Research has shown quite clearly that for the majority of people looking for a therapist, the rapport he or she feels is influenced more by compatibility of personality, than professional qualifications, experience, age or gender.

This is not to say that the latter qualities are unimportant, indeed they are!

However, most would agree that: if you experience a strong aversion to a particular therapist, it is highly unlikely that you will want to engage in a working relationship with this therapist.

Good Therapy Australia, a not-for-profit health promotion charity, has designed a therapist profile page and directory search facility that maximises the chance of a “good match” between therapist and client.

Their website – www.goodtherapy.com.au – includes information on the various approaches to therapy. Educating one’s self about the different orientations can be helpful because what appeals to one person will not necessarily appeal to everyone.

While some therapists work primarily with dialogue – the session is essentially a conversation – others, who have trained in complementary modalities such as Art Therapy, Gestalt, Psychodrama or HeartMath; may incorporate therapeutic processes that engage us in a number of different ways.

These processes, often experiential in nature, enable us to become more aware of the emotional/physical/mental blocks that keep us stuck.

Whether you are struggling with depression, anxiety, or self-destructive patterns, what you ultimately find helpful will depend on your openness to moving beyond your present situation, and the quality of connection you create with your therapist.

To explore what is meaningful for you, you may want to participate in Good Therapy’s online surveys: Looking for a Therapist; The Therapeutic Space; Questions for Therapists.

http://www.goodtherapy.com.au/flex/surveys/253/1

Also, an article that addresses some of the issues relevant to Choosing a Therapist:

http://www.goodtherapy.com.au/flex/choosing_a_therapist_title/101/1

END OF ARTICLE

I think this provides some excellent insight and advice. I would also suggest asking the following questions after the first visit:

1. Did the therapist strive to fully understand your situation?
2. Did they outline a plan you had confidence in?
3. Did you trust them and feel positive about returning?

 A good GP can be a fantastic guide to a good therapist as they regularly hear the feedback of patients who have been referred. Another source of psychologists that have a special interest in depression and anxiety and are in your area can be found at www.beyondblue.org.au

My recommendation is that if your therapist doesn’t tick all the above boxes after your first visit you should find another. This is much easier said than done when you are feeling very low which brings me back to my first point, that you should seek out a therapist before it gets to a crisis situation.

What has been your experience in finding a therapist? Do you have any suggestions? What do you like best about a therapist? What do you like least?

Please add your contribution by responding to this blog. Your responses are anonymous as you just need to enter your first name and email address (which won’t be published).Your suggestion could really help someone else.

Kind Regards

Graeme

Tags: anxiety, depression treatments, finding a mental health professional, finding a psychologist, finding a therapist, psychology, therapists

Article in The Economist June 27th, 2009 - Page 89

A friend recently made me aware of a very interesting article in The Economist.

The hypothesis

Randolph Nesse, a psychologist and researcher in evolutionary medicine at the University of Michigan, likens the relationship between mild and clinical depression to the one between normal to chronic pain.

Dr Nesse’s hypothesis is that, as pain stops you doing damaging physical things, so low mood stops you doing damaging mental ones - in particular, in particlar pursuing unreachable goals. He asserts, that pursuing such goals is a waste of energy and resources. Therefore he argues, there is likely to be an evolved mechanism that recognizes certain goals as unattainable and inhibits their pursuit - and he believes low mood is at least part of that mechanism.

The evidence

In a study published recently by Carsten Wrosch from Concordia University in Montreal he studied depression in teenage girls. They measured the “goal adjustment strategies” of 97 girls aged 15-19 years over the course of 19 months. They asked participants about their ability to disengage with unattainable goals and re-engage with new goals. They also asked them about a range of symptoms associated with depression, and changed over the course of the study.

Study findings

Their conclusion was that those that experienced mild depressive symptoms could indeed disengage from unattainable goals. It also found a remarkable corollary:those women who could disengage from the unattainable, proved less likely to suffer more serious depression in the long run.

Mild depressive symptoms can therefore be seen as a natural part of dealing with failure in young adulthood.

My take on this theory

As I have highlighted many times before, it is so difficult to make conclusive statements about “depression” as the term covers a multitude of conditions. Having said that, my gut tells me that there is something to this theory. I guess that comes from my own personal experience. On each occasion I have experienced a severe depressive episode, it has often been close to a downturn in the economy. I formally worked in recruitment, which is an industry very closely linked to the health of the economy and is also very accountable.

When I began missing my budgets, rather than blaming the economy, I tended to blame myself for not working hard enough. This also would explain why those with perfectionist personality traits are so vulnerable to depression - you can never achieve the goal of perfection.

It also reinforces my belief that when you are depressed you should set “whisker goals”. These are small attainment goals that put you on a path of “wins” that often have a positive impact on self esteem. It is also essential to celebrate these small wins so your brain knows that it is doing something right. A small celebration could be buying yourself a coffee, gelato, chocolate or your favourite magazine.

Your thoughts please?

I would be very interested for others to share their opinion regarding this theory. Please do so by responding to this blog.

Kind Regards

Graeme

www.IamBackFromTheBrink.com

Tags: depression, depression help, depression treatments, goals, rational thinking

With all our medical advances, why is it that the incidence of depression and anxiety is skyrocketing. The World Health Organisation says that depression is the most disabling disease in the Western World today, yet all mental healthcare specialists seem to talk about is “evidence based” treatments such as counselling and anti depressants. Whilst these strategies have been shown to be helpful for some people, if this was really cutting edge advice, why aren’t we seeing the incidence of depression declining or at the very least plateauing. This in no way seeks to imply that medication and psychological counselling don’t have their place in treating depression, just that we are not exploring all the variables

Having interviewed thousands of people who have battled with depression, I am convinced that there are some serious issues with the “evidence based” approach to treating depression. These can be summarised as follows:

1. The “evidence” is where the money is

Unfortunately clinical trials are very expensive to run so private funding will only be directed towards those areas where “investors” can see a return on investment. In the world of depression treatments, this means that the vast majority of funds are directed towards medication and psychological counselling interventions. This means that important lifestyle strategies such as exercise, emotional support,nutrition, relaxation, and fulfilling work are relatively ignored. Ironically these less discussed strategies can be much less costly to implement.

1. When you’re holding a hammer everything looks like a nail

The vast majority of depression treatment studies are undertaken by doctors or psychologists. Whilst there is nothing wrong with this per se, most of these studies are evaluating areas where they have expertise (which makes sense). This means that the comparisons are often looking in isolation at one drug verses another (or a placebo) or one psychological intervention verses another. Quite often meaningful advancements in areas can come from someone outside the established “paradigms”. I love the story of the little boy who came across rescue workers who had been struggling for 3 hours with sophisticated hydraulic equipment trying to dislodge a truck which had been tightly wedged under an overhead bridge.  After being encouraged to leave the site he quietly said “Why don’t you let down the tyres?”.

1. We are not just DNA

As human beings our bodies and minds are intricately linked. Depression treatments that focus purely on a “biological illness” are seriously limited. Much of the despair that exists in the western world today can be linked to loneliness, family breakdowns, excessive and unfulfilling work, and financial crises. Saying that depression is caused by low levels of serotonin is like saying teen pregnancies are caused by a sperm fertilising an egg – yes, but…. Depression treatments that fail to reconnect us with our passions and purpose are ultimately going to be short lived solutions.

What are the right depression treatments?

To find out what works best in managing or overcoming depression, we must ask the people who are living with depression what works best for them. In 2007 I asked just that, and their answers were (in order) exercise, support of family and friends, psychological counselling, fulfilling work, relaxation/meditation, nutrition and medication.

Coincidentally, the Black Dog Institute (BDI) –one of the pre-eminent mood disorder units in the world - also undertook a study directly asking those with depression what helped them most. Although there were some differences in the studies, lifestyle strategies were also shown to be extremely important. One of the authors of the published study, Professor Gordon Parker, who has been practicing psychiatry for over 30 years, has now started advising General Practitioners and their patients to exercise regularly to aid recovery.

If Professor Parker, who has published over 600 clinical papers and book chapters regarding mood disorders, can learn something from these results, perhaps we all can.  

Tags: back from the brink, depression anxiety, depression help, depression research, depression treatments, exercise and depression

I flew to New York on May 25 with the objective of finding Literary Agent to take on my book to complete US versions for the existing two.

On Wednesday I went to the first day of Book Expo America which was dedicated to authors. There were about 400 people there and they had some great seminars regarding how to plot your way through the publishing maze which gave some excellent insights.

We then had the opportunity to do a “pitch slam” with Literary Agents. Over here, publishers receive an average of 300 manuscripts per day and very rarely follow up any directly and rely on the LA’s to vet opportunities.

In “pitch slam” the 400 authors have 3 minutes to tell their story to about 50 LA’s with a view to getting feedback on their project and perhaps a signal of interest that could lead to the LA taking on their project. Before getting to NY I had done a lot of research to find out who would be the best LA’s to take on my project. I had targeted 6. Of the 6 I slammed, 5 expressed interest and my 3 top picks expressed very strong interest including one saying “I’m totally on board – don’t bother seeing any other agents”. I had emailed my top 3 LA’s prior to getting to NY with my new 3 minute keynote demo and I think this added considerable momentum (http://www.pineapplemedia.com.au/Cowan.html  )

I had another great day yesterday and by chance met with Judith Curr the Executive Vice President of Atria books which is a division of Simon and Schuster. Believe it or not she is an Australian who is now based in New York. She was the publisher of “The Secret” which has now sold 7 million copies. She asked me to post her copies of my books and follow up with her executive editor which is very exciting.

A key part of the US success will be getting on board the American celebrities to be interviewed in BFTB. BFTBToo is ready to go almost immediately but it makes sense to launch the 2 together.

On Monday we head to Chicago to see the Depression and Bipolar Support Alliance to get their support (which I need for local credibility with the high profile people) for getting the project underway. I have already had email and phone contact with them and it is looking very good.

On Friday night Hilary and I went to “Jersey Boy” – a musical about Franky Valli and the Four Seasons. It was just sensational – real stand up, shout and cheer show. After that we strolled through Times Square which at 11pm was just jam packed with people – you feel guilty for going to sleep in this place.

Hope all is well back home.

Kind Regards

Graeme

Tags: back from the brink, depression books, depression help, depression treatments

I’ve just had some exciting news that “BACK FROM THE BRINK TOO: Helping your loved one overcome depression” has been named SANE’S 2009 BOOK OF THE YEAR which is very humbling and gratifying at the same time.

After the success of my first book, it quickly became apparent that the family members of those suffering with depression were often desperate themselves. This lead to me researching over 700 depression caregivers and their loved ones, to find out exactly what questions they wanted answered. I’m sure this was a major reason why the book was nominated. I would like to sincerely thank those who participated in the research and of course my parents, who had faith in me when I had lost faith in myself.

FROM SANE’s PRESS RELEASE

SANE Australia Executive Director Barbara Hocking says family members of people with mental illness play an enormous role in providing care and support for people living with depression, as well as other forms of mental illness.

‘Not only does Back From The Brink Too provide much-needed practical guidance for family carers and raise awareness of the key role they play in helping to manage mental illness, but it also works to reduce the isolation many families experience,’ Ms Hocking said.

‘We are delighted to present the SANE Book of the Year Award to Mr Cowan for his contribution to helping the community better understand the experience of mental illness and its impact on families and friends’

Graeme Cowan says of the Award, ‘I am honoured and humbled that SANE Australia has recognised my book. Only after recovering from my own depression did I come to understand the tremendous toll that my illness caused my family.  I would like to dedicate this award to my loved ones and the two million other Australians that support those living with depression and anxiety.’

END OF RELEASE

What is more gratifying than the award is regularly receiving letters and email from people saying that both books have been a tremendous help to them.

If you know someone who is trying to support a loved one with depression, you might consider forwarding this email to them.

Further details regarding the book (and purchasing facility can be found at: www.DepressionCarer.com )

I am heading off to New York, Chicago and Los Angeles on May 25 to meet with Literary Agents and two major US Depression organisations with a view to doing US versions of both books. The award couldn’t have come at a better time.

Kind Regards

Graeme

www.IamBackFromTheBrink.com

Tags: depression book, depression caregiver, depression carer, depression help, depression treatments, overcoming depression

I was recently asked to be one of the judges for the Black Dog Institutes writing competetion entitled “Tackling Mood Disorders in the Workplace”. The winners were announced yesterday by the Minister for Mental Health The Hon Barbara Perry.

PRIZES

1. Maree Matic - Sydney
2. Daniel Taylor - Adelaide
3. Rowena Harris - Tasmania

In addition to these 3 there were 10 “Highly Commended”

JUDGES SUMMARY

The judges were very impressed with the standard of the 200+ submissions to this years contest. Entries came from those living with mood disorders, their work colleagues, and managers. When assessing each contribution we decided to place equal weight on relevant ideas raised, writing style, and practical suggestions to improve the current situation.

The vast majority of entrants still feel very reluctant to disclose their illness for fear that it will have an adverse effect on their career prospects. It seems that a “work mask” is still very much the norm. Comments such as “the act is taking its toll” and “hiding in the toilet is not a long term solution” reflected the quiet despair.

The occupations most frequently represented in the submissions were teachers, lawyers, and recruitment consultants.

It was very difficult to narrow the final field down to the 3 winners and 10 “Highly Commended”, but they provided some clear messages.

Organisations need to be much more proactive in educating employees and managers, in how to recognise and support those with a mood disorder. Whilst the importance of appropriate policies was highlighted, contributors stressed that the most crucial element was a compassionate manager who reached out to address the issue quickly. Many lamented that “values on the wall were not lived on the floor”.

Whilst diversity in gender, ethnicity, and physical disability, is actively encouraged in many organisations, it is sadly lacking for those with mood disorders. In addition to supportive work colleagues, the other critical organisational requirement is flexible hours to allow for doctors/therapist visits, and low mood in the morning, when required.

Those working with mood disorders stressed that they also have an obligation to balance their lifestyle and manage their mental health – “Ironically it was only when I started working on my wellness that my work performance improved.” Many also explained that their mental health was made worse by pursuing the wrong career. Despite the challenges of work, the vast majority stressed how important it was to their self esteem.

It was extremely difficult to pick a final winner, but we felt that the contribution chosen, could well act as a summary for all 200+ entries.

Graeme Cowan, Judges Chairperson May 28, 2009

I couldn’t help but think that this competition was so important as it raised so many ideas regarding how things could be improved in the this area of where we all spend so much time, yet as I have highlighted previously, only 9% of those with depression feel comfortable discussing their condition with work colleagues - how absurd is that.

IF YOU COULD CHANGE ONE THING

If a genie suddenly granted you one wish about how you would change the workplace to be a better place for those who live with depression and anxiety, what would it be. I would love you to respond to reply to this blog with your thoughts.

Kind Regards

Graeme

Tags: anxiety, burnt out, depression, depression cure, depression help, depression treatments, work stress

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Tags: depression anxiety, depression at work, depression cure, depression help, depression treatments

With a new year in front of us we always wish that it will be better than the last year. Whilst many of the people who review this blog have depression and just want to get over it, I think dwelling too much on what you don’t want rather than what you do want can be counter productive.

Focus on what you do want

The science of happiness has shown us that contented people regularly set goals for themselves (see previous entries). Whilst the thought of this for someone with depression often seems particularly onerous, I believe that it has many advantages.

My experience with goal setting

During a depression outpatient course at I completed at Northside clinic, I was encouraged to set weekly goals around exercise and contact with family and friends. We not only had to write these down but we had to schedule them into a diary and report back to others on our progress the next week. I found that although I often didn’t feel like it, I would often force myself to get out of bed and go for a walk. I inevitably felt better after having taken the walk. The same applied to my contact with family and friends. It is very common to want to isolate when depressed, but like the exercise, I often felt better having made the effort to meet with loved ones. Of course I was also seeing my psychiatrist as well and found  a medication that also seemed to help. Eventually this goal setting involved leisure activity and meditation and finally it progressed to doing voluntary work and then writing “BACK FROM THE BRINK”.

After some time to reflect, I began to realise that I was seeking 3 outcomes in life:

1. Physical and mental vitality
2. Good relationships with support, fun and intimacy
3. A career that enabled me to contribute and prosper

I decided that I would set weekly goals around these 3 outcomes: vitality, intimacy, and prosperity. When you have depression, I think a week is as far as you want to look ahead and most of the time you should be trying to live one day at a time.

Vitality

By far the most important aspect of this is regular exercise. How much? 30 minutes brisk walk (or equivalent) 6 days per week. Eating well is also extremely important and this should involve lots of fruit and vegetables, omega 3, and low levels of fatty foods. As my health improved I also embraced meditation and continue to do it twice a day, every day.

I also include in this category regualr contact with doctors and psychologists. It is also important to limit alcohol consumption.

Some of the fun things here are sport, hobbies, movies, travel etc.

Intimacy

As my physical health improved I began investing much more time into my relationships, and began to yield the benefits from that. I realised that in my past I often let career come before relationships and realised what I mistake that was. I have come to realise how important having strong relationships are for your mental health. I also joined GROW, a 12 step support group which was wonderful. The mutual support is priceless.

Prosperity

The final part of my recovery came from finding out what I really wanted to do with my career. Whilst I had enjoyed my early career in marketing and human resources, I was really seeking something outside of the mainstream corporate environment. I began doing some volunteer work with Volunteering NSW, helping to place prospective volunteers into the right roles. I saw how people’s self esteem lifted substantially when they found fulfilling work. Eventually things evolved where I began writing my books and speaking about overcoming depression and turning around lifes difficulties. I truly love my work now.

Yearly goals

At the start of each year I now set goals under each of these three categories. Each week I determine what I’m going to do to help make these happen. If ever everything seems too much I give priority to goals in the order nominated: vitality, intimacy and then prosperity.

I really believe that we all have unique gifts to contribute to the world and are capable of very happy and fulfilling lives. Does that mean that I will be forever immune to depression? No it doesn’t, but I try to focus on what I do want rather than what I don’t want.

If you have any comments about setting new year goals, please respond to this blog.

Kind Regards

Graeme

Tags: depression, depression treatments, new year goals, resolutions

Last week we held the first of four web and phone based seminars on overcoming depression. It also differed from other courses on this topic as it was designed with both the depression sufferer and their caregiver in mind.

We had over 100 people participating from all over Australia, New Zealand, the United Kingdom and the USA which I was really very pleased with.

What really really works in overcoming depression

It was interesting running a session on this over the web as when you put depression into Google you get over 87,700,000 page impressions. Surely everyone can access anything they want to know. Unfortunately that is just the problem. Most people are so time poor and don’t know just where to start.

I also found this to be an issue when I was in the depths of my depression and just had a hunch that a session that covered 7 evidence based strategies shown to help beat depression would be valuable to some people.

From my perspective it was a little strange presenting to over 100 people without being able to see their response so I was very keen to do some market research after the event.

The information presented in the seminar was helpful

I was very pleased that 70% Strongly Agree and 30% Agreed with this statement.

There were suggestions made during the seminar that I could action this week.

Strongly Agree 60% Agree 40%

I was very pleased with this also as I truly believe that action is one of the main enemies of depression.

I found the telephone and web simulcast concept convenient

Strongly Agree 70% Agree 30%

It could be improved by:

Having more time for questions

Strongly agree 49% Agree 42%

One of the issues when people listened via the web is that they could not ask verbal questions. This was also compounded by me trying to cover too much in the first session. The technology does allow for written questions to be conveyed and based on the feedback, I have decided to cover the formal presentation in the first hour and then have 20 minutes of answering questions at the end.

All in all I was very pleased with this first attempt. Of course I will be very keen to get additional feedback after the end of the next 3 seminars but I am very hopeful that it will be a great medium for 2009 and beyond.

The next 3 sessions will cover:

Finding the right mental health professionals

Building a support network

Helping to prevent a crisis and sustaining the care

If anyone has any questions or comments regarding these seminars please respond to this blog or email me at graeme@IamBackFromTheBrink.com

Kind Regards

Graeme

Tags: beating depression, depression carer, depression phone and web seminar, depression sufferer, depression treatments, overcoming depression

Since the launch of BACK FROM THE BRINK TOO I have been able to research a number of visitors to my site to find out how I can further help the person suffering from depression and their caregiver.

The people that responded to the survey said that one of the things they would really value was the opportunity to participate in an anonymous telephone seminar on how the sufferer and their caregiver can work together to overcome depression.

I have come across some technology that enables the participants to either listen via their computer with speakers (using the internet) or by phone. It would also be possible to listen to a recording if you weren’t able to make the designated time. It will also be possible for me to answer questions raised before each seminar.

This type of format would allow me to share a much broader range of information than is possible in a book. In particular, with each point raised, I would like to share the perspective of both the person living with depression and the caregiver.

I have also come to realise that whilst some people like reading books, there are many others that would prefer to listen and watch.

Broadly speaking, I would see 4 seminars each being of around 60-90 minutes on a Tuesday night at 8pm, Sydney, Australia time. Each seminar will have accompanying materials

WEEK 1: WHAT REALLY, REALLY, WORKS IN MANAGING/ OVERCOMING DEPRESSION?

This will briefly outline the symptoms of depression but focus mainly on the evidence based strategies that are most effective for overcoming depression. I will outline a specific plan of action I recommend.

WEEK 2: FINDING THE RIGHT HELP FOR THE SUFFERER AND CAREGIVER

This week will show sufferers and carers how to find appropriate mental health professionals. It will include strategies to encourage the sufferer to seek help. It will also explain the mental health maze and how to access the right expertise. Getting the correct diagnosis and treatment is fundamental to recovery.

WEEK 3: BUILDING A SUPPORT NETWORK FOR THE SUFFERER AND CAREGIVER

Never have both parties been more in need of the care of family and friends. I will show how to build a plan brick by brick so both the sufferer and their caregiver can feel well supported. This support and cooperation is essential for implementing treatment strategies. Friendship is the special key to mental health.

WEEK 4: HELPING TO PREVENT A CRISIS AND SUSTAINING THE CARE

The taboo subject of self harm and suicide will be discussed from the perspective of the person living with depression and their loved ones. Strategies to help prevent a crisis occurring will be clearly explained. Recovery from depression is rarely a straight line and I will discuss what both parties can do when the road gets rocky. I will also outline some case studies of people who have been transformed by depression and gone on to lead very fulfilling lives.

There are of course costs involved in putting something like this on, but I plan to make Week 1 free so people can try before they buy.

The first seminar which will be on November 25^th, 2008.

If you have any questions or comments please respond to this blog.

Kind Regards

Graeme

Graeme Cowan

www.IamBackFromTheBrink.com

Tags: back from the brink too, depression caregivers, depression treatments, graeme cowan, overcoming depression