All posts by huibee

介紹書:<親愛的,其實那不是愛>

這本書是蠻久以前在大眾書局買下的,一直放著沒看。到那天決定翻一翻,覺得其實也還蠻不錯的,適合一些處於不健康關係裏頭的人,學習如何識別和認清自己處於怎樣的關係,如何面對、一步一步走出所謂的偽愛關係,給自己療傷。

sunxuanhui

生活中不難發現處於這種關係的人(並不只是一種,作者蘇絢慧理出十二種),有時候因為孩子、有時候因為已付出的青春、有時候因為年紀、有時候因為家人或外界的看法等,而讓自己呆在不只是不快樂,而是甚至已經在一點一點腐蝕自己生命的關係裏……

如果心裡真的有許多的疑問和不確定,不妨看看這本書,又或許看完了,反而更確認自己現有的關係了呢!

Safety Seeking Behaviour

(This is my 200th post!! Well done, Hui Bee!! It’s been 4 years writing here.)

There is a tribe who believe that to make the sun rise, they have to build a bonfire each night and dance around it till dawn. Because of this belief, the tribe spends most of their time collecting wood and preparing for the night (Wells, 1997). They are exhausted. This ritual has taken over their lives, but they can’t stop this as they are obliged to make sure the sun rise again for the world the next morning.

A safety seeking behaviour is something a person does to stop a feared catastrophe from happening. But safety behaviours actually make the fear stronger especially in long-term by preventing the person from discovering that the disaster is not going to happen anyway. Overcoming anxiety involves having the confidence to tolerate that anxiety whilst dropping these behaviours.

Some clinical cases

Little Alan believes that if he plays badminton, he will not sleep at night. So he has completely stopped playing badminton that he used to enjoy.

Ms Stephy has panic attacks and agoraphobia, so she shops online, and avoids shopping malls and crowded places at all cost. Now she barely gets too panic, but her life is so limited.

Mr Patrick has social anxiety. He avoids social interactions and social situations whenever possible. Even when he speaks to others, he avoids eye contacts and keeps the conversation minimal. People find him uninteresting, aloof and weird.


So, back to the tribe sunrise ceremony. How would they discover that whether or not the ritual really makes the sun rises?

How would Little Alan know whether playing badminton really lead to insomnia?

How would Ms Stephy know whether the crowds lead to her panic attacks? How can she live a more fulfilling life?

How would Mr Patrick knows whether avoiding social interaction and eye contact help with his problems?

(You might notice that they all pay huge cost in long-term in order to ease their anxiety in short term. “Short term gain, long term pain”)


It seems that this is part of us human, when we do things like “touch wood” or knocking the door before entering the hotel room. For many with OCD and anxiety disorders, it is highly important to identify their safety seeking behaviour, and do some psychoeducation around it to make them willing to drop them, or test dropping them (behavioural experiment).

More importantly, there are also times when we therapists teach them certain coping skills (e.g. abdominal breathing), and it ends up being used as safety seeking behaviour “as long as I focus on my breathing, I will not get panic attack and faint here in the mall.” So, the intention (beliefs) behind these behaviours is important. Why do you do this? Is it as a way to cope (coping strategies), so that you can continue shopping, or is it as a way to avoid a disaster you think might happen (safety seeking)?

核心自我是不能被评估的…

new doc 2018-07-04 14.26.14-1

 

这是基于 Albert Ellis, 史上第一个创始了认知治疗的心理学家所说的“人们不能评论自我,只能评论行为”所画的。

如果一个人因为做了一些糟糕的事,而把自己或被别人标签为“糟糕的人”,那这个人要怎么改变自己呢?

只有通过只评价行为,不评价个人,只改变行为,而个人就只是存在着的,是无法被合理公平地评价,无法被改变的。

所以从现在开始,不再评价自己,也停止评价别人,更拒绝被别人评价。

核心自我(core self) = 体验式自我 (experiential self) = 觉察性自我 (awareness self)

Simple Breathing Relaxation 简单呼吸放松

Here is a 5-minute recording of tension release breathing, just follow the instruction (breath in – hold your breath & notice the tension – breath out and release the tension). Hold your breath for as long as you are comfortable, and try to exhale slowly and gently. You can do this anytime anywhere, with eyes open or close.

5 mins breathing relaxation - Recording


这是个简单的五分钟紧张释放呼吸录音,只需要跟着指示(吸气 – 屏气并注意肌肉紧绷感 – 呼气)。只要不造成不适,屏气时间尽可能长;而呼气的时候尽可能缓慢轻柔。在任何时候任何地方都可以做,不闭眼也可以。

五分钟呼吸放松 – 录音

Pity, Sympathy, Empathy, Compassion

This is a great graphic created by Psychologist Robert Shelton, comparing Pity, Sympathy, Empathy and Compassion:

pity-sympathy-empathy-compassion

People working in the health care sector (nurses, doctors, counsellors, carers etc) are always told that we should have “empathy”, which was also something I used to think I should always aim to have, to feel the pain and the suffering of my patients and sometimes of their family members. And I’d say, sometimes that becomes so natural in me, that seeing people suffering or talking about their sad past and weeping, tears would start filling my eyes too.

It’s good to understand and feel how others are feeling. Quite often I can help them better, we feel very much in-sync with each other. But sometimes this emotion that I sense interfere with the therapy. And not just that, I get so emotional long after the session has ended.

I realised that what we’d want to aim, is sympathy, or even better, compassion, but, not empathy. When I have compassion, even when I do not feel their suffering, I’m still very eager wanting to help them, to release their pain. This makes me feel better, as I quite often got stuck with “I can’t imagine how it’s like to go through that.” (e.g. a friend, who is the only child of a single mother, lost her mother quite suddenly. I have siblings, even if I lost my parents, it’s still not the same for me, I can’t imagine how it’s like for her. – I can give many examples like this, where I can’t imagine and hence can’t sense their pain. What’s more, even if I could imagine, it might still not be the same as experiencing and feeling it for real).

So now I’m no longer insisting that I should be empathising with all my patients. Of course I still do, somehow naturally, quite often. But if I do not, I have learnt that my job has a lot to do with a heart of compassion, I want less suffering in people, I want them to be able to help themselves and ease their pain. This way, the emotion affects me less, and I can help more people too.

焦虑(Anxiety) VS 担忧 (Worry)

最近刚从北京回来,发现那里的一名助教老师告诉我,她一直以为“焦虑”和“担忧”是一样的东西,也会互换着用。

担忧或许可以算是焦虑的一种,尤其比如说你对生活中任何大小事情都有忧虑,那你可能是“广泛性焦虑障碍” (Generalised Anxiety Disorder, GAD),如果你特别担心自己的健康有些什么状况,不断在网络搜寻关于健康相关的资讯,不断进行不必要的体检,那你可能是”健康焦虑“(Health anxiety),等等。

但是,担忧和焦虑有好一些显著的不同…

  • 担忧更多时候发生在头脑里(以文字/语言的形式),焦虑则更多时候发生在身体里(心率上升、冒汗等);虽然焦虑也可以以认知的方式(包含文字/语言、意象/画面)呈现,但一般都会带来躯体的症状。
  • 担忧的事物一般更具体一些,焦虑的事物更含糊(或广泛)。
  • 担忧比较可能(但不一定)带来问题解决,焦虑则比较不会。
  • 担忧带来的是比较轻微的情绪困扰,焦虑可以使人无法正常生活和工作等。
  • 担忧的原因一般比较实际和具体。
  • 担忧一般持续的时候比较短,焦虑却可以长时间不断地存在着。
  • 担忧属于正常的心理现象,焦虑则往往需要心理或药物的治疗。

要注意的是这只是拿两者作比较,两者的差别并不是完全的、绝对的。