Tuesday, June 22, 2021

Helping our patients to reconcile the external rules, principles and values with their internal ones


Society or the “collective others” have certain rules, principles and values.

We as individuals, have certain internal rules, principles and values.

Following the external rules, principles and values will make others happy and achieve external harmony.

Following the internal rules, principles and values will make us happy and achieve internal harmony.

The question is, can we have our cake and eat it too? Can we have external harmony as well as internal harmony?

Maybe …..

In counseling, we sometimes help folks to sync and reconcile the inner rules, principles, and values of an individual with the external rules, principles, and values of others. The smaller the gap, the lesser the tension. When it is in conflict, knowing which one is more important in a given context is important. Sometimes, knowing how to hold lightly the opposing rules, principles and values of the external and internal in the same space is also very important.

Monday, June 21, 2021

How to identify folks or kids on the spectrum by these simple key clues



When trying to identify folks or kids on the spectrum, I tend to look for the following simple “key clues”.

1. Do they have a strong bias towards the “thinking/objective data” rather than the “feelings” when it comes to taking in information, making decisions or taking actions?

2. Do they have a strong bias towards following and trusting their own inner rules, principles and values, rather the rules, principles and values of the outside world? In other words, are they more strongly “inner compass orientated” rather than “outer compass orientated”?

3. Obsessive compulsive features with difficulties around “shifting gears”. 

4. Sensory difficulties with one or more of the 5 senses. 

5. Is there significant psychosocial dysfunction or adjustment issues that cannot be readjusted easily?

Sunday, June 20, 2021

Helping our patients to surf life with “metaphorical truths”


In medical school, I was taught that depression and anxiety are due to chemical imbalances. So we can give people a chemical to correct that imbalance. I use to think that this was the “literal truth”, but now, I think it’s more of a “metaphorical truth” rather than a literal one.

When dealing with the more logical and objective aspect of a person’s health, it’s easier to find the “literal truths” to guide our actions. You have got a broken arm. This is what it is. This is how we are going to fix it.

However, when dealing with the more psychological aspects of a person’s health, it’s more abstract. It’s harder to find or use the “literal truths” to understand and guide our actions. So in counseling, especially in Acceptance Commitment Therapy ACT, we often use the “metaphorical truths” to help our patients better navigate their more abstract “feeling world”.

Metaphors are a great way to describe an idea or concept in a way that literal truth can’t fully convey, or where literal truths are not yet available. So when using “metaphorical truths”, although it’s not the “literally truth”, it can still be helpful and useful.

Here is one of my favorites.

Life is like a ocean of waves. Sometimes it’s calm. Sometimes it’s choppy. And once in a while, a tsunami comes along. It’s inevitable. We can’t fight it. We can’t run away from it. We simply have to embrace it, get back on the board, and surf it the best way that we can🏄‍♂️

What’s your favorite “metaphorical truth”?

Saturday, June 19, 2021

Helping our patients to understand and integrate our thinking and feeling minds better


In counseling, we often see the extremes of personality traits.

We often see the extreme “logical thinking folks” who have struggles with the feelings, AND

We often see the extreme “emotional feeling folks” who have struggles with the logical, rules and boundary setting part of their lives.

If not careful, they tend to swing from one end to the other leading to emotional exhaustion at times.

The aim is to give these folks the emotional literacy to fully understand and fully accept themselves for who they are, and then scaffold their weaknesses or “fill in the gaps”.

CBT (Cognitive Behavioural Therapy) is probably more logical and thinking based in its approach.

ACT (Acceptance Commitment Therapy) is probably more feeling and “value based” in its approach.

We use both to help “bridge the gaps” for these folks. In essence, we aim for them to become more “bilingual”, and integrate their thinking and feeling minds for better functioning and adaptation.

Without those abilities, they may be in a state of frequent inner conflict and disharmony.