What if You Could Change Your Attachment Style?

In my top 20 psychology books countdown, I put the 2012 title: ‘Attached: The New Science of Adult Attachment, and How It Can Help You Find – and Keep – Love’ by Amir Levine and Rachel Heller in 9th place, thanks to its Amazon.com star rating of 4.6/5.

 

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Attachment styles research is an area that I’ve been fascinated in since I first learnt about it in year 11 psychology class. If you are interested in learning more about it, I do recommend checking the book out, as our attachment styles tend to have a much more significant impact on how we are in intimate relationships than most people are aware of.

What Are Attachment Styles?

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Attachment styles are initially developed in the context of our relationship with our primary caregiver growing up. This is usually the mother, but in other cases, it can be the father, guardian or potentially even a nanny.

Almost all children can usually be categorised as having one of four attachment styles based on how they respond to the strange situation test, which was initially designed and researched by Mary Ainsworth in 1969. They can be considered to have a secure attachment, an ambivalent insecure attachment, an avoidance insecure attachment, or a disorganised attachment.

In the strange situation procedure, an infant between the ages of 9 and 18 months is placed in a room with some toys for 21 minutes and is observed playing through a two-way mirror while the primary caregiver and a stranger enter and leave the room. This situation was meant to recreate what may happen in a normal infant’s life so that their typical reactions could be observed.

The strange situation procedure went as follows:

  1. The primary caregiver and infant enter the room.
  2. The infant explores the room while the caregiver watches but doesn’t play with the infant.
  3. A stranger enters and talks with the caregiver, then approaches the infant. Caregiver leaves while this occurs without saying goodbye.
  4. The stranger tries to engage with the infant.
  5. The primary caregiver then returns and greets and comforts the infant. Stranger leaves.
  6. Caregiver leaves again, and the infant is alone.
  7. The stranger comes back in and tries to interact with the infant.
  8. The primary caregiver then comes back in, greets and picks up the infant, and the stranger leaves.

What is worth looking at during this process is how the infant interacts with the new environment and toys in the room, how they associate with the stranger, and how the infant reacts to when the primary caregiver leaves the room (departures) and comes back in to greet or soothe the infant (reunions). These responses are very predictive of what attachment style the infant has, and also what attachment style the primary caregiver may have.

Attachment styles are not set in stone, and they can change over time, but like most things I write about, gaining an awareness of your own attachment style is a crucial first step before you try to look at how you can improve it.

A Secure Attachment

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Infants who are securely attached to their primary caregiver will be willing to explore a new room when they enter it. They will turn around and check in with their parent from time to time as they are their “secure base”. They may even come back if they are starting to feel too scared or overwhelmed, as their parents are their “safe haven” and help them to calm down emotionally and physically when they are distressed. Once they feel calm and safe again, which may be very quickly, they will then go back out and explore once more.

The secure infant will engage with the stranger when the primary caregiver is there, but might be warier when alone with the stranger, and could become upset when the parent leaves, but is then able to calm themselves down after a little bit. They are thrilled to see their primary caregiver once they return, however, and will be responsive to their communication and interactions.

Essentially, a secure child feels that their primary caregiver will meet their needs appropriately and responsively, and they learn to turn to them when they need it and do things by themselves when they do not. It is the ideal attachment style for learning, development of skills, and forming and establishing healthy, long-term relationships.

In intimate relationships, being securely attached is ideal. It means that you enjoy being close and intimate with your partner when they are there and are happy to do your own thing when they are not. You feel comfortable opening up to them or talking to them about your feelings or concerns, and feel comfortable helping your partner out with their issues too. Relationships seem relatively natural to you, and you are more likely to have a happy, long-term relationship.

An Anxious/Ambivalent Insecure Attachment

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Infants who are anxious or resistant are usually this way as a result of unpredictably responsive caregiving, where sometimes their caregiver is too full-on, sometimes they are appropriately responsive, and other times they are not responsive. As a result of these inconsistencies, the infant usually amplifies their emotional needs in an attempt to try and get them met on a more regular basis.

Anxiously attached infants are distressed even before the separation in the strange situation procedure, do not like to explore the area or interact with the stranger, show resentment for being left alone and are quite clingy and unable to calm down or be comforted easily once the parent returns.

In intimate relationships, being anxiously attached is tough. It means that you love being close with your partner, but find it quite difficult to be apart, often fearing that they don’t care or that they will stop loving you or will be unfaithful towards you when they are not around. You have a tendency to become preoccupied with fears of abandonment, especially in times of high stress, and may inadvertently push your partners away by making them feel like they don’t have enough independence or that you don’t trust them enough.

An Avoidance Insecure Attachment

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Infants who have this style will try to ignore or avoid the primary caregiver in the strange situation. They outwardly show little emotion during departures and reunions with the caregiver, and they will also not explore too much regardless of who is in the room.

The ignoring or turning away from the primary caregiver is actually a mask for internal distress, however, as heart-rate and other physiological responses are similar to that of the anxiously attached infants upon the separation from their primary caregiver. It seems to be that these infants want to be comforted when distressed, but over time try to suppress their emotional needs because their parents are not attuned or responsive to their distress or able to meet their needs in ways that would help them. As a result, they try to pull away, keep to themselves, and show the world that they don’t have any needs.

As an adult, having an avoidant attachment is also tricky for intimate relationships. It means that you are likely to value independence and freedom a lot, and tend to feel smothered or trapped if you spend too much time with your partner. As a result, you will manage to push partners away, especially if they are demanding or needy. You are also likely to not share enough of your own emotional needs or desires with your partner and may resent them for expressing these things to you.

Two avoidantly attached individuals may seem like they could have a good relationship together, but often there is “not enough glue to keep them together”, and they fade further apart from each other over time.

A Disorganised Attachment

 

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There is a fourth attachment style known as a fearful or disorganised. This was later identified by one of Ainsworth’s graduate students Mary Main and is where the infant flips between signs that they are overwhelmed with a “flooded attachment system” and strategies of desperation. This is often a consequence of significant trauma, as a reliable coping mechanism has not been established in the infant. They want to be close to their primary caregiver, but they are also terrified of being close to them.

Adults with a disorganised attachment who have been through a complicated relationship with their parents or guardians will find it tough to initiate and maintain a healthy and happy intimate relationship when they are older. They will often vacillate between feelings of being trapped and smothered and wanting freedom one minute and then worrying about how they would ever cope if they lost their partner the next. Their behaviour and strong emotional reactions can be confusing to both an individual with a disorganised attachment and the people they date.

But How Do I Find Out What Attachment Style I Have?

If you aren’t too sure what attachment style you have based on the descriptions above or from reflecting on your experience as a child or in intimate relationships, you can also take a free online test to find out. I have taken the test titled “Your Actual and Ideal Attachment Styles” at personalityassessor.com on three occasions now. The first time was on the 22nd of October 2014, back when I was still married, the 12th of April 2017, when I had just bought an apartment with my girlfriend, and the 12th of August 2018, 4 days before I was about to leave everyone in my life in Australia to move to Vanuatu for 2 years.

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Can Attachment Styles Change Over Time?

These are the results from the three attachment style surveys that I took, followed by the description that was included in my 2018 results at the personality assessor website:
Attachment Anxiety:
  • 2014 = 13th percentile – very low
  • 2017 = 3rd percentile – extremely low
  • 2018 = 2nd percentile – extremely low

You are currently extremely low in attachment anxiety. People extremely low in attachment anxiety tend to desire extremely low levels of closeness in their relationships, and also experience extremely low concerns about rejection and abandonment.

You’ve decreased a lot in Attachment Anxiety over time.

The decreases that you have experienced in Attachment Anxiety have been extremely consistent over time.

You indicated that you would like to stay the same with respect to attachment anxiety. Researchers believe that most people want to decrease at least a little bit in attachment anxiety.

Attachment Avoidance:
  • 2014 = 89th percentile – extremely high
  • 2017 = 47th percentile – about average
  • 2018 = 52nd percentile – about average

You are currently about average in attachment avoidance. People about average in attachment avoidance tend to desire about average levels of independence in their relationships, and they tend to experience about average levels of comfort with depending on romantic partners and opening up to them.

You’ve decreased an extreme amount in Attachment Avoidance over time.

The decreases that you have experienced in Attachment Avoidance have been extremely consistent over time.


You indicated that you would like to decrease with respect to attachment avoidance. Researchers believe that most people want to become a little less avoidant.

My Attachment Style

Based on the 2014 finding, I had an avoidant attachment style. That makes a lot of sense to me and is how I have typically been in most relationships. I was also a pretty quiet and anxious child growing up and kept to myself a lot even though on some level I really valued and craved for a solid relationship where it was possible to feel connected and have a sense of belonging without losing my sense of self in the relationship. I’ve always kind of struggled to show this to the other person, however, and often got accused of not caring enough in the relationships that I have been in.

While I can definitely see my part in the unhealthy relationships I have been in, I also have had a tendency to be attracted to and get involved with females who exhibited an anxious attachment, which only made the issue worse. If things go well in an avoidant/anxious relationship, which they usually do at the start, the quality of the relationship can feel great. Both of you are getting your relational needs met (maybe for the first time) and it is exciting and fun and nice. Once one person becomes distressed is when the problems begin, however, and they always do…

Before 2015 had a big tendency to shut down emotionally whenever I was overwhelmed or distressed, focus on getting through what I needed to do practically, and in general minimise my emotional needs. It was classic avoidance attachment behaviour. This pulling away caused distress in someone with an anxious attachment, however, and they would then amplify their emotional needs in response to the greater perceived distance in the relationship. They may have feared abandonment, and protested that I didn’t care or needed to give them more so that they would feel secure. I would then feel more overwhelmed and trapped, and pull away further in an attempt to calm myself down. Anyone with an anxious attachment would then begin to feel even more insecure and distressed and try to protest further. This vicious cycle often continued to play out and escalate, maybe with brief interludes, until the relationship ended, usually in a not so pleasant way.

Based on my 2017 and 2018 findings, it says that I would now be considered to have a secure attachment style:

Your prototypical attachment style is secure. Securely attached individuals enjoy being close with others, and form new friendships easily. They usually desire moderate levels of involvement in their close relationships.

This is pleasantly surprising to me because I still do feel more avoidant in my attachment then I would like to be, but my avoidance is now considered average, and my anxiety is extremely low. Comparatively speaking, I am still much more avoidant than anxious when it comes to relationships, but securely attached overall. I am a bit sad to see that my avoidance has crept up a little bit again since 2017, but hope that if I keep working at it that I can continue to bring it down further in the future.

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How Do We Improve Our Attachment Style?

Occasional conflict is inevitable in any relationship. Being in a relationship with someone with a secure attachment will help you to get through difficulties in life and your relationship, no matter what your age or attachment style is.

  • If you have a secure attachment too, it is likely to be pretty easy for you to have a happy relationship.
  • If you have an avoidant attachment, a secure partner can give you the space you need when you need it without getting annoyed at you or demanding for more.
  • If you are anxious, a secure partner can sit with your distress and hear you out until you have calmed down and your emotional needs have been met.
  • If you are disorganised, a secure partner will also try to help you work through and make sense of whatever it is that you are feeling and give you what you need, whether that is more space, a calming presence or greater closeness.

In time, a relationship with someone who is securely attached can help you to become securely attached too.

If you have had similar difficulties in multiple romantic relationships, think that you may be avoidant or anxious in your attachment style, or are securely attached but are in a romantic relationship with someone who you feel may be avoidant or anxiously attached, I hope that this information has been helpful to you.

An understanding of your own and others attachment styles really could stop you from falling into the same relationship traps, and give you a much better chance to have a long, happy and healthy relationship going forward.

 

Dr Damon Ashworth

Clinical Psychologist

 

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The Five Lessons I Discovered From Being Kind

On January 1st, 2018 we kickstarted our Deliberately Better movement.

If you would like to join our movement, please feel free to join our Facebook group today. The only requirement to be accepted in the group is that you want to improve your life in some way.

Along with other passionate and driven allied health professionals, we aim to highlight the various ways that people can choose to act if they wish to scientifically improve their health and well-being.

In January, we aimed to engage in a random act of kindness each day.

This was a fun experiment, and I tried to make a video of my acts of kindness every second day, which I was mostly successful with:

  • On day 2, I gave a positive review on Airbnb and recommended for people to stay where I did
  • On day 4, I supported a friend on a hang gliding expedition
  • On day 6, I spent some quality time with my dad and played a round of golf with him
  • On day 8, I donated some spare change to the Royal Children’s Hospital
  • On day 10, I helped Angelina out with a school assignment and helped them to feel safe at nighttime
  • On day 12, I bought a copy of the big issue to support a rough sleeper
  • On day 14, we left a big tip at a restaurant that stayed open for us
  • On day 16, I donated plasma to the red cross blood bank
  • On day 18, I topped up some stranger’s parking meters
  • On day 20, I donated some clothes to charity
  • On day 22, I supported an organisation that was trying to raise money to protect a wilderness area in Tasmania
  • On day 24, I proofread a book that my friend had written and wanted to publish

  • On day 26, I engaged with a scammer from Nigeria and spoke about the various techniques that he used to rip off vulnerable people.
  • On day 28, I went and played a beach volleyball tournament with my sister Tahnee.
  • On day 30, I handed out bottles of water to people who were homeless around Melbourne.

Even though it was weird to film and promote the acts of kindness that I engaged in, the month really did teach me a few valuable lessons. These are:

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  1. Trying to be kind to others feels good

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2. Viewing or hearing about others acts of kindness feels great

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3. Hearing about or seeing others acts of kindness encourages people to be kinder too

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4. Trying to be kind to others can improve social anxiety

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5. Trying to be kind to others can enhance energy levels and physical health

To assess changes in how I felt from the beginning to the end of the month of kindness, I completed the Positive and Negative Affect Scale (PANAS), as developed by Watson, Clark and Tellegen (1988). This scale has two 10-item scales; one for positive affect and one for negative affect.

If you would like to assess your levels, please answer from 1 to 5 on the following questions for how much you have felt this way recently:

1 = very slightly or not at all

2 = a little

3 = moderately

4 = quite a bit

5 = extremely

Positive affect items:

_______ active

_______ alert

_______ attentive

_______ determined

_______ enthusiastic

_______ excited

_______ inspired

_______ interested

_______ proud

_______ strong

Negative affect items:

_______ afraid

_______ scared

_______ nervous

_______ jittery

_______ hostile

_______ guilty

_______ ashamed

_______ upset

_______ distressed

If you want to compare your scores to previous norms, first add up your totals for your positive affect and negative affect.

A 1989 study of 815 Detroit adults by Quinn found an average for positive affect of 36.0. For negative affect, the average was 18.2 (Quinn, 1989).

In 1993, an unpublished study by Wilkinson found an average of 33.5 for positive affect in 114 adult men and 33.9 in 115 adult women. For negative affect, it was 14.2 for the men and 15.5 for the women (Wilkinson, 1993).

What I find interesting about these findings is that US adults report both higher positive and higher negative affect, indicating that they may be more expressive (and more aware) of their emotions than Australians.

My score for positive affect before the kindness challenge was a 32, which was below the norms for both Australian and US adults. Given that I was feeling exhausted by the end of 2017, this makes sense to me. Extraverts are more likely to experience higher levels of positive affect also, and I would consider myself more of an ambivert.

After a month of kindness, this score had shot up to 41, which was more than one standard deviation higher than the norm for Australian men, and much higher than the average for US adults too.

My negative affect was less impacted by my acts of kindness, however, with my score remaining at 16 at both the start and the end of the month. I was slightly less irritable by the end of the month, but I was also a little bit more afraid, and this could have been due to the videos that I was putting up.

Either way, I seem to experience slightly more negative emotions than the average 1993 Australian, and somewhat less than the average 1989 individual from Detroit.

My experiment with being kinder didn’t solve all of my problems, but it did help me to take a few risks, challenge myself, put myself out there more, grow as a result, and hopefully put a few smiles on some people’s faces. That is enough for me, for now.

2018 DELIBERATELY BETTER AGENDA:


* In February, we gave up or cut down on something that was having a negative impact on our quality of life.
* In March, we focused on our diets and looked at what were the most effective ways to lose weight or get into the best shape of your life.
* In April, we looked into the different habits of high performers and how they improve their skills and become as effective as they are at what they do.
* In May, we’ll be looking at how to hijack your hormones and get in control of your sleep, metabolism and energy.
* In June, we’ll be checking out the latest and greatest developments in health and wellness literature, and passing on the top tips from the fields of medicine, psychology, neuroscience, behavioural economics, fitness and nutrition.
* In July, we’ll be exploring the benefits of minimalism, looking at ways to develop and stick to a budget, how to financially plan for the future, how to cut back on spending, how to create passive income streams, and the top tips for investing in or trading on the stock market.
* In August, we’ll be getting into the gym and out onto the track to explore how to bulk up, shred down, get ripped and be the most physically capable than you have ever been in your life.
* In September, we’ll be looking at the latest trends in health technology, and exploring the various options that you have if you want to improve your psychological and physical well-being.
* In October, we’ll be focusing on how to stress less, and sharing the latest tips to calm down quickly if you are distressed and want to live a more relaxed lifestyle in general.
* In November, We’ll be trying something new, and looking at the multitude of benefits that novelty can play in our lives.
* Last, but not least, in December, we’ll be taking stock of the year, reviewing what worked and what didn’t, and cultivating gratitude for all of the fantastic things in our lives.

All of this knowledge and content could cost thousands of dollars, but for 2018 only we’ll be sharing it all for free.

If you would like to help build the deliberately better movement, please join our Facebook group and invite three people that you know who want to improve their health in 2018.

Everyone is encouraged to get involved by commenting, liking, sharing or posting, but please keep it friendly, positive and focused on any of our monthly topics.

 

Thanks,

Dr Damon Ashworth

Clinical Psychologist

Are You Living the Life That You Want?

In 2016, I decided to take on the challenge of accountability. As a Clinical Psychologist, being accountable was all about evidence-based living – engaging as much as possible in thinking patterns and behaviours that have been shown to lead to a happier, more satisfying, higher quality of life.

The following were the five key areas that I focused on as highlighted in my ‘Do You Want to Be Deliberately Better?’ Article:

1. Tuning in rather than tuning out

2. Turning towards my values rather than away from my fears

3. Maintaining an ideal work/life balance

4. Writing things down rather than keeping things in

5. Developing a growth rather than a fixed mindset

I made this declaration public as I was aware that people’s desire to remain consistent meant that I would be more willing to follow through on these targets and achieve these goals. All of them were based on solid research and were expected to have a positive flow-on effect for my long-term psychological well-being in 2017 and beyond.

While I did make some progress in being more accountable to myself, especially with numbers 2, 4 and 5, I continued to struggle with numbers 1 and 3.

Part of the problem was that I think I’ve always been the person who wants to be able to do everything and I do struggle at times to prioritise and separate what is really essential to me from what is critical to others. The other part of the problem is that I was working too hard, not saying no to what I didn’t want to do enough, and not leaving adequate time for leisure and socialising or even personal growth, creativity and health.

I was often extraordinarily drained and fatigued by the end of the work week and would spend most of the weekend recovering and trying to catch up on chores and paperwork to try not to fall even further behind with administrative duties than I already was. I was also financially in debt even though I was working full-time, and I was stressed out more than I would have liked to be too.

Mainly, I didn’t have enough time or space to reflect on where I was or what I needed, and when I did, I still didn’t make the necessary changes to make sure that my life was consistent with how I wanted it to be.

It’s not just me

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What seemed to help me a lot was reading the thought-provoking self-help book ‘Take time for your life’ by Cheryl Richardson. In this, she highlights the seven common obstacles that people seem to face in living their best lives. These are:

  1. They generally have difficulty putting themselves first
  2. Their schedule does not reflect their priorities
  3. They feel drained by certain people or things
  4. They feel trapped for monetary reasons
  5. They are living on adrenalin
  6. They don’t have a supportive community in their life
  7. Their spiritual well-being comes last

— Cheryl Richardson

I don’t know about everyone else, but I could check yes to all of these items except for number 6. I wasn’t spending as much time as I wanted with friends, but when I did, I felt well supported by them all. As for the rest, I wondered “How does she know me so well?“, but then I realised how many people there are out there that must be falling into similar traps.

My aim for 2017 was to take time for my life

Here’s how I’ve gone towards creating my ideal lifestyle so far:

  • I have moved into a fantastic apartment in the city where I am within easy access by bike, foot or public transport to all of my work, sport and leisure commitments.
  • I have begun regularly using the swimming pool, spa, sauna and gym that is a part of this unique apartment complex. As the gym here is excellent, I have been able to save by cancelling my external gym membership.
  • I have sold my car to avoid having to pay $70 a week for a car spot, not to mention the registration fees, car insurance, petrol, parking fees, fines, and depreciation in the value of the car. This also has the added benefits of never getting stuck in peak hour traffic, as well as more walking and bike riding to get to places, which reduces the amount of time I need to set aside for these activities elsewhere.
  • I have started listening to audiobooks more whenever I am walking around the city by myself. This has resulted in me getting outdoors more, reading less inside, and opened up more time for other personal growth, leisure and social activities.
  • I have finished up working at Mill Park and moved into the city for all of my work days. This means that I can get up later in the morning on work days, and ride or walk or catch public transport to work no matter where I am.
  • I have cut down the days that I see clients from 5 to 4, with Mondays now dedicated towards maintenance, administration, health, creativity and well-being. Because of this reduced workload, I am less stressed and more energetic. I am currently up to date with all of my administrative duties, paperwork, and continued professional development for the first time in 3 years.
  • This has also helped me enjoy my weekends more, as instead of playing catch-up on things I can socialise and relax and plan various adventures that I may not have had the time or energy to do in the past.
  • Even though I am working one day less per week, by buying less stuff and reducing my expenses I am no longer in any financial debt and am saving towards buying a place of my own.
  • I have started up another website – sleepdetective.com.au, which aims to help others to achieve the best sleep they can.
  • I have now donated plasma and platelets through the Red Cross Blood Bank three times. This can be done every two weeks and takes about 45 minutes, and really can make a huge difference for those suffering from leukaemia and certain autoimmune diseases.
  • I have found a new General Practitioner, Nutritionist and Dentist to ensure that my physical health is going well and made the necessary appointments to assess or fix up any of the issues that have become apparent.
  • I have had a DEXA scan to assess my bone density, lean muscle mass and fat. I will be having another one of these in 3 months to monitor my progress and ensure that I remain in the healthy range for a male my age.
  • I have resumed monthly sessions with my Psychologist to ensure that my mental health and clinical practice are as optimal as possible.
  • I have signed up for a year membership with the meditation app Calm, which will help me to continue strengthening my meditation practice. I will aim to practice this for at least 10 minutes per day to make sure that I keep trying to tune in rather than tune out.
  • I have also booked in for a 10-day Vissapana meditation retreat in April and a 12-day P&O cruise at the end of July. Both of these getaways involve switching off from all technology for the duration of my stay and will provide me with plenty of time for rest, relaxation and reflection, essential elements for tuning in and developing greater insight.

No Regrets?

Now that I’ve shared the changes that I’ve started to make towards my ideal lifestyle, I want to ask you this:

If you only have one life to live, and that life is yours, what changes do you need to make now to ensure you don’t accumulate any more regrets in the future?

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In her viral blog post and subsequent book “The Top Five Regrets of the Dying”, palliative nurse Bronnie Ware listed the top five regrets that the dying people she cared for typically had. These were:

  1. They wished they’d had the courage to live a life true to themselves, not the life others expected of them.
  2. They wish they hadn’t worked so hard.
  3. They wish they’d had the courage to express their feelings.
  4. They wish they’d made a bigger effort to stay in touch with their friends.
  5. They wish they had let themselves be happier. 

— Bronnie Ware

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Remember, we tend to regret the things that we don’t do much more than the things that we do. Be brave, give it a go, and see what happens. If you’re not sure what you want or how to figure it out, booking in for a session with a Psychologist could definitely help!

Dr Damon Ashworth

Clinical Psychologist

Do You Want To Be Deliberately Better?

Good company in a journey makes the way seem shorter. — Izaak Walton

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It was 2016 when I first decided to take on the challenge of being accountable to myself. I later wrote this blog so that I could take responsibility for my actions in an open, transparent way, do what I said I was going to do, and “practise what I preach.”

For me, as a Psychologist, becoming deliberately better is all about evidence-based living. It is about engaging as much as possible in thinking patterns and behaviours that through research have been shown to lead to a happier, more satisfying, higher quality of life.

The following were five key areas that I planned to focus on for the year of 2016, with the idea of it having positive flow-on effects for my long-term psychological well-being in 2017 and beyond.

The best part is that just by stating these objectives where they can be publicly seen, my desire to be consistent and faithful to my word did seem to actually help me to stay more committed to achieving these goals:

1. Tuning in rather than tuning out

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Too often in Western Culture, we spend all of our day “doing”, rushing around and completing tasks, and not enough time “being”, simply living in the moment and being connected with our thoughts and feelings and sensations as we are experiencing them in the present.

Other ways that people tune out of their experiences are through distracting themselves with watching too much TV or spending too much time on social media or surfing the internet, smoking cigarettes or using drugs, drinking too much caffeine or alcohol, eating junk food and keeping busy with too much work. Some of these strategies are successful in blocking out what we feel in the short-term, but if we never listen to the signals that our body sends us, they will only amplify in intensity over time, until eventually, we will have no choice but to take notice of the message that is being given.

Formal mindfulness practice is considered to be the best way to first adjust to and get the most benefits out of tuning in and just being. Mindfulness practice consists of maintaining our attention on whatever is occurring at the moment in an open, curious, accepting, patient, non-judging, and non-striving way. I recommend learning guided meditations first, and then practising on your own if you’d prefer once you have figured out the various forms of meditation and how they help you. A few free apps that I would recommend if you are interested in learning these skills are Smiling Mind, Calm, and Headspace.

Once you have learnt the basics of mindfulness, it then becomes a lot easier to also engage in informal mindfulness practice, where you apply these same mindfulness principles in whatever task that you do throughout the day. By tuning in through Mindfulness, the benefits have been shown to include reduced stress, pain and anxiety, improved sleep and mood, a higher capacity to soothe yourself when you are distressed, and a reduced risk of a future depressive episode.

2. Turning towards my values rather than away from fear

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I regularly bring up values with my clients. It is for a good reason. The way I see it, there are two primary motivators in life. We can either be motivated to move towards what is important to us (our values), or we can be driven to move away from the things that we fear.

What is interesting, as first pointed out to me in Daniel Kahneman’s book ‘Thinking, Fast and Slow’, is that most people are predisposed towards being risk adverse, and being more motivated by what they may lose rather than what they could gain. This means that most people play it safe, stay in their comfort zone, try not to change things too much, and don’t take any chances, even if the potential gains outweigh the potential losses.

Most people need at least a 2:1 ratio of things being likely to turn out well before they will take a risk, and some people will never take a chance unless a positive outcome can be 100% guaranteed (which isn’t really a risk at all). The risk of dying in a plane crash or being eaten by a shark are both extremely low, but I’ve met several people who choose not to fly or swim in the ocean because of these fears. My question to these individuals is “What do you lose by not taking this risk?” The chance for fun? Excitement? Adventure? Considering that these values are all important to me, I’d allow myself to feel the fear, sit with it, and take the risk so that I can live a more vibrant, enjoyable and meaningful life.

All of the most successful treatments for anxiety involve exposure to the feared stimuli as an essential part of the treatment. By facing up to our fears, anxiety can be reduced and no longer cause significant distress or functional impairment. It is uncomfortable, but worth it in the pursuit of a goal that is consistent with your values. By living in line with your values and not those of your family, friends or society, you are much more likely to feel energised, motivated and satisfied with where you are at and where you are headed.

3. Maintaining an ideal work/life balance

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One of the biggest traps that I see with my clients is putting off enjoyment today until some designated time in the future (e.g. once I finish uni, once I get a job, once I pay off the house, once I’ve saved a certain amount). What tends to happen in the meantime is that they dedicate most of their life to study and work and saving, and postpone looking after themselves or having fun, exercising, engaging in hobbies, being creative, learning a new skill, travelling, and socialising with others.

The Grant Study, which began in 1938 with 268 Harvard undergraduate men, is still running and collecting data over 77 years later. Across all of this data, they found that one thing was the most significant predictor of health and happiness later in life, and this was relationship warmth. Individuals who were in loving relationships, had close families, and good friends outside of their partner and family were considered to be the most satisfied with life. It wasn’t just about the number of friends or family either, it was about having those quality relationships where you knew that you could depend on the other person when you needed them the most.

Making more money did have some correlation with overall happiness and health outcomes, but individuals with greater relationship warmth also tended to make more money. It is, therefore, crucial to spend time with others and to put energy into cultivating positive relationships. Given this data, socialising with those that we care about should never be seen as a waste of time.

4. Writing things down rather than keeping things in

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Planning and reviewing are essential for minimising stress and ensuring that we are staying on track with our goals. In the excellent book ‘Getting Things Done’ by David Allen, he recommends both a daily review and a weekly review, where you are able to go through everything that has occurred and process it into an all-encompassing management system. By having everything where it is supposed to be, and either filed away or waiting to be done at a particular time and place, it is meant to ensure that our head is as clear as possible. This then enables us to focus on whatever is most important to us at the moment (e.g. the task that we are doing).

I recommend to my clients to quickly jot down whatever is incomplete or still to be done at the end of the workday, followed by a quick plan on when you are able to address this task and the first step that you would do. It shouldn’t take any longer than 5 minutes a day, and can really help in making sure that you can switch off from work once you are at home. For individuals that don’t sleep well due to a racing mind, doing this same process with anything that is on their mind two hours before they go to bed will also reduce their likelihood of being up all night thinking.

The crucial step is ensuring that we are writing down when we will do it (and what the first action is), rather than just making a to-do-list. The Zeigarnik effect shows that our brains will continue to remind us of something that is incomplete until we have done it or have a plan to do it. Surprisingly, once we have a plan (and it has been written down in a place that we won’t forget), our brains treat the task as already being done, and the result is a less busy mind, less stress and more energy. So even if you want to finish painting the house, but won’t have time until your annual leave in 3 months time, write it down. Or create a someday/maybe file, and put it in there.

5. Developing a growth rather than a fixed mindset

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In her book ‘Mindset: The New Psychology of Success’ Carol Dweck has identified a concept that is more crucial towards academic and occupational success than intelligence.

Individuals with a fixed mindset believe most of our traits, including our intelligence and personality, are fixed or unchangeable. Because of this, they tend to view successes as evidence that they are great, and mistakes as evidence that they are horrible or not good enough. Unfortunately, what this means is that whether they win or lose carries massive consequences, because in many ways their identity is on the line with everything they do. If they experience a setback, they won’t try to learn from it or improve, because what’s the point, they apparently aren’t good enough, so why bother trying. They’ll also give up more easily when things become challenging and tough.

Conversely, the individuals with a growth mindset will view their performance on a task as just that – their performance on the task, and not an indication of how smart or capable they are. They see setbacks as chances to learn and grow and improve their skills going forward. Because of this, they are more happy to challenge themselves and persevere through difficulties. They are also much more compassionate and understanding of themselves when they make a mistake, rather than self-critical like the individuals with a fixed mindset.

Fortunately, a growth mindset can be taught. By praising behaviour and effort (“You tried so hard”) rather than characteristics (“You are so smart”), and viewing mistakes as an essential part of the learning process, growth mindset training increases motivation, resiliency and achievement. So even if you don’t naturally look at things in this way, it’s never too late to learn and grow.

 

Dr Damon Ashworth

Clinical Psychologist

Health is a Balance

Health is a balance. Our body has an innate drive to maintain balance. It makes constant adjustments internally, to meet demands placed on the system by external lifestyle stresses. By altering physiologic functions such as breath, heart rate and metabolism it is able to keep the internal environment within ideal parameters. Health is not a destination, we do not reach an end point of balance. It is fluid. The fulcrum on which stability has been established will continuously change, as demands placed upon us throughout life also change. We will no doubt encounter events which cause the body to deviate from its natural state as life stresses are unavoidable. While we often grow from adversity, if prolonged, the effects of stress, eating poorly or moving less, can lay the foundations for the disease process to set in.

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Osteopaths have a unique way of looking at the body. Osteopathy is a tool for which to facilitate the bodies inherent desire for balance. By searching for where it has compromised from injury or strain and ensuring its motion and mechanics are unobstructed, the body is better able to return to health. It is no secret that a patient’s capacity to heal rests with their ability to maintain a balance of their internal environment. Those that succeed with this look different and their bodies feel different. There are quality and fluidity in their movement and vibrancy in how their tissues respond to treatment. They feel ‘healthy’, and the outcomes of treatment are far greater.

Health is rooted in the old English word ‘hælþ’, meaning wholeness. When science began to focus on structure and could see how the disease affected normal tissue, through dissection and under a microscope, being healthy became an ‘absence of disease’. Now a person is no more healthy, in the absence of disease, then a tradesman is without his tools. Without disease, we are simply not sick. We are declared ‘well’ when we no longer have the symptoms of being ‘unwell’, yet are often none the wiser for the cause that shifts the balance of health and provides an optimal environment for disease to begin.

“To find health should be the object of the doctor. Anyone can find disease” Dr AT Still

In more recent times, research has enabled us to establish the connection between mind and body, and so the meaning of health is once again, realigned with its original roots. Whole. Whole in the sum of its parts. Parts which are equal and balanced. Merriam-Webster defines health as ‘the condition of being sound in body, mind, or spirit’, which  I agree with almost entirely except the or because these are not separate entities. They are interdependent, making up different but equal parts of the whole. Say you are sound in body and spirit, but the mind is lacking, perhaps you are overly stressed or anxious. Muscles become tense, blood pressure rises, adrenals become overworked and nutrient absorption and hormone levels begin to be affected. Before long, the immune system becomes compromised, and through a loss of internal balance, we become susceptible to disease.

A balanced life on the outside makes it easier to maintain balance within. We are only healthy when balance exists between these parts, so one must continually devote time each day to each aspect of health. Neglecting one and thus upsetting the balance of the internal environment, may lead to permeation of ill health through the others. This makes us susceptible to disease, decrease vitality and reduces our bodies capacity to heal.

 

References

  1. “Definition Of HEALTH”. Merriam-webster.com. N.p., 2017. Web. 5 Mar. 2017.
  2. “Online Etymology Dictionary”. Etymonline.com. N.p., 2017. Web. 5 Mar. 2017.
  3. Sternberg, Esther. The Balance Within. 1st ed. New York: W.H. Freeman, 2001. Print.
  4. Still, A. T. The Philosophy And Mechanical Principles Of Osteopathy. Kirksville, Mo.: Osteopathic Enterprise, 1986. Print

How Do I Know if My Back is Out?

Is my back out? Out of alignment? Out of place?

These are some of the most common questions I get asked in private practice. I’m here to tell you, however, that your back doesn’t go in and out like a fiddler’s elbow. In fact, if you had dislocated a joint in the spine… well… you certainly wouldn’t be making your way onto my treatment table.

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Something must be out I can’t bend to the right!

Of course, you can’t, because your body doesn’t want you to bend to the right. When there is an injury to your body, it goes into protection mode. The brain sends molecules designed to heal (inflammation) to the site of injury. Your muscles then tighten to prevent further damage and the nervous system goes into a hypersensitive state in an attempt to protect you from anything that may be a threat to tissue health.

But this other therapist I went to just cracked me back into place!

Manipulation increases your circulation, decreases muscle tension and causes a local change in the nervous system. This is why it feels better and allows your body to move more freely. It has nothing to do with your bones being cracked back into their original place.

While potentially providing an explanation of pain for the patient, terms such as tibial torsion, twisted pelvis, short legs and joints being “out” can affect our fears and belief system. It can begin to make us guarded in movements which we believe may put our ‘back out’. A lack of movement causes stagnation of fluids which may prolong healing. A developing sense of fragility accompanies how we view the injured structure, and our focus becomes not on the complex nature of pain itself but fixated on the supposed mechanical cause. We use this as a rationale for a pain response, potentially without tissue damage.

It is language like this that promotes a passive reliance upon treatment on putting the patient ‘back in’. A management strategy which is good for the clinic’s business but not so great for a complete resolution of your symptoms.

So if you have a practitioner that tells you you’re out again… it may be time to look elsewhere.

What’s all this pain about?

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Pain is the primary presenting complaint given to an osteopath. It is an economic burden and can dictate how patients live their lives. So naturally, it is the best place to begin joining the 50,000 people starting up a blog every day

Recently, I had a referral from our massage therapist for a work cover patient that wasn’t happy with how he was progressing with his current treatment and management plan. He had lower back pain resulting from excessive lifting at work. He was the sole income provider for his family and had tried therapy for over 3 months with little to no improvement.

Firstly I listened to his story. Really listened, without interrupting him. His frustration was evident as he explained that not even an MRI scan could detect any abnormalities. He went on to say he hated his job, missed playing sport and also doing the things he used to do before he was married with kids and a mortgage. He was also fed up with the side-effects caused by medication cocktails used to help manage his pain.

We began to talk about his back pain. I told him, “all pain is a product of the brain which is designed to protect us. It brings to our attention any actual or potential threats to tissue health so that we may act upon it” (1) The information coming from the periphery is not pain, it is a warning. It’s the brain that decides whether or not it will hurt”.

“Great, so you think it’s all in my head,” he asked me, a tone filled with a mixture of sarcasm and frustration

“Yes and No. I have no doubt you are experiencing pain, you wouldn’t be here otherwise. But when the pain has been around for a long time, sometimes the information coming from our back, doesn’t accurately represent the condition of the tissues. Pain is reliant upon context, the brain must put together the warning messages it’s receiving, and everything else related to the injury. How you think and feel about your pain, what you’ve heard, and your previous experiences all affect the answer to the question is this dangerous or not?”

At this point I pause for dramatic effect, letting the information seep in. The patient stared at me, with a furrowed brow. He hasn’t heard this before.

So I continue, “Do you think your brain is worried about how you’re going to support your family with a bad back? How being at work makes you unhappy? How you’re going to pay off your mortgage without an income? What about being unable to adequately explain your pain despite the most sophisticated medical imaging techniques?”

There was no doubt that this man’s body was responding to all of these stimuli. “No wonder your nervous system has now become sensitive to anything that may affect your back. Without it, you would be unable to provide for your family”.

I did some treatment with him and gave him advice on diet, exercise and other potential lifestyle changes. We mutually agreed on the “this is what you can do to help yourself” approach, rather than previous generic instructions that preached “Don’t do this and don’t do that!”

At the conclusion of the consult, he shook my hand vigorously, understanding now spread across his features, accompanying a somewhat goofy smile. It was a light bulb moment for him. He got it. He felt empowered by an understanding of his pain, and now he had the tools to more appropriately manage it.

A patient armed with knowledge and understanding can be more actively involved in their own management. A patient who helps themselves is a patient with better prognostic outcomes.

  1. Butler, D. & Moseley, L. (2013). Explain Pain (2nd Ed.). Adelaide, South Australia: Noigroup Publications