I’m a psychologist & changing challenging behaviours has been a significant component of my career. The absolute blunt end of our careers is that people are individuals & they have full agency over their choices. We, as clinicians have professional integrity - if a patient / client chooses not to follow our recommendations; it isn’t our fault. All we can do is be open, honest & accepting & that is the end of our responsibility
So good! And so true! I learned as a RN, and now a practicing PMHNP, this technique is very effective. Not only with substance abuse but even more so with personality disorders! When you have to make them think of their own solutions, then they are much less inclined to act out and demand things.
I never actually worked in the field, but I did finish a psychology university. And also did some training in order to become a clinical psychologist, but I never managed to go all the way. Anyway... One of the techniques I saw working pretty well with people was some sort of total freedom. Meaning that I used to tell friends that wanted to talk to me as if I were some sort of counselor in the field that whatever. If you don't want to change, you don't have to, there are other options, it's more in the real that you might have troubles if you don't rather than you have to. Because many times people were having issues in the real of I don't get along with my parents. And I used to tell them that getting along with your parents it's not a requirement, it's more in the realm of life might be very hard if you do. And that you don't have to like it, love them, whatever... It's enough to keep some sort of decent interactions. My personal issue with the training was that people doing the training had this view that psychotherapy is some sort of magical process that solves people's life. And I was like... No it doesn't. You might get slightly better. It might be a way for you to circumvent a difficult situation by talking about it with someone neutral rather than someone who might have a biased opinion, stuff like that. Anyway... Things that probably made people feel that they are not going to change necessarily, but rather do better. And I am not sure if this actually helped them feel better, but I can say that I had these conversations for years and years and years. So probably such an approach is at least good for the topic of adhesion to the program. From what I know, psychotherapy has a big problem in what concerns adhesion. Many people start it and stop after a few sessions, others never even try going because the idea of change as something imposed from the exterior is not to their pleasing. And many people do go to psychotherapy because they are suggested to do so by others. But I think that if they hear that they don't have to change, it's rather sufficient to just spend some time there without doing anything in particular, in time it will grow on them and change will occur. I personally enjoyed going, it's just that I found it a bit to expensive for my budged. Otherwise, I would probably still go, claiming that I don't like it, that I don't want to, stuff like that and yet changing bit by bit. And probably for the better.
I am always in need of greater resources in managing change. I learned that behind every behavior is a need. And, it’s helped me shed shame and be curious about new ways to change my behavior. As Jung might posit: mythology (why?) over pathology (what’s wrong with me?). Some noncompliance issues could be helped with systems changes. Like, if insurance covered more time with psychiatrists to build rapport, I think I would have followed medications more easily earlier in my life. For years, I had 15 minute sessions with rotating residents that were confusing even when I took notes. Now, I can afford longer sessions where my psychiatrist can explain things thoroughly. And, if insurance covered more medications that would be helpful. So often I’ve had to change meds due to coverage issues. Thanks for your wisdom and all those in the comment section who help people like me. Really makes me tear up to know how much we all care and want each other to do better. - 31 yo living with bipolar I, psychosis, schizoaffective and PTSD and neurological issues from 2 skull fractures.
I have had similar issues with "rotating residents" (and/or "locums" - who have moved on by the time my next psychiatrist appointment comes up). Very frustrating. We think that we might have established some rapport with an individual (locum) psychiatrist, (or a resident), and the next minute, they're gone, and one has to move on too, and start all over with yet another one. Like you, had I experienced more consistent rapport with practising psychiatrists, rather than a never ending stream of temporary ones, I might have been far more compliant with my meds, earlier on. I desperately needed consistency, and I was constantly looking for lasting rapport, and without these, I felt at sea, (and also, somewhat defiant, as my own parents never offered consistency, or genuine rapport, being somewhat punitive - so basically, I rebelled). I was particularly interested to read in your comment that your path has been a similar one to my own - Bipolar I with psychosis, which eventually led to schizoaffective disorder, CPTSD, and finally (most recently) neurological issues following a brain bleed (an AVM). I too have huge challenges in managing (and even facing) change. Thank you for your thoughts in your comment, I identified strongly with them!
I have found that UPR goes a long way in MH. Client's sense a lack of authenticity and genuineness on the part of the MH practitioner can improve outcomes. In some instances this may be the only positive/respectful relationship they have had and the valuing they receive is powerful. Not everyone is ready for change because they feel safe in their maladaptive behaviours or change is too difficult a task. Love your non-judgmentalism Dr Syl. It is about supporting not blaming whilst gently steering and enabling autonomy.
My loungeroom is naturally dark, so I keep one of the blinds open all the time. Not only does the light come in, but I can look onto my garden. Win/Win.
Im not getting the proper one on one training in my site. So this channel really helps me think about how I want to run my therapy sessions. Thank you.
Hey Dr. Syl - I've done a fair bit of work on my needle phobia and I'm completely desensitised to images now, but I i just thought I'd point out (no pun intended haha) that for many, many years the thumbnail with syringes would have been super distressing to me and there would have been 0 chance of me watching/clicking the video because of it.
Yeah every time I watch those dramatized TV interventions I'm so angry at them because I can see that if somebody was doing that to me it would make me 1000% worse guilt and shame just make people wanna crawl deeper into their hole and hide from the world it it doesn't make sense to people who haven't experienced it but you'll use your coping mechanism to relieve the guilt of using your coping mechanism people telling you that you've hurt them it's just gonna make you want to die not get better people need hope that they can have a better life not accusations or convincing! When I also this makes me think of my eating disorder and like how people need to stop telling anorexic to eat at sandwich as if we don't know what we're doing is dangerous or stupid no one cares why and no one asks you what it's doing that helps no one understands what you get out of it they just think you're being dumb or doing it for attention but yeah sometimes you can't convince people to change sometimes they're not ready yet and you have to just accept that they are the way they are all you can do is encourage harm reduction and keep them as safe as possible but it's ultimately their choice but people tend to get so angry at the idea of letting others do stupid stuff and it's like we all have our vices who are we to judge each other's way of being it's hypocritical
Don’t sit TOO close though 😂 One time during a… dang, what would you call it 🤔 Anyway I was in college and my therapist called in local mental health to see if I needed to be admitted (mostly for SI but I had a SH habit at the time too). The guy sits down and is knee to knee with me and telling me why he’s there and what’s going to happen and he finishes with ‘Can we do that, A-?’ and I said ‘We can if you back up’ 😬 My therapist snorted 😂 PS I’m not weird, I got my bachelors in psych but my sever depression derailed my masters degree plans 😒
First! Q 1: Hi Dr Syl, I often overthink stuff, and I’ve recently been told by a doctor and psychologist that I am showing early warning signs of psychosis, they will go to a meeting to figure out what to do. However not all my symptoms are people/shadow people, noises, it’s also dots, flickers, things appearing like they are moving, colours, and lines, are these also related to psychosis or is there something else? Q 2: Also, they asked if I have delusions and I answered idk, is it a delusion to think that everything in your life is a hallucination? The people, buildings everything, if so is it also a delusion to think that I am dreaming and everything is a dream and one day I’ll wake up?
Dots, flickers, things appearing like they are moving, colors, and lines are all hallucinations that can be present in psychosis but they could also be because of another condition but seeing that your psychiatrists thinks you are showing early signs of psychosis id say that unless you have reason to think otherwise that, yes those are hallucinations. And delusions can be symptoms such as thinking nothing is real but it could also be many other things. I’m no psychiatrist but maybe I could help who knows. Hope things get better for you
@ It’s not a psychiatrist (sorry I didn’t make that clear) it’s a doctor, and a psychologist so two people in the session, thank you for clearing it up for me, it helped👍✨
Yikes Dr. Syl, the notion that someone presenting with mental health issues is doing so because of their own problematic behaviour is so blame-y we're back in the 1950s!
@@douglasmoran1104he’s just saying that people who come to a psychiatrist have had some sort of incident or problem in their life that needs to be addressed. It’s not their fault that it had happened, and he isn’t blaming them for it rather championing them for reaching out and accepting help
I don't think that's what he meant. He is talking about patients who relapse often do something maladaptive to their health, such as quitting medication. BUT he isn't saying that the mental illness in itself is the problematic behavior. Of course he doesn't think that, that would be insane lol.
I’m a psychologist & changing challenging behaviours has been a significant component of my career. The absolute blunt end of our careers is that people are individuals & they have full agency over their choices. We, as clinicians have professional integrity - if a patient / client chooses not to follow our recommendations; it isn’t our fault. All we can do is be open, honest & accepting & that is the end of our responsibility
So good! And so true! I learned as a RN, and now a practicing PMHNP, this technique is very effective. Not only with substance abuse but even more so with personality disorders! When you have to make them think of their own solutions, then they are much less inclined to act out and demand things.
I never actually worked in the field, but I did finish a psychology university. And also did some training in order to become a clinical psychologist, but I never managed to go all the way. Anyway... One of the techniques I saw working pretty well with people was some sort of total freedom. Meaning that I used to tell friends that wanted to talk to me as if I were some sort of counselor in the field that whatever. If you don't want to change, you don't have to, there are other options, it's more in the real that you might have troubles if you don't rather than you have to. Because many times people were having issues in the real of I don't get along with my parents. And I used to tell them that getting along with your parents it's not a requirement, it's more in the realm of life might be very hard if you do. And that you don't have to like it, love them, whatever... It's enough to keep some sort of decent interactions. My personal issue with the training was that people doing the training had this view that psychotherapy is some sort of magical process that solves people's life. And I was like... No it doesn't. You might get slightly better. It might be a way for you to circumvent a difficult situation by talking about it with someone neutral rather than someone who might have a biased opinion, stuff like that. Anyway... Things that probably made people feel that they are not going to change necessarily, but rather do better. And I am not sure if this actually helped them feel better, but I can say that I had these conversations for years and years and years. So probably such an approach is at least good for the topic of adhesion to the program. From what I know, psychotherapy has a big problem in what concerns adhesion. Many people start it and stop after a few sessions, others never even try going because the idea of change as something imposed from the exterior is not to their pleasing. And many people do go to psychotherapy because they are suggested to do so by others. But I think that if they hear that they don't have to change, it's rather sufficient to just spend some time there without doing anything in particular, in time it will grow on them and change will occur. I personally enjoyed going, it's just that I found it a bit to expensive for my budged. Otherwise, I would probably still go, claiming that I don't like it, that I don't want to, stuff like that and yet changing bit by bit. And probably for the better.
I am always in need of greater resources in managing change. I learned that behind every behavior is a need. And, it’s helped me shed shame and be curious about new ways to change my behavior. As Jung might posit: mythology (why?) over pathology (what’s wrong with me?).
Some noncompliance issues could be helped with systems changes. Like, if insurance covered more time with psychiatrists to build rapport, I think I would have followed medications more easily earlier in my life. For years, I had 15 minute sessions with rotating residents that were confusing even when I took notes. Now, I can afford longer sessions where my psychiatrist can explain things thoroughly. And, if insurance covered more medications that would be helpful. So often I’ve had to change meds due to coverage issues.
Thanks for your wisdom and all those in the comment section who help people like me. Really makes me tear up to know how much we all care and want each other to do better.
- 31 yo living with bipolar I, psychosis, schizoaffective and PTSD and neurological issues from 2 skull fractures.
I have had similar issues with "rotating residents" (and/or "locums" - who have moved on by the time my next psychiatrist appointment comes up). Very frustrating. We think that we might have established some rapport with an individual (locum) psychiatrist, (or a resident), and the next minute, they're gone, and one has to move on too, and start all over with yet another one. Like you, had I experienced more consistent rapport with practising psychiatrists, rather than a never ending stream of temporary ones, I might have been far more compliant with my meds, earlier on. I desperately needed consistency, and I was constantly looking for lasting rapport, and without these, I felt at sea, (and also, somewhat defiant, as my own parents never offered consistency, or genuine rapport, being somewhat punitive - so basically, I rebelled). I was particularly interested to read in your comment that your path has been a similar one to my own - Bipolar I with psychosis, which eventually led to schizoaffective disorder, CPTSD, and finally (most recently) neurological issues following a brain bleed (an AVM). I too have huge challenges in managing (and even facing) change. Thank you for your thoughts in your comment, I identified strongly with them!
@ I truly treasure your reflective comment! Thank you!
Appreciate what you are doing Dr.Syl….🤙🏻
I am a Personal Trainer and so this video was very helpful. I found it interesting not to shame or blame.
I have found that UPR goes a long way in MH. Client's sense a lack of authenticity and genuineness on the part of the MH practitioner can improve outcomes. In some instances this may be the only positive/respectful relationship they have had and the valuing they receive is powerful. Not everyone is ready for change because they feel safe in their maladaptive behaviours or change is too difficult a task. Love your non-judgmentalism Dr Syl. It is about supporting not blaming whilst gently steering and enabling autonomy.
When those who don’t want to change and think they are always right it’s damn near impossible to alter that
My loungeroom is naturally dark, so I keep one of the blinds open all the time. Not only does the light come in, but I can look onto my garden. Win/Win.
Im not getting the proper one on one training in my site. So this channel really helps me think about how I want to run my therapy sessions. Thank you.
Very interesting topic to discuss. Thank you
Hey Dr. Syl - I've done a fair bit of work on my needle phobia and I'm completely desensitised to images now, but I i just thought I'd point out (no pun intended haha) that for many, many years the thumbnail with syringes would have been super distressing to me and there would have been 0 chance of me watching/clicking the video because of it.
Yeah every time I watch those dramatized TV interventions I'm so angry at them because I can see that if somebody was doing that to me it would make me 1000% worse guilt and shame just make people wanna crawl deeper into their hole and hide from the world it it doesn't make sense to people who haven't experienced it but you'll use your coping mechanism to relieve the guilt of using your coping mechanism people telling you that you've hurt them it's just gonna make you want to die not get better people need hope that they can have a better life not accusations or convincing! When I also this makes me think of my eating disorder and like how people need to stop telling anorexic to eat at sandwich as if we don't know what we're doing is dangerous or stupid no one cares why and no one asks you what it's doing that helps no one understands what you get out of it they just think you're being dumb or doing it for attention but yeah sometimes you can't convince people to change sometimes they're not ready yet and you have to just accept that they are the way they are all you can do is encourage harm reduction and keep them as safe as possible but it's ultimately their choice but people tend to get so angry at the idea of letting others do stupid stuff and it's like we all have our vices who are we to judge each other's way of being it's hypocritical
Don’t sit TOO close though 😂 One time during a… dang, what would you call it 🤔 Anyway I was in college and my therapist called in local mental health to see if I needed to be admitted (mostly for SI but I had a SH habit at the time too). The guy sits down and is knee to knee with me and telling me why he’s there and what’s going to happen and he finishes with ‘Can we do that, A-?’ and I said ‘We can if you back up’ 😬 My therapist snorted 😂
PS I’m not weird, I got my bachelors in psych but my sever depression derailed my masters degree plans 😒
First!
Q 1:
Hi Dr Syl, I often overthink stuff, and I’ve recently been told by a doctor and psychologist that I am showing early warning signs of psychosis, they will go to a meeting to figure out what to do. However not all my symptoms are people/shadow people, noises, it’s also dots, flickers, things appearing like they are moving, colours, and lines, are these also related to psychosis or is there something else?
Q 2:
Also, they asked if I have delusions and I answered idk, is it a delusion to think that everything in your life is a hallucination? The people, buildings everything, if so is it also a delusion to think that I am dreaming and everything is a dream and one day I’ll wake up?
To Q2: Do you FEEL like that, or are those things you actually believe,, even if someone else says otherwise?
@ I can’t help but believe it, ik it sounds weird
Dots, flickers, things appearing like they are moving, colors, and lines are all hallucinations that can be present in psychosis but they could also be because of another condition but seeing that your psychiatrists thinks you are showing early signs of psychosis id say that unless you have reason to think otherwise that, yes those are hallucinations. And delusions can be symptoms such as thinking nothing is real but it could also be many other things. I’m no psychiatrist but maybe I could help who knows. Hope things get better for you
@ It’s not a psychiatrist (sorry I didn’t make that clear) it’s a doctor, and a psychologist so two people in the session, thank you for clearing it up for me, it helped👍✨
Oh my god, 19th i guess.
Psychiatry is committed crimes against humanity.
I don't have a problem with substance but have a memory fefacet
Yikes Dr. Syl, the notion that someone presenting with mental health issues is doing so because of their own problematic behaviour is so blame-y we're back in the 1950s!
It’s true if you think about it
@Aeolus_ca I've thought about it, and believe it's wildly blamey
@@douglasmoran1104he’s just saying that people who come to a psychiatrist have had some sort of incident or problem in their life that needs to be addressed. It’s not their fault that it had happened, and he isn’t blaming them for it rather championing them for reaching out and accepting help
I don't think that's what he meant. He is talking about patients who relapse often do something maladaptive to their health, such as quitting medication. BUT he isn't saying that the mental illness in itself is the problematic behavior. Of course he doesn't think that, that would be insane lol.
Thats not what it means.