The Inevitability of Change - Learning to be in the Moment

By Ms Ali V Flint

They say “the only things certain in life are death and taxes”, but there’s another - the inevitability of change. The fact that nothing stays the same is something that bears thinking about as a human being in a temporary body, with to-do-lists that are never completely done, existing on a planet that we have a complicated relationship with.

One of the reasons I cherish the Buddhist teachings is their timeless relevance and universal applicability to all. A deep dive in to the topic of impermanence during a recent study module left me processing long after the weekend Zoom lessons concluded. The need to absorb these teachings via my laptop in my lounge room rather than taking a flight to Sydney and being with my Sangha was another lesson in itself – acceptance of unwanted changes, of yet another frustration associated with Covid-19, of finding peace with what is, and appreciating that technology can let us connect in alternative ways.

Some people might find impermanence and change confronting or saddening - and there definitely is that element within the teachings. The fragility of life, and the search for meaning while we live it, are not easy issues to meditate on. Considering impermanence and change however powerfully promotes the preciousness of each experience we have, honours each connection we make, and reminds us that the memories we collect may be all we have at the very end.

It’s understandable to fear change, protect the perimeter of our comfort zones, and grasp at the familiar. We cling to everything from our youth, identity, beloved pets, friendships, jobs, health, societal expectations and rapidly-growing children who will at some point look down from the mountains they too have climbed.

A lot of my work involves supporting teenagers with mental health issues – which simultaneously keeps me connected to my younger self and shines a light on every day (and the lines on my face) on the planet so far. There is nothing like a teenager to give you brutally honest feedback or remind you of how ancient you seem. In other words, everything is relative, depending on where we personally sit on the spectrum of what is being considered.

Consider for a moment a golden sunrise gliding its way across the backdrop of a pink dawn sky. As the flaming globe keeps ascending, the sky dances through a colour wheel of pinks, purples and blues. Now imagine that you are a teenager late home for curfew again and every star that disappears is replaced by a cloud that spells out the trouble which you will face when you get home to your angry, worried parents. Take this moment instead to daydream that you are feeling weary at the end of your long life, but also grateful to be surrounded by your loved ones. Someone opens the curtains for you so you can enjoy nature’s lightshow. This sunrise may very well be the last one you experience. The opening scene on your final act. Perspective-taking can be reality-making

We rely on the beauty and awe of the natural world to comprehend and describe lofty concepts that occupy our busy minds and fill bookshelves, theatres and song lyrics. Poetry tugs at our heart strings in the same way – so I appreciated the threads of Zen poetry that were woven through the recent weekend module. For the keenly observant, layers of deep complexity are seemingly hidden within most simple reflections, in the same way that a moment can hold incredibly varied meanings depending on the context and attitude of the perceiver.

Below is a classic Japanese poem that can be seen at Sarusawa Pond – by a beautiful Buddhist temple in Nara Park, Japan (ironically translated as ‘monkey swamp’). What an insightful way of highlighting how the same event can affect each of us in different ways:

At the clapping of hands
The carp come swimming for food
The birds fly away in fright, and
A maid comes carrying tea.

It sometimes takes a startling wake-up call in the form of the death of a loved one, a health scare, being made redundant, a soul mate asking to separate, or the loss of possessions in a house fire or natural disaster to remind us we are on borrowed time and nothing really lasts forever. Don’t wait for such a day. If you are reading this, part of you already knows that it is within your power to stop sleep-walking through your life.

The present moment is all we have. Wishing away our struggles and chasing the next goal is literally erasing the precious time we do have. Being mindful of the moment you are currently experiencing is a mindset and a habit that can be practiced. We are all weavers. Humankind and the rich ecosystems we are part of are undeniably interconnected. Our lives are a myriad of unique tapestries. Truly noticing and appreciating the various threads within the tapestry - that is the way to truly see all the colours and textures of your life.

I extend an invitation to you - to meditate on the following:

Death is certain.
The time is uncertain.
What will you do with this one precious life

About the Author

Ali is a compassionate, highly intuitive psychologist with over 15 years of clinical experience. Friendly, down-to-earth and practical in her approach, Ali seeks to truly connect with her clients and support them to tap into their own inner wisdom and strength.

How to improve mental health in 2020 - What’s the difference between a top down and a bottom up approach to wellbeing?

By Richard Fryer

If you’re feeling stressed, anxious or depressed at the moment – you aren’t alone. It’s a difficult time for many of us, but fortunately there are practices we can integrate into our lives to enhance our sense of wellbeing. By learning to use bottom up and top down approaches, and to find the ones that work the best for you, you can maintain and perhaps even improve your mental health into the future.The World Health Organisation describes mental health as a state of well-being that enables a person to realise their full potential. Mental health is a fundamental building block of human performance – not something separate or somehow less important. Yet how many organisations have their wellbeing programs separate from their performance initiatives? In my experience, the answer is ‘most’.

We sometimes neglect the importance of wellbeing while focussing on the day-to-day of “living our lives”. So, how do we nurture more mental health and well-being? There are many different ways proven to help people increase their levels of wellbeing which can be broadly grouped into two types of activity.

The first set are ‘top down’ approaches – thinking and talking techniques. These might include talking with a psychologist, socialising with friends, learning new skills and some types of mindfulness meditation. Talk about your experiences with the people you’re close with, immerse yourself in learning new skills, spend time non-judgementally noticing what thoughts and feelings arise for you. You could spend a moment writing down all the feelings that arise for you. Often our inner thoughts are very tumultuous, and it can be surprising how much we’re feeling at any given moment. By taking a moment to name those thoughts and feelings we can make some space for them. Naming difficult thoughts and feelings won’t make them go away, but it can help us to carry them lightly.

The second set can be called ‘bottom up’ approaches as they work through the body to improve the mind. The body and the mind work together to shape our experiences, by using a bottom up approach we can improve our sense of wellbeing through physical experiences. Bottom up approaches to wellbeing include exercise, yoga, diaphragmatic breathing, music and other forms of play. Schedule some time to do things that make your body feel at peace.

You may notice that some activities are a combination of top down and bottom up – for example mindfulness practise that uses breathing as a way to connect with the present moment non-judgmentally.So which mix of approaches is best for me? The answer is likely to be ‘the one that you enjoy doing the most’ – which you’ll discover with expert psychologist help and encouragement! The most important point is that investing time in our mental health is an essential foundation for flourishing in our lives – not something that we should put off because of seemingly more “urgent” work or life priorities.

This is why expert ACT therapist help in building your psychological flexibility can really enhance your life performance outcomes – they have the skills and training to integrate mental health and wellbeing work with valued living improvement work, recognising that everyone needs a bit of everything from time to time.

Richard Fryer is a general and sport and performance psychologist at Brisbane ACT Centre. He works with a broad range of clients, whatever their struggle to help people realise their life performance potential – and live more rich, full and meaningful lives – during the Covid-19 crisis and beyond!

ACT at the time of COVID-19

By Marcela Costanzo

I woke up this morning with the unsettling feeling of finding a new and scary world out there, this is how much change has happened in so little time. It brought home to me what has been emphasized to us ACT practitioners at every training we have ever done: the value of applying skills on ourselves, not only to develop mastery, but also to truly experience the benefits of what we as therapists suggest to our clients.
This morning I had to make a conscious effort to follow that advice closely. The last few weeks have seen a rise in anxiety levels for everyone I know, and I am not an exception to that. Like many people, my mind alternated between disbelief and bleak scenarios; getting caught up in assumptions, rules and judgments that quickly became unhelpful.

Of course, being an ACT therapist, I understood that my anxious mind was trying to be my friend, save me from potential danger and alert me to treacherous situations. After all, that is the duty of the human mind!

And then I grounded myself, putting both feet on the floor and asked myself: ‘What is important for me right now?’ I noticed how my mind tried really hard to pull me out of this exercise. However, I realized I still have some choices and focused on those things I still some control over, like writing a blog for our clients at the Brisbane ACT centre.

I noticed the uncomfortable emotions that showed up: frustration, impatience, fear and anger just to name a few. Readers may be experiencing those emotions as well. It is totally understandable! After all, I would have preferred to be writing about something else right now, and things may get worse before they improve. How can we not feel anxious at this unprecedented time? And yet, remember that you still have some control over your actions.

You can still choose to act kindly and compassionately towards family and friends, colleagues, and fellow shoppers at the supermarket.

You can still spare a compassionate thought for the countless people who have lost their jobs and are struggling to pay their rent, and for all of us who have to spend more time at home. In these circumstances, some may be more lonely and others may be experiencing the stress of spending long periods with an abusive family member.

Personally, a commitment I made early this morning is to catch myself every time I say ‘Now I can’t ….’ And replace it by ‘How can I ..? So I would love to invite you to join me in being creative in asking this question. When you face the reality that you can’t socialise with your friends, I would love you to ask yourself: ‘How can I keep in touch with my friends in this time of physical distancing?’ ‘How can I look after an elderly family member in the time of physical distancing?’

I realized this morning how much we all need the psychological flexibility that is the ultimate aim in ACT. Remember that when you feel overwhelmed or close to despair, your ACT practitioner will be there for you and do not hesitate to reach out. We are in the process of starting to deliver psychological services remotely, using the great technology at our disposal. We are confident that ACT will help you in the challenging times of COVID-19!

About the Author

Marcela is a clinical psychologist and ACT clinician who is passionate about using modern cognitive behaviour therapies, in particular Acceptance and Commitment Therapy (i.e. ACT!), to help ease many common human struggles. She has expertise in helping clients with a range of presentations including but not limited to anxiety, depression, life transitions, acute stress, relationship issues, change of careers, adjustment disorders, grief and loss, sleep difficulties, self-esteem, chronic pain, body image (all ages) and substance abuse.

If you are feeling depressed – ACT can help

By Peter Gillogley

In this article you will find answers to some Frequently Asked Questions (FAQ) about Depression based on some recent research. Questions address by this article include:

How common is depression?

What evidence-based treatments are there for depression?

Will my depression ever get better?

How does rumination cause depression?

Treatment for rumination

Where can I get help for depression?

How can I get help for depression?

How common is depression?

You are not alone, actually depression is pretty common. According to the National Survey of Mental Health and Wellbeing, around half of Australians experience a psychological problem in their lifetime, with about one-in-five people experiencing a common psychological problem in the last 12 months. More than one-in-twenty Australians experienced a clinically significant disturbance in emotions or feelings, such as depression in the previous 12 months. That’s a lot of people, some of which may be experiencing trouble sleeping, appetite changes, libido changes, or difficult feelings such as despair, melancholy, misery, sadness, hopelessness, worthlessness, unmotivated, and low energy.

What evidence-based treatments are there for depression?

Fortunately, recent research is telling us that Acceptance and Commitment Therapy might help. Acceptance and Commitment Therapy (ACT) is a modern form of cognitive behaviour therapy (CBT), that teaches specific, structured evidence-based skills to help you better manage difficult thoughts and feelings, so they are less an obstacle to you living a life that is guided by who and what is important to you.

ACT is an evidence-based approach for psychological problems, with an impressive research base of over 200 Randomised Control Trials supporting the effectiveness of ACT. ACT helps depressed people, as effectively or better than other established psychological treatments.

Will my depression ever get better?

It is common for people experiencing depression to feel like things will never change, or that any gains made during therapy in managing difficult thoughts and feelings will “wear off”. Recent research is much more optimistic. In one Finnish study, over two-thirds of depressed participants who received ACT treatment, no longer met diagnostic criteria for depression. And the gains made during ACT therapy are still detectible 3 years later. A similar study found gains made during ACT treatment were still detectible 5 years later.

How does rumination increase depression?

Sometimes, reflecting on past experiences can be a useful way of learning and becoming wiser. However, if there is a gap between what we have and what we want, our problem-solving minds can try to be helpful by trying to figure out what went wrong, or what we need to do next. This might work more often, if figuring out what to do with difficult thoughts and feelings was as easy as every-day challenges in the physical world, like finding your missing socks. When our problem-solving minds don’t achieve immediate success, they often turn the intensity dial even higher, screen out distracting experiences from the outside world (that might hold useful information), so your mind can focus on what is happening inside your head. So, despite your mind trying to be helpful, this pattern of thinking can turn into unhelpful brooding. A consistent finding of resent research is that repetitive negative thinking (rumination) prolongs and deepens sad and depressed mood.

Treatment for rumination

ACT is sensitive to the rumination behaviour and provides a vantage point to notice what is happening and provide more flexible ways of responding when difficult thoughts and feelings arise and you find yourself brooding or ruminating over and over again. Notice that ACT is not trying to change your negative thoughts (although your thoughts might change) or make them go away. When you notice yourself hooked by a particular thought, ACT teaches you how to unhook from that thought and focus more of your energy on living a meaningful life, rather than struggling with your thoughts. One recent study showed that even a brief two-session ACT intervention can help unhook from difficult thoughts and increase valued living.

In summary, depression is common, and ACT can help you live a more vital life.

Where can I get help for depression?

Therapists at the Brisbane ACT Centre are trained in evidence-based treatments for depression, such as Acceptance and Commitment Therapy for depression.

How can I get help for depression?

You are welcome to make an appointment with me today (Book an Appointment with Peter Gillogley) or one of my fellow ACT therapists at the Brisbane ACT Centre.

Ten things you can do to deal with depression

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So you find these dark periods are here again. You may try many things which help somewhat but depression keeps coming around. You don’t want it, and you don’t like it. But when it is here anyway, here are some tips which may help:

1. Allow yourself to feel the way you feel.

Society and social media would have you believe that something is wrong with you if you feel depressed. Of course these feelings are unpleasant and you don’t have to like them, but they are normal, common and occur to everyone to various degrees. Feeling depressed is unpleasant enough, but in addition you may feel guilty, angry, sad or anxious about being depressed. Just being ok about whatever you feel can lessen these secondary emotions.

2. Become aware of your thoughts and don’t take them all as gospel.

Taking your thoughts at face value would be like heeding every piece of advice and advertisement you hear on the radio. It’s more useful to know you are listening to the radio and hearing an advertisement. You have thoughts but your thoughts are not you. Many of our thoughts are automatic and just pop up, and may not be that helpful. Seeing your thoughts for what they are gives you a chance to decide which ones to pay attention to.

3. Put your efforts towards changing your actions rather than your thoughts and feelings.

We have the idea that we need sort out our thoughts and feelings first before we can make changes to our lives. The research shows that it is the other way around, that the only part you can control are your actions . Your thoughts and feelings will likely change if you engage in different actions.

4. Bring your attention to the present moment.

When you have lots of difficult thoughts and feelings, they can demand all your attention so that you go about your day in on auto-pilot. Expand your awareness to include what there is right here and now, using your five senses, and notice small details with openness and curiosity. So you may notice feeling sad, as well as apprehensive as well as doubtful, as well as hear birds, see trees, taste your sandwich, see your friend’s face……

5. Set time aside to practice mindfulness.

There is nothing magical about mindfulness. It is paying attention in a purposeful and open way. It is a skill that needs repeated practice, like running or swimming. You can practice mindfulness doing every day activities such as having a cup of coffee, brushing your teeth, washing dishes, walking and driving. There are many great apps available with audio guides to assist you, including “Smiling Mind” and “ACT Companion”.

6. Connect with what is important to you.

Sometimes being depressed is so unwanted that you spend all your efforts trying to feel better, thereby behaving in ways that are at odds with what is important to you. You may value meaningful relationships, nature, learning, or helping others. Find opportunities to put these values into actions. The things you care deeply about are often on the flip side of what causes you pain or distress. You may feel guilty about withdrawing from your family or not turning up to work – the flip side of that may be because you value connection and contribution.

7. Take lots of small steps repeatedly to build helpful habits.

Make changes in your behaviour in the direction of what you value, no matter how small that seems. Lots of small actions in the right direction will be more helpful than setting big unrealistic goals, then feeling overwhelmed and guilty when you don’t do them. Build helpful habits over time that will help you handle depression in the future when it comes around again. Some of the most helpful habits are exercise, healthy eating and meaningful relationships, and they all take time and repeated actions.

8. Be grateful for what you do have, do something for others.

Life can be extremely challenging at times, but in the midst of that we can usually find things that we can be grateful for ways to help others. Research shows that actively fostering gratitude and compassion can counteract depression, and that doing something for others boosts the giver’s happiness even more than the receiver’s.

9. Cut yourself some slack and be kind to yourself.

Many of us find it easy to be kind to others, but find it hard to cut ourselves some slack. When you beat yourself up about something, imagine how you would react if you were listening to a friend telling you their struggles, and see if you can give yourself the kindness you would give to a friend.

10. Seek professional help if you are struggling.

This can include a whole range of allied health and medical professionals. However be aware of quick fixes or grand promises. There is a role for prescription medications from your GP or psychiatrist. However the evidence is that for mild to moderate depression, there are many other treatment options that work better than or as well as medication. They include exercise, relaxation techniques, and a whole range of psychological treatments including cognitive behaviour therapy and mindfulness-based therapies such as Acceptance and Commitment Therapy. The advantage of the non-drug treatments are that you have skills you can use throughout your life, and without the side effects. In the end it is about respecting your preference and helping you be aware of all your options, and if required, using medications in the safest possible way while minimising side effects.

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Where does Suffering Come From?

By Dr. Rob Purssey

The ACT model predicts that a lot of suffering is caused by becoming entangled in difficult and painful thoughts and feelings, and then is further exacerbated by trying to push those thoughts and feelings away.

In ACT terminology getting caught up with difficult thoughts is called ‘cognitive fusion’, and trying to push unwanted thoughts and feelings away is called ‘experiential avoidance’. Fusion with difficult thoughts and struggle with painful feelings are very likely to be key processes in all human psychological struggle. What can we do to keep moving forward when facing pain and suffering in our lives? More than a thousand studies suggest that a major part of the answer is learning ACT – psychological flexibility skills.

An exciting recent study of a large sample of community adults recruited via the internet (N=955) examined the interaction between cognitive fusion and experiential avoidance in relation to psychological distress – and found, as predicted by the model:

“The predicted interactive effect was found across all four symptom measures, with the significant positive association between cognitive fusion and symptom measures being strongest at higher levels of experiential avoidance. These results provide support for proposals that individuals with high cognitive fusion and high experiential avoidance may be particularly prone to experiencing psychological distress.”

You can check out the study here: http://www.sciencedirect.com/science/article/pii/S2212144716300035

ACT aims to help people to more effectively handle difficult thoughts and feelings by learning key psychological flexibility skills, and with self compassion and resilience, keep doing what is important, even with their tough inner experiences. Our skills coaching at the Brisbane ACT Centre directly addresses both cognitive fusion and experiential avoidance, and our resources page is a great place to start.

Directly undermining fusion with defusion, and directly increasing psychological flexibility with willingness and acceptance – key ACT skills – can quickly improve your life, easing struggling with suffering, enhancing more vital living. If that interests you get in touch with our friendly staff at the Brisbane ACT Centre today.

___________________________________________

Abstract

http://www.sciencedirect.com/science/article/pii/S2212144716300035

Acceptance and Commitment Therapy, a popular transdiagnostic treatment approach, is based on the central tenant that human suffering develops and is exacerbated by psychological inflexibility. Cognitive fusion and experiential avoidance are two interrelated processes central to psychological inflexibility. Despite substantive theoretical rationale that these two processes impact one another’s association with emotional distress and psychopathology, the interaction between cognitive fusion and experiential avoidance in relation to psychological distress has yet to be empirically examined in the extant literature. As such, we examined this interactive effect in relation to four indices of psychological distress (anxiety, depression, stress, and posttraumatic stress) in a large sample of community adults recruited via the internet (N=955). The predicted interactive effect was found across all four symptom measures, with the significant positive association between cognitive fusion and symptom measures being strongest at higher levels of experiential avoidance. These results provide support for proposals that individuals with high cognitive fusion and high experiential avoidance may be particularly prone to experiencing psychological distress.

Using Cutting Edge Virtual Reality Technology to Treat Depression

By Dr. Rob Purssey

Self criticism can be a helpful tool but for many people it can be damaging, pulling us away from the things that matter most to us or slowing us down with anxiety or depression. A wealth of research shows however that we can learn to manage overly self critical thoughts and feelings using self compassion.

However, many of us are resistant to self-compassion.

Check out this awesome study in which they used an immersive virtual reality scenario. Participants interacted compassionately with a crying virtual child while embodied in a virtual adult body.

In the second phase, one group of participants then embodied the child body and could experience a recording of their compassionate gestures and words being delivered to them from this (child) embodied first-person perspective.

By having participants embody an adult and then a child virtual body in succession, our scenario effectively provided a self-to-self situation enabling participants to deliver compassionate sentiments and statements to themselves.

Fascinating stuff.

Participants of the study had three 8 minute virtual reality exposures each one week apart, at the end of the three experiences. 60% of the 15 participants reported decreased depression symptoms a month later.

Self compassion is a skill that can be learned to help live life more meaningfully, and is a core part of acceptance and commitment therapy.

http://www.spring.org.uk/2016/02/depression-treated-24-minutes-new-therapy.php

Full study here – http://bjpo.rcpsych.org/content/2/1/74