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All posts for the month June, 2016

Have you ever wondered why we eat the food that we eat?  In an age where, despite knowing the health risk, we still have large proportions of us who are overweight and, sadly, a large number of children who are overweight, too.

Usually, humans eat for three main reasons:

  1. We eat because we are hungry. Our body needs to keep us on an even keel and it makes us hungry when we start to be deprived of energy.  This is homeostatic eating – keeping the things in our body in some sort of balance.
  2. We eat because it is a certain time of the day or because we usually have food in a certain situation. This is called cue-elicited or learned eating.  We might always eat around 6 o’clock at night.  We might always come home after school or work and stand at the fridge and choose a snack.  Certain things outside of us, like the time of day or who we are with or certain weather might trigger us to eat because we have learned to do so over time.
  3. We eat because things taste delicious or are appealing to us in some way. When we eat because something is really palatable, we call this hedonic eating.

Hedonic eating is usually what drives us the eat foods that are not particularly healthy for us, but they taste mighty good.  Because unhealthy foods taste so good, we are prepared to work harder for them.  In most cases, unhealthy food has a higher reward value.  However, not everyone is equally affected by the reward value of certain foods.  Researchers call this, reward sensitivity.  Different children (and adults) will be more sensitive to the reward value of some foods and, the thing is, that reward sensitivity is related to weight.  High reward sensitivity children (and grown-ups) prefer high sugary and fatty food and beverages and these tend to be the kids who are prone to eating too many unhealthy foods.

So, the challenge is – how do we make healthy foods more rewarding? How do we make children like healthy foods more?  Despite knowing that we should eat healthier foods, the consumption of vegetables is far below recommended guidelines.

I’ve just been to a conference where I met some researchers from Belgium.  They have been busy trying to find out ways that we can help kids like their veggies more.

We already know that children’s eating habits are affected by:

  • their preferences for food (and their reward sensitivity)
  • their genes
  • the food that their parents’ consume
  • the way that their parents offer them food
  • and the availability and accessibility of food children can choose from in the home

….But can we change the foods that children like?

Researchers  took a list of vegetables and had children in an early childhood centre determine which vegetable they liked the least.  They voted, hands-down, for chicory.  So armed with the ultimate unlikable vegetable, they set about seeing whether they could change children’s minds about eating it.

So, every second day for a couple of weeks, they repeatedly offered the children a bowl of chicory.  They divided the children into three groups. One group was just given the opportunity to have the chicory each time.  The second group was given a social reward – they were told that the researcher would be really proud of them if they tried it.  The third group was given a sticker each time they ate some of the chicory.  It’s important to note that the researchers weren’t rewarding them for the amounts that they ate (because we do not want to encourage children to override their own internal systems to tell them when they are full and that could result in overeating), just that they tried it.  They also measured how much chicory the children tried each time.

Expecting to find that the children who were rewarded to perhaps have eaten the most chicory, the researchers found that, after a couple of weeks of presenting chicory every second day, all of the groups had started to eat more chicory – whether they had a reward for it, or not.  They all increased their consumption over time.  But, AMAZINGLY, the children all started to report that they liked chicory more over the course of time.

The thing seems to be, that in getting little folk to eat something they screw their noses up at and say that they don’t like, there is no need to make a song and dance about it.

Rewarding tasting a new food, either with a social reward or a little present, was no different to just exposing them to the food reasonably often.  Try just repeatedly making vegetables an option for them.  Of course, don’t offer veggies at the same time as you offer the lollies, chips and ice-cream because these highly hedonic foods will likely always win, but don’t get out of the habit of serving it up to them and see what happens over time.

As a psychologist, it’s always affirming when you get the new information that confirms what you have done as you’ve been making it up as you’ve gone along as a parent.  When my children were younger, we used to have a weekly “try something new night” where we would offer something that they may not have had before.  The kids never had to eat all of it, but it was offered for them to taste.  It was a bit of a weekly adventure trying foods from different cultures or from different plants.

Perhaps you can experiment at your place? …..but remember, the secret does not lie in the bribes or threats, just in a little bit on offer, often, over time.

At various times in our lives, for a variety of reasons, we can get too busy, too sick, too tired, too sore, too “I-can’t-be-bothered” or even, concerningly, too depressed to do the day to day pleasant things that are ever-so-important to a happy mood.

When people stop doing the things that they normally do – perhaps because they are re unwell, because they’ve had a big fright, or perhaps they are not getting along well with others – it can be quite easy for them to withdraw from the people and responsibilities around them.

They say ‘no’ to invitations, they stay in bed longer or they may retreat into a mindless activity. They can even stop doing the day to day things we all do to look after ourselves, shower, eat well or move our bodies. They can also start to skew their thinking and only notice negative things.

The longer a person stays in a downward spiral of withdrawal, the less likely it is that they are going to bump into someone who tells them a funny story, see someone who is smiling at them or do something that makes them feel good.  The chances of them having a pleasant day or even a pleasant moment can start to erode away.

Before too long, they can be stuck in a negative mood vortex, where they don’t expect nice things to happen, they don’t get out and about where the chances of nice things happening are greater and so they fail to access the things that are needed to keep a mood buoyant.

They can move from upset to sad, terrified, depressed and lonely.  Their felt energy can deplete and sadly, they can lose hope. It can be harder for them to extract joy out of things that are normally joyful for them. Psychologists and mental health professionals call this anhedonia and it is often a symptom of a Major Depressive Episode.

With young children, parents are usually pretty quick to pick up when they are not their usual selves.  Other times it can be a little harder to notice and there are a few key times in a life span where we really need to watch withdrawal:

  • the teen years – it is normal for adolescents to spend longer times in their room (or the bathroom) alone, but if they skip meals, say ‘no’ to things they would usually love, have fewer invitations or friends over, then it’s worth a conversation.
  • when people live alone
  • the elderly
  • the grieving
  • those with chronic illness or pain.

How can we help?

Essentially, we need to help people who have withdrawn to get what psychologists call, “behaviourally activated”.  Sometimes, behavioural activation is no easy task.

When I think about behavioural activation, I often think about when I was a little girl and I would play with my friend, Elizabeth and our siblings in Elizabeth’s round, blue wading-pool.  We played a game where we would all try to go round and round in the same direction as fast as we could and then someone would yell the magic word (which may have been something like “bottom” or “fart”) and we would stop running and we would lie back and float around in the vortex we made.  Then, we made up another game, which was very similar.  We’d go round and round and then someone would say “the word”, but this time we would have to try to go in the opposite direction.  It would usually see us all falling over in fits of giggles as the water forced us over, but if we held our ground and worked one step at a time, we could actually get the water moving in the opposite direction pretty quickly.

This is what it can feel like when you have been inactive physically, socially and emotionally for a lengthy period of time.  Getting started on things again can feel like you’re going the wrong way in the little blue pool.

However, if you keep going often and persistently enough, you can turn the vortex around and have it go the other way – spiraling on towards more happiness.

So, we need to help people avoid being withdrawn.  It can be as simple as:

  • planning something pleasant to do each day – a short walk, a soak in a bath, some time with nature…it doesn’t have to be expensive and activities planned will vary from person to person
  • using a calendar or diary and making sure there is some social activity and some physical activity – it doesn’t need to be long, the hardest part is just getting going. If they turn up, they don’t need to stay for too long, but they do need to move against the force.
  • get back to the senses – make a list of your favourite things to see, hear, smell, touch, taste and do.
  • get back to doing something that you are good at – be that crosswords, drawing, music, growing a plant. We feel better when we feel a sense of mastery over something.
  • volunteer to help someone or something else.

It’s much better to catch a withdrawn and negative spiral of decline as early as you can.  The first few moments of effort will be hard, but before long, the water in the little blue pool will go the other way…the way that means more sweet moments and maybe even giggles or laughter.

The new website for my practice is ready to launch – click here

When people casually enquire into what you do for a living and I tell them I’m a Clinical and Forensic Psychologist, I get a range of responses.  I’m proud of my title and my profession.  It represents a lot of hard work.  However, telling people what I do can, sometimes, change the mood of a conversation.

There are a range of questions that I’ve come to expect that can follow and I think the questions that people ask me when they meet me at functions, formal and informal, are important for everybody to know.  Without proper answers to some of these questions, people may perceive barriers that may prevent them from seeking help from a psychologist if they or one of their family members ever needed help.

So, let’s see what I can do to talk down some of these barriers….

  • Are you reading my mind?

Many people don’t know what psychologists do and how they differ from psychics, psychiatrists or even counsellors.  Each of these kinds of jobs involves assisting others in some ways.  Psychologists study human behaviour using scientifically supported ways.  Psychologists do not claim to have psychic powers or gifts pertaining to peoples’ souls or minds.  Unlike counsellors, psychologist in Australia have to go through a long and rigorous process to be registered to practice and this registration offers a range of protection for clients that are written in National Law.  Unethical or dangerous practices can lead to de-registration. Unlike psychiatrists, who are medically trained, psychologists in Australia cannot prescribe medication, but many psychologists will work in conjunction with psychiatrists to care for their clients.

  • How is talking to someone supposed to help? 

Whilst listening is essential to the practice of good psychology, psychologists do a lot more than just listen and talk.   A psychologist can offer a listening ear with the added bonus of years of training about what accumulated years of research can tell us how to assist.

One of the things that can stop people from accessing help, is the idea that they are a burden to others – so much of a burden that other people won’t be able to cope with their distress.  One of the advantages of seeing a registered psychologist is that these are people who should know how to take care of themselves when client’s present with heavy burdens so that the client’s issues are dealt with professionally and not too personally.

  • Aren’t psychologists attracted to the field because they have their own issues?

The pathway to becoming a registered psychologist in Australia is a long one with no less than six years of closely monitored and regulated training required for basic general registration.  Some people may choose to study psychology after they have had an interesting personal experience or because they themselves found a psychologist assisted them when they needed it – much in the same way, people might choose to study and practice medicine or nursing after being inspired by the care they received in a hospital.

However, I believe that a large majority of people are drawn to the profession of psychology because they are interested in human behaviour and want to help people to solve difficulties in their lives.  If a psychologist in training has issues that might impair their ability to practice, they should be given this feedback as part of their training.

The very desire to help others needs to be carefully titrated through psychological supervision and formal self-reflection.

It’s not just in the choosing of the profession, but in the maintenance of the profession that psychologists need to reflect on their own issues.  Just because a person is a registered health professional, does not protect them from ever getting a mental health issues themselves.  Self-care is critical and all psychologists should practice with plans in place to keep them as healthy as they can be.

  • “That work must be so very hard – how do you manage it?”

Yes, the practice of psychology can be challenging, but a professional  psychologist will always take steps to manage any stress or burden.

Indeed, self-care is one of our greatest professional responsibilities.

A failure to take steps to take care of ourselves can lead to compassion fatigue, burn out, and even breeches of important ethical boundaries.  Our psychology registration board considers it mandatory that psychologists take care of themselves and stipulates that we regularly consult our peers about our work to ease stress and to open our eyes to possible blind spots, share new theories and skills and think about issues in different ways using different frameworks.

  • Is it always the parents’ fault?

One of the things you learn very early when you study psychology is that human behaviour is very complex.  Parenting is obviously an essential part of anybody’s upbringing, but there are also many other aspects of a person’s sense of wellbeing, especially as we get older – biology, thought patterns, other relationships, peers, health, community just to name a few and then all of the combinations of these variables, too.  Of course, in cases of obvious parental abuse and neglect, parenting factors stand out loud and clear, but there are amazing stories of those who have suffered great atrocities at the hands of their parents, yet have gone on to live happy and fulfilled lives.  We would love to study these people more, but they rarely present for help.

I hate to think parents might avoid bringing a child for psychological help because they are concerned they will get “blamed”, but I suspect this might be the case sometimes.

Psychologists are there to assist and promote well being and safety and address the factors that might be triggering, maintaining or exacerbating a problem.  If a person has issues that have to do with parenting, then they will be assisted appropriately.

….

Summing up, this is how I try to answer the questions I get asked at parties…without ruining the mood of the function or event.  I hope my answers can assist in reducing any barriers that people might have to seeking out a psychologist if they need to see one.

Most of us have something that we would rather avoid.  Some of the things we commonly fear are probably dangerous in certain circumstances, but we like to avoid them in all situations if we can. Spiders, snakes, heights, flying, clowns, the dark…there are a long list of things that can unsettle people from time to time.

When someone has an extreme or irrational fear of something and the fear is causing them significant issues in their lives, we call this a phobia.

A fear of a specific creature, object or situation is referred to as a simple or specific phobia – although some people who have simple phobias would not see them as being simple.

Some phobias can be extremely debilitating making it hard for people to go about their day to day lives.  Many parents will know of the troubles that a fear of the dark can cause a household when a little person needs lots of support to get to sleep at night.   I have seen someone with a spider phobia that was so significant, she was having trouble sleeping for fear that a spider may crawl into her mouth. She also avoided walking on any grassy areas when she could.  I’ve also had quite a few little ones over the years who have been phobic of balloons.  This has meant they’ve often avoided birthday parties and they have made their parents cross the road to avoid shops that might have balloons on a display or sign in their shop front.  One person I saw could not even handle people saying the word “balloon”.  Clearly, all of these little ones had phobias that were getting in the way of their lives in way too many ways.

Some people are born with a predisposition t o develop a phobia and we do know that anxiety can run in families.  Most phobias develop in our young years.  They might be precipitated by a scary experience.  In fact, most of the young people I have seen in my practice with phobias often blame a brother or sister for exposing them in a pretty scary way to something that they then stayed sacred of for a long time.  It may also be that the younger member of the family has watched a movie that might have been scarier than they could manage.

Stephen King and big brothers might have a lot to answer for, but in this day and age, parents also need to be mindful of scary internet content, too.

A internet gaming character called Freddy in “Five Nights at Freddy’s” also has a lot to answer for when it comes to generating fear in those who may be too young to understand.

People, young and old, will go to quite a deal of trouble to avoid the things that they are phobic of and this is where a psychologist might focus the main thrust of their treatment of a phobia.  In the early years of psychology, phobias would be dealt with by exposing the person to the thing they were frightened of and forcing them in that situation in what was called “flooding”.  When I think of flooding I often think of Indiana Jones movies where Dr Jones has to fall into or crawl through a pit of insects or snakes.  However, we would be unlikely to treat phobias in that way anymore.  We really want to focus more on people learning how to manage rather than just being thrown in the deep end.

Instead, we usually work with the child to walk through a series of graded exposures.  We would firstly generate a scale of scariness with the person who is scared.  In the case of balloons, it might be that they might rate a picture of a balloon as about 20 scary points, a video of balloons 30, touching a deflated balloon as 40 , and inflated balloon as 80 and popping an inflated balloon as 90.  Everyone will likely generate a slightly different list.

We have to be careful we do not assume that all phobias are exactly the same.

We would then teach the child some things that could do to manage the anxious arousal (maybe breathing exercises and some self talk) and we would start with the lowest level task and help the person manage that fear until it was very easy for them.  We want them to really take their time and actually manage rather than just hold their breath and do it quickly without registering it.  When they and really mastered their fear at one level then we would move up to the next level.

Interestingly, some knew research is emerging to suggest that sometimes a dose of a certain antibiotic (D-Cyclosterine) can assist children who are getting treatment for phobias.   It is thought that the antibiotic works on learning and seems to assist children progress through their graded exposure tasks.

So, if you have a little one who is fearful of something, if it’s at the point where it is significantly interfering with their lives on a regular basis and the fear is extreme and very distressing, be sure to seek some psychological help.  If you have noticed some fears starting to develop, while it is tempting to help your child avoid the things that distress them, see if you can encourage them to face their fears in a gentle and gradual way.  Don’t drop them in the deep end of their fear.  Negotiate an easy starting point and build from there.  Rewards for being brave will also help.

Oh, and as always, adults who model brave behaviour in the face of simple fears will be much more helpful than adults who freak out!