Category Archives: Anxiety Disorder

Habit Reversal

Do you have some bad habits, like nail-biting, hair-pulling, crossing legs, digging nose, thumb sucking etc?

During the year-end school holiday last year I saw a young boy who’s in primary school. The parents said he had so many habits that he can’t control himself with, including sucking his thumb, enlarging his nostrils, clenching his jaw, etc. Most of them are to do with facial muscles. He’s quite intelligent and performing well academically. However, he was warned and punished many times in class and during assembly due to his bad habits. So the parents decided to take him for professional help. His motivation to change wasn’t high initially, but it soon became clear that working on these bad habits are beneficial to him. Towards the end of the session, I also found that he has bruxism (teeth grinding), just like his mother. And the father thought that it’s in the genes.

We met for four sessions over three weeks, focusing mainly on habit reversal and muscle relaxation. Three months later when I checked with the father again, over 90% of his habits has disappeared, it’s no longer a problem. I’d have started hypnotherapy if he didn’t respond so well.

So, any bad habits, including thumb-sucking, nail-biting, smoking or over eating, and also teeth grinding while one’s sleeping can be target with basic habit reversal techniques plus muscle tension awareness in general. What’s important is actually the motivation, “are you willing to work on your problem?”

Support Group is running now!

Yes, since my post written in 2017, I’ve finally managed to organise the first meet-up for Support Group for Anxiety and related problems. It went really well and we were all very pleased to meet each other and made this happened together, despite our levels of anxiety! We will continue to meet monthly and welcome new members.

Meet-ups for Depression and other problems will follow soon…

If you’re interested, please fill in the google form here:

https://goo.gl/forms/PaFNW2LBfOkOOeUv1

 

A few criteria to fulfill:

  • You’ve been assessed or diagnosed with the problem you specified by a mental health professional (be it a psychiatrist or psychologist or GP or…).
  • You’re attending and participating in this willingly, not being forced by others.
  • You are able to arrange your own transport and pay for your expenses.
  • You are able to pay a small fees for administrative/materials purpose.
  • You demonstrate the ability to treat others non-judgmentally and with respect, and maintain confidentiality.
  • In between our monthly meet-ups, we stay connected in Whatsapp group, however, you will only be able to join the group after first showing up in the meet-up.

 

To read more about it, please check out my previous post:

Support Groups in KL/Klang

Stuttering and Stammering

It gets quite uncommon nowadays to meet people who stutter. I used to see it a lot more on TV, and it’s not much presented nowadays. I wonder if people no longer suffer from this problem, or they just don’t get out there and socialise much (so we hardly get to meet them and talk to them). (It also seems that most children grow out of it anyway).

Till few months ago I received an email from a lady in her 20s. She said it was depression that she needs help for. At first, based on what she wrote, I was thinking she might be quite socially anxious. And towards the end, she casually mentioned that she also had stammering issues.

I, also, quite casually replied to her that if she’s keen, I can help her with her stammering issues, on top of her depression. Undeniably I was quite “eager” inside, I was thinking I finally might meet one whom I can put what I learnt into practice.

That was few months ago. Now she almost, no longer stutters. She told me sometimes she will still do it, deliberately, just because she was quite used to it (due to some techniques that I coached her to try), now it’s all under her control, she can do it or not based on her will (just like everyone of us?). She is a lot more confident than when I first saw her, a lot more socially active too. It wasn’t quite “depression”, hence her previous treatments (mainly medication) didn’t help her much.

I don’t think people generally seek help from psychologist for stuttering and stammering issues, but yes, psychotherapy will help, hypnotherapy too. So yes, please get in touch if you happen to be one or know someone who might need this probably-life-changing therapy.

 

Extra knowledge: Stuttering VS Stammering

Stuttering refers to the repetition of words or syllabus when one is speaking, while stammering is when one is unable to make out the sound while speaking.

#口吃 #结巴 #治疗 #催眠 #心理治疗

寻求安全行为

有一个部落相信,为了让太阳升起,部落里的每个人,每晚必须建立一个篝火,并围绕着它跳舞直到天亮。由于这种信念,部落每天花费大量时间收集木材并为夜晚篝火做准备(Wells,1997)。他们筋疲力尽。这种仪式已经占据了他们的生命,但他们无法阻止这一点,因为他们必须为整个世界确保第二天早上太阳再次升起。

寻求安全行为是一个人为了阻止恐惧灾难的事情发生所做的事情。但安全行为实际上使恐惧更加强烈,特别是以长远来说,人们没有机会发现其实灾难无论如何都不会发生。克服焦虑的过程,就包括有信心地放弃这些行为同时容忍焦虑。

一些临床病例

小艾伦认为,如果他打羽毛球,那他当晚就会失眠。所以他完全停止了他曾经最喜爱的羽毛球运动。

林女士患有惊恐发作和广场恐怖症,所以她在网上购物,不惜一切代价避开购物中心和拥挤的地方。现在她几乎没有太恐慌,但她的生活是如此有限,甚至已经许久没有和闺蜜见面聊天吃饭。

郭先生有社交焦虑。他尽可能避免社交互动和社交场合。即使他和别人说话,他也会避免眼神交流并保持简短的谈话。人们发现他无趣,冷漠和怪异。


所以,回到部落日出仪式。部落民族要怎么发现仪式是否真的让太阳升起?

小艾伦要怎么知道打羽毛球是否真的导致失眠?

林女士如何知道人群是否导致她的惊恐发作?她怎么能过更充实的生活?

郭先生如何知道避免社交互动和目光接触是否有助于解决他的问题?

(你可能会注意到,为了缓解他们在短时间内的焦虑,他们都已付出长远的巨大代价。“短期收益,长期痛苦”)


当我们“触摸木头”(touch wood)或在进入酒店房间之前做敲门之类的东西时,这些迷信似乎是我们人类的一部分。对于许多患有强迫症和焦虑症的人来说,识别他们的安全寻求行为非常重要,并且围绕它进行一些心理教育以使他们愿意放弃它们,或者测试放弃它们(行为实验)。

更重要的是,有些时候我们的治疗师会教他们某些应对技巧(例如腹式呼吸),并最终被用作寻求安全的行为 — “只要我专注于我的呼吸,我就不会惊恐发作并且不会在商场里晕倒。”因此,这些行为背后的意图(信念)很重要。你为什么这么做?它是一种应对(应对策略)的方式,以便您可以继续购物,或者你用它来预防您认为可能发生的灾难(安全寻求)?

This is a Chinese translated version of the post Safety Seeking Behaviour.

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)?

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