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I'M SO SORRY, BUT... WHAT IF THEY WON'T GET HELP? REPONSIBLE RECOVERY ARE YOU EATING FOR DEPRESSION?
WHAT IF THEY WON’T GET HELP?
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One of the greatest challenges of assisting another person who might be experiencing a mental health problem, is how we respond in the cases where the person doesn’t want to get help. In our programs we teach staff at all levels of the organisation how to identify the warning signs that a colleague may be experiencing mental distress, and how to respond appropriately to have a conversation with the person and point them in the right direction for further, professional help. Participants are often relieved to have a clear cut process of steps to follow so they know they are doing (and saying) the right thing. The challenge when it comes to being a first responder though, is the question – what if the person doesn’t want to get help?
Author: Emi Golding
We can do all the right things, follow the steps, but ultimately, the decision to get help (or indeed follow the advice provided by the professionals) is up to the person themselves. And so it should be. It is that person’s life after all.
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But where does that leave us as a first responder? How do we handle these situations? In our training we go through the ways you can encourage the person to get help, and how to help overcome obstacles, but the fact remains that the person simply may not be ready to take that next step.
WORKLIFE | FEBRUARY 2019
And this is where we need to be able to manage ourselves, and our own emotional wellbeing. This is arguably the single greatest skill that a first responder or a helper can have – the ability to offer appropriate support and assistance, without taking over responsibility for the result. It is never easy, especially if we really care about the person, and we want to see them get better. Or on the other hand if we are seriously concerned about the risks of them not getting help. I want to make a proviso here – the following does not apply in the case where there is a serious risk to the physical safety of the person themselves, or anyone associated. If there is a risk of suicide, or that someone may be permanently injured, then we may need to get help for the person even if they don’t want it. But in most scenarios that won’t be the case. A term that has been used to describe the ideal state for a helper to be in is ‘compassionate detachment’. This refers to a state where you can feel and demonstrate compassion for the person, but you are detached from the expectation of any particular result for them. Let me repeat that – you’re not attached to the result. When we give advice, support or assistance, it is useful to ask ourselves
‘what is really behind my actions in this scenario?’ ‘Do I have an expectation here?’ ‘Am I truly giving altruistically, or do I have an agenda?’ Even if that agenda is seemingly good - that we want to see the person get better - it’s still an expectation that attaches our own sense of satisfaction or wellbeing, with the outcome from the situation. An outcome which, is determined not by you, but by the person who you’re helping. Ultimately, other people’s actions are outside of our control. So by having an expectation that they ‘should’ do something or ‘should’ get a certain result, you’re putting yourself in a situation where you don’t’ actually have any say over the matter. What if you could give (advice, support, assistance) without any expectations? Without expecting the person to follow through and heed our advice,
and without expecting them to appreciate it or say ‘thank you’? That is really respecting the person’s capacity and strengths, their right to self determination, and their personal power. And that is how you also ensure your own sense of wellbeing, knowing that you’ve done what you can, and the rest is up to them. So what do you do when the person won’t help themselves? You remind yourself that it is their life, and their choice. And it doesn’t reflect on you. Its not about you. It’s easier said than done, but when you can do this effectively, you’ll find that not only are you ensuring your own wellbeing, but you’re also allowing that person to take ownership and responsibility for their own wellbeing, their own life. WORKLIFE | FEBRUARY 2019
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5 reasons why we don’t take responsibility
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Often discussed in terms of addiction, but relevant to most mental health challenges, responsibility is a central tenant for recovery. A 2012 survey of people who have recovered from mental health problems and addiction has highlighted the very important role that personal responsibility plays in recovery, being identified as one of five key influences in the recovery process. Despite this, there continues to be a disproportionate reliance on external support, and a reluctance to think of and talk about mental health challenges in personal recovery terms. Let’s look at some of the reasons this may be.
We mistake comfort for recovery Numbing the raw emotional edge, or physical pain, doesn’t equate to recovery. The burden for recovery is often placed in medication. Whilst it may be a necessary intervention in the acute phase, morphine doesn’t heal a broken bone, it just masks the discomfort whilst the body does the healing. The same can be applied to many
of the common mental health conditions.
We often confuse responsibility with blame, or fault. When we hear the word “responsible”, we have a tendency to interpret it as ‘fault’ or ‘blame’. Responsibility has nothing to do with blame, or the past. Response-ability has everything to do with what happens now. What is your ‘response’? What is your ‘ability’ to ‘respond’ to these circumstances?
We equate responsibility with less freedom The concept of responsibility carries a weight with it for many people, akin to ‘burden’ or ‘obligation’. Like no longer having the freedom to party with friends during the
week because you’ve got ‘responsibilities’. It is hard work to rewrite conditioned thoughts and behaviour. There is another burden though, one that is felt acutely in every episode of depression or anxiety or withdrawal. The feeling that someone achieves when they take on the responsibility of their recovery is far more rewarding than the avoidance they had been mistaking as freedom.
Recovery is mistaken as Return In The Wizard of Oz, it was Dorothy who had the power to return to her home from the moment she arrived in Oz, not Glinda the Good Witch, and not the snake-oil selling Wizard. According to Glinda, she needed to experience growth in herself before she could leave Oz. The process of recovery is sometimes misconstrued as ‘things returning to the way they were’. It’s rare that this is likely, or helpful in the concept of recovery. Personal responsibility in recovery leads to shifts in thinking style, paradigms and identity, that can lead a new and better ‘normal’, with new coping mechanisms to deal with future challenges. WORKLIFE | JANUARY 2019
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THE PROBLEM WITH SELF CARE
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A pernicious wind is blowing through western mental health. It’s the idea that we are fragile and that we should be kinder with ourselves. Let me explain. Most of my patients in practice are not there because they’ve been too tough with themselves, if anything they’ve been far too kind and accommodating in one specific area: self care, or the lack thereof. And it’s a trend on the increase, that promises to hurt millions of people.
Low Challenge + Low Support = Boring You don’t have any real challenges or demands placed on you, work is easy, and your pretty much left to your own devices to do it. You don’t have any nurturing or supportive people or activities. You’re just existing. This is boring.
High Challenge + High Support = High Performance You are learning new things regularly, you are stretched to reach further, and achieve even better results. At the same time, you have good solid support structures in place to help you get there. This is the zone of high performance. This is where you want to be.
Let’s explore this through an interesting leadership lens. Stay with me, you’ll see the relevance soon. This model of leadership explains that there needs to be a balance between ‘supporting’ staff, and ‘challenging staff’, which havs principles that transfer over to self care. Why am I talking to you about leadership in self care? Because, in order to do self care properly, you have to be your own leader. No one else can do it for you. Think of the following four situations:
High Challenge + Low Support = Stress You are faced with high demands, new things to learn, complex problems to solve, but you are not given much emotional or practical support to meet those demands. That can be stressful.
Low Challenge + High Support = Status Quo You don’t have a lot of demands placed on you, in fact you don’t have enough things to do, or it’s just very repetitive, easy work, and you have a lot of emotional and practical support around you, which is nice, but you don’t need it. This maintains the status quo. It may feel good in the moment, but doesn’t help you grow and achieve long term.
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Like it or not, you are a leader. When it comes to self care, you are leading yourself. If you want to be confident, happy, grow, have the edge, then you’re going to need to challenge yourself, to push through those times when you may not feel motivated, experience discomfort or even pain, and do the things that scare you. Of course, to do that, you need to make sure you are also providing yourself the support and nurture you need. Like a high performance athlete, you need a strong work ethic AND you need the best nutrition, medical team, recovery time. It’s about getting the balance right for you. For most people, they need to up the ante. They are being too soft. What about you?
Is your diet making you
depressed?
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s the modern diet of processed, preserved, emulsified and artificially sweetened food-like products making us a more depressed nation? Researchers are sharing evidence that the answer is YES. According to the Food and Mood Centre of Deakin University, many common mental health disorders, including major depression, bipolar disorder, schizophrenia, anxiety disorders, autism, obsessive compulsive disorder, and attention deficit hyperactivity disorder (ADHD) are associated with nutrient deficiencies. Essential vitamins, minerals, and omega-3 fatty acids are often deficient in the general population, and are remarkably deficient in patients suffering from mental disorders. These deficient diets are related to sub-optimal functions in both the brain and the gut. The brain is
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responsible for dosing our central nervous system with certain neurotransmitters that affect mood and sleep, whilst our gut is the manufacturing site that produces a large portion of those neurotransmitters (particularly serotonin). Poor diets have an impact on both the production and the distribution of these neurotransmitters.
Can eating a nutrient rich diet make you happier? Studies have suggested that specific diets, as well as supplementation of vital nutrients and amino acids, can help support mood and effectively reduce symptoms of mental health disorders, however there is yet to be convincing evidence that a good diet is likely to boost happiness above a ‘normal’ baseline beyond the effects of a short-term dopamine release. According to Dr Gary Wenk, a Neuroscience Researcher and Professor at Ohio State University, and author of Your Brain on Food, tryptophan is a substance found in most protein-based food and is the precursor to the neurotransmitters associated with mood and sleep (serotonin and melatonin). Wenk advises that simply consuming more tryptophan (and producing more serotonin) does not guarantee that the
brain’s neurons will release it. If too much serotonin is produced, then the excess is simply discarded. However, if you eat less tryptophan, your brain generally produces less serotonin, resulting in a negative impact on mood and sleep. Whilst we have all experienced the short-term boost to mood that can be achieved through foods such as high energy carbohydrates, or dark chocolate, this is not sufficient to improve mood long-term. In fact, a poor diet may even suppress this response in the brain. A study published in the journal Neuropsychopharmacology (2014) investigated whether it was possible to deplete the brain’s reward chemical, Dopamine, in humans by restricting access to the amino acid Tyrosine, also found in plant and animal based proteins. Within a few hours the subjects showed a blunted dopamine reaction to rewards known to stimulate this response, and their overall mood was also slightly depressed.
Can a nutrient-rich diet help to prevent mental illness? Julia J Rucklidge, PhD is a Professor of Clinical Psychology in the Department of Psychology at the University of Canterbury, Christchurch, New Zealand. According to Rucklidge, multiple studies from around the world demonstrate that those who eat a prudent, Mediterranean style diet have a lower likelihood of depression, whilst populations who have a diet high in processed foods have a higher risk of depression. Only one study in the metaanalysis failed to support these findings, but none indicated that the typical Western diet (defined as heavily processed, high in refined grains, sugary drinks, and low in fresh
produce) was effective at promoting positive mental health.
Can high doses of micro-nutrients support recovery from mental illness? This is an emerging area of research, and to date the results are looking optimistic for the use of high dose micro-nutrients as a complementary means of supporting the recovery process. Rucklidge has reported clinical trials with micro-nutrients that have shown significant improvement in the recovery figures for ADHD, mood disorders and Post-Traumatic Stress Disorder. Professor Rucklidge advises that a high-dose of micro-nutrients was administered in the studies, and that most multi-vitamins available at pharmacies and chemists do not contain the tested dose.
Too expensive to eat well? Many have complained that healthy food is too expensive – from the perspective of money and time. Michael Pollen, author of The Omnivore’s Dilemma, warns against the myth of ‘cheap’ food, claiming that what is saved at the checkout is paid later in physical or mental health issues. Worklife | August 2018
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apologise to each other, and we discovered that there were five basic apologies. “What one person considers to be an apology is not what another person considers to be an apology, so people are really missing each other even though they are trying to apologise.” Do you recognise your own apology language from the following five that were identified?
’ so “Im
Accept Responsibility I was wrong, I should not have done that.
” … t u B , y r or S
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How to apologise so your colleague can forgive you
Author: Alison Skate
ave you ever received an apology that just didn’t feel like an apology? The word ‘sorry’ was used in a sentence, but it didn’t meet your apology needs. Perhaps this left you feeling frustrated, with lingering disappointment, or perhaps feeling even more annoyed after the apology was delivered than beforehand. Perhaps you have been the person offering an apology, a sincere one in your mind; regardless, your colleague remained unforgiving and held a grudge.
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For many individuals, all
Dr Jennifer Thomas and Gary Chapman, Baptist Pastor and author of The 5 Love Languages, researched the ways in which people offer apologies, and how they like to have an apology offered to them. Their research resulted in the publication of their book The 5 Apology Languages. Chapman explains why apologies so often miss their mark. “For two years we researched the topic to find out how people typically
they want is to hear the words, “I was wrong.” If the apology neglects accepting responsibility for their actions, many will not feel as though the apology was meaningful and sincere. We are going to make poor decisions that hurt our mates, and we are going to have to admit that we were wrong. For someone who speaks this apology language, if an apology does not admit fault, it is not worth hearing. Chapmans says, “Don’t ever use those two words [I’m sorry] alone.
Tell them what you’re sorry for.”
asking what they would need you to do or say to make things right.
Expressing Regret
attempt to deflect blame and is understood as a sincere commitment to repair and rebuild the relationship.
Genuinely Repent
I’m really sorry, I feel really badly about that.
Make Restitution
I don’t want to do this again, I’ll do things differently in the future.
Chapman explains that expressing regret zeroes in on emotional hurt. It is an admission of guilt and shame for causing pain to another person. For those who listen for “Expressing Regret” apologies, there is no need for explanation or “pay back,” provided the apology is truly sincere. It doesn’t make excuses or
What can I do to make this up to you? For someone whose primary apology language is making restitutions, no matter how often you say “I’m sorry”, or “I was wrong”, they will never find the apology sincere. You must show strong efforts for making amends. Finding the right way to make this restitution often involves
For some individuals, repentance is the convincing factor in an apology. People with this apology language will doubt the sincerity of an apology if it is not accompanied by their partner’s desire to modify their behaviour to avoid the situation in the future. One important aspect of genuinely repenting is verbalizing your desire to change. Your colleague cannot read your mind. It is important to remember that change is hard. A person must first set goals for their change. After you create realistic goals, then you can start implementing a plan to change.
Request Forgiveness Will you forgive me?
When the apology is offered like this
The interpretation is this
“I’m sorry you’ve decided to feel offended by what I said.”
Not my fault, your choice.
“I’m sorry I didn’t get it finished on time, but I told you I couldn’t access my document.”
Not my fault, you knew about the problem and did nothing to help.
“I’m sorry if I did anything to upset you”.
I’m not acknowledging my specific behaviour; I may not even be aware of what I did.
“I said I’m sorry, but it’s not going to change anything now, is it?”
I’m not going to address this behaviour now or in the future.
Some people want to hear their colleague physically ask for forgiveness. It shows that you realize you’ve done something wrong. Requesting forgiveness is not easy. It often leaves one vulnerable to the fear of rejection. Requesting forgiveness assures your mate that you want to see the relationship fully restored. Requesting forgiveness is not easy. It often leaves one vulnerable to the fear of rejection, demonstrating that you are willing to put the future of the relationship in the hands of the offended individual. These explanations are excerpts from a report on the author’s 5 Apology Languages. You may have more than one primary apology language, in which case an apology would mean more if all of those elements were incorporated in an apology to you. You can take the test for yourself at 5lovelanguages.com We suggest encouraging your whole team to learn and share their apology languages. Worklife | August 2018
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MAP YOUR DAY FOR RESULTS
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Success is a habit that is established through the daily practice of achieving goals. When setting goals there are a few key questions to consider: • What is motivating the achievement of this goal? • How will I know when I’ve achieved this goal? • What are the actions I need to take in order to attain success in this goal? A MAP for your goals needs to include two elements - a Mission, and the Action Plan.
Mission
The mission is a description of the endstate you want to have achieved by the end of the day - it is the evidence procedure. It is a good idea to include a statement in your mission about what you will be able to focus on once this goal has been achieved. An example of a mission is: My mission, by 5:00pm on Monday, 25th of February, is to have submitted costings of the graduate recruitment program to the CFO, in order to focus on the EVP phase on the 26th. I’ll know I’ve achieved this mission when I’m
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looking at the Sent Items folder in Outlook, and I can see the email with costing attachment that I sent earlier. Including the next focus in your mission ensures that you remain towards motivated, or focussed on what you want to achieve, rather than the consequences you are trying to avoid.
Action Plan The action plan involves all the tasks that need to be completed in order to achieve this mission. Prioritise each task in order of importance to the mission, and then allocate a specific amount of time needed to complete each action. If you need to enrol the help of other people in an action ensure they are aware of the time frames. If there is a task on your action plan that you know you don’t want to, ensure that it is given a high priority so it doesn’t fall to the end of your list of actions. When you need to do something you don’t want to do there is a tendency for tasks listed higher on your action plan to take longer than necessary. Don’t let self-sabotage spoil your mission! Get that task out of the way as early as practical so that you can focus on completing all of the other actions in your plan on time. Set a maximum of three daily goals – the ones that will have the greatest impact on productivity. All other goals are likely low priority and can be delegated or reconsidered.