Shore Therapy

Living With Grief

October 8, 2015 by admin

Living with grief. Shore TherapyGrief is what we describe as our reaction to loss, particularly when we lose someone we are attached to or love. We talk about the reaction to loss in a general and almost stereotypical way, however, in reality it is a very personal and individual experience. Everyone reacts and expresses their loss differently. Sometimes, understanding how other people grieve can offer some ideas about how to process your own grief.

Firstly, and possibly most importantly, there is no timetable for the grieving process, you will take the time you need to. The Grief Centre, speak about how you may never get over your grief, but that in time, even though at the beginning it feels impossible, you will learn to grow around it.

When someone you love dies, it can feel like part of you is missing, that things can never be the same again. Many people describe feeling scared, abandoned, lonely, vulnerable, guilty, hurt, tearful, devastated, angry, numb and much more, when they are experiencing loss. Unfortunately, it is not uncommon for these feelings to be overwhelming and create a sense of isolation. Often people feel as though no one understands how painful their feelings are, and in a way this may be true. No one has the unique love and connection that you experienced with that person, but we all have to experience loss in our lives, and we all need support during this time.

For some, expressing their grief in an emotional way is too difficult, and often, it comes out in a physical way. Your body may begin to show signs of stress such as, insomnia, headaches, weight loss/gain, loss/increase of appetite, lowered immunity, exhaustion, nausea and more. Though they are not pleasant these are all normal experiences when we lose someone we love.

It is also common for your thoughts and behaviours to feel out of control. Thoughts can be dark, angry and hopeless, and often feel chaotic, while behaviours can be unrecognisable. For many people, grief can be so overwhelming that all we can manage is pain, numbness, indifference or angry. These overwhelming emotions often encourage us to behaviour in unusual ways such as, crying, sobbing, feeling out of control of your feelings, isolating yourself, avoiding others, silence, inability to concentrate, feeling confused, panic attacks, increased sleeping, difficulty getting up in the morning, losing your temper easily, lashing out at those around you, denying the death of your loved one and many more.

Dark thoughts, often of wanting ‘to be with’ the person who has passed, or thoughts or ‘wanting to end the pain’ are very common when living with grief.

If you or a person close to you is expressing thoughts of self-harm, harming others or suicide please contact a professional immediately or dial 111.

Phases of Grief:

There are five phases of grief, which we flip-flop between depending on the day, time or situation. The final phase is where we hope to end up if we process our grief in a healthy way.

Denial:

Often the pain or shock of the loss of a loved one is so extreme that we struggle to accept the reality of their death. We find it difficult to accept that our loved one is no longer with us, and won’t again walk through the front door. It is not uncommon to refuse to hear facts, and hide away from their meaning. This is a natural defence mechanism that helps us cope with the initial pain of grief.

Anger:

At times during our grief, we will allow the reality to resurface and along with it all the pain. The pain is too extreme for us to hold, so we morph it into something easier to express and cope with, anger. The anger can be expressed toward, themselves, family, friends, objects and even strangers. It is also not uncommon for our anger to be expressed towards the person we lost. On one level we understand how irrational those feelings are, but on the other, we may resent the person for leaving us and causing us pain.

Guilt:

Frequently after we express or notice our anger, we are left with feelings of guilt. Sometimes guilt regarding our anger towards them, guilt about not seeing them enough, guilt that ‘wrong choices where made’ etc. It is not uncommon during this time that those experiencing grief, to make statements such as “if only we had notice his illness earlier” or “if only I had spent more time with them” or even bargain with a ‘higher power’ or God. We may swear to donate to charity, or stop smoking or be a better person if God would bring our loved one back. These are very normal feelings and thoughts to have when living with grief.

Sorrow:

Sorrow is the phase we are probably most familiar with during our grief. The feeling of emptiness, intense, crushing sadness and even thoughts of ‘why bother to continue with life without my loved one’ are all typical of this phase. The sorrow feels as though it will last forever, and you will never, ever, get over your loss. But it is important to understand that this sorrow is not always a sign of mental illness, or depression. It is a terribly sad situation, and you are allowed to feel uncontrollably sad. Even though this phase is painful, it is an essential part of healing.

Acceptance:

This is the final phase of grief and where we all hope to reach. This is not the point where we feel ‘OK’ about the death of our loved one, but more the acceptance that they have gone, and aren’t coming back. We will never be ‘OK’ with the loss, but we can learn to grow and continue without them.  Accepting the reality of this, can be a long and painful experience.

What May be Helpful:

Although living with grief is excruciating, and the urge to withdraw and disappear is overwhelming, the following ideas may help you to cope through this painful time.

  • Seek support from your family and friends.
  • Take time away from your regular routine, such as work, university, study, or other responsibilities.
  • Cry when you need to. Crying and expressing your emotions is a way to heal. You can either do this alone, or with those you love around you.
  • Remain aware of your breathing. Breathing deeply when you feel overwhelmed or emotional may be helpful to regain control of your thoughts, feelings or behaviour.
  • Try to eat, drink and sleep regularly.
  • Avoid alcohol as much as possible.
  • Try going for a walk each day, perhaps with a family member or friend to keep you company.
  • Even though you don’t feel like it, finding someone to talk to about your grief whether a family member, friend or a professional, is always a great way to process your feelings and thoughts.

Experiencing grief is a natural, but painful part of life. Take the time you need to work through how you feel.

Filed Under: Grief

Relaxation Skills

September 2, 2015 by admin

Relaxation SkillsIn today’s society we are all so busy being busy, that we often forget to relax and unwind. This can lead to a number of issues down the track – such as anxiety, stress and burnout. Relaxation skills can be a great way to unwind and reduce the risk of these issues.

What are Relaxation Skills?

Relaxation is the intentional letting go of tension. This tension can be physical tension in the muscles or it can be mental or psychological tension. During relaxation, the nerves in the muscles change the types of signals that they send to the brain. These different signals bring about a sense of calmness both physically and emotionally. Muscle relaxation has a huge effect on the nervous system and therefore, can be seen as a treatment of both physical and psychological stress.

Why use Relaxation Skills?

When you have been under extended periods of stress or when you have no break from work or other stressful situations, you seldom allow your high levels of muscle tension to decrease. The tension then ends up staying with you for longer periods. Eventually you become so used to being tense that this becomes your new base-line or ‘normal’ state of being. Often you won’t even realise that you are tense or stressed! But it can begin to affect you day to day life.

When it gets to this stage it can be really difficult to shift this tension without professional help.

Three Key Features of Relaxation Skills?

  1. Recognising Tension
  2. RELAX!!
  3. Practice

Recognising Tension

The following questions may be helpful to initiate your recognition of your tension:

  • Where do you feel tension?
    • Do you notice tension in your face and jaw?
    • Do you clench your fists?
    • Are your neck and shoulders tense?
    • What other parts of your body do you feel tense?
    • Are there parts of your body where tension goes unnoticed until you feel pain?
  • What are the characteristics of the tension?
    • Do your muscles feel stretched and sore?
    • Do you muscles feel hard and contracted?
    • Do you muscles fee fatigued?
    • Does there appear to be effort involved in maintaining normal posture?
  • Which events within yourself lead to increased tension?
    • Anger?
    • Thinking about you difficulties?
    • Changes in breathing or heart rate?
    • Loneliness?
    • Boredom?
    • Impatience?
  • Which external events lead to increased tension?
    • The way people speak to you?
    • Loud noises?
    • Having to wait in ques or traffic?
    • Being watched while working?
    • Your relationship?

RELAX!

If you follow the steps below you may be well on your way to learn how to relax. This exercise should take about 15-20 minutes. However, if you only have 5 minutes to spare, then 5 minutes is better than nothing!

  1. Find a quiet and relaxing space:

Choose a comfortable chair in a place that is free from noise and interruptions (make sure you turn off your phone).

  1. Clear your mind:

Try to clear your mind of all worries or disturbing thoughts. If these worries or thoughts drift back into your mind while you are relaxing, do not worry, and just gently push them out of your mind again. Let your mind be calm and clear.

  1. Practice the slow breathing method:

Breathe in for 3 seconds and breathe out for 3 seconds, thinking the word ‘relax’ every time you breathe out. Let your breathing flow smoothly. Imagine the tension flowing out of your body each time you breathe out.

  1. Relax your muscles:

For each of the muscle groups in your body, tense the muscle for 7-10 seconds then relax for 10 seconds. Relax you muscles in the following order.

  1. Hands – curl hands into fists, then relax.
  2. Lower Arms – bend you hand down at the wrist, as though you were trying to touch the underside of your arm, then relax.
  3. Upper Arms – tighten your biceps by bending your arm at the elbow, then relax.
  4. Shoulders – lift your shoulders up as if trying to cover your ears with them, then relax.
  5. Neck – stretch your neck gently to the left, then forward, then to the right, then to the back in a slow rolling motion, then relax.
  6. Forehead and Scalp – raise your eyebrows, then relax.
  7. Eyes – screw up your eyes, then relax.
  8. Jaw – clench your teeth (just tighten the muscles), then relax.
  9. Tongue – press your tongue against the roof of your mouth, then relax.
  10. Chest – breathe in deeply to inflate your lungs, then breathe out, then relax.
  11. Stomach – push your tummy out to tighten the muscle, then relax.
  12. Upper Back – pull your shoulders forward with your arms at your side, then relax.
  13. Lower Back – while sitting, lean you head and upper back forward, rolling your back into a smooth arc, thus tensing your lower back, then relax.
  14. Buttocks – tighten your buttocks, then relax.
  15. Thighs – while sitting, push your feet firmly into the floor, then relax.
  16. Calves – lift your toes off the ground towards your shins, then relax.
  17. Feet – gently curl your toes down so that they are pressing into the floor, then relax.
  18. Enjoy the feeling of relaxation

Take some slow breaths while you sit still for a few minutes enjoying the feeling of relaxation.

 

Practice

Practice once or twice every day for at least 8 weeks. The more you practice the easier this will become.

However, if the above amount feels too much perhaps, during the day, try relaxing specific muscles whenever you notice that they are tense.

Hunt, C.J., Andrews, G. & Sumich, H.J. (1995).

Filed Under: Anxiety, Relaxation

Understanding Bipolar

August 18, 2015 by admin

Understanding BipolarBipolar is a condition which a person’s mood can cycle from overly positive and active (up, also called mania) to very depressed and inactive (down). People will have periods of stable mood in between these states. Everybody who is diagnosed with Bipolar experiences it slightly differently, but generally there are similarities in symptoms. It is important to know that Bipolar can be managed well with the right combination of strategies, usually a mixture of the right medication for you and therapy.

What Causes Bipolar?

Unfortunately at this point in time the exact cause of Bipolar is not know, however, there is thought that genetic and biochemical factors combined with stressful life events may all play a significant role. If someone in the family/whānau has relatives with Bipolar, they may have an increased chance of developing it.

Early trauma (e.g. grief, physical, emotional, sexual abuse, neglect etc), physical illness, lack of sleep, misuse of drugs/alcohol, substances and medications may also be risk factors for the onset of first and subsequent episodes.

When does it start?

Bipolar often starts in a person’s late teens or early adult years, but adults in later life can also develop Bipolar.

The diagnosis in children is currently controversial. Up to 2% of the adult population are diagnosed and around 5% of people may experience milder, but noticeable mood fluctuations.

Episodes of mania and depression typically recur across the life span. Between episodes, many people with Bipolar are free of symptoms, with others having some ongoing symptoms.

Signs of Bipolar

Everybody experiences mood shifts in daily life, but with Bipolar these changes can be more pronounced. Often, people with Bipolar will seek help during ‘down’ periods as they feel bad, but when they are ‘up’ they feel fantastic. They may not be aware they are acting in ways that concern others- typically it is family members and others who know you well who are concerned during periods of mania.

Depressive Episodes

Symptoms may include:

  • Low or depressed mood
  • A sense of hopelessness
  • Lack of energy
  • Feelings of guilt or worthlessness
  • Inability to concentrate
  • Loss of interest in, or enjoyment of usual activities
  • Sleep disturbances
  • Wanting to escape one’s mind
  • Suicidal thoughts and behaviours*
  • Eating problems

*Suicidal thoughts and specific plans for suicide must always be taken seriously by others.

 

Manic Episodes

Symptoms may include:

  • Elevated or ‘high’ mood
  • Restlessness
  • Extreme irritability
  • Talking very fast
  • Poor judgement
  • Racing thoughts and ideas
  • Unable to sleep
  • Feeling very important
  • Risky behaviour (e.g. overuse of drugs/alcohol, spending money, aggressive or overly sexualised behaviour)
  • Doing things very fast and often (e.g. excessive cleaning, exercise)

It is not uncommon for the person experiencing a manic episode to be unaware of the changes of their attitude and behaviour. After a manic phase is over, they may be shocked at what they have done and the effect it has had on them and/or others.

Where to Get Help?

A GP is the best person to talk with first. Find a GP that you feel comfortable and confident with, tell them what is going on for you and how it is affecting your life. If necessary, they may refer you on to a mental health professional who may complete an assessment and discuss various options of treatment.

Common Treatment Options:

Medication

Everybody is different, so different medication types, doses and combinations may suit different people.

Some people may not fully respond to medication or simply find medication difficult to tolerate. It is helpful/important for people to take the medication as prescribed, and to feedback to their GP any symptoms or side effects they are experiencing so adjustments can be made. Due to this it may take a while to find the right medication that suits you, and that may change overtime.

Talking Therapy

Talking therapies such as psychotherapy, DBT (Dialectical Behavioural Therapy) or CBT (Cognitive Behavioural Therapy) can be an important part of treatment of Bipolar.

A good therapist who you feel you can trust can help you to cope with feelings and symptoms, and change behaviour patterns that may contribute to your mood changes.

Talking therapy is not just ‘talking about your problems’, effective therapies that help Bipolar typically involve using tools to get balance  into your thinking and feel states, and may also involve working towards gaining insight and acceptance.

 

If You Are In Crisis

If you are in extreme distress and need immediate help, you or your family can call the crisis mental health services or call an ambulance. Each District Health Board (DHB) will have a local or 0800 number for you to call.

The number of your local crisis team can be found on the link below:

http://www.health.govt.nz/your-health/services-and-support/health-care-services/mental-health-services/crisis-assessment-teams

 

The information provided for this post has been provided by the Mental Health Foundation of New Zealand – Mauri tū, Mauri ora. www.mentalhealth.org.nz

Filed Under: Bipolar

Clear Communication

August 5, 2015 by admin

Making Clear Statements or QuestionsClear Communication

Tips for making simple statements or questions are below:

  • Use short statements or questions
  • Ask one question or request at a time
  • Be specific
  • Avoid strong emotional statements

Praise

Everyone needs to feel appreciated, though sometimes we forget to express this to those we care about. If you praise people for their good behaviours, they are more likely to continue those behaviours than if you criticise the negative behaviour. Just as importantly, praise can help others feel better about themselves, and it can feel great for you to.

Tips for praising others are below:

  • Look at the person
  • Say exactly what he or she did that pleased you
  • Tell the person how you feel
  • Give praise for even small changes
  • Praise people immediately after the behaviour
  • Avoid ‘back-handed’ compliments

Requests

If you want or need someone to behave in a particular way or do something for you, you are unlikely to get your needs met if you do so in an aggressive or ‘nagging’ tone. If you want or need something from someone, you should state clearly what is required of this person and if you tell them how much it is appreciated it is more likely to be successful.

Tips for requesting of others is below:

  • Look the person in the eye
  • Be specific with what you need or want from this person
  • Say how you feel

Please keep in mind that we also communicate with out body language and tone of voice. If these do not match your request you are unlikely to succeed!

Unpleasant Feelings

Often people find it difficult to express their unpleasant feelings, however, if they are not expressed then the person will not know that what they are doing is upsetting for you. Often, if you do not express these unpleasant feelings they can build up and create resentment, which can cause more damage and pain in the long run.

We tend to dislike expressing our unpleasant feelings because we are afraid or worried about the other person’s reaction. However, expressing how you feel, even when it is difficult or painful is an essential part of communication and relationship.

Tips for expressing unpleasant feelings:

  • Create eye contact and speak in a calm and assertive manner
  • Be specific!
  • Tell the person how you feel
  • Suggest how this could be prevented in the future

Please keep in mind again, that body language and tone of voice are essential to express your message correctly!

Listening

We have all had the experience where we talk to someone who does not seem to be paying attention to you, and how painful this is! Therefore, listening and paying attention to those around help maintain and create relationship.

Below are some tips for being a good listener:

  • Make eye contact
  • Appear interested
  • Minimise distractions around you (put your cell-phone down, turn off the TV etc)
  • Ask follow up questions
  • Repeat the main theme of the conversation to check you haven’t missed the point.
  • Show that you care about their feelings.

Hunt, C.J., Andrews, G. & Sumich, H.J. (1995).

Filed Under: Communication, Marriage

What is a panic attack

July 22, 2015 by admin

What is a Panic Attack?
Panic Attacks
When we are exposed to a physical threat our bodies have an automatic response to help defend ourselves and escape a threatening situation. This response is known as the fight/flight/freeze response, which activates our central nervous system and our bodies become more attuned to our environment. Often we become more alert, our heart rate speeds up, muscles become tense and ready for action, sweating increases to cool the body and our breathing rate increases so that we can get oxygen into our bodies faster. With all of these changes happening at once, we are able to run very quickly from our attackers (flight), fight our ‘enemies’ (fight) or remain hidden so as not to be seen (freeze).

How Does a Panic Attack Cause Problems?

In today’s society we are rarely exposed to any real physical threat. Instead, most of the threats we do experience are psychological or mental. It does not help to fight physically or run away when dealing with these situations. Unfortunately though, the fight/flight/freeze response still gets turned on. We may have the increased breathing rate which serves no real purpose and actually causes problems for some people. This tends to lead to hyperventilation or over-breathing, this can cause dizziness, breathlessness and chest pains.

It is important to realise that these feelings are all part of a physical response to threat and are not a sign that you have some physical disease. These symptoms do not mean that you will die, go crazy, or lose control.

What Do I Do Next?

It is very likely that you will be more able to manage your panic attacks in the future if:

  • You learn how to relax and manage your stress effectively
  • You try to notice your anxiety or stress before a panic attack occurs, increase your awareness of your warning signs
  • You remember to use breathing exercises when you become anxious.

Hunt, C.J., Andrews, G. & Sumich, H.J. (1995).

If you would like more information regarding panic attacks or would like to book in an appointment with a team member at Shore Therapy please click here.

 

Filed Under: Anxiety, Panic Attack

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