Saturday, 24 January 2015

Acknowledging that we need help: T2 article dated 25 Jan'2015

When Mr Sengupta came in, he appeared perfectly healthy. A gentleman of average built in his mid- 40s, he was polite and pleasant. Mr Sengupta was embarrassed to talk about his problem and occasionally burst out laughing during our interaction. He had a fear of elevators and could never get into one. Because of this peculiar problem, he said that he occasionally missed appointments, got late and lost out on opportunities as he needed to climb staircases which would delay him or tire him out before important meetings when they were held in multi- storeyed office buildings. Part of our first- day conversation went like this... 

Therapist: So you cannot get into an elevator.

Client: No, never. I clearly remember visiting a relative's apartment in Delhi, when I was in Class IV. It had a small, dingy old elevator. I refused to get in and my father had to climb up the stairs. ( Bursts out in an awkward laugh) 

Therapist: You seem to be embarrassed about this? 

Client: I am! Isn't it funny? How weird and irrational is this? I am a grown man and I have a team of people who depend on me and my decisions, and yet I am scared of this thing which is a part of everyday urban life. I am laughing right now but at times I feel angry at myself.

Therapist: You feel angry at yourself that you have this irrational fear… 

Client: Yes! I am so embarrassed that in spite of suffering so much I avoided talking about it for so many years and seeking professional help, but finally I made up my mind and though it is difficult for me to talk about it I am willing to work on it.

Luckily for Mr Sengupta, his frustration nudged him to finally address his problem and he came out of his avoidance strategies. Many of us however are not so lucky. We keep denying a problem for as long as we can. We are embarrassed to admit it, even to ourselves, that there is something within us which perhaps needs attention and a little fixing.
The admission of our problem entails facing our own ' imperfect' self, of which we are so critical about. The sense of shame that nudged Mr Sengupta to finally seek help was also the reason why he avoided the issue for so long. He was aware of his problem all his life but it took him years before he was ready to acknowledge it.

We gave him one experimental assignment. In the coming week he had to try and stand in front of an elevator and pretend to get in, and then observe his emotions, feelings, body sensations and what actually happens to him when he tries doing that. Mr Sengupta diligently went through the motions, twice as instructed, and came back next week. 
Excerpts from the session... 

Client: I did your exercise twice, once it was during office time. I called the elevator telling myself that I would get in to go to the 10th floor. The very idea was freaking me out though I knew very well that I was not actually going to get in. As soon as I pressed the button, I could hear screaming noises inside my head telling me that I was a fool to try this. That I was going to make a fool of myself. I could visualise myself inside the elevator. I was panicking and throwing a fit like a six- year- old, I was going crazy and everyone around was looking helplessly at me. I also felt palpitation.
The second time it was in an empty elevator in my apartment at night.
This time the feelings of discomfort were there but the intensity was much less.

Therapist: That's great. Well done! So now would you agree that may be your fear is actually coming from a preconceived notion that getting into an elevator would make you very uncomfortable and you might not tolerate that experience? And that this fear is more about ' making a fool of yourself'? 

Client: Yes, I realise that. I somehow believe that the moment the elevator door is shut, I will start panicking even though it has never actually happened as I never got into an elevator. And my fear is actually an extreme anxiety of how I will be perceived. During the second round of exercise, a small part of me was very tempted to actually get into that elevator and see if I could go through with the experience.

Therapist: Very good! Then shall we put this belief to test? Do you have a trusted friend or family member with whom you can test this belief? Maybe you can try the apartment elevator at night with a friend and start with just one floor movement. And if you hear the voice again which tells you that you are going to make a fool of yourself, humour it by saying that that is exactly what you are trying to do! 

Mr Sengupta could take the leap of faith with his wife. He found that the first few attempts in the elevator did make him uncomfortable and anxious but was much more bearable than what he had anticipated. He was so relieved that on the first day itself he practiced a few times and found the uncomfortable feeling easing away. Eventually he was able to increase his tolerance level and use the elevator even with people in it.

As in the case of Mr Sengupta, many times our own demand for a ' perfect' self becomes a hindrance to learning and growth. Perhaps his initial childhood fear got reinforced and became more complex as a result of his self- judgement and selfcriticism.
To change something within, we often need to let go of our inner judgements and address the issue with compassion for ourselves.

Dr Sangbarta Chattopadhyay and Dr Namita Bhuta are medical practitioners, psychotherapists and life coaches Share your problems with them at 
dr. sangbarta@ gmail. com 

Friday, 23 January 2015

How do you stick to new year, and everyday resolutions: T2 article dated 11th January 2015

New Year brings with it new beginnings. For many of us, this means making a new set of resolutions. Most of us are aware of the changes we can bring into our lives to be healthier and happier. The problem is that year after year the resolution list just stays on paper, seldom executed.

Have you ever wondered why despite knowing what is good for us, we keep failing to do those things? Aren't we all at times torn between that part of us which wants to lose weight, cut down on drinking or smoking, stay off Facebook or fried food, call our parents more often or start writing that book which is in our head, and the other part which wants to sleep five minutes more, puts off starting the exercise schedule, loves to procrastinate and finds any excuse to not initiate a change? Joseph Shrand, MD of Harvard Medical School, says that our desire to self- discipline and self- restrain is a rational decision where we logically weigh the options, understand the long- term consequences and then perhaps choose something bigger over instant pleasure. This ability comes from the frontal and prefrontal area of our brain, which is the newest part of evolutionary development. Unfortunately this part is easily overruled by our more primitive instincts of pleasure, which resides in the older regions of our brain.
So how do we assist our rational side which wants to be healthy, happy and productive and outsmart our pleasure- seeking, change- resisting urges? Here are a few science- backed strategies to help you stick to your New Year resolutions.

Train your willpower rigorously: 

Willpower is not something people just have. Like muscle, we can train our willpower to make it stronger. In an experiment at the State University of New York, researchers asked 122 smokers who were trying to quit to exert extra self- control for two weeks, either by avoiding sweets or by squeezing on a grip strengthener for as long as they could twice a day. In the following month, 27 per cent of those who were diligent about practising their self-control exercise successfully kicked their smoking habit, compared with just 12 per cent of volunteers who'd been given a task that didn't call for self- control. Exercise your willpower more often and more regularly to strengthen it throughout the year.
Don't get disheartened by the initial inability to exercise your willpower whenever you choose to exert it. Try practising self- control twice a week, like pushing yourself extra in the gym or staying off sugar.

Aim for one change at a time: 

It's great to know what all you want to change but it's not possible to change everything at once. Prioritise what you would like to change and choose one thing at a time. Trying to incorporate changes according to the priority list one by one is more likely We can train our willpower to make it stronger. If you get frustrated, it becomes easier to give in to temptation. Appreciate your own efforts and encourage yourself
to bring you success rather than an abrupt shift in your entire lifestyle.

Outwit your inner rebel:

 " I am never going to use a credit card again" or " I am off all forms of sweets" sounds very grand and noble as a resolution but is more likely to fail as " never" implies that even one failure would mean the resolution has failed. Instead try more realistic resolutions, like " I will consciously choose to avoid unhealthy food" which has more scope to be effective.
Avoid the all- or- none law and make room for flexibility.

Turn your resolution into a doable plan of action: 

"This year I am going to lose 10kg" may sound like a specific resolution but losing weight itself is a pretty broad goal. To lose weight we need to exercise, change our dietary habits.
We can then make a resolution like " I will start running from this week and my target is to cover 10km each day by the end of the year" or " In the first week itself I will consult a dietician and follow the diet plan". You can further break these down into a to- do for every month, week and day.
For example, 
Week One of my fitness plan:
.. Wake up an hour early 
.. Go for a walk/ run or gym 
.. Consult a dietician 
.. Follow the diet plan.

Write them down on paper and put it up at a place where you can see it often. When making the next week's plan of action, incorporate the backlog of the previous week.

Be gentle Don't be too harsh on yourself. To stick to a resolution plan and be able to focus on your greater good over your primitive pleasure sense, you need to prioritise your well- being. If you get frustrated, it becomes easier to give in to temptation. You need to be soft but firm towards yourself, not indulgent. Appreciate your own efforts and encourage yourself. Don't get bogged down by small failures, just try again the next day.

Wish you all a very happy and fulfilling year ahead.

Dr Sangbarta Chattopadhyay and Dr Namita Bhuta are medical practitioners, psychotherapists and life coaches Share your problems with them at 
dr. sangbarta@ gmail. com