Monday, October 19, 2020

Are you a Self Sacrificer?

In Schema Therapy, “self sacrifice” is defined as excessive focus on voluntarily meeting the needs of others in daily situations, at the expense of one's own gratification.  The most common reasons are:  to prevent causing pain to others;  to avoid guilt from feeling selfish;  or to maintain the connection with others perceived as needy .  Often results from an acute sensitivity to the pain of others. Sometimes leads to a sense that one's own needs are not being adequately met and to resentment of those who are taken care of. (It can overlap with concept of codependency.)

Of course it can be good for society, but if excessive, it can be problematic, especially if it’s not balanced with adequate self care. It’s hard to give, what we don’t have. 

When our needs are not met, and our self care is neglected, our mind may default into the self preservation mode of “what about me”.

The problem is, when “self sacrificers” put their needs first, they tend to feel bad or guilty, and this will create an inner conflict between self sacrifice, and “what about me”. This will increase the chance of stress and burnout.

So how can we minimize or mitigate this?

Simply be aware, defuse or unhook from our “self sacrifice” schema, accept that every superpower has its own Kryptonite, and remember the mantra of oxygen mask on us first, so that we can look after many. Looking after ourselves first does not equal selfishness. It’s looking at the bigger picture. 


Friday, October 16, 2020

Are you a “should and must” thinker?

One of the strategies in counseling and Cognitive Behavioural Therapy (CBT), is to help and switch the “should and must” thinker into the “it would be nice” thinker, and back again depending on context. Of course, “should and must thinking” is great for giving us the focus and motivation to act, and at the same time, can be a great source of pain and suffering if we don’t ever succeed, due to our unrealistic expectations.

Examples are:

  • Life should be fair versus it would be nice if life is fair.
  • People should always be nice versus it would be nice if people are nice.
  • People should have common sense versus it would be nice if people have common sense.
  • People should always do the right thing versus it would be nice if people do the right thing. 
“It would be nice” helps us to accept what is IS, but still thrive for it.  We understand that like is not fair, but we can still try and thrive for it. 

Doesn’t work all the time, but it would be nice if we can give it a try.

Friday, October 9, 2020

Inner communication vs outer communication

When we think about our communication, we can focus on our “outer communication/dialogue”, or our “inner communication/dialogue”.

So let’s talk about our inner communication and internal dialogue.

Some folks may have inner dialogues that are not as “refined” as their outer dialogue. It can be less tactful, less caring, less compassionate, more critical, more repetitive, more impulsive, and often less well timed.  

So why is that?

Perhaps we constantly get feedback from others for our outer dialogue, but not so much for our inner ones. If we call someone stupid, we might get unfriended. Calling ourself stupid, and we think we can get away with it.

In counseling, we can help our patients with that missing feedback. We reflect, explore, and help our patients gain “constructive feedback” on those inner dialogues.

Better statements may lead to better outcomes, and better questions may lead to better answers and possibilities.

Statements like “I can’t do this”, or questions like, “Why are people so nasty”, may lead us down an unhelpful path. There may be better alternatives. “What is good about this problem”, is one example of a better question, leading to better answers and more possibilities.

The question is, can we all invest more time and focus on improving our inner communication and “self talk”? 

Sunday, October 4, 2020

Are you an inner compass person or an outer compass person?

Part of counseling is to help folks to understand self, and to fully accept self, the good and the bad. 

Are you an “inner compass” person or an “outer compass” person?

In other words....

1. Do you tend to make decisions or take actions based on your own inner feelings, principles/values (inner compass) OR

2. Do you tend to make decisions or take actions based on the feelings, principles/values of others (outer compass)?

Each has its pros and cons.

The “outer compass” folks are great at trying to create outer harmony by pleasing others, making them happy, being pragmatic, trying to fit in, but if excessive, they can “lose themselves” in the process. This can create a lot of inner disharmony and unhappiness. Some may refer to this as “moral injury” in some context. 

The “inner compass” folks are very good at knowing who they are, and living life true to who they are. However, if one is not careful, it can create a lot of friction for themselves if the outer compass is too different to the inner compass, leading to maladaptation.

In counseling, we often see the “extreme outer compass” folks, and the “extreme inner compass” folks. Outer compass folks have to learn to be a bit more inner compass, and the inner compass folks have to learn to be a bit more outer compass perhaps, in order to adapt better.

Which one are you bias towards? The inner compass or the outer compass?

Have you ever gone from one extreme to the other? Have you ever been able to find that elusive sweet spot, in order to balance your inner and outer compass? How can you learn to be more of one or the other?

I often view it like left handedness and right handedness. The reality is that we all use both “inner and outer compasses”, but there may be a bias towards one over the other.

School and parenting expect us to be more outer compass as a general rule. So I often see those children with “extreme inner compass” struggle here, leading to adjustment issues with fight/flight stress responses, which then may lead to a number of diagnoses, including ASD, ODD etc. “Extreme outer compass” kids are vulnerable at school too, especially with peer pressure, and if they find themselves in the “wrong crowd”. They are also more vulnerable to the judgement of others. 

For those with a partner, your partner will tend to be the opposite. So naturally, you will learn the opposite, although it can be quite annoying, as this may not be your natural tendency. Inner compass folks will be perplexed at why the outer compass folks worry about what other thinks, and outer compass folks are perplexed at why the inner compass folks are so stubborn.

Furthermore, when one is experiencing a negative outcome from following the outer compass, one can make a “sharp switch” to the inner compass in a more reactive way. This may cause problems. Of course, this can also be done in a more healthy, intentional way, through skills in Acceptance Commitment Therapy (ACT). 

One can use inner compass effectively, or ineffectively. The same as the outer compass. If one use the outer compass in the wrong way, it can seem “out of context” or unauthentic. If one uses the inner compass in the wrong way, it can come across entitled or selfish.

Acceptance Commitment Therapy (ACT) focuses more on the inner compass. What’s our values, and how can we take committed actions towards these values. Empathy training and social skill training are a little more about the “outer compass” perhaps. To do well in life, we need both don’t we? Having said that, life is a team sport. As long as we have those elements in our team, we don’t have to do or be everything, although there needs to be awareness and appreciation.

Saturday, September 26, 2020

Why it’s important to have value based goals and to take value based actions

When making goals and taking actions towards our goals, it’s important to consider our “value based goals/actions” rather than just simply “generic goals/actions”. Why?

Value based goals and actions are linked to our inner values, feelings, and principles and hence, are more emotive, meaningful, and purposeful. If they are more emotive, meaningful, and purposeful, then they may be more sustainable.

If we have strong values around family and connection, then explore goals and activities around that. If we have strong values around creativity and beauty, then maybe some goals and activities around that. For some If us, it might be values around productivity and helpfulness, so explore around that.

Values are hard for many us to define, and getting clarity around this first will be very helpful.

Wednesday, September 23, 2020

Why getting clarity around your values and expectations so important

I often see many folks whose lives are not in line with their values and expectations.

The bigger the gap, the bigger the stress it seems.

To close the gap, we only have 3 options.

  1. We can help them to find or create a life that is congruent with their values and expectations.  It’s about making changes to the outside world i.e. the external locus of control OR
  2. We can help them to change or defuse/detach from their values and expectations to be in line with their life.  This is more about changing our internal world and how we perceive things i.e. the internal locus of control OR
  3. We can help them to change both. 

Whichever way, the first step is have clarity around what those values and expectations actually are.

Simple psychoeducation can be fundamental and critical for solving our emotional problems

I think that sometimes we can underestimate the value of simple psychoeducation as part of the counseling process. Examples are:

  • We can learn about the simple fight, flight or freeze as a response to stress. 
  • We can learn that anger may be a simple manifestation of stress.
  • We can learn that stress may be a response to maladjustments in our lives, and to sort out these maladjustments, we need to look at the external locus of control (our external factors), and the internal locus of control (our internal factors). 
  • We can learn that when a child is showing aggressive behaviors, it may represent the simple fight response to stress, and stress can be due to disconnection, shame, or loneliness. 

I often use the following metaphor to explain to my patients about the importance of simple psychoeducation and emotional literacy.

To solve maths we need to know what numbers are i.e. simple numeracy.

To solve communication, we need to know the alphabet i.e. literacy.

To solve finance, we need to know financial literacy.

So to solve emotional problems, we need simple emotional literacy first through simple psychoeducation.

It’s simple, but fundamental and absolutely critical. 

Monday, September 21, 2020

How to navigate through the loss of something in our lives

Have you ever suffered a loss of something? 

A loss of a love or relationship 

A loss of security and certainty

A loss of job, business or finance

A loss of a friend or connection 

A loss of freedom and autonomy 

A loss of meaning and purpose 

A loss of reputation

A loss of hope 

A loss of a family 

A loss of good health to name a few

When faced with a loss, we all go through various identifiable stages of loss. It may not be completely linear, but can fluctuate from one stage to another. 

1 Stage 1:  A sense of disbelief 

2 Stage 2:  The truth sets in, and we experience stress with fight, flight, or both. 

3 Stage 3:  We find “emotional acceptance” (not just “intellectual acceptance”)

4 Stage 4:  We adapt and grow from the experience. 

From experience, people often get stuck in stage 2, or fluctuate between stage 2 and 3. Being chronically stuck in fight/flight/freeze mode will cause a lot of physical, mental, and social health problems for us.

Counseling is to assist us to move from stage 1 and 2 to stage 3 and 4, with emotional acceptance often being the rate limiting step. 

Saturday, September 12, 2020

The ABC of thinking equation in Cognitive Behavioural Therapy (CBT)

One of the most useful tools in Cognitive Behavioral Therapy (CBT) is the “ABC of thinking” equation. It helps us to understand why we feel how we feel, react how we react, do what we do, and how we can change that. 

I often get patients to give me a list of their negative reactions to triggers, and apply those variables to the ABC of thinking equation, like in algebra.  It is often very enlightening. 

So like in algebra, if we know A (triggers) and C (reactions), we can work out B (Beliefs, thoughts, fused stories).  This will give us the opportunity to change or defuse from those beliefs, and associated thoughts/stories. 

Triggers (A-Antecedent event) + Beliefs (B-Beliefs) = Reactions (C-Consequence)

When people have a negative reaction to a trigger, the natural tendency is for us to try and change/remove that trigger, avoid the trigger, change/suppress our outward reactions to that trigger. Often this does not work long term as we don’t often have full control of our external environment, and changing those does not change the beliefs that underlie that context.  In actual fact, it often reinforces it.  This strategy represents the external locus of control. 

Alternatively. we can focus on our beliefs/thoughts/stories underlying that context. Same trigger but different beliefs lead to a different reaction.  So if we can change or defuse from our beliefs/thoughts/stories, we can change our reactions to our triggers, and how we feel about them.  This represents the internal locus of control. 

The common unhelpful beliefs, thoughts, and “fused stories” (the B in the equation) are:

I am not good enough.

You can’t trust anybody.

I can’t cope on my own.

Everyone will leave me in the end.

Nobody loves me.

I am all alone.

I am the black sheep. I am too different.  

When someone does something wrong, they need to be punished including me.

Things has to be done properly or not at all.

Why me. Why can’t I have what I want.

Something bad is going to happen to me.

If I fail, I am insignificant. 

Once we are aware of them, we can defuse/detach from them or even change them. Like when we know and understanding how a magic trick is done, the optical illusion has less grip on us. 

Naming them is one strategy and simply state, “Ah Mr Personal Trainer is here” if the feeling of inadequacies pop up for example. Then understand that the feelings of inadequacies is to propel us to take action for self improvement, and not simply to “feel bad” may help with some folks. Feelings are used for both feedback/information, and to propel/take helpful value based actions.  Feelings have both passive and active functions, and when used more mindfully and intentionally, rather than simply reactively, better outcomes may be achieved.