Why won’t she* just eat – A look into the brain of someone with Anorexia Nervosa

Why won’t she* just eat – A look into the brain of someone with Anorexia Nervosa

It would be a very frightening feeling to watch someone you care about fading away in front of you and very frustrating when they often refuse to do the one thing that you know they need to do.  It is hard to understand the mindset of someone with anorexia nervosa.  Why won’t they just eat? 

7 ways to help your child with separation anxiety

Does your child ever get anxious or upset when you need to leave them? Check out these tips.

*Please note: this blog contains affiliate links. If you choose to purchase via these links, a small proportion of the profit will be returned to Healthy Mind Centre Launceston to help fund ongoing services and supports.

As I dropped my kids at their preschool the other day, there was a new child in the class who was visibly upset. He was screaming and crying as the teacher helped untangle his fingers from his mother’s coat, as she walked head-down toward the door to leave. I think tears were in everyone’s eyes. It’s incredibly difficult, for the mum who is already late to work and has a classroom full of curious and sympathetic eyes watching as she struggles to walk away from her pleading child, for the teacher who is trying to support the child whilst managing 20 other “Good Mornings”, and most of all for the child, who’s brain is in full fight or flight mode and everything in their body is screaming “No, no, please don’t leave me, I don’t feel safe or OK right now”.

You might know by now that at HMC, we truly believe in a proactive, rather than a reactive approach when managing children’s behaviour. When we (and our kids) feel like we have a plan, we understand our plan, and we know what our job is and what comes after that, we feel much calmer and our confidence is higher. Now, this doesn’t mean we don’t have our off days, of course we do! Additionally, our children are humans, not robots, and they have their own moods and perceptions that can vary things unexpectedly. But in general, if we all feel proactive, it’s a lot easier to deal with challenges because we feel safe and we can predict what comes next. So,here are some tips for managing separation anxiety in situations like school drop-offs.

  1. Create and rehearse your goodbye strategy, at home where everyone feels safe and comfortable. Have your child be part of creating this strategy. Make it short and simple, and practice practice practice. Your child should be bored silly of it by the time you are done.

  2. Do a practice run, on the weekend if you can, or in the school holidays when no one else is around. Do as many practice runs as you and your child need to, again, until you are both bored by it. Make sure your practice run follows your goodbye strategy in point 1.

  3. Be educated about separation anxiety. Know what is happening so you are informed. Know how parents can accidentally reinforce anxiety in their children, and how to avoid doing this. A great resource for you is this book.

  4. Have a transitional object. This might be a comforting teddy, an item of yours, or something special you have created together. Or it could be something imaginary, like this. Use this in your routine and when you are practicing.

  5. Be aware of you own reactions. Model that you believe it’s a safe place for your child to go. Show excitement for them to experience it.

  6. Validate their feelings. Their experience is akin to you freaking out because you’ve been left alone by your loved one, in a strange city with an unfamiliar job to do. It’s tough, and they will be helped by some empathetic reflections by you, such as “Yeah, I can see it’s really tough for you when I go to leave, you get really worried”.

  7. On D-day, model a positive goodbye. If you child sees you are anxious about leaving them, it can make their fear worse. Be comfortable with the idea that school is a safe place, and let them know you truly believe that.

Hopefully these tips are helpful. They can of course be modified to suit any situation where you need to leave your child without their secure caregiver. We’d love to know if they made things a little easier with you and your little one. Remember that if difficulties persist and you and your child need a little (or a lot) more support, seeking help from a qualified mental health practitioner is probably a good idea.

Olivia Boer is a Clinical Psychologist and the Director of Healthy Mind Centre Launceston, a group allied health practice in Launceston, Tasmania.

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GROWTH MINDSET 💪

Have you heard of it? Perhaps you have seen it on a poster in your kid's classroom, or seen a blog or motivational post on Facebook or Instagram. It's a fairly big idea in popular psychology at the moment, based on Carol Dweck's book "Mindset".

In a nutshell, a Growth Mindset refers to the idea that our abilities and knowledge can be developed. We can get smarter, do better, and achieve greater through putting in time and effort. This is in contrast to a Stuck Mindset, which refers to the idea that abilities and understandings are relatively fixed; aka, you either have it or you don't.

Why is this so important in parenting? Well, for starters, if we have a growth mindset we have more confidence to try again when we fail at something, we change direction when we realise we were stuck, and we ask for help when we need it. A growth mindset is more than thinking positive thoughts, or even having flexible thoughts. It's also more than just praising and rewarding effort, and it's definitely not enough by itself - even the strongest growth mindset needs to be backed up by taking action.

So what does a growth mindset look like in parents? 
👉Thinking about the underlying cause of a parenting challenge, finding a new way, and applying that new way next time
👉Considering parenting difficulties as an opportunity to grow, rather than admitting defeat or concluding that it's just not your cup of tea
👉Adopting a curious attitude toward parenting and embracing opportunities to learn
👉Creating a belief in yourself, in your own parenting skills and abilities, and your capacity to change 
👉Rewarding your parenting actions rather than your parenting traits 
👉Being ok with being vulnerable and taking feedback, then committing to growth and taking pride in all your hard work and effort.

I challenge you to notice your stuck parenting thoughts and flip them into a growth thought (and then take action on this!).

How do you feel about your parenting from this point onward, once this happens?

Olivia Boer is a Clinical Psychologist and Director of Healthy Mind Centre Launceston, a private allied health practice in Launceston, Tasmania. 

Photo by Markus Spiske on Unsplash.

Photo by Markus Spiske on Unsplash.

Kick self-doubt in the balls really hard and keep going!

We all struggle with self-doubt from time to time. Our Accredited Mental Health Social Worker Sam has put together 5 tips for tackling self-doubt head on.

When I started to write this article, I felt immediate self-doubt about its title. Was it too aggressive? Was it too inappropriate? Is this what a professional mental health professional should say? Will people judge me for it? Will it cause offence? I began to worry, over analyse, feel anxious and stress about it. I was listening to self-doubt creep around and whisper bitterness to me.

And then I thought, no! Self-doubt sucks and deserves to be kicked in the balls!

Self-doubt is that little voice that sits in the back of your mind and makes you wonder about all the awful things about yourself. It comes quietly in the night when you’re trying to sleep. It pops up when you’re about to meet up with a friend. It shoots you down when you have a brilliant idea. It makes you question your abilities when aiming for an important achievement. It strangles you after browsing social media. In short, self-doubt does all it can to hold you back.

Worst of all self-doubt knows you really, really well. It knows your insecurities and it knows exactly how to hurt you.

Sure, self-doubt might help us at some points. Such as waking us up to our limitations. It might wisely suggest that I can’t jump that gap on my bike like I used to.  Or it might suggest appropriately, that no I can’t pull off that fashion statement as I once did.

But besides some of the friendly wake up calls, self-doubt is really no friend to us.

Self-doubt eats away at us. And if we are not careful self-doubt will take a big chunk out of our self-esteem. The confidence we once had to walk into a room smiling, feeling comfortable, and self-assured, can be destroyed. It leaves us nervous, quiet, scared and unsure of ourselves.

So how do we kick self-doubt in the balls?

Challenge the doubt: The doubt that sneaks in, challenge it and ask yourself whether it is based on realistic facts or is it shrouded in untruths? If you discover it to not be true, don’t listen to it.

Remind yourself: Remind yourself of all the times you have overcome hardships or tackled tough obstacles. Remind yourself that you have had the strength and abilities to do those things in the past. There is no reason why you don’t have those strengths and abilities now.

Avoid comparisons: Don’t compare yourself to other peoples’ success. Don’t be sucked in by other peoples’ Instagram photos or the awesome lives people post about on social media. It’s not about them, it’s about you. Look at where you have come from, look at your achievements, look at where you are going. That’s all that matters.

Stop it: Be bold and stand up to those self-doubting thoughts. They don’t have control, you do. Tell them ‘stop it! You are not helping me! I am in control!’

Confidence: Even if we are a super confident person, at times we will have these self-doubts. That’s okay, it means you’re human. But you can choose to listen to them and not strive ahead, or you can choose to kick that self-doubt in the balls and keep going.

Sam Shand is an Accredited Mental Health Social Worker at Healthy Mind Centre Launceston, a private allied health practice in Launceston, Tasmania. 

Top 5 calm down strategies for kids, according to a psychologist.

Do you ever struggle with strategies to get your kids to regulate their emotions or behaviour? Try out these ideas, and be sure to let us know how you go.

1. Slow, deep breathing.

Asking a child to do slow breaths can be “boring”. Tell your child to do some “cake breathing” - breathe in like they are smelling a freshly-baked birthday cake, then once they have a lungful of air, tell them to breathe out like they are blowing out birthday candles. Older children can breathe in like they are smelling some other preferred scent (chocolate chip cookies just out the oven, anyone?), and breathe out like they are blowing on a spoonful of hot soup.

2. Movement.

Getting active is one of the best ways of shaking off distress. Younger kids love a spontaneous dance party to a catchy song, and older kids can often be redirected into chucking a ball around or having a jump on the trampoline. Bonus points if parents get involved in this one too!

3. Sensory input.

Whilst we don’t recommend using food as a strategy to manage emotions, tasting something with a strong taste is a great strategy for redirecting attention. Other sensory strategies can include touching something squishy or slimy, or pausing and noticing different sounds you can hear inside and outside over a 30 second period.

4. Kindness and compassion.

Doing something special for someone else is a great way to get out of a negative mood and feel good again. Younger kids love making a card or present for someone, and older children can help prepare a meal or self-care activity for an important person.

5. Time in.

Whilst distraction and redirection are great, nothing beats a cuddle and some reflection about and validation of your feelings, no matter what your age is! Take some time to sit with your child and reflect what emotions you see them feeling, and let them know all feelings are ok and you are right there with them.

Olivia Boer is a Clinical Psychologist and Director of Healthy Mind Centre Launceston, a private allied health practice in Launceston, Tasmania. 

What to expect when you are referred to a psychologist

You take the morning off work and head to your GP, with the plan on telling then you have been struggling with feeling stressed, not sleeping well, or feeling low or flat. Perhaps you are often feeling angry, or beginning to feel like you don’t want to live like this anymore. When you see your GP, they ask you some questions and assess how things are going. You fill out a short questionnaire about how you have been feeling, and then your GP says it…

I would like to refer you to a psychologist.

Your GP completes some paperwork, generally including a Mental Health Treatment Plan and a referral to the psychologist (or Mental Health Social Worker/Occupational Therapist), and tell you to contact the psychologist to make an appointment. Alternately the psychologist may contact you when they receive the referral.

You will usually organise an initial appointment on the phone, and the psychologist or their receptionist will let you know if you need to complete any paperwork and should let you know any terms, such as the clinician’s details, cancellation notice periods, session fees and rebate information. You can request a copy of all this information in writing. You may need to wait a while for an appointment, depending on the clinician’s wait list time. You can often request an earlier appointment if it comes up sooner, and you can make yourself available at short notice.

Then your first appointment comes around

Try to arrive 10-15 minutes early to complete any paperwork, and allow yourself to catch your breath and get comfortable in the surroundings. You might want to jot down any concerns you have if you are worried you might forget them. Your clinician will come and greet you, and you will go with them to their consult room. The initial appointment is often mostly for gathering information about your difficulties and any relevant history, as well as completing some basic assessments and creating a treatment plan. Your clinician will usually share this information with you at the end of the first appointment, including their recommendations about what happens next. Once the appointment is over, you pay for the session (or sign a bulk bill form if it’s a bulk-billing clinician - we don’t offer this at HMC) and book in future appointments. Often future appointments are fortnightly, but sometimes they are a little more frequent or spaced out further.

Congratulations!

It's now time to give yourself a little bit of space to process that you have done it! You have commenced treatment and taken the first step toward optimising your life. Now you have a safe person in your team, that will help you work toward becoming the best version of yourself.

Olivia Boer is a Clinical Psychologist and Director of Healthy Mind Centre Launceston, a private allied health practice in Launceston, Tasmania. 

Tips for ending therapy successfully

By Catherine Bishop.

I think we often focus on how to start therapy successfully and how to know if it is working but we can forget that ending therapy well is just as important. Here are some quick tips for ending therapy well:

1)      Start with spacing sessions out

Talk with your therapist about increasing the amount of time between appointments.  If you have been seeing your therapist fortnightly consider spacing sessions to monthly and then maybe to every second month.  This is a good way to allow time to strengthen the skills that you have already learnt in therapy and to see if there are any other skills that you may be missing.  Spacing sessions out is a good way for you to see how you will manage when you are no longer seeing your therapist and if there are any other challenges that you had not spoken about yet. 

2)      Don’t end therapy as soon as you start feeling better

A lot of people make this mistake of cancelling all their appointments as soon as they start to feel good. I find that many people that do this will then quickly return to therapy when things start to slip again.  It is great that you are starting to feel better but it is important to remember that this is a really good time to get more practice in the skills you have been learning in a supported way.  It is often easier to practice the skills when your emotions are not as overwhelming as when you first came in. It also means you have the opportunity to plan ahead for future challenges (see the next tip).  It is often forgotten that therapy is not just for people who are struggling with their mental health - sometimes when you are feeling well this can also offer a chance to explore other opportunities for personal growth and living a more meaningful and fulfilling life as you are no longer so consumed with big emotions. 

3)      Have a staying on track plan

Make a staying on track (or relapse prevention) plan with your therapist.  This should include strategies and skills that you have for coping; difficult situations that may come up in the future and how you are going to handle them; warning signs that things are starting to go downhill (so you can catch it early and use your strategies to get back on track); signs that you need some extra support again; and ways to get extra support (this may be from friends, family members, a partner, or professional supports such as your therapist).  Having a written plan is really useful for you to be able to go back to if you are stuck.  Hopefully you don’t need it but it’s better to have it in case you do – it’s kind of like taking your first aid kit on a bush walk – you don’t take it with the intention of getting bitten by a snake but it’s there if you need it.     

4)      Keep practising your strategies after therapy ends

Keep any handouts and your staying on track plan in a safe place and review these regularly.  Practice the skills you have learnt so you don’t get rusty and can easily use them when you need them.  Otherwise it can be very easy to forget.  The first question I ask people if they return to therapy is if they have been using their strategies!         

5)     Remember that you can always come back

The door won’t lock behind you.  Sometimes life challenges can bring up old problems again and you may need some support in refreshing your skills or learning some new ones.  Sometimes people just need a few extra sessions as a top up, kind of like your booster shot when you have a vaccination.  Often it is easier the next time as you already know how it works!    

Catherine Bishop is a psychologist and clinical psychology registrar at Healthy Mind Centre Launceston.

The Importance of Positive Attention

Most parents who are dealing with behaviour problems in their children notice that things are starting to get a bit negative around their home. More negative than positive. It starts to seem like much of the time, their interactions with their kids include some kind of asking them to do something (for the 100th time!), threatening consequences, or venting that no-one helps around here. From the kid’s perspective, their parents are always on their back or nagging about something. An excellent recipe for irritable households where no-one is enjoying anyone’s company much.

This happens even when the kids aren’t displaying serious behaviour problems.

For example, Mum and/or Dad are stressed because of XYZ and are feeling a little tired and irritable anyway, or maybe they are running late to school drop-off. And the kids just won’t get ready/make their bed/find their shoes, no matter how many times they ask or threaten to dock pocket money. Sound familiar?

The things is, when things are negative for a while, kids (and adults) can start to tune out and stop paying attention to what is being said. What is the point? They just get yelled at anyway and most interactions leave everyone feeling cranky. Why would anyone be tuned into that kind of relationship?

I want you to stop and think about a negative relationship that you have had with an important person in your life, or someone who was in an authority position. Perhaps an awful ex-boss or your cranky old maths teacher. What is it that defined that person? What were their attributes? How did these attributes affect your relationship with them? How motivated were you to work for them, going the extra mile to do your best? Hint: probably not very much.

Now, think about a really positive relationship you have had, an excellent supervisor or that awesome teacher you had in Grade 9. What was it about them that made them awesome? What were their personal attributes? How hard did you try to work your best for them? If you are like most people, you probably tried a whole lot more.

The key difference between these two people is the degree of positive attention they provided.

When your child is feeling irritable from all the negativity in the house, what kind of boss do they see you as? The bad boss! So, how motivated are they going to be to work hard and go the extra mile for you?

Increasing the level of positive attention you pay your child will help to change that uneven balance of negative to positive interactions and help both the household, and the parent-child relationship to become a bit happier. This can be done in a variety of ways. Tune into our next blog post for some tips and tricks! (You can do this easily by following our facebook page or subscribing to our email list).

Olivia Boer is a Clinical Psychologist and Director of Healthy Mind Centre Launceston, a private allied health practice in Launceston, Tasmania. 

The ABCs of behaviour

Aay, bee, cee, dee, eee, eff... sorry, got a little off track there. Lots of ABCs going on both at home and at HMC Launceston these days. Which brings me to todays blog topic: What are the ABCs of behaviour. 

A is for Antecedents

Or Anticipating a behaviour, depending on who you talk to. For both options, it means what is happening immediately before a behaviour occurs. It can be something happening in the individual's environment, or it can be an internal event such as an individual's thought or feeling. 

B is for behaviour

This one is pretty obvious; it's the actual behaviour that occurs. Remember, behaviours can also be what we want to see occurring, not just a "problem behaviour" that we want to reduce in frequency (how often it happens), intensity (how big/strong it gets), or duration (how long the behaviour goes for).

C is for consequences

Understanding the consequences of a behaviour, or what happens immediately after a behaviour occurs, is almost as important as understanding the behaviour itself. This is because consequences are VERY important in determining whether a behaviour is more or less likely to occur again the next time the individual is in a similar situation. 

Why do we care about understanding behaviour?

Our actions can have significant implications for our social, emotional, and educational/occupational functioning. Being able to understand why a particular behaviour is occurring what what can be done to increase or decrease the likelihood of that behaviour occurring can make our lives, and the lives of those around us far more pleasant, happy, and less stressful. 

Putting it all together

Think about the following example: Jimmy, aged 4 and his Mum are at the supermarket. Jimmy doesn't want to stay next to the shopping trolley (even for some Coles Mini's at the end) and runs off to the other end of the supermarket isle (the Behaviour). What happened immediately before (Jimmy seeing a big long expanse of space to run in) and immediately after (Jimmy's Mum running after him yelling for him to come back, which is quite exciting for Jimmy whilst she chases him around the supermarket) can make Jimmy more likely to do the same thing next time him and his mum go shopping. By changing the antecedents (for example, Jimmy's mum clearly establishing rules, what will happen if he breaks the rules, and giving him his own shopping list to follow) and the consequences (for example, Jimmy's Mum requiring him to hold her hand throughout the rest of the shopping trip), we can expect that Jimmy's behaviour to be closer to what his mum would like, next time. 

One final point...

When we are attempting to shape/change another person's behaviour, it is important to remember that reducing a problem behaviour is not enough. We also need to reinforce the desired behaviour (what we want to see the individual doing next time), so the individual has something to replace their old behaviour with. 

If you need some help with behaviour (yours or someone else's), have a chat to one of our clinicians who can help you work it all out. 

Olivia Boer is a Clinical Psychologist and Director of Healthy Mind Centre Launceston, a private allied health practice in Launceston, Tasmania.