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Mental Health

The world health organisation

  • Abbreviated to WHO

  • International health authority within the UN

  • 193 member countries

  • Australia has been a member since 1948

  • WHO’s definition of health (from 1946)

    • Health is a state of compete physical, mental and social well-being and not merely the absence of disease or infirmity

Dynamic health & wellbeing

  • It is a constant state of change, changes can occur quickly or slowly

  • A person could be experiencing optimal physical functioning and then contract an infectious disease making them feel sick

Subjective Health & wellbeing

  • It means different things to different people

  • An elderly person may view their health and wellbeing as good if they can live independently and look after themselves.

Dimensions of Health

Dimension of Health

Definition

Social health

Is the ability to form meaningful and satisfying relationships with others and the ability to manage or adapt appropriately to different social situations

Physical health

Relates to the functioning of the body and its systems, it includes the physical capacity to perform daily activities or tasks

Mental health

Relates to the state of a person’s mind or brain and the ability to think and process information

Spiritual health

Relates to ideas, beliefs values and ethics that arise in the minds and conscience of human beings. It includes the concepts of hope, peace, guiding sense of meaning or value and reflection on your place in the world

Emotional health

Relates to the ability to express emotions and feelings in a positive way

Optimal physical health and wellbeing

  • Healthy body weight

  • Absence of illness, disease or injury

  • Optimal blood pressure

  • Optimal levels of energy

  • Appropriate levels of fitness

  • Physical capacity to perform daily tasks

  • Well functioning body, systems and organs

Optimal social health and wellbeing

  • Productive relationships with other people

  • Supportive and well - functioning family

  • Supportive network of friends

  • Ability to manage or adapt appropriately to different social situations

  • Effective communication with others

Optimal emotional health and wellbeing

  • Recognise and understand emotional actions and reactions

  • Effectively express and manage emotional actions and reactions

  • Experience appropriate emotions in given scenarios

  • Have a high level of resilience

Optimal mental health and wellbeing

  • Low levels of stress and anxiety

  • Optimal self esteem

  • Positive thought patterns

  • High levels of confidence

  • Use logic and reasoning to form opinions and make decisions

Optimal spiritual health and wellbeing

  • A sense of belonging and connection the world

  • Positive meaning, place and purpose in life

  • Peace and hope

  • Developed personal values and beliefs

  • Acting according to values and beliefs

Defining emotions

  • Are conscious mental reactions subjectively experiences as strong feelings usually directed towards a specific object

Emotions VS Feelings

Emotions

Feelings

Sensations in the body

Generated thoughts about emotions

Can manifest consciously or subconsciously

Experienced consciously

Emotion wheel benefits

  • Improves emotional intelligence

  • Helps to identify the root causes of emotions

  • Shows how different emotions connect

  • Supports finding new ways to cope with emotions

How do you use the emotions wheel?

  1. Use the emotions wheel when you want to explore the emotions you are feeling

  2. Begin with more general emotions in the centre (e.g. sad)

  3. Move towards the outer emotions and identify the specific emotions you are feeling.

Undestanding emotions

Emotion

Effects on your body (physiological)

Effects on your mind (psychological)

Disgust

Covering sensory areas, nausea, vomiting/gagging

Avoidance of the trigger, revulsion

Anger

Tense muscles, hot, sweating, grinding teeth

Unable to relax, easily irritated, overwhelmed

Sadness

Tightness of chest, heaviness of limbs, watery eyes, headaches

Trouble sleeping, loss of appetite, crying, grumpy/irritable

Happiness

Feeling light/uplifted, energetic, warm, grounded

Willingness to take life as it comes, satisfaction, gratitude, open to new ideas

Fear

Cold, shortness of breath, sweating, rapid heart rate

Tense/nervous, difficulty concentrating, irritability, sleep disturbances

Surprise

tingling skin, rigid muscles, heavy stomach, grasping items

Dependent on whether the trigger is positive or negative, disorientation

Contempt

Eye rolls, upright posture so to “look down“ on others

Negative comparisons, dismissive, lack of respect, sarcasm/mockery, emotional disconnect

Identifying emotions using facial cues

Emotion

Facial Cues

Disgust

  1. Lowered eyebrows

  2. Wrinkling on the side and bridge of the nose

  3. Upper lips is raised in an inverted ‘U‘

  4. Lower lips raised and slightly protruding

Anger

  1. Eyebrows pulled down and together

  2. Eyes opened wide and staring hard

  3. Lips pressed tightly together

Sadness

  1. Inner corners of the eyebrows pulled up and together

  2. Upped eyelids drooped and eyes looking down

  3. Lips corners pulled downward

Happiness

  1. Eyes are narrowed and there is some wrinkling around the eyes

  2. Cheeks are raised

  3. Lips are pulled back and teeth are exposed in a smile

Fear

  1. Eyebrows raised and pulled together

  2. Raised upper eyelids

  3. Tensed lower eyelids

  4. Jaw dropped open and lips stretched horizontally backwards

Surprise

  1. Eyebrows raised, but not drawn together

  2. Upper eyelids raised, lower eyelids neutral

  3. Jaw dropped open

Contempt

Tightened and raised lip corners on one side of the face

  • Contempt is the only unilateral expression

  • It can occur with or without a hint of a smile or angry expression

Rejection

  • An emotion

  • To dismiss as inadequate, unacceptable or faulty

  • Cannot be controlled

  • The brain is sired to detect rejection as a way of protecting us from it

Impact on mental health

  • Stress and anxiety for the future

  • Self doubt

  • Low self esteem and self worth

  • self isolation

  • sadness and depression

  • anger

  • reliance on addictive substances

Managing rejection

  • While we cannot control rejection, we can control our response to it

  • Changing your perspective about a situation can help you manage rejection

ABCDE Model

  • Can be used to help address a variety of emotional difficulties, including responding to rejection

  • Activating event - or situation

    • the event your client faces, that triggers unwanted responses

  • Beliefs

    • The thoughts and beliefs you client holds about A

  • Consequences

    • The internal and external behaviour that result from B

  • Dispute

    • Challenging the beliefs and thoughts at B. Are they rational?

  • Exchange

    • Exchange old beliefs and thought for new rational, balanced ones

Failure

  • is a feeling

  • Is a lack of success in doing or achieving something, especially in relation to a particular activity

  • Can be controlled

Common causes of failure

  • Lack of supportive relationships

  • Low self esteem

  • Making comparison to others

  • poor self concept

  • Negative self concept

  • Negative self talk

  • Shame

  • Unrealistic expectations

Failure Mode

  • Failure can cause individuals to feel threatened

    • Some people will dismiss the value of the task, criticise the people involved or question the fairness of the situation faces.

    • Others may flee the failure by disengaging our attention

Embracing failure

  • Trying something new and having to recalibrate is an essential part of life

  • Failure is a normal part of the learning process

Reframing failure

Growing from failure requires more realistic thoughts about failure:

  • Failure is a sign that i’m challenging myself to do something difficult

  • I can handle failures

  • I can learn from my failures

Suppressing Emotions

  • People suppress emotions for many reasons, including

    • Told to do so by others

    • to conform

    • To avoid a feeling that may feel socially unacceptable

    • To replace an uncomfortable feeling with a more acceptable one

    • Past experiences may be too difficult to process

Effects of suppressing emotions

  • The continual suppression of emotions can have various detrimental effects:

Physiological

Psychological

  • Tightening of muscles

  • Physical pain

  • Nausea

  • Digestive problems

  • Chronic illnesses

  • Irritability/moodiness

  • Anxiety

  • Depression

Evaluate the consequences of suppressing emotions.

Through suppressing emotions, an individual may feel more accepted by others and able to avoid uncomfortable feelings. However, by suppressing emotions, a person may experience physical pain or psychological effects such as anxiety and depression. Therefore it is not recommended to suppress emotions.

Mindest

  • A habitual or characteristic mental attitude that determines how you will interpret and respond to situations

  • The mindset you embrace and foster can impact how you:

    • Thank about situations

    • resppond to situation

Fixed Mindset

  • A mindset that people can dopt whereby they believe their intelligence, talents and personalities are fixed traits that innate and cannot grow

Features of fixed mindset

  • believe that talent and intellect is static and limited

  • have a desire for approval and achieving success

  • avoid challenge and the rick of failure or mistakes

  • resist seeking and embracing constructive feedback

  • view mistakes as an indicator of talent and intellect

  • stick to tasks and activities in which then can be successful

  • view effort as a reflection of lower ability and avoid embracing challenge

Growth mindest

  • A mindset that people can adopt whereby they believe their intelligence, talents and personalities are traits that can grow through efforts, challenge and feedback

Features of a growth mindset

  • Believe that learning and growth is possible in every area

  • have a desire for learning and trying new things

  • embrace challenge and rick to improve skills and knowledge

  • seek and embrace constructive feedback to pave next steps

  • acknowledge and reflect upon mistakes as a tool for improvement

  • explore new subjects and interests with openness and curiosity


Fixed mindset

(Verbs: ‘resist‘ and ‘avoid‘)

Growth mindset

(Verbs: ‘seek‘ and ‘acknowledge‘)

thinking

Feedback can be interpreted as a personal critique or judgment, leading individuals to feel threatened or demotivated

Feedback is seen a valuable tool for growth, providing insights into areas of improvement

behaviour

Indivuals can resist feedback or dismiss it entirely, preventing growth and limiting their ability to refine their skills

Individuals actively seek feedback, acknowledge its value and use it constructively to improve their performance and understanding

Feedback

Research suggests you can see the difference in a person’s mindset within their brain waves. People with both mindset answered questions and got feedback, whilst their brain waves were analysed

  • People with a fixed mindset were only interested when the feedback reflected on their ability but when they were presented with information that could help them learn, there was no sign of interest

  • Only people with a growth mindset paid close attention to information that could stretch their knowledge. Only for them was learning a priority.

Common thinking errors

  • Magnification and minimisation

  • Emotional reasoning

  • Overgeneralisation

  • Disqualifying the positive

  • Magical thinking

  • ‘Should’ statements

  • All-or-nothing thinking

  • Jumping to conclusions

  • Personalisation

Magnification and minimisation

  • Refers to exaggerating or minimising the importance of events

    • believing your own achievements are unimportant

    • Believing your own mistakes are excessively important

    • You get a stain on your new shoes and think they’re ruined and can’t be word anymore

Overgeneralisation

  • Refers to making broad interpretations from a single or few events

    • “I felt akward during my job interview. I am always to awkward“

    • A person becoming upset when a bird poops on their car “birds are always pooping on my car“

Magical Thinking

  • The belief that thoughts, actions, or emotions influence unrelated situations

    • “If i hadn’t hoped something bad would happen to him, he wouldn’t have gotten into an accident.”

Personalisation

  • The belief that you are responsible for events outside your control

    • when your basketball team loses a game, you think it’s entirely your fault

    • My mom is always upset. She would be fine if I did more to help her

    • When a women receives a note that her child was having difficulties at school, she tells herself that this shows what a bad mother i am

Jumping to conclusions

  • Interpreting the meaning of a situation with little or no evidence

    • I bet no one will come to be birthday parts

    • I’m really going to blow it. What if I flunk?

    • People are looking at me. Hey probably think my shirt it ugly

    • Emma didn’t invite me to her party. I bet she thinks I’m weird

Emotional Reasoning

  • The assumption that emotions reflect the way things really are

    • I feel like a bad friend, therefore I must be a bad friend

    • I dont’ feel like doing this, so I’ll put it off

    • I feel ugly so I must be ugly

    • I feel terrified about going on airplanes. it must be very dangerous to fly

Disqualifying the Postitive

  • Recognising only the negative aspects of a situation while ignoring the positive

    • You might receive many compliments, but only focus on the single piece of negative feedback.

    • A person might do a good job but will tell themselves that anyone could have done as well

    • You score two goals in your soccer game, but all you can think about is the shot you missed

“Should“ statements

  • The belief that things should be a certain way

    • I should always be perfect

    • She should just know what I want

    • I shouldn’t have made so many mistakes

    • I should always be happy. I should never be sad

All-or-nothing thinking

  • Thinking in absolutes such as “always“,”never” or ”every”

  • Looking at things in black and white categories

    • I never do a good enough job on anything

Stress

  • Is a psychological or physiological response produced by internal or external stressors

  • The stress response begins in the brain

Sress responses

  • Psychological responses to stress are divided into two categories

Emotional Changes

Cognitive Changes

Influence the way a person feels

Influence a person’s mental abilities such as their perceptions, ability to learn and think

Fight, Flight or Freeze response

  • Is a survival mechanism

  • Is an involuntary response

  • Triggered by a threatening, fearful or otherwise stressful situation

  • Whether we fight, flee or freeze depends on the situation and the proximity of the threat

  • Result in psychological changes produced by the sympathetic nervous system (part of the PNS) in readiness for

    • Fight: confronting and fighting off the threat

    • Flight: Escaping by running away to safety

    • Freeze: Keeping absolutely still and silent to avoid detection

  1. During periods of intense stress (physical or psychological), the body enters a state of ‘Fight, flight or freeze‘

  2. During the FFF response, feelings and emotions bypass prefrontal cortex (which rationalises these feelings)

  3. Without the prefrontal cortex, we act reactively and can feel in less control of our feelings

  4. In order to remain in control of emotions, we require a safe processing environment

Amygdala

  • Is a small part of the brain

  • Plays a number of roles within emotional control such as:

    • Processing aggression

    • Anxiety

    • Fear

  • If you see something that frightens you, your amygdala might tell your body to panic

Prefrontal cortex

  • Higher level functioning and processing

  • Planning, organising, initiating, self-monitoring

  • Thinking through responses to situations

  • Weighing up pros and cons

  • Planning responses

  • Thinking about consequences of actions

  • Reading body language and facial expressions

  • Is known to the higher order associating centre of the brain as it is responsible for:

    • Decision making

    • Reasoning

    • Personality expression

    • Maintaining social appropriateness

    • Other complex cognitive behaviours

The nervous system

  • Is divided into 2 main parts

  1. Central Nervous system (CNS)

    • made up of the brain and spinal cord

  2. Peripheral Nervous system (PNS)

    • The network of nerves that runs throughout the head, neck and body

The Autonomic Nervous System

  • The autonomic nervous system is further divided into two parts

    1. Sympathetic Nervous System

      • Carries signal related to you “fight or flight“ response.

      • Increases heart rate, blood pressure, breathing rate and pupil size

    2. Parasympathetic Nervous system

      • Relaxes your body after periods of stress or danger

      • Decreases hear rate, blood pressure, pupil size and increases digestive juices

Fight, Flight or Freeze Response

  1. The reaction begins in you amygdala (Remember: The amygdala is responsible for perceived fear)

  2. The amygdala response by sending signals to the hypothalamus

  3. The hypothalamus stimulates the autonomic nervous system (ANS)

  4. The ANS can activate either the:

    a. Sympathetic Nervous System (drives the fight or flight response)

    b. Parasympathetic nervous system (drives freezing)

  • Your reaction depends on which system dominates the response at the time

  • The fight, flight or freeze response (stress) can impact the brain and the body in so many ways

Emotional Dysregulation

  • Is an inability to control or regulate one’s emotional responses, which can lead to significant mood swings and significant changes in mood

  • When dysregulated a person may be operating outside of the window and cannot effectively manage or cope with their emotions

Hyperarousal

  • Also known as “fight or flight response

  • Is an heightened state of activation/energy

  • Occurs when the nervous system kicks into high alert, even when danger is not present

  • A person may not feel in control over their actions

  • Symptoms: Angry outbursts, fear, anxiety, emotional overwhelm, hyper vigilance, “deer in the headlights“ freeze

  • Causes people to feel stuck “on“ which can make it difficult to form healthy sleeping habits, manage emotions and concentrate effectively

  • Physically, the body may seem tense and on the brink of explosion, which can eventually result in angry outbursts and hostility

Hypoarousal

  • Also know as “shutdown“ or “collapse“ response or Freeze

  • Like hyperarousal, it can be triggered by feeling threatened, recounting traumatic memories, or feeling emotions associated with past trauma

  • Symptoms: Numbness, emptiness, blank stare, inability to speak, dissociation

  • Is when a person has too little arousal as the result of an overloaded parasympathetic nervous system

  • Can impact a person’s sleep and eating habits, leaving them feeling emotionally numb, socially withdrawn and finding it difficult to express themselves

Grounding Strategies

  • Support individuals to focus on what’s going on around them instead of their thoughts

  • Allow a person to slow breathing, lower heart rate and allow the brain to process information

    • When distressed, the fight/flight response is activated, making it very difficult to think clearly

Grounding Strategy Benefits

  • Ground a person in the present moment and reorient them to their current reality

  • Stop rumination (e.g. repeitive thinking on negative thoughts/outcomes)

  • Keep you from ‘Spiralling‘

  • Manage intrusive thoughts

  • Reduce the intensity of distressing memories or flashbacks

  • Avoid and manage panic attacks

  • Resist urges to self-harm

  • Cope with chronic pain

  • Boost mood

  • Build resilience

Grounding strategies

  • Can be used anywhere, at any time and without others knowing

  • Box breathing

  • FInger tapping

  • 5-4-3-2-1

  • Reorienting yourself

  • Mindful observation

  • Finding your feet

  • Body awareness

  • Imagine yourself somewhere safe

  • categories

  • Describe an activity

  • Mental exercises

Box breathing

  • Inhale for 4 counts

  • Hold for 4 counts

  • exhale for 4 counts

  • Hold for 4 counts

  • repeat

Finger tapping

  • slowly tapping the tip of each finger against the tip of each thumb

5-4-3-2-1

  • What are 5 things that you can see right now?

  • What are 4 things you can touch right now?

  • What are 3 things that you can hear right now?

  • What are 2 things you can smell right now?

  • What is 1 things you can taste right now?

Reorienting yourself

  • Where am I right now?

  • What is the day today?

  • What is the date?

  • What is the month?

  • What is the year?

  • How old am I?

  • What season is it?

Mindful observation

  • Notice an object in you immediate surroundings

    • Notice is in detail - the shape, the colour, texture and function of the object

    • Spend at least two minutes observing the object in great detail

  • Slowly move your focus to another object and repeat the process

  • What do you notice about your body as you do this?

  • What do you notice about your thoughts as you do this?

Finding your feet

  • Place your two feet flat on your floor

    • Notice how your feet feel in your shoes

    • Can you feel the fabric of your socks? Can you feel the pressure of the your shoe on particular parts of your feet? Can you feel any sensations in your feet?

  • Wriggle your and notice how that feels throughout your foot

  • Imagine that you feet are connected to the ground

    • Notice how solid your feet are and how you are connected to the earth. Notice that you are strong and centred

Body Awareness

  • Take 5 long deep breaths through your nose

  • Place both fee flat on the floor, Wriggle your toes, Curl and uncurl your toes several times. Spend a moment noticing the sensations in your feet

  • Stomp your feet on the ground several times. pay attention to the sensation in your feet and legs as you make contact with the ground

  • Clench your hands into fists, the release the tension. Repeat this 10 times

  • Press your palms together. Press them harder and hold this pse for 15 seconds. Pay attention to the feelings of tension in your hand and arms

  • Rub your hands over your head like you’re trying to reach the sky. Stretch like this for at least 5 seconds. Bring you arms down and let them relax at your sides

  • Take 5 more breaths and notice the feeling of calm in your body

Imagine yourself somewhere safe

  • Imagine yourself in a safe, soothing, calm and comfortable space. This place might be real or imaginary

  • Imaging this place in as much detail as you can:

    • What does it look like?

    • What is around you?

    • What are sounds around you?

    • What is the temperature?

    • Are you sitting, standing or walking?

  • Notice how it feels to be completely calm and peaceful here. How does you body and mind change when you imagine being in this place?

Categories

  • Think of a category - e.g. animals, songs, musicians, famous people, cities, countries, cars, TV shows, sports, athletes, fruits, vegetables, books

  • Think of one things in the category for every letter of the alphabet - e.g. Animals: Aardvark, Bat, Cat, Dog, Elephant etc

Describe an Activity

  • Describe an everyday activity in great detail

  • E.g. to get to school, I walk to the train station. I leave the front door, closing it behind me and locking it with my key. I walk down my driveway and turn left down my street. At the corner, I turn right and walk past a playground

Mental Exercises

  • Examples

    • Count backwards from 100 by 7

    • Name all the objects you can see

    • Spell your full name and the names of three other people backwards

    • Name all of your family members, their ages and one of their favourite activities

    • Think of an object and draw it in your mind

Remember

  • Grounding works in different ways. which means what works for someone might not work for you and vice versa

  • Don’t be afraid to trial and find the right version that feels right for you

Ready to learn plan

  • Step 1: Identify your potential triggers

  • Step 2: Reflect on your behaviour and physical symptoms

  • Step 3: Identify strateies that will help you to relax and resume a healthy arousal state

    • Examples include: a conversation, listening to music, time out, grounding strategies, stroking textured items, seeing a support staff member

Emotional Coaching

  • Involve guiding someone during times of heightened emotions about more effective responses

  • Helps people to become more aware of their emotions and to manage their own feelings

Emotion Coaching Process

  • There are 5 steps of emotion coaching

  1. Be aware of emotions

  2. Connect with the person

  3. Listen with empathy and validate

  4. Label emotions

  5. Find good solutions

Be aware of Emotions

  • Tune into the person’s feelings and your own

  • Understand that emotions are a nartural and valuable part of life

  • Observe, listen and learn how the person expresses different emotions

  • Watch for changes in facial expressions, body language, posture and tone of voice

Connect with the person

  • Use emotions moments as opportunities to connect

  • Try not to dismiss or avoid emotions

  • Recognise feelings and encourage the person to talk about their emotions

  • Avoid dismissing feelings

    • e.g. “It’s not that big of a deal.“ “You shouldn’t feel that way“ “Get over it.“ “That’s no reasons to be upset“

  • e.g.

    • I get mad when things don’t work out either

    • Let’s sit here for a moment. I’ll stay with you. It’s ok to feel ______

Listen with empathy and validate

  • Respect the person’s feelings by taking time to listen carefully

  • Show the person that you understand what they are feelings

  • Avoid unsolicited advice

Label Emotions

  • Help the person identify and name emotions

  • Identify the emotions the person is experiencing instead of telling the person how they should feel

  • e.g.

    • Tell me what you’re feeling

Find Good solutions

  • Explore solutions to problems together

  • Don’t expect too much too soon

  • Avoid fixing the problem on the person’s behalf

    • e.g. “I’ll fix it“ “I’ll talk to her“ “I’ll get you a new one“

Empathy

  • The actions of understanding, being aware of, being sensitive to and vicariously experiencing the feelings, thoughts and experience of another

Sympathy

  • Feelings of pity and sorrow for someone else’s fortune

Impact on thinking

  • Beliefs and values determines how you treat others and yourself (attitude) and how you approach any situation (behaviour)

  • Being aware of our thinking patterns can help us make more informed choices

  • Belief: Education can unlock a person’s potential and provide them with the tools to succeed in life, regardless of their background

  • Value: Lifelong learning

  • Attitude: Approaching education with a growth mindset. Challenges and mistakes are opportunities for learning and improvement

  • Behaviour: Actively seek out new learning opportunities, participate in discussions and consistently strive to improve my understanding.

Navigating differences

  • Throughout life, we have ample opportunities to navigate differences, including friends who have different values to us

  1. Identify people’s values

    • Identify the values of the person

    • When you know what lies behind a conflict, you can quickly get to the heart of the problem and achieve a resolution

  2. Get talking

    • When talking and actively listening to one another, individuals are more likely to understand and accept one another’s viewpoint

    • Be mindful that people’s view points aren’t necessarily right or wrong, just different

    • Even if someone’s values might seem illogical or mean, reserve judgement

  3. Find common ground

    • Identify where the values of both individuals might overlap, rather than where they clash

    • aim to negotiate a win-win solution that accommodates both sets of values