Featured

Cognitive Defusion: How to unhook from negative thoughts and feelings

This entry is a short one. I have been in a depressive episode for the past 7 weeks or so now. At times like this, my mind automatically generates unhelpful thoughts and feelings, that despite knowing that there is validity in them, these thoughts and feelings are unhelpful in my work towards my own recovery. The skill that you’ll read about shortly is one skill that I am still working on, putting it into practice when my mind isn’t too bogged down by the cloud of depression. It is a skill that I show and do with my patients to continue using as it can be a way to get us out of the incessant loop of negative thoughts and feelings that gnaw on us until it feels that there is nothing left of us to salvage.

I hope you find this helpful as it has been helpful for me.

“You cannot stop the waves, but you can learn to sift” – Jon Kabat-Zann

According to Russ Harris in ACT Made Simple (2009), cognitive diffusion is:

– Looking at thoughts rather than from thoughts/emotions.

– Noticing thoughts/emotions rather than becoming caught up in those thoughts/feelings.

– Letting thoughts/feelings come and go rather than holding onto them.

For example, the thought, “I’m useless” is a common thought that most of us can relate to. In cognitive defusion, instead of being caught up in that thought, we notice it instead and say, “I have the thought that I am useless.” The act of noticing and saying that thought/feeling to ourselves aloud or in our head, creates a sense of distance and allows us to be in the here and now (being present) in order to live the life we want to live.

Featured

I Am Loveable

As the kilometres tick along as I ran earlier this evening, my mind drifted to my childhood and bad memories started flooding into my mind. The podcast I was listening to started to drone on in the background, my breathing becomes shallow and fast, while my legs continue to turn, my cadence increasing.

My father has tried calling me 2 weeks ago, and I ignored it. It was the second day of Chinese New Year, and I think he wanted to send me good wishes for the new year. This year, I opted to only wish him via text on WhatsApp. It does sound like I am a terrible daughter, for ignoring his calls and not wishing him in person via a video call. I am trying not to beat myself up too much about it because I no longer want to do what I am obliged to do. I want to be in control over my mental well-being and not let anyone muck that up. I did not even respond to his voice message on WhatsApp informing me that he has remitted some ‘ang pow’ money into my bank account. It is my money to begin with anyways. He lives off the rent money from my house in Malaysia and pocket money from my other two sisters. Reading what I am writing all sounds really bad. I have to admit, the voice in my head that tells me that I am an ungrateful daughter, visits me each time I feel angry and resentful towards my father. I try hard not to self-flagellate, but that voice in my head haunts me.

This whole idea that a good Chinese daughter will bring honour to the family still rings true. I think it is an antiquated virtue that does not relent, no matter what. The more I process what happened long ago, the more I realise that I no longer can keep being the filial Chinese daughter to may father. I have to contend with knowing that I have done my duties as a good daughter, caring for both my late mother, as she succumbed to cancer and to my father, when he suffered a heart attack soon after my mother passed. I must believe that this is good enough for me to rid the pangs of guilt I still feel whenever I feel angry towards my parents. It is all a paradox to me.

So, what were the memories that flooded my mind when I was running earlier? What is was, simply put, was that I am still coming to terms with the reality that I was an unwanted child, an after thought, an accident baby, as I have been told by my mother so many times: “We didn’t plan to have you after your brother. But, then, papa and I thought, maybe you’d also be a son.” Instead, I am their daughter. Such a disappointment.

I have to believe that I was loved. But at the same time, I know that if I continue to hold onto this belief, I will never feel the pain from being unwanted. As my therapist reminds me: “We can’t heal without feeling the feelings.” I am loveable, I am loveable, I am loveable. This will be my new mantra from now on.

Featured

Feeling Overwhelmed

It has been awhile since I’ve updated my blog. I haven’t been able to do much of anything since my last post. I’ve since stopped working and have been given sick leave from my psychiatrist since mid September. My follow up appointment is mid Oct, and I feel that I am no better than when my sick leave began. I no longer feel that I can go back to working as a mental health nurse at this point. I am unsure if I ever will be able to doing this work.

While running today, I finally decided to listen to a podcast by Tim Ferriss that was aired on September 15th, 2020 with Debbie Millman, the host of a very popular podcast called Design Matters. It was a difficult listen because both of them shared their experiences of childhood sexual abuse, their experiences of realising that they needed help to cope with mental health issues, and what strategies they have used and are still using to assist with their recovery.

What struck me most is what Debbie Millman said earlier on in the podcast, and I quote:

And when I got older, talking 15, 16, 17 years old, at that point, I thought, “Well, I’m not going to let this impact me. I’m not going to let him win my life. I’m going to try to have the best life that I could have.” Not realizing at that young age, as you’ve mentioned, the body keeps the score. You cannot outrun your own psyche. It is not possible. It is just not possible.

Your psyche is too strong to just take those experiences and sweep them under a rug and never ever look at them again.

– Debbie Millman

This has been my default thinking to minimise what has happened to me throughout my early teenage years to early last year when I first was officially diagnosed with clinical depression. I was working in a locked mental health ward and has just started my job there for only 4 weeks before I got unwell. This was definitely not the first time I have had a mental breakdown. I have remembered numerous depressive episode throughout my teens, young adulthood, and throughout my 30’s but I did not think of seeking professional help at that point because it was just unthinkable. It just was not something that I would have done because of the stigma surrounding my culture and where I was brought up (All I can say is that I grew up in a Asian family in Southeast Asia). Even if I did seek out help, I would not have known where to begin, as the health care system where I grew up did not have a robust mental health service due to the stigma attached to it. Somehow, my coping mechanism through believing that what happened to me was nothing and it was in the past and how I would not let it affect my life, kept me going. But, as Dr Bessel Van Der Kolk’s book “The Body Keeps the Score”, my body has found a way to finally show signs of the abuse and everything started crashing down on me.

I will be turning 41 this November and listening to Debbie Millman and Tim Ferriss talk about their lifelong struggle with mental illness and how Debbie talks about being in therapy for the past 30 years, somehow, made me feel that this is going to be my reality as well, and I feel defeated mostly, but, at the same time, there is a glimmer of hope for me as others have gone through similar journeys. The feeling of defeat mainly comes from the hopeless that I feel and how this cycle of depression will come and go, and come back again, and there is nothing much I can do about it apart from learning new coping strategies to help manage and hopefully prevent another depressive episode by being more mindful of when my mood is starting to dip. I also feel that, does it mean that I need 3o years of therapy to be able to finally have some semblance of actually living life, and not just going through the motions as what I have been doing the past 34 years? This is something that I will only know as my journey continues towards seeing the light at the end of the tunnel.

Here is the link of the podcast transcript from the podcast I mentioned in my blog, if you’re interested:

Letting People In…

A trauma brain is a brain that is reactive and vigilant all of the time, affecting the way we regulate our emotions, heightening our sense of anxiety and making it hard to trust anyone. Scientific data shows that traumatic stress can reduce the functioning of the prefrontal cortex that is responsible to assist us to analyse and think logically, regulate and interpret emotions, control impulses and solve complex problems.

I’ve been unable to write anything the past 4 to 5 months because my mental health has been deteriorating. There has been so much going on at work, mostly interpersonal relationships with my colleagues, that has been very challenging because I find it very difficult to set boundaries and be assertive, thus, to avoid conflict, I bend over backwards to avoid it at all cost, making me a people pleaser. My therapy sessions the past months have all been about interpersonal struggles at work, feelings of utter helplessness in my inability to set boundaries and be assertive.

I started this blog entry with an ambition that I was going to write a long one this time around since my long hiatus, but, I don’t think I can manage it, so, I am going to cut to the chase. What I really want to say is that I now have insight that all my interpersonal struggles the past couple of months, validating as it is, was exacerbated by my trauma brain. Everything gets amplified, and thrown out of proportion. I know now because today is my farewell with my colleagues as I have made a very difficult decision of resigning from my work as a mental health nurse to focus on myself… to pause and focus on my recovery. It still feels like I have given up at this point, but I am certain that I’ve made the necessary decision because I am in a really, really bad place. My colleagues gave me a bouquet of flowers and a hand made card, which was painted in watercolour by my associate charge nurse! (the profile picture of this post is the handmade card) and lots of hugs and encouragement. One of my colleague reminded me this: “You are walking the talk as how we always tell our clients. You’re not giving up because you know, that you will never say this to your client. I am so glad you have made this decision to focus on yourself to heal.”

What I’ve realised from this is, “I need to let people in… I need to learn to trust again… it’s time to stop keeping people at bay.”

5 fun things to do

I came across a new app developed in locally in New Zealand called Groov. It’s an extension from their parent app, Mentemia. It’s been helpful to keep me grounded. I’m going to see if I can try these activities that they recommended.

sharing.mentemia.com/shared/linkid-5-fun-things-to-do-by-yourself

How Work is Like Currently

The last post I wrote about how I am coping with work was on January 17, 2021. I know that it has not been too long ago for an update about how I am coping at work, so, I thought I share some thoughts on what’s going on.

The past 2 to 3 months, work has been exhausting. I find myself dragging myself out of bed when the alarm goes off and forcing my brain to stop the anxiety thought loop that would start the moment I open my eyes. The level of stress I feel on each work day is all consuming and difficult to describe in words. Recovery is long and difficult and the days when I feel that things might finally start to look up, these days never seem to last long enough for me to sustain some respite from the constant struggle day-in-day-out. At work, it seems that my eyes and mind are focused on the task at hand but my soul was somewhere far away, like a distant observer watching me carry out work tasks, one after the other.

Since the start of last week, I have taken some time off work. I have 4 more days remaining for some respite before I need to go back to work at the start of next week. I am not looking forward to it as I know what it entails. But, life goes on, and I need to continue pushing forwards, even when I feel I’m dragging myself through mud. My relationship with my colleagues have been difficult because I still don’t have the language I need to create boundaries and to be assertive. My opinions and ideas doesn’t get heard or it just gets disregarded during meetings. Decisions have been made on my behalf while I am away from work, assuming that whatever this decision might be, would be ok with me. I don’t have a voice yet. Maybe, one day, this would change. I need to start learning to find the words to create boundaries and to be assertive.

Worthy of Time

Serendipitous find on Instagram that I think has been very helpful at articulating thoughts and feelings that I would not be able to find words to describe for myself.