Internet Gaming

This year the World Health Organisation (WHO) Gaming Disorder, of which problematic internet gaming comes under.  Gaming Disorder is defined as having patterns of problematic gaming behaviour for at least 12 months, where there has been an increased priority given to gaming at the cost of other interests and daily activities.  The behaviour also needs to cause significant impairment to daily functioning, such as interfering significantly with one's work, relationships and school.  Such disruption could lead to jobs lost, or significant warnings for performance.  This may seem like drastic definitions, however in a recent study from Finland, where they reviewed 50 studies on internet gaming, correlations between problematic gaming behaviour and depression, anxiety, OCD and somatisation were found.  With increasing advances in technology and new games invented and being downloaded everyday, gaming disorder, whether accepted as a clinical diagnosis or as part of the landscape we live in, is here.

One significant impact internet gaming can have is on the quality of sleep.  Unlike a tennis match with a limited pool of players, within your time zones, who have a limited physical capacity to keep going, internet gaming is boundary-less.  It is difficult to identify clear finish times, and to manage gaming relationships.  Sleep is impacted when it is difficult to wind down and "finish".  Particularly if time zones mean that you could be disadvantaged if you stop while other players keep going.  The temptation to load up on caffeine, push through natural sleep and tired cues impacts sleep.  Conflict in gaming relationships can be toxic.  What gets said in chat forms behind a screen can lack the civilities and appropriate courtesies than what is considered sporting behaviour.  This too can keep you awake.  We also know that flickering lights and blue light from screens impact sleep negatively.

If you are wondering where to go for help, speaking to a trained professional to help with problematic internet gaming behaviour, and therefore improve quality of sleep would be a helpful first step.

Depression In Men: Stealth Mode

Symptoms of Depression in men can go undetected.

It is commonly thought that men are socialised to hold their emotions in check so as not to look weak and "unmanly".  Yet emotions and the ability to feel makes us human.  It brings the best of us to others as we express not only what we think, and in what we do, but also in what we feel.  Emotions are a way for us to have a sort of thermometer to indicate to us what is going on deep within us.  When our emotional life is in a state of constant turmoil and aggravation, the clinical signs of depression can surface.  Depression in men can be difficult to detect.

As men may find it difficult to express just how despondent and despairing they are feeling (as in when they are in the grip of depression), they may not signal or seek for help at the early stages of depression.  They may not themselves recognise the start of the downward spiral of mood.  Added to this, is the uncommonly known symptoms that characterise depression in men.  In addition to the typical symptoms of depression, low mood more days than not, change in appetite, impacted sleeping, gripping thoughts of low self worth, guilt, shame, loss of pleasure, thoughts of self-harm and suicide, there are some additional symptoms to look for in men.

Depressive symptoms in men include:

  • Increased irritability, anger and interpersonal sensitivity
  • Physical symptoms - headaches, body pains, impacted sexual functioning and libido, digestive difficulties
  • Increased risky or self-harm behaviour: Substance use, reckless driving, aggressive sport playing inducing injuries, risky sexual behaviour

Men are for more unlikely to seek help for their mental health.  Being aware of the risk factors for men, knowing the complete picture of depression in men can help with early detection, and awareness that could make the difference.

What you can do:

  1. Affirm their experience without trying to solve or fix things. Listening is a powerful affirmation of someone's experience and offers the hope that they will not be judged as being weak.
  2. Read some material together, exploring the commonalities of other men's experiences and recognising the experience of your friend or loved one as being common to many.
  3. Offer to be there for the next step - making an appointment with your family doctor.
  4. Make sure you have support for yourself as well.

Be sure to read some of our blogs on Men's mental health.

Gentlemen! Your health matters!

Men's Health - did you know?

We look at men's health in this post.  Did you know that statistically men live 4.4 years less than women?

Did you know that 70% of overall health is controllable through factors such as regular exercise, balanced diet, sufficient sleep and having strong friendships?

Did you know that men who are physically inactive are 60% more likely to suffer from depression than those who are active?

Did you know that 54% of Australian men are insufficiently active?
(According to the Australian Institute of Health and Welfare)

Although exercise has been shown to play a huge role in men’s health, it can be hard to know where to start. Thankfully, there’s a whole field of psychology research dedicated to figuring this out. Phew!

What we do know

So what does this research tell us? Men need to be doing a minimum of 2 ½ to 5 hours of moderately intense exercise (i.e. brisk walk) each week OR 1 ¼ to 2 ½ hours of vigorous exercise each week (e.g. hiking, running, carrying heavy loads, and sports such as basketball and soccer). In addition to the options above, you also need to include at least 2 muscle strengthening workouts per week (e.g. weights, resistance training or body weight exercises).

Starting somewhere is better than nowhere, so start somewhere – Is it too ambitious to begin running 3 times a week? Start running once a week. Intimidated by the equipment at the gym? Learn how to use one new piece of equipment each week. Just aim to get your body moving. Increase exercise gradually rather than attempting to reach the recommended goals all of a sudden. Smartphone apps can help you gradually increase and track your exercise, like Couch to 5k (C25K), Runkeeper or Zombies Run.

Call a mate or find an exercise buddy – Research suggests you are more likely to make changes if others are changing with you. Get a family member, friend or colleague to join you. Start a culture of friendly badgering about when you will next exercise together. Perhaps join a sports team or your local Park Run (http://www.parkrun.com.au/) so that the exercise is goal-directed and social.

Celebrate your changes – Regularly look back at what you have achieved over time with your exercise buddy and make a big deal about it. Put up a victorious Instagram post. Take photos of yourself periodically and track the changes – they will happen with time and persistence!

Don’t just celebrate your physical changes – exercise makes your brain happier too, reducing symptoms of depression, stress and anxiety. Research suggests that even within 5 minutes of moderate exercise a noticeable increase in mood can be felt. Furthermore, the effect of exercise on depression has been found to be comparable to the effect of antidepressants in adults with major depression (Blumenthal et al., 2007)! So take note of your mental improvements and celebrate them, because exercising improves your mind as well as your body.

For more information on Men’s Health Week, watch the Centre for Effective Living Facebook page.

Introducing Teens To Mindfulness

Mindfulness in teens has many benefits. It can help their focus and concentration, which can help with academic performance, it can improve empathy and social skills and even help manage stress and control impulses. Yet teens may resist efforts to introduce them to mindfulness. They may think that it is yet another adult attempt to tell them what to do and let’s face it, that’s the last thing any teen wants. So how can you introduce teens to this highly beneficial practice? Here’s a few tips from my experience teaching mindfulness to teens in our clinic:

Teach them the neuroscience behind it - you may think that the last thing a teen wants is more education but this is not so. I’m always amazed by the response I get from teens when I go into my mini neuroscience lesson. Teens who seem quite skeptical at first are quite intrigued by how their brains work. I think they appreciate the respect that they are shown when one explains principles to them rather than simply giving them instructions. Explain to the teen that our emotions are triggered by the Amgydala while rational thinking takes place in our prefrontal cortex. When the Amygdala mistakenly thinks we are at risk it hijacks the prefrontal cortex, which we need if we are to think effectively and rationally. Mindfulness helps kick the prefrontal cortex back into action, which helps us think rationally and effectively.

Invite them to try it out - tell them the science behind it and then invite them to test it out for themselves and see if it works for them. Encourage them to try it out each day for a week and reflect on their experience. Encourage them to be their own scientist, experiment with the practice and then decide for themselves if it is something they want to continue or not.

Make it simple and practical - Teenagers probably don't want to spend half an hour sitting on a mat and meditating, teaching them to do everyday tasks mindfully is likely to be a more practical option for them ,as it is for us. My favourite is the 5 senses exercise as you can apply it to any everyday activity and it doesn't require you to take time out of your life to do it. This exercise simply involves using all 5 of your senses to focus on whatever you are doing. For example, while walking to or from the bus you can notice 5 things you can see, then 5 things you can hear, 5 things you can feel in contact with your body and anything you can smell or taste.

The teenage years have their challenges but teens also have great capacity to learn and this is a time of significant brain development. Teaching teens practical life skills such as mindfulness gives them simple strategies they can use to help navigate the ups and downs of adolescence and adulthood.

For more articles on adolescent mental health look here.

Embracing Emotions Mindfully

Unpleasant emotions and Mindfulness

Do you ever think this way in regards to how you feel? Do you dislike feeling unpleasant emotions? Do you try to avoid unpleasant emotions in any way you can? Mindfulness can help with this.

"I hate feeling this way"
"I can't stand this feeling"
"It’s stupid and unacceptable to feel this way"

It is common for my clients to report disliking unpleasant emotions and to view them as unacceptable. It is common for them try to escape the uncomfortable emotion. However attempting to avoid and escape uncomfortable and unpleasant emotions can create significant distress and lead to a range of problems.

The problem is, we all experience emotions and they are an important part of being a human. Some emotions are pleasant, where as others are uncomfortable and we would prefer if we did not feel that way. We can't always avoid feeling unpleasant! There is a difference though between disliking unpleasant emotions, but nevertheless accepting that they are part of human experience and riding them out, versus experiencing an unpleasant emotions and perceiving it as unbearable and something to get rid of.

Although it makes sense to avoid any unpleasant emotion or distress, what generally happens though, is the more we fear or struggle with, or attempt to avoid the distress, generally the worst the distress gets. By attempting to avoid the distress, it actually makes it worst.

For my clients who find their emotions distressing, I help them to understand that their feelings can't hurt them and to see them differently. A skill I teach them is mindfulness. Being mindful can help them to observe their feelings and begin to accept them; to let them be there and ride them out versus pushing them away.

If you find your emotions distressing here a few tips to start being mindful:
- Stop and observe how you feel
- Do not judge how you feel as 'good' or 'bad'
- Label what you are feeling as just a feeling ("It's just my anxiety again")
- Imagine your emotion to be like a wave that will pass
- Engage in mindfulness meditation. Start with a mindfulness of breath recording then try recordings on being mindful of thoughts and emotions

How To Support Friends and Family Who Care For Children With Autism

Supporting friends and family who care for children with autism

“It must be upsetting to see such small successes.”
“I don’t know how I could do it”
“My friend had a child that was a late talker, but now the parents can’t stop him from talking!”

These are just a few of many unhelpful comments I’ve heard people say in an effort to empathise with parents who have children with Autism.

Prior to my career as a psychologist, I worked as a behavioural therapist with children on the Autism Spectrum (ASD) and their families, and I myself have friends and family members who care for ASD children. I have often observed families feeling isolated and misunderstood by their friends and family, even though they were trying to be supportive. In light of autism awareness month, I asked my friends and family who care for children with Autism what they have found helpful and unhelpful. From their reflections and my own, here are a few pointers on how to support your friends and family who care for a child with Autism.

Keep Up Social Interactions – Taking the time to call or meet with your friend to hear about their experience as a parent. If your friend/family member is bringing their child, ask them what would work best for them. For example, often children with ASD can get distressed by certain environments, be understanding if your friend wants to avoid these places. If the child does get upset while you’re meeting, realise that parents can feel concerned that those around them may become judgemental. In those situations, reassure parents that it’s fine, you understand that their child can become stressed or anxious, and that you aren’t concerned about their child’s behaviour.

Join with them - Join with them in the difficulties but also celebrate the successes, these can be things as simple as their child being able to walk through a supermarket without becoming distressed. Don’t think that these changes are insignificant, if a parent is sharing it with you, it’s likely that it’s taken them a long time to get to that point. Don’t always assume that parents of children with autism are struggling, despite the challenges, parents can often be coping well and delighting in their child. Delight alongside them!

Learn – Seek out information about autism and ask your friend what has been helpful for their family and how you can best support them. Be willing to get to know their child and delight in their strengths and personalities. Teach your friends and family to do the same. Try to avoid telling your friend or family member facts you’ve discovered about ASD. Even though it may be unintentional, this can give your friend the impression that you think they don’t know enough to help their child. More often than not, they have committed a large portion of their life to seeing specialists and learning how to care for their child.

Watch your language – Before we know it, we can slip into language that implies someone with Autism is defective. This can be hurtful to parents and their children even if it is unintentional. A helpful way to watch how we speak is to focus on the positives and spend time investing in these unique children.

Don’t compare their child with other children – I have observed people trying to give carers hope by telling them about success stories they have heard about other children with Autism. For example, “I know another child who was a late talker but now the parents can’t get them to stop talking!”. This can bring parents to feel misunderstood and unheard. Every child with Autism is unique and different, the development of one child does not necessarily reflect the development of another. Rather than compare children, share in the joys of your friends child and celebrate their strengths.

Self Esteem and Teenagers on The Autism Spectrum

"Why don't I fit in?"
"What's wrong with me?"
"Why won't people be friends with me?"

These are all common questions I hear from teenage clients on the Autism Disorder Spectrum. Self-esteem issues and difficulties establishing friendships are all common issues for those who are on the spectrum.

People with Autism Spectrum Disorder tend to see the world differently and act differently, often leading them to be a target for bullying or criticism. An unwillingness of other teenagers to make allowances for their social mistakes can lead them to be socially isolated.

All of this can really bring down the confidence of someone on the spectrum. They may begin to tell themselves that their way of seeing the world and doing things is wrong. They may begin to believe that there IS something wrong with them.

To parents or loved ones of those on the spectrum, here are a few tips for improving their confidence:

  • Reinforce their positive qualities and encourage them to foster their strengths.
  • Encourage them to be involved in activities they are interested and talented at.
  • Be kind and patient with them- they are probably not being kind or patient with themselves.
  • Show them unconditional love and acceptance. It is important for them to know they are loved and valued by you

If you are on the spectrum, here are some tips for improving confidence:

  • Focus on appreciating your positive qualities. Think of qualities of yourself that you are proud of, you have received compliments for or are valued by others
  • Don't give up on making friends; don't retreat or isolate yourself. Doing so can make you feel more depressed or unappreciated. Consider joining an ASD support group with people who understand.
  • Consider taking small steps into a hobby or interest that can provide a way to connect with others in a safe environment where your interests are shared with others, and can be appreciated.

If you or your loved ones with ASD are struggling with self-esteem, the psychologists at the Centre for Effective Living understand the unique challenges of those on the spectrum. Speaking with a trained professional can help with improving self-esteem, along other difficulties such as anxiety and depression.

Workplace Bullying

She talked to me about the confusion she felt. Was she justified for calling her a stupid ****? Sure she was learning the job still. However, she wondered if it was necessary to be put down constantly. She wasn't sure, but it seemed like she was getting rostered on to work at hours that were unreasonable, especially as her boss knew she was a single mother and had limited childcare. Then there were the last minute requests for things to be done a certain way and in a time frame not even superman could deliver. Then the closed door meetings. Often when nobody was around. They were frightening, her boss was intimidating. She yelled, she swore she demanded, she put down. Dare she say she felt she was being bullied? Would anyone believe her? Who would she tell?

Workplace bullying is repeated and unreasonable behaviour directed towards a worker or a group of workers that creates a risk to health and safety. Workplace bullying is very real. It is not a single incident, it is a series of targeted acts that leave you feeling threatened. You dread going to work because you have a very real feeling that you are not safe, and you are not sure what is going to come at you next.

Employers have a responsibility to create a safe workplace. Which means you have the right to a safe and bully free work place. Refer to your work place bullying policy and procedures. Take the steps to speak confidentially to someone about your next steps. Seek advice and believe that you do not have to put up with this. Know your rights by referring to this link http://www.safework.nsw.gov.au/health-and-safety/safety-topics-a-z/bullying/workplace-bullying.

If Your Child Is The Bully

Most children at one point or other will tease other children, but bullying is more than teasing. Bullying is defined as repeated verbal, physical or social behaviour towards another person that causes physical and/or psychological harm. With the advent of social media and portable devices, bullying has become more pervasive, rather than only occurring in person or at school, cyberbullying can occur in the home, anywhere and 24 hours a day.

We often spend time thinking about how to help children who are victims of bullying, but what if your child is the bully? Discovering that your child is a bully can be distressing and heartbreaking. It’s so easy to see this as an attack on our parenting and we can be quick to jump to defend our child. However, it’s important to take this information seriously and step in early to help your child change their behaviour. Here are some ways you can help your child if they are bullying others:

1. Talk to Your Child

Once you’ve been notified of your child’s bullying behaviour, the first step is to talk with them about it. It’s often tempting to try to make your child feel ashamed, but this will cause them to close up and not want to share with you. The best approach is to try to show understanding and reflect back to them what you hear them saying. Allowing your child to speak openly without shaming them can help you understand the reasons for their behaviour.

After you’ve heard your child’s side of the story, it’s important to talk with them about the consequences of their bullying behaviour on others and make it clear to them that this behaviour is unacceptable. There are a number of ways you can help your child identify the consequences of their behaviour. One way is to ask questions that require your child to imagine themselves in the other child’s shoes i.e. “How would you feel if someone excluded you?” or “Imagine if someone stole your lunch, how would you would feel?”. Another useful way to discuss the consequences of their behaviour is to ask your child to recall how the other child reacted to their behaviour i.e. “How did Tim react when you hit him? What did his face look like? What did he say?”. You need to firmly communicate that their bullying behaviour is not acceptable.

2. Support the School’s Bullying Policy.
The next step is to contact the school, become aware of their policy on bullying and what the consequences are to be for your child. You can ask the school if there are things you can be doing at home that support their disciplinary measures. By supporting the school’s response to your child’s behaviour, you are clearly indicating to your child that bullying is not ok.

3. Understand the Heart of Your Childs Behaviour
Talk with your child and their teacher to try and identify what is at the heart of their bullying behaviour. It may be that your child has difficulty controlling their emotions, they may struggle with beliefs of inadequacy or they may be bullied themselves. In some cases, bullying behaviour is a misinterpretation of messages to “stand up for yourself” or it can be a reflection of conflict they’ve seen at home or on TV. It may be appropriate to seek help from one of our Psychologists who are skilled in identifying and addressing these difficulties. We can also provide you with assistance and support when addressing your child’s behaviour. There are numerous reasons why a child may bully others and identifying these reasons is key to intervening and helping your child develop more healthy and positive relationships.

What to do if your child is being bullied

Bullying is a behaviour that is rarely tolerated in most workplaces.  What about in the school yard? Have you ever heard parents say that children should be left to “sort it out” or “toughen up”? I disagree! If we do not tolerate bullying of adults, how much less should we tolerate bullying of children! In fact, research shows that being bullied as a child can result in several difficulties throughout one’s life including psychiatric diagnoses, difficulties with trust and low self-esteem, to name a few. Children who are bullied can experience depression, anxiety, poor sleep and impaired academic performance.

So what can you do about it? Firstly, create a safe space for your child to talk about such things. It can be difficult listening to a child’s stories in the midst of everything else you have to do but talking with them regularly means that they are more likely to tell you when something is awry. When your child does open up don’t dismiss their feelings, rather, validate their feelings whilst teaching them what to do about it. Praise them for telling you about it and be encouraging as you advise your child.

Teach your child a statement that he / she can say in response to any bullying and have them practice at home. For example, “Stop it, I don’t like it”. Teach them to speak confidently in a loud and clear voice. Tell your child to notice the colour of the other child’s eyes when talking to them. This is a little trick that will help your child to hold their head up, which in turn makes them appear more assertive and less intimidated by the bullying. Encourage them to then walk away and play with someone else.  Role play the scenarios at home with you playing your child to model the behaviour to your child, and then you playing the bully so your child can practice.

Encourage your child not to be alone but to stick with their friends. In fact, encouraging your child to be friendly and make lots of friends is a very useful way to reduce their risks of future bullying. Discuss friendships and how to make friends and the importance of having a wide social network.

Importantly, speak to your child’s teacher. It’s important for your child to know that you have their back and whilst you will teach them how to handle bullying, they need to know that you will also do something about it and that they are not in this alone.

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