Monday, 24 November 2014

Wants and Needs

As higher education institutions have adopted business models a customer service orientation toward students has taken root. This is not always a bad thing. It helps faculty and staff stay on their toes and work hard to address legitimate needs of our consumers. It can serve to market the school well and also to advance its image and brand.

As with most things, however, there is a pernicious shadow to these trends, one that is anathema to college mental health which is all about addressing the needs of students. But customer service many times becomes more about satisfying wants. This in turn has created a phenomenon in which those around a student, such as parents, faculty, staff, administrators, and other stakeholders, have taken on a positively entitled, demanding posture concerning something they think should be done for a student. Sometimes there may be a positive basis for the expressed want, sometimes not.

Counseling and psychotherapy is about an individual's need to change something about themselves, something that is contributing to their own unhappiness. The things which need changing are determined by a trained professional, working collaboratively, who evaluates the individual's needs. Many times, early in therapy, clients focus on their wants and not their needs, but this is what may have led to the cultivation of life problems in the first place. Wants are often about being comfortable, while counseling, at least in the beginning, will entail a degree of discomfort. Lasting change is rarely if ever a comfortable process.

So we may face scenarios in which insisting on wants may actually lead to harm for a student, and therefore represent an abuse of counseling services. This we are obligated to prevent or stop altogether. Just as no one can dictate how a physician treats your ailing kidney, no one can dictate how psychotherapy is to be conducted (though insurance companies try to do this all the time). It is unhealthy for anyone to attempt to control what ought to be a collaborative working relationship between client and therapist. Counselors are obligated to uphold standards around this issue, so don't be surprised when they say "No." Of course, folks can seek other opinions elsewhere, where it it will be less convenient and more costly, if they like. Or they could give it several sessions first, say five or six, and then make judgements about the effectiveness of therapy after the discomfort begins to wane.

Saturday, 22 November 2014

7 alternatives to harmful behavior

Mental illness does not just affect our minds and our thoughts. It affects our behavior. There are things that people struggling with mental health will do that helps them feel better, but are actually more damaging in the long run. These include self-injury, substance abuse, eating disordered behaviors, acting out obsessions, lashing out at others and more.

 
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It can be difficult to stay away from harmful behaviors, especially during times of great distress. This is why it is important to have alternate ways of coping. It can take a long time to change harmful behaviors, as they do serve a purpose. As a starting point, though, here are some ideas of what you could do instead of engaging in harmful behavior.

1. Replacement behaviors
If you don't want to engage in a destructive behavior, replace it with something else. People use this strategy all the time to quit smoking by sucking on hard candy, chewing gum or playing with putty to give their hands something to do. In other cases, this could mean drawing on yourself with a red marker instead of cutting or drinking tasty non-alcoholic beverages when you feel the urge to drink. The point is to put something less harmful in the place of the old behavior.

2. Creative expression
You can engage the emotions you are feeling without engaging in the behavior that usually
accompanies it. Try to take that energy that is pushing you towards self-destruction and let it live out another way through using it as fuel for creativity. What does your drug use look like when painted as an animal? What would your eating disorder say if it were a character in a novel about your life? Looking at your behavior from a creative perspective can also help you see things differently, which is a good start for more permanent change.

3. Talk to someone
You don't have to go through tough times alone. If you are worried that you'll engage in harmful behavior, see if you can spend time with someone else. You can talk about what is triggering your desire to engage in the behavior or you can just try to focus on something else now that you're not alone. If you don't have someone to spend time with, see if you can call someone. If there's no one to call, try writing an email to someone you trust. Involving another person can make it easier to resist.

4. Write it out
Written expression can help calm down feelings that surround destructive behaviors. There are many ways you can do this. You can try to process what you are feeling through journaling. You can vent out everything that's causing you distress and tear the paper into as many pieces as you'd like. You can write a letter to bring to your therapist the next session. The point is to communicate instead of act.

5. Distraction
Sometimes, it is better to get your mind on something else. My mother would say that if you're feeling miserable, you might as well clean. If you're able to, you can use the stress you are under to accomplish another task. Not all of us can do that, though, and self-care is an excellent way of distracting. You can use this activity in advance to come up with things to do.

6. Take out your frustration on something inanimate
At times, people feel so much tension, pain, anger and frustration that they can't slow down and do something else. In this case, let the damage be something inanimate, not your body or another person. Sit in your parked car with loud music on and yell at whoever or whatever is causing you problems. Punch a pillow or even your whole mattress. Destry things that won't harm you in a disassembled state (yes on tearing up a pillow; no on breaking glass). Redirecting your emotions allows you to feel catharsis without causing any actual harm.

7. Reward yourself
For some people, having a reward system helps keep dangerous behaviors in check. This can have as much or as little structure as you'd like. It might be a system set up in advance where you have a list of rewards for making it X amount of days without engaging in harmful behavior. It could also be having a secret snack stash or video game that you gain access to only when you are actively controlling your impulses. Some people like having a visual reminder of how long they've made it without those behaviors. You know yourself best, so find what motivates you and use it to stop yourself from doing further harm.


What do you find helps when you feel like engaging in harmful behaviors? Trade tips in the comments.

Wednesday, 12 November 2014

Lapse, relapse and recovery

Part of recovery is relapse. It's almost expected. At some point, after things have gotten better, they'll probably get worse again. The truth is, though, that your attitude towards relapses will have a big impact on how you handle them and whether you can use them to grow.

   
Witthaya Phonsawat/FreeDigitalPhotos.net
First of all, a relapse can be many things. It might be returning to substance abuse or self-injurious behaviors. It can also be falling into another depressive episode or having obsessive thoughts again. It is an increase in symptoms that you have previously managed to reduce.

Then there's the definition of relapse. Some people think that any step backwards is a "relapse." The thing is, there is a difference between a lapse and a relapse. A lapse is engaging in a behavior or experiencing an increase in symptoms. Lapses happen to the best of us. They are not the same as a relapse, which is a series of lapses that put you back into the state of illness you were in before.


Some mindsets, such as that of Alcoholics Anonymous and other groups in that tradition, say that a lapse means you're back at day one. This can be very discouraging. But it's not the only way to view it. A lapse can be a learning experience. It tells you about what triggers your symptoms and what your areas of weakness are. This allows you to become stronger in your recovery.

If you experience a lapse, don't give up and give in. Messing up once or having a bad day doesn't mean you have to start over. It doesn't mean you're having a relapse. It just means that you now know what you need to work on. Resist the urge to fall back into old patterns. Take the time to think and maybe journal about what happened and why. Share these thoughts with your therapist, who can help you come up with strategies to avoid similar pitfalls in the future.

Sometimes lapses do add up, though, and become a relapse. While not ideal, this is perfectly normal. But if you could become better once, you can do it again. Stay open and honest with your therapist and support system. If you are struggling, let someone know. It is easier to get back on track with someone cheering you on. Keeping secrets is a sign of trouble.

Every day you spend free of destructive behaviors or symptoms of illness should be celebrated. Whether or not all of those days are in a row is secondary. Each time you make the choice to be healthy, you are right to be proud of yourself. Whether you had a single lapse or are in a full relapse, recovery is still an option. Life has lots of ups and downs. It's what you do with them that matters.


What has your experience been with lapses and relapses? What keeps you on track towards recovery? Share your thoughts in the comments.