Warm slippers and hot chocolate. It may not be the cure for depression, but it still helps. ♡
Warm slippers and hot chocolate. It may not be the cure for depression, but it still helps. ♡
> The capacity to form and maintain healthy emotional relationships which generally begin to develop in early childhood.
> Enduring bond with ‘special’ person
> Security & safety within context of this relationship
> Includes soothing, comfort, and pleasure
> Loss or threat of loss of special person results in distress
> John Bowlby (1907-1990) British Child Psychiatrist/Psychoanalyst
> He was the first attachment theorist, describing attachment as a “lasting psychological connectedness between human beings.”
> Bowlby believed that the earliest bonds formed by children with their caregivers have a tremendous impact that continues throughout life.
> According to Bowlby, attachment also serves to keep the infant close to the mother, thus improving the child’s chances of survival.
> Disturbance/ Disruption of initial attachment bond between child and caregiver renders person insecure as an adult.
> The central theme of attachment theory is that caregivers who are available and responsive to their infant’s needs establish a sense of security in their children.
> The infant knows that the caregiver is dependable, which creates a secure base for the child to then explore the world.
> From our childhood experiences we develop schemas that are connected with dependability of others and the worth or ‘lovable-ness’ of self.
> These schemes are easily maintained across time into adulthood as they are reinforced over and over again.
> In the literature these schemas are referred to as attachment styles.
(Hazen & Shaver 1994)
> Can I count on this person to be there for me if I need them?
> Are others trustworthy and responsive?
> Am I lovable and able to elicit caring?
fearful- tend to recognize their need for others, but avoid others and frame them as untrustworthy.
Dismissing- Tend to deny their need for attachment and frame others as untrustworthy.
Tend to cling to attachment figures or aggressively demand reassurance, often fearing that they are somehow deficient or unlovable.
Tend to believe that others are reliable and see themselves as lovable and worthy of care.
***A sense of security provides better
1.better Affect regulation
> less reactivity
> less hyper arousal
> less under arousal
> more acknowledgement of support seeking
A Sense of Security Provides
2.Better information processing
> more flexibility, curiosity, openness
> tolerance of ambiguity and uncertainty
> more ability to collaborate, to disclose, more assertive and empathetic
A Sense of Security Provides
4.Sense of Self (love)/ is more positive.
> Seeking and maintaining contact is viewed as the primary motivating principle from childhood into adult relationships
> A secure connection offers a safe haven and a secure base.(needs for connection, comfort and caring are key)
> Accessibility and Responsiveness builds bonds
> Separation Distress – a predictable process.
> Cling and Seek
> Depression and Despair
Attachment Styles are working models of self and others
> The way we see ourselves
> The way we see others
> The way we see relationships
> Predict the way we will respond
> Emotions will automatically arise when an attachment figure is perceived as inaccessible or unresponsive.
> Attachment Injuries
> An Attachment injury occurs when one partner violates the expectation that the other will offer comfort and caring in times of danger and distress.
> It is characterized by an abandonment or betrayal of trust during a critical moment of need.
> When a partner cries out for help and there is no response, the sense of basic trust that is the foundation upon which the welfare of their bond depends is shattered.
Believes and trusts that his/her/their needs will be met.
Parent: Quick, Sensitive, Constant
Child: Secure, Exploring, Happy.
Subconsciously believes that his needs probably won’t be met.
Parent: Distant, Disengaged
Child: Not very explorative, Emotional
Cannot Rely on his needs to be met.
Parent:Inconsistent, Sometime sensitive, Sometimes neglectful
Child:Anxious, Insecure, Angry
Severely confused with no strategy to have his needs met
Parent: Extreme, Frightened, Frightening, Passive
Child: Depressed, Passive, Angry, Non-responsive.
REf: OTMH, 4th Floor., attachfromscratch.com
I can see you are angry/upset right now/and/or/ I am upset right now. I need to take a moment away from this conversation.
That is a harmful comment. That is a hurtful comment.
Will you lower your voice? If you cannot lower your voice, I will
have to end the conversation.
Please take a few deep breaths – you may not realize but you’re talking “at” me.
That makes me uncomfortable.
That’s not very nice.
I don’t appreciate…
Wow, that doesn’t make me feel good at all.
That’s too far.
**step down approach – what your body language, and lower your voice, space the words out.**
Remember: It’s not selfless or selfish its self care.
What are smart goals?
Smart goals are:
What is your goal?
How will you do it?
What actions are required to achieve my goal?
How will I track my goal progress?
Pick behaviours you can, or are willing to change first.
Can I achieve this goal right now?
Can I fully commit to this goal?
How will I overcome set-backs in my goal?
Set a time-frame for your goal
Include a specific start, goal and end date.
Set several small goals with shorter timelines within a long-term goal, to increase motivation and confidence.
—Example Smart Goal—
Specific: Increase my vegetable intake by 2 servings per day, by packing 1 snack baggie with 1/2 cup veggie sticks at lunch, and adding 1/2 cup veggies to my dinner plate.
Measurable: I will check off each day on my calendar that I achieve my goal.
Is this goal Attainable? Yes. I want to improve my meal planning skills, to benefit my nutrition and health.
Is this goal realistic?. Yes. This is a goal I can start immediately.
I will overcome set-backs by focusing on getting back-on-track the next day. I will use my calendar tracking to motivate me.
What is my Time Line?
Start date: March 11, 2017
End Date: None. I plan to make this a daily routine, and will track my progress each month.
Set 1-3 goals at a time. Setting too many goals at once can make it hard for you to achieve them.
Record and track your progress, to help you stay focused and motivated!
Have a family member or friend work on your goal with you! Or, share your goal progress with others.
Plan a head. Consider, and be prepared for obstacles; and think about how you can overcome any set-backs.
Remember why your goal is important to you. This wil help you stau motivated when obstacles arise!
Celebrate your successes no matter how small. Find ways to reward yourself!
Stay positive! Take time to reflect on what has worked so far, and think about what you can change going forward. Set-backs are normal, and should be expected. Think about:
Was my goal too big?
Was I working on too much at one time?
Do I need to focus on a different target behaviour?
What got in the way of my success?
What are some solutions?
Was my time frame realistic?
Modify your goal if needed, or start over if you need to.
Reference: Brochure I found. Loblaws.
Psychiatric illness tend to fluctuate over time, with their severity increasing and decreasing at different points in time. An episode of an illness (or a relapse) occurs when symptoms are severe and functioning is impaired. Understanding what factors contribute to relapses can help people learn how to manage their illness more effectively, and to prevent relapses or decrease their severity.
Psychiatric illnesses fluctuate over time in their severity
The stress- vulnerability model of psychiatric disorders provides a useful way of understanding how different factors influence the course of mental illness. According to this model, the course of a psychiatrist illness is influenced by several factors: biological vulnerability, stress, medication, drugs and alcohol, coping skills, and social support. Each of these factors is described below, and illustrated in the accompanying diagram.
Each Person has biological vulnerability to different diseases. This vulnerability is determined by a combination of generic and other biological factors. For example, some people have a biological vulnerability to cardiac disease: some people have a vulnerability to specific types of cancer, and some people have a vulnerability to specific psychiatric disorders. Common psychiatric disorders to which people are biologically vulnerable include schizophrenia, schizoaffective disorder, bipolar disorder, major depression, and anxiety disorders.
Once a person has a biological vulnerability to a mental illness, that mental illness may either develop spontaneously or be triggered by stress. Even among people who have a psychiatric illness, vulnerability may differ from one person to another. On average, people who have a greater biological vulnerability to an illness experience more severe symptoms and difficulties.
Stress refers to something in the environment that forces the person to adjust in some way. Stress can take the form of specific life events, such as the death of a loved one, a major move, or being a victim of crime. Stress can also be caused by living in difficult conditions, such as living with people who are hostile and critical, living in unpredictable and dangerous environments, or living in poverty.
People who are biologically vulnerable to a psychiatric disorder and who are exposed to stress are more likely to develop that disorder. Once people have a psychiatric disorder, stress can cause relapses and worsen the course of the illness.
Stress can affect biological vulnerability, leading to symptom relapses.
Although biological vulnerability and stress influence the course of the psychiatric disorder, they can be affected by several factors. Those factors include medication, drugs and alcohol, coping skills, and social support.
Medications for psychiatric disorders can decrease biological vulnerabiltiy. Medications are effective at both decreasing the severity of symptoms and preventing symptom relapses. People who take medications regularly and do experience relapses tend to have less relapses.
Alcohol and Drugs use can increase biological vulnerability. Some substance can directly increase biological vulnerability, while other substances can decrease the beneficial effects of medications on vulnerability. People with psychiatric disorders who use alcohol and drugs regularly are prone to more frequent relapses of their symptoms.
Medications decrease biological vulnerability.
Alcohol and drugs increase biological vulnerability.
Stress can be deceased by coping skills, social support, and engaging in meaningful activity.
Coping Skills are strategies that people use to minimize the effects of stress. Examples of coping skills include relaxation, positive self-talk, problem solving, talking out one’s feelings with a friend or support person, exercising, journal writing, and artistic expression. People who have several different coping skills are less susceptible to the negative effects of stress.
Coping skills decrease the negative effects of stress.
Social Support refers to the help and caring that people feel they can count on from other people. Supportive persons can include family members, friends, members of the treatment team, a clergy member, or anyone else with whom a person has a close relationship. Good social support can decrease the effects of stress. Supportive people can sometimes solve problems with a person and decrease stress. For example, if a man feels criticized by his supervisor at work, a supportive person can help him identify strategies for learning more specifically about his supervisor’s concerns. Supportive people can also help a person deal with the negative effects of stress. For example, if a woman has been a victim of crime, she can talk it over with a supportive person, and benefit from that person’s concern and empathy.
Social support and coping skills can interact with one another. People with good coping skills can obtain more social support by reaching out and engaging with other people. Supportive people can also improve others’ coping skills by helping them develop more effective strategies for dealing with stress. People who have more social support tend to experience fewer and less severe relapses.
Social Support decreases the negative effects of stress.
Meaningful Activities are tasks that provide a strong sense of purpose and gratification to a person. Being invovled in meaningful activities helps people to structure their time and gives them somethign to look forward to every day. Examples of meaningful activities include work, going to school, parenting a child, doing volunteer work, caring for someone else, and being a regular participant at a peer support program. Having meaningful activities to engage in reduces suseptibility to stress, because people are actively pursuing their goals and are less focused on stress.
Engaging in meaningful activities decreases the negative effects of stress. V
The stress- vulnerability model points to five ways with psychiatric illness (and their families) can improve the course of their illness and reduce relapses and rehospitalisation:
1. Take psychiatric medications as prescribed.
2. Avoid alcohol and drug use.
3. Increase coping skills.
4. Increase social support.
5. Engage in meaningful activities, such as work, school, and parenting.
Taking these steps can help reduce relapses or lessen the severity of relapses, and therefore can help people make progress toward their personal goals.
Reference: Unknown. Brochure
Grounding Techniques are designed to help you deal with painful, overwhelming feelings. Grounding can be done anytime anyplace, anywhere. You can practice the skills privately and no one has to know or you can ask for support. Do not focus on past or the future stay in the present. Do not judge things as bad or good, stay neutral. Do not journal or think negative thoughts.
Ways to Ground yourself
Find a special place in your home where you have placed safe, soothing objects.
Play a category game with yourself, ie think of types of dogs, bands from the 80s, 90s, types of cars, etc.
Describe an everyday activity in detail to yourself or to someone else.
Say an affirmation.
Read something positive saying each word to yourself.
Think of something funny.
Count to 10 or say the alphabet S l o w l y
Run cool or warm water or your hands.
Hold ice cubes in your hands.
Carry a safety object with you.
Connect your body with the environment, ie I feel my feet making contact with the floor.
Eat, Walk mindfully– noticing the subtleties of the activity.
Focus on your breathing and accompany a positive, pleasant word with each inhalation and exhalation.
Say kind statements to your self.
Think of all your favourites, ie colour, food, animals, season, TV show.
Say a positive coping statement ie, this will pass, I can handle this.
Think of positive things that you are looking forward to in the future, ie social outing with a friend.
Make an index card or upload your most effective grounding techniques.
Think about people and animals you care about. Look at photographs of them.
List 5 things you see
List 4 things that you can touch
List 2 things that you can smell
Take one breath.
Cognitive Distortions = Unhealthy Thinking Habits
Do not/Try not to become overwhelmed by the many Cognitive Distortions that exist.
Pick 1 or 2 to work on. That’s IT! Pick easy ones to work on.
These are organized in a way to facilitate memory
The Common Ones
All or Nothing
Black and White Thinking
Feelings are Facts
Filtering (to ignore)
The Really Harmful ones (To self-esteem- to others)
Discounting the Positives
The Common Ones
All or Nothing/ Black-White Thinking
You see things or people in absolute, black or white categories. If a situation falls short of perfect, you see it as a total failure.
You define yourself or others in absolute terms such as good or bad, smart or stupid, introverted or extroverted, fat or thin, attractive or ugly, and so on.
Moreover, you may categorize your behaviour as being either completely acceptable or absolutely unacceptable, without acknowledging the many possibilities that lie between these two extremes.
More often, we exit somewhere in the middle of a spectrum versus on one side only. Much of this comes from perfectionist personality types where we have to be perfect or we’re a failure – there is no middle ground.
Example: I’m a failure. Example: I’m right
To overgeneralize things. You often make a broad conclusion based on a single incident or a single piece of evidence. If something bad happens only once, it is expected to happen over and over again.
For example: You see a single negative event, such as a romantic rejection or a career reversal, as a never-ending pattern of defeat and will conclude that things will always happen that way.
You find yourself using words such as “always” or “never.”
Thus, you generalize one instance in the present to ALL other instances.
Pick out the overgeneralizations in this sentence:
“Everything always goes wrong for me.”
Exaggerating Hint Words
Always, Never, Everyone, All the time, All woman/men, all “race”
Once in a while, sometimes, that individual, that specific incident, today
Inferring a person’s possible (usually negative) thoughts from their behaviour and nonverbal communication.
Taking precautions against the worst reasonably suspected case or some other preliminary conclusion, without asking the person.
Making negtive assumptions about what other people are feeling, thinking, and why they act the way they do, in particular, what they are thinking about YOU. Thus, you interpret things negatively when there are no facts to support your conclusion.
Although it is true that people make negative judgements about others; chances are this occurs much less often, and what you’re assuming is far more negative than reality.
They probably think I’m incompetent.
They noticed by hand shaking. They know I’m anxious. They think I’m pathetic.
They think I’m a “know-it-all.”
They are looking at me funny. They must think I look weird.
Mindreading Hint Words
He/She/They, Them, My boss thinks..
Fortune Telling, “Little What If Thinking.”
Also known as: Probability Overstimations
A probability overestimation is a prediction that a person believes is likely to come true, even though the actual likelihood is relatively low. Moreover, the prediction is that things will turn out badly. Said another way, an inaccruately high probability of danger is estimated. Example: A car weaves slightly in the lane next to you and you thnk, “That guy is going to hit me!Trying to kill me!
Hint: Did your self-talk start with “What if..”?
Catastrophe Thinking, “Extreme What If Thinking.”
The worst possible outcomes are predicted. Imagining that basic needs (safety, self-esteem, sustenance, etc.) are threatened.
Thinking that a situation is unbearable or impossible when it is really just umcomfortable. Most of the statements will overestimate a particular negative outcome and underestimate your ability to cope.
Example: A first year student began to get extemely anxious once she learned that she could not take all her courses. Her thoughts rose from an undesirable schedule to not being able to graduate and being jobless and homeless.
Furhter, you assume that if a negative event were to occur, it would be absolutely terrible and unmanageable. Below are more general examples:
Example: I won’t be able to handle it. Everyone will think I’m an idiot, I’m going to look stupid in front of the whole class, and no one will talk to me. I’ll be a social outcast.
Feelings are Facts:
Refers to the tendency to judge or evaluate something illogically, totally on the basis of your feelings. You believe, “if it feels likely, it IS likely. If it feels dangerous, it IS dangerous.” You assume that your negative emotions reflect the way things really are or will be.
Example: I feel terrified about going on airplanes. It must be very dangerous to fly.
I feel guilty. I must be a rotten person. It was my fault.
I feel angry. This proves I’m being treated unfairly.
I feel so inferior. This means I’m a second-rate person.
I feel hopeless. I must really be hopeless.
I feel anxiety. Something bad is goign to happen.
I feel ugly, so I am ugly.
Because I feel inadequate, I am inadequate.
I will never get well.
Filtering (Selective Attention):
Focusing entirely on negative elements of a situation, to the exclusion of the positive. This is where you pick out a single negative detail and dwell on it exclusively, so that your vision of all of reality becomes darkened.
Example: You receive many positive comments about your presentation to a group of associates at work, but one of them says something mildy critical. You obsess about their reaction for days and ignore all the positive feedback.
Magnification (Minimization/ Mazimization)
Giving proportionally greater weight to a preceived failure, weakness or threat, or lesser weight to a preceieved success or opportunity, so the weight differs from that assigned to the event or thing by others.
Therefore, you blow things way out of proportion or shrink their importance. This is also called the binocular trick. When you look through one end of the binoculars, all your shortcomings seem as huge as Mt. Fuji. When you look through the other end, all your strenghts and positives qualities seem to shrink to nothing.
Hence, you exaggerate the importance of your problems and shortcomings, and/or you minimize the importance of your desirable qualities.
Example: Focusing on a personal flaw
focusing on another’s achievement and ignoring your own contributions
Focusing on someone else’s desirable qualities while comparing your own imperfections.
The Really Harmful Ones (To Self-Esteem and to Others)
Discounting The Positive:
You reject positive experiences by insisting they “don’t count.” Discounting the positives takes the joy out of life and makes you feel inadequate and unrewarded.
Example: If you do a good job, you may tell yourself that it wasn’t good enough or that anyone could have done better.
When you disbelieve a compliment or positive appraisal.
When you give away or deny good things that come your way, such as gifts or compliments.
Labelling is an extreme form of all-or-nothing thinking. Instead of saying, “I made a mistake,” you attach a negative label to yourself: “I’m a loser,” “a fool,” “a failure.” or “a jerk.” Labelling is irrational simply because you are important as a person. You are not only worthwhile by what you do. Only humans exist, losers, fools, jerks do not. These labels can lead to anger, anxiety, frustration, and low self-esteem.
You may also label others. When someone does something that bothers you, you may lebel that person, “she’s a nag” “He’s a freak”. In that moment, you see them as totally bad. This makes you feel hostile and hopeless about improving things and leaves little room for constructive communication.
We have a list if rules about how we and others should behave. People who break the rules make us angry, and we feel guilty when we violate these rules. A person may believe they are trying to motivate themselves with should and shouldn’ts, and yet the outcome of using “shoulds” is the complete opposite. For example, “I really should exercise. I shouldn’t be so lazy.” “Musts,” “oughts” and “have tos” are similar offenders. Should statements, which are hidden perfectionist expectations, are incorrect or exaggerated assumptions about how things should occur. The emotional consequence is guilt. Lastly, when a person directs should statements to others, they often feel anger, frustration and resentment.
Example: He shouldn’t be so stubborn and argumentative.
Example: After playing a difficult piece on piano, a gifted pianist told herself, ‘I shouldn’t have made so many mistakes.” This made her feel so disgusted that she quit practicing for several days.
Example: I shouldn’t eat that doughnut.
Example: I should visit my family every Sunday.
This usually doesn’t work because all these shoulds and musts make you feel rebellious and you get the urge to do just the opposite.
Should Hint Words
I choose to
I hope to
I want to
I plan on
(get into action )
Personalization is the tendency to take things personally and make things about you when they are not about you. You may do this automatically without fact finding first.
To define further,
Personalization occurs when you hold yourself responsible for an event that isn’t entirely under your control. You may take on all the responsibility rather than acknowledge the different factors that may have contributed to the situation.
Personalization also happens when you frequently compare yourself to what you are hearing and seeing, “That happens to me too”, “I have that”, “Wait,I have that”. “I’ve been there.” Essentially, making it about you.
Personalization also occurs when you think or believe what people saying or doing (e.g. laughing down the hallway, have a grumpy look on their face) is in direct reaction or relation to YOU.
If this is a habit for you, you are likely to find yourself overreacting to interpersonal interactions. That is because personalization confuses understanding and boundaries in relationships, especially around dependency and co-dependency issues.
It increases social anxiety.
It’s no wonder that Personalization leads to guilt, shame, and feelings of inadequacy!
Rule: Don’t personalize other people’s inappropriate behaviour.
Example: When a woman received a note that her child was having difficulties at school, she told herself, “This shows what a bad mom I am,” instead of trying to pinpoint the actual cause of the problem.
Example: When another woman’s husband yelled at her, she told herself. “If only I were a better wife, he wouldn’t yell at me.”
Example: My boss is in a bad mood today; he must be angry with me.
When we hold other people responsible for our own pain, or take the other track and blame ourselves for every problem, we are doing a great injustice to ourselves and to others. instead of pinpointing the cause of a problem, you assign blame. This distortion robs you of appropriate responsibility, and prevents growth. Blame usually doesn’t work very well and will just get tossed back and forth without result or movement.
SELF BLAME: You blame yourself for something you weren’t responsible for or beat up on yourself relentlessly whenever you make a mistake.
OTHER BLAME: Some people do the opposite. They blame other people or their circumstances for their problem, and they overlook ways that they might be contributing to the problem.
Example: The reason my marriage is so lousy is because my spouse is totally unreasonable.
Example: I’m a terrible mother.
Example: I’m a lousy friend.
Example: Stop making me feel bad about myself!
Nobody can “Make” use feel any particular way- only we have control over our own emotions and emotional reactions (Byron Katie does a lot of this sort of talk). Only if we believe a persons negative perception of us do we hurt (ourselves).
Unfavourably comparing yourself is like having a special magnifying glass that magnifies some things (your negatives, other people’s positives) and shrinks others ( your positives, other people’s negatives.) Try recognizing everyone (including yourself) as having unique strengths and weaknesses. If you have to compare, try to compare evenly – include both favourable and unfavourable comparisons.
Example: “She’s thinner, so she’s prettier and smarter; who cares if I have nice hair?”
Example: “He is more interesting and intelligent because he owns his own business; who cares if I make more?”
Reference: This material is from OTMH, Third Line,Oakville ON