用于精神病患的接纳与承诺疗法 (ACT)

近几年在北京当助教和翻译的时候,常遇见学生问说除了药物以外,还有什么方法可以帮助精神分裂患者,尤其许多患者用药虽然很重,但还是有幻听(auditory hallucination) 和妄想(delusion) 的症状,严重困扰着生活。

其实现在有越来越多的研究表明接受和承诺疗法(ACT)对于精神病患者很有帮助。作为干预,ACT不是特别针对症状减轻,而是强调对精神病症状更灵活的反应,以鼓励价值驱动的行为(就是你的生活由你的生活意义和价值来决定,而不是完全被你的病状所控制)。许多的案例研究显示,用ACT帮助偏执狂 (Paranoia),妄想 (Delusion) 和相关的情绪障碍,虽然症状没有完全缓解,精神病依然存在,但却相当程度的减轻了患者的痛苦,而且生活的功能性和基于价值的活动(Value-based activities) 显著增加。

所以如果你,或者身边的家人或朋友患有精神分裂症,尤其幻听和妄想的症状在用药后依然对生活造成相当的困扰,可以考虑留言或电邮联系,因为只要患者有心改变,6到10次基于 ACT 的心理治疗就可以学习新的应对方式,减轻痛苦,活得更有意义。

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?”

ACT Therapists in Malaysia

I came across Acceptance and Commitment Therapy (ACT) in 2011 and fell in love with it almost immediately. Since then I have been practicing it on myself, then subsequently learning it from books, and started to incorporate it into my daily clinical practices.

Now I’ve also completed the course with Russ Harris. I’m wondering if there’s any ACT therapists in Malaysia out there, and if yes, please get in touch (my email: hello@huibee.com, my mobile 017-2757813) and let’s form a Malaysian ACT community together!

 

What’s ACT?

  • It stands for Acceptance and Commitment Therapy, pronounced as “act” (one word)
  • It’s a type of psychotherapy, not a long-term treatment
  • 3rd wave of CBT (Cognitive Behavioural Therapy)
  • It focuses on 6 processes, which can be combined into these:
    1. Being present
    2. Opening up
    3. Doing what matters
  • As of late 2018, there are over 250 RCTs (randomized controlled trials, the gold standard of research) published in peer-reviewed journals, that show the effectiveness of ACT with many disorders, such as depression, anxiety, stress, OCD, chronic pain and psychosis.

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

The Freedom to Choose

“We who lived in concentration camps can remember the men who walked through the huts comforting others, giving away their last piece of bread.

They may have been few in number, but they offer sufficient proof that everything can be taken from a man but one thing:

the last of the human freedoms –

to choose one’s attitude in any given set of circumstances, to choose one’s own way.”

- Victor E. Frankl

This is a quote from the book “Man’s search for meaning”, a book written by Viktor Frankl published in 1964, the author recorded his experiences as a prisoner in Nazi concentration camps during World War II.

Just to, perhaps remind all of us that, even in the most difficult and challenging situation, there’s still one thing that we all possess – the freedom to choose. We might not be able to leave the situation, but we can choose how we’re reacting to the situation, how we are treating ourselves and those around us. And nobody can take this away from us.

关于“正念”的迷思

正念越来越流行,却也有越来越多关于“正念”的迷思:

  1. 正念=冥想:有成千上万的方法来练习正念,而冥想静坐只是其中一个方法。
  2. 正念源自于佛教:许多宗教也进行正念练习。但正念不是一个宗教的概念,它只是一个心理技术/状态。
  3. 正念=放松:就算在充满挑战的情况里,你感觉焦虑愤怒,但你还是可以正念地接纳一切,活在当下并与环境互动,而完全不感到放松。
  4. 正念用于控制想法,去除负面想法,带来更多积极正面的想法:正念帮助我们觉察我们的想法,允许想法来来去去,并能选择哪些想法可以帮助我们朝目标前进,而哪些想法我们可以放下。
  5. 正念用于控制情绪,带来更多积极的情绪、感觉美好快乐:正念在于更完整地体验生活,也就代表体验更完整地、不管是你喜欢的积极情绪(如:快乐、爱)或消极的情绪(如:悲伤、恐惧)。

 

想更了解正念?也可以看看这个:

冥想 VS 正念