As the philosopher Epictetus said almost 2,000 years ago:
"The thing that upsets people is not what happensbut what they think it means."
Event What you think What you feel What you do
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Tuesday, December 18, 2007
Exercise to destress the body
Jackobson's Relaxation Exercise
The following exercise needs to be done in a couch or bed, the person has to rest on his back, keeping all his muscles in a relaxed position with out any tension in any part of the body. All exercises need to be done twice with very deep concentration. Each exercise can be done in half a minute, more emphasis need to be given to the relaxed state of the muscle than the tensed state. It will be beneficial to do the exercise with eyes closed so as to achieve maximum concentration. This exercise can be done at any time of the day.
Take deep breath and concentrate on your breathing for three minutes
1. Slowly clench your fist, clench it tighter and tighter and feel the maximum tension. Slowly release it and feel the relaxed state
2. Fold your arm towards your shoulder and feel the tension, press it harder and harder and feel the maximum tension. Slowly release it and feel the relaxed state
3. Stretch your arm downwards, stretch it as much as possible and feel the maximum tension. Slowly release it and feel the relaxed state
4. Raise your forehead and feel the tension in your forehead. Slowly release it and feel the relaxed state
5. Bring your forehead downwards and feel the tension. Slowly release it and feel the relaxed state
6. Close your eyes tighter and tighter and feel the maximum tension. Slowly release it and feel the relaxed state
7. Clench your jaws tighter and tighter and feel the maximum tension. Slowly release it and feel the relaxed state
8. Press your head on the bed and feel the tension. Slowly release it and feel the relaxed state
9. Turn your face right side and press it as hard as possible on the bed. Slowly release it and feel the relaxed state
10. Turn your face left side and press it as hard as possible on the bed. Slowly release it and feel the relaxed state
11. Raise your head and press it on your chest. Slowly release it and feel the relaxed state
12. Shrug your shoulders as much as possible and feel the tension. Slowly release it and feel the relaxed state
13. Slowly arch your spine - lift your chest and stomach keeping your waist on the bed. Slowly release it and feel the relaxed state
14. Take deep breath, hold your breath and feel the tension. Slowly release it and feel the relaxed state
15. Pull your stomach inside and feel the tension in your abdomen. Slowly release it and feel the relaxed state
16. Push your stomach outside and feel the tension in your abdomen. Slowly release it and feel the relaxed state
17. Press your heels on the bed and feel the tension in your legs. Slowly release it and feel the relaxed state
18. Press your toes forward and feel the tension in your calf muscle. Slowly release it and feel the relaxed state
19. Press your toes backward and feel the tension in your legs. Slowly release it and feel the relaxed state
20. Clench your fist and press your heels on the bed. Slowly release it and feel the relaxed state
21. Clench your fist, press your heels on the bed, pull your stomach inside, shrug your shoulders and hold your breath. Slowly release it and feel the relaxed state
22. Clench your fist, press your heels on the bed, pull your stomach inside hold your breath clench your jaws, close your eyes and press your head on the bed. Slowly release it and feel the relaxed state
Saturday, December 15, 2007
Care for Dementia - Mental Health Solutions
Mr Ravi Samuel, a trained cognitive behaviour therapist, believes in the power of care, not cure, for dementia patients, says Susan Philip For many silvers, dementia, a progressive brain dysfunction, is akin to entering a dark world of disorientation, forgetfulness and chaos. There may still be no cure for Alzheimer's disease but right care can do much to dispel the darkness. That's the conviction of Dr Ravi Samuel, a Chennai-based cognitive behaviour therapist, who is determined to bring light to the lives of countless patients suffering from the ailment. "Despite the general literacy level of 56 per cent, most people in India know little or nothing about dementia care," says the 39 year-old, trained in London and Copenhagen and the only professional in Chennai certified by the Rehabilitation Council of India to work with elderly dementia patients.
Samuel offers cognitive rehabilitation therapy (CRT) to dementia patients, especially those with Alzheimer's -he is the only practitioner of CRT in Tamil Nadu. CRT is a guided therapy to learn, or relearn, ways to concentrate, remember and solve problems. Samuel started using it in India about three years ago. He uses software called 'Brain Train' developed in the US, which comprises various puzzles, like anagrams, mathematical calculations, logic sequences and memory tests, to stimulate every part of the brain. According to Samuel, CRT has proved useful in the initial stages of dementia. "Patients who undergo cognitive difficulties stop making an effort to regain their lost skills and go into depression," says Samuel. "That worsens the problem. These exercises help them regain much of their brain function and improve language, calculation skills and concentration.
The patients grow confident and can make the best use of their skills." Dr Deepak Arjundas-one of Chennai's leading neurologists, using occupational therapy, neuro-psychology and cognitive rehabilitation therapy to handle dementia cases-finds Samuel's skills to be effective. "He interacts with both patients and caregivers and ensures that the caregiver knows enough to handle things well. He evaluates the patient, sets exercises and demonstrates to caregivers how these exercises are to be conducted."Take Waris Ali, 75, for example, a patient of Alzheimer's, who was referred to Samuel by Dr Arjundas, a noted neurologist in Chennai. Medical tests revealed an infarction of the brain (a condition in which a segment of the brain is affected) and cognitive difficulties. He suffered loss of mobility, and low bladder and bowel control. Samuel started CRT on him, prescribing exercises for him while his family continued his medical treatment. Today, Waris no longer suffers from incontinence, has regained some mobility and responds to communication better. Samuel also believes in the power of images.
In 2002, Samuel developed the Dementia Pictorial Book, an illustrated book on dementia management, which was commended by the UN, WHO and Cancer Society, and found mention in world conferences of Alzheimer's Disease International (ADI) in 2002, 2003 and 2004. "I've always loved reading comics but often avoid reading a proper book," he confesses with a smile. The Dementia Pictorial Book is a comic book with a difference. There are no superheroes or legendary kings fighting epic battles. Instead, it depicts the real story of Usha, a teacher who developed Alzheimer's after retirement and shows how her family coped with the challenges. It underlines the progressively degenerative nature of Alzheimer's-patients ultimately need care in all aspects of their lives and care giving must be a shared family responsibility. Illustrator Xavier Rajan observed Samuel's sessions with Usha and other patients of dementia and interacted with their families before finalising the storyline with Samuel.
The text is bilingual, in English and Tamil.Samuel felt the book needed to do more than make the rounds of academic circles-it needed to reach the target group. With this in mind, he approached Chennai-based Vision Age India (VAI), an organisation offering community-based services to the elderly, of which he is a founding member. The ITC group sponsored the printing and the book was officially released on 9 March 2006.In fact, VAI has provided a strong platform for Samuel to reach out to silvers. From conducting seminars on physical, emotional and financial concerns of the elderly, VAI has widened its base since its inception in 1997 and now lobbies government on issues like lack of healthcare services and insufficient pension for seniors. It is funded by contributions from individuals and corporate bodies.Samuel is also a member of 10/66 Dementia Research Group, a research wing of Alzheimer's Dementia International, a key global body involved in dementia-related work. The group is currently conducting a worldwide study of the disease. "Symptoms of Alzheimer's are difficult to spot early, even in well-informed circles," says Samuel. "Initial symptoms are too often confused with normal deterioration owing to ageing." Apart from genetic factors, Alzheimer's can also result from ailments like tuberculosis, Parkinson's disease, brain injury, tumours or infections, alcoholism, nutritional deficiency and AIDS. "Withdrawal from social communication and depression act as a catalyst to the disease," adds Samuel. His advice to the elderly: undergo a medical check-up at least once in three months (those who suffer from diabetes and hypertension should go once a month); and develop a healthy lifestyle. "Read newspapers, read a book, socialise."
To families with patients of Alzheimer's, he has this to say: "Keep talking to them even if they don't make much sense. It creates positive vibes. Encourage them to do things. The focus has to be on care, not cure." As hired help is beyond the means of many families of dementia patients, VAI has launched home care for them, with trained personnel on a part-time basis, free of charge. Staff visits their homes and provides care, giving the family a much-needed break. While Samuel is doing his best to generate awareness on dementia, he feels India has a long way to go in coming to terms with the disease and the problems of the elderly in general. "In the West, help is available on various levels," he points out. "Respite care facilities, which let patients be admitted for a short time while caregivers take a break and community nursing facilities, where trained personnel assist caregivers at home, are easy to arrange. None of these facilities are
available in India."
He also feels events like the World Elders' Day make a mockery of the elderly. "They are celebrated with inane events like fashion shows and 'Best Couple' awards," he says with evident disdain. "But their problems are not being addressed at all." For his part, Samuel is determined to change this. And with him is his wife Sunitha, 39, a lawyer. "I'm happy that my husband is able to help so many people," she says. "I don't mind the late hours. He's so cheerful and patient with those who come to him for help, and he's the same at home too." Offering him quiet support are his mother Lalitha, 69, a retired schoolteacher, and father Dhanaraj, 70, a former employee of the Integral Coach Factory. Samuel likes to think positive and believes a little care goes a long way for dementia patients. "Do not let go so easily," he says, "and let them sink into a world of darkness and oblivion."
Ravi Samuel, cognitive behavioral therapist can be contacted at The Clinic
26/1 Arcot Street, T.Nagar, Chennai - 600 017, Tamil Nadu, India
0-91-44-2433 7439
http://www.urclinic.com/
26/1 Arcot Street, T.Nagar, Chennai - 600 017, Tamil Nadu, India
0-91-44-2433 7439
http://www.urclinic.com/
Vision Age India: NGO for the Care of the Elderly
1 - Parjwal Apartments, 1, Zacharia Colony 2nd Street, Choolaimedu, Chennai 600 094 Tamil Nadu, India
091 44 372 1418 VAI@visionageindia.org
http://www.visionageindia.org/
1 - Parjwal Apartments, 1, Zacharia Colony 2nd Street, Choolaimedu, Chennai 600 094 Tamil Nadu, India
091 44 372 1418 VAI@visionageindia.org
http://www.visionageindia.org/
Featured in Harmony MagazineJuly 2006
Mastering the Mind
Mastering the Mind
Appu (name changed), now aged 19, was a very violent child. He regularly beat up classmates to within an inch of their lives. He also had severe learning disability. Appu's parents were at their wits' end. This is when Ravi Samuel, who practices cognitive behavior therapy (CBT), stepped in. Today, Appu is stable and holds his own in college.Samuel is a Cognitive Behavior consultant trained in London.
CBT has gained wide currency in the West in the last decade or so, but has yet to find a strong foothold in India, due mainly to the fact that training is available only abroad and costs are prohibitive. Samuel is keen on popularizing CBT in the country because his experience shows that the therapy works very well here.CBT holds that distorted thought processes about stimuli - which in turn cause distressed emotions - are responsible for psychological distress. It aims to help the client become aware of the thought distortions, and of the behavioral patterns reinforcing it. Unlike traditional therapy, where the therapist is essentially the wise listener, the CBT therapist is 'active' and participates in solving the client's problem, helping him/her set treatment goals.
"Basically, CBT is a way of getting patients to look at stressful situations from a different perspective," explains N Rangarajan, who holds an MRC Psych degree and runs The Clinic, Chennai, where Samuel practices.A combination of cognitive therapy and behavior therapy, the effectiveness of CBT in treating various conditions - including chronic anxiety, insomnia, eating disorders, difficulty in establishing and sustaining relationships, job- and school-related problems and substance abuse - has been well researched and clinically proven by hundreds of studies. It started gaining popularity around the 1960s and '70s and its track record helped it to become widely used.
CBT is particularly useful for women, especially if they consult a therapist in the initial stages of a problem. If caught early, problems can be treated without recourse to medication. Medicines used to treat such problems often have a sedative effect, preventing the patient from performing daily activities, because of which women hesitate to seek treatment, says Rangarajan. Most mental problems which women are prey to stem from common factors, like verbal or physical abuse. These problems are aggravated by the educational and professional avenues that women take up now, adding burdens on one hand without lessening the load on the other, he says.CBT has proved effective and less time-consuming than traditional treatment methods like Freudian Analysis. But early treatment is important. "If, as is often the case, help is sought only when the patient becomes dysfunctional, then the treatment has to be a mix of CBT and medication," says Rangarajan.
"A person's response to a situation depends on how he looks at it, processes it, interprets it and emotionally reacts to it," says Samuel. When emotional reaction goes haywire, it can affect learning, inter-personal relationships and professional competence.Take the case of the CEO of a big company who is so low in self-esteem that he cannot delegate and ends up doing even mundane tasks. As a result, he is constantly stressed out. CBT is working wonders with him too; Samuel's goal is to tackle the root problem and raise the man's self-esteem.Faulty thought processes is another danger factor. People who are prey to it skip steps in thinking - leading to wrong conclusions. For example, merely hearing of a couple of accidents can lead to travel phobia, where the patient believes that an accident is inevitable if s/he travels.
Obsessive Compulsive Disorder - where a patient performs routine actionslike washing hands in a repetitive cycle - and depression are other common problems the world over; and for all these, CBT provides effective help and gives maximum results, assert Samuel and Rangarajan.So how does CBT work? The therapist helps the client learn to test his/her thoughts and assumptions by checking them against reality. Mirroring and challenging thoughts are two techniques used. In the first, the therapist copies the abnormal reactions of the patient - often an eye-opener that puts the patient on guard against such actions. In the second, faulty thought processes are challenged. Patients are made to see the lack of logic in their assumptions, resulting in weaning them away from such beliefs.In Appu's case, Samuel found that the child's learning disability exposed him to the ridicule of his classmates and uninformed staff members at school. His defence mechanism was to emulate the gory video games that he spent much time on. Samuel's first step was to impose a total ban on the games. Then he set about tackling the psychological problems using CBT.The hyperactive child would refuse to sit still though, and Samuel had to conduct his therapy literally on the move - on long walks or at a cricket match. He tackled specific goals, as CBT dictates. For instance, the notion that dyslexia prevented him from performing well academically, leading to a refusal to put in any effort at studies, was gradually removed by urging him to put in some effort, the positive results acting as encouragement.Samuel has worked with Appu for six years now, taking him through school to college. "He still needs monitoring because the problem could manifest in different ways in reaction to different situations," says Samuel. But the worst is over, thanks to CBT.
Due to many factors, including the stigma that dogs mental illness, and financial implications, both men and women hesitate to seek treatment. A Tata Consultancy Services website offers free treatment for various illnesses over e-mail. For those silently suffering from psychological problems, it is a godsend. Samuel, consultant therapist for the website, treats e-mail correspondents using CBT. He has been treating clients over the Internet for the last one year.Many of his patients are NRIs, who are glad of a therapist who understands the Indian psyche and problems specific to Indian culture, he says. The patient mails him, outlining his/her problem, and he offers advice and exercises in reply. If the therapy is carried out intensely and frequently, it can be as effective as one-to-one therapy, says Samuel. Of course, face-to-face meetings are preferable where possible, he acknowledges.Treatment over the Internet, possible only with CBT, has obvious advantages, like the fact that it can be conducted without the knowledge of even close relatives. Other forms of therapy involve more of analysis and are dependent on one-to-one meetings between the therapist and the patient. They are also more wide in range and scope as far a goals go, while CBT takes up goals one at a time and deals with each specifically, making communication over the Net easier. It also involves behavioral exercises which can be set out over e-mail. However, it has not been taken up in earnest, says Samuel, because it is not a paying proposition for the therapist.Samuel has created a website (www.UrClinic.com).
– Susan PhilipAugust 14, 2005
Appu (name changed), now aged 19, was a very violent child. He regularly beat up classmates to within an inch of their lives. He also had severe learning disability. Appu's parents were at their wits' end. This is when Ravi Samuel, who practices cognitive behavior therapy (CBT), stepped in. Today, Appu is stable and holds his own in college.Samuel is a Cognitive Behavior consultant trained in London.
CBT has gained wide currency in the West in the last decade or so, but has yet to find a strong foothold in India, due mainly to the fact that training is available only abroad and costs are prohibitive. Samuel is keen on popularizing CBT in the country because his experience shows that the therapy works very well here.CBT holds that distorted thought processes about stimuli - which in turn cause distressed emotions - are responsible for psychological distress. It aims to help the client become aware of the thought distortions, and of the behavioral patterns reinforcing it. Unlike traditional therapy, where the therapist is essentially the wise listener, the CBT therapist is 'active' and participates in solving the client's problem, helping him/her set treatment goals.
"Basically, CBT is a way of getting patients to look at stressful situations from a different perspective," explains N Rangarajan, who holds an MRC Psych degree and runs The Clinic, Chennai, where Samuel practices.A combination of cognitive therapy and behavior therapy, the effectiveness of CBT in treating various conditions - including chronic anxiety, insomnia, eating disorders, difficulty in establishing and sustaining relationships, job- and school-related problems and substance abuse - has been well researched and clinically proven by hundreds of studies. It started gaining popularity around the 1960s and '70s and its track record helped it to become widely used.
CBT is particularly useful for women, especially if they consult a therapist in the initial stages of a problem. If caught early, problems can be treated without recourse to medication. Medicines used to treat such problems often have a sedative effect, preventing the patient from performing daily activities, because of which women hesitate to seek treatment, says Rangarajan. Most mental problems which women are prey to stem from common factors, like verbal or physical abuse. These problems are aggravated by the educational and professional avenues that women take up now, adding burdens on one hand without lessening the load on the other, he says.CBT has proved effective and less time-consuming than traditional treatment methods like Freudian Analysis. But early treatment is important. "If, as is often the case, help is sought only when the patient becomes dysfunctional, then the treatment has to be a mix of CBT and medication," says Rangarajan.
"A person's response to a situation depends on how he looks at it, processes it, interprets it and emotionally reacts to it," says Samuel. When emotional reaction goes haywire, it can affect learning, inter-personal relationships and professional competence.Take the case of the CEO of a big company who is so low in self-esteem that he cannot delegate and ends up doing even mundane tasks. As a result, he is constantly stressed out. CBT is working wonders with him too; Samuel's goal is to tackle the root problem and raise the man's self-esteem.Faulty thought processes is another danger factor. People who are prey to it skip steps in thinking - leading to wrong conclusions. For example, merely hearing of a couple of accidents can lead to travel phobia, where the patient believes that an accident is inevitable if s/he travels.
Obsessive Compulsive Disorder - where a patient performs routine actionslike washing hands in a repetitive cycle - and depression are other common problems the world over; and for all these, CBT provides effective help and gives maximum results, assert Samuel and Rangarajan.So how does CBT work? The therapist helps the client learn to test his/her thoughts and assumptions by checking them against reality. Mirroring and challenging thoughts are two techniques used. In the first, the therapist copies the abnormal reactions of the patient - often an eye-opener that puts the patient on guard against such actions. In the second, faulty thought processes are challenged. Patients are made to see the lack of logic in their assumptions, resulting in weaning them away from such beliefs.In Appu's case, Samuel found that the child's learning disability exposed him to the ridicule of his classmates and uninformed staff members at school. His defence mechanism was to emulate the gory video games that he spent much time on. Samuel's first step was to impose a total ban on the games. Then he set about tackling the psychological problems using CBT.The hyperactive child would refuse to sit still though, and Samuel had to conduct his therapy literally on the move - on long walks or at a cricket match. He tackled specific goals, as CBT dictates. For instance, the notion that dyslexia prevented him from performing well academically, leading to a refusal to put in any effort at studies, was gradually removed by urging him to put in some effort, the positive results acting as encouragement.Samuel has worked with Appu for six years now, taking him through school to college. "He still needs monitoring because the problem could manifest in different ways in reaction to different situations," says Samuel. But the worst is over, thanks to CBT.
Due to many factors, including the stigma that dogs mental illness, and financial implications, both men and women hesitate to seek treatment. A Tata Consultancy Services website offers free treatment for various illnesses over e-mail. For those silently suffering from psychological problems, it is a godsend. Samuel, consultant therapist for the website, treats e-mail correspondents using CBT. He has been treating clients over the Internet for the last one year.Many of his patients are NRIs, who are glad of a therapist who understands the Indian psyche and problems specific to Indian culture, he says. The patient mails him, outlining his/her problem, and he offers advice and exercises in reply. If the therapy is carried out intensely and frequently, it can be as effective as one-to-one therapy, says Samuel. Of course, face-to-face meetings are preferable where possible, he acknowledges.Treatment over the Internet, possible only with CBT, has obvious advantages, like the fact that it can be conducted without the knowledge of even close relatives. Other forms of therapy involve more of analysis and are dependent on one-to-one meetings between the therapist and the patient. They are also more wide in range and scope as far a goals go, while CBT takes up goals one at a time and deals with each specifically, making communication over the Net easier. It also involves behavioral exercises which can be set out over e-mail. However, it has not been taken up in earnest, says Samuel, because it is not a paying proposition for the therapist.Samuel has created a website (www.UrClinic.com).
– Susan PhilipAugust 14, 2005
Monday, December 3, 2007
Relaxation Exercise
Jackobson's Relaxation Exercise
The following exercise needs to be done in a couch or bed, the person has to rest on his back, keeping all his muscles in a relaxed position with out any tension in any part of the body. All exercises need to be done twice with very deep concentration. Each exercise can be done in half a minute, more emphasis need to be given to the relaxed state of the muscle than the tensed state. It will be beneficial to do the exercise with eyes closed so as to achieve maximum concentration. This exercise can be done at any time of the day.
Take deep breath and concentrate on your breathing for three minutes
1. Slowly clench your fist, clench it tighter and tighter and feel the maximum tension. Slowly release it and feel the relaxed state
2. Fold your arm towards your shoulder and feel the tension, press it harder and harder and feel the maximum tension. Slowly release it and feel the relaxed state
3. Stretch your arm downwards, stretch it as much as possible and feel the maximum tension. Slowly release it and feel the relaxed state
4. Raise your forehead and feel the tension in your forehead. Slowly release it and feel the relaxed state
5. Bring your forehead downwards and feel the tension. Slowly release it and feel the relaxed state
6. Close your eyes tighter and tighter and feel the maximum tension. Slowly release it and feel the relaxed state
7. Clench your jaws tighter and tighter and feel the maximum tension. Slowly release it and feel the relaxed state
8. Press your head on the bed and feel the tension. Slowly release it and feel the relaxed state
9. Turn your face right side and press it as hard as possible on the bed. Slowly release it and feel the relaxed state
10. Turn your face left side and press it as hard as possible on the bed. Slowly release it and feel the relaxed state
11. Raise your head and press it on your chest. Slowly release it and feel the relaxed state
12. Shrug your shoulders as much as possible and feel the tension. Slowly release it and feel the relaxed state
13. Slowly arch your spine - lift your chest and stomach keeping your waist on the bed. Slowly release it and feel the relaxed state
14. Take deep breath, hold your breath and feel the tension. Slowly release it and feel the relaxed state
15. Pull your stomach inside and feel the tension in your abdomen. Slowly release it and feel the relaxed state
16. Push your stomach outside and feel the tension in your abdomen. Slowly release it and feel the relaxed state
17. Press your heels on the bed and feel the tension in your legs. Slowly release it and feel the relaxed state
18. Press your toes forward and feel the tension in your calf muscle. Slowly release it and feel the relaxed state
19. Press your toes backward and feel the tension in your legs. Slowly release it and feel the relaxed state
20. Clench your fist and press your heels on the bed. Slowly release it and feel the relaxed state
21. Clench your fist, press your heels on the bed, pull your stomach inside, shrug your shoulders and hold your breath. Slowly release it and feel the relaxed state
22. Clench your fist, press your heels on the bed, pull your stomach inside hold your breath clench your jaws, close your eyes and press your head on the bed. Slowly release it and feel the relaxed state
The following exercise needs to be done in a couch or bed, the person has to rest on his back, keeping all his muscles in a relaxed position with out any tension in any part of the body. All exercises need to be done twice with very deep concentration. Each exercise can be done in half a minute, more emphasis need to be given to the relaxed state of the muscle than the tensed state. It will be beneficial to do the exercise with eyes closed so as to achieve maximum concentration. This exercise can be done at any time of the day.
Take deep breath and concentrate on your breathing for three minutes
1. Slowly clench your fist, clench it tighter and tighter and feel the maximum tension. Slowly release it and feel the relaxed state
2. Fold your arm towards your shoulder and feel the tension, press it harder and harder and feel the maximum tension. Slowly release it and feel the relaxed state
3. Stretch your arm downwards, stretch it as much as possible and feel the maximum tension. Slowly release it and feel the relaxed state
4. Raise your forehead and feel the tension in your forehead. Slowly release it and feel the relaxed state
5. Bring your forehead downwards and feel the tension. Slowly release it and feel the relaxed state
6. Close your eyes tighter and tighter and feel the maximum tension. Slowly release it and feel the relaxed state
7. Clench your jaws tighter and tighter and feel the maximum tension. Slowly release it and feel the relaxed state
8. Press your head on the bed and feel the tension. Slowly release it and feel the relaxed state
9. Turn your face right side and press it as hard as possible on the bed. Slowly release it and feel the relaxed state
10. Turn your face left side and press it as hard as possible on the bed. Slowly release it and feel the relaxed state
11. Raise your head and press it on your chest. Slowly release it and feel the relaxed state
12. Shrug your shoulders as much as possible and feel the tension. Slowly release it and feel the relaxed state
13. Slowly arch your spine - lift your chest and stomach keeping your waist on the bed. Slowly release it and feel the relaxed state
14. Take deep breath, hold your breath and feel the tension. Slowly release it and feel the relaxed state
15. Pull your stomach inside and feel the tension in your abdomen. Slowly release it and feel the relaxed state
16. Push your stomach outside and feel the tension in your abdomen. Slowly release it and feel the relaxed state
17. Press your heels on the bed and feel the tension in your legs. Slowly release it and feel the relaxed state
18. Press your toes forward and feel the tension in your calf muscle. Slowly release it and feel the relaxed state
19. Press your toes backward and feel the tension in your legs. Slowly release it and feel the relaxed state
20. Clench your fist and press your heels on the bed. Slowly release it and feel the relaxed state
21. Clench your fist, press your heels on the bed, pull your stomach inside, shrug your shoulders and hold your breath. Slowly release it and feel the relaxed state
22. Clench your fist, press your heels on the bed, pull your stomach inside hold your breath clench your jaws, close your eyes and press your head on the bed. Slowly release it and feel the relaxed state
Sunday, December 2, 2007
Eating Disorder - Commonly Undiagnosed
Eating Disorder
Are you aware there is something called Eating Disorders! Yes, a person can have problems with their eating habits,when they have psychological problems or faulty ideas about their body image. We all learn to eat in our childhood and presume that it goes on without any problem. Eating Disorder is a very common condition among children and adults and it commonly goes unnoticed. Women is the one who serve the food for the family members and makes sure everyone takes sufficient food, but when it comes to their eating habits they make lot of compromises. Sometimes if someone eats more or if there is a guest, there may not be enough food, in that case many women just drink some water or milk and go to sleep. It is ok if it happens once in a while but if it happens regularly about three times a week then it can affect the person's health.
The present fashion of being 'thin' has resulted in more number of young girls and ladies getting into the habit of eating less or missing meals. Young girls seem to give more importance to being fashionable than being healthy. Inspite of evidence, to reduce weight, a person has to do lot of exercises, many ladies just reduce food and it leads to many nutritional and health related problems. It is not wrong to get fascinated by our beautiful slim heroines and girls on the fashion TV and want to look like them. But the fact is these heroines and girls eat well and do lots of exercises in their free time. In the west it is normal habit for people to go for walks in nearby beautiful parks even while it is freezing cold.
Those with eating disorders have tendency to misinterpret what they see in the mirror, they may see a normal shaped figure or even if they are thin they will think they are fat and out of fear of gaining weight will start avoiding food.
Medical Problems due to Eating Disorders
Loss of Fat
Problems in thyroid
Intolerance to cold
Affects to muscles in the heart
Pain in the abdomen
Constipation
Irregular periods
Skin problems
Affects bones
Affects the teeth
Being mentally dull
As there is a habit of eating less there is also a habit of eating more than required quantity. As such if the food is very tasty, so we tend to eat more than the required quantity. In European countries people eat food, which are not very tasty, but of nutritional value, so they stop with the required amount.
In general we may eat more because of the tasty food, but people with eating disorders eat more when they tensed or worried excessively about their weight. After eating they will try to vomit the food, sometimes even by putting their hands inside their mouth. This is more prevalent among women who remain alone during the day, particularly in Indian women who are living abroad as they are alone in the house during the daytime.
Tips to remember
Men in the house should make sure that the ladies have sufficient quantities to eat and they are taking the food regularly.
Certainly look thin but by doing exercises and not by starving.
When you cook food make sure there is some extra portion
If you are worried or tensed try to talk to someone or write down your thoughts avoid eating to reduce tension.
Certainly remain thin by doing exercises not by starving.
A 27-years-old lady living with her husband and 6-years-old daughter in a high raised flat approached me for the problem of eating excessively and then starving for many days. She has the habit of getting tense when she is alone at home thinking of various problems, to overcome the tension she started eating large amounts of food and will try to vomit because of the heavy feeling and fear of putting on weight. When she came for psychotherapy it was found that she was scared of the future as her husband was in a temporary job. So when she had to stay alone during the day time she started thinking about her daughter's education, professional education and marriage and got very tensed. In psychotherapy it was found that she was brought up with the attitude that only if there is a permanent job she can feel secure. This faulty attitude, which was deeply imprinted in her mind, was changed with the facts as to how her husband being a doctor has been changing jobs every two years and how that has only increased the income and the present state of job market is also such that people like to keep changing jobs for better prospects. Following the change in the attitude she stopped getting tense, which prevented her excessive eating behaviour.
Eating disorder is normally found in people who have poor self-esteem and negative self-image. It is also found among those who have minor psychiatric problems like anxiety disorder and depression. The best form of treatment for these disorders is Cognitive Behaviour therapy; it is a very effective form of psychotherapy in which faulty thought, thinking process, faulty beliefs and attitudes, faulty emotional reactions are identified and changed through interesting real life exercises for the mind and behaviour. The behaviour therapist will give them diet charts to follow to enable them to have sufficient nutritional intake. The therapy will help them to stop misinterpreting their body shape arbitrarily as a thin one and enable them to have more objective opinion and to include certain reliable friends opinion. Most importantly the therapy will enable them to stop depreciating what they are and what they do and develop a good self esteem.
Are you aware there is something called Eating Disorders! Yes, a person can have problems with their eating habits,when they have psychological problems or faulty ideas about their body image. We all learn to eat in our childhood and presume that it goes on without any problem. Eating Disorder is a very common condition among children and adults and it commonly goes unnoticed. Women is the one who serve the food for the family members and makes sure everyone takes sufficient food, but when it comes to their eating habits they make lot of compromises. Sometimes if someone eats more or if there is a guest, there may not be enough food, in that case many women just drink some water or milk and go to sleep. It is ok if it happens once in a while but if it happens regularly about three times a week then it can affect the person's health.
The present fashion of being 'thin' has resulted in more number of young girls and ladies getting into the habit of eating less or missing meals. Young girls seem to give more importance to being fashionable than being healthy. Inspite of evidence, to reduce weight, a person has to do lot of exercises, many ladies just reduce food and it leads to many nutritional and health related problems. It is not wrong to get fascinated by our beautiful slim heroines and girls on the fashion TV and want to look like them. But the fact is these heroines and girls eat well and do lots of exercises in their free time. In the west it is normal habit for people to go for walks in nearby beautiful parks even while it is freezing cold.
Those with eating disorders have tendency to misinterpret what they see in the mirror, they may see a normal shaped figure or even if they are thin they will think they are fat and out of fear of gaining weight will start avoiding food.
Medical Problems due to Eating Disorders
Loss of Fat
Problems in thyroid
Intolerance to cold
Affects to muscles in the heart
Pain in the abdomen
Constipation
Irregular periods
Skin problems
Affects bones
Affects the teeth
Being mentally dull
As there is a habit of eating less there is also a habit of eating more than required quantity. As such if the food is very tasty, so we tend to eat more than the required quantity. In European countries people eat food, which are not very tasty, but of nutritional value, so they stop with the required amount.
In general we may eat more because of the tasty food, but people with eating disorders eat more when they tensed or worried excessively about their weight. After eating they will try to vomit the food, sometimes even by putting their hands inside their mouth. This is more prevalent among women who remain alone during the day, particularly in Indian women who are living abroad as they are alone in the house during the daytime.
Tips to remember
Men in the house should make sure that the ladies have sufficient quantities to eat and they are taking the food regularly.
Certainly look thin but by doing exercises and not by starving.
When you cook food make sure there is some extra portion
If you are worried or tensed try to talk to someone or write down your thoughts avoid eating to reduce tension.
Certainly remain thin by doing exercises not by starving.
A 27-years-old lady living with her husband and 6-years-old daughter in a high raised flat approached me for the problem of eating excessively and then starving for many days. She has the habit of getting tense when she is alone at home thinking of various problems, to overcome the tension she started eating large amounts of food and will try to vomit because of the heavy feeling and fear of putting on weight. When she came for psychotherapy it was found that she was scared of the future as her husband was in a temporary job. So when she had to stay alone during the day time she started thinking about her daughter's education, professional education and marriage and got very tensed. In psychotherapy it was found that she was brought up with the attitude that only if there is a permanent job she can feel secure. This faulty attitude, which was deeply imprinted in her mind, was changed with the facts as to how her husband being a doctor has been changing jobs every two years and how that has only increased the income and the present state of job market is also such that people like to keep changing jobs for better prospects. Following the change in the attitude she stopped getting tense, which prevented her excessive eating behaviour.
Eating disorder is normally found in people who have poor self-esteem and negative self-image. It is also found among those who have minor psychiatric problems like anxiety disorder and depression. The best form of treatment for these disorders is Cognitive Behaviour therapy; it is a very effective form of psychotherapy in which faulty thought, thinking process, faulty beliefs and attitudes, faulty emotional reactions are identified and changed through interesting real life exercises for the mind and behaviour. The behaviour therapist will give them diet charts to follow to enable them to have sufficient nutritional intake. The therapy will help them to stop misinterpreting their body shape arbitrarily as a thin one and enable them to have more objective opinion and to include certain reliable friends opinion. Most importantly the therapy will enable them to stop depreciating what they are and what they do and develop a good self esteem.
Anger - A sign of Weakness
Is Anger destroying you?Anger Management-What You Need to Know
Anger destroys a person's health, personal life, career and even social life. A casual family window-shopping trip can turn out to be most distressing trip for the entire family if a family member gets into an anger outburst either with a family member or stranger. Says Mr. Ravi Samuel, a psychotherapist; "Anger is an emotion ranging in severity from irritation to intense fury. Its impact is psychological, and it can impair a person's ability to think rationally and logically." He continues, "Anger is also accompanied by a physiological arousal to respond verbally or physically." Is it not getting common these days to see two people on the road swearing at each other?
A Powerful Emotion
As we attempt to comprehend the factors that trigger off anger, it becomes vital to understand that biologically, the amygdala (also known as the 'feeling brain') experiences emotions prior to the thalamus (known as the 'thinking brain'). This explains why a person, spurred by anger, tends to indulge in certain verbal expressions and physical acts. "Anger is caused by interpreting external events as an insult to a person's dignity or that of others and can further intensify by repeatedly pondering over such events", adds Mr. Samuel.
A Growing Concern
Stress, interpersonal conflicts and the distressing break-down of relationships can have adverse effect on some people and can manifest itself in difficulties in controlling anger. Anger has become a common problem today for almost all age groups, irrespective of gender.
"Children are being brought to my clinic by parents concerned about their child's destructive activities and uncontrollable behaviour", Mr. Samuel states. "Executives who are troubled by their inability to deal effectively with their teammates, also seek my help. Moreover, housewives too, when faced with deteriorating relationships with their spouse and children, approach me for guidance."
It has been discovered that anger can be influenced by genetic factors and social circumstances too. Also, people from disturbed family backgrounds may display a greater predisposition to anger. Mr. Samuel adds, "On the other hand, anger is an emotion that should be expressed. However, you require knowledge to help you handle this powerful emotion."
Implications of Anger
Anger is known to have a huge impact on a person's mental and physical health. If overlooked, it can lead to problems such as high blood pressure, stroke, heart attack, insomnia headaches, digestion problems, abdominal pain, loss of hair and skin problems (eczema) too. It can also lead to disorders such as anxiety and depressive disorders.
"Suppressing anger, however, without dealing with the underlying cause or emotion, can also have a negative effect and can lead to passive-aggressive behaviour and hostility", reveals Mr. Samuel. "Being assertive without being destructive is the best balance you can learn in dealing with this emotion. Physical violence towards people is certainly abusive behaviour, which I seek to actively discourage", he states.
Anger Management Techniques
"There are several techniques, such as relaxation techniques and cognitive restructuring, which can be practiced to overcome anger", assures Mr. Samuel. "However, in cases of uncontrollable anger, a psychotherapist will also have to work on the person's self-esteem, emotional coping techniques and problem-solving capabilities."
While some people seek timely help when their relationships get affected due to poor anger management, there are others who even opine that anger is a 'life skill' that they are equipped with. "It is such people who are likely to suffer from the impact of anger on their mental and physical well-being and this can also adversely affect the quality of life of people around them", emphasizes Mr. Samuel.
Anger Management Techniques
CBT is a combination of cognitive therapy, which examines undesirable thoughts, attitudes, and beliefs (known as cognitive processes) and behaviour therapy, which focuses on the behaviour adopted in response to such thoughts. With the help of structured techniques, a CBT therapist seeks to identify the thoughts that cause distress.
CBT encourages challenging negative beliefs to gain a realistic view of situations. This involves a collaborative effort between the therapist and client, to work on the client's problems and help equip the client with beneficial skills to overcome distortions in thought patterns.
A case study…
45-year old Mr. Ranganathan, a very efficient manager in a multinational company, was faced with growing resentment from his staff and the management, due to his display of anger in trivial issues too. Mr. Ranganathan also found most of his ideas turned down by the Board of Directors. Aware of the implications of the situation, he approached Mr. Samuel.
On detailed evaluation, it was discovered that he displayed a highly condescending attitude towards the staff and derived a sense of mastery by shouting at people. His presumption was that his subordinates would perform their duties out of morbid fear and was even blissfully oblivious of the resentment and hostility.
Mr. Samuel identified his dysfunctional thoughts, faulty beliefs and undesirable behaviour. Using CBT, techniques such as 'mirroring' and 'benefit analysis', Mr. Samuel enabled Mr. Ranganathan to resolve his issues amicably and overcome his anger.
The 'mirroring' technique involves the therapist enacting the behaviour of the person, which helps put him on guard against such dysfunctional actions. 'Benefit analysis' is another technique in which the therapist enables the person to understand how his actions, if replaced with right behaviour, can be beneficial to him in several ways.
With CBT gaining a firm foothold on treating psychological issues, anger management techniques can provide respite to those in need of help in managing their emotions.
Anger destroys a person's health, personal life, career and even social life. A casual family window-shopping trip can turn out to be most distressing trip for the entire family if a family member gets into an anger outburst either with a family member or stranger. Says Mr. Ravi Samuel, a psychotherapist; "Anger is an emotion ranging in severity from irritation to intense fury. Its impact is psychological, and it can impair a person's ability to think rationally and logically." He continues, "Anger is also accompanied by a physiological arousal to respond verbally or physically." Is it not getting common these days to see two people on the road swearing at each other?
A Powerful Emotion
As we attempt to comprehend the factors that trigger off anger, it becomes vital to understand that biologically, the amygdala (also known as the 'feeling brain') experiences emotions prior to the thalamus (known as the 'thinking brain'). This explains why a person, spurred by anger, tends to indulge in certain verbal expressions and physical acts. "Anger is caused by interpreting external events as an insult to a person's dignity or that of others and can further intensify by repeatedly pondering over such events", adds Mr. Samuel.
A Growing Concern
Stress, interpersonal conflicts and the distressing break-down of relationships can have adverse effect on some people and can manifest itself in difficulties in controlling anger. Anger has become a common problem today for almost all age groups, irrespective of gender.
"Children are being brought to my clinic by parents concerned about their child's destructive activities and uncontrollable behaviour", Mr. Samuel states. "Executives who are troubled by their inability to deal effectively with their teammates, also seek my help. Moreover, housewives too, when faced with deteriorating relationships with their spouse and children, approach me for guidance."
It has been discovered that anger can be influenced by genetic factors and social circumstances too. Also, people from disturbed family backgrounds may display a greater predisposition to anger. Mr. Samuel adds, "On the other hand, anger is an emotion that should be expressed. However, you require knowledge to help you handle this powerful emotion."
Implications of Anger
Anger is known to have a huge impact on a person's mental and physical health. If overlooked, it can lead to problems such as high blood pressure, stroke, heart attack, insomnia headaches, digestion problems, abdominal pain, loss of hair and skin problems (eczema) too. It can also lead to disorders such as anxiety and depressive disorders.
"Suppressing anger, however, without dealing with the underlying cause or emotion, can also have a negative effect and can lead to passive-aggressive behaviour and hostility", reveals Mr. Samuel. "Being assertive without being destructive is the best balance you can learn in dealing with this emotion. Physical violence towards people is certainly abusive behaviour, which I seek to actively discourage", he states.
Anger Management Techniques
"There are several techniques, such as relaxation techniques and cognitive restructuring, which can be practiced to overcome anger", assures Mr. Samuel. "However, in cases of uncontrollable anger, a psychotherapist will also have to work on the person's self-esteem, emotional coping techniques and problem-solving capabilities."
While some people seek timely help when their relationships get affected due to poor anger management, there are others who even opine that anger is a 'life skill' that they are equipped with. "It is such people who are likely to suffer from the impact of anger on their mental and physical well-being and this can also adversely affect the quality of life of people around them", emphasizes Mr. Samuel.
Anger Management Techniques
CBT is a combination of cognitive therapy, which examines undesirable thoughts, attitudes, and beliefs (known as cognitive processes) and behaviour therapy, which focuses on the behaviour adopted in response to such thoughts. With the help of structured techniques, a CBT therapist seeks to identify the thoughts that cause distress.
CBT encourages challenging negative beliefs to gain a realistic view of situations. This involves a collaborative effort between the therapist and client, to work on the client's problems and help equip the client with beneficial skills to overcome distortions in thought patterns.
A case study…
45-year old Mr. Ranganathan, a very efficient manager in a multinational company, was faced with growing resentment from his staff and the management, due to his display of anger in trivial issues too. Mr. Ranganathan also found most of his ideas turned down by the Board of Directors. Aware of the implications of the situation, he approached Mr. Samuel.
On detailed evaluation, it was discovered that he displayed a highly condescending attitude towards the staff and derived a sense of mastery by shouting at people. His presumption was that his subordinates would perform their duties out of morbid fear and was even blissfully oblivious of the resentment and hostility.
Mr. Samuel identified his dysfunctional thoughts, faulty beliefs and undesirable behaviour. Using CBT, techniques such as 'mirroring' and 'benefit analysis', Mr. Samuel enabled Mr. Ranganathan to resolve his issues amicably and overcome his anger.
The 'mirroring' technique involves the therapist enacting the behaviour of the person, which helps put him on guard against such dysfunctional actions. 'Benefit analysis' is another technique in which the therapist enables the person to understand how his actions, if replaced with right behaviour, can be beneficial to him in several ways.
With CBT gaining a firm foothold on treating psychological issues, anger management techniques can provide respite to those in need of help in managing their emotions.
Divya Mohandas
Social Anxiety Disorder and the solutions
What is Social Anxiety Disorder?
In social anxiety disorder (SAD) a person experiences extreme anxiety when they have to interact with known and unknown people irrespective of gender. Patients avoid all types of social functions, get-togethers and parties.
SAD is found among both men and women. These people lead a normal life expect in relation to interacting with people. They take a very long time to relate to other people including colleagues. They form very few close relationships within and outside the family. Invariably the person with whom they form relationships are also socially shy people.
Do people develop this in childhood or as adults?
A person can acquire SAD as a child or develop it during adulthood. Socially shy parents or parent may teach the child to avoid unnecessary interaction, which the child may follow in the initial years. Then it becomes their nature to avoid people. In adults, it can happen when successive relationships result in disappointment, rejection, criticism or being exploited financially or sexually. Similarly people who were subjected to emotional abuse may develop SAD.
Take the case of the college boy befriended by a married woman. She told him about her unhappy life and how he made her very happy. Hearing such sentiments, the boy took it upon himself to keep the woman happy.
After five years, to his shock and disbelief, he saw her getting very intimate with her boss. She also started avoiding him. The boy became very withdrawn and developed a distrustful attitude. He started avoiding people even for official purpose. Whenever he had to meet someone, he would make an excuse. This affected his work to the extent that he lost five jobs. This does not mean all exploitative relationships lead to SAD!
How does it affect a person’s life?
The sense of avoidance is so high that they will not hesitate to resign their jobs if it necessitates interaction with people. Even if the salary is lucrative, they will refuse promotion and remain in a self-defined comfort zone.
In a married couple, if one partner has social anxiety, the other person’s friendliness can be misinterpreted as loss of interest in marriage, or even unfaithfulness. This can lead to enormous strain in the relationship.
If motivated to attend a social gathering, they will be silent spectators and will be thinking of how to leave the place. Seeing their discomfort, people slowly stop inviting them for social gatherings.
What is the treatment for Social Anxiety Disorder?
SAD is treated with medicines and psychotherapy. Social anxiety manifests due to faulty thought processing, dysfunctional beliefs and consequent anxious physical reactions. This can be either secondary to a traumatic real life experience or totally imagined.
Cognitive Behaviour therapy is very effective along with anxolytic medication. In this, the person is enabled to identify the initial experience, which leads to the formation of thoughts process causing the anxiety.
The CCLD approach — ‘Challenging’ old faulty beliefs and thoughts, ‘Controlling’ the physical manifestation of anxiety that leads to avoiding the situation, ‘Learning’ what to say after saying hello and ‘Doing’ interactive sessions with people initially in role play with the therapist and then slowly moving towards real life situations — is believed to be very helpful. The entire therapy takes about 15 sessions and the progress directly depends on the efforts of the person to perform the physical and cognitive homework.
On an average, what is the percentage of people suffering from Social Anxiety Disorder?
There is no definite epidemiological data to answer this question. Around five per cent of people could be suffering from this disorder.
What is the biggest hurdle involved in fighting Social Anxiety Disorder?
People do not consider this as a problem and so they just learn to live with it. Only if it grossly disturbs their vocation or marital relationship do they look for treatment.
People have a tendency to expect medicines or their birthstone to solve their problems. Instead if they put in efforts on physical and cognitive exercises they can easily overcome this embarrassing and socially paralysing disorder.
People with social anxiety disorder live a very restricted life, which they find to be comfortable and compromise on many aspects of life. The comfort feeling they have is another hurdle that prevents them from seeking help.
The writer is a Cognitive Psychotherapist based in Chennai.
In social anxiety disorder (SAD) a person experiences extreme anxiety when they have to interact with known and unknown people irrespective of gender. Patients avoid all types of social functions, get-togethers and parties.
SAD is found among both men and women. These people lead a normal life expect in relation to interacting with people. They take a very long time to relate to other people including colleagues. They form very few close relationships within and outside the family. Invariably the person with whom they form relationships are also socially shy people.
Do people develop this in childhood or as adults?
A person can acquire SAD as a child or develop it during adulthood. Socially shy parents or parent may teach the child to avoid unnecessary interaction, which the child may follow in the initial years. Then it becomes their nature to avoid people. In adults, it can happen when successive relationships result in disappointment, rejection, criticism or being exploited financially or sexually. Similarly people who were subjected to emotional abuse may develop SAD.
Take the case of the college boy befriended by a married woman. She told him about her unhappy life and how he made her very happy. Hearing such sentiments, the boy took it upon himself to keep the woman happy.
After five years, to his shock and disbelief, he saw her getting very intimate with her boss. She also started avoiding him. The boy became very withdrawn and developed a distrustful attitude. He started avoiding people even for official purpose. Whenever he had to meet someone, he would make an excuse. This affected his work to the extent that he lost five jobs. This does not mean all exploitative relationships lead to SAD!
How does it affect a person’s life?
The sense of avoidance is so high that they will not hesitate to resign their jobs if it necessitates interaction with people. Even if the salary is lucrative, they will refuse promotion and remain in a self-defined comfort zone.
In a married couple, if one partner has social anxiety, the other person’s friendliness can be misinterpreted as loss of interest in marriage, or even unfaithfulness. This can lead to enormous strain in the relationship.
If motivated to attend a social gathering, they will be silent spectators and will be thinking of how to leave the place. Seeing their discomfort, people slowly stop inviting them for social gatherings.
What is the treatment for Social Anxiety Disorder?
SAD is treated with medicines and psychotherapy. Social anxiety manifests due to faulty thought processing, dysfunctional beliefs and consequent anxious physical reactions. This can be either secondary to a traumatic real life experience or totally imagined.
Cognitive Behaviour therapy is very effective along with anxolytic medication. In this, the person is enabled to identify the initial experience, which leads to the formation of thoughts process causing the anxiety.
The CCLD approach — ‘Challenging’ old faulty beliefs and thoughts, ‘Controlling’ the physical manifestation of anxiety that leads to avoiding the situation, ‘Learning’ what to say after saying hello and ‘Doing’ interactive sessions with people initially in role play with the therapist and then slowly moving towards real life situations — is believed to be very helpful. The entire therapy takes about 15 sessions and the progress directly depends on the efforts of the person to perform the physical and cognitive homework.
On an average, what is the percentage of people suffering from Social Anxiety Disorder?
There is no definite epidemiological data to answer this question. Around five per cent of people could be suffering from this disorder.
What is the biggest hurdle involved in fighting Social Anxiety Disorder?
People do not consider this as a problem and so they just learn to live with it. Only if it grossly disturbs their vocation or marital relationship do they look for treatment.
People have a tendency to expect medicines or their birthstone to solve their problems. Instead if they put in efforts on physical and cognitive exercises they can easily overcome this embarrassing and socially paralysing disorder.
People with social anxiety disorder live a very restricted life, which they find to be comfortable and compromise on many aspects of life. The comfort feeling they have is another hurdle that prevents them from seeking help.
The writer is a Cognitive Psychotherapist based in Chennai.
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