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Archive for the ‘daily writings and musings of the psychologist’ Category

Rhea (name changed )had been wondering as to where had she gone wrong in her decision to make her marriage a dream marriage that she had always dreamt about. She had wanted her marriage to be a mean to her happiness and love. She wanted to share a home full of marital bliss with her life partner Sam . Those two had always been looked upon as if they were a kind of made for each other couple during the six month long courtship. It wasn’t long since everyone at their reception ceremony had praised their complementing and completing each other .

Yet something went wrong immediately after they had returned from their honeymoon.She to utter dismay felt that she was not able to cope up with the demands being made on her by the family members of Sam. .She was feeling bad that she had not come upto the expectations of her mother in law. Her husband would often find her guilty of having upset his mother.Her mother in law would insult her ,in the kitchen and would not allow her to cook anything. if she had really been trained to be a housewife only things would have been different.She has been a professional programmer in an I.T. company and her husband who worked alongside her in the same organisation knew it very well.Then why this sudden demand of attending to household work .She would get into the bed room to discuss the post wedding trauma with her husband who often refused to discuss anything about his mother’s stand.

Jatin’s (name changed ) wife had left home to be with her mother for a week, has not returned now for many months as she decided to get out of the marriage because Jatin has not been taking her out to their regular pub joint after marriage as had been promised by him before they got married.

Ruby and Rohit (names changed ) had a long history of having been in love with each other from their childhood days and their courtship continued for more than twenty years before they decided to tie their knot. But after marriage everything turned tipsy turvy when Ruby found out that Rohit had been two timings even when he was into relationship with her .

Some of these young people may appear to be living next to us or people could be within us . But young marriages are not the only ones having jolts and jitters . Couples in their fifties and sixties years of age too have been having tough time in current situations as they either moot separation or move forward to a divorce.

Said Sudhir (name changed) “Our journey towards a blessed relationship of matrimony happened 19 years ago. We have two sons (17 and 12 ) . Recently I saw my wife talking to someone on social media Thereafter it has been a journey full of hardships and everyday fights .My marriage and its subsequent outcome had far-reaching effects on both my emotional and physical heath, as well as my self esteem and personal identity .I have decided to end this tortuous relationship.

Marriage is changing and evolving .it’s meaning in all strata of society ,be it young ,old , middle aged couples ,any income group is not the same any more .

We have had and we continue getting couples from any age group ,financial and milieu as you have read in some of the cases mentioned above .

A life long commitment to matrimonial relationship is a turning into a burden for some of the young couples .And some of the elderly couples feel it has been a difficult journey . They want to bring it to an end .But the decision to separate , from your partner with whom you have been planning to turn your dreams into a reality and walk hand in hand with each other ;to separate marital life to finally making the decision to proceed with a divorce and to coping with the stress and heartache is not so easy either ..

This is where we at Family Therapy India can help couples like above and many others who are facing turmoils into their relationships .

Our Family Therapy ,Relationship and marriage counselling sessions can help you change your life for the better.

You can learn how your personal choices are affecting your life, and that your happiness is up to you. You can’t always change your circumstances, or the situations you face in your life, but you can change how you act or react to those circumstances. It is up to you to decide what your future will look like, and to create your own happily ever after. Our family therapy ,Relationship and marriage counselling can help you find yourself, and let go of the feelings of anger, frustration, betrayal, and despair that are holding you back. It can teach you how to set goals and move toward a positive and successful future within your marriage, You can learn how to make permanent, lasting changes that benefit both of you and of course other members of your family.

Our Emotions Focussed Therapy and Counselling can help you regulate your emotions and learn the process of the best decision making on personal, financial, and practical aspects of your life that will develop better understanding for you and your partner to reaffirm your relationship.

We offer Family therapy , relationship and marriage Counselling sessions for families ,men, women and couples who are living with children, recently married, thinking of separation, getting a divorce, or experiencing relationship difficulties .We strongly believe in helping all those couples who are facing difficulties within their relationship at any age to understand each other’s mental and emotional state . We help them to set their communication better and overcome obstacles that are preventing them from achieving the happiness they deserve.

Get in touch with us today or write to us mansikpramarsh@gmail.com

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In a world where love often seems to flow outwardly towards others, we often forget the essential foundation of love: loving oneself. The adage “love yourself, because if you don’t, no one else will” rings true, yet many struggle to prioritize self-love amidst the demands of daily life and societal expectations.

The question of who the most important person in one’s life is elicits varied responses, revealing a common tendency to prioritize others over oneself. From romantic partners to children, parents, and friends, individuals often place their own needs and desires on the backburner in favor of nurturing relationships with others. This selflessness, while admirable, can lead to feelings of loneliness, emptiness, and even depression when one’s own needs go unmet.

Society has long praised the spirit of sacrifice as the ultimate virtue, but perhaps we’ve misunderstood the true essence of selflessness. While acts of giving and sacrifice are noble, they should not come at the expense of neglecting one’s own well-being.

Lord Krishna’s teachings to Arjuna emphasize the importance of acting without attachment to the outcome, but they also underscore the significance of honoring the self. Neglecting oneself in the pursuit of pleasing others ultimately diminishes one’s own capacity to give and love fully.

Self-love is not selfish; it is a prerequisite for genuine connection and fulfillment in relationships. Just as a mother must nourish herself to properly care for her child, individuals must prioritize their own physical, mental, and spiritual well-being to be of service to others. This concept may seem counterintuitive in a culture that glorifies self-sacrifice, but it is essential for creating sustainable and healthy relationships.

Cultivating self-love requires a conscious effort to prioritize one’s own needs and desires. It involves setting boundaries, practicing self-care, and acknowledging one’s worth independent of external validation. Learning to love oneself is a journey that requires patience, compassion, and vulnerability. It means embracing both our strengths and weaknesses, recognizing that imperfection is inherent to the human experience.

The path to self-love begins with self-awareness. Taking the time to reflect on our values, passions, and aspirations allows us to connect with our authentic selves. From there, we can identify the areas of our lives that need nurturing and attention. This may involve letting go of limiting beliefs, forgiving ourselves for past mistakes, and embracing our unique gifts and talents.

Self-love also involves practicing self-compassion. We are often our own harshest critics, but learning to treat ourselves with kindness and understanding is essential for fostering a positive self-image. Rather than dwelling on our flaws and shortcomings, we can choose to focus on our strengths and accomplishments. Self-compassion enables us to weather life’s challenges with resilience and grace.

Pampering oneself is not indulgent; it is an act of self-love. Whether it’s treating oneself to a relaxing spa day, indulging in a favorite hobby, or simply taking a moment to savor the present, self-care is essential for nourishing the mind, body, and soul. In a world that glorifies busyness and productivity, carving out time for self-care may feel like a luxury, but it is a necessary investment in our overall well-being.

Believing in our own worthiness is perhaps the most powerful aspect of self-love. When we recognize our inherent value as individuals, we no longer seek validation or approval from others. Instead, we derive our sense of self-worth from within, knowing that we are worthy of love and acceptance simply by virtue of being human.

In conclusion, embracing self-love is not a selfish act; it is a necessary foundation for building healthy, fulfilling relationships with others. By prioritizing our own well-being, we become better equipped to give and receive love authentically. Self-love is not a destination but a journey—one that requires patience, courage, and self-compassion. As we learn to love ourselves unconditionally, we pave the way for a life filled with joy, connection, and abundance.

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Being in love is wonderful, isn’t it? Dating, feeling those butterflies, and longing to see each other again—it’s a special time. But as relationships grow, they change. Long-term relationships are about more than just love; they’re about managing life together.

When you’re in a long-term relationship, you’re not just looking out for yourself anymore. You’re building a life with someone else. That means dealing with all sorts of things: money, jobs, family, and more. It’s not always easy.

Communication is key. It’s how you talk about your problems and work through them together. Every argument is a chance to make your relationship stronger. Instead of fighting, try to understand each other’s point of view. That’s how you grow as a couple.

One of the hardest parts is merging your lives. You’re bringing together two different worlds, with different families, careers, and goals. It takes compromise and patience.

But even with all these challenges, it’s important not to forget about romance. As time goes on, the initial excitement might fade. You might find yourself focusing more on everyday worries than on each other. That’s normal, but it’s important to make time for romance too.

Romance doesn’t have to be grand gestures. It’s the little things that matter, like holding hands or cuddling on the couch. These small moments keep the spark alive.

Understanding each other’s needs is crucial too. Life is full of ups and downs, and you need to be there for each other through it all. When you have disagreements, listen to each other and find a solution together.

It’s also important to make each other happy. In the midst of busy lives, it’s easy to forget what really matters. But love is what makes life meaningful, so cherish it.

In the end, being in a long-term relationship is about facing life together. It’s about growing and learning as a couple. Yes, there will be tough times, but love will see you through.

In conclusion, long-term relationships are a journey. They’re about more than just love; they’re about building a life together. With communication, understanding, and a little romance, you can make your relationship stronger than ever. So cherish each other and the love you share—it’s worth it.

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WHAT IS EYE MOVEMENT DESENSITIZATION AND REPROCESSING (EDMR)?

EMDR (Eye Movement Desensitization and Reprocessing) is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences.

Francine Shapiro developed EMDR in 1987, she based EMDR on the notion that emotional distress can be processed when asleep during the rapid eye movement (REM). Phase.

She utilised this natural process in order to successfully treat Post-traumatic Stress Disorder (PTSD). Since then, EMDR has been used to effectively treat a wide range of mental health problems.

Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference.

It is widely assumed that severe emotional pain requires a long time to heal. EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma.

WHAT IS AN EMDR SESSION LIKE?

After a thorough assessment, you will be asked specific questions about a particular disturbing memory.

Eye movements, similar to those during REM sleep, will be recreated simply by asking you to watch the therapist’s finger moving backwards and forwards across your visual field.

Sometimes, a bar of moving lights or headphones is used instead.

The eye movements will last for a short while and then stop.

You will then be asked to report back on the experiences you have had during each of these sets of eye movements.

Experiences during a session may include changes in thoughts, images and feelings.

With repeated sets of eye movements, the memory tends to change in such a way that it loses its painful intensity and simply becomes a neutral memory of an event in the past.

Other associated memories may also heal at the same time.

This linking of related memories can lead to a dramatic and rapid improvement in many aspects of your life.

WHAT CAN EMDR BE USED FOR?

In addition to its use for the treatment of Post-traumatic Stress Disorder, EMDR has been successfully used to treat:

  • anxiety and panic attacks
  • depression
  • stress
  • phobias
  • sleep problems
  • complicated grief
  • addictions

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As Families go distant and international what happens to the elderly needs a special look.

Mr Subhash an octogenarian and his wife Sita a graceful old lady of 76 years have been roughing it out all alone for past twenty years or so. Their two sons moved out of the country in their career pursuits and have since settled abroad. A once in three years trip from either of their sons hardly provide the old couple a feeling of being part of the larger family. Yet they carry on taking care of each other. Mr Subhash suffers from sleep disorders , recurrent depression and anxiety. Sita fights her own battle with her old age issues yet bravely accompanying her husband to his sessions with the psychologist.

Similarly Mr Naweja a businessman finds it tough to carry on further as his son and daughter have moved out of home to metro cities to carve out their own career paths. Mr Naweja in his mid seventies suffers from and fights with many physical and mental ailments as he keeps his dates with doctors and the psychologist. He had lost his wife five years ago .A few months in the metropolis where his son works , were spent sitting alone at home but he eventually decided to come back and join business at his old place.

Mrs Khedekar lost her husband about twenty years ago when she was in her early forties .She didn’t give up then as her two sons were quite young and needed to finish their education.Her elder son moved abroad to meet his own career dreams and the younger one to another city for his pursuit of happiness.Years of loneliness has resulted into her developing psychosis ,schizophrenia and a host of other diseases.Though under the professional care of a trained nurse life is still very lonely for her resulting into periodic reversals of her treatment.

In recent times many of the older adults are leading their life all alone without the love and support of their near and dear ones as their wards necessarily have moved out on account of their careers to metropolitans , or abroad . In such a situation it is obvious that besides the emotional stress elders also have to take the stress of taking care of their mental and physical health and also to ensure a little bit of social health so that they don’t get loners and restricted to within .

In many cases it has been observed that the new couples prefer a life away from their parents in order to understand and know each other better and develop intimacy . Such a step is always good provided the periodic and regular touch with elders is maintained .

Let’s browse a few facts :

  • Globally, the population is ageing rapidly. Between 2015 and 2050, the proportion of the world’s population over 60 years will nearly double, from 12% to 22%.In India there are currently 138 millions elderly persons comprising of 67 million elderly males and 71 million elderly females .
  • Mental and neurological disorders among older adults account for 6.6% of the total disability (DALYs) for this age group.
  • Approximately 15% of adults aged 60 and over suffer from a mental disorder.
  • Maintenance of brain health is as important as the physical health of the elders .
  • While most have good physical health, many older adults are at risk of developing psychological ,mental disorders, neurological disorders and brain health problems.
  • They in their loneliness may develop substance use problems as well as other health conditions such as diabetes, hearing loss, and osteoarthritis.
  • As people age, they are more likely to experience several co morbid physical,mental and neurological conditions at the same time causing much distress to the elderly.

Risk factors for mental health problems among older adults

There may be multiple risk factors for mental health problems at any point in life. Older people may experience life stressors common to all people, but also stressors that are more common in later life, like a significant ongoing loss in capacities and a decline in functional ability. For example, older adults may experience reduced mobility, chronic pain, frailty or other health problems, for which they require some form of long-term care. In addition, older people are more likely to experience events such as bereavement, or a drop in socioeconomic status with retirement. All of these stressors coupled with the prospects of staying alone without the company of their near and dear ones can result in isolation, loneliness or psychological distress in older people, for which they may require long-term care.

Mental health has an impact on physical health and vice versa. For example, older adults with physical health conditions such as heart disease have higher rates of depression than those who are healthy. Additionally, untreated depression in an older person with heart disease can negatively affect its outcome.

Older adults are also vulnerable to elder abuse – including physical, verbal, psychological, financial and social abuse ; abandonment; neglect; and serious losses of dignity and respect. Current evidence suggests that 1 in 6 older people experience elder abuse. Elder abuse can lead not only to physical injuries, but also to serious, sometimes long-lasting psychological consequences, including depression and anxiety.

What is the way out for us? Is a question often asked by the family members ,when they bring their parents and other elders for a counselling session or for a family therapy interaction with the author .

Tanvi (name changed ) had come to the clinic along with her mother in law . Her mother in law stays alone in the city just refuses to leave her familiar home and move with her son abroad.The septuagenarian suffers from depression,anxiety , sleep issues .Tanvi had to eventually tell this psychologist,”I am leaving her to your care .You act as a local guardian for her and keep us informed of her welfare”.

Though Tanvi could say that but several others of such elderly and their wards are left at their wits end ,not knowing whether to abandon their dream careers and come back ,force the elderly to accompany them or to leave their senior members of their family at the hands of domestic workers and professional agencies .

The struggle continues .

Family is always happy when the elders are happy and healthy.

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A desperate father wanting the child compete for competitive exam ,a helpless mother not able to help her child understand anything being taught in the class room or at the tutorials ,a frustrated teacher regularly complaining to the parents to displine their child or take him /her away from the class are instances that we come across every day. Instances of tantrums throwing , of anger bursts ,laziness regular fights with siblings , not listening to parents ,indulging into internet browsing ,surfing of unwanted sites,staying away from home till late hours or not listening to parents are often seen as bad behaviour ,bad habits and bad attitude by many parents.It is rather sad that parents do not understand all such things mentioned above could be on account of child’s poor mental health or mental disorders. Resultantly youngsters are not understood correctly and they suffer frustration and uncalled for irritation.A good mental health free from any kind of disease or disorder is what a child must possess . But what if and for those who are not so blessed ,do parents really understand how can they know if there is anything lacking in their child’s mental health and if so how to help their child cope up.

Differentiating Mental health and mental illnesses is very important for any parent ,teacher and all those who are involved in mentoring youngsters. A healthy mental health would mean that we are of sound mind and are capable of deciding what is good or bad for us and behaving well socially economically and emotionally. A mental illness may not necessarily mean that you can not be any of the above .It could mean that in some areas of your life you may be finding it difficult to behave and decide appropriately psychologically . A mental disorder or a psychological distress are two different concepts and parents need to understand how it may apply to their child if he /she exhibits a behaviour inappropriate to the situation.

Thus, it is essential to understand that psychological distress in a given situation does not indicate absence of mental health .A psychological disorder or distress can be short term ,or of a long lasting nature depending on how the person has been affected and hence affecting the child’s overall state of well-being. Mental illnesses, on the other hand, are health conditions involving changes in thinking, emotion or behaviour (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, professional or family activities.

Mental health is a subjective phenomenon and an individualized experience, different for every person. A state of mental well-being for one individual may not be the same for another individual.  Factors that may induce mental well-being for individuals will also differ. The state of being sound at a mental level can vary within a day and from day to day. There can be an incident that may boost or degrade a person’s mental health on a daily basis.

Thus, mental well-being is a daily affair.

Mental health is often seen to be on a continuum, where the scale starts from mental well-being on one end to emotional problems and concerns in the middle to mental illnesses at the other extreme.

It is often seen that mental health and mental illnesses are not understood correctly. There are a lot of myths that surround mental health and thus lead to the widely seen stigmatised approach. Let’s take a while to debunk the myths and understand the actual facts about mental health:

Myth #1: Mental illnesses are not real illnesses.

Fact: Mental illnesses are not the regular ups and downs of life. Mental illnesses create distress, don’t go away on their own and are real health problems. When someone is physically injured, they see a doctor. Similarly, mental health problems also require seeing a mental health professional- psychologist/counsellor/psychiatrist.

Myth #2: “Mental illnesses will never affect my child or me”

Fact: All of us can be affected by mental illnesses. Researchers estimate that as many as one in four Indians will experience a mental illness at some point in their life. You may not experience a mental illness yourself, but it’s very likely that a family member, friend or co-worker will experience challenges.

Myth #3: Mental illnesses are just an excuse for poor behaviour.

Fact: It’s true that some people who experience mental illnesses may act in ways that are unexpected or seem strange to others. We need to remember that the illness, not the person, is behind this behaviour. People who experience a change in their behaviour due to a mental illness may feel extremely embarrassed or ashamed around others. It is important to understand that people with a mental illness are one of us.

Myth #4: Stress causes mental illnesses.

Fact: No one factor can cause mental illnesses as these are complicated conditions that arise from a combination of genetics, biology, environment, and psycho-social factors. Stress may aggravate the mental or physical state of the problem for an individual but it is never the sole problem of an illness.

Myth #5: People with mental illnesses are violent and dangerous.

Fact: People who experience a mental illness are no more violent than people without a mental illness. It’s also important to note that people who experience mental illnesses are much more likely to be victims of violence than to be violent. Excluding them from society because they are violent is because of a misunderstanding and stigmatic approach to mental health.

Myth #6 : People who experience mental illnesses are weak and they have a character flaw.

Fact:  Stress impacts well-being, but this is true for everyone. Many people who experience mental illnesses learn skills like stress management and problem-solving so that they can remain optimally functional. Taking care of yourself and asking for help when you need it are signs of strength, not weakness. Mental illnesses don’t determine the character of a person. Mental illnesses are like other ailments and can be managed.

Myth #8: People who experience mental illnesses cannot go to work or follow a regular lifestyle.

Fact: Mental illnesses do not certify that someone is no longer capable of working. Most people who experience serious mental illnesses want to work but face systemic barriers to finding and keeping meaningful employment. Medical or therapeutic help can allow them to resume work and a manageable lifestyle.

Myth #9: Children cannot have mental illnesses. Those are adult problems.

Fact: Even children can experience mental illnesses. In fact, many mental illnesses first appear when a person is young. Mental illnesses may look different in children than in adults, but they are a real concern at a younger age as well. Unfortunately, many children don’t receive the help they need. It is important to remember that illnesses can occur and be diagnosed as early as 6-8 months of age.

Being mentally healthy is not about being perfect. Nor is it about being extraordinarily intelligent or successful or rich. Mental health is irrespective of these factors. These factors may influence the mental health of an individual but they are not a cause nor do they determine the state of an individual’s mental health. We all can suffer from mental health problems and we all can attain better mental s health and healthy state of mind if we recognise the deviation in time

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Cognitive Behavior Therapy is recommended to clients to get the necessary treatment for their negative thoughts to bring about the desired positive change .

The key principle behind CBT is that our thought patterns affect our emotional understanding of the events which, in turn, can affect behavior and subsequent interaction with the people we interact with .

CBT also is believed to make us aware of our own negative emotions influencing our thought patterns .CBT helps us analyse and understand others behaviour as elicited by our own emotional understanding of the situation.

CBT highlights how negative thoughts can bring about negative feelings and actions.Similarly how negative emotions can interpret a positive event ,in negative tones . But, if we reframe our thoughts in a more positive way, it can lead to more positive feelings and helpful behaviors.Or if we work on developing positive emotions about ourselves and situations the thoughts will become more accepting .

While conducting CBT the therapist trains the patient to recognise such negative reading by his mind and how to reinterpret the situation with a positive frame of mind. The patient can continue to use these skills so learnt, in all difficult situations and overcome depression,anxiety or other mood disorders .

Depending on the issue the patient is dealing with and the expected specific goals of the CBT , the therapist can make use of several ways to administer CBT. It will basically involve :

  • identifying specific problems or issues in the client’s day to day life.
  • Helping the client become aware of unproductive thought patterns and how they can impact his or her life
  • identifying negative thinking and reshaping it in a way that changes how he or she feels
  • learning new behaviors and putting them into practice

After speaking with the client and learning more about the issue the client wants help with, the therapist will decide on the best CBT strategies to use.

CBT involves making use of the appropriate combination of a few the following 9 strategies:

1. Cognitive restructuring or reframing

This involves taking a hard look at negative thought patterns. When we tend to over-generalize, and apprehend that the worst is about to happen , or tend to get into too much details for every thing we do we find it difficult to act. Our thoughts can prevent us from doing what we want to do and create havoc in our life.

The therapist in this situation will help us identify the negative patterns of our thoughts and inaction . He trains us as to how to reframe those thoughts so they’re more positive and productive and propel our action taking connative behaviour.

For example: “I am not valued in my office because I’m totally useless” can become “I may not be the best worker , but I’m as valuable an employee as can be and I contribute the same way as others do .”

2. Guided discovery

In guided discovery, the therapist will acquaint himself with our viewpoint. Then he will ask questions designed to challenge our beliefs and broaden our thinking.

The client might be asked to give evidence that supports clients assumptions, as well as evidence that does not.

In the process, the client will learn to see things from other perspectives, especially ones that he or she may not have considered before. This can help client choose a more helpful path.

3. Exposure therapy

Exposure therapy can be used to confront fears and phobias . The therapist will slowly expose you to the things that provoke fear or anxiety, while providing guidance on how to cope with them in the moment.This can be done in small increments. Eventually, exposure can make us feel less vulnerable and more confident in our coping abilities whenever the anxieties build up.

4. Journaling and thought records

Putting down your thoughts in writing is a very simple yet effective way of getting in touch with your emotions.One can list down repeated negative thoughts that occur frequently and disturb your homeostasis .It will certainly help to write down your positive thoughts also as would be the inclusion of new thoughts and new behavior for day to day interaction.

5. Activity scheduling and behavior activation

When you are in a negative frame of mind you tend to put off activities in fear or in anxiety.Writing schedules of such activities and visualising them before you begin practicing them can give you the confidence .With such a positive confidence it becomes easy to overcome negative emotions connected with such activities.

6. Behavioral experiments

Behavioral experiments are used for anxiety disorders that involve catastrophic imagining . The psychologist here asks you to express your apprehension as to what will happen if you perform the given task that you otherwise have been dreading to perform. Once you have (reluctantly ) completed the given task you are asked to talk about whether the apprehension came true. Over time, you may start believing that your apprehensive anxiety is not very valid as nothing that you expected to happen actually took place.

7. Meditation, Relaxation and stress reduction techniques.

Perceptive meditation, progressive muscle relaxation and positive imagery building exercises are undertaken to bring about a total positive control over mind ,body and soul to eliminate the phobias,fears anxieties and depression.

8. Role playing

Role playing can help us overcome negative thinking , apprehension and work through difficult relationship and situations. A role play out done with the help of therapist can lessen fear and can be used for:

  • improving problem solving skills
  • gaining familiarity and confidence in certain situations
  • practicing social skills
  • assertiveness training
  • improving communication skills

9. Successive approximation through small successes

This involves taking tasks that seem overwhelming and breaking them into smaller, more achievable steps. Each successive step builds upon the previous steps so you gain confidence as you go, bit by bit.

To know more about CBT and undertake the same ,please get in touch with us mansikpramarsh@gmail.com

917314263087

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We regularly get queries from young parents asking for support to understand the behaviour of their wards suffering from Autism Spectrum Disorder and the behaviour difficulties faced by the affected children.

Children suffering from ASD have behaviour issues which are quite common. These issue relate to more about their communication, social interaction,working within the structured schedule and processing of the sensory information.However if parents are trained and equipped with the appropriate strategies , much of the stress and strain can be reduced bringing relief to the family and the child.They can often be managed through effective activity and behavior management.

There are many difficulties, ASD children face in their behaviour. These issues can be identified as difficulties in communication, issues of  sensory processing, social interaction, and physical balance issues that can make active play more difficult for these kids. Parents and caregivers need to understand that  such behaviours as appear inappropriate are in reality symptoms of the difficulties the child with ASD is facing in his her day to interaction and communicate with others .

Understanding the Causes of Inappropriate Behaviour

The main causes of behavioral difficulties are generally as follows:

Difficulties with communication: Children with ASD struggle with both verbal and expressive language, understanding what is being said to them, and comprehending non-verbal communication cues. This can, become quite frustrating for both the communicator and the child .The child may not be into problem behaviour but to the other person it would appear so ,which causes frustration at both ends.

Difficulties with social situations: The difficulties presented by social situations for a person with ASD are much more than mere communication; people with ASD struggle to understand others’ points of view and grasp the “unspoken rules” of social interaction that state when to, begin and when end a conversation. They are in no position to get the emotional nuances of social communication. Due to all of this, children with ASD may avoid social contact, and they are more likely to experience being harrassed and feel overwhelmed by unnecessary intervention by others in their life .

Difficulties with unstructured time: People with ASD have a hard time dealing with situations where there is no set schedule, as their brains have a hard time sequencing activities on their own out of the given timetable and schedule. Due to this some of the children with ASD are more likely to act out during the period which is not scheduled earlier eg.free period or suddenly declared break times, as they feel confused and frustrated.

Difficulties processing sensory information: Those with ASD often have over or under-sensitive senses, leading to a tendency to get overwhelmed or to seek attention to such a degree that it becomes embarrassing for the accompanying parent and the person interacting with the child.. ASD affected child may react strongly to an unwanted touch, be very selective and particular food eater, get largely disturbed and irritated by loud noises ( be it a noise coming from far off .The child feels unable to concentrate on account of background noise and reacts adversely.

Additionally, one should always remember that people with ASD do not easily adapt to change.Parents managing their ASD ward should be aware of the changes being brought about in their environment or schedule that can trigger problem behaviours.A sudden bout of Illness (especially seizures, which ASD individuals may be prone to) can also trigger adverse reactions as the child with ASD cannot give verbal expression to his or her pain. Doctors advise parents to use picture posters or diagrams to help children express where they are feeling pain.

Dealing with Problem Behaviour

It’s key to understand that the child is using these behaviours to try to communicate something to you, or to achieve some specific function. It’s vital to look under the surface of these behaviours so as to discover the unaddressed needs below. Try to asses what you child is trying to tell you, rather than reacting to the behaviour itself (resist “punishing”; few ASD children actually understand the cause and effect implied by it). It’s also advised to keep a “behaviour diary” or chart so that one can identify patterns in a child’s behaviour and from there, isolate what’s triggering the child’s episodes. One can then develop strategies to avoid or manage the triggers (be sure to introduce these slowly, as sudden changes in routine will do more harm than good). Likewise, expect the child to initially resist the change; stay patient and be consistent with it regardless, and make sure that other family members, teachers, and caregivers are also keeping consistent with it.

One should also develop supportive therapies to help the child shed his or her frustration; these typically include: exercise, brief time out periods in a quiet, darkened space, and relaxing activities. Set achievable treatment goals and don’t push too hard for rapid improvement, as people with ASD can struggle to integrate new knowledge and change behaviours.

To get the best out of a child with ASD, it’s often helpful to employ the following strategies:

  • Speak clearly and precisely (and use short sentences) in order to work around the difficulties that arise with complex verbal communication.
  • Use visual supports. Many children with ASD process visual information more easily than other forms of information. Timetables can be helpful to assist children in understanding schedules.
  • Create “social stories”. These are brief descriptions (using words and images) of situations, events, or activities that help tell a child with ASD what to expect during an upcoming social situation.
  • Help the child identify his or her emotions. This is often challenging to a child with ASD; use visual aids (such as “stress scales”) to help the child quantify what he or she is feeling and how intensely, and help the child learn via physical associations, such as showing him or her that anger connects to a reddening of the face, stomach pain, the urge to cry, etc.
  • Help them learn to relax. Children with ASD find it hard to relax, and can be very “intense” and obsessive in their interests. Try to work relaxing activities or some quiet “alone time” into his or her daily routine.
  • Make their environment more soothing. As children with ASD can become overwhelmed by sensory information, it’s important to ensure their environments are as free as possible of sensory irritants. Flickering lights, devices that give off background noise, scented candles, etc., should be removed.
  • Give praise, in the form your child likes best. Praise is as important to an ASD child’s learning as it is to most children’s learning, but depending on their unique needs, praise may have to be modified to suit the child. For example, some may not like hugs, some may not recognize verbal praise. Often visual cues like stickers on charts or time doing a favourite activity as a reward are effective forms of praise. Praise should be as immediate as possible so that the child can assess cause and effect.

Seeking Help

 If your child’s behaviour is placing him or herself at risk, or others at risk, you should seek professional help by a psychologist or psychiatrist, rather than trying to handle the situation on your own.

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We often think that our children have better resilience to their anxiety and they become normal once we have either given them positive strokes, bought them a chocolate, a gift or diverted their attention by permitting them to play video games. But it needs to be understood that anxiety doesn’t happen to the kids like the way we experience it happening to us adults. Anxiety in children can trigger, in panic attacks, in their tantrums, in their sudden rush of energy or it may occur in the untimely defiant behaviour. We as parent just push it aside by ascribing it to their misbehaving or being in the company of wrong friends. However, children may react differently depending on the immediate situation, past incidents or future anticipations.

As psychologists counsellors and family therapists we have to deal with couples, parents and other family members of our clients who always appear to be suffering from anxiety, In most such cases their children too suffer from similar anxiety or otherwise children from families where there is a good coordination amongst parents struggle with anxiety too.

Some parents would pretend and hide their issues of anxiety and other concerns from their children. Even when kids are understanding the parents would try to act as if everything was fine. These parents would do everything they deem fit or within their reach to calm their wards and reset their nervous system through various practices of calming. Children can pick up anxiety from their parents through the verbal communication, through the body language of their parents, through their mood disorders or the kids themselves can react to any general event in the family and develop a full or partial panic attack.

We have seen many a parents fighting and undermining each other when they come to us. They fail to realise that when they behave so their children too suffer mental agony and a fear of being abandoned by either or both of their parents. Children feel abused when their parents fight. They feel cheated by their parents. Children want to live in a typical family life environment irrespective of the riches or poverty. Any thought of living without a parent causes them much mental pain and that triggers anxiety. To them, their family is their safety nest. Their family enables them to play, to study, to make friends. It helps them grow. It is the reason of their being here in the world. To them family is the only reality, rest all is just make believe. Any iota of doubt on family’s continuity causes deep anxiety.

Parents should remember that their children would always pick up the stress and trauma that their parents experience and exhibit. The parents may think that their children are safe and that children have not been exposed to any kind of stress, physical, sexual, or emotional or personality abuse. They may believe that they are offering their children a great childhood compared to parents’ own childhood or other experiences that parents had to suffer. But actual truth is far from this. Children can become anxious for many reasons triggered by the parents’ obvious circumstances or not so obvious happenings within the family. Some of these reasons could be the actual and some could be as perceived by the children. To us adults many of those reasons might not be major, but to a child they become quite significant in triggering insecurities and anxiety thereof. Should the parents happen to be separated or divorced the self-blaming mind of the children would always be devastated by the memories of the times when the family was together. They would not understand the sudden blow of isolation and the non-availability of the parental umbrella. They struggle to be emotionally available to the single parent they now live with and at the same time add on a make believe relationship with the parent they have been separated from which they continue to believe was on their account. A two edged anxiety of this kind breaks them. It shreds the very fibre of their mental balance.

Children are often left heartbroken if there happens to be a fight in their family. They tend to believe that all tension is on account of their being a cause of distress to their parents. Often they are left with a broken trust. They feel guilty with their self-confidence devastated by the memories of parents shouting at each other. They are afraid of the sudden isolation caused by such disputes amongst their parents.

We always assume that our children are understanding. They adjust to the life as they grow. That they have stronger plasticity. This could be applicable in some way but it is not the complete truth. They are not as strongly fortified against anxiety as we tend to believe. Children do build up their defence mechanisms but these defence mechanisms may prove more damaging to their growing personality during adolescence and later on in their grown up relationships. We often come across young persons and old people alike who suffer from the traumas of their growing up years in anxiety.

We give hereunder some of the symptoms that we have witnessed in children while counselling the families .

1) Dissociation: Children have exhibited dissociation by completely cutting themselves off mentally from what is happening in their families. They form their own make believe world to hide the pain. Though parents may believe that the child is being creative, when the child speaks to and play with imaginary characters. Riya 6 years is one such case. Her parents do not see each other eye to eye. Their constant bickering causes much anxiety to the child. The child is seen talking to her doll most of the times and refuses to part with the doll when she goes to school or goes to bed. Her parents eventually brought her to the counsellor when her teacher noticed the child talking to the doll she had brought into her school bag to the classroom.

Monty’s (9 years) parents had been advised by the psychologist that their child suffers from ADHD because that’s the only way he can get their attention and evoke sympathy from them. His parents both working, hardly find time to spend with their child. Their occasional outbursts cause him such a deep distress. He exhibits his anxiety by getting irritated, by indulging into hyperactivity, impulsiveness and inattentive behaviour.

Depression was diagnosed in Deepa (10 years) as a mood disorder because the chronic emotional outbursts indulged in by her grandmother and mother in their interactions caused much disturbance to the child.

2)Gastrointestinal: Meenu’s (5 years) anxiety has been cropping up in her difficult behaviour to ease up herself. She holds up her anxiety in her abdominal area. In spite of her feeling pressure on the stomach she would refuse to sit on the pot to clear her stomach. She suffers from constipation. Her bowel training has been conducted a few times. But whenever she needs to clean her bowels, she holds on to her stool and often soils her clothes. A better approach would be to ensure the child is offered a better protective environment at home free from tension and stress. We noticed she catches on to her parents’ anxiety and expresses her own in the manner described.

3) Obsessive seeking of Validation: Divya (11 years) exhibits lack of self-confidence. She most of the times struggles to express herself confidently. She would often speak in almost inaudible tone She needs to be reassured that others are paying attention to her and she must speak louder with confidence. She always needs validation from her mother.

Children themselves may not be aware of their anxiety but parents and the teachers need to read the symptoms and signs that speak of anxiety in the children.

If you can be aware that a life experience has created anxiety in their lives, you can bring attention to it and help them cope with that anxiety. You must take your child to a psychologist for evaluation and necessary counselling wherever needed. The psychologist may have to counsel the parents too.

Just being aware that your child can suffer from your chronic circumstances and catch on to anxiety should be taken as an initial step to prevention. Take them to a psychologist whenever or if they exhibit symptoms of anxiety. Whenever possible speak to them about their fears, concerns and phobias whether implied or implicit. Children should be trained and encouraged by both parents to discuss, open up and ask questions from parents should there be any stressful occasion in the family. This will help them to understand that there can be differences of opinions, arguments and even conflicts within the family but that you will always protect them and be with them to take care of them.

Family is Everything
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We reproduce below the interview of our Ramneek Kapoor Psychologist and Family Therapist once again for the benefit of our readers and clients.

1 .What is ‘stress’

“I would refer to stress as “the mental, psychological, intellectual, emotional and physical unease to the personal situation and the expectation rose either by the self or by others to face/handle the situation “.

  1. Are all kinds of stress bad? How do we identify between good and bad stress?

“All kinds of stress is not bad, only the distress caused is bad. Eustress is a good stress that gives a high and stimulates the adrenaline. When you feel good about certain situation and event and feel you are able to handle it, you look forward to such a situational stress which results into a moral boost and good emotional physical feeling”.

  1. Do you think people are aware what stress does to their mind, body and soul? Do you think that once they realise how negative stress has adverse effects on them, they will be in a better position to manage it?

“Only a limited few numbers of people could be aware of the negative effects of the stress on their physical, mental, social, spiritual and emotional well being. Mere realisation that the stress is bad will not be enough. We need to also educate and inculcate in them the stress relieving self empowering meditation exercise routine on day to day basis. Preksha Meditation (perceptive meditation on the psychic centres) under the guidance of trained teacher will go a long way in relieving stress.

  1. In the world we are living in today, how important is it to spread awareness about stress? Are there any statistics that reveal how serious the problem of stress is one’s life?

“The very fact that more than 50 percent people suffer from the depression, anxiety and stress sometimes or the other in their life with no trained professional help to cope with this reflects the pitiable position of the awareness amongst common people. In fact no official statistics from any governmental source are available on the subject nor has any NGO worked on the subject authentically”.

  1. How do you think our previous generations managed stress better than today? Even with the state of the art technology and advance in medical sciences, why have we as humans not been able to cope/ deal with stress?

“It is a fashion to always refer to the better life of the previous generation. The fact is that the technological advancement has also brought with it the person related emotional, psychological and physical maladies in addition to making life easier. The state of art tech development has brought about personal isolation, in the midst of many. The person today is cut off and alienated from the self. He or she is always lost into an uncalled for competition with the others on the social media and into the realms of the imaginary virtual world.

  1. Do you think people today are ignorant about stress? Ignorance is bliss, but is this kind of bliss worth it?

“No they are not ignorant. They prefer living in the comfort of uncomfortable stress. The rat race takes its toll and the victims enjoy the bites of killing stress and anxiety and many other mental ailments. Eventually the person ends up with either cardiac problems or the chronic depression and anxiety will take toll on such persons “.

  1. Are there some observable and prominent symptoms a stressed individual will experience? Such as physical, mental, emotional, physiological etc.?

“Yes ;the breathing discomfort , sleeplessness , insomnia, loss of memory, eating disorder either binge eating or not getting hungry, social anxiety, irritation , unmanaged anger, repeated headache, psychosomatic pains , and weight gain/ weight loss are some of the prominent observable symptoms”.

  1. Who are the most stressed people according to you? What could be the causes for them being the most stressed?

“Adolescents, working women, housewives, company executives and even professionals with deadlines of times to meet are always under stress. But the large share of the stress cake goes to adolescents in the modern times. With the race to always look outwards and keep pace with the demands of peer aping the adolescents find it difficult to cope with the stress. This generation is neither amongst the younger generation nor are they amongst the adults. The social media, the rigid demands on their performances in academics and career aspirations’ of the parents for them, are some of the major reasons for this generation being most stressed

  1. What according to you triggers ‘stress? Do you think by being aware of the triggers we can be in a better position to manage stress?

Triggers of stress can be any event or situation that threatens the mental and physical equilibrium (homeostasis) of the body . The events can be either external or internal

. External can be the political, social, economic, competitive, family, academic, or work atmosphere. While internal triggers will relates to irresponsible behaviour, uncalled for self expectations, negative attitude towards life in general, and looking for perfectionism in self or others.

  1. What can be some of the long-term effects of stress? How does stress affect a person physically, mentally and emotionally?

The long term effects of chronic stress can be

  • Chronic sadness and depression. (2.) Chronic mental and physical fatigue. (3.) Chronic stress related illness (consistent headache, stomach ache, bowel problems, social anxiety) and other psycho somatic physical illness. (4) Isolating self, withdrawal, self destructive nihilistic thoughts .

Physical problems of the stress can be , sleep disorders, back, shoulder or neck pain, migraines , headaches, acidity, upset bowels, constipation, weight gain or loss, hair loss, loss of libido.

Emotionally the person can become nervous, edgy, depressed, moody, phobic, and not be able to focus and eventually suffering from Nervous breakdown.

  1. Please mention 5 useful tips for fighting/ managing stress? How can one follow these in his/her daily schedule and busy day?
    1. Accept life as it comes.
    2. Accept your self.
    3. Identify “ME” and try to become “ME” rather than becoming him, her ,they or she.
    4. Accept that perfectionism is a myth and utopia.
    5. Follow a healthy diet plan, an exercise and meditation routine to keep your heart health and positive.
  1. According to you, how can one prevent stress in everyday life? How do we know that the levels of stress have crossed the healthy limits? Until when can a person manage it on his/ her own?

“Stress is a natural occurrence but taking on too much can be avoided . Relax whenever you feel mentally, physically or emotionally exhausted before your stresses break you down”.

  1. Stress does not tend to only affect one person; its effects tend to spill over to the people around them. How do you think that we as a friend/ family member help a person dealing with stress?

“Stress is a personal problem but its manifestation can be felt and definitely seen in the family, friends and other areas of one’s life. The friends and family too should know that the life has to be lived in positive moments and as such the negativity should be eliminated from the life completely.

  1. What message would you like to give to our readers this Stress Awareness Month?

“Live life in positive emotions, the negatives are not meant for the living “.

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