Category Archives: Basic & General

河流上的飘叶

正念练习:河流上的飘叶(取自“接受与承诺疗法”Acceptance and Commitment therapy)

这是个闭眼练习。首先阅读说明,当你理解了这个练习的过程后,闭上眼睛开始。 (或者你可以使用这篇文章末尾的录音)

想象一下美丽、缓慢流动的溪流。水流过岩石,然后穿过山谷,周围有些大树。偶尔,风吹来,一片一片的叶子落入溪流中,随着河水漂流。想象一下,你正坐在那条小溪旁边,在天气很好的一天,看着河水的流动与树叶的飘落。

现在开始意识到你的想法(思维)。每当一个想法出现在你的头脑中时,想象把它写(或放)在其中一片叶子上。如果你用文字思考,把它们作为文字,轻轻地放在叶子上。如果头脑出现的是图像或画面,就将它们作为图像放在叶子上。目标是留在溪流旁边,让溪流上的树叶继续流动。不要试图让河流流得更快或更慢;不要试图以任何方式改变叶子上出现的东西。如果树叶消失,或者你的思绪飘到了其他地方,那就停下来、注意这发生了,然后再次回到溪流边,把刚刚的想法放到叶子上,让叶子随着河水流走。

(图像的生动或清晰程度无关紧要,只要有这个概念在就可以了– 觉察自己的想法,一旦发现它们就轻轻地放下)

继续进行至少5分钟。如果你现在已经了解说明,请闭上眼睛开始试试。

(练习后继续阅读)

当河流在流动,你也能注意到想法并轻轻地把想法放下时,这就是认知解离 (Cognitive defusion) 的时候。记得头脑本来就是设计来思考的,所以它总是会不断弹出各种想法,你虽然不能控制这点,但你能选择是否对这些想法作出反应,或者选择轻轻地放下它们。如果你认为“我做得不对”、“这个练习对我不起作用”或“我怎么会没有想法”,留意到它们也是你其中的一些想法,后退一步,把它们也放到落叶上。一些其它特别“粘”的想法(比较难以觉察和解离的想法),包括含强烈情绪的想法、比较性的想法等。

这里有两个中文版本的录音:

“河流上的飘叶”录音I

“河流上的飘叶”录音II

(类似的内容,只是前面的指示稍微不同;5-6秒后指示才开始)

多些练习,有问题的话,不妨在这留言。

Mental Problems Relapse Prone Situation

Relapse Prevention plays a big part in treatment of mental disorders. It normally involves two parts, (1) to identify high risk situations, what are the situations that are likely to cause relapse? (2) to prepare of coping plans, what would you do if you find that you are in one of these situations and feeling overwhelming?

Here are some general examples of relapse-prone situations to most commonly seen psychological, mental or psychiatric problems. There are normally some high-risk situations that are specific to each individual and the psychological problem that s/he has.

  • Stress: from any source really, it could be accumulative, or due to single (major) event
  • Negative emotional states, such as anger, anxiety, depression, frustration, and boredom
  • Physical illness: when you don’t feel well physically, your emotions are affected too
  • Social isolation (Very important! Face-to-face social interaction has been found to reduce risk of depression, yes F2F, not through whatsapp or instagram!)
  • Major life transition events (graduating from college, starting a new job, getting a promotion, getting married, becoming a parent, ending a relationship, loss & grief, moving house etc)
  • Going back to the environment that is related to your onset of previous episode(s)
  • Social pressure, interpersonal conflicts (especially for relapse of addictions)

So yes, do pay attention if you are in one or some of those abovementioned situations, and watch out for those early warning signs, including by watching out how your sleep patterns, appetite, mood level and (physical & social) activity level are.

Why do I need Psychotherapy on top of Medication?

Case 1:

My OCD client. She used to take medication many years ago, and has stopped after her condition was well under control and they were planning for pregnancy. The symptoms came back quite aggressively during her pregnancy, but with the support of her husband and family, she didn’t take any medication till her delivery, then she found me. We started psychotherapy (mainly mindfulness and Exposure Response Prevention) few months back, if you ask her what her advice was based on her experience, she would tell you, “I should have started psychotherapy when I was taking medication. That was when my symptoms were less intense with the medication, and the exposure would have been much easier. That way I could learn the techniques and use it later when I no longer medication. I wasted the opportunity. When my symptoms returned and I couldn’t take medication, I don’t know what I can do at all. I struggled till my baby was delivered.”

Case 2.

My anxiety client. She was referred to me by a psychiatric consultant, when we first met, she was rather cheerful and calm, and was tailing off the medication instructed by her doctor. Then she never came back for follow up. Till two months later, she texted me saying she had been so anxious and was unable to sleep for the past nights. We had our second session where she learnt some coping skills. When I followed up with her over the phone, she told me she was much better practicing what I told her to, and was able to sleep. Another month gone, and I received her text again saying she was under much stress and worrying a lot. She asked if there was anything she could do to stop worrying and being so anxious about things. I told her to come back for a follow up session.

 

Psychotherapy doesn’t work like tranquiliser. You pop the pill into your mouth, within 15 minutes or so you get much calmer. Psychotherapy doesn’t work like anti-depressants either. You take the medication regularly for few weeks, your depressed mood, your anxiety and OCD symptoms subside significantly.

However, psychotherapy equips you with coping skills and techniques, if you practice regularly, it becomes YOURS. You become your own therapist. When you spot the early warning signs and symptoms, you can treat yourself, without medication, without any wait.

So when you get much more stable after taking medication, it’s always good to start psychotherapy, which help you tail off medication more easily, understand yourself and the illness better, and prevent future relapse better.

The elderly companion

I came across quite a few “love-less” relationships in some elderly couples recently. They are normally above 60 years of age, retired, spending a lot of time together (if not all the time), and starting to argue within 5 seconds of a “conversation”.

I am not sure if it’s right for me to call them “love-less”. But there does not seem to be anything else, other than complains, arguments, resentment, and even hostility. Sometimes I feel like they are hating each other.

Whenever I try to shift the topics to something else, within a short while, and often without me realising, the topic is again back to the partner, what s/he has done, how s/he hates him/her doing that etc. I observe “loathing” on their faces when they talk about their partner.

“Hmm.. Ok. It appears that you two dislike each other very much, and dislike spending time with each other, and will start arguing once you talk. How about separation? Have you guys considered —” (Normally I don’t get to finish what I intended to say)

“No la! This is normal what! Don’t be silly la! You know how old we are now… It’s normal la, spending time together and arguing. You are young, you don’t know just yet”

Deep down most of them admit that they are no longer able to live the life on their own, without that partner who has been with them for many decades, whether with or without children. “Divorce” never crosses their minds, it can’t be mentioned, they don’t even consider it, as if it will lead to some disaster, socially, familial, morally etc. But they feel miserable with this life of retirement, it was never what they imagined to be (free, joyful, enjoyable etc). Even when they go on holidays, they can argue non-stop.

Other than listening to them, I’m not sure what I can do to help them. They don’t need any medication. They do need some counselling or psychotherapy, but they are not keen to stick to doing homework and learning new skills to communicate better, to manage anger better etc., they think they know better.

But normally, if both are relatively healthy, I’d at least recommend them to spend more time separately, look for their own interests and circles of friend, develop purpose of life of their own. This usually helps, as it indirectly enhances the quality of time they spend together. What say you?

Free and Alive – An email from a reader

My work email (hello@huibee.com) does receive emails quite frequently, from people seeking psychological helps, worried family members, potential clients, advice seekers, existing psychology students etc. However, this one is quite unique!

I’ve got the permission of the reader to share this email that he’s written to me last week.


Hi,

There is a story I want to tell You, I hope this letter reaches you and you’ll have some time to read it.

I’m a 21 yo guy from Hungary. 
A few years ago somehow, somewhere on the internet I stumbled on this post:
http://huibee.blogspot.hu/2012/09/behavioural-experiment-for-social.html?m=1
I don’t remember how I actually managed to find such a thing, but It was haunting my mind for years. “You should go take a banana for a walk, that would be fun”
I was daydreaming about it a lot more than I’m proud to admit
Not because it’s something foolish to think of, but because I haven’t done it for years, even though I wanted to and could’ve.
I even put in on my bucket list to make sure I’ll do it one day.
Then I realized that every day could be that “one day”. I don’t have to wait for it, not a single day.
So one day, on april 8th, 2018 I went for a walk with my banana, called “bobo” (I assume it’s not protected by copyright, right?)
It was amazing. People were laughing, smiling all the time around me. Someone even stopped to pet the banana, while other took pictured of it (and me). Since it’s 2018, it’s not a common thing to see someone taking a walk with their banana.
Of course there were some grumpy people who just didn’t get it and looked at me with that judgemental, disgusted face
I’m never affected by such things, I didn’t care about how they thought that i’ve lost my mind or whatever, all I cared about is the smile on the faces when walked past me.
It was a wonderful feeling. The sun was shining, it wasn’t too cold nor too hot, everything was just right.
I wish I could do other things with such a “free” spirit. Do you know any other ideas that are similar to this in some way? You know, that day for that 3-4 hours I felt really alive, which I haven’t felt for a long time. I’ve been trying to find my place in this mess called “world”, but it’s really difficult if you are entirely different than everyone else.
Honestly I really wish that you would understand how big impact that post had on my life.
If you have some free time, I would like to continue emaling for a while, if you don’t mind.

Thank You,


The post he mentioned was written during the time when I was in the UK and doing a diploma with Donald Robertson. You can also read it here (I moved my blog over in 2013, but the old link he provided has got a video of us doing it).

I’ve never thought that my blogpost would reach someone that far away, and influenced him in such special way. I mean, seriously, we can never imagine how things may turn out. I’m so glad that he took the effort and initiation to look for my contact (wasn’t available in my old blog) and got in touch with me.

Be kind, be grateful, and live your life to the fullest. Try out different things, embrace new experience.

He also attached the picture of his pet, Bobo, at the end of the email.

banana

Watching the Mind-Train

Meditation Exercise: The Mind-Train

Following my favourite Leaves on the Stream (see here), I am introducing another mindfulness exercise. It is an eye-closed exercise (though possible to do it with eyes opened when you are familiar), so please read the instruction first.

Imagine you are standing at a railway bridge gazing down at three sets of train tracks. A slow mining train is on each set of tracks moving away from you. Each train is composed of a string of little coach/car. Seemingly endless, all three chug slowly along underneath the bridge.

Now, as you look down, imagine that the train to the left carries only ore composed of sensations, perceptions, and emotions (e.g. sounds you hear, hot sensation you feel, sweaty palms, sadness you notice, itchiness you feel etc). The middle train carries only your thoughts (your evaluations, predictions, and self-conceptualisation etc). The train on your right carries your urges to act (e.g. your pull to look away, your urge to scratch your face or stop the exercise, your efforts to change the subject). Looking down on these three tracks can be seen as a metaphor for looking at your mind.

Now, find a comfortable chair to sit in for a while in a spot where you won’t be disturbed and you can be quiet. Begin the exercise by thinking of something you’ve been struggling with lately, then close your eyes and picture the three tracks. Your job will be to stay on the bridge and gaze down at these three trains moving away from you. Take at least 3 minutes just to watch what comes up for you.

Mind train. (Forgive my very basic skills, it's not as simple in my imagination!)

Mind train. (Forgive my very basic skills, it’s not as simple in my imagination!)