Depression Treatment Options


However the client should be aware of the treatment options so that he /she can discuss with the consultant. Broadly speaking, the treatment of depression rests on two factors Medication, and Psychotherapy or Counselling.

  • Medication is required for moderate and severe depressive disorder cases.
  • Counseling and psychotherapy serves as an edge in treating depression and need to be started simultaneously along with medicines.
  • You should continue the full course of psychotherapy even if you are feeling better to prevent a relapse.
  • Suddenly stopping antidepressants can precipitate a relapse. Medication needs be tapered gradually under your doctor’s supervision.

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TO WATCH OR TO BE



With the recent incident of the Ministers, watching pornographic film has brought about much ethical debate in the media; however the psychological impact has not been discussed. Sexuality is an issue which profoundly impacts not only an individual but also the family at large. In my experience, with only several exceptions, pornography has been a major or minor contributor or facilitator in the acquisition of their deviation or sexual addiction apart from complete psychological isolation from family. Treatment (psychotherapy) of the same is necessary as it tends to recur as all other means of control used by individual and society fail without an insight into the urge.
I found four factors common to nearly all of my clients, with almost no exceptions, especially in their early involvement with pornography.
1. Addiction
A porn movie becomes an addiction as the material provides a very powerful sexual stimulant or aphrodisiac effect with powerful imagery as a base of further fantasies, followed by sexual release, most often through masturbation. Once addicted, they could not throw off their dependence on the material by themselves, despite many negative consequences such as divorce, loss of family, and problems with the law (as with sexual assault, harassment or abuse of fellow employees). Interestingly my clinical experience, education is positively correlated with sex addiction; that is to say higher the education and intelligence greater is the person’s vulnerability to sex addiction. Reason being, their finer ability to use their intelligence to fantasize.
2. Escalation
Like drug addicts, sex addicts with the passage of time require rougher, more “kinky” kinds of sexual material to get sexually aroused. If their spouses or girlfriends were involved with them, they eventually pushed their partners into doing increasingly bizarre and deviant sexual activities. They often preferred this sexual imagery, accompanied by masturbation, to sexual intercourse itself. This nearly always diminished their capacity to love and express affection to their partner in their intimate relations. In many cases, this resulted in a fall out in the relationship when the woman refused to go further-often leading to much conflict, separation or even divorce.
3. Desensitization
Material (in books, magazines or film/videos) which was originally perceived as shocking, taboo-breaking, illegal, repulsive or immoral, though still sexually arousing, in time came to be seen as acceptable and commonplace. There was increasingly a sense that “everybody does it” and this gave them permission to also do it, even though the activity was possibly illegal and contrary to their previous moral beliefs and personal standards.

4. Acting Out Sexually
There is alarmingly increased tendency to act out sexually the behaviors viewed in the pornography including compulsive promiscuity, exhibitionism, group sex, voyeurism, frequenting massage parlors, having sex with minor children, rape, and inflicting pain on themselves or a partner during sex. This behavior frequently grew into a sexual addiction which they found themselves locked into and unable to change or reverse–no matter what the negative consequences were in their life.

PORNOGRAPHY AND ITS IMPACT ON THE FAMILY
However, in my clinical experience, the major consequence of being addicted to pornography is not the probability or possibility of committing a serious sex crime (though this can and does occur), but rather it’s disturbance of the fragile bonds of intimate family and marital relationships. This is where the most grievous pain, damage and sorrow occurs. There is repeatedly an interference with or even destruction of healthy love and sexual relationships with long term bonded partners. The most important negative consequence is that it isolates one from one’s own self. The ‘real’ world no longer appears appealing and the individual prefers to be in his own world ultimately severing emotional ties that gives meaning to his own existence. No amount of ‘knowing that its bad’ helps to reverse this habit. It’s like a latent cancer, it almost never disappears on its own or reverses its course unless there is some psychotherapeutic intervention.
PARENTING ISSUES AND PORNOGRAPHY
With the explosion of internet usage parents need to keep in control on the internet usage of their young ones. Their curious mind and age is bound to take them in this direction if left unattended on the net. Pornography films are often dismissed off as ‘educative’ or seen as rebelliousness by care givers. However parents need to be aware that there is tremendous peer pressure on the young adults and they often resort to pornography to be a part of the ‘in’ group or for the purpose of self education. When parents provide scientifically correct and age appropriate sex education to the child from a young age, they squash this curiosity and the chances of their child being misinformed via porn films. In fact sex education classes are conducted in many schools for the same purpose. It is a myth that imparting sex education will increase sexual activity in young adults. Rather as parents and caregivers it is your duty to ensure that the child is well informed about the sexual boundaries and the consequences. In fact in many of the abuse cases that I have handled in my practice, children were unable to protect themselves from further abuse because they felt responsible and guilty of the abuse and were unable to convey their feelings their parents whom they thought they could not talk as it’s a taboo topic or worse still would blame them. Because the topic was never raised by their parents they have nowhere else to talk about but their peers or left on their own for further experimentation.
Watching porn movies has a far outreaching psychological impact, especially on a young adults mind. Most of the porn films are made by men and are often extremely sexist in nature often debasing or humiliating a woman. Therefore children at a very young and impressionable age learn to disrespect women in general and treat them as object of sexual pleasure, have distorted perceptions about sexuality, destroys confidence, commitment and responsibility of an intimate relationship and institution of marriage in particular and making polygamous relationship an acceptable idea. In addition, pornography portrays “unhealthy” or even antisocial kinds of sexual activity such as sadomasochism, abuse and humiliation of the female, involvement of minors, incest, group sex, voyeurism, exhibitionism, etc.
Watching pornographic films over an extended period of time raises a fundamental question of who you become as a person watching it.

SURVING CANCER



Being diagnosed with cancer affects a patient not just physiologically but also psychologically, and has a deep impact on the emotional status of the patient and his family for an extended period of time. And while there are treatments for the physiological symptoms of the patient, dealing with the psychological trauma associated with cancer is another story altogether. Cancer is an experience of repeated traumas and for undetermined length, unlike an accident. The patient may experience posttraumatic stress disorder (PTSD) symptoms anytime from diagnosis through completion of treatment and cancer recurrence.

As is seen in the case of our Indian skipper Yuvraj Singh how the misdiagnosis and then the reconfirmation of the cancer must have been a series of highs and lows. Especially for a sportsperson who works under tremendous pressure to be fit and putting out an outstanding performance, trauma such as this can be doubly difficult psychologically rather than physically. Any ones guess would be whether he will be able to return to the stadium fit enough to play his best innings. Here is a glimpse of what he might be undergoing…

Although, the end of treatment is often marked with a sense of relief, accomplishment, and even joy in having gotten through a difficult experience. Yet for many cancer survivors, it is also a stressful time filled with new routines to learn, as well as mixed feelings about what they’ve just gone through. Many people find themselves unsure of how to move forward, wondering, “Now what?” Therefore, effects of PTSD are long-lasting and serious. It does not end with the end of the treatment. It may affect the patient’s ability to have a normal lifestyle and may interfere with personal relationships, education, and employment even after the patient is ‘cured’. Because avoiding places and persons associated with cancer is part of PTSD, the syndrome may prevent the patient from seeking medical treatment or psychotherapy. It is therefore important that cancer survivors and their family receive information about the possible psychological effects of their cancer experience and early treatment of symptoms of PTSD.

Also, as a patient, they may have been so busy learning about their diagnosis, working with the medical team, and going through treatment that they didn’t fully feel the emotional impact of the diagnosis until after end of the treatment. It’s common for many cancer survivors to have a variety of complex and often conflicting feelings about their diagnosis, treatment, and recovery. It is normal to feel relieved that treatment is over, yet angry or sad about having gone through such a serious illness. Or, they may feel guilty about surviving a diagnosis that other people do not. The patient may also feel anxious and fearful about the cancer coming back, or worried that the treatment didn’t work. It is normal, too, to feel confused about what they’ve been through and to be concerned about the future. Family and friends can provide much comfort and support during this time. However, survivors often feel a bit isolated from loved ones and the world around them. Loved ones usually mean well, but they might not be fully aware of all the emotional challenges that can arise for you after overwhelming, interfering with your day-to-day activities and even your health.
Another concern faced by many cancer survivors is the realization that life after their diagnosis and treatment never really goes back to what it was before cancer. Many survivors find they are not able to return to their old “normal” life but must adapt to a “new normal.” Understanding what your new normal is can take time. This process may involve: Reflecting on what you’ve been through. Identifying changes you might want to make in your life. Recognizing what you’ve learned and what’s changed about yourself. Re-evaluating personal relationships or professional goals.
Discovering new ways of finding meaning and fulfillment.
In India, we find that patients usually resort to prayer, fasting, performing ceremonies in order to deal with their illness as against proactively seeking information from the doctor, reading up on the net and medical journals, exercising, eating healthy, meditating or seeking professional help to deal with their emotions. (Stress and Coping amongst infertile women Research conducted by Dimple Shah for Mumbai University, 1994.). Although these actions mimic active coping mechanisms, in essence it is passive coping mechanisms resigning pessimistically and blaming fate for their misfortune and instilling deep fear and helplessness, therefore unable to relieve the person of stress. Patients and their family needs to be informed of these inactive and potentially stress inducing coping mechanisms and be guided to utilize proactive coping mechanisms mentioned above from the beginning.

Therapies used to treat PTSD are those used for other trauma victims. Treatment may involve more than one type of therapy. Feelings of sorrow, grief, hopelessness; coupled with mood swings, fear of losing life, leaving behind loved ones and anxiety and depression are very common amongst patients fighting against cancer. Serious psychosocial distress was seen 40% more among cancer survivors of 5 years or more than in those who have never had cancer. About 10% develop major depressive disorder; others experience an adjustment disorder. In young adult cancer survivors, one small study found that 20% of participants met the full clinical diagnosis of post-traumatic stress disorder (PTSD), and 45% to 95% displayed at least one symptom of PTSD. Survivors of adult cancer are at an increased risk of suicidal ideology (having thoughts about suicide), while as many as 13% of childhood cancer survivors experience suicidal ideology.

The prognosis of cancer it is proven scientifically that an emotionally stable person reacts better to the medication and treatment modalities of cancer. This is where a person’s inner strength becomes paramount. Yet it is expected that the person who has been diagnosed with cancer will initially at least crumble under the stress of the trauma. Here the key is, the support system that has a tremendous impact to help the patient bounce back to fighting cancer is the family and friends. Psychotherapy from the time of diagnosis to surgery and post treatment is crucial in providing this supporting network. When one member of a family has cancer, the whole family is affected and, in fact, psychotherapists consider these family members to be “secondary patients.” Cancer affects an entire family, not only because there are genetic links to cancer and cancer risk, but because when one member of a family has cancer the whole family must deal with the illness.

The therapist focuses on solving problems, teaching coping skills, and providing a supportive setting for the patient. Some patients are helped by methods that teach them to change their behaviors by changing their thinking patterns. Some of these methods include helping the patient understand symptoms, teaching coping and stress management skills (such as relaxation training), teaching the patient to reward upsetting thoughts, and helping the patient become less sensitive to upsetting triggers. Therapist may also use group work and introspective art therapy help the patient express their emotions. Sometimes having someone paying attention to the painful emotions itself is healing and patients show tremendous resilience once they are able to confide in someone who can demonstrate strength to listen to their pain, which family members are unable to do so at that point of time.

Most importantly cancer trauma, like other life threatening traumas bring back the past and often unconscious hurts and losses and therefore the psychological effect appears long lasting and compounded. Often people close to the patient find the person overreacting and are unable to understand where they are coming from. They feel hurt, angry and confused. But if you make an effort to understand that these emotions of hurt, anger and confusion that you are experiencing are not really incident related or even yours; that they belong to the person who is suffering from cancer you will be better able to deal with both the patient and the emotions thrown into you. Doing this is not as easy as it sounds and this is also where the psychotherapists step in. Psychotherapists help the family to experience and deal with these emotions that are thrown into them and also help them make better response choices. Therefore the psychological treatment on which the prognosis of cancer depends is strengthened using multifaceted psychotherapy approaches. It is beneficial to start with these sessions from the time of diagnosis and continue till post treatment; as although we expect psychological reactions to emerge within the first three months of diagnosis, there is no fixed rule and if not brought into the forefront of therapy may remain suppressed and resurface later on after many years, often with unconceivable strength.
Follow up article on Yuvraj singhs recovery from cancer
https://revivallife.wordpress.com/2012/04/14/surviving-cancer-2/

ACID ATTACK AND ITS IMPACT



In a male chauvinistic world, woman is considered to be the property of man. Be it a spurned lover, a suspecting husband or a man who is shooed away when he wants a relationship, each feels humiliated and wants to take revenge against the woman. The easiest way to hurt the woman in such instances is throwing acid on her. It makes the man feel immensely and rather sadistically satisfied if the woman is disfigured. Experts believe that the foremost reasons behind this barbaric act are easy availability of acids and illiteracy among the masses. The overwhelming majority of the victims are women, and many of them are below 18 years of age. These attacks are often the result of family and land dispute, dowry demands or a desire for revenge. There are umpteen instances in history of how women were treated in times of war or conflict. With the advent of industrialization and inventions, acid has come handy to these egotists in their bid to disfigure women. Acid throwing could well be described as the attempt to control or subjugate women.

Victims of attacks not only undergo severe physical trauma but also traumatic changes in the way they feel and think. Psychological trauma is caused by both what the terror victims suffer during the attack, as they feel their skin burning away, and what they suffer after the attack with respect to the disfigurement or disabilities they have to live with for the rest of their lives. Victims suffer psychological symptoms such as depression, insomnia, nightmares, paranoia, and/or fear of facing the outside world, headaches, weakness and tiredness, difficulty in concentrating and remembering things, etc. They feel perpetually depressed, ashamed, worried and lonely. Usually, acid burn victims suffer severe psychological symptoms for years, if not forever, because they are constantly reminded of the violent act by their physical scars. The feeling of lack of hope and worth may never leave them.

Social and Economic Consequences
Acid burn victims face a lifetime of discrimination from society and they often become lonely. They are embarrassed as they think people may stare or laugh at them, and may hesitate to leave their homes fearing adverse reactions from the outside world. Victims who are not married are not likely to get married and those who have suffered serious disabilities because of an attack, like blindness, will not find jobs and earn a living. Discrimination from other people, or disabilities such as blindness, makes it very difficult for victims to fend for themselves and they become dependent on others for food and money.
It has, therefore, been argued that acid attacks need to be classified as a separate offence and harsher punishment needs to be prescribed. It has been further stated that the new law must include guidelines for handling/supporting victims economically, socially and psychologically, and provide compensation. In fact since acid is so readily available across the counter in medical and other stores, acid attacks are a relatively cheap and effective way of committing acts of violence against women. Buying hydrochloric acid is as easy and cheap as buying a bar of soap; a litre of acid costs anywhere between Rs. 16 and Rs. 25.
There is, however, no law to regulate acid sales except for the Manufacture, Storage and Import of Hazardous Chemicals Rules, 1989 (amended in 2000), and this only applies to industrial situations. Furthermore, there are no regular inspections and stock checking for acid sales as there are for explosives. It has been argued by some that controlling or regulating acid sales is an impossible task, as acid is used for many things including car batteries, etc. Thus, the deterrence should come in the form of stringent laws that punish the perpetrators. However, Bangladesh, a country with the highest incident rate of acid attacks, has passed a law in 2002 to control acid sales. Thus, acid violence can be tackled on both fronts simultaneously with harsher punishment on the perpetrator and control over the sale of acid to stop it from getting into the hands of criminals. International commerce of sulphuric acid is controlled under the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988, which lists sulphuric acid under Table II of the convention, as a chemical frequently used in the illicit manufacture of narcotic drugs or psychotropic substances.
Nitric or sulphuric acid has a catastrophic effect on human flesh. It causes the skin tissue to melt, often exposing the bones below the flesh, sometimes even dissolving the bone. When acid attacks the eyes, it damages them permanently. Many acid attacks survivors have lost the use of one or both eyes. But the scars left by acid are not just skin deep. In addition to the inevitable psychological trauma, some survivors also face social isolation and ostracism that further damage their self-esteem and seriously undermine their professional and personal futures. Women who have survived acid attacks have great difficulty in finding work and, if unmarried (as many victims tend to be), have very little chance of ever getting married. In a country like India this has serious social and economic consequences. The New York Times (Dec, 26, 2001) reports that kerosene as well as acid has fast become the weapons of choice for attacks on wives in India. The major victim of attacked is Women(47%) and Men(26%). Children(27%) could not escape from the attack. Sometimes domestic animals or birds are also victimized. The sad fact is that women who have been victimised by these attacks are mostly at the hands of someone known and close to them.
Landmark Judgement
Referring to the compensation to acid victims, the Law Commission, headed by Justice A.R. Lakshmanan, quoted the landmark judgement of the Honourable High Court of Kerala in the State of Karnataka in the Jalahalli Police Station vs. Joseph Rodrigues case (decided on 22 August 2006) wherein the accused was convicted under Section 307 of the IPC and sentenced to imprisonment for life. A compensation of Rs. 2,00,000, in addition to the trial court fine of Rs. 3,00,000, was to be paid by the accused to the victim’s parents. The acid attack deeply scarred the victim’s physical appearance, changed the colour and appearance of her face and left her blind. However, in many cases throughout India, punishment often did not take into account the deliberate and gruesome nature of the attack but only rested on technicalities of injuries. It is apt to recall here that the Law Commission also proposed a law known as ‘Criminal Injuries Compensation Act’ to be enacted as a separate law by the government. This law intends to provide both interim and final monetary compensation to victims of certain acts of violence like rape, sexual assault, acid attacks, etc., and should provide for their medical and other expenses relating to rehabilitation, loss of earnings, etc. Any compensation already received by the victim can be taken into account while computing compensation under this Act.

Pune ST bus driver runs amok killing 8 people, injuring over 30 people and smashing 37 vehicles before he was forcibly brought to a halt by two youths. The man appeared dazed and glassy eyed and was later discovered that he was suffering from schizophrenia, a mental illness. 25 million people suffer from schizophrenia in our country and an attempt is made to rehabilitate them and make them economically…Edit


Pune ST bus driver runs amok killing 8 people, injuring over 30 people and smashing 37 vehicles before he was forcibly brought to a halt by two youths. The man appeared dazed and glassy eyed and was later discovered that he was suffering from schizophrenia, a mental illness. 25 million people suffer from schizophrenia in our country and an attempt is made to rehabilitate them and make them economically…Edit

HOW TO IMPROVE YOUR MEMORY



Ramesh (37 years old) had been coming for therapy for depression for a week now. One evening he came for the session really frustrated. He asked tentatively whether loss of memory could be due to his depression or the related antidepressants that he was given by his psychiatrist. He then went on to explain that he had excellent memory as far as numbers were concerned, so much so that as a child he could remember almost all 49 children’s marks in the class as the teacher called them out aloud before handing over the papers. Yet the previous evening when he had to give his new office number to his very important client he could not just get it right. It almost cost him his contract as the client got offended.

When I asked him when he started noticing this forgetfulness in him, he mentioned that a little before his divorce 3 years ago he had been noticing his forgetfulness but had been too emotionally wrapped up to pay further attention to it. He now realizes that the forgetfulness has been increasing over the years. Initially he thought that he was preoccupied and later brushed it off as a sign of early ageing and even hereditary. But yesterday’s incident was disturbing him.

First and foremost any physical disorder needs to be eradicated. Secondly causal factors as well as the mechanism of forgetting need to be understood. Usually mental decline begins by the age of 40 or 50. However people who are undergoing high emotional stress for an extended period of time also experience these symptoms as early as in their 30’s. Some of the stressors one cannot do away with given the stressful and competitive environment we live in, however we can counter them with certain changes in lifestyle. Health conscious people interested in living quality life introduce yoga/ physical exercises to their routine along with dietary changes. Similarly for mental health one needs to introduce what is called Neurobics in their life, a mental gym. Also contrary to popular belief, the mental decline most people experience is not due to the steady death of nerve cells. Instead, it usually results from the thinning out of the number and complexity of dendrites, the branches on nerve cells that directly receive and process information from other nerve cells that forms the basis of memory. Dendrites receive information across connections called synapses. If connections aren’t regularly switched on, the dendrites can atrophy.

The function of memory is primarily carried out by the cortex and the hypothalamus in the brain. Hypothalamus is the emotional seat of the brain. Anything which is emotionally laden is usually easier to recall, however if there is a flood of emotions it leads to confusion however if this flood continues for extended period of time, it can even cause atrophy in dendrites. This reduces the brains ability to put new information into memory as well as to retrieve old information. The good news is that aging brain, however, continues to have a remarkable ability to grow, adapt, and change patterns of connections. Therefore establishing associations and new pathways for connection have a healing effect on the brain.

The exercise program calls for presenting the brain with nonroutine or unexpected experiences using various combinations of your physical senses—vision, smell, touch, taste, and hearing—as well as your emotional “sense.” It stimulates patterns of neural activity that create more connections between different brain areas and causes nerve cells to produce natural brain nutrients, called neurotrophins, that can dramatically increase the size and complexity of nerve cell dendrites. Neurotrophins make surrounding cells stronger and more resistant to the effects of aging. Also, using multisensory approach, retrieving from the memory becomes easier with a web of associations supporting the matter. More often than not, adults don’t exploit the brain’s rich potential for multisensory associations. Think of a baby encountering a rattle. She’ll look at it closely, pick it up, and run her fingers around it, shake it, listen to whether it makes a sound, and then most likely stick it in her mouth to taste and feel it with her tongue and lips. The child’s rapidly growing brain uses all of her senses to develop the network of associations that will become her memory of a rattle. Adults miss out on this multisensory experience of new associations and sensory involvement because we tend to rely heavily on only one or two senses. As we grow older, we find that life is easier and less stressful when it’s predictable. So we tend to avoid new experiences and develop routines around what we already know and feel comfortable with. By doing this, we reduce opportunities for making new associations to a level that is less than idea. Simultaneous sensory input creates a neural “safety net” that traps information for future access.

Social interactions are also non routine and therefore socializing has similar effect. However we find more often than not that people who are undergoing emotional stress / depression want to be left alone and withdraw from social contacts. Is it any wonder why Psychiatrists suggest going for a walk rather that doing a fitness workout alone in your gym? Going for a walk allows one to experience all 5 senses and also provides the brain with social nutrients necessary to heal the brain.

Here are some of the ways in which you can use mental gym to improve on your memory:

1. Involve one or more of your senses in a novel context.
By blunting the sense you normally use, force yourself to rely on other senses to do an ordinary task. For instance: Get dressed for work with your eyes closed. Eat a meal with your family in silence.
Or combine two or more senses in unexpected ways: Listen to a specific piece of music while smelling a particular aroma.

2. Engage your attention. To stand out from the background of everyday events and make your brain go into alert mode, an activity has to be unusual, fun, surprising, engage your emotions, or have meaning for you. Turn the pictures on your desktop upside down. Take your child, spouse, or parent to your office for the day.

3. Break a routine activity in an unexpected, nontrivial way.
(Novelty just for its own sake is not highly Neurobic.)
Take a completely new route to work. Shop at a road side market instead of a supermarket. Normally, placing a key in a lock uses vision and “motor memory”—an unconscious “map” in the parts of our brain that control movement—which provides an ongoing feedback that allows us to sense where parts of our body are in space. (This is called the proprioceptive sense.)

Neurobics is recommended as a lifestyle choice, not a crash course or a quick fix. Simply by making small changes in your daily habits, you can turn everyday routines into “mind-building” exercises. It’s like improving your physical state by using the stairs instead of the elevator or walking to the store instead of driving.

Ramesh worked on these mental gym exercises for about 6 months and started regaining confidence in himself and also noticed his stress reducing, life feeling more meaningful, increase in interest and involvement in routine as well as novel things and social interactions and in general an elevated mood.

CREATING AND INCLUSIVE ENVIRONMENT IN THE COMPANY


You are at a senior managerial post in an innovative technical company. By enlarge the company environment is that of commaradie and the competition is healthy. You had employed Rita at a managerial post few months ago. You value her talent and her input to the company is crucial. She is an amicable personality and excellent with her work. One day she steps into your office with a grim expression on her face and informs you that she has decided to look for a new job and would appreciate a reference from you. After briefly discussing with her you realize that she likes her work and she is leaving because she feels marginalized and isolated by the other office colleagues. You have been aware of socializing of office staff, mainly male staff, at a beer joint over the weekends for quite some time, and have encouraged it by going there yourself along with them occasionally as it seemed to increase their commaradie. You did not pay much attention to a few who seemed to avoid going there for example Ramesh who has two elder sisters who are to be married and an ailing mother. He chooses not to go for his family responsibilities. Harsh too who is a single parent does not visit the joint as he has to pick up his child from the day care, nor does Ritesh who does not drink. Rita too does not visit the joint as she is the only woman in the office.
Many a times office information is informally circulated amongst the staff members at this joint and it also seems to encourage mentoring of rookies. Govind who visits the joint regularly learnt of one such possible opening in the organization a few months prior to its announcement at the joint. He then strategically placed himself in such a manner that he would be the most eligible person fitting the profile for the position by the time it was announced. Rita who is technically sound would have been better suited for the post were she aware of the information before hand like Govind or if the information was released simultaneously to all.
Rita hit her limit when she found this out and feels left out of the crucial information which could have been a crucial promotional move upwards for her career. She believes this will be an ongoing phenomenon in the company politics as she is excluded from the group and therefore wants to move. You value her talents and skills and do not want to lose her. You now realize that those who are not in the beer joint clique feel isolated and left out although the clique does not intentionally sets themselves out to be exclusive. You also know that such cliques are a part of regular office politics but cannot deny that they provide few with benefits that give them a head start to many promotions. You wonder whether you have been complicit in this matter and how you could promote an atmosphere of inclusiveness or even how you could help Rita.
This incidence has opened your eyes to the following facts:
• These socializing outside of office colleagues having similar interests like sports, gym, hobby classes, bars, prayer places etc is natural and unavoidable. The inclusion of those based on the commonalities of gender or religion or lifestyle, although unintentional, provides them with opportunities to pass on crucial company information as a privilege of being a part of the ‘haves’ clique.
• The loyalty and intimacy amongst the ‘haves’ community which allows these special privileges is obvious to them. While they enjoy the benefits it also creates a self doubt and they are bound to worry about securing the same based on purely their merits and abilities, especially since they may not receive specific and honest feedback on their shortcomings.
• On the other hand, the ‘have nots’ are undeniably going to feel that such favoritism is unfair and will be demoralized. Tying opportunity and promotion to anything other than performance hurts the morale of the workers leading to poor performance, mistrust and reluctance to seek guidance when necessary.
• A leader who is aware of these dynamics but tolerates such inequalities is unlikely to be respected both by the haves and the have nots because at some level both the cliques know the practices are unfair. Given these facts t0 transform this atmosphere into an all inclusive environment is not possible.

The leaders could deal with such situation the following ways:
• Explicit information about the expectations and performance evaluations must be given to the staff. Feedback must be timely, specific and direct.
• You could introduce the inclusive policy while formulating project teams to promote collaboration and opportunities for staff from diverse backgrounds to interact and bond with each other in an mentorless environment.
• If the managers don’t have the skills to mentor people different from themselves, companies could provide training and coaching to the managers. Such training when done on a regular basis reflects company’s policies to be fair and caring.
• Special socializing work- based opportunities could be provided by the company for all. Many companies have now introduced sports based activities for the same.
• Leaders should be prepared to face resistance by the haves as they may perceive it as a loss of a status or privilege as they can be frightening and disorienting. This could lead to targeting the have-nots as scapegoat or sheer rage towards the have nots. Leaders have to be firm in setting limits and consequences of such behaviour.
• Rita’s situation is not irreversible but will require sensitive understanding and communication to her about many such past hurts and upsets. Talk to her about how things could be changed and what kind of a support would she like from the company to make her feel comfortable.
• Help her identify mentors and supportive co workers, encourage them to include her professionally both in office and outside the office.
• Insist and encourage Rita to include herself in social activities and accept invitations for the same although she may not enjoy it initially.
• Help her to gain insight that awareness of emotions could help her to make free and powerful decisions rather than limit her. Most wise decisions are not solely based on how a person feels rather takes both the emotions and thoughts into consideration. That she could still go ahead and socialize based on logical choices and decisions if she wants to move up the corporate ladder and that handling her own momentary uncomfortable feelings is not that difficult.
An inclusive and welcoming workplace will improve not only company morale but also the company’s bottom line, too.

HANDLING SELF SABOTAGING & SELF LIMITING BEHAVIOURS


Susanne was recently hired on a senior managerial post. She had wanted this break for months but now that she had bagged it she has been really struggling. She found herself sabotaging her own career by procrastinating work that was crucial, coming late to work, late submissions of reports etc. She herself is troubled by her self destructive behaviour. She cannot fathom why she is continuing to behave against her self interest although it consistently leads herself to misery. We have all seen this in our friends and are quick to point it out, but regrettably shove our own misfortunes under the carpet.
A friend who is bright and outstanding in her own career always ends up in relationships with partners who are unable to contribute anything to the household. So while she ends up working very hard paying for the household, her unemployed partner relaxes at home. Eventually, she questions herself and breaks away from the relationship. After repeated such relationships, she questions herself on her own wisdom but is unable to arrive at any conclusions. What seems glaringly obvious to those closest to her, she is oblivious to it. Why despite her high intelligence at work and in other spheres of life is she having a blind spot to this aspect, which is in fact the most crucial factor, determining her happiness for her?
Your colleague is extremely talented and is in great need to upgrade her salary, but she lands herself with jobs which require more work and pay less. You see no apparent reason why she can not get better pay and a cushiony job for herself, but have witnessed her struggling. You ask her what keeps her in the current job although her boss is exploiting her. She confides that she feels that if she left him now, he would be stranded and she would in a way feel responsible for his misery. She viewed it as being unethical, disloyal and selfish. So although she wants to shift to another job, she subordinates her own goals and ambitions for her ideals. It makes no sense to you as she often complains about being stuck and although you can hear her anger, she is unaware of her deep resentment.
You have wanted to loose 10 kgs that you have put on post the child birth, 5 years ago but to no vail. You have the available resources, will power and confidence, but for some reason or the other your priorities take a back seat. Now with the back problem increasing it has become a pressing issue and you are beat as to why does you are unable to stick to the diet regimen. You don’t like the way you look and feel and now it seems to even hinder in your work life. But something stops you from successfully adhering to your fitness program.
You are chronically late with your taxes and invariably end up with bitter arguments with a dear friend. You are aware that your friend is doing you a favour by taking your file although he handles only corporate work. You also know that the last week of march he has his hands full with last minute changes from the bigger clients but end up only 2 weeks before the last date. Now your relationship with him is turning sour because of your consistent insensitivity to his needs.
Why do you end up postponing your work, your personal agendas and indulge in self limiting and self destructive behaviour. There seems no apparent reason. But most importantly how do we overcome them? In all the above given situation the issues seem maladaptive or harmful but if we give it a closer look it is an adaptive response or beneficial to the individual. However absurd or inappropriate the adaptation is, the individual stands to be protected with this response. The harmful consequences to these solutions are easily identifiable but the beneficial aspects are concealed and obscure. This is so because the beneficial reasons are outside the individuals conscious awareness and therefore the individual is unable to bring about any changes to them with conscious resolutions. In fact if they were aware of it or was brought into their awareness, they would be able to change them. This kind of an inexplicable behaviour represents an unconscious conflict which can be changed only by bringing it to the fore front. The maladaptive response is the only symptom which gives us a clue about this conflict and it continues to repeat till it is made conscious and resolved.
For example an overweight person may temporarily feel motivated to join a weight loss program but her actions on a day to day life are unsupporting of the resolution, representing an inner conflict. Her actions are in accordance with the unconscious motives rather than conscious motives. Although she wants to loose weight to take care of herself physically, she may have a conflicting motive that if she looses weight then people will not take care of her, weightloss will bring her into limelight and she may be frightened that she will emotionally slip into another intimate relationship, she may be afraid to repeat the unhappy marriage of her parents, or may be anxious about some aspects of sexuality. Whatever the reasons are, they are so terrifying for her that she hides out in the huge body to avoid facing the consequences.
People who often repeat abusive relationships have as children repeatedly experienced people around them not paying any heed to their emotions and feelings. In fact when they have expressed their emotions they may have been rebuked or criticized or maybe nothing changed despite their communications and they may have learnt this not to tune into the feelings to avoid feeling the pain. This then became their maladaptive coping mechanism which they repeat in their adulthood. They have learnt to protect themselves by getting into relationships of power where they experience helplessness experienced in childhood over and over again so that they do not have to feel the emotional pain of not being heard again, infact often they operate blindly without being aware of their feelings (their learnt maladaptive protective behaviour of childhood). It is their way to bring to surface the conflict and attempt to resolve their childhood pain in the current situation. This is precisely why although intelligent enough they are unable to choose wisely in their relationships or set appropriate limits as they are operating without their feelings. Your emotions act as a vital compass to guide important decisions about love and work, without which you are likely to get hurt.
How can we recognize these maladaptive coping mechanisms which need to change if we want to progress in our life? Follow the following steps and work out your inner conflict:
Think about a problem with which you have struggled for a long time.
Describe the ways in which it is maladaptive. How does this
problem hurt you or hold you back or make you unhappy? What
is its impact on your relationships at work, at home, and socially?
1. Have you attempted to change this problem? If not, why not? If
so, describe the nature of your efforts?
2. In what ways have your efforts been successful? If they have
been unsuccessful, why?
3. In what ways have your efforts been self limiting? How were they
sabotaged?
4. Now focus on the adaptive aspects of the problem. However absurd it may seem, try to answer them.
How is this problem adaptive? What are the benefits? Who are
the beneficiaries? That is, how might lovers, friends, family, and
coworkers benefit from it? How might you benefit from it?
5. What aspects of yourself does it allow you to avoid?
Who would experience a loss if the “problem” were eliminated?
Describe the loss. What would its impact be?
6. How would you be forced to grow and mature if the “problem”
were eliminated? That is, in what ways would you be forced out
of your comfort zone?
7. How would others be forced to grow and mature if the “problem”
were eliminated? How would they be helped or hurt by the
elimination of your problem?
8. If you achieve your goal or eliminate your problem, how would
your life be different? Would it be more populated with people?
More isolated? Busier? More lonely? More leisurely?
9. How would your lifestyle change?
10. How would your friendships be affected?
How would key people in your life react? Would they be pleased?
Would they be envious? A bit of both?
11. What would your parents think about it (answer this even if they
are no longer alive).
If you are partnered, what would your partner think about it?
How would your partner feel about it?
12. What would your children think about it? How would they feel
about it? How would they be affected?
13. As a function of this change, who would be more likely to enter
your life? Who might leave it?
14. What difficult or frightening situations would you have to
confront?
15. How can these “symptoms” be overcome and mastered?
The questions above provide you with a structure for thinking about the meaning of a puzzling conflict. At first, these questions seem absurd to many people. However, over time, they begin to make sense. Answering these steps can be a wonderful beginning to changing an unwanted behavior or situation. Talk your fears over with a trusted friend. Develop a plan for overcoming your “problem”. Give yourself a timeframe for overcoming your “problem” or achieving your goal. If after your efforts, you are unable to take any of these steps, consider seeking psychotherapy from an experienced clinician. We know enough about psychodynamics and unconscious motivations that most symptoms can be understood and effectively addressed.

COPING MECHANISMS AT WORK



Handling employee self sabotaging behaviours at work place
You are a regional head of a company. You have recently hired a new center manager. His credentials are excellent and his work experience speaks for itself. But at every turn he seems to sabotage himself. For example he will give a terrific presentation but will come in stained clothes, he will generate dynamic and innovative ideas for product launch but will forget to calculate the risk factors, will send in reports regularly but will forget to arrange the papers in order, or while addressing delegates he will forget to acknowledge the key person.
You are aware of the organizational dynamics and how this can adversely affect his job security as well as tarnish your reputation. He is a talented man, not easily found and you want to make the best of the situation with a little tweaking if possible, so you bring this up with him. When you do so, he readily acknowledges his mistakes and promises to try harder. But its sounds like deja vue to you and past experiences speak louder than the words that you are hearing from him. You already know that the forces are beyond his control. You feel frustrated and upset and wonder what could possibly motivate him to be more proactive in these behaviours. It is apparent to both of you that his behaviours have nothing to do with his abilities or intelligence, but they remain maladaptive. But not known to both of you is that these so called maladaptive behaviours may actually have some benefits, perhaps in a way that he is himself unaware, being in the unconscious. That in some way they represent a solution to an internal conflict or difficulties and the reason he seems to be unable to give them up however much he tries is because they protect him. Because his maladaptive behaviour has motives outside his conscious awareness, his conscious decisions remain unsupported and therefore fail. Were he aware of these unconscious motives he would’ve been able to change them.
These maladaptive behaviours are our unconscious minds signal to our conscious mind to pay attention to these unresolved conflicts and to heal them. However absurd it may sound, this is our minds defense system to heal, just like fever is our body’s defense to kill antibodies. Fever is just a symptom or a clue to underlying illness as is maladaptive behaviour is a clue to underlying conflict. It is universal phenomenon. What keeps him from achieving his dreams to succeed? The reasons are the same as any other individual. These same reasons makes a business delay income tax returns, one from not going to the dentist till the pain gets unbearable, a student from not studying, another person from being late every day at work.
Consider this, that while on a conscious level he might want to succeed very much, but on a deeper unconscious level he may be terrified of doing so. Maybe succeeding at the managerial level may take him into uncharted territories. He may be unaware of his fears of competition. For example, if he has an elder brother who was always viewed as more intelligent so although he did poorly in studies he excelled in sports and they never crossed each others path till financial success came into picture. Although he was street smart along with being intelligent and is a combination for success, succeeding at work would be outshining his brother and he maybe fearful of doing so. Maybe earning more money would represent that his mother will not be pleased or that it is incompatible with his self image of being a duffer.
It is obvious that whatever the psychological reasons are, they can not compensate for the corporate damage and you cannot expect them to protect him. Just discussing these also may indicate to him that he is not accountable for his actions and you do not want to do so. More importantly you don’t want to corrupt the environment of the corporate and pass on wrong messages to other colleagues and subordinates, but nor can you ignore them. His behaviour converts individual difficulties into organizational dysfunction. What you need to do is discuss his troubling behaviour with him and tell him firmly that he must find a way to change it. You empathize with him about his frustrations on his inability to change his self sabotaging behaviour but insist on changing them. If you find yourself getting too involved in personal dynamics or internal dynamics of his mind, repeatedly draw boundaries by telling him that they maybe important insights but that does not change the corporate facts and for the sake of work relations you rather avoid getting into them, as often employees regret such personal conversations later on. Instead after taking him into confidence talk to the Human Resource department and include some coaching for personal development. In some cases where these behaviours are resistant to change, the best tool for gaining self awareness is psychotherapy. Make him aware of where these services are available through the employee assistance program. Conversations such as these are always difficult and require a lot of tact but are essential for maintaining employee morale and relationships.