved

 

The subject of suicide is always heavily covered in the news . Mainly due to the time of year where most people believe suicide numbers rise (though some studies suggest otherwise) but also due to well publicised suicides of an ex-sportspeople and a number of celebrities `coming out` about depression and attempted suicide. While some of the stories have to be seen in the context that any publicity is good publicity, it does highlight the issue that suicide rates are rising. Statistics from the WHO say that over one million people commit suicide every year and this figure is rising every year. That is one death every forty seconds and a sixty per cent rise since 1945. One factor in this is clearly our modern, hectic lifestyle which cares little for emotional well-being. It is also strongly believed that other factors including living conditions, cultural and family restrictions as well as religion play a major role. Alarmingly, suicide amongst young people aged between 15 and 25 is on an all time global high. Interestingly, there are approximately twenty million attempted suicides per year, according to the WHO meaning that 1 in 20 actually achieve their aim.

One of the main features of some of the more recent stories of suicide in the media has been that suicide was committed by people who seemingly had everything to live for and showed no signs of depression, worry or any kind of problem beforehand. One must then ask, was it planned or was it just an explosion of feelings that lead to the ultimate in spontaneous death? Many times, these questions can never be answered and loved ones and friends left behind torture themselves with thoughts of uncertainty, guilt and anguish.  Is it however possible that someone ends their life so brutally without a long catalogue of problems? We can only speculate about this but an analysis of suicide notes (WHO) suggests that  many times  one single event pushed an otherwise depressed person over the edge. However as  much as we speculate, suicide is one of the most perplexing aspects of human behavior. There are also many myths surrounding the subject :

Myth:    People who talk about suicide don’t do it. Fact:   Talking about suicide can be an appeal for help. Most people usually communicate their intentions to suicide to another person, either directly or indirectly. This could include dropping hints about suicide, talking about death or dying, or writing a poem. If not responded to, the person’s thoughts could progress to action – a suicide attempt. All talk of suicide should therefore be taken seriously and acknowledged as such to the suicidal person. People who talk about suicide should be encouraged to talk further and seek professional support.

Myth:    Once a person decides to complete suicide, there is nothing anyone can do to stop them. Fact:   The suicidal crisis represents a cry for help rather than a wish to die. A part of the person wants to live and a part wants to die. With help the person can be encouraged towards life. If the person receives the help he or she is seeking, an attempt is less likely. Suicidal crises can be relatively short-lived. To protect the person during this time: stay with the person, listen to their struggle and encourage them to keep safe. Help the person to access professional support, as many people do move beyond seeing death as an option with professional assistance.

Myth:    All deaths are preventable.  Fact:   Despite our best efforts to help a person at risk of suicide, some people who attempt suicide will die as a result of their actions.

Myth:    Suicides happen without any warning/ are spontaneous acts/ people keep their plans to themselves. Fact:   Studies have indicated that as many as eight out of ten people give warning of their intention to suicide. More often, this intention is not recognised rather than hidden.

Myth:    Talking openly about suicide increases the risk. Fact:   It is important not to treat suicide as a taboo subject. Raising the issue sensitively and asking directly about suicide gives the person at risk permission to speak about his or her distress, and demonstrates to the person that you care. Rather than feeling worse, the person at risk could feel relieved if the issue of suicide is raised in a caring and non-judgmental manner. This could prevent action and increase the chances of the person at risk seeking further help.

Myth:    People who talk about suicide/ make a nonfatal suicide attempt are just seeking attention. Fact:   All suicidal thoughts and behaviours are a cry for help that need to be listened to and responded to. We cannot make assumptions about the person’s intentions and need to take this seriously. Anyone distressed enough to talk about or attempt suicide needs professional support. Addressing the underlying problems through talking with a professional helper could reduce the likelihood of future attempts.

Myth:    Suicidal people always want to die. Fact:   The majority of people who attempt suicide are confused about whether they want to live or die. Most people want to live better and happier lives but need relief from the intense emotional pain they are experiencing. If people in the midst of a suicidal crisis were certain that they wanted to die, they would not be communicating their distress to others. In communicating their distress to others in this way, suicidal people are actually reaching out for help to ease their emotional pain.

Let me leave you with a few choice quotes on the subject:

“Suicide is a whispered word, inappropriate for polite company. Family and friends often pretend they do not hear the word’s dread sound even when it is uttered. For suicide is a taboo subject that stigmatize not only the victim but the survivors as well “. EARL A. GROLLMAN, Suicide

“The reality of suicide is far different from the fantasy. Most suicidal thinkers romanticize their death by suicide, failing to realize that any suicide gesture or attempt can result in permanent brain, kidney, or liver damage, loss of limbs, blindness, or even death”. SUSAN ROSE BLAUNER, How I Stayed Alive When My Brain Was Trying to Kill Me

If you are feeling suicidal or know someone who is..there is always help at hand. http://www.suicidehotlines.com/

Dr. Nicholas Jenner is a Counseling psychologist in private practice working with individuals,couples,  groups and companies globally. Online therapy is, in my experience, effective for treating a number of major conditions. Are you having issues that you need to talk through? I have a range of plans that can help you get the help you need.  Online Therapy details : Here …… Take advantage of the “online therapy” tester. Try the first three sessions for free. Contact me for more details.

 

The best of today from Psychology Today

Too Much TV May Make Your Child Anti-Social

Childhood television viewing linked to anti-social behavior in adulthood
Published on March 2, 2013 by Dennis Rosen, M.D. in Sleeping Angels

The American Academy of Pediatrics is just one group among many which strongly recommends restricting the amount of time children spend in front of the television. There are good reasons for this recommendation, as regular readers of this blog already know.The more time children spend watching TV, the less sleep they’re likely to get, the less likely they are to be physically active, the less likely they are to read, and the more likely they are to suffer from overweight and obesity.

Read More….

 

Are Affairs Really Worth It?

Before embarking on an affair (or a marriage), read this book!
Published on March 2, 2013 by Jenni Ogden, Ph.D. in Trouble in Mind

The Mess of Infidelity

I am a book lover and a fan of Goodreads, which is where I record my own book reviews and read the reviews of others. Reading, after all, fits all the criteria of my Psychology Today blog title, “Brains, Books and Being Happy”. Reading (and writing even more so) are good for the brain,  and both reading and writing books have a place way at the top of my list for making me happy. But it is a rare book I think is so important for our psyche and our potential happiness that I think it worth reviewing here.

Read More…

 

3 More Ways to Stop Screaming at Your Kids

By better understanding your anger as a parent, you will yell less.
Published on March 1, 2013 by Jeffrey Bernstein, Ph.D. in Liking the Child You Love

Here are some more powerful, effective tips from my book 10 Days to a Less Defiant Child to help you avoid the yelling trap with your child or teen

Read More…
Dr. Nicholas Jenner is a Counseling psychologist in private practice working with individuals,couples,  groups and companies globally. Online therapy is, in my experience, effective for treating a number of major conditions. Are you having issues that you need to talk through? I have a range of plans that can help you get the help you need.  Online Therapy details : Here …… Take advantage of the “online therapy” tester. Try the first three sessions for free. Contact me for more details.

 

Determining factors in Recovery from Rape and Sexual assault

(Rape Trigger warning)

I was rather disturbed to read a recent newspaper article stating that certain sections of the police force in the UK had been encouraging rape victims to drop cases in order to keep statistics on the good side. READ.  This is horrifying and makes a mockery of the “serve and protect” stance taken by law enforcement.

Rape should never be encouraged and certainly not in these times where one cannot pick up a newspaper without reading about some vile act committed in one country or another. Anyone who has been raped,whether male or female will attest to the trauma experienced, the overpowering of will, the helplessness, the violation and the long, hard road to recovery. Some never recover (as I know from my clients) and spend their lives dealing with the ongoing effects of being attacked . So to have the very institution that is responsible for catching the offenders to allow them to walk free (and maybe do it again) is scandalous at best. I can only imagine how the victims are feeling…liked being raped again.

When rape occurs, recovery is difficult even if the victim is treated properly after the assault and how the victim is dealt with by police, hospitals, doctors and family and friends determine how long the recovery process is. Burgess and Holmstrem READ MORE studied 109 women who attended the Boston City Hospital in 1974 complaining of rape. They collected their data at the time of initial presentation at the hospital and again 3 months later. They documented the “rape trauma syndrome”.  They found two phases of adjustment following rape or attempted rape. They call these the acute phase and the long-term reorganisation phase, both of which are stress reactions to a life threatening situation.

Immediately following the rape they found that an equal number of women had an “expressed” style where they showed feelings of fear by crying, smiling, sobbing or a “controlled” style where the woman was calm and subdued. The primary emotion expressed by victims is one of fear. Most all say that they felt they were going to be killed or badly injured. They reported that in the reorganisation phase women develop increased motor activity, changing their jobs, home or lifestyle as a defensive reaction to the assault. Nightmares relating to the life threatening nature of the assault and the powerlessness and alienation are common. The development of phobic reactions to situations reminiscent of the rape also occur. Some mistrust of men with subsequent avoidance and hesitation, along with a variety of sexual difficulties may develop. Victims are often concerned about the effects of the rape on their close interpersonal relationships wondering how this will affect them.

Interestingly in the same report, the authors looked at the factors that determine a victim’s ability to cope and readjust after the attack. I quote directly from the report :

The way the woman is treated as a victim may also influence her ability to cope.

This includes treatment by:

1)  The police. Of necessity the police are required to question the victim thoroughly. If this is not explained to her she may perceive that she is not believed and this can reinforce feelings of guilt and self blame.

If she is unable to accurately describe her assailant or recall details of the attack, this may reinforce feelings of low self worth and inadequacy.

2) Hospital service.  If the victim is treated in an impersonal manner then the feelings of depersonalization are reinforced. If hospital staff offer judgement comments on her behaviour then feelings of guilt can be produced.

3) The courts. The above comments apply here as well. The cross examination can seem like a repeat of the rape experience.

4) The circumstances of the assault can affect the victim’s coping capacity.

Whilst a victim’s response to rape may follow a predictable pattern, each individual’s circumstances provide differences that will affect their coping capacity and reaction. The fact that a victim’s psychological adjustment to rape, is in part determined by the social systems that impinge upon them, indicates a need for a widespread community response to ensure that those systems are both responsive to victim’s needs, and used to their maximum therapeutic capacity and this includes the above mentioned police force.

Dr. Nicholas Jenner is a Counseling psychologist in private practice working with individuals,couples,  groups and companies globally. Online therapy is, in my experience, effective for treating a number of major conditions. Are you having issues that you need to talk through? I have a range of plans that can help you get the help you need.  Online Therapy details : Here …… Take advantage of the “online therapy” tester. Try the first three sessions for free. Contact me for more details.

 

The Mental Torment of Sexually Abused Children

TRIGGER WARNING : If you are uncomfortable reading about sexual abuse, please do not read further.

It is estimated that up to fifty percent of sexual abuse victims who receive medical treatment after episodes of abuse carry no physical scars at all. However, it is also estimated that all of them will carry the mental scars for most, if not all of their lives. This makes perfect sense. Abuse victims often report that the physical touch was not the worst part of the abuse but the burden of carrying the “secret” and knowledge of the abuse which stays with them at all times superseded this many times over. This burden also carries the responsibility of what to do with this information. Revealing it could mean being taken away from loved ones or the break-up of a family as well as legal consequences for the abuser. This can cause great hardship for a young mind.

The mental aspects of abuse are cleverly manipulated by the abuser. While the physical boundaries are being destroyed and violated, so is the mind. A child can be lead to believe that their body and mind are under the control of others.  Abusers often try to convince a child that what they might believe is happening is really not or when it is mentioned, the child is blamed and the abuse often denied and ignored. Another method is to rename the abuse as a “special” game that only the child is allowed to play. Statistics tell us that most incidents of abuse take place at night, often leading the child to believe it was a dream and making recollection hazy. The sad fact is that many sexually abused children are denied the right to justice due to the mental manipulation of the abuser and carry these scars for a lifetime, trying to cope with life as best they can. However, mental health issues as a result of the abuse are often played out later in life as the subsequent adult tries to deal with the torment of the past. Let’s look at some of these :

Dissociation

Children who are abused tend to emotionally shut off while the abuse is taking place. However, they often take this defense mechanism into adulthood and dissociate when confronted with anything that reminds them of the abuse. Hence, they find it hard to enjoy close relationships and intimacy. This dissociation can range from the mild, referring to oneself in the third person, to extreme complete depersonalization. Due to the abuse, many victims have been taught (or indeed taught themselves) to ignore feelings and emotions, so they often see this behavior as “normal”. In some cases, when the abused has not been believed, the dissociation acts almost as a “friend” and in a way protecting and validating them as it did at the time of the abuse. Many hold onto this and are afraid to let it go, fearing life without it. Since there is a strong likelihood that the victim was in a dissociative state at the time of the abuse, they often find that large chunks of memory of the abuse and other times in their life are blurred, often returning briefly in dreams and flashbacks.

Multiple Personality Disorder

The most extreme example of dissociation is the formation of two or more distinct personalities that take over control of behavior. Research tells us that most sufferers of MPD had a history of sexual abuse in childhood.  Multiple personality disorder typically develops at a young age because of some kind of very traumatic experience, usually long-lasting and severe abuse. The earliest age when MPD can develop has not been clearly established, but seems to coincide with early infancy. Abuse that leads to development of multiple personality can be emotional, physical, or sexual, or combinations thereof. In reality, all abuse is mental. The mind perceives and interprets the harmful acts as abusive. The after effects of childhood sexual abuse seem to be responsible for more than 90% of all MPD cases. By contrast, non-abusive traumatic events do not cause multiplicity. Multiple personality disorder only develops when a person is helpless and unable to escape  suffering or the threat of suffering, especially when the abuse is repetitive or lasting weeks, months, and years. A significant factor leading to the development of multiple personality is the dependence of the victim on the abuser and establishment of a personal relationship . The abuser becomes an essential and psychologically inseparable part of existence, but also the torturer in the mental sense. The cognitive substrate of the brain is unable to reconcile these dramatically opposing experiences and is forced to split into pieces. The likely triggers (severe traumas) of permanent dissociation hint that the number of possible personalities could run in the dozens. In extreme cases, when the abuse is lifelong, several hundred personalities might be expected to exist.

Mentality

One of the most crippling aspects of sexual abuse is the development of an unhealthy outlook on life in the form of a set mentality. Unlike the diagnosable disorders above, mentalities are often more subtle but just as destructive in their own way. For example, many abused children take on a victim mentality as the child starts to organise the world around its own wound. The abused child sees the world as unsafe, unpredictable and dangerous. The child has learnt through the abuse that what they feel, want or think make no difference and they feel hopeless, ineffective and lack the ability to contradict this with evidence to the contrary. They are often tormented with the thoughts they they were somehow to blame for the abuse and they asked for it or deserved it. Life is consequently full of “shoulds”, leading the abused to the mistaken belief that they had a choice. The basic assumptions about life that most of us take for granted are challenged in a victim mentality, that is invulnerability, I can’t or won’t get hurt, I have worth and the world is understandable and has meaning. These thoughts often lead to problems in later life by seeing poor treatment by others as “normal”, an acceptance that abilities to change are limited and an exaggerated sense of self-blame. Most adults in these cases are passive people. However, paradoxically, some can become agressive…treating others poorly as defense against being hurt. Some become perfectionists, wrongly believing that one needs to be perfect to be accepted. Other attempt to keep control over others while fearing losing control themselves.

Once again, the attitude of the offender has a lot to do with the formation of a victim mentality in the abused. Many abusers show characteristic of “other”-blame as opposed to the self-blame shown by victims and they fit well together. Often an offender will blame the child for “seducing” them or blame circumstances for the abuse. An person with offender mentality will continue to abuse without being overwhelmed with guilt or remorse so there is no internal motivation to stop. They can always find a justification for it. They often paint themselves as “misunderstood” or “framed” by society and sometimes the victim. There is some feeling that people with the offender mentality are often substance abusers as well. In one recent study, up to 45 % of abusers who “blamed” the victim were either alcoholics or took drugs to some degree. This could suggest that substance abuse causes sexual abuse but more likely, the offenders were looking to find a reason to justify what had happened.

This is just a small portion of the disorders that can arise from abuse..there are many others. However, in therapy, the biggest gift a therapist can give an abuse victim is to believe their story and help them relive it in such a way that they can reconstruct their world and gain new insight. It helps to show abuse victims how to question long held beliefs about themselves and the world and their place in it. This is incredibly important as in some quarters, there is the belief that victims often lie about abuse. In my experience of treating victims (and being one myself), they rather tend to minimise it. It is also vital that the therapist feels the need to show emotion towards the act of abuse and the abuser. Many victims have been met with stonewall faces and attitudes all their lives and it can be refreshing to come across someone who feels outrage when talking about it.

Dr. Nicholas Jenner is a Counseling psychologist in private practice working with individuals,couples,  groups and companies globally. Online therapy is, in my experience, effective for treating a number of major conditions. Are you having issues that you need to talk through? I have a range of plans that can help you get the help you need.  Online Therapy details : Here …… Take advantage of the “online therapy” tester. Try the first three sessions for free. Contact me for more details.

Focus to avoid Rumination

One of the biggest difficulties we face when trying to instigate change in our lives is protecting ourselves from the effects of the past and an imagined future. Even when the past has been somewhat dealt with, the brave new world known as our new future life can be difficult to deal with, hold many fears and lead us to rumination. It is in this process of rumination (a form of daydreaming) where we are at our most vulnerable mentally. We allow negative thoughts and “big picture” concerns to affect our lives and judgement. What do I mean with “big picture” concerns? These are the things that we busy ourselves with thinking about such as global issues, political and financial structures and other’s behavior that we have no chance in the world of influencing. Yet we try, blame and judge and make ourselves miserable. Our minds race, trying to solve problems that have no solution and the result is depression. How many of these issues can you or should you directly influence? Let’s say, for example, that you’re very concerned with the rise of international terrorism.  How can you, as an individual, influence global politics to such an extent that you’re going to have a personal impact on the future of this issue? Unless you’ve committed yourself to a career in international politics, the chances are that this concern of yours, critically important though it may be, will not fall within your circle of influence. Fundamentally, outside of being well-informed on these issues that concern you, your time would be much better spent focusing on the issues that lie directly within your own influence.

One of the best descriptions of this process was written by Stephen Covey in his best-seller, The 7 Habits. Covey depicted two circles to describe where people spend their time : The Circle of Concern, which contains the activities mentioned above and the Circle of Influence, the smaller circle that we really should be focussing on.  This contains all the activities that we can have an influence on, namely our own focus,  thoughts and behavior. As in this diagram :

The circles represent the 2 areas where you can focus your time and energy. The vast majority of people focus too much time and energy outside of their Circle of Influence, and in their Circle of Concern.

Covey notes that highly effective people think and act primarily within their Circle of Influence. They forget about the things over which they have no or very little control, preferring instead to focus their time where they can actually make a difference. By doing this, they gradually expand their Circle of Influence as they deflect the thoughts from outside. To give a concrete example, let me list some common things people generally worry about (Circle of Concern), followed by an example of something they could do to improve the situation (Circle of Influence):

  • The environment – recycle your plastic, be environmentally more responsible
  • Personal finances – learn new skills to find a job or earn a promotion. Face difficult situations head-on.
  • Physical health – exercise for 20 minutes daily. Change diet.
  • Being single – work on your social skills so you can meet more potential partners. Drop perfectionist values.

When you’re faced with something that comes at you from your circle of concern, but that isn’t within your circle of influence, you meet that challenge by changing something that is in your control. When you figure out what that is and respond accordingly, you will have learned a valuable lesson. The lessons of childhood, adolescence and adulthood are hard enough, but they mainly concern themselves with the outside world. The lessons I am talking about here are different: they concern themselves with the inner you. They deal with self-esteem, values, purpose, meaning, direction, and your unique destiny in this world. These are the real lessons: the ones that really count.

Dr. Nicholas Jenner is a Counseling psychologist in private practice working with individuals,couples,  groups and companies globally. Online therapy is, in my experience, effective for treating a number of major conditions. Are you having issues that you need to talk through? I have a range of plans that can help you get the help you need.  Online Therapy details : Here …… Take advantage of the “online therapy” tester. Try the first three sessions for free. Contact me for more details.

My New Website

I have been busy reworking my Online Therapy website and I invite you to check it out . Here. All the usual features plus some free services and resources….Hope you like it.

What is it really like to be an online patient?

Many people reading this will have heard of online therapy but might find it hard to imagine how it works. What better than to hear from someone who has been there and done that. Here one of my former patients shares her experiences of life in online therapy.

I was a reluctant client at first due to my experience of therapists and years of trying to deal with my issues. Someone passed me the details for Dr Jenner’s therapy and I immediately put it in a drawer and forgot about it. Online therapy…what next?..I thought. Surely that cannot be effective, so I forgot about it for a few months. Then something happened for the worse and sent me into a spiral that left me depressed with no hope of recovery and resigned to my fate.I had experienced the triple whammy…financial, health and personal problems all at the same time and I felt desperate. As always happens, I could not find his details at first and that depressed me even more. I searched on the internet, found him and made tentative contact. I sent a long email, not really knowing who would read it, if anyone would read it and unsure of the response. I felt bad that I had spilled my guts to a total stranger and regretted my decision to write. Just as I was going to bed one night, I received my answer. Dr Jenner wrote me a long reply that seemed just to fully understand what I was going through. He didn’t offer solutions, just compassion and empathy and I felt better that at least one person in this wretched world seemed to understand what I was going through. He suggested that we get together online via video and talk about he might be able to help me. I asked him if it would be ok if we did that on the phone first and we set up the call. He called me one evening and we spoke for about an hour….he didn’t say much but what he did say mattered and I felt understood. I signed up for a course of therapy and I started in May 2012. Due to my financial problems at the time, he allowed me to pay over a period of time. This enabled me to start. Two hours before our first video session, Dr Jenner called me and asked me if I had any questions and put me at ease about appearing on video.The first session was easier than I had anticipated and I found myself getting more and more comfortable as time went on. It was great to think that I didn’t have to go into town to see my therapist and I guess that is the big advantage for many people. What I found amazing was that Dr Jenner gave me assignments to do from a self-help book between sessions and I was free to contact him by phone or mail if I hit a rough patch. This was never the case with other therapists. I always got an answer within 24 hours, mostly in the evenings. Was the treatment effective…certainly. I found that Dr Jenner centered first on the things I could change quickest…things that would have a real positive effect on me and he gave me constant encouragement to set small goals and not procrastinate. We are now nine months down the line and I am taking a little hiatus while I go back to my past and rectify a few things. I will be back in therapy in a few months. Despite my early misgivings, Dr Jenner has become a trusted confidant. He has allowed me to get close enough while still keeping the boundaries needed for therapy. I cannot imagine my life now without him in it or doing therapy any other way.

Dr. Nicholas Jenner is a Counseling psychologist in private practice working with individuals,couples,  groups and companies globally. Online therapy is, in my experience, effective for treating a number of major conditions. Are you having issues that you need to talk through? I have a range of plans that can help you get the help you need.  Online Therapy details : Here …… Take advantage of the “online therapy” tester. Try the first three sessions for free. Contact me for more details.

 

Depression : An everyday tale

It is an overwhelming fact that depression rates are on the rise in most corners of the globe. Globally, millions of people are living with the misery of the so-called “cancer of mental health” on a daily basis. Some have had their symptoms alleviated by medication, some have sought therapy and there are many others who live with it without getting help. Some are not even aware that they are suffering and some choose not to recognise it, for whatever reason. There are those who have adapted their lives to the extent that they see their depression as a “part” of them, have no trouble talking about it. There are others who feel stigmatized and discriminated against and hide their illness and there are those who live in fear of the consequences of their depression hoping it will not take over their lives. I recently met someone who had been suffering on and off from depression for over thirty-five years. We talked about how this had left an imprint on his life, how it affects him and how he had tried to adapt in order to lead the best life possible. He cut a despondent, resigned figure who had seemingly given up. I asked him if I could write his story….he gladly agreed and here it is :

When did you first realise you were depressed?

I often wondered why my parents were always so miserable. Now I realise that they were depressed too. I guess it would be easy to say that I inherited my depression from them but I know it is not as simple as that. When I look back, it first hit me in my teens. I was an awkward teenager, never with the “in crowd” and consequently got bullied and pushed out. I didn’t dress or act like them which didn’t help. I preferred my own company. Now I realise that I was not doing things because of my depression.  I never thought that anything was wrong until I made a mistake at work and started crying when my boss criticised me.

What happened then?

Well, my boss had some previous experience of depression and took me to the GP. I was distraught to have shown such vivid emotion in front of my employer. Luckily he understood, and guided me somewhat. I thought my world was about to end. Depression and mental illness had always been a taboo subject in my family due to my grandmother being “mad” and my parents often criticised and ridiculed others who suffered. My boss took me to the GP and he prescribed antidepressants.

Were you offered other treatment, such as therapy?

No and my parents would not have allowed it. In those days, that meant being “locked up” and that would have brought shame on the family.

What was your experience with medication?

I remember at first,  the days full of “zombie-like” feelings, the impression that I was in another dimension but after a while I felt better and the side-effects waned. After that it was a case of remembering to take them. After a year, I decided not to take them anymore and gradually came off them. I don’t regret that at all. I know people who have been taking them for twenty years.

Would you consider yourself still depressed ?

Most definitely. Look, it comes and goes but I am still as miserable as I was as a teenager. I still avoid things that could potentially hurt me psychologically and have really stayed in my comfort zone all my life. I read an article once that stated that some people’s depression never goes away and they should just accept that and adapt their lives accordingly. I can believe that in my case but I am not sure you can accept it or adapt to it…or if you should.

Now the big question…How has being depressed impacted your life?

Well, I would say it’s the little things that have the biggest impact. Waking up in the morning with seemingly nothing to look forward to (or so I think), the difficult interaction with other people. The constant rumination about what other people think of me, regrets and my past. Makes daily life difficult. However, the worst thing is how I think about myself as a weakling, a fragile being who is knocked back by the smallest upset. How I can’t get out of that feeling and it gets worse before it gets better. I haven’t been able to stay in a relationship and that is one of my biggest regrets. I think the worst thing is that I feel society stigmatises depression to the extent that people with it are not seen as “normal”. The health insurance companies treat you like a monster when they hear the word and employers keep you at arm’s length.

How do you see your future?

(laughing) I have a great future behind me !! Look I am resigned to the fact that I will probably suffer from this forever. I know I don’t do much to change that but we are like an old married couple who are together because the alternative is not so rosy. I know that if I am better, new challenges will come and those would be difficult to handle.

What advice would you give to other sufferers?

Well, they probably need to do the opposite to me. I was (and still am) scared of getting better. What would this new world bring? I would have to face things that would scare me to death. I would strongly recommend anyone newly diagnosed to seek help as soon as possible. Join groups, get therapy, medication, anything that can lessen the Impact. To try to survive without help is doomed to fail.

It is not too late for you..why don’t you take your own advice?

This question was never answered. He quickly made his excuses and left. The path out of depression was seemingly too hard to contemplate. Can it really be the case that someone would accept their illness because the alternative is harder to contemplate? I guess this is an issue that people often forget. Getting well can be as difficult as getting sick, brings new challenges and a new world that calls for courage to live in. I didn’t get the chance to thank him for allowing me to talk to him. It must have been painful to go over some of the issues that had been a part of him for years. Who knows? Maybe someday…

Dr. Nicholas Jenner is a Counseling psychologist in private practice working with individuals,couples,  groups and companies globally. Online therapy is, in my experience, effective for treating a number of major conditions. Are you having issues that you need to talk through? I have a range of plans that can help you get the help you need.  Online Therapy details : Here …… Take advantage of the “online therapy” tester. Try the first three sessions for free. Contact me for more details.

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