Why online counselling is better than meeting your counsellor in-person and how to select.

online from home

Two years of pandemic have given us new science about the effectiveness of online counselling, live psychotherapy and telehealth, video-delivered psychotherapy and the use of video conferencing technology for individual coaching as well as couples counselling.

This is an update of my older blog due to the 2.5 years of our experience with the online delivery of courses, tutoring, education, social engagement, mental health and wellbeing. We now have scientific evidence to match our personal and professional experience of operation, normality and implicitness of video conferencing.

Efficacy and Accessibility

A brand-new meta-analysis of efficacy regarding video vs in-person treatment concludes that “…Live psychotherapy by video emerges not only as a popular and convenient choice but also one that is now upheld by meta-analytic evidence…” (JOURNAL Clinical Psychology & Psychotherapy. Volume28, Issue 6 Special Issue: Psychological Consequences of COVID‐19, Pages 1535-1549)

Necessity and convenience

Individualised and real-time online services for well-being, life coaching and mental health are popular. Increased disruptions in public life such as social movement and waves of outbreaks of infectious diseases impel the demand. People reduce their commutes and value the safety and convenience of home over the workplace and face-to-face socialising. Video conferencing, live chat and phone conversations have widely replaced in-person contact to address personal emotional challenges as well as mental well-being.

Efficiency and Cost

Video conferencing makes it easy and accessible to keep a healthy routine of self-care. Online counselling offers advantages in flexibility, efficiency and mobility. It demonstrates a broad range of suitability. Many people can benefit from online consultation services via video call, phone sessions, text messaging and chat.

The VDP (video delivered) improvement is most pronounced when CBT is used, and when anxiety, depression, or PTSD are targeted, and it remains strong though attenuated by publication bias. Clinically, therapy is no less efficacious when delivered via videoconferencing than in-person, with efficacy being most pronounced in CBT for affective disorders (mood disorders).

Ephrem Fernandez et al. Clinical Psychology & Psychotherapy. Volume28, Issue 6

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Boundaries and Safety from Home

Some of my online clients appreciate in particular the virtual nature of online therapy, because it also offers an additional sense of safety, built-in boundaries of time, distance and technology (i.e. mute microphone, camera on/off, etc) and occasionally anonymity.

Staying home and still being able to connect with me online is often a relieve, when suffering from anxiety or nervous tension. For clients with low mood or depression it is helpful to know that they can shorten their sessions if needed or take a break without needing to commute.

How to find an online counsellor, live coach and video-delivered psychotherapist

1. Using the first session wisely

The most important criteria for the success of remote therapy and coaching is the working alliance with your virtual coach and online therapist. A relationship of mutual trust and respect contributes 50% to successfully working together. I recommend to invest the first appointment in order for you to get a feel for your rapport.

Ask yourself if your therapist or coach is listening, resonating and empathising with you. Do you feel unconditional support and respect? From my personal experience in therapy I want my therapist to be kind, but not too soft or fluffy. It is key that he/she is honest about their feelings and thoughts and enquires into your interpersonal connection.

2. Background and Training

You can usually check the background and education of your counselor, coach and therapist on their website and social media such as LinkedIn. A simple google research will also provide you with some appearances in their professional capacity – you might find publications, videos and programs of their involvements.

Regarding further development, professional registers, specialty education and memberships it might be worthwhile to look into the online listings and registers of certifying institutions where you can search by name or location. In addition to these formal checks, I recommend for you to also get an understanding of your practitioner’s personal and professional journey through life. Does this person embody an open mind, a wholesome approach to life and possess values that serve you well?

3. Technology and Infrastructure

Although most social media provides channels and means to converse online, WhatsApp, FaceTime, HangOuts, Skype et al might not provide the best technical stability, privacy and confidentiality.

  • Does your therapist, coach and counsellor use a renown video conferencing software that enables audio, video and screen as well as file sharing features?
  • Which timezone is he/she based in and how does that align with your schedule?
  • And even more importantly: Does the connection work?
  • Is the quality of sound and vision high and stable? After all, if the line is bad, your session will be a waste of time and money.

4. Cost and Efficiency

Apropos money: Cost depends on duration, practitioner experience, specialisations and clientele. Much like seeking out a personal trainer, it is essential that you become clear of your ambition, budget and priorities.

Beware of someone who makes unrealistic promises or seems to want to make a sale rather than seriously offering services with integrity and decency. Online coaching is not a one-off. Therapy and counselling benefits from regular and steady commitment to depth and experience.

Most decent practitioners value timeline over quick-wins and hence are willing to reward your engagement into a process and a series of sessions over time. Expect to pay in a range of 100 to 450USD (70 to 400EUR, 130 to 660AUD, 400 to 3500HKD) with rates being typically higher for business coaching.

5. How to prepare as a client

From many years of experience as an online counsellor I have learned to check with my clients if they are ready to work with me. Here is what I am asking for in order to ensure best results. I basically want you to show up for an online session in exactly the same way you would show up face-to-face in my office – my recommended online way is per video call.

  1. Environment – be in a quiet space, with good light and sound and a steady camera
  2. Attitude – be dressed in smart casual and ready to stay focused while our meeting lasts
  3. Discipline – be on time, but prepared to wait a few minutes in the waiting room feature
  4. Privacy – be present (no cats, colleagues or other communications)

Being well prepared is great gift of respect from both sides. It always yields better results for your online therapy.

Wishing you an insightful and healing online experience, Counselling Psychologist Sebastian

Resource

Good Practice in Action 047 – Fact Sheet: Working Online in the Counselling Professions is published by the British Association for Counselling and Psychotherapy, BACP House, 15 St John’s Business Park, Lutterworth, Leicestershire LE17 4HB. (Updated March 2019)

MEN’S WATCH AND TALK – online event

men's group watch and talk

This is an online event for men to get together to watch and discuss a documentary about a men’s group and – amongst others – the question “What does it mean to be a man?”.

In the film, the members of a diverse group of men take center stage. Their personal reflections on life’s challenges is contrasted by a journey to WWI sites – shockingly topical – mirroring the present times of war in Europe.

Counselling Psychologist Sebastian hereby responds to the recent impact of the pandemic on quality of life in Hong Kong and Asia Pacific. The intention being to reflect on male topics and to connect through a shared experience – far away from the often depressing daily news.

“Every man is an island. But some men build island chains, underneath they are connected”

E V E N T

  • Monday 28 March 2022 on Zoom
  • Start 19:30 HKT time
    • Introduction & Meditation (or technical setup)
    • Watching the movie (70′)
    • Sharing session (30′)
    • Closing Meditation
  • End 21:30 HKT time
  • Cost: FREE – registration required

M O V I E durch T E C H N I K

  • Participation in the Zoom Meeting is free of charge upon registration
  • Participants need to rent or buy the movie on Vimeo
  • The purchase is not part of the registration
  • Link and further info: MAKE ME A MAN

D I S C L A I M E R

Sebastian has no affiliation with the owner/producer/promoter of the film, nor is he affiliated with the vimeo platform. Sebastian does not have any commercial upside by organising this event. I simply liked the documentary as a piece of art and deem it worthwhile sharing with likeminded men.

Register here…

Micro-pollution of the mind. How it causes negativity and poor performance

What are micro-stresses and how do they affect you?

Micro-stresses are the abundance of minor annoyances and small adversities we experience throughout the day. The driver who cuts you off in traffic, the colleague who slows down your time-sensitive assignment, the broken coffee machine that messes with your refreshment pause.

Each occurrence on it’s own does not seem like a big deal. It’s the accumulation that weighs on you like a stein-holding contest. Added up, they are a whole lot of straws resting on the proverbial camel’s back. They are often the reason we’re exhausted at the end of the day (in HBR. July 2020) or why we will snap at the most minor of inconveniences.

In this short read you will learn that micro-stresses only get to you if you let them and what you can do to develop a teflon-skin from which stressors just roll off.

Why “micro” and not “macro“?

While macro stress manifests more directly and instantly, micro stress will nibble at your subconscious over a prolonged period. Wearing you down bit by bit until you feel overwhelmed by the sheer weight of it all. Managing these micro stresses could be the key to unlocking a heightened sense of worth.

There are many facets to the world of micro-stress. One aspect is purely psychological: how we interpret actions, how we manage situations, and how we will dwell on minor irritations. The link between both is Emotion.

The salient stressors in the lives of most human beings today — at least in the industrialised world — are emotional. Just like laboratory animals unable to escape, people find themselves trapped in lifestyles and emotional patterns inimical to their health.

― Gabor Maté, When the Body Says No: The Cost of Hidden Stress

But this only represents half of the story. Maintaining a healthy lifestyle is also paramount to overall wellbeing. A healthy level of diet and exercise will have a doubling effect on mental health. These activities promote and maintain overall health and create a fulfilling feeling of achievement, which goes a long way when dealing with stress of any kind. 

The effects of stress on overall health

Stress plays a massive part in our overall mental welfare, but people often don’t acknowledge its effect on physical health. Many studies have proven stress to cause increased heart rate and blood pressure. It is estimated that stress negatively impacts the lives of up to 85% of the population, and 60-80% of all doctor visits are for stress-related ailments and complaints.

In strong cases, stress can manifest as panic attacks, paranoia and poor mental health along with a weakened immune system. And more frequently than you may realise, unmanaged stress can lead to physical burnout.

How to train yourself to deal with micro stress

The first step to dealing with micro-stress, is identifying and acknowledging its existence. Due to the sheer volume of micro-stresses, some studies claim that we are on the receiving end of between 20 and 30 micro-stressful situations on any given day. We can analyse these occurrences, determine the common factors and learn how and when to disengage when we encounter them. 

A helpful habit is to halt what you’re doing and gather yourself for a moment or just a few seconds. As micro-stresses impact our daily lives, then conversely, micro-affirmations can have a positive effect. Small pauses can have big impacts.

Engage in short activities that generally induce a calming effect on your personality. Everyone has their preferred method. Standard practices include listening to calming music, taking a walk, or practicing some simple breathing exercises.

The important factor is to take a break from what you are doing. If you work in an office environment, get away from that screen. Set a timer if you need to. Get up and stretch, take in some nature if possible, or talk to a friend—but avoid any topics that generally get you riled up.

Conclusion

Micro-stresses are NOT a genuine problem endemic to today’s society, even though it is impossible to prevent them altogether. The stress only arises within our SELF (after all the coffee machine is not stressed at all about it’s poor performance) and we can adopt several ways to avoid becoming overwhelmed.

Amongst those ways are mindful attitudes like kindness, acceptance and patience. Moreover, it is essential to respect and listen to your body, feelings and emotions: maintain a healthy diet, regularly engage in physical activities and work on getting a good night’s sleep. 

We no longer sense what is happening in our bodies and cannot therefore act in self-preserving ways. The physiology of stress eats away at our bodies not because it has outlived its usefulness but because we may no longer have the competence to recognise its signals.

― Gabor Maté, When the Body Says No: The Cost of Hidden Stress

2 answers from a client regarding depression

This is a short read. A client of mine kindly provided some feedback on his counselling process with me and what he thinks of medication facing symptoms of depression.

This is an update of an older blog. You can read the original blog here…

How counselling helped you with low mood and lacking pleasure?

Looking back, it’s difficult to remember how I got myself into such a mess. At the time, though, it was very real, destructive and dark. My sessions with you were like a lifeline. One of the most important factors was feeling that I had a team around me. That you shared my different battles and that I was not alone. Your wholehearted approval (and surprise) when I mentioned that I had gone sailing while in the very depths of melancholy was especially memorable! Various insights you offered – and a couple of the books you recommended – helped me to better understand my depression. Some of the techniques and words of advice you shared helped me to create a toolkit to dig my way out of the hole I was in.

Counselling in Hong Kong for adults seeking emotional balance
Photo by cottonbro on Pexels.com

Where would you draw the line to medication and psychology?

As you will recall, I chose to go onto Prozac during all of this. In retrospect, it’s hard to know what role, if any, it played in my recovery. In fact during the first ten days, it made me worse. However, there was a watershed point about 6 weeks after I started the Prozac when I began to quickly and steadily recover. At the time, it felt as if I had absorbed a sufficient level of Prozac and my brain was now being flooded with happy chemicals. However, I have no way of objectively quantifying what was the Prozac and what was my natural recovery mode kicking in. If I were ever to go into serious depression again (God forbid), I would probably go back onto anti-depressants. I would certainly immediately go into counseling. I hope these comments are helpful to others.

(anonymous)

Happy birthday pandemic

A developmental view on our struggles with a prospering little one

“Dear Pandemic,

You are now two years old and have developed quite a character already. It took us a while to realise that we all are your parents and that you are now in our lives. Many of the adults still struggle with demanding responsibilities.

Your motor skills keep us on our toes, Just recently you started running and climbing. It is sometimes scary how easy it is to lose sight of you. Then we can’t find you, only to have you appear in places we thought we had safaguarded from your access. We protect areas that are not suitable for you, but you still gain access.

Recently you started carrying more and more things with you, attracting family members, colleagues, neighbours and strangers with your temparament. Everyone around seems drawn to watch how you become more self-aware. Some think this is cute and harmless, but we are not always so sure. Currently you are all that matters to you. You have discovered to scream “No!” to anything we propose and your moods can truly be contagious.

When you stubbornly resist direction at this age, I do wonder how much waywardness there might still come in a few years. And I shudder. Seeing you interested in other children makes us curious and we are stunned by how well you seem to observe and imitate.

We have seen so many different ways of parenting and we clearly see the helplessness and overburdening expressed on clumsy and failing approaches of interaction. A lot of the parental behaviour is inconsistent and oftentimes arises out of convenience, complacency but mainly stems from stress. It’s the over-activation of the constant need to be vigilant, but also the toll of emotional rollercoasters – endlessly swinging from high to low.

Moments of joy and hope come crashing down with despair and a deep sense of loss of control. Dealing with this young pandemic can be challenging in Hong Kong, Asia and worldwide. It is helpful to seek coaching or counselling with a registered counsellor who can help to understand your own psychology and to provide you with tools and techniques to strengthen your capacity.

Your language skills are stunning. Just recently you surprised us with more letters of the greek alphabet and with an unusual appetite for the longer words. In addition, you also frustrate us with your rapid development of new and more refined behaviours. Entertaining table after table in a restaurant? Not a problem for you. Goofing around with air crew members? Yup, they can regress to toddlers themselves when interacting with you.

As inexperienced parents we need to remind ourselves of some basics to deal with a 2y-old. Being knowledgable and prepared for the development and challenges to come is a good start. Exercising pretend play is absolutely age appropriate (i.e. by using virtual communication channels or bringing travel destinations to your home through food, movies, music and activities AND by exploring and expanding on the things around like growing plants and flowers at home, visit nature, outdoor sights and activities.”

Riding the tiger – How family reunions bring out your inner child

Family reunions act like time machines. The identities and independence we created for ourselves come crashing down the moment we arrive in familiar circles. The matrix of generational dynamics has us acting and feeling the deja-vus of our inner child.

The Drama of Coming Home

Festive holidays often mean a coming home – figuratively, literally and nowadays also virtually. Because of tradition, good intentions and the part of us that is looking forward to reuniting, we tend to suppress some negative factors that soon start to aggravate.

“Tiger years are years of change and the tiger stands for quick action. This can mean hot temper and drama at home.”

Tom Jones

Clashing Past and Present

Holidays come with cultural and traditional norms and obligations plus expectations regarding the behaviour of hosts and guests alike. Oftentimes creating a screen of perfectionism or a facade of flawlessness. Returning to the familial home and community for the holidays creates pressure to conform to expected behavior which is now at odds with one’s identity.

The inner child awakens with more force when we are spending time with family members in close conditions. The wounds of our unmet, neglected and abused psychic needs start hurting more than usual. Research studies have shown that most people describe parts of their family relationships “conflicted or “ambivalent” and a significant prevalence of estrangement between family members. 

Four fundamental psychic needs

  1. Belonging & Attachment
    • The desire to belong, connection and community is essential to our survival and hence makes us all social beings. The child in us hardwires disruptions during early childhood from neglect, rejection, abandonment and abuse. Parenting shapes the attachment styles we internalise as adults.
  2. Autonomy & Safety
    • As much as we strive for belonging and attachment, we also long for exploration, self-expression and independence. Safety is gained through control. The more we are or feel in charge, the more we are or feel in control. “Control Freaks” are driven by the anxiety of dealing with uncertainty.
  3. Gratification & avoiding listlessness
    • Learning to tame this need correlates with success, but it also causes frustration and low mood. Spoiled children struggle with unfulfilled cravings often acting out in an agitated way. Unhealthy lifestyles are often connected with an excessive satisfaction of this need to compensate neglected other needs.
  4. Recognition & Acceptance
    • As social beings, we all seek recognition and acceptance from others to feed our sense of self-worth. Parents can equip us with a good amount of self-worth, which then protects us from being overly needy. However they can also fail to do so, which then often leads to behavioural patterns of people pleasing, self-sacrifice or approval seeking.

Acting out of inner conflict

Many of my clients in Hong Kong carry a strong inner conflict between autonomy and attachment. They find themselves in a zone of suffering between the pull of powerful, rich, egocentric, critical or traditional parents and the push of autonomic growth and control of their own educated, gifted and competent selfs.

Meeting with family typically induces a mixture of excitement and dread in many people.  However, with forethought and realistic expectations we can sidestep family drama and even create new positive memories. Old wounds may resurface and we easily fall into behavior patterns that are hauntingly familiar. 

Furthermore, the pressure is on to give the impression of our best selves, that we are living our best lives (thanks, social media!).  Such is the need for approval and acceptance that we will forego our autonomy.  The disparity between feelings and actions will distress the individual, making tensions between family members rise.

Nurturing your inner child and those of others

Self-awareness first

Work out when and how you are going to factor in self-care whilst you are out of your usual routine.  If you know being around people 24/7 is simply going to wear you out and you get grumpy when you get tired, plan for some downtime.  Even people who adore the holiday season and their families usually need a break to recharge.

Setting Boundaries

Before you get home, consider making it clear ahead of time exactly what activities and events you are willing to participate in this year.  Encourage others to do the same.  Setting such boundaries will protect you and your family in the long run. Did you know that setting boundaries makes you happier?  Setting realistic expectations ahead of time will prevent disappointment and the risk of others loading on emotional blackmail on the spot.

Lower your expectations

Rather than mentally trawling through the Rolodex of past grievances before you get home, filling your headspace with negativity, try to use this time for forethought by mindfully setting your own realistic expectations … and lowering them!!!  Acknowledging your own triggers ahead of time and accepting the family situation for what it is will help you to keep a cool head when you get there.  Ultimately, you can only control your own actions, trying to manage others will only lead to disappointment and frustration.

Activity vs Idle time

Plan plenty of (optional) activities for everyone to do together. Try getting active to shift any negative energy; go for a long walk in nature, pick a funny interactive board game or cook something together.  This could be the opportunity to forge new positive memories rather than focus on past hurts.  After all, research shows that our memories of past events are rarely accurate anyway.

Backing up for self-protection

Finally, work out your backup plan if everything gets too much.  Before conflict breaks out or someone says something hurtful, have a mental, emotional and practical “escape route” planned out when you feel the heat rising. 

Knowing you have this option sorted just in case ahead of time will improve the likelihood that you can distance yourself from the drama and retreat before you get sucked in.  It is about you being able to take a step back and consider the situation with perspective. 

Hotel Q(uarantine) – The emotional hardship of 21 days has sailed

counselling soul

The broad window in my Sigh-ing Pun* hotel boasts a great harbor view. I often sit on the broad windowsill watching the busy waterways between Hong Kong Island and Kowloon. It strikes me how fast and lineal some of the ferries plough through the waves. Sailing boats are rarer and more interesting to look at.

Some sail more smoothly than others. All find the same conditions, but some clearly master what they come across with more skill than their fellow travellers. They artfully hold the vessel steady and gain momentum in the elements – independent of size or shape. 

Understanding emotional meteorology

I wonder how I can keep a stable course throughout my journey of 21 days. Like the solo sailors who conquer an ocean – always fearing to capsize on a whale – I am afraid to drown on account of the inert mass of my body and mind. The Highs and Lows of my internal weather have frequently interfered with the moral compass.

Any emotion can be used to gather way. I can even sail against the wind at a pointed angle. It’s not going to be fun, but it can be done. I knew that I will face sunny days, stormy, rainy and calms. Part of my self-care was to allow any weather to arise without fighting it. Accepting the fronts to pass.

Key to survival is a sound sense of the elements. A ship sails better with the wind and the water, not against it. I am well advised to feel the breezes of my mood and to detect and accept the undercurrents of my emocean. But how? How can I bear gusts of anger when I read the news? The spray of unfairness, like a slap in the face?

Using what you have aboard

When I feel the elements getting at me, as best I can, I try to decenter and defuse from thoughts and reactions that appear in my mind. I do so by shifting attention away from myself and towards things I am grateful for, feel joyful about or just to things that are more relevant to my life right now, like helping people with my work as a counsellor in Hong Kong.  

I was grateful for being greeted by the frigate of HK admin, operating smoothly as usual. Holding up a massive pandemic undertaking seamlessly with solid organisation and politeness. Thank you to all the people working day and night to keep our normal life going – efficient at the airport, caring at the hotel and the jolly-friendly testing staff – in particular on NYE!!!

Alternatively, I bring back the focus of attention to my body and expand awareness from head to toe. Connecting with any sensations in my body helps to feel what is already there, honing in on pain, tension, heartbeat, heat and the breath. With the awareness of feeling I settle in with the here and now. Being fully present with the elements, the emotional weather – outside and inside.

“So maybe that’s what all that advice to live in the present moment is getting at: If you can invest more attention in the sensory world than in your narrative overlaying it, you might identify the former, rather than the latter, to be what’s true.”

Drake Baer 2017 thecut.com

Balance is important, intention is paramount

Balancing ourselves becomes easier when we know how we steer, what our sails are and where, understanding which ropes to hold tight and where to best place us and our crew in order to keep gliding steadily. I remain agile by moving around from bathroom to desk, from bed to window ledge and from yoga mat to the door.

Only by actively handling the pushes and pulls of the elements, can we stabilise the boat. Drifting is never an option, unless we do it on purpose (aka sober). Daydreaming can be positive-constructive, whereas the shallows look guilty-dysphoric or with poor attentional control.

We can choose different modes when sailing through life. We can cruise having pleasure in mind, we can be competitive in Regatta-mode having winning in mind or we can set sail having a destination in mind. It helps me to know what I am sailing for. My motivation is the mastery of navigation in order to arrive at shores I thought I could not reach. Competing only with myself.

*Sai Ying Pun intended!

Booze to ban in the month of Jan

counselling for alcohol coaching change habits

The non-drinking movement

The new year is upon us. It’s a time to review our habits and behaviors of the last 12 months and identify what changes our happier, healthier future selves will thank us for.  In 2021, 6.5 million people aimed to complete ‘Dry January’, an increase of a whopping 2.6 million people on the previous year.

The great news is once we put down the booze, we begin to see multiple improvements across health and performance.

Impact on mood and emotion

Firstly, by abstaining from alcohol, you won’t have to deal with erratic mood swings or ‘hangxiety’ (the common hangover anxiety).  Alcohol disturbs the normal release of your neurotransmitters, including dopamine, serotonin, and endorphins.  Alcohol is a sedative, so your brain compensates by exciting the stimulatory systems. 

It seems to affect people more severely if they are already prone to anxiety, typically those using alcohol as a social lubricant.  There’s a lag time, so these signals continue after we stop drinking. A 2013 study on rats still felt fear, depression, and anxiety symptoms 14 hours after alcohol blood levels reached zero.

Impact on sleep

A common mistake people make is to consider alcohol as a sleep aid. Yet sedation is not the same as regular sleep.  In reality, alcohol plays havoc with our sleep cycles and the quality of our sleep after drinking. Our hours in bed are littered with micro-awakenings, preventing us from achieving restorative sleep. 

A study on just under 100,000 Japanese students found alcohol to disturb a multitude of sleep functions, including short sleep duration, difficulty initiating sleep, and waking up early.  The disturbance effect increased with the number of consecutive days the participants drank.

“Hop on the bus, Gus; you don’t need to discuss much.

Just drop off the key and get yourself free”

50 Ways to leave your lover, Paul Simon, 1975.

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Impact on Cardiovascular functioning

People rarely consider the detrimental effects alcohol is having on their cardiovascular function.  Drinkers collectively raised a glass upon hearing the news that one glass of red wine might lower the risk of coronary artery disease, diabetes, and stroke. 

However, people rarely stay within the recommended guidelines, and doctors would prefer we abstain from drinking altogether.  Indeed, binge drinking is the top factor leading to premature death for males under sixty.

Impact on weight and shape

A common side effect of giving up booze is weight loss.  We tend to forget about the hundreds of calories contained in each glass we’re knocking back, but these often show up later on our waistlines.  This effect compounds when one considers that alcohol causes a spike in the body’s insulin secretion (to deal with all that sugar consumed!). Blood sugar levels then fall, hindering exercise performance.  

Impact on workout and fitness

Furthermore, alcohol stops the absorption of vital vitamins and minerals such as thiamine, B12, folic acid, and zinc.  Without these, the human body cannot generate new cells, build a robust immune system or metabolize food efficiently. 

Of course, when you’re not so hungover, you’re also more inclined and motivated to hit the gym rather than the biscuit tin.  Trading a pint for a gym pass will not only help you drop the pounds but will have innumerable benefits for your body and mental health. 

Beer isn’t a good post-gym drink, either: it won’t help you re-hydrate or supply energy. Alcohol dehydrates you because it is a diuretic, meaning that it makes you pee and remove fluids faster than other drinks. Instead, reach for some (coconut) water.

Impact on sexual performance

If all that didn’t get your attention and convince you to take a break from drinking, perhaps this will: alcohol ruins your sex performance.  Sure, a few drinks lower our inhibitions and make potential partners seem more alluring (hello, beer goggles).

But when it comes to the crucial act, males may find their ability to maintain an erection or ejaculate impaired.  Sober sex might sound intimidating, but reassuringly, almost three-quarters of Cornell University students reported being sober when they had their best sexual experience.

Forming healthy habits

For most people, drinking is nothing more than an ingrained behaviour requiring distraction or replacement with more rewarding activities to overcome. Remember that most of our drinking really is just a bad habit, often starting with browsing you favourite wineshop online or stopping-over at the convenience store on your way home.

A period of abstinence will help your mind to form new healthier habits and your brain with learn to pass through the bottled racks unimpressed. Bad habits lead to a closed state of mind from which we deem healthier alternatives less attractive. We risk missing out on the real rewards in life: meaning, intimate connection and achievements.

Counselling helps to increase awareness of unhealthy habit loops and enables sustaining change of thinking and behaviour. Seeing a counsellor in Hong Kong or online provides the support for you to add the emotional and physical strength back into your life.

Committing to dry January and joining thousands of other people may be the kick-start you need to break this habituation, teach your brain new reward pathways, and give your whole body a chance to perform optimally. So raise a glass of Perrier to the new year and you may just find that sober life is a resolution that endures.

Mindful Holidays for a joyful year ending

Joyful holidays

Joy as a Mental Strategy

When I prepare mentally for the holiday season, I remind myself of one mindful attitude in particular: JOY. Joy is an attitude of the heart. The warm feeling we can choose to feel from inside with intention.

I am mindful of my intentions for the festive season. This includes my intention to engage with loved ones, with neighbours and strangers in soft and kind way. But even more so to engage with myself by pacing my levels of tension, impatience and striving.

Also setting an intention that makes a difference from other times of the year. I ask myself, looking back what is the one thing that I want to have accomplished (i.e. making some people happy with a poignant choice of gifts; having spent quality time with some people I love; having met with people without masks and little risk of infection).

Traps of mindlessness

Some of us seem to be driven by perfection, sometimes based on missed chances during our own childhood or due to chasing a nostalgic high we want to replicate. It is essential to bethink yourself of the purpose of the holidays and how you want to celebrate it.

Mindfulness suffers when we get ahead of ourselves, when we are not being present with all our senses.

Some of us want to please too many people or cater for too many needs (i.e. giving, meeting, singing, eating, resting, celebrating, reading, cheering, greeting, kissing, …). It can be difficult during these times of heightened expectations to allow yourself to be human.

Cultivate mindfulness over the holidays

In any culture, important holidays typically put a strain on families and relationships. Christmas being the one I grew up with. It is also a time when sadly I receive more enquiries from couples. Holidays come with cultural norms and obligations, loads of expectation regarding behaviour and family dynamics galvanise.

Being mindful means to pay attention from moment to moment without judging. The reward then is to be able to engage with each other in harmony without being carried away by our minds, our work or our (hi)story.

Coming back to Joy

Mindfulness can simply mean to practice joy, generating warmth from your heart. For some that might mean to be a bit less self-involved and for others that might mean to offer more of what one truly has to offer: their own joyful presence not “presents”. Please find free guided meditations, links to more and reading material on Counselling in Hong Kong website https://counsellinghongkong.com and contact counsellor Sebastian Droesler for more information.

Three simple practice during the festive season

  1. Choose to focus your attention on one thing or task at a time. Be fully present with the task at hand. When you speak to someone, think before you talk. When you eat, chew and taste before you swallow. When you drink, smell and savour the good stuff. When your attention is being pulled or your mind wanders, notice where it went and then bring it back.
  2. Expand your awareness without judgement without striving. Take a moment to observe yourself and your surroundings in stillness. Resist the temptation to leap forward into the next thing to do. What do you notice about yourself? Watch what is going on around you? No need to change anything. But if you choose to act, do it with elegance.
  3. Practice your Lovingkindness. Lovingkindness is the practice of wishing well. You can use phrases such as “may you be happy. May you be healthy.” that you can say in silence to yourself, loved ones, strangers and even people you find difficult. Connect with positive emotions of goodwill and benevolence. We’re not trying to manifest any reality (we’re not going to make anyone healthy by wishing that they are), but rather seeing how it feels to say these words to another person while genuinely meaning it.

If you are looking for counselling or coaching via in-person sessions with Sebastian, you can find his office conveniently in Lan Kwai Fong, Central Hong Kong.

A bundle of nerves to rule them all: Unpacking the vagus nerve.

The vagus nerve relates to our capacity to function as social beings through maintaining our emotional regulation, fear response and social connections. We all constantly cycle through stages of disconnection, mobilisation and social engagement. Our Autonomic Nervous System adapts protection and connection from moment to moment.

However, patterns of protection can compromise our social engagement system. This article highlights some neuro-physiological explanations for why we are often not smooth and balanced. It also addresses ways to regulate and staying connected.

What is so special about the vagus nerve?

The vagus nerve connects the brain with the heart and other major organs and runs on autopilot without requiring intervention. This system regulates our heartbeat, breathing and other autonomous body functions such as digestion, body temperature and sexual arousal.

…the different branches are related to unique, adaptive behavioral strategies and articulates three phylogenetic stages of the development of the mammalian autonomic nervous system. These stages reflect the emergence of three distinct subsystems, which are phylogenetically ordered and behaviorally linked to social communication (e.g., facial expression, vocalization, listening), mobilization (e.g., fight-or-flight behaviors), and immobilization (e.g., feigning death, vasovagal syncope, and behavioral shutdown). 

Porges, Stephen W. (2010). The Polyvagal Theory.

Vagal branches are related to unique adaptive behavioural strategies that are essential for our survival. These strategies developed in three stages from immobilisation to mobilisation to social communication. As part of the autonomic nervous system, it is triggering the human defence mechanism that consists of fight, flight and freeze when there is danger or perceived threat.

It stimulates the body’s response when put under STRESS and it goes into shut-down mode when overwhelmed. However, our stress response is essential for survival, but needs to be tamed to enable social engagement.

How to understand your states of arousal?

The human survival mechanism is an integral part of our physiology. As such, the ability to sense and identify danger is inherently a valuable tool in our biological makeup and is termed “neuroception“. However, due to experienced trauma for example, the brain can map irregular associations resulting in a dysregulated nervous system. The first step, then is to recognise that this is happening.

“Trauma compromises our ability to engage with others by replacing patterns of connection with patterns of protection. If unresolved, these early adaptive survival responses become habitual autonomic patterns.”

Dana, Deb. (2018). The Polyvagal Theory in Therapy

Paying attention to states of arousal is vital, either in the moment or retrospectively. Consciously acknowledging when you experience one of the three defence mechanisms can make all the difference. If you find yourself uncharacteristically defensive (fight), feeling the overwhelming need to escape from a situation (flight), or rooted to the spot in a blind panic (freeze), it’s essential to understand the reasons behind these reactions.

Psychology and physiology merge in stages of the vagus nerve

My clients easily relate to the different stages of their vagal activation which can be described in terms of body and mind. The ventral vagal activation is represented by an open mind (“I may”, “may you be happy”) and an orientation towards others and the environment (posture, tone of voice, feeling warm).

Sympathetic arousal is reported as an increasingly narrowed mind with thoughts about taking action ranging from “I can” to “I should” to “I must” and simultaneously from feeling concerned/activated to anxious/angry to panic-fuelled/acting up. Body sensations include elevated heart rate, heavy breathing and feeling hot.

When the system becomes overwhelmed the dorsal vagal state of “I can’t” (“I collapse”, “I shut down”) takes over and clients of mine report to withdraw, self-medicate or zone out. This state is also characterised by a lack of connection, presence and self-control.

Due to the nature of the nervous system, we can feel each of these responses in varying degrees. A workaholic may have an active “flight” response, feeling a need to keep busy and seemingly unable to slow down. In someone else, a flight response may result in addictions – fleeing from emotions by making them go away with substances. 

Once identified, we can then understand what triggered the episode. Try to determine what happened immediately before the incident. Was it a comment, a specific tone of voice that someone used? Perhaps a smell or a particular situation made you feel overwhelmed.

How to cultivate the social engagement system?

We can take some steps to regulate and manage our nervous system. With a bit of practice using exercises that calm the nervous system and target the vagus nerve, we can maintain a healthy emotional balance.

In order to improve emotional wellbeing, it is important to understand how both internal and external factors impact mental health. Start by looking at your immediate surroundings. What elements spark joy for you? What aspects of your environment make you feel uncomfortable or overwhelmed? Think about what you can do to improve this environment. 

Even more important than the external environment is the internal struggle. One problem you may face is an abundance of self-criticism, overthinking and perfectionism. Practice snapping out of negative mental loops by

  • Simply letting your experience be: When you stub your toe, pause and feel the pain. No need to express it, stay with it – it is already there.
  • Simply letting go of any add-on experience: When you stub your toe, there is no need for anger, no need for cursing, no need for writing a screenplay about it.
  • Simply develop a more helpful attitude: When you stub your toe, pause and change your attitude. Does the leg of the kitchen table ask you to be more cautious or even to refurbish?

Directly Stimulating the vagus nerve can have tremendous effects on your reaction to stress. Breathing practices, yoga, physical movement, humming or singing, grounding exercises or working with temperature changes can all be valuable tools to help regulate your body when you catch yourself in a fight, flight or freeze response.

There is a wealth of information available for a more in-depth explanation of polyvagal theory and methods you can use to improve emotional well-being. Deb Dana has written an informative and helpful book on the subject, called “The Polyvagal Theory in Therapy.” Irene Lydon runs an exceptional YouTube channel outlining methods for improving mental health.