laura, Author at Your Mind Matters

DISTRESS TOLERANCE – AN INTRODUCTION TO A DIALECTICAL BEHAVIOUR THERAPY (DBT) PRINCIPLE

laura on 11/09/2024

There’s no question that feelings can be highly, highly unpleasant. For many people, emotions can become so overpowering that they can compel us to do things we mightn’t be proud of – we can yell, throw things, or binge drink.

Many clients we see at Your Mind Matters struggle with big emotions – some clients report feeling emotionally dysregulated when they’re upset, and struggle to bring themselves back to a baseline, neutral state. It’s a common problem, and can lead to all kinds of difficulties.

This blog is about Distress Tolerance, which is a host of psychological tools that can help us when we’re struggling with truly overwhelming feelings. The goal of Distress Tolerance is not to eliminate an emotion, or even significantly reduce its intensity – instead, it’s about teaching us to tolerate the emotion, and withstand the urges that can come with it. It belongs to a kind of therapy called Dialectical Behaviour Therapy (DBT).

DBT is an evidence-based therapy for multiple forms of mental health challenges, and contains plenty of ideas that can be great for anyone’s emotional wellbeing. DBT breaks itself up into lots of different bits and pieces – one of these is a Skills component, that has Distress Tolerance as a sub-school inside it. You can think of DBT as a big book – Skills is a chapter, and Distress Tolerance takes up a few pages in that chapter.

Distress Tolerance is about asking yourself what behaviours your emotions urge you toward, with a particular focus on the kind of behaviours that lead to greater distress later on – i.e., make the situation worse. For instance, if you were a tennis player whose emotions led to an urge to smash your racquet against the court, your Distress Tolerance goal could be to reduce your racquet-smashing – because this will make you feel embarrassed or guilty later on, and avoid the competitive consequences that come with it. Note the player’s goal wouldn’t be to feel less angry, although this would be nice… instead, Distress Tolerance asks you to ride that emotion more effectively, and not make the feeling worse.

Other behavioural goals can be:

Not binge-drinking alcohol.
Not texting people with threats, sarcasm, or aggressive themes.
Not using drugs.
Not self-harming.

Distress Tolerance asks clients to build a Distress Tolerance Toolkit – i.e., a set of skills that include self-soothing, distraction, connecting with others, and mindfulness. Again, we’d hope these tools reduce the intensity of your feelings; but more importantly, we’d hope they lead to you tolerating your distress without engaging in life-worsening behaviour.

There are lots of methods and strategies DBT uses in their Distress Tolerance framework – many of them are available for free from their official website: (https://dialecticalbehaviortherapy.com/distress-tolerance/).

Some questions for your reflection:

Why don’t I like unpleasant feelings? Aside from being viscerally uncomfortable, is there something I’m worried the feelings will do to me? I.e., that I’ll lose control, or not be able to recover?

How do I deal with highly unpleasant feelings? If I watched myself living with difficult feelings on CCTV, what would I see myself doing?

Do I do things that make my life worse, or increase a sense of shame or guilt? What sort of things are they? Do I want to change these typical responses, and why?
Lastly – am I being too hard on myself? Often, clients say they ‘respond badly’ to certain feelings… but there’s nothing necessarily wrong with eating more chocolate than usual, or scrolling on your phone for a few minutes. If you want to change those things, that’s great – but it’s certainly not compulsory for good mental health.

This blog was written by Patrick (Paddy) Carey – Clinical Psychologist at YMM.

Paddy works with adults presenting with anxiety disorders, mood disorders, trauma and stressor-related disorders, obsessive-compulsive disorders, substance and gambling issues, psychosis spectrum disorders, and grief and loss. He is trained in Cognitive Behaviour Therapy (CBT), Acceptance and Commitment Therapy (ACT), Cognitive Processing Therapy (CPT), Metacognitive Training (MCT), and mindfulness approaches.

Paddy is focused on developing warm, trusting, and strengths-based relationships with clients. He recognises that his clients are the foremost experts in the room, and unearthing their own expertise is crucial to applying his skills.

To learn more about Paddy, check out the “Our Team” page on our website! https://yourmindmatters.net.au/our-team/

Do you have a fear that’s holding you back? Overcoming Fears

laura on 20/06/2024

People can be scared of many different things, such as dogs, airplanes, needles or insects. And the degree to which we’re fearful of these things can also vary. For example, I personally am scared of birds (this is also known and ornithophobia). Yes, I know…terrifying. However, it’s a mild fear, as this does not stop me from walking through a park where I know birds will be present, or walking down the sidewalk when I see them on the footpath in front of me. I may not like it, but it doesn’t interfere with my life. Unfortunately, this may not be the case for everyone, because, as mentioned above, the degrees of fear can vary. Many individuals will go out of their way to avoid that which causes fear. Some may never go on a desired holiday, or see family interstate due to being frightened of flying. Others may avoid going outside in spring and summer due to their fear of bugs. In these circumstances, seeing a psychologist can be helpful, in order to help tackle this issue.

One way to do this, and my preferred way, is through systematic desensitisation. This involves gradual exposure to that which causes fear and discomfort. To start off, I work with my clients to develop a hierarchy, starting with what causes the least amount of fear, or anxiety, and building up to that which causes the most fear. It’s important that clients follow these steps in an environment that is safe and predictable. Let’s use fear of dogs as an example. Depending on the severity, step one may be just talking about dogs. Believe it or not, this alone can be enough to cause uneasy feelings for some. I ask my client to rate their anxiety level for step one (1-10). The idea is that the more the client is exposed to this step, they will become desensitised, leading to their self-rating to drop over time. Once the client is comfortable and essentially bored with this step, we then move onto step two. Step two may involve looking at pictures of dogs. For example, I would advise against going to a dog park to observe dogs there, as this is an unpredictable environment, as we cannot control or stop a dog from running up to the client, which could lead to more distress. Moving, on, step three may involve looking at videos of dogs. Once again, the client would continue to rate their level of discomfort, and eventually, once this drops to an extremely comfortable level, we move on to the next step. Eventually, the aim and goal would be to have the client comfortably sitting in a room with the dog, and even interact with a dog.

In addition to a hierarchy, it is beneficial to work on breathing strategies in sessions as well. These help ease some of the discomfort within each step. Learning to challenge unhelpful and unrealistic thoughts via CBT (Cognitive Behavioural Therapy) is also very helpful, as often, we overestimate the level of threat, and are more fearful of certain things than necessary.

If an individual has an animal-related fear, such as the above, it can be beneficial if the psychologist they are working with utilises animal-assisted therapy. Therapy dogs are generally quite well-trained and love people. Exposure to therapy animals is done in a safe and predictable environment, and it’s reassuring to know that the specific dog is friendly, and that the handler (in this case, the therapist), has an understanding of the client’s fear, and can work with the client in a manner in which they are comfortable. As opposed to attempting to interact with a dog at a dog park, or on the street, which is less predictable. However, it is important to ensure that the psychologist and therapy animal you choose to work with are suitable for your own level of fear, as some dogs can be more excitable than others and may not be suitable for someone who has trouble even being in the same room as a dog.

*blog featured image: <a href=”https://www.vecteezy.com/free-vector/phobia”>Phobia Vectors by Vecteezy</a>

If you think working with a psychologist would help you tackle your fear, give us a call to find a psychologist that is suitable for you. Please note that Johana is able to assist with clients who have a moderate fear of dogs, as Luna is an excitable dog.

This blog was written by Johana Xanthopoulos, Clinical Psychologist at Your Mind Matters.

Johana works with a range of clients, including children and adolescents. Working previously in an early childhood intervention setting, Johana has skills and experience working with a range of childhood disorders, particularly Autism Spectrum Disorder. Johana’s other special interests include anxiety and depression. She has also completed Animal Assisted Therapy training with her dog Luna, who you may see in our office.

Johana is fluent in English and Greek.

The Upstairs/Downstairs Brain – Why kids have a hard time managing feelings and emotions.

laura on 17/06/2024

We have all had moments where we have felt overwhelmed and dysregulated. Swamped by big feelings and emotions, it can feel like they have control of our body, rather than the other way round. For children, this can be a particularly scary experience, and they can struggle to calm down. Teaching children about how their brains work is an important step in gaining mastery over our emotions. Knowledge is power!!

It can be helpful to think of your brain as like a house. There’s an “Upstairs” and “Downstairs” part.

Source: Image by Dan Siegel

https://www.facebook.com/drdansiegel/photos/when-looking-at-the-brain-from-bottom-to-top-imagine-your-brain-is-a-house-with-/10153612839872208/

The Downstairs part (Brainstem and Amygdala) looks after our basic survival functions. The Downstairs part is intact at birth. It is responsible for:

Regulating breathing and heart rate
Sensory processing
Sensing threat

The Upstairs Part (Prefrontal Cortex) is our “thinking brain”. Fun fact parents – it’s not fully developed until you’re about 25, so it’s under construction for most of childhood and adolescence and is shaped by experience. It’s responsible for:

Logic and reason
Problem solving
Making decisions and managing emotions

When we are calm, ready to learn, play and socialise with others, our Upstairs and Downstairs brains are communicating well. The Upstairs brain is in charge, and it can THINK before it ACTS.

But when we feel stressed, angry, or upset, our Upstairs and Downstairs brains stop communicating well. The Downstairs Brain REACTS before we THINK. When the Amygdala perceives threat, it activates a fight/flight/freeze response in the body (depending on the environment we are in and our temperament). Recent research suggests that we may utilise a fawn response as well (people pleasing). The Downstairs brain channels adrenaline, and makes us super strong, super fast and REACTIVE. This often leads children to meltdown or to become dysregulated, as they are overwhelmed by stress. In this state, it is very hard to think clearly, and it becomes the role of parents and teachers to help the child to regulate.

So, what can we do?

Recognising signs of stress early allows us to manage our feelings, utilise strategies and regulate our emotions. In therapy, children learn to identify their emotions and associated body symptoms and develop strategies to manage stress and anxiety. Having movement breaks or moments to recharge throughout the day, and utilising strategies, can help us with managing the build-up of stress in the body and increase our coping capacity for when we do have big feelings and emotions.
Sometimes, especially for younger children, it’s overwhelming when big feelings and emotions are triggered. If a child is dysregulated and highly stressed, the first goal is to regulate (calm heart rate and breathing, help the child to access the Upstairs Brain).
Parents and teachers can help by:
- Keeping calm and connect! Make eye contact, move down to their level, and use a soothing tone and body language to communicate empathy. Empathic statements that reflect how a child is feeling, and NAMING the emotions/feelings they are experiencing, can help to regulate the brain and move it from a REACTIVE to a REFLECTIVE state.
  - “I can see you’re feeling angry, it didn’t go the way you expected.”
  - “You’re really upset that your friends hurt your feelings.”
  - “You’re feeling scared at trying something new.”
- Redirecting to a calm space or activity to help soothe. A calm space such as a child’s bedroom or the trampoline can offer a space for the child to soothe and reduce sensory overwhelm. You can stay nearby and offer the child a chance to reconnect when they’re ready and feeling calmer.
- Setting safe limits to ensure everyone’s safety. Naming the feeling and setting limits on unsafe behaviour – offer viable alternatives to allow the child to express the emotion/feeling they are experiencing in a safe manner.
  - “I can see you’re mad, I won’t let you hit me. You can hit the beanbag, or the cushion.”

Remember: You can’t pour from an empty cup!

If you are feeling stressed or dysregulated yourself, it’s okay to take a moment to step away and allow yourself space to calm down. We cannot co-regulate a child if we don’t feel calm and regulated ourselves. We want to RESPOND calmly, rather than REACT. Parenting is hard work, and it’s important to be self-compassionate.

The Power of Repair:

And once a child is calm, there’s the opportunity for REPAIR and learning. We all make mistakes and have reactive moments, even as adults. Offering your child a chance to repair the relationship, strengthens your connection and helps model healthy communication. It also helps build self-esteem and reduce the shameful feelings associated when we feel we have “messed up”.

“Hey I was wondering about how you were upset yesterday. I wonder if you were feeling this way because…….. Sometimes I feel that way too. I wonder what we could do differently next time? I love you and we can work through this together.”

Further Resources:

Dan Siegel and Tina Payne Bryson – The Whole Brain Child

https://drdansiegel.com/book/the-whole-brain-child/

Kids Want to Know – Why do we lose control of our emotions?

https://www.youtube.com/watch?v=3bKuoH8CkFc

‘If you would like to learn more about developing emotional regulation for children, or upskill as a parent in coregulation skills, our team are here to help! Call us now and take that first step towards a calmer family life.

This blog was written by Shivonne Cammell – Senior Accredited Mental Health Social Worker at YMM.

Shivonne completed her undergraduate degree in psychology and neuroscience at Monash University, followed by a Master of Social Work at University of Melbourne.

Shivonne specialises in utilising play therapy to help children recover from trauma and grief, develop resilience, enhance family relationships, and adjust to new social circumstances in positive ways. She also has experience working with adolescents and adults to address issues including anxiety, low mood and depression, low self esteem and interpersonal difficulties.

Shivonne is a warm and approachable clinician, who works from a strength-based approach incorporating methodologies including cognitive behavioural therapy, acceptance and commitment therapy, interpersonal therapy, and relaxation and mindfulness strategies.

To learn more about Shivonne, check out the “Our Team” page on our website! https://yourmindmatters.net.au/our-team/

Self-compassion: Why is it important?

laura on 01/05/2024

Photo by Giulia Bertelli on Unsplash

Life can be extremely difficult. The possibility of human experience is endless. Regardless of how privileged or disadvantaged we are; human beings all connect in our capacity for psychological suffering.

We all can move to listening to a harsh internal critic. Do you have an inner critic? If so, what is the purpose of this critic? Is this critic chastising you, searching for your flaws, punishing you, and comparing you? Is it maybe even preventing you from doing things you love, or from living by your values and being your authentic self?

Let’s consider a few examples:

Imagine you have broken your leg and fractured your ribs from a bicycle accident and that you have the choice of getting help with daily tasks from companion A or companion B.

Companion A says to you: “Suck it up, it’s not that bad, you’re pathetic! Plenty of people are worse off than you, quit with the baby tears”

Companion B says to you: “This absolutely sucks. You must be in some really awful pain and feel like you’ve lost some independence that I know is so important to you. I’m here for you, let’s just take it slow together”

Strangely we are often the Companion B to our friends but often not to ourselves!

Imagine a close friend of yours just went through a romantic relationship break-up. They tell you their heartfelt story, and you listen intently from start to finish. Your friend isn’t perfect, but they deserve to be happy. You reassure them that they’ll get through this, they’re a wonderful human being, and that it can be painful, but they will be okay.

You don’t judge your friend. You don’t tell them they are not worthy, they are unlovable, will never find anybody, are ugly, stupid or that they need to change. You show your friend compassion. Strangely we often don’t do the same for ourselves!

Imagine you are at work and your boss calls you in for a meeting to have your annual review. She discusses your strengths and lets you know she is so happy to have you on the team. She then gives you some constructive advice related to organisation/planning skills. Coming from a place of critical judgment, you only hear the negative, and tell yourself, “I’m an incompetent idiot. I’m a shambolic mess and I can’t do anything right”. You head home and feel stressed out, go over all your flaws from memory and can’t sleep.

Coming from a place of fairness and acceptance, you see and hear the whole message, and tell yourself, “I’m doing a really solid job & working well with the team. I’m going to take on her helpful advice and learn from this”. This is a more compassionate response.

What is self-compassion?

There are many different definitions of self-compassion in the literature. I kind of like Neff (2003) that suggests there are 3 components that collaboratively interact to develop a self-compassionate frame of mind:

Self-kindness versus self-judgement – Self-kindness is simply that! Responding with and developing a tendency to be caring and understanding with oneself, and letting go of the harsh judgmental critic. It is about being honest with ourselves about our pain, our flaws, our mistakes and not ignoring, and also not wallowing in self-pity; but acknowledging and responding with genuine kindness, soothing and comfort to the self.
A sense of common humanity versus isolation – The common humanity aspect involves recognizing that all human beings have cracks, and make mistakes. We aren’t alone here! Nobody is perfect! These flaws and cracks make us who we are and connecting one’s own flawed condition to the shared human condition helps with greater perspective and understanding. Individuals who are self-compassionate accept themselves as they are and for who they are, rather than what or who they “should” be.
Mindfulness versus overidentification – Mindfulness involves simply being aware of one’s present moment experience and accepting things as they are. It is not ignoring or ruminating, but observing and accepting the pain, and being self-compassionate. Mindfulness will also help in developing self-compassion habits, like recognizing when your body is feeling anxious and your thoughts are being judgmental toward yourself.

What we know from the research is that when you’re critical and judgmental of yourself, you’re more likely to experience feelings of anger, anxiety, sadness, loneliness and insecurity. When you treat yourself fairly you are in a position to manage these uncomfortable feelings with acceptance.

Self-compassionate individuals often take pride in their human characteristics and believe they are good natured, well-meaning, and competent, and happily understand their unique weaknesses or areas they can work on. They know they are a work in progress and embrace it.

It’s kind of hard to break old habits and practice self-compassion.

I encourage you to treat yourself fairly and with kindness, and see what happens.

References

Barnard, L. K., & Curry, J. F. (2011). Self-compassion: Conceptualizations, correlates, & interventions. Review of General Psychology, 15(4), 289-303.

Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and identity, 2(3), 223-250.

This blog was written by Karen Dreher – Counsellor at YMM.

Karen is a member of The Australian Counselling Association (ACA). She has completed a Masters of Counselling, a Graduate Diploma in Psychology, and additional training in Gottman (couples) Therapy.

Karen is a person-centred counsellor who values the diversity of human narrative and her client’s own personal meanings, experiences and feelings. Karen provides a warm, empathetic, authentic space that supports clients in engaging in their own self-understanding and healthy well-being.

To learn more about Karen, check out the “Our Team” page on our website! https://yourmindmatters.net.au/our-team/

How can a diagnosis be helpful: to assess my child or not?

laura on 30/03/2024

Image source: Photo by Sebastian Pandelache on Unsplash

Why an assessment may be helpful?

Is your child experiencing difficulties concentrating at school, establishing and maintaining friendships, or unable to meet their academic requirements? There may be more going on for your child than simply misbehaving or not fitting in. More often than not, children are disciplined for behaviours beyond their control leaving them feeling worthless and frustrated. An assessment gathers valuable information from parents, teachers, and your child, focusing on both your child’s strengths and challenges, creating a space to better understand who they are and how they learn best.

What is an assessment?

In the realm of child development and education, psychoeducational assessments serve as valuable tools in understanding your child’s cognitive, academic, social, and emotional functioning. These assessments can provide crucial insights into your child’s strengths, challenges, and learning style, aiding educators, parents, and healthcare professionals in tailoring support and interventions. However, like any tool, psychoeducational assessments come with both benefits and drawbacks that merit consideration.

But, I don’t want to ‘label’ my child!

Whilst it can be overwhelming and upsetting for parents to learn their child may be experiencing social, emotional, behavioural, or intellectual challenges, parents should not shy away from psychoeducational assessments. Understanding their child’s diagnosis is a tool for identification rather than a limitation, is important. Receiving a diagnosis can open doors to appropriate support services and interventions, empowering both the child and parent to navigate challenges effectively.

Are there different kind of assessments and why do I need them?

Cognitive assessments:

Designed to measure a child’s cognitive abilities, including verbal and non-verbal reasoning, memory and processing speed. These tests provide valuable information regarding a child’s intellectual strengths and challenges. For parents, understanding their child’s cognitive profile assists in making informed decisions around educational placement and/or interventions. As for teachers, it helps guide instructional strategies and accommodations tailored to a child’s learning style and abilities, providing further supports and scaffolding within the classroom.

Academic assessments:

Evaluates a child’s proficiency in different academic domains, including reading, writing, mathematics, and language skills. Achievement assessments help identify the presence of a specific learning disorder that may impact a child’s academic progression, such as dyslexia or dyscalculia. Results from an academic assessment allow for goal setting to help promote a child’s academic progress, which may include access to tutoring, educational support services, or guiding teachers to tailor their approach to suit the child’s individual needs.

Social-emotional assessments:

Examining a child’s social capabilities, emotional regulation, behaviour, and interpersonal relationships can help identify whether there are any underlying factors that may help explain and be contributing to a child’s behavioural challenges at home and/or school. For instance, the presence of anxiety, attention deficit hyperactivity disorder or autism spectrum disorder may be the reason a child is experiencing social and emotional difficulties across different contexts. For parents, these assessments provide insights about how to foster a child’s social-emotional development. Additionally, for teachers, it allows them to implement the appropriate classroom management strategies and create a supportive classroom environment for a child to flourish and develop positive social interactions and emotional well-being.

Adaptive functioning assessments:

Examining a child’s daily living skills, independence, and ability to function effectively in different environments (i.e., home and school) is valuable in helping determine the best way to promote independence, autonomy, and inclusion in daily activities. Parents will have the understanding and tools that will help inform decisions about support services and transition planning for adulthood.

Further information

For more information about the process of a psychoeducational assessment, please visit https://yourmindmatters.net.au/learning-assessments-what-when-why-and-how/.
The following website offers valuable information and resources for children with Specific Learning Difficulties: https://speldvic.org.au/

This blog was written by Nicole Gerson – Psychologist at YMM.

Nicole completed her Masters in Educational and Developmental Psychology at Monash University. She has a passion for conducting psychological and educational assessments to better understand an individual’s strengths and difficulties. Nicole works closely with clients to help develop targeted strategies and assist each client to reach their full potential.

To learn more about Nicole, check out the “Our Team” page on our website! https://yourmindmatters.net.au/our-team/

Pathological Demand Avoidance (PDA): What is it? And how can we support individuals with a PDA profile?

laura on 06/03/2024

Image source: https://sunshine-support.org/resources/#infographics

What is Pathological Demand Avoidance

Pathological demand avoidance, or Pervasive Drive for Autonomy (PDA)*, is an anxiety-driven need for control and resistance to demands/expectations that threaten a sense of autonomy. Whilst everyone experiences demand avoidance at times (e.g., refusing to complete homework or household chores), for individuals with PDA, everyday demands such as “put on your shoes” or “take a shower” can cause significant anxiety and evoke extreme emotional reactions (panic attacks or meltdowns). In fact, individuals with PDA may resist demands even if it’s something that they enjoy or want to do. It is the expectation, rather than the nature of demands, that leads to a perceived lack of control. Thus, demands that may trigger PDA include:

Direct Demands: Instructions e.g., Brush your teeth, put your shoes on, do your homework, corrections, or discipline.
Indirect Demands: Praise, discussions/comments about the future, transitions, social expectations.
Internal Demands: Hunger, thirst or needing to use the bathroom.
Wants/desires: Hobbies/interests, special occasions.

*Pervasive drive for autonomy is the preferred name for many within the autistic community.

So, how do we identify individuals with a PDA profile?

Core Features of a PDA Profile

At present, PDA is not included in the International Classification of Diseases (ICD-11) or the Diagnostic Statistical Manual (DSM-5-TR) as a formal diagnosis. Rather, PDA is currently considered a profile of autism characterised by:

Resistance/avoidance to ordinary demands of life and use of “social strategies” to regain autonomy:
- PDAers may employ various social techniques as a means of avoiding demands, including:
  - Distraction: Giving compliments, changing the subject, feigning injury, mimicking.
  - Excuse Giving: “My legs don’t work”, “I can’t hear you”, “I’m blind.”
  - Refusal: “NO!” “I can’t do that.”
  - Withdrawing into fantasy: “I’m a dinosaur.”
  - Controlling the actions of others around them: “You do it”, suggesting alternatives.
- These behaviours can often be misinterpreted by others as manipulative. When distraction, control and avoidance strategies fail, anxiety levels are heightened, and distress escalates, which can lead to aggression (hitting, kicking, biting), elopement, or self-harm. It is important to note that these behaviours are not deliberate; rather, PDAers experience panic and a fight/flight/freeze/fawn response.

Image by https://www.thinkpsychologists.com.au/blog/pda-pathological-demand-avoidance/

Surface social communication abilities:
- PDAers may present with less obvious differences in social communication and understanding than other autistic children. They may have strong verbal fluency and exhibit more eye contact. However, they may also struggle with understanding social hierarchy, e.g., wanting to be co-teachers or co-parents, and have a preference for being in control during play.

Other key characteristics include:

Intense emotions or mood swings
Comfort in role-playing and storytelling
Intense focus on interests, often directed at other people

Pathological demand avoidance can present differently depending on the setting and an individual’s capacity for demands at any one time. In school, a PDA child may refuse to start tasks or engage in distracting behaviours to avoid work. At home, they may have frequent meltdowns about routine tasks such as taking a shower or getting dressed.

So, how can we support individuals with PDA?

Strategies to Support PDA Children

It is important to understand that PDA behaviour is driven by anxiety and that PDAers respond to demands as if they are a direct threat to their safety or well-being. Thus, low arousal approaches that reduce anxiety and provide a sense of control are essential for supporting PDAers. The Pathological Demand Avoidance Society recommends an approach that is flexible, based on trust, and collaborative. This is called the PANDA approach, as outlined below.

Image by PDA Society UK

Pick Your Battles:
- Minimise non-essential rules and agree on non-negotiable boundaries – Ask yourself what rules are important for the child, family or class. Prioritise rules as high, medium or low priority.
- Allow for some choice/control by providing two options or allowing “no” as a response.
- Provide explanations.
Manage Anxiety:
- Recognise and respond to the child’s cues that they are becoming overwhelmed or stressed.
- Reduce uncertainty.
- Treat distressed behaviours as panic attacks and support throughout
- Recognise that when in a heightened state, a child is not fully in control of his or her behaviour, as the emotion centre of their brain takes over.
Negotiate/Collaborate:
- Keep calm
- Proactively negotiate
Disguise Demands:
- Reframe requests – Instead of using words such as “need”, “must” “wont” “can’t” or “it’s time to” try using phrases such as “is it okay with you” “how do you feel about”, “I wonder.”
- Use declarative language, e.g., “The clothes are on the bed.”
- Disguise demands as challenges – “I bet I can get my coat on first”.
- De-personalise the request, e.g., “it’s the school rules.”
Adapt:
- Use humour, novelty, distraction, and roleplay.
- Be flexible and have a plan B.
Be cautious with rewards or praise:
- Rewards charts can create additional demands if the original demands are not achieved. Instead, try providing spontaneous rewards.
- Praise or encouragement can be perceived as a demand; instead, try providing praise indirectly or focusing on the process. When offering encouragement, provide choices or exit strategies.

Resources

If you’d like to learn more about PDA and how it presents, please see the following:

Websites

Books

Understanding Pathological Demand Avoidance Syndrome in Children: A Guide for Parents, Teachers, and Other Professionals by Phil Christy, Margaret Duncan, Ruth Fiddler, and Zara Healy.
Me and My PDA: A Guide to Pathological Demand Avoidance for Young People by Gloria Dura-Vila and Tamar Levi.
The Educator’s Experience of Pathological Demand Avoidance by Laura Kerbey

If you’re noticing patterns of demand avoidance in your child or would like some help supporting individuals with a PDA profile, please feel free to contact our admin team on 9802 4654.

This blog was written by Michaela Hughes – Psychologist at YMM.

Michaela has a special interest in working with children and young people with a range of neurodevelopmental disorders including Autism Spectrum Disorders (ASD), ADHD, Intellectual Disability and Language Impairment.

Michaela believes in a warm, empathetic, and collaborative approach to the therapeutic process and that treatment should be tailored to the client’s individual needs. She strives to adopt a client-centred approach, drawing on a range of evidence-based treatments including cognitive behavioural therapy, play-therapy and mindfulness-based therapy.

To learn more about Michaela, check out the “Our Team” page on our website! https://yourmindmatters.net.au/our-team/

Understanding and Managing Children’s Challenging Behaviours – For parents

laura on 13/02/2024

Photo by Caleb Woods on Unsplash

Have you ever experienced the challenge of navigating a teenager’s sudden outbursts or trying to calm a younger child’s meltdown in a crowded store? It’s a common scenario for many parents.

Understanding why the challenging behaviour occurs

Psychologist Ross Greene’s Collaborative & Proactive Solutions (CPS) approach emphasises that if they could do well, they would do well.

Understanding why children exhibit challenging behaviours is the first step toward effectively managing such behaviours. No child wakes up and decides that they want to do ‘bad’ things or have a meltdown in front of all of their friends! Fundamentally, all children want to do well, and it is up to parents and caregivers to try to understand why they are engaging in behaviour that interferes with their ability to meet expectations at home, school or in the community.

Often, children with behavioural challenges are labelled negatively. Let’s have a look at some of these all-too-common terms…

‘They’re attention seeking!’.

This label identifies an unmet need in the child’s life but offers limited solutions. It implies that the child is acting with intention.

‘They’re manipulative!’

Children engaging in challenging behaviours do so impulsively, emotionally and without much forethought. Competent manipulators possess many skills, such as planning, impulse control, and organisation.

‘They’re unmotivated!’

This label doesn’t capture what is going on with a child and may create low self-worth, leading to further challenges in the future.

‘They’re testing the limits!’

This often leads parents to prioritise compliance over understanding and addressing factors contributing to behaviours.

Children may lack the skills to behave appropriately. They may have unsolved problems or even unmet needs contributing to their behaviour. Adults can help by collaboratively finding the cause of their child’s challenging behaviours and helping them implement strategies.

Image by Nichole Schlechter on https://nicoleschlechter.com

Managing challenging emotions and behaviour

When a child is struggling to regulate their emotions, their ability to engage in problem-solving and collaboration is compromised.

The Zones of Regulation framework provides a systematic approach to help children understand and manage their emotions and behaviours. By categorising emotions and states of alertness into four colour-coded zones – Green, Blue, Yellow, and Red – children learn to recognise and label their feelings, gaining awareness of their current emotional state.

Techniques such as deep breathing or taking a break may help young people calm down in the Red Zone, while activities like visualisation or positive self-talk can help them shift back to the Green Zone.

It is essential for parents to remember that when a child is engaging in unsafe, challenging behaviours, the critical goal is always de-escalation. No learning occurs when a person is dysregulated. The team of child clinicians at Your Mind Matters can support children and their parents in learning to use de-escalation strategies to calm their bodies and minds.

This poster was put together by Elina from Your Mind Matters but is based on information from https://zonesofregulation.com/. Have you seen the movie Inside Out (PG ages 6+) to recognise these characters?

Teaching adaptive behaviour and skills

In addition to emotion regulation, it’s essential to teach children adaptive behaviours and skills that will help prevent future challenges, according to Ross Greene’s Collaborative & Proactive Solutions (CPS). Children who demonstrate challenging behaviours already receive negative natural consequences for their behaviours. Giving them more consequences and punishing them (e.g. detentions, removing favourite toys, yelling) does not give them the skills to succeed and instead may just further harm their self-esteem.

What interventions DO solve problems and teach skills?

Identifying situations where the child’s skills are consistently lacking:

E.g. Your child yells and cries when they lose

Implement a cool-down routine.

E.g. A go-to activity to regulate emotions when upset.

Teaching the child practical ways to improve their skills:

E.g. Teach the child how to recognise physical signs of anger and disappointment.

E.g. Teach coping strategies like self-talk

Remove barriers that impact the child’s success:

E.g. Modify the game to reduce the emphasis on winning/losing.

Practise, practise, practise!

E.g. Role playing different reactions to losing a game.

Provide accommodations:

E.g. Allow for mistakes and setbacks and be flexible in your approach as the child learns the new skill.

Managing challenging behaviours in children and teens can be a daunting task, but parents and caregivers do not have to navigate it alone. Every child is unique, and finding the right strategies may take time and patience. If you would like support in parenting a child with challenging behaviour, our team of clinicians can help.

Additionally, if you are interested in learning more about Ross Greene’s CPS model to working collaboratively with children and teens, you may enjoy his lecture below:

https://www.youtube.com/watch?v=VsTvUiSxfls

This blog was written by Elina Makela – Psychologist (Educational and Developmental Psychology Registrar) at YMM.

Elina is passionate about helping young people presenting with behavioural and emotional difficulties. Elina works collaboratively with families to support young people with developmental difficulties related to Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). She also has a strong interest in working with young people who experience eating difficulties, poor body image, sleep issues, and anxiety. Through warmth, compassion and play, Elina creates rapport with her younger and adolescent clients.

To learn more about Elina, check out the “Our Team” page on our website! https://yourmindmatters.net.au/our-team/

Working through trauma from a schema therapy lens

laura on 11/01/2024

Photo by Aditya Saxena on Unsplash

My previous blog aimed at providing a brief overview of trauma and posttraumatic stress disorder. Click here to read more: https://yourmindmatters.net.au/a-brief-overview-of-trauma-and-posttraumatic-stress-disorder/. This blog focuses on how therapy can aid in processing past traumatic or upsetting experiences.

There is an abundance of research on various modalities for working through trauma in a therapeutic context. Here we unpack the use of imagery rescripting, a schema therapy intervention. Please note, this is not the sole treatment approach available.

What is Schema Therapy?

Schema Therapy focuses on understanding how our past experiences have shaped our schemas (beliefs specific to ourselves and the world around us). During our childhood, our needs may not have been met (e.g., our need for support, nurturance, safety/protection, emotional connection) which contributed to the development of early maladaptive schemas, unhelpful behavioural patterns and coping mechanisms.

A part of schema therapy is aimed at building attunement (‘tuning in’) to our emotional responses when faced with a triggering situation or event. It is about building awareness of how current life stressors can activate our schemas and lead to strong feelings and behavioural responses. Often, it is not the current event that evokes such an intense emotion, but more about how we interpret this event and the meaning we derive from it based on our early experiences. For instance, exposure to trauma or an upsetting event may lead to interpretations such as “This is my fault”, “I am bad/unworthy/not good enough”.

Preparation for Processing Past Trauma

Prior to moving into imagery rescripting, your clinician will complete a thorough intake and assessment. Often, it may be necessary to build emotion regulation skills and learn relaxation strategies, to ensure that you are ready to move to the part of therapy where rescripting occurs. You might be asked to complete questionnaires, which look at the symptoms you experience and the impact on your daily functioning. This can provide valuable information and can be used to measure your progress throughout treatment.

Imagery Rescripting

Imagery rescripting is a therapeutic technique, where through the guidance of a trained clinician, one re-imagines a past painful memory, entering the image from the perspective of their child self. The aim is to change the way one feels and thinks about the event, by inserting new meanings/interpretations and leading to a corrective emotional response. The focus is on imagining a different outcome where the individual’s needs (for example, for safety, protection, nurturance) are met. During an imagery rescripting exercise, one does not need to relive the traumatic or upsetting event. What occurs is that the image is paused when a ‘hot spot’ (the moment feelings of distress begin to appear) is reached, and the therapist enters the image to support the client and meet their needs.

Now at this point, you may be thinking, “but that doesn’t change what actually happened”. And you are right. We can’t go back and change the past, but what we can do is change how you think and feel about the memory. Brain studies have shown that the brain responds in a similar way to imagining and actually experiencing an event.

The process of imagery rescripting takes approximately 12-15 minutes, but can vary from person to person. Once the image has been rescripted, you will have the opportunity to reflect on the experience of the exercise with your clinician. Many clients have provided positive feedback regarding imagery rescripting and reported a shift in their emotional response and beliefs when they think of the rescripted memory. This includes feeling ‘lighter’ when thinking about the memory, feeling less distressed and reduced anxiety.

If you would like some support in working through past upsetting experiences, our team of psychologists are here to help.

This blog was written by Maria Kampantais – Psychologist and Clinical Registrar at YMM.

Maria has been consulting at YMM since 2016 and has an interest in working with clients presenting with anxiety disorders and past trauma. Maria offers a warm and supportive space to assist clients in navigating their presenting concerns and explore past painful experiences. Maria aims to support clients to build awareness into how past experiences may have shaped their belief system and subsequent emotional responses, and move towards healing through developing helpful coping mechanisms. Maria draws on various evidence-based therapies including Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), mindfulness techniques, and Schema Therapy.

To learn more about Maria, check out the “Our Team” page on our website! https://yourmindmatters.net.au/our-team/

Breaking the Cycle: Why Avoidance Behaviours Lead to More Avoidance

laura on 11/11/2023

Photo by Possessed Photography on Unsplash

Anxiety can be an uncomfortable and distressing feeling that we want to get rid of. This can lead to making choices that will alleviate our anxiety in the quickest way. Avoidance behaviours can encompass a wide range of physical and mental actions, from procrastination and refusing to think about certain things, to social withdrawal and distracting oneself. These behaviours can momentarily ease discomfort but ultimately reinforce the problems they are meant to alleviate.

Here’s how the cycle of avoidance typically unfolds:

Temporary Relief

When we avoid a difficult situation, we experience temporary relief from the discomfort, anxiety, or fear associated with it. This relief reinforces the idea that avoidance is helpful.

Escalation of Anxiety

Over time, avoiding the situation increases anxiety because the problem remains unsolved. This makes the problem more overwhelming and challenging when we come to address it at a later date.

Reinforcement of Avoidance

Since avoidance initially provided relief, we’re more likely to use it again in the face of similar challenges. This strengthens the use of avoidance behaviour as a coping strategy.

Negative Consequences

Avoidance behaviours often lead to negative consequences, such as missed opportunities, damaged relationship and compromised performance (i.e., academic grades or work-evaluations). These consequences can amplify the problems we were trying to avoid in the first place.

Breaking the Cycle

Breaking the cycle of avoidance can seem daunting and overwhelming. However, gradually taking steps to confronting feared situations will go a long way in breaking down this cycle and building a sense of confidence. While it may be tempting to jump into the deep-end and tackle your biggest fear first, taking a slow and persistent approach allows for you to learn and practice skills that can assist you.

Seek Support

Reach out to friends, family, or professionals for support when dealing with challenging situations or emotions. Having a support network can make it easier to confront problems.

Mindfulness

Practicing mindfulness helps keeps us in the present and from catastrophising about hypothetical outcomes.

Problem-Solving

Instead of avoiding problems altogether, break it down into more manageable steps. Create an action plan to assist with tackling these steps.

Self-Compassion

Be kind to yourself. Avoid self-criticism, and recognise that there may be set-backs. Self-compassion can reduce the fear associated with confronting difficulties.

Avoidance behaviours may offer temporary relief, but they are ultimately counterproductive, fuelling a cycle of increased avoidance. To break this pattern, it’s vital to confront challenges directly and adopt healthier coping strategies. By doing so, we can not only avoid the negative consequences of avoidance but also experience personal growth and resilience.

This blog was written by Simone Chaochalakorn – Psychologist at YMM.

Simone has experience working in a variety of contexts, including working with young children in primary schools, as well as adolescents in clinics. Alongside this, Simone has also assisted adults and seniors with concerns such as work-related stress, relationship difficulties, anxiety and low mood. Simone uses a client-centered approach, in which she strives to understand each individual and their unique problem, in order to find the most effective strategies to help them.

To learn more about Simone, check out the “Our Team” page on our website! https://yourmindmatters.net.au/our-team/

Assertiveness: What does it look like and why it’s important

laura on 13/10/2023

Photo by Brett Jordan on Unsplash

Most people have experienced situations where they have not received what they wanted or needed. These might have been at work, with friends, family, or in intimate relationships. Some may have thought “I am just not an assertive person” and let it go or potentially have it fester into ongoing resentment or sense of helplessness. Some, may have reacted in an opposite manner, with anger and frustration, but this too did not result in needs being met but rather fractured relationships.

Assertiveness is important in all spheres of life from domestic to social to vocational. If you have ever found it difficult to get your point across, to even speak up or keep your cool and had a difficult time communicating your needs, you will undoubtedly recognise the importance of assertive communication in balancing relationships and having needs met.

Whilst one might accept these circumstances as the norm of not being assertive, assertiveness is actually a set of skills that can be learned and developed. Personality, culture, life experiences and previous relationships may all make this skill harder to learn for some people, however it is possible to learn to be assertive and doing so is likely to make a positive difference to one’s life.

So what is Assertiveness and what is it not?

Although the meaning of “assertive” may be familiar, it is important to consider what Assertive Communication actually looks like and what it entails.

Assertive communication has been defined as “the ability to speak and interact in a manner that considers and respects the rights and opinions of others while also standing up for your rights, needs, and personal boundaries” (Pipas & Jaradat, 2010, pp. 649). In other words, it’s a communication style which is comprised of direct yet calm, respectful and reasonable expression of your needs whilst also taking the other party’s needs into account. It is standing up for your values without impeding another’s right to do so. Assertiveness is a key skill that can help you to better manage yourself, people and situations. It can help you to influence others in order to gain acceptance, agreement or behaviour change whilst allowing one to feel less guilty for saying ‘no’ to tasks or plans that may not be serving them. It is not coming out as the champion of a heated argument. Assertiveness is knowing when and how to demonstrate your view.

Conceptually, if we look at communication styles on a continuum, assertiveness is the middle balance between being passive (where one is overly focussed on the needs of others’, but struggles to vocalise their own) and being aggressive (where a person may be overly forthright and demanding about their needs, but fail to acknowledge the needs and wants of others). Assertiveness is therefore a positive personality characteristic that enables individuals to be present, actively engaged and aware of their rights, whilst also extending the same to others. They are a benefit to both themselves and society (Parmaksiz, 2019).

Benefits of Assertiveness vs Consequences of when it’s lacking

The importance of feeling considered, heard and valued is well established. Not having our reasonable needs or wants met and feeling that these are not seen as important or valued, leads to feelings of stress and upset. These negative emotions can compound over time and can become a “time bomb” with detrimental impacts on our self-esteem, anxiety and stress (Bulantika and Sari, 2019). A lack of assertiveness may contribute to depression and anxiety, whereas maladaptive approaches to assertiveness may manifest as aggression (American Psychological Association, n.d.a, para. 1).

What are some of the traits of Assertive Communicators?

There are certain traits that are present in effective assertive communication, spanning both verbal and non-verbal characteristics.

Direct eye contact which communicates confidence and that the person is not intimidated
Assertive posture/stance which balances an open confident stance without looking aggressive. Hand gestures and fidgeting also need to be minimised.
Tone of voice should be confident, strong, but not loud and aggressive.
Clarity of communication is vital, so using specific words that clearly communicate ones needs with little room for ambivalence can assist in getting the message across.
Facial expression needs to remain calm and important to not express anger or anxiety.
Timing of any conversations needs to be considered and appropriate as should the audience
Non-threatening: the person should not blame or threaten the others in order to get their way.
Ability to own your mistakes whilst not taking the ownership for the mistakes of others is part of standing up for own beliefs.
Communication needs to be framed in a positive, proactive but precise manner and self criticism should be avoided when trying to be assertive. It’s imperative that when trying to have effective communication, you’re clear on your position and needs.

While assertive communication skills come naturally for some individuals, these skills can be developed through practice. Effective communication can assist career progression and improve relationships. Relationships are complex and individual and sometimes we may need additional support navigating them. Psychological therapy can be helpful to develop skills in assertiveness in a safe supportive space. If you would like some support with better managing communication and improving the quality of interactions, why not give us a call today? Our team of highly skilled and well-experienced practitioners are here to help.

References

American Psychological Association (n.d.a) Assertivness. In APA Discitonary of Psychology. https://dictionary.apa.org/assertiveness
Bishop, S. (2013). Develop your assertiveness. London, UK: Kogan Page Limited.
Bulantika, S. Z., & Sari, P. (2019). The effectiveness of assertive training techniques and thought-stopping techniques to increase student assertiveness ability. Biblio Couns: Jurnal Kajian Konseling danPendidikan, 2(3), 109–116.
Millacci, T (2017). Assertiveness in the Workplace: A Quick Guide. https://positivepsychology.com/assertiveness/

Pipaş, M., & Jaradat, M. (2010). Assertive communication skills. Annales Universitatis Apulensis Series Oeconomica, 12, 649–656.
Williams, M (2023). What is Assertiveness and why isis important. https://www.lawsonpsychology.com.au/2023/06/30/what-is-assertiveness-and-why-is-it-important/