What is Schema Therapy and How Can it Help Me?

What is Schema Therapy & who benefits from it?

Schema Therapy is an evidence based treatment thats works at a deeper level to solve ongoing problems where other approaches have had limited success. The approach combines gaining insight into difficulties, helping you manage negative emotions, reduce avoidance, change thinking, and develop better coping skills. Unlike other approaches, Schema Therapy goes beyond symptom reduction and aims to improve your relationships, help you feel more empowered to live the life you want and ultimately improve your overall quality of life.

You may benefit from Schema Therapy if you have ongoing difficulties like long term depression or have had painful or difficult childhood experiences. Schema Therapy may help if some relationships and situations trigger disproportionately large emotional reactions. 

What are Schemas?

Schemas are negative beliefs that while false, feel true. Examples of Schemas include Defectiveness and Shame, Abandonment and Failure. Schemas create a filter that influences how we think about ourselves, what we expect from others and how we see the world. When our needs are met, Schemas lie dormant. When we experience stress, feel rejected or feel we are failing, Schemas may be triggered. For example, you might know rationally that you are loveable, but still feel unlovable.  Schema Therapy is about not only knowing but feeling deep down that you are lovable, to help you to feel safer and able better able to trust others.   

Schemas develop largely because of our early home environment and in part due to our temperament. Schemas develop in childhood when our core needs for nurture, autonomy, and reasonable limits are not met.

What are Modes?

Modes are the coping responses we have when the Schemas are triggered. These modes represent the different sides of us. For example, an individual with an Abandonment Schema may find themselves in an avoidant mode to numb themselves to the painful feelings of abandonment. The work in Schema Therapy is about being able to recognise and reduce unhelpful coping modes that become activated and to develop more constructive ways of coping meet your needs.

What are the stages of Schema Therapy?

In the initial stages of Schema Therapy, the aim is to become aware of and understand what your Schemas and Modes are and how they get triggered. We then work together to manage and reduce unhelpful modes such as avoidance that are contribute to distress. We work collaboratively to find more constructive ways of getting your needs met and begin to heal your more vulnerable sides. The aim is to help the healthy adult parts of you to run the show and reduce the unhelpful coping modes many of us default to in times of stress.

How long is a course of Schema Therapy?

Schema Therapy is a longer-term therapy of around 20+ sessions optimally. Those with a mental health care plan can access 10 sessions a calendar year. Therefore, some clients split their therapy across 2 calendar years. Alternatively, people also use their private health funds with extras to reduce therapy costs.

How can I get the most out of Schema Therapy?

The two most important things when undertaking Schema Therapy are to have an open mind and to create time and space to undertake practice between sessions. Like most things, it doesn’t change overnight but with the right approach and joint effort from client and therapist the rewards are very much worth it!

How do I get started?
After initial assessment, the first step of Schema Therapy is to determine both your Schemas and how you cope with these when they become activated.

Please download the Young Schema Questionnaire and the SMI from the client resources page of my website (scroll to the bottom of the page to view downloads section). To download them successfully, please click on the downward arrow. Once you are finished completing them, please email them to me ahead of our next session. Collectively, they will take one hour to complete. I will then present the results to you at your next session. We will use this information to plan your treatment.

Tena Davies

Clinical Psychologist

Mindfulness and Mindful Eating

What Is Mindfulness And Mindful Eating?

What comes to mind when you think of mindfulness? Do you imagine a group of people sitting cross legged in silent solidarity while they try to clear their minds? It can be hard to imagine this type of meditation in the busyness of modern life. Fortunately, there are many types of meditation or mindfulness that can fit into a busy schedule.

Mindfulness is defined as the state of being fully engaged and connected to what is happening in the present moment often in the immediate environment. Mindfulness is not thought stopping or clearing the mind but rather drawing attention to the present moment by attending to the five senses. This includes noticing the physical world (smells, sounds, sensations) and observing thoughts without judgement and then bringing attention gently back to the present moment. The aim is to acknowledge that the mind has wandered and then return one’s attention to the present.

What is mindful eating and how can it help me?
Mindful eating involves bringing the five sense to the experience of eating by noticing the sounds, textures, smells, and colours associated with eating food. This can also involve noticing our responses to food without giving into it. For example, noticing our respond to the smell of freshly baked bread without necessarily consuming this food.

Mindful eating can help an individual to slow down their food consumption and help them to tune into their bodily internal cues of hunger and satiety. It can also assist them to distinguish the difference between hunger and thirst, between eating out of hunger and eating for comfort or eating to relieve boredom. Research tells us that mindful eating can assist with over eating or binge eating.

Who does it benefit?
Mindfulness can be beneficial for everyone but especially for those experiencing common health conditions such as depression and anxiety because it helps an individual focus on the immediate environment instead of negative thoughts. Mindfulness can be a good antidote for rumination and thus reduces stress and worry. Over time, mindfulness training can teach the mind the skill of being present.

Is there evidence for mindfulness?
Yes, there is a significant amount of evidence that suggests that mindfulness can help reduce insomnia, stress, anxiety and worry. Recent research has even found it to be as effective as CBT for common conditions such as depression and anxiety.

What if I’m keen but short on time?
The benefits of mindfulness meditation can be achieved in just a few minutes a day. If you can fit in a cup of tea or surfing the web on your phone, then there might be room for 5-10 minutes of mindfulness a day.

What’s the best way to start?
I find the best way to start mindfulness is by following a guided meditation program. There are several Apps on the market such as the headspace App, which charges users a fee. Free or low cost apps include the smiling mind, Calm or Buddhify. Alternatively, mindfulness can be searched for in the App Store or Google Play. I do not receive any incentive from these Apps and am recommending them based on client feedback.

Can mindfulness be built into day to day life?
Absolutely! Mindfulness practice can be brought into daily life by bringing your five senses to any experience. One of my favourite mindfulness activities is mindful hand washing or applying hand lotion.

Any activity can be turned into a mindfulness activity but it’s easiest when there’s rich sensory input such as walking in nature or showering. Mindful eating is also practical and involves noticing the smells, textures, temperatures and colours when savouring food.  The next time you engage in these activities try noticing the sounds, smells, textures, and colours that are present.

In my practice, I often recommend mindfulness as an intervention to improve a patient’s well- being. I find that those who engage in mindfulness report it improves their symptoms. It’s also a great lifelong skill to increase resilience and be present.

Article written by Tena Davies, Psychologist. The aim of this article is to give you ideas on well being. Please note this article is not intended to replace therapy. Tena Davies is Psychologist based in inner city Melbourne. Tena has expertise in psychological counselling with adolescents and adults. She also works as a cyber expert providing cyber safety education to schools and professionals. As a Psychologist, Tena believes in helping clients to gain insight into their difficulties and teaching them new skills to grow and thrive. Click here for more information on Tena, or to contact her for an appointment.

Nutted Out Nutrition’s dietitians believe mindful eating is an important part of changing eating behaviours and incorporate mindfulness into many aspects of our appointments.

Reflections on motherhood

With Mother's Day coming up, I've been thinking about the experience of motherhood, of the joys and the challenges that it brings and of the brave face that many put on who are finding it difficult. 

Feeling negative and distressing emotions as a mother is common place. I think motherhood is challenging due to a range of factors. Firstly, I believe it's the greatest adjustment a woman can make because it represents a loss (in part) of one's former self and an ever evolving set of responsibilities as they child grows up. Often mother's go from having mastery at work to questioning their competence and judgment in their role as mothers. This is amplified by the desire to want to be the best mother possible. A second factor is the relentless nature of the job that requires mother's to put their own needs and wants aside to care for their children. This often means less than ideal health behaviours such as poorer eating patterns, interrupted sleep, less frequent exercise and limited rest, which in turn negatively impacts mental health. Finally, motherhood often comes with juggling many pressures-trying to keep up with old friends, make new ones, lose the baby weight, progress one's career, be a good partner, and above all be a good mum!

For some, the many demands of motherhood can bring on post natal depression and anxiety. This may manifest in a sense of vulnerability and isolation. Many experiencing this put on a brave face because they may fear judgement for others. Fortunately, help is available and there are steps you can take to keep well. 

How to keep well as a mum

Build your team

Whether you have stacks of support or none at all use your resources to get as much support as you can. 

This can include reaching people who will help with your child such as a babysitter, friend or relative or using a childcare service. It can also include seeking advice from your maternal health nurse, Dr or a Psychologist or even just developing a rapport with those in your community. Some mums find  that investing time in themselves helps them to cope.

Get out of the house

Go out even if you don't-especially if- you don't feel like it. It can be easy to stay home when you feel off but this can lead to increased feelings of isolation and depression. Fresh air and a bit of social contact can do wonders for one's mood. 

Invest in relationships 

Many mum's report feeling isolated when they first become mothers. With pre-baby friends at work and the daunting prospect of making new mum friends it's not surprising that women can feel lonely. 

The holy grail of social support is hitting the jackpot with your mother's group. However, not every mother's group is a hit. If you're struggling to meet new mum's try joining a baby class or a mother and baby class such mum and Bub yoga. Mum friends can really nourish your soul because they may be going through similar challenges, which helps to normalise them. 

Look after yourself

Self care is one of the things that often gets sacrificed to meet the demands of caring for a baby. However, looking after yourself will give you more energy and mental headspace to care for your beautiful little one(s). 

The health behaviours that matter most in terms of mental health are diet, exercise, and sleep (if you can can it!). 

Live for the special moments 

While there may be moments of frustration and loneliness that accompany motherhood there are always little moments of magic like have a cuddle, exchanging a smile and celebrating your child's milestones. 

Make gratitude a habit

Motherhood can be a competitive sport filled with comparisons but it pays to stop and reflect on everything you do have instead of what is lacking. This could include  reflecting on what you are grateful for. Everything from having a safe home to enjoying meaningful relationships to appreciating nature (the beautiful changing colours of autumn leaves) is worth reflecting on. Studies show that those who make reflecting on gratitude a daily habit.. . 

Maintain your relationship with your partner

The concept of date night might be laughable with a young baby. However, it's worth putting aside at least an hour a week to connect with your partner. If you can't leave your house get take away and eat at the table. 

Know when it's time to seek help

If you don't feel like yourself, have lost your zest for life and things feel like too much of an effort it might be time to talk to Psychologist and in doing so work out new skills to deal with difficult situations. This questionnaire can help you determine if your level of distress warrants doing something about it. 

Practice relaxation 

Relaxation and mindfulness can help your mind go on a much needed holiday and teaches you the skills to be present. I find a simple way to do this is by downloading a mindfulness app such as the Smiling Mind (free) or Headspace,

You can also practice mindfulness (the skill of observing the present moment) in everyday activities such mindfully applying hand cream or hand wash. This involves noticing the colours, sounds, smells, textures and sensations involved in these activities. The same principles would apply to walking in park, cooking, and drinking a coffee. 

As a Psychologist, I often work with mum's who wish to improve their well being. I find this work rewarding because mother's tend to be very motivated to change. I am always touched that mum's come to see with the ultimate goal of working through their issues so they can be even better mothers. Now that's love!

If you would like to more about postnatal depression please visit PANDA.

Article written by Tena Davies, Psychologist. The aim of this article is to give you ideas on well being. Please note this article is not intended to replace therapy.

Tena Davies is Psychologist based in inner city Melbourne. Tena has expertise in psychological counselling with adolescents and adults. She also works as a cyber expert providing cyber safety education to schools and professionals. As a Psychologist, Tena believes in helping clients to gain insight into their difficulties and teaching them new skills to grow and thrive. Please see www.tenadavies.com for more information.

Guest post on Mental health and healthy eating by Dietitian, Melissa Adamski

Nutrition and Mental Health

Many of us know nutrition is an important factor when it comes to our physical health; it can play a role in our gut health, our heart health and many other areas. But what about our mental health? Can nutrition and diet help us to feel better? Could it potentially be used as part of a treatment plan for mental health conditions such as depression?

To help answer these questions we must first recognise that mental health conditions are very complex; they are complex in their treatment and complex in their development. Usually there will be multiple factors involved in both development and treatment, and so we must not think of nutrition and diet as being a ‘cure’ or single preventative factor when considering our mental health.

However, a good diet with emphasis on a number of key nutrients, may be able to provide support to individuals who have been diagnosed with a mental health condition, such as depression. If you are interested in using nutrition and diet to support improvement of symptoms, or as a preventative strategy, the first thing to consider is your overall diet – how does this stack up? We know that dietary patterns such as the Mediterranean diet can have significant benefits for health, including mental health. So instead of thinking about what single foods you can add into your diet, consider what your overall diet looks like over a whole week; are there improvements you can make? To help improve your overall diet, there are a few simple steps you can start with:

·         Reduce your red meat intake to 2-3 times for week and increase your fish consumption

·         Make sure you have at least 6 serves of vegetables per day

·         Include legumes in your meals at least 2-3 times a week

·         Include more healthy fats in the diet such as extra virgin olive oil and avocados

·         Have a handful of nuts at least once a day

Once you have started to improve your overall diet, you can start to think about specific nutrients and how they may benefit you. Folate, omega 3, zinc and vitamin D are a couple of nutrients associated with improved mental health and there may be benefit in tailoring your diet to focus on these.

What about supplements you ask? To understand whether a supplement is right for you there are a number of factors that come into play when looking to answer this question. Firstly, food has many other components (some known and some unknown), that are not present or able to be replicated in supplements, so in some instances there may be more benefits from foods. However, it all depends on your condition and what you are trying to improve- you may need to have nutrients at an amount not possible to achieve through foods alone and supplements may play a role and be beneficial.

Overall, nutrition and diet are very important to consider in both the management and prevention of mental health conditions. It is important to seek advice from an Accredited Practising Dietitian to understand how you can make changes to your diet that are specifically right for you. It is also important to involve your treating psychologist – a team approach can help ensure you are getting the most appropriate advice and best results.

Melissa Adamski is an Accredited Practising Dietitian (APD) and nutritionist; her private practice, Nutted Out Nutrition, provides appointments in Melbourne CBD and the eastern suburbs. Nutted Out Nutrition believes nutrition and diet are fundamental components of good health and work with clients to personalise nutrition recommendations to help ensure they are useful and achievable. More information can be obtained from www.nuttedoutnutrition.com.au  

Mindfulness and it's benefits

What is mindfulness?
What comes to mind when you think of mindfulness? Do you imagine a group of people sitting cross legged in silent solidarity while they try to clear their minds? It can be hard to imagine this type of meditation in the busyness of modern life. Fortunately, there are many types of meditation or mindfulness that can fit into a busy schedule.

Mindfulness is defined as the state of being fully engaged  and connected to what is happening in the present moment often in the immediate environment. Mindfulness is not thought stopping or clearing the mind but rather drawing attention to the present moment by attending to the five senses. This includes noticing the physical world (smells, sounds, sensations) and observing thoughts without judgement and then bringing attention gently back to the present moment. The aim is to acknowledge that the mind has wandered and then return one's attention to the present.

Who does it benefit?
Mindfulness can be beneficial for everyone but is beneficial for those experiencing common health conditions such as depression and anxiety because it helps an individual focus on the immediate environment instead of negative thoughts. Mindfulness can be a good antidote for rumination and thus reduces stress and worry. Over time, mindfulness training can teach the mind the skill of being present.

Is there evidence for mindfulness?

Yes, there is a significant amount of evidence that suggests that mindfulness can help reduce insomnia, stress, anxiety and worry. Recent research has even found it to be as effective as CBT for common conditions such as depression and anxiety.

What if I'm keen but short on time?
The benefits of mindfulness meditation can be achieved in just a few minutes a day. If you can fit in a cup of tea or surfing the web on your phone, then there might be room for 5-10 minutes of mindfulness a day.

What's the best way to start?
I find the best way to start mindfulness is by following a guided meditation program. There are several Apps on the market such as the headspace App, which charges users a fee. Free or low cost apps include the smiling mind, Calm or Buddhify. Alternatively, mindfulness can be searched for in the App Store or Google Play. I do not receive any incentive from these Apps and am recommending them based on client feedback.

Are there more active forms of mindfulness?
For those who prefer more active forms of meditation mindful colouring or talking a mindful walk may suit.

What is relaxation and how can it help?
While mindfulness aims to help the individual become alert and present in the moment, relaxation is aimed at changing a feeling state to that of feeling more calm. Both are valuable. An excellent relaxation technique is progressive muscle relaxation. Here's a free relaxation recording from Western Sydney University. For those who are interested in Yoga and deep relaxation the iRest Yoga Nidra program may be of interest.

Can mindfulness be built into day to day life?
Absolutely! Mindfulness practice can be brought into daily life by bringing your five senses to any experience. One of my favourite mindfulness activities is mindful hand washing or applying hand lotion.

Any activity can be turned into a mindfulness activity but it's easiest when there's rich sensory input such as walking in nature or showering. Mindful eating is also practical and involves noticing the smells, textures, temperatures and colours when savouring food.  The next time you engage in these activities try noticing the sounds, smells, textures, and colours that are present.

What is mindful eating and how can it help me?

Eating mindfully involves bringing the five sense to the experience of eating by noticing the sounds, textures, smells, and colours associated with eating food. This can also involve noticing our responses to food without giving into it. For example, noticing our respond to the smell of freshly baked bread without necessarily consuming this food.

Mindful eating can help an individual to slow down their food consumption and help them to tune into their bodily internal cues of hunger and satiety. It can also assist them to distinguish the difference between hunger and thirst, between eating out of hunger and eating for comfort or eating to relieve boredom. Research tells us that mindful eating can assist with over eating or binge eating.

How can I measure my progress?
Progress can certainly be estimated intuitively. However, biofeedback measures a person's neural activity or heart rate and gives a person feedback while they meditate so that an individual can adjust their approach. Muse is product that measures neural activity and provides audio feedback by stilling or increasing nature sounds. While an expensive option, it may help those that want to measure their progress. Again, I do not receive any benefit from noting this product.

In my practice, I often recommend mindfulness as an intervention to improve their well being. I find that those who engage in mindfulness report it improves their symptoms. It's also a great lifelong skill to increase resilience and be present.

Article written by Tena Davies, Psychologist. The aim of this article is to give you ideas on well being. Please note this article is not intended to replace therapy.

Tena Davies is Psychologist based in inner city Melbourne. Tena has expertise in psychological counselling with adolescents and adults. She also works as a cyber expert providing cyber safety education to schools and professionals. As a Psychologist, Tena believes in helping clients to gain insight into their difficulties and teaching them new skills to grow and thrive. Please see www.tenadavies.com for more information.

Night time technology use and sleep

Obtaining a good night's sleep is important for our mood, concentration and psychological well being. The use of technology at night time can interfere with both the amount that we sleep and the quality of our sleep. Sleep as you may know, is critical for our mental health.

Impact of bright screens on sleep

Viewing bright screens (e.g. from a phone, computer or tablet) at night can significantly impact feeling sleepy because viewing screens increases alertness and inhibits the secretion of Melatonin. Research tells us that viewing screens at night effects sleep, circadian patterns (sleep/wake cycle) and unsurprisingly, next morning alertness. Screens have a particular type of light that makes them bright and this light mimics the effects of sunlight on the brain. In other words, when we view a bright screen our brain thinks it's the morning sun and wakes itself up by inhibiting Melatonin. There is some evidence that viewing screens up to 5 hours before bed can impact our sleep quality where screens are viewed for 1.5 hours or more.

Technology use increases our mental alertness because we may also become absorbed in what we are doing and delay our bedtime. A meta analysis of studies with teenagers, found that using technology at night was related to later bedtimes because of the increase in alertness and failure to recognise sleep signals due to being engrossed in technology.

Not all forms of technology use are equally stimulating. Generally speaking, active forms of technology use (playing video games and texting) are more stimulating than passive ones (reading an e-book). Therefore, it's worth engaging in more passive forms of screen use (or none at all) prior to going to bed.

What to do about screen use

The first thing is to have 'no screen time' before bed for at least an hour. As well, a consistent bedtime routine to prepare the body and mind for sleep may be beneficial.

If you can't bear to be without screens there are few screen light reducing products that reduce the intensity of the concentrated blue light emitted by bright visual displays. The ones I recommend based on user feedback are: night shift which is a setting on iPhone/iPads and F.lux which is both an app for android phones and program for desktops. F.lux is free.

You can buy orange tinted glasses to further reduce out the concentrated blue light from bright visual displays. These glasses work by blocking out the concentrated blue light.

Avoiding night time temptation to view screens

The best way to avoid the temptation to respond to texts or looking something up on your phone is to have all devices charging in a separate room. Studies have also shown that young people who have screens in their bedroom get up to an hour's less sleep per night!

Article written by Tena Davies, Psychologist. The aim of this article is to give you ideas on well being. Please note this article is not intended to replace therapy.

Tena Davies is Psychologist based in inner city Melbourne. Tena has expertise in psychological counselling with adolescents and adults. She also works as a cyber expert providing cyber safety education to schools and professionals. As a Psychologist, Tena believes in helping clients to gain insight into their difficulties and teaching them new skills to grow and thrive. Please see www.tenadavies.com for more information.

Impact of alcohol and recreational drugs on mental health

Consuming alcohol and taking recreational drugs can have a significant impact on our mental health. Alcohol and drug consumption impacts a person by changing the balance of chemicals in the brain that helps us to think, feel and make decisions. As well, the use of alcohol and drugs can leave a person feeling agitated, flat and unmotivated. In my experience, those who report alcohol and drug use also report a decrease in healthy behaviours (exercise, achievement, healthy eating, good sleep) that protect mental health. The result being increased levels of depression and anxiety.

Depressants

Depressants such as alcohol, heroine and inhalants can lower your mood. Over time depressants also lowers the serotonin (the feel good chemical) secreted in the brain that helps you regulate your mood. Regular drinking can make anxiety and depression worse due to upsetting the balance of neuro chemicals and the decrease in seratonin. Depressants such as alcohol can also decrease the quality of a person's sleep despite it making them feel sleepy. This is because it interferes with the sleep cycle.

Stimulants
Stimulants such as methamphetamines and ecstasy can in the short term increase a person's drive and motivation. However, they may leave an individual feeling flat and agitated increasing their negative psychological symptoms. Over time, stimulants can exacerbate depression, anxiety, memory and concentration.


What to do instead
Instead of consuming alcohol and/or recreational drugs use other strategies to manage stress. These can include exercise, learning relaxation and mindfulness, developing more effective problem solving skills, and learning skills to manage rumination. If you are using alcohol and drugs to mask worries try to work through these with someone you trust. If that hasn't worked seek advice from a registered Psychologist.

In my practice
As a Psychologist, I assess self care and lifestyle factors such as alcohol/drug consumption to determine if these factors are exacerbating a person's mental health. Where this is the case I work with the individual to develop alternative coping strategies. That being said, I do not treat addictive disorders where this is the primary cause of a person's distress. In this instance,  I refer to drug and alcohol programs.

Article written by Tena Davies, Psychologist. The aim of this article is to give you ideas on well being. Please note this article is not intended to replace therapy.

Tena Davies is Psychologist based in inner city Melbourne. Tena has expertise in psychological counselling with adolescents and adults. She also works as a cyber expert providing cyber safety education to schools and professionals. As a Psychologist, Tena believes in helping clients to gain insight into their difficulties and teaching them new skills to grow and thrive. Please see www.tenadavies.com for more information.