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Many people find attending their first therapy session nerve wrecking. That’s completely normal and understandable as you’re confiding in a stranger. Through this blog I aim to remove some of the fears or concerns you might have about the initial therapy consultation through explaining what normally unfolds in this meeting. I’ll also provide some pointers on how you can prepare yourself. #mentalhealthmatters #telehealth #counselingpsychology #mentalhealthsupport #privatepractise #counsellor #counseling #mentalwellness #growth #wellbeing Format of session The initial meeting will be formatted slightly different than the rest of our sessions together. I’ll briefly inform you about the way I work, any limits to confidentiality and questions about the current issues you’re currently going through. I’ll also inquiry about your past, so I can get to know you better and have a more complete picture of you. Counselling will always be carried out in partnership with you. I’ll ask you about your current expectations of therapy and what ideally, you’d like to get out of our work together. We will also touch on how we could structure working towards your objectives together over time. If you’re seeing me for an online session, please make sure you’re basing yourself in a confidential setting, e.g., in a private room or area where no one can listen in to our conversation. Avoid walking outside or speaking in an office at work with thin walls/glass doors (even if you are using headphones). Allow yourself to have enough time, so you’re not rushing to the meeting. Make sure your computer or devise has enough charge available. Prior to dialling in, please test that the sound and camera on your computer are working. Remember to turn off and remove any other distractions such as phones so we can be truly present in the meeting. Face to face session, make sure you allow enough time to travel to the meeting room on time. There will be water available on site and access to a bathroom. You’re welcome to bring your own drink if you prefer. Make yourself comfortable in the waiting area and I’ll greet you as close to the booked appointment time as possible. The administration that happens in the introductory therapy meeting I’ll need to receive some basic information from you before we can begin our work together. If you haven’t already filled out the introductory information sent to you prior to your appointment, please do so while waiting. A signed informed consent form, personal information form and a quick intake survey. The survey is administered for me to receive some baseline information that we can work with. We can pinpoint if there seem to be more anxiety or depression present or if there are any other pressing concerns that I need to be aware of. I’ll take some notes throughout the session all data will be kept as secure as possible. Payment will be carried out either through an emailed invoice via Stripe (for the online sessions) or through an emailed invoice. You can pay via a bank transfer after the session. Scheduling in the next couple of sessions will be discussed to ensure you have access to regular care to reach your personal therapy objectives. You can reschedule appointments up to 24 hours before the meeting without incurring any fees, unless it's a public holiday or Sunday the day prior (this information be stated clearly in your informed consent form). I hope this information removes some of the reservations you might have about seeking therapy so you know what normally happens when attending your first session. If you’ve got any other questions, please don’t hesitate to reach out to me. Take care and look forward to seeing you soon.

Do you feel more comfortable expressing yourself in your native tongue? I’ve noticed most people in therapy feel more comfortable communicating in their own language. It’s only natural to feel more relaxed speaking about your emotions in the language you grew up with. In fact, sometimes there are certain nuances and cultural reference points that are tricky to translate into another language. For therapy to work well it’s important to feel comfortable in order to build a solid foundation of trust with your therapist. Photo credit: wix The national healthcare route As a newly arrived expat in Norway, it can be quite challenging to navigate the national mental healthcare system as much of the public information is communicated in Norwegian only. My aim is to provide you with some practical insight into the process so you can locate the therapist with the best fit for you. Please note the following information is not related to asylum seekers, as they have other resources available to them. The starting point to access national health care is to acquire a so-called identification number. There are two types in Norway and as a foreigner you can contact Skatteetaten (tax authority) to apply for the one most suitable to your specific circumstances. If you’re experiencing any non-urgent mental health issues and have received a D or fødelsenummer (birth identification number) from Skatteetaten, the normal route through the Norwegian health system would be to book an appointment via your personally assigned GP (Fastlege). You can book an appointment in the Helsenorge app yourself. If your GP isn't able to assist, you can ask for a referral to a mental health specialist (distrikts psykiatrisk senter) or a therapist in private practise with governmental funding. Like in many other countries, the drawbacks of being referred to a psychologist within the public system is that it’s often accompanied with long waiting times. In addition, you might not have flexibility in choosing the therapist yourself, compared to a private practice. However, the costs are significantly lower. Rask Psykisk helsehjelp is a low threshold treatment option if you’re experiencing anxiety or mild to moderate depression. You don’t require a referral from your GP (if you’re above 16 years old). This route is offered by the Kommune for free. It’s also available if you have sleeping issues or starting to develop alcohol dependency. Privately practising English-speaking therapists A simple google search is normally the best way forward for the most up to date information on private clinics or individual practitioners offering therapy in various languages. Consider if it's important for you to have a therapist who has experience from working and living abroad possibly with a deeper understanding of issues facing internationals. Please note, this information is not conclusive, but could serve as an initial starting point for your search of seeking non-emergency mental health assistance in Oslo. For more information, please feel free to contact the relevant therapist. The information was to the best of my knowledge accurate at the time of publishing but might change over time. Please don't hesitate to get in touch if you need any further assistance or contact the appropriate governmental body for more advise. best fit for you.

Maintaining psychological wellbeing during this prolonged exposure to COVID-19 and the feeling of uncertainties it brings can be challenging. If you or your employees experience several of the below mentioned warning signs over a longer period of time, you might want to seek assistance: · Loss of work motivation. A typical sign is when tasks that used to make you feel enthusiastic, no longer evokes a similar response. · Feeling overwhelmed with tasks to finish. Difficulties in an ability to stop or control worrying thoughts, leading to feelings of helplessness. · Becoming short tempered. This anger response is frequently directed towards innocent bystanders, e.g. taxi drivers, shop assistants, children, partner or colleagues. Alternatively, you are increasingly more sensitive and easily led to tears. · Changes in cognitive function, such as a loss of sharpness and focus leading to reduced work productivity and difficulties in making sound and logical decisions. · Behavioural changes such as a loss of appetite, overeating, increased intake of alcohol or other substances, insomnia or difficulties to relax or finding enjoyment in activities you used to engage in. Some people start to avoid social situations, e.g. lunch with colleagues, meeting friends, etc. · Physical changes, such as reduced immune function leading to frequent illness, head/muscle/back ache, teeth grinding, an upset stomach or stomach pain. Photograph by: Nelly Antoniaudo via Unsplash Personal coping strategies Working from home during a prolonged period of time naturally comes with its own set of challenges. A large proportion of staff are currently suffering from feelings of loneliness and a sense of being isolated. Reaching out to friends, colleagues, family members, or even strangers via any means available to you, can assist in regaining a sense of connection. Exercising control in an otherwise uncertain world can bring about a feeling of calm. You can bring back a sense of belonging through messaging, creating WhatsApp groups, writing emails to old friends or using Face Time/Skype. Having a dedicated work space, preferably where you are able to close the door and be distanced from your bedroom can be beneficial in keeping work and relaxation areas separate. Try to keep to a regular routine incorporating frequent breaks and opportunities to go outside for a walk. If you are juggling the management of home schooling children as well as working, create clear boundaries where you let people know when you are available or busy. These boundaries are important to communicate to work colleagues and managers as well. It is also vital to reduce and challenge any negative self-talk of not being good enough. Remind yourself that you are currently experiencing a challenging time and you are doing the best you can under these difficult circumstances. Physical health can have a substantial impact on your psychological wellbeing. Make sure you are prioritising healthy nutrition, hydration, sleep, relaxation and keeping physically active. Try to incorporate all these elements into your daily routine, even if it’s only for a brief period of time, e.g. a five min meditation, writing in a journal, reading a book or listening to a short piece of music. If the activities you used to engage in are currently impossible to get involved in, imagine alternative ways of adapting these or explore a completely new activity. Supporting your employees Employers can support their staff through a wide range of activities. Building in more flexibility in working practises enables employees to balance the caring for elderly or children with work. Adapting working hours or even allowing temporary job sharing can assist in balancing conflicting demands and avoiding busy commuting times. Companies can also offer specialist online learning around wellness (mental health) to their staff. In order to make working at home easier and healthier, companies can assist with resources and training. Upskilling employees through online training programmes can prove encouraging to their individual professional development and can help keep you motivated while navigating prolonged experience of uncertainties. Employers can provide access to external employee assistance programmes (EAP’s) in person or online. It is also important to keep an open line of communication with regular catch ups between staff members and to introduce online social events to keep the human connection going. Encourage teams to collaborate and connect using online tools to update each other on their progress. Keep boundaries clear to avoid staff working too long hours, so they do not feel like they have to be accessible at all times. Another way companies can assist is to change the annual leave calendar to let some days be taken over to the following year. If you are struggling during this challenging time, please don't hesitate to contact a health professional. You can find details in the resource section of this website.

In today’s self-centred society many people come across, as having copious amounts of self-esteem. Just a quick scan on social media reveals people portraying themselves as if they’ve got it all worked out. However, when you scratch the surface this image often masks a lot of insecurities and fragile ego’s. Low self-esteem can have a serious impact on your professional life and might hold you back. It’s likely to make you avoid rather than embrace challenges and therefore achieve less than you’re capable off. Fortunately, with some work you can develop a more realistic positive view of yourself. #selfesteem #selfworth #selfbelief #personalgrowth #mindfulness Self-esteem is at times referred to as self-worth or self –respect. Genetics do play a role in the development of self-esteem. However, more frequently a lack of self- belief stems from past experiences (Cherry, 2018). Perhaps you were never able to live up to others (family, friends, society’s) expectations. As a counsellor I’ve come across many clients that get judged and criticized by loved ones. Maybe something happened, a traumatic event that knocked you down. Whatever it was, it doesn’t define who you are today and you can change. There are strategies to draw upon in order to develop a more healthy balanced view of yourself. “People with low self-esteem usually have deep-seated, basic, negative beliefs about themselves and the kind of person they are. These beliefs are often taken as facts or truths about their identity rather than being recognised as opinions they hold about themselves.” Centre for Clinical Interventions (CCI) Reconstruct the image of your “ideal self”. We all have an idea of the “perfect me”, the person we would ideally like to be, e.g. competent, witty, attractive, intelligent, etc. If this image is unattainable we’re likely to feel shame and guilt. Do some soul searching and listen to what’s important to you, try to define and map out your authentic self. This is the you that act in ways you like, enjoy, respect and admire – the best version of you. Think of situations in the past when you felt empowered and happy. Once this has been identified work through your fears that might hinder you reaching this goal. Make it a stretch goal that’s realistic to reach. “ If you can see your path laid out in front of you step by step, you know it’s not your path. Your own path you make with every step you take. That’s why it’s your path” Quote by Joseph Campbell in Brené Brown’s, “Braving the Wilderness” Engage in realistic self-assessment Silence the inner critic who has perfected its negative self-talk. See yourself for what you are. Question any negative thoughts you have about yourself, replacing them with more realistic cognitions. In fact, the less attention you give to your self-criticism, the quieter it becomes (Kirschner, 2019). Don’t’ be overly harsh on yourself Accept yourself as you are and avoid trying to fit into groups that you don’t really want to join. Find like-minded friends or colleagues that accept and support you for who you are. This makes for a more relaxed and safe environment where your true self can be expressed. Avoid approval seeking This can be a difficult habit to break, but it’s crucial to trust your instincts and find your inner strength. Acknowledge that the work you produce is good enough; it doesn’t have to be perfect. Constantly seeking approval from others never leads to lasting self-esteem (Olsen, 2019). Assertiveness skills Practise defining and firming up your boundaries. Identify what’s important to you and acknowledge that it’s ok to say no to certain things. In the beginning it’s likely to feel awkward, especially as people are used to a more nonassertive you. But they will soon learn to respect what’s vital to you. This is likely to boost your feelings of self-worth. You could practice speaking up for your rights in a less threatening social situation; e.g. a restaurant, shop, etc., eventually widen the practise to professional or home environments. Practise mindfulness To avoid anxious thoughts worrying about the future or ruminating about the past, bring your attention to the present. Detach from negative thoughts without reacting to them. Use mindfulness practices such as meditation, yoga, or simply pay attention and be present to everyday experiences. The above strategies aim to build up a more realistic well-balanced view of yourself and your abilities. This is by no means an exhaustive list on how to increase your self-esteem. Perhaps you need to seek professional assistance to examine what your deep-seated core belief about yourself is. Your self-esteem has been formed over a long period of time, so please keep in mind that this is not a quick fix. View it as a long-term strategy where if you put in the work, you will reap the benefits overtime. It's definitely worth your effort. References: Campbell, Joseph, as cited in Brown, Brené “Braving the Wilderness – the Quest for True Belonging and the Courage to Stand Alone”, 2017, Random House Publishing Group. Centre for Clinical Interventions, Government of Western Australia (2018) Retrieved from: https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Self-Esteem Cherry, Keandra, “What Exactly is Self-Esteem?Sep, 2018, Retrieved from: http://www.VeryWellMind.com Kirschner, Diana, “Do You Ever Feel Like There’s Something Wrong With You?” 2019, Psychology Today. Retrieved from: https://www.psychologytoday.com/us/blog/finding-true-love/201902/do-you-ever-feel-theres-something-wrong-you Olsen, Loren, “3 Essential steps to lasting self-esteem”, 2019, Psychology Today. Retrieved from: https://www.psychologytoday.com/us/blog/finally-out/201902/3-essential-steps-lasting-self-esteem

According to a survey by Cigna (as cited in SCMP, 2018), Hong Kong workers are the 5th most stressed population globally, just slotting in behind South Korea, Nigeria, Taiwan and the United Arab Emirates. The survey found a massive number; 95% of 18-34 year olds feel stressed. In this group of Millennials, 26% find the pressure unmanageable. Working excessively long hours, at relatively low salaries with the added strain of unaffordable housing; all plays a part in stress experienced by Hongkongers. It’s not all doom and gloom though. In fact it’s common knowledge that exposure to limited periods of stress isn’t harmful; it can even be motivating. But, prolonged time exposure of extreme pressure, can take its toll on your health. Thankfully, there’re strategies to prevent running yourself into the ground. #burnout #stress #mentalhealth #success Burnout isn’t entirely caused by stressful work or having too much responsibility. Factors such as lifestyle and personality traits (perfectionism, overachiever, Type A behaviour and controlling tendencies), also play an important part. “ The difference between stress and burnout is a matter of degree, which means that the earlier you recognize the signs, the better able you will be to avoid burnout.” PsyD Sherrie Bourg Carter Below follows six burn out warning signs. If you experience some of these, the majority of the time, you might want to consider seeking support. What to look out for? Lack of enthusiasm You consistently feel demotivated at work. Things you used to enjoy now seem meaningless and you have become disillusioned. There might be disconnection between what you actually do at work and what you want to do. Helpless Perhaps you feel powerless, as if you are out of control. You find yourself paralyzed with no hope or ability to change the situation. Short fuse Maybe you come across as grumpy with a pessimistic and negative worldview. You feel quite unlike your old enthusiastic self. It’s possible you get frustrated over minor issues and take it out on innocent bystanders. Perhaps you’re feeling cynical and resentful of the situation. You might also be more emotional and close to tears. Loss of sharpness You don’t feel as “on the ball” like you used to do. It’s common that the memory becomes muddled up and you become increasingly forgetful. It takes more effort to pay attention and concentrate. It’s also likely you find it difficult to cope with deadlines and time pressure. Behaviour change You feel completely drained of energy that result in decreased work output and make more mistakes. You are likely to isolate yourself and possibly try to escape social situations. Perhaps you avoid the canteen and eat at your desk more frequently. You might have a loss of appetite and a change in eating habits. It’s also possible you’re struggling with insomnia. Physiological changes Some people experience stomach issues, such as digestion difficulties. It’s common to have frequent aches and muscle pain (the Brain Fund, 2017). Dizziness and issues in handling loud noise can take its toll. As your immune system is lowered, it’s relatively common to contract various illnesses. Burnout can cause long-term physical changes to your body, e.g. vulnerability to serious illnesses, cognitive impairment, etc. Prevent stress from escalating into full-blown exhaustion Utilise the three R acronyms (helpguide.org, 2018): · Recognise (look out for warning signs) · Reverse (undo damage by seeking support and manage stress) · Resilience (build your resilience to stress by taking care of your physical, and emotional health). Stress Management Techniques 1. Gain control at work. Try to actively manage your time through speaking to your boss and/or co-workers. Delegate, prioritise and if it’s possible, eliminate work. If you find it hard to let go of certain tasks, try viewing it as an opportunity to teach others new skills, e.g. give your PA more responsibility to chase up on unpaid invoices, organise client events, etc. 2. Self care. This is so much more than just getting some exercise, eating well and having a massage (although that’s great as well!). We frequently neglect to look after ourselves, so treat yourself kinder and listen to what your body and mind is urging you to do. Seek out support, take time for social events and get out in nature. For self care suggestions read: https://www.levacounselling.com/blog/how-to-adopt-a-sustainable-self-care-routine. 3. Don’t be a people pleaser. Learn how to say no and don’t overcommit. 4. Change the way you think. Challenge your old way of thinking and introduce some more flexibility in your thinking patterns; e.g. is your deliverable good enough or does it have to be perfect? Is the way I do things, the only correct way? 5. Don’t push yourself to the limit. Put reasonable demands on yourself, no one is going to thank you if you drive yourself into the wall. 6. Rest. Commonly, this is the best medicine. Try your hardest to keep weekends work free, to give your body and mind time to recover. The aim of this article was to inform about the signs and prevention of burnout. However it’s not conclusive. If you’re worried you might be at risk, please seek professional assistance to rule out any other possible underlying cause; e.g. nutritional deficiency, undetected illness, etc. Try to identify and keep an eye on your personal stress warning indicators, as only you know yourself and your triggers best. Attempt to undo any damage done through seeking support and managing the stress. To prevent future outbreaks, build up your stress resilience through some of the ways to prevent burnout discussed above. If you are feeling completely overwhelmed and the stress is having a seriously negative effect on your quality of life, you might have to contemplate taking some sick leave or a career break to get your energy levels up and your life back on track again. Keep in mind that there is often a solution to be found where you least expect it. References: Bourg Carter, S., “The Tell Tale Signs of Burnout… Do You Have Them?”,Psychology Today, (2013), Nov., 26th. Retrieved from: https://www.psychologytoday.com/us/blog/high-octane-women/201311/the-tell-tale-signs-burnout-do-you-have-them Cigna Survey, cited in SCMP, “All Work and No Play Makes Hongkongers the World’s Fifth Most Stressed Population”,South China Morning Post, (2018), July, 10th. Retrieved from: https://www.scmp.com/business/article/2154538/all-work-and-no-play-makes-hongkongers-worlds-fifth-most-stressed Smith, M.; Segal J., Robinson L., Sebal R., “Burnout Prevention And Treatment - Techniques For Dealing With Overwhelming Stress”,Helpguide , (2018). Retrieved from : https://www.helpguide.org/articles/stress/burnout-prevention-and-recovery.htm/ The Brain Fund, (Hjärnfonden), “Utbränd eller gått in i väggen? Vi reder ut begreppen.”,Hjärnfonden, (2017), Dec, 12th 2017, Retrieved from : https://www.hjarnfonden.se/2017/12/utbrand-eller-gatt-in-i-vaggen-vi-reder-ut-begreppen/

The moving dust has barely settled. Kids and partner have adjusted to new routines, when the “now what” question pops into your head. The trailing spouse syndrome is not a diagnosable illness. However, many dependants struggle with feelings of overwhelm and low mood. An international career posting abroad whether it’s for a couple of years or a lifetime, can be an exciting prospect bringing positive experiences. Sadly, the potential difficulties the life change bring is not readily discussed. #rel Obstacles dependants face Media tends to portray dependants as women in financial dependency without goals in life. Reality is substantially more nuanced. This group often consist of highly educated men and women or same sex partners, frequently with substantial amount of work experience behind them. They might have given up or put their own careers on hold to support their partners and family’s time abroad. Common issues faced are the non-acceptance of professional qualifications, language barriers and not being granted work permits. This situation can make you feel vulnerable. Simmering feelings such as loneliness, isolation, bitterness, loss of identity, low self-esteem and depression can bubble up to the surface and take hold. The issues are often caused by difficulties adjusting to a different culture, being away from your social support and a lack of professional fulfilment. However, the establishment period in your new home can also represent a possibility to pause in life and question if you’re living in line with your values. Build a new community around shared interests The absence of a solid social network in a new country can be a demanding situation many people struggle with. It can be difficult and take time to build up new relationships. Remember that many people in your new “home” country are in the same seat as you. Try to build new friendships through staying open minded. It’s perfectly acceptable to show your more sensitive and vulnerable side to develop a deeper bond. "Identify what you used to love doing earlier on in life" Investigate if similar hobbies or new activities you always wanted to try out are offered in the new country. Examples could be physical activities such as hiking, yoga, dance or creative outlets like photography, cooking, handicrafts, etc. Join local or international social networks such as Internations, Facebook groups, volunteering organisations or test friendship apps like Bumble BFF, Hey!, VINA or Meetup. Clarify your values and find purpose Put some time aside to really think through and define what you ideally would like to get out of your new life situation. Avoid over identifying with your previous title or work role. We are so much more than an employment description. Identify what values are vital to you at this point in your life. How would you like people to remember you? Identify realistic goals, half-way goals and a reasonable timeline. Perhaps this period of time is the perfect opportunity to do something you never had time to engage in previously, e.g. write a book, start your own company, study, spend time with the children, start a new exciting project or simply taking a break. Open up and seek assistance Many dependants feel they ”should” be happy because they have been provided with an opportunity to experience living abroad. They might push away unpleasant feelings and shoulder on. Sometimes this can lead to behaviours that make the situation worse. If you feel low, try to open up to trusted people, e.g. your partner, friends or seek confidential assistance from a mental health professional. To conclude, lower the bar on the demands and ideals you and the environment puts on you. Take time to pause, identify and live more in line with what is really important to you. Focus on building and maintaining a supportive community around you. Through creating new exciting experiences, establishing friendships and finding purpose you get more out of your time abroad. Remember that it’s ok to not feel ok. If needed, please don't hesitate to reach out for assistance. http://www.openuniversity.edu

Don’t’ you just hate that feeling of tossing and turning in bed, anxiously counting the hours until the alarm goes off. Worrying about how tired you’ll be the next day before that important meeting, test or presentation. But, set your mind at rest, there are plenty of things that you can do to improve your sleep. We all know that keeping a regular sleep pattern and having sound sleep is important for our physiological and psychological wellbeing. But did you realise that insufficient sleep increases the stress hormone cortisol? In turn, this has a negative impact on our immune system, and it can eventually lead to illness (if exposed over long time). Moreover, poor sleep affects not only our mental state (attention, concentration, memory, impaired judgment), causing us to not perform well on the task at hand. It also has a direct impact on our emotional (irritable, sensitive), and physical (coordination, reaction time, stamina) states. Poor sleep often leads to worsening relationships, reduced psychological wellbeing and impaired work performance (The Centre of Clinical Interventions, 2018). So how can we make the few precious hours we spend in bed count and wake up feeling more rested? The following suggestions might prove helpful. Eight simple steps to improve your sleep. 1. Regular timings Try to go to bed and wake up about the same time every day, even on a weekend (!). I know this sounds harsh, but your body and mind will thank you for it. Avoid to take naps during the day, as it is trickier to go to sleep in the evening and to stay asleep the whole night. 2. Log off and cool down As we all know electronic devices, e.g. smartphones, tablets, TV, etc. confuse the body’s internal clock into thinking it should stay awake (our brains register the blue light as daylight). On your iOS devices you can turn the night shift feature on, which is located in settings. Dim the lights in the evening and create a cut off time (aim for one hour before bed) to unplug. 3. Create your own sleep routine Create your own schedule of relaxing self-care practices before hitting the pillow. It is considered one of the most effective ways to combat stress. For example, read a favourite magazine, have a shower or bath, use a yoga app (I love the flexibility of the yoga studio app, listen to some calming music playlists on Spotify or iTunes or try out a brief guided meditation. If you are finding it difficult to quieting your busy mind, you have tense muscles or a racing heart, try spend some time doing relaxation exercises, e.g. deep breathing, or progressive muscle relaxation (The National Sleep Foundation, 2018). Time yourself performing the routine, tweak it as fit and stick with this new habit. Not only will the sequence make you sleepy, but it might also have the positive effect that it makes you look forward to going to bed. 4. Investigate Monitor your sleep at night with a FitBit app to detect if there are any specific associations, e.g. when you sleep less deep, etc. Alternatively you can use a sleep diary recording simple data such as: https://www.cci.health.wa.gov.au/~/media/CCI/Mental%20Health%20Professionals/Sleep/Sleep%20-%20Worksheets/Sleep%20Worksheet%20-%2001%20-%20Sleep%20Diary.pdf This is useful in identifying any patterns and areas for improving sleep habits. If you are unable to fall asleep, don't stay in bed for more than 20 minutes and avoid watching the clock. Get up and do something non-exciting and repetitive, e.g. knitting, sort paperwork, etc. Keep the daytime activities the same, even though you have had a poor night sleep to avoid reinforcing insomnia. 5. Cut back on caffeine, nicotine and alcohol Caffeine (coffee, tea, cola, chocolate) and nicotine (cigarettes) act as stimulants and stay active in your system for a long time (about six to eight hours). Cutting caffeine at 2pm and swapping your afternoon pick me up to decaf or herbal tea is likely to have a positive impact. I love www.pukkaherbs.com  and https://www.teapigs.com.hk for their intense and interesting flavours. Although a glass of wine might make you feel relaxed and sleepy, its deceptive as alcohol is actually a sleep pattern disrupter. It may interrupt your circadian rhythm by affecting levels of chemicals that tell your body when its time to sleep or wake up. In addition, your body uses a lot of energy and water to break the alcohol down. The dehydration and digestion can therefore disturb your sleep and keep you awake. 6. Healthy diet and exercise It probably goes without saying that a healthy balanced diet will improve your sleep. However, eating a large meal before going to bed can interrupt sleep. Experts suggest exercising for about 30 minutes a day (if possible). Although its best to not engage in strenuous exercise four hours before bedtime. Try to expose yourself to 20 minutes of daylight first thing in the morning to regulate melatonin levels. 7. Create a tranquil haven Avoid working, studying or watching TV in your bed. It is important for your body and mind to associate the bed with sleep and sex only. Invest in a comfortable mattress, pillow and bedding. Make sure the room is completely dark with black out curtains. You could use aromatherapy oils like lavender in a humidifier to create a sleepy ambience. Use eye masks and earplugs for obtrusive noise and make sure the temperature is pleasant (no full blast air conditioning). If possible, try not to have pets and/or children in bed. 8. Go easy on yourself If you have persistent thoughts, try to write them down in a worry diary and deal with it in the morning. Negative thoughts, stress and worries about sleep can increase the risk of insomnia. Healthy balanced thinking is vital for sleeping soundly. Remember to give yourself a break, no one is perfect and you can only do your best. There are a number of things we can do to improve our ability to sleep well. Whether that is tweaking the external environment, regulating our routines or changing our diets to induce sleep. This is by no means an exhaustive list. You might want to consider contacting a sleep specialist or other mental health practitioner for more support. They could work with you to establish individualised sleep management strategies. Please share if you find this article helpful or comment if you have any additional suggestions on how to improve sleep. References: The Centre for Clinical Interventions, 2018, Website: http://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Sleep The Centre for Clinical Interventions, 2018, Website: https://www.cci.health.wa.gov.au/~/media/CCI/Mental%20Health%20Professionals/Sleep/Sleep%20-%20Worksheets/Sleep%20Worksheet%20-%2001%20-%20Sleep%20Diary.pdf The National Sleep Foundation, 2018, Website: https://sleepfoundation.org/sleep-topics/3-signs-too-stressed-sleep-and-how-unwind

Many of us see ourselves as incompetent at work, although the evidence clearly points to the opposite direction. Perhaps you feel inferior, unworthy of your success and worry that you're inadequacy is going to be"found out"? A common response to avoid the fear of failure, is to work all hours or over prepare tasks. Success is seen as a result of external causes such as luck or circumstances, over talent, brains and grit. This phenomenon has been described in psychological literature as the Impostor Syndrome (IS). Thankfully, there are many ways of overcoming these feelings. Over time I've noticed there's a tendency for high achieving professionals to perceive themselves as inadequate. Frequently, they believe their colleagues idolise them as fantastic leaders with almost supernatural abilities. This is clearly an image impossible to live up to, so they never feel qualified, knowledgeable or effective enough. This nagging feeling of self doubt leads to anxiety and displays itself through over preparing work tasks or procrastination over a task followed by frenzied overwork. Successes are not internalised but often dismissed as being due to external factors, such as luck and circumstances out of their control. Objective evidence and praise for their abilities is brushed off and instead focus is on shortcomings. Frequently, they compare themselves to others and feel inferior. There's often a fear of being found out as being a failure. These observations are in line with Clance and Humes who first defined the concept back in 1985, with an addition by Mark Leary (2000) who introduced a self-presentational strategy. Why do so many of us feel this way? There seems to be certain criteria that have an impact on people developing IS. The syndrome affects both men and women, but especially when the individual stand out (Hendriksen, 2017). Studies have shown that women are typically more affected and likely to suffer the consequences (Young, 2011). I found this particularly true for women working in a male dominated field or taking STEM courses at university or not matching the majority of the main culture (e.g. due to ethnicity, leaders or individuals labeled as "talented", LGBT, etc). Dr Christian Janet (2018) explains people are particularly susceptible to develop IS, when there is a lack of role models to identify with within the family (e.g. a first generation professional or first in a field). Recent studies have shown that men are also affected but in general find it harder to open up and talk about it. "A real bias against female competence persist"Valerie Young, 2011 The upbringing seems to have a major impact on developing the state. Dr Carol Dweck (2008) explains that parents overpraising children means the children have nowhere to grow. For example labelling a child as smart, who then make a mistake will question the label, e.g. you got it or you don't. This in turn decreases their willingness to try new things for fear of failing. There's also a tendency for perfectionism in individuals affected by IS. Frequently, they set themselves high and almost impossible standards to reach. A middle of the line parenting style is preferable, as over involved parents protecting their children seems to lead to a feeling of inability to perform. Whereas a lack of paternal warmth and/or supportive friends can also make you vulnerable to the IS state (Hendriksen, 2017). The good news is that you can take control over this general condition and make a positive change. Try incorporating some of the following ideas and reflect on how it makes you feel. 12 suggestions to combat the feeling of not being "good enough" 1. Normalise This happens to many people (colleagues, bosses, etc), remember that you are not the only one. Successful people like Natalie Portman, Neil Gaiman, Meryl Streep and Sheryl Sandberg have openly discussed how they have coped feeling like frauds. 2. Internalise (own your successes) You deserve to be exactly where you are. 3. Deliver Don’t overpromise on deliverables and focus on the project, not yourself. It does not have to be perfect. 4. Challenge self-critical thoughts Introduce more self-compassionate thoughts to replace and silence your negative and destructive internal monologues. 5. Reinforce Positive traits, write down your strengths and keep it to hand, revisit your resume frequently and acknowledge your achievements. 6. Balance Make sure you keep a healthy balance, do not tip over into egocentricity, but stay authentic and humble. 7. Owing up to mistakes Do not feel you know everything, you have a lot of room for development. This creates a culture of risk taking and openness that often builds trust. Admit to your colleagues that you are not an expert in everything. You can learn together. 8. Analyse Try to understand where these feelings of doubt are stemming from and do they motivate you to do something? 9. Develop Adopt a growth mindset where you view any mistakes as an opportunity to develop yourself further. You will add a fresh perspective. If you lack knowledge in a field, invest in training. 9. Seek out a mentor For guidance navigating intimidating environments. 10. Teach Sing up to be a mentor, teach colleagues, or new graduates, as it will provide you with renewed confidence in your own abilities and keep your passion alive. 11. Reach out Tell a trusted friend, colleague or family member how you feel. Just be careful of any dismissal. Surround yourself with people who appreciate your hard work. 12. Accept compliments Say a simple “thank you” and work on believing people's compliments. Ironically, the feeling that one is a fraud can inspire greater effort, conscientiousness and improving your practise, leading to more success and promotion. This in turn can trigger another round of impostor feelings with the accompanying feelings of self-doubt, anxiety and can even lead to depression. There's also a risk that you stop asserting yourself or take necessary risks, as you are fixated on not making a mistake. There's a need to break this negative cycle in order to build up a psychologically healthier more balanced self. If IS has an obstructive impact on you, try to incorporate some of the suggestions above into your daily life. Remember that you can make a positive change. Do not hesitate to reach out to a psychology professional should you require more support. If you think this blog could benefit someone, please feel free to share this blog. References: Clance, P. & Humes , 1985, "The Impostor Phenomenon - Overcoming The Fear That Haunts Your Success", Atlanta: Peachtree Publishers. Dweck, C., 2008, "Mindset - The New Psychology of Success", Ballantine Books. Hendriksen, E., 2017, https://www.psychologytoday.com/intl/blog/how-be-yourself/201708/nine-ways-fight-impostor-syndrome Leary, M. R., Patton, K. M., Orlando, A. E., & Funk, W., 2000, The impostor phenomenon: Self-perceptions, reflected appraisals, and interpersonal strategies. Journal of Personality, 68(4), 725-756. Moring, A., 2017, https://www.inc.com/amy-morin/7-reasons-people-with-impostor-syndrome-struggle-to-succeed.html Young, V., 2011, "The Secret Thoughts of Successful Women", Crown Business.

Are you finding it challenging to build strong friendships? You might be surprised to hear what a common issue this is, especially in later life. As we all know, having close friend relationships is crucial for people's psychological wellbeing. Unfortunately, as we age it can become more tricky to develop and uphold meaningful friendships. Time constraints due to work and family obligations, relocations and a fear of being judged hinders us. But there are many steps we can take to gain valuable friendships in later life. It often involves being brave, letting our guards down a little, and show some vulnerability. A helpful strategy can be to let go of preconceived ideas of what people might think of you and to invest more time and energy into building relationships. What are the benefits of close friendships? Strong social support networks such as close friends, colleagues and family are crucial for people’s psychological wellbeing. Historically we have always been social beings thriving on interactions. In fact, our survival depended on being part of a group, hunting in groups watching each other’s backs. This evolutionary context might explain why feeling excluded can have a detrimental effect on people’s mental state. We all know how close friends make your life richer and research demonstrates that it can even improve your life expectancy (Carr, 2015). In fact, friendships provide a strong base, a sense of security protecting us from stress, anxiety and depression. Challenges to develop relationships in adulthood. Our mindset change as we grow older, partly based on biological changes in our brain. As children, our prefrontal cortex is not fully developed. This contains the so called executive functioning ability, (area of the brain that deals with judgment, planning and personality). As we age we are more concerned about what others might think of us and we start to judge others. It can feel terrifying to be rejected. This partly explains why it is so easy for children to strike up a conversation and make friends with strangers, whereas it can be much more challenging as a teenager or adult. In adulthood, we tend to have less time at our disposal to develop friendships and our priorities might have changed (e.g. work more, busy parenting, looking after elderly parents, partner, etc). Making friends during your educational years is easier as you are naturally forming social groups in rather structured environments, e.g. studying the same subject, living in the same dorm, hobbies, etc. Meaningful and close friendship bonds in later life prove harder to form. These often revolve around having gone through something life changing together, e.g. a relocation, first time parents, taking a course, trips or working towards something meaningful. Living in a busy crowded city like Hong Kong, it is natural and common to develop feelings of loneliness and anonymity. Arriving from abroad and leaving close social networks behind is tough. It is likely to test even the most socially adept’s confidence in building relationships. However, there are plenty of opportunities for friendship building in large cities like HK. People are curious and open to opportunities in meeting new friends, probably due to the mobility of expats and locals educated or travelling abroad. People who spend time overseas without their close or extended family on hand, seem to rely and build intimate long lasting friend relationships. Ten simple steps on how to identify and develop meaningful relationships. 1. Say yes to invites It sounds obvious, but it is vital to expose yourself to as many different environments as possible, e.g. accepting invites to bbq’s, fundraisers, baby showers, happy hours, networking events, junks, hikes, etc. Go along even though you don’t know the individual that well and might not feel like going. You never know, you might make some interesting connections along the way. 2. Identify your target group Take a strategic approach, think about and write down where you would be likely to meet up with potential friends sharing similar interests, values, etc. Have you got a passion that you would like to pursue? Try to think outside the box, e.g. taking up creative, cooking, language or exercise classes, new mum groups, cultural associations or activities such as dragon boating, movie clubs, hiking groups, cycling groups, etc. 3. Volunteer Hong Kong is a volunteers hub, there is something for everyone, from cooking, teaching languages, looking after babies in charities, cleaning beaches, to fundraising, workshops, etc. Investing your free time is an excellent way of getting to know people, giving back to the community and perhaps even learning a new skill along the way. Please have a look at the following options for ideas: https://www.sassyhongkong.com/whats-on-hk-volunteer-charities-organisations/. 4. Pay attention to your surroundings Start connecting with co-workers, clients, service providers at work, other parents in the playground, exercise classes, etc. If you are working from home, break the isolation and join a co-working space for those vital social connections. 5. Utilise your existing contacts Ask for introductions, e.g. if you are moving to a new location, connect with people and get them to introduce you to people living there already. 6. Practise makes perfect Read up on how to improve your social skills, e.g. how to start a conversation and pay attention to your non-verbal communication; such as your body language. Practice incorporating these skills to make them feel natural. If you are shy, start small with making small talk in a less threatening place, e.g. the local shop, restaurant, etc. (Moring A., 2018). Try to stay up to date on current events, but avoid discussing too controversial subjects. 7. Make the most out of Social Media Use social media to make connections with individuals interested in similar areas to you. Be brave expand your network through attending talks, workshops, etc., advertised online. 8. Identify and Replace Negative Thoughts If you hear that critical voice in your head stating, “you're not interesting, funny,” etc. and “why would anyone like to get to know you”. Challenge that thought with contrary evidence. Replace the voice with more productive thoughts such as, “I might not be hilarious, but I'm good enough and I've got a brilliant sense of humor”. With practice, this will become second nature. More realistic thoughts will improve your social confidence and assist you in moving forward. 9. Keep with it Making new friends is similar to dating in the way that you might click with some at first and once you get to know them a bit better, you realise you're perhaps not the best match. In the face of setbacks, try to stay positive and keep on making new connections. 10. Be patient and show vulnerability In order to develop a deeper friendship with someone, research shows it takes on average five longer conversations to connect and it is important to share something personable to create a bond (Hendriksen, 2018). Try to relax and let your personality shine through. Thankfully, in general people find it hard to relate to individuals perceived as perfect. Kindness is a trait rated highly in a future friend. Stay attentive; demonstrate strong listening and caring skills and share something personable, as it will make you more relatable. If you find it challenging to build and maintain relationships in adulthood, try incorporating some of the strategies mentioned above. However, if you're suffering from loneliness, please don't hesitate to reach out to a psychology professional, helpline, etc who can support and collaboratively identify a strategy that works for you. If you found the blog helpful and you think it might assist others, please feel free to share it on social media. References: Carr, D., (2015), https://www.psychologytoday.com/us/blog/the-third-age/201503/want-live-longer-make-good-friends Handsonhongkong (2018), Website: http://www.handsonhongkong.com Hendriksen, E., (2018), “How to Be Yourself”, episode 131, The Psychology Podcast. Moring, A., (2018), “12 Ways to Improve Social Skills And Make You Sociable Anytime”, Lifehack. https://www.lifehack.org/articles/communication/12-ways-improve-social-skills-and-make-you-sociable-anytime.html SassyMamas (2017) https://www.sassyhongkong.com/whats-on-hk-volunteer-charities-organisations/