When the world shut down in 2020, making therapy available online was required as an alternative to traditional in-person appointments. While it wasn’t a method I typically offered prior to this, I have since realised online therapy offers a lot of positives and it is possible to build a trusted relationship and provide meaningful and life-changing support. However, it does also have a few drawbacks so let’s look at both some of the pros and cons to therapy online.
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Pros:

• Increased accessibility: This can work well for people with busy schedules, those who don’t want to get stuck in Auckland traffic, individuals in rural places or areas without adequate mental health support, as well as for people with mobility challenges. Being able to offer online sessions also enables me to offer sessions outside of usual office hours, providing more flexibility
• Comfort: Sometimes being able to attend a therapy appointment from the comfort of your own home can feel less daunting and overwhelming
• Lower cost: Online therapy can be more cost-effective due to less travel expenses and time commuting to and from appointments
• Continuity of sessions: Sometimes circumstances like a minor illness or being away from the city would require an in-person appointment to be cancelled. However, online appointments enable the momentum of therapy to continue by not having to rebook at a later date.

 
Cons:

• Reduced social cues: Due to only getting a snapshot of each other on screens, it’s possible that sometimes body language, facial expressions, or cues to speak are missed or misinterpreted. I do think it is possible to navigate this by acknowledging that it can happen and having an agreement to work through this and let each other know if this has occurred
• Tech issues: Technical glitches, such as poor internet connection or software malfunctions, can cause disruption and occasionally frustration for both the client and the therapist. However, in-person appointments also have aspects that can be disruptive, such as accidentally being late to appointments and usually disruptions are able to be worked through without too much negative impact
• The need for privacy: Privacy at home is also important so you can speak freely without concerns that someone at home can overhear you or will interrupt you. Often this can be managed by organising the household to go out or by playing some music in the hallway to muffle any sounds
• It’s not for everyone: Online therapy may not be suitable for individuals dealing with severe mental health issues or crisis situations. In-person therapy may offer more immediate support and interventions necessary for these situations.

 
In summary, online therapy offers some drawbacks, but many positives. The suitability of online therapy ultimately depends on individual preferences and the nature of the issues being addressed. As with any form of therapy, research into finding a qualified and registered professional as well as ensuring a good therapist match are both necessary to ensure a positive and beneficial experience.


Photo by Hillary Black on Unsplash

A lot of my work involves supporting clients who have experienced trauma. Examples of traumatic events include physical or sexual violence or other situations where there is a threat of serious harm or death (American Psychiatric Association, 2013). Witnessing or being involved in traumatic events can have a serious effect for those affected by it and some examples of these are described below.
 
Avoidance:
Sometimes what has happened is so hard to deal with, you might find yourself trying not to think about it, blocking out memories, or trying to shut off from your emotions. You might also find yourself avoiding things that remind you of the trauma, for example, the place where it occurred. 
 
Changes to thoughts/beliefs:
Going through a traumatic event might change your beliefs. For example, if you have been harmed by someone, you may find yourself believing “no-one can be trusted” or “the world is unsafe”. Sometimes people can develop the belief that they were responsible for what happened, even though the responsibility actually lies with someone else.
 
Changes in emotions:
The impact of trauma can increase the experience of certain emotions, often shame, guilt, disgust, horror, and fear. Also common is an increase in anger and irritability, which may be hard to control. You might notice that your emotions fluctuate more, are experienced more intensely and/or that your emotions are kind of numbed. 
 
Triggers:
You might find yourself coming across triggers that remind you of the trauma in some way. Being triggered could bring up distressing emotions, such as fear or shame, thoughts or memories about the trauma, or physical sensations such as nausea or a racing heart. Triggers can include smells, sounds, sensations, or even people that remind you of the trauma in some way. 
 
Increase in threat detecting:
Being harmed can increase your sensitivity to perceived threats around you. You might feel more jumpy, unsafe, and hyper-alert of potential dangers. 
 
Reduced self-care:
Sometimes people who have been through something traumatic start engaging in harmful or reckless behaviours. This can include increasing drug/alcohol use or self-harm. This can be a way of trying to cope with difficult thoughts, emotions or memories or you may just feel less regard for your own safety and worth. You may also find yourself withdrawing from social or enjoyable activities. 
 
Other commonly experienced issues include sleep and concentration difficulties. People can also become quickly overwhelmed or disoriented, which can often happen if you get overly stressed. Furthermore, to try and manage these difficulties on a daily basis can be absolutely exhausting, so you many find yourself feeling mentally and/or physically shattered a lot of the time.
 
Sometimes people who have been through trauma can develop posttraumatic stress disorder (PTSD), which is characterised by some of the issues described above. PTSD can have ongoing impact on life but it can be helpful to developing understanding about the symptoms as well as develop strategies to deal with some of the issues, which can be achieved through effective therapy. 

None of this stuff means you are crazy, flawed or weak, but is just what happens sometimes when your mind tries to cope with horrible things. Fortunately, humans are amazingly resilient, and despite sometimes going through horrific experiences, people frequently do go on to live meaningful and enjoyable lives. 
 
In NZ, there may be funding available for therapy for people who have gone through sexual abuse or other sexual violence. Here is a link for more information https://findsupport.co.nz/
 
 
References:
 
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

The experience of making a mistake or failing is an inevitable part of life, although it can be an unpleasant experience at the time. If you are anything like me and a lot of the rest of the population, after a mistake you might quickly make some harsh self-judgments or self-blame about the mistake. This could include negative self-talk or negative thinking, along the lines of "I am a terrible human", “how could I be so stupid”, "I can never do anything right" or other delightful thoughts. These can then lead to the experience of some uncomfortable emotions, such as feeling ashamed, frustrated, hopeless, sad, angry, or hopeless. All the fun stuff really. Once this process begins, it can turn into a vicious cycle of negativity that is hard to stop. 
 
If you think about how you would talk to a loved one or friend when they need support after they have made a mistake, it is pretty unlikely that you would be harsh and judgmental and make comments like "yes, you are a loser for making that mistake". This is because we know this is not a kind or supportive thing to do. So... why are we so mean to ourselves sometimes...?
 
Often it is a lot easier to show compassion and kindness to others, than it is to ourselves. This might be because we can have unrealistically high expectations about our own abilities or behaviours. As being mean to ourselves only makes us feel worse, it can be useful to practise being a bit kinder or compassionate. One way to do this is to introduce the practice of self-compassion. This is a concept that is used in the field of psychology and is defined as a way of treating yourself with kindness and support, particularly in challenging situations (Neff, Kirkpatrick, and Rude, 2007). Previous research (Neff, 2003) has found that the practise of self-compassion can be helpful in lots of different situations, from reducing depression and anxiety to increasing life satisfaction.
 
The first step to practising self-compassion is to start catching yourself when you are in ‘beating yourself up mode’. Then, when you are able to recognise this, you could try to start being more self-compassionate by treating yourself as you would treat a friend or loved one in the same position. This might be to include some self-talk such as ‘it’s ok, people make mistakes, you will be ok’, or some other supportive words. It may feel a bit strange at first but this is a new skill to learn, so will likely take a bit of practise. 
 
For more information on self-compassion, the website of one the main authors and researchers in the subject, Kristin Neff is a good start (link here). It includes information about self-compassion, including the some of the research that has been undertaken as well as a few self-compassion practise exercises to try. Alternatively, it might be something you want to work on with a psychologist in therapy. It may also be useful to look at some of the possible reasons the mistake occurred in the first place, and whether anything can be done to prevent/reduce the chances of it happening again in the future. Although, some of these reasons may be the subject of a whole new (and as yet unwritten) article :)
 
In summary, practising self-compassion can be a really useful way to address the self-criticism that can occur in the process of making mistakes. And, because life is made up of both good times and the bad, mistakes will happen :) Because of this, the practise of self-compassion is something I try to incorporate both in my work with clients as well as my daily life. 
 
 
References
Neff, K. D. (2003). The Development and Validation of a Scale to Measure Self-Compassion. Self & Identity, 2(3), 223.
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Neff, K. D., Kirkpatrick, K. L., & Rude, S. S. (2007). Self-compassion and adaptive psychological functioning. Journal of Research in Personality, 41139-154. doi:10.1016/j.jrp.2006.03.004

Throughout life we come across people who try to take too much of our time, energy, or money. For example, you may have a parent who criticises you in every telephone call, leaving you feeling sad, worthless, or frustrated. Or a friend who repeatedly asks for a financial loan without paying it back, and you feel too awkward to bring this up because you worry that it will end the friendship. Or a colleague who takes up too much of your time asking questions or is disorganised, leaving you stressed or unable to complete your own deadlines.

If you are kind-hearted, compassionate, and generous, you may try help these people, whether that means giving them your time, attention, energy, or money. However, this can lead you to feel physically, psychologically, or financially drained, which is not helpful for you or others around you. One way to reduce the impact of this is being able to set and maintain effective boundaries. Below is a 3-step process that can be a helpful skill in looking after yourself and maintaining effective relationships with others.

Firstly – identify the behaviour you are no longer going to put up with. For example, for a negative phone call from a parent, you might decide that you are no longer going to put up with being nagged or criticised because this behaviour is not acceptable and makes you feel like crap.

Secondly – set the boundary for the behaviour you are no longer going to put up with. For this step, think about some ways you could put the boundary in place. You don’t necessarily need to tell the person “this is my boundary now so back off”. It could just involve establishing some rules for yourself or for the person. For example, for the critical parent phone call, you might decide that you are only going to speak for 10 minutes per phone call and if criticism starts in that time, you are going to make an excuse and end the call. Or, you might ask your parent not to make negative comments about your career choices when they phone you.

Another example of a boundary might be to decide never to speak to your parent at all, but this will probably not be helpful if you want to maintain a relationship with your parent. Think about the boundary that you want, but be realistic at the same time.

Thirdly – maintain the boundary. Sometimes people will react negatively to changes. For example, a critical parent might try and make you feel guilty about shorter phone calls. However, this does not mean that you should get rid of the boundary, but instead that you will have to work to maintain the boundary. It will take practice, consistency, and persistence, but it is worth it if you want to work towards no longer being criticised and emotionally drained each time they call.

Some things to remember. Boundary setting and maintenance can be hard and takes work! This is especially true when you are setting boundaries for people who have not had many limits placed on them before. However, if the reason for having the boundary is solid this will provide the motivation for continuing to work to keep the boundary in place.
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Boundary setting can be a new skill to learn so you might make mistakes when starting out. Keep at it, as it may get easier over time and with practice. Being able to set and maintain boundaries is a useful skill to have in terms of practicing good self-care, standing up for yourself, and being assertive.

​Life is complex and we can all sometimes find ourselves feeling trapped, confused, or overwhelmed by change. These situations can be difficult to resolve alone. Well-meaning advice from friends or family can be biased or unhelpful, so it can be beneficial to seek professional advice. Just as you would pay a dentist to fix your teeth, or a doctor for a physical health issue, seeking the support of a psychologist can enable you to work through a difficult situation and find effective solutions. Here are some examples:

• Mental health – commonly experienced difficulties include anxiety, depression, intense anger, or issues arising from past trauma. These can get in the way of living the life you want, as you might find yourself avoiding people or having low energy and motivation. It can be useful to talk to a psychologist to get more understanding about your mental health and to develop strategies that can help.

• Stress management – being overly stressed can feel awful. You might experience exhaustion, low motivation, and irritability. Although it is difficult to eliminate stress completely, it is possible to develop stress management strategies. A psychologist can work with you to figure out some tactics for increasing your stress resilience as well as developing some in-the-moment strategies during intense times of stress.

• Increasing life satisfaction - sometimes people can feel aimless and lacking in purpose and meaning. A psychologist can help you to gain clarity of what is truly important and help you to take steps towards creating a meaningful and satisfying life. It can be useful to work together to identify goals in different life areas as well as develop strategies that can overcome any potential barriers to goal achievement.

• Relationship issues – relationships are complex and it can be hard to figure out what to do with a difficult interpersonal situation. Working with a psychologist can be helpful to gain an objective view of the situation and potential ideas on how to tackle it. This might include developing problem-solving strategies, such as learning how to develop and maintain boundaries with others.

• Problem solving – sometimes people face big decisions about life changes, for example ending a relationship, changing a job, or having children. A psychologist can support you to put together a plan regarding the situation. This can include consideration of the available options and weighing up the pros and cons to each and as well as evaluating the benefits or disadvantages of making the change.

• Developing emotional intelligence – mood swings or intense emotions can feel uncomfortable. Talking to a psychologist will help you to get more understanding of emotions and can help you figure out things to do to lessen the impact.

• Understanding behaviours – sometimes you might find yourself doing something unhealthy even though you know it is bad for you.  Examples are over-eating, over-spending, or letting people treat you badly.  A psychologist can help you to develop self-awareness and support you to work out some of the possible reasons for the behaviour. From there, you can work together to develop strategies to address the underlying reason and figure out more effective ways of coping with it.

 
Regardless of your reason for engaging in therapy, it is important to make sure you are seeing someone you feel comfortable with, can trust, and can build a good rapport with. If you have any reservations, say so.  A good psychologist will understand and be able to provide you with some alternative options.

Having depression can be challenging, both for the person experiencing it and for the people around them, whether it's a partner, family member, friend or colleague. This is a list of some ideas for how to show your support for someone who is going through a difficult time:

1. Be there. Spend time with the person, listen to their experience, and show empathy. It can be tempting to launch into ‘problem solving mode’ and make some suggestions about what they can or should do. However, it is not that easy to just feel better and stop being depressed. Spending time with someone, listening, and showing you care can be really helpful in letting the person know they are not alone. 

2. Find out about depression. Find out about the symptoms of depression, as it can involve more than feeling sad or down. Other signs can include sleep difficulties, low motivation, and having a hard time concentrating. Also, check out some options where professional support can be accessed, so you are able to make suggestions if the depressed person asks for help. However, keep in mind you cannot force anyone to see a GP or psychologist, but it can be helpful to know of some resources just in case the depressed person asks for some options in getting help.

3. Offer some practical support. It can be hard for people with depression to think clearly or make decisions so it can be useful to offer some specific practical help. This could include asking if they would like some help with housework, making a cup of tea, or offering a ride to the GP.

4. Suggest activities. People with depression can have low energy and motivation and they withdraw from pleasurable or social activities when it is actually really important to keep up daily tasks. The depressed person may not feel up to their usual activity levels, so make some suggestions for activities more suited to their current situation. This might include catching up for coffee with a friend rather than attending a large social gathering, or going to a movie or other activity that  reduces the social demands placed on them. But also, remember to respect their wishes if they really do not want to participate.

5. Be careful with your words. Phrases such as “cheer up”, or “your life is great, what have you got to be depressed about??” are usually unhelpful as they can make the depressed person feel worse about being depressed and/or completely misunderstood. Instead, it can be helpful to try and validate their experience, such as acknowledging they are going through a tough time but letting them know you are there for them.

6. Look after yourself. It can be really exhausting and difficult supporting someone who is depressed, as you need to be patient, kind, and show caring to someone that may appear they do not care or appreciate the support. So, it is important that you are looking after yourself as well as your loved one. This can include making sure you take time out for yourself, spending time with friends (even if you don’t talk about what is going on), eating well, and trying to get enough sleep and rest. Also, acknowledge that you are doing a great thing by supporting your loved one who is going through a tough time – it is not easy!

7. Get help if you have any concerns about suicide or self-harm. You can let your loved one know if you are worried about their safety but it is also really important to seek professional help if you have any concerns about someone’s safety. In New Zealand, we have a number of support agencies available, including the Suicide Crisis line on 0508 828 865 or Lifeline on 0800 543 354. There is also support available through the local community mental health support services, and the urgent assistance contact number in Auckland is 0800 800 717.