Your Triggers Belong to You

*Trigger warning – the word “trigger” is used a lot in this blog 😊

Yesterday, I was triggered. Really triggered.

It started early — a moment in a morning meeting where an experience just landed wrong. Later, a comment from a close friend. Then again, mid-session with a client. (Yes — even therapists get triggered. Even with all the training and self-awareness and bracketing, sometimes our stuff sneaks through the cracks.)

There was a theme behind it all. I won’t go into it here, but let’s just say my brain was on high alert for anything remotely related to this particular thread. Hypervigilance doesn’t always show up with sirens — sometimes it’s just this subtle, gnawing sense that something’s off. That you're not okay. That the ground beneath you isn't quite steady.

When We’re Triggered, Our Brain Looks Outward

The first thing most of us do when we're triggered is look around and try to locate the cause.
“I shouldn’t feel this way. Why aren’t I over this?”
“They shouldn’t have said that.”
“That look… I know what that meant.”

This is understandable. The human brain is wired for protection, and it wants to make sense of the discomfort quickly. Blame — even self-blame — gives the illusion of control. But this pathway also tends to leave us stuck. Stuck in defensiveness. Stuck in shame. Stuck in old stories that play on loop.

Here's the Hard Truth (That Also Sets Us Free)

In most cases — not all, but many — our triggers are ours.
We are triggered.
Other people don’t trigger us.

That feeling that rushes in out of nowhere — the pounding heart, the shut-down, the heat in your face, the mental static — is often an emotional flashback.

Unlike visual flashbacks, emotional flashbacks don’t come with vivid scenes or memory reels. They come with feeling states. Panic. Shame. Helplessness. Rage. Grief. Often disproportionate to the moment at hand — and often rooted in something much earlier in our lives or an insecurity just simmering under the surface.

The comment my friend made wasn’t cruel, but it hit the same nerve as a criticism I used to hold over myself — something that made me feel invisible, or too much, or unlovable.

My client’s behaviour wasn’t malicious, but it echoed a confused value system that has yet resolved.

Triggers often tie back to core wounds — beliefs like:

• I’m not enough

• I can’t trust people

• No one sees me

• I always mess things up

• I’m too much to handle

These are old scripts. And when they’re activated, your body reacts as if you're right back there — 5, 10, 20 years ago.

What To Do In a Trigger: Responding to Emotional Flashbacks

Here are some ways to anchor yourself when you’re caught in the middle of it.

1. Name it: “I’m having a flashback.”

This one shift can change everything. You're not broken. You're not overreacting. You're remembering — just not consciously. Naming it helps bring your prefrontal cortex (your thinking brain) back online.

2. Get safe — physically and emotionally.

Step away. Breathe. Cancel something if you need to. You can’t work through a trigger while still swimming in the middle of it.

3. Ground yourself in the present.

Try:

• Noticing five things you can see, four you can touch, three you can hear, two you can smell, one you can taste.

• Planting your feet firmly on the floor and pressing down slowly.

• Saying: “Right now I’m safe. I’m not back there. I’m here.”

4. Soothe your nervous system, not your ego.

Often we want to mentally “solve” the trigger. But before you dissect the story or assign blame, tend to your body first. That might mean deep breathing, movement, stretching, a weighted blanket, music — whatever brings a sense of settling.

5. Get curious (later, not during).

After the intensity passes, ask:

• What did that moment remind me of?

• What part of me needed protection just then?

• What old belief got activated?

• What do I know now that I didn’t back then?

A Final Word

This isn’t about excusing harmful behaviour. Some situations are genuinely unsafe or unacceptable. But many triggers happen in emotionally neutral moments that hit an unresolved nerve. And recognising this gives you a choice.

You can pause. Step back. Check in. And respond, rather than react.

We all carry stories we didn’t write — stories shaped by trauma, attachment wounds, or early dynamics that were bigger than us. The work of healing isn’t pretending we’re never triggered again. It’s learning how to meet the moment with compassion and skill, and letting those old stories loosen their grip over time.

If emotional flashbacks are a regular part of your life, you’re not weak — you’re likely carrying something your nervous system never got the chance to properly process. Therapy can help unpack these patterns and offer support in learning how to come back to yourself, gently and safely, when you're thrown off course.

Trauma & Addiction: Why It’s Not About the Substance

When we talk about addiction, it’s easy to get stuck in the obvious. Drugs. Alcohol. Gambling. But the reality of addictive behaviours is far broader, and far more human, than we’re often willing to admit.

We all have ways we try to regulate pain—some are just more socially acceptable than others.

What often gets missed in public conversations is this: for many people, addiction doesn’t start with pleasure-seeking. It starts with pain-soothing. And beneath that pain, often, is trauma.

But trauma and addiction don’t just co-exist. They interlock. They feed each other. And sometimes, they camouflage each other—making both harder to treat unless we see the link clearly.

Addiction Is a Response, Not a Character Flaw

For someone carrying unresolved trauma, addictive behaviour is rarely about getting high or escaping reality in the stereotypical sense. It's about survival.

This might mean:

• Using alcohol to calm a body that’s constantly hypervigilant.

• Overeating to feel emotionally “full” in a nervous system that learned hunger early—emotional or physical.

• Losing hours to porn, shopping, or social media to dissociate from the internal chaos that hasn’t been named yet.

• Working compulsively to avoid stillness that might bring up long-buried pain.

These patterns are attempts to self-soothe. To create temporary safety. And they make sense in the context of a nervous system shaped by threat, neglect, or unpredictability.

Trauma Wires the Brain for Imbalance

One of trauma’s deepest impacts is that it reshapes the reward system in the brain.

Early trauma—especially attachment trauma or chronic relational disruption—can cause the brain to release stress hormones (like cortisol) in high doses and dial down the production of feel-good chemicals like dopamine or oxytocin.

What does this mean? The baseline for “normal” becomes dysregulated. People who’ve experienced trauma often feel flat, foggy, chronically anxious, or emotionally numb. Their nervous system is in survival mode, not presence.

So when something—anything—temporarily lights up the dopamine system, it can feel like relief. Like aliveness. Like control.

Addictive behaviour fills that neurochemical gap. But the brain quickly adjusts, needing more of the substance or activity to achieve the same effect. Over time, this creates a cycle where the person becomes less able to generate those good feelings naturally.

It’s Not Always About the Big “T” Trauma

Not everyone who struggles with addiction has a history of abuse, neglect, or dramatic events. Sometimes trauma is subtle. Chronic invalidation. Emotional absence. The kind of family system where feelings were shut down, achievements were everything, or connection was conditional.

We sometimes refer to this as developmental trauma—where core needs for safety, attunement, and emotional regulation weren’t consistently met during critical periods of growth.

In these cases, addictive behaviours can emerge as attempts to:

• Create a sense of identity when one wasn’t mirrored back.

• Control a world that once felt chaotic or emotionally unsafe.

• Avoid internal criticism that mimics old external voices.

Why Addiction Can Feel Like Love

Here’s a nuance that often surprises people: for many trauma survivors, their addiction is the most reliable thing they’ve ever known. It shows up. It delivers (at first). It doesn’t abandon, reject, or shame—until it does.

That’s why talking someone out of addictive behaviour with logic rarely works. It's not just a habit. It's a relationship. Sometimes, it’s the only dependable source of comfort they’ve had.

So in therapy, we don’t just focus on the behaviour. We focus on what the behaviour represents:

• What need is it meeting?

• What feeling is it muting?

• What memory or belief is it protecting you from revisiting?

Only by understanding the emotional function of addiction can we begin to support new, healthier forms of regulation that feel safe and sustainable.

Healing Requires More Than Abstinence

Stopping the addictive behaviour is a part of healing—but it’s not the end goal.

Trauma-informed therapy focuses on helping individuals:

• Identify the original wounds and unmet needs driving the behaviour.

• Build safety in the body through grounding, somatic awareness, and emotional regulation.

• Learn alternative ways of managing stress, loneliness, shame, or dysphoria.

• Develop compassionate self-understanding, rather than shame-driven narratives.

Because the truth is—people don’t give up addictions just because they “know better.” They let go when they feel safe enough to.

Final Thoughts

Addiction isn’t about bad choices. It’s about coping. And often, it’s a brilliant (if costly) strategy from a time when someone was trying to survive something too big to handle alone.

If you or someone you know is stuck in this cycle, therapy can offer more than just insight. It can offer a new relationship—with your emotions, with your body, and with parts of yourself that learned long ago that soothing had to be outsourced to something else.

Procrastination, Paralysis, or Protection? Understanding the ADHD Freeze

You’ve likely been there. You know what needs to get done. Maybe it’s an email. Maybe it’s tidying the house, starting an assignment, or making a phone call you’ve put off for weeks.

And yet… you’re stuck. Not moving. Maybe scrolling. Maybe staring. And then the self-talk starts:
“Why am I like this?”
“Everyone else just gets on with it.”
“I’m so lazy.”

But here’s the truth—what looks like procrastination on the outside is often a protective response on the inside. Especially if you live with ADHD, anxiety, or other neurodivergent ways of processing the world, what you're experiencing is less about laziness and potentially more about overwhelm.

Your nervous system isn’t failing you. It’s doing what it thinks it needs to keep you safe. The problem is, it doesn’t always know the difference between a deadline and a tiger.

Let’s unpack a few strategies that can help when you feel paralysed—not by forcing productivity, but by working with how your brain actually operates.

1. Start So Small It’s Almost Ridiculous

When the task in front of you is vague or too big, your brain shuts down. “Write that report” or “Clean the whole kitchen” may as well be “Climb Everest.”

Instead, shrink the task to the tiniest possible action. Open the document. Name the file. Write one sentence—poorly. Put one dish in the sink.

Once you’ve started, you may find momentum builds. Or it may not. Either way, you’ve taken a step. That counts.

2. Don’t Go It Alone: Try a “Body Double”

A surprisingly effective strategy—especially for those with ADHD—is working alongside someone else. Not because they’re helping, but simply because they’re there.

Whether it’s a friend on a video call, a co-working space, or even sitting in a shared space with someone quietly nearby, the presence of another person can help regulate your nervous system and provide just enough gentle pressure to get going.

This approach is often called “body doubling,” and it’s less about accountability and more about connection and calm.

3. Time It (But Keep It Short)

When a task feels endless, starting feels pointless. So limit it. Set a timer for 5, 10, or 20 minutes. Tell yourself, “Let’s just do this much.”

This technique taps into something called the time horizon—how far into the future your brain can comfortably plan. Shortening the window helps tasks feel manageable, and it often tricks the brain into starting without triggering the alarm bells of overwhelm.

4. Lower the Bar—Deliberately

High standards often keep people stuck. If it can’t be done perfectly, the brain decides it’s not worth doing at all.

The antidote? Allow yourself to do it badly.

First drafts can be awful. Dishes don’t have to be all done. Emails don’t need the perfect tone. Start messy. Progress matters more than polish.

The saying I often share with clients: “Done is better than perfect.” Let that be your motto for a while.

5. Pair the Task with Something That Feels Good

Not every task can be transformed into something enjoyable—but we can change the experience around it.

This might look like:

• Folding laundry while listening to a favourite podcast

• Doing emails with a hot drink and music

• Wearing something soft and cosy while cleaning

If the task itself is neutral or boring, make the surrounding environment pleasant. Your brain is more likely to cooperate.

What to Keep in Mind

• You’re not broken.

• This isn’t about laziness or lack of motivation.

• These are real strategies rooted in how executive function and emotional regulation work.

And sometimes, despite all the tools, it’s still hard. That’s okay too.

Working with a psychologist can help unpack the patterns beneath chronic stuckness—whether it’s related to ADHD, trauma, anxiety, perfectionism, or all of the above. The goal isn’t to fix you, but to understand what’s going on and learn to work with your brain, not against it.

Struggling with getting started, even on the smallest things?
Therapy can help uncover the roots of that stuck feeling and offer strategies tailored to your nervous system. You don’t have to white-knuckle your way through it.

Panic Attacks vs Anxiety Attacks: What’s the Difference?

Over the years, I’ve noticed something in conversations with clients: the terms panic attack and anxiety attack often get used like they’re the same thing. And honestly, it makes sense. Both can feel overwhelming, frightening, and hard to put into words. But while there’s overlap, they’re not quite identical—and knowing the difference can actually help you feel a little more in control when these moments show up.

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What Is a Panic Attack?

A panic attack is a sudden surge of intense fear or discomfort that comes on quickly—often out of the blue. It’s like your body has pressed the red “alarm” button without your permission.

Common symptoms include:

Pounding heart or palpitations

Trouble breathing, shortness of breath

Sweating, chills or shaking

Dizziness, nausea, or feeling faint

Chest pain or pressure

A sense of unreality or detachment

Fear you’re “going crazy” or even dying

Panic attacks usually peak within 10–20 minutes (though those minutes can feel endless). They can happen in panic disorder, but also in other anxiety conditions, PTSD, or even depression.

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What Is an Anxiety Attack?

Here’s the twist: “anxiety attack” isn’t an official clinical term. People use it to describe when their anxiety builds so much it feels like an “attack.”

Unlike panic, anxiety tends to build gradually. It’s often tied to a stressor—like exams, a job interview, relationship stress, or financial worries. Instead of a sudden tidal wave, it’s more like a storm front rolling in.

Symptoms often include:

Muscle tension or restlessness

Racing thoughts or worry loops

Irritability or feeling “on edge”

Difficulty concentrating

Trouble sleeping

Fatigue from being in constant “high alert”

And anxiety attacks don’t usually stop after 20 minutes—they can last hours, sometimes days.

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Key Differences

Onset: Panic attacks are sudden; anxiety attacks build over time.

Duration: Panic peaks fast and fades; anxiety can linger.

Triggers: Panic may feel random; anxiety is usually linked to a stressor.

Symptoms: Panic leans physical (heart, breath, chest pain); anxiety leans cognitive and emotional (worry, dread, tension).

Both are exhausting, both are very real—but understanding which you’re experiencing can be reassuring.

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Why Knowing the Difference Helps

It’s not about putting you in a box—it’s about guiding treatment and giving you language to describe your experience.

Panic attacks: often benefit from exposure-based strategies that reduce fear of the sensations themselves.

Anxiety attacks: respond well to therapy focused on managing worry, reducing avoidance, and building stress tolerance.

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Coping Strategies in the Moment

Whether panic or anxiety, some strategies overlap:

Ground yourself: Use the 5–4–3–2–1 method (name 5 things you see, 4 touch, 3 hear, 2 smell, 1 taste).

Slow your breathing: Try inhaling for 4, exhaling for 6–8. This tells your nervous system you’re safe.

Talk back to your thoughts: “This feels awful, but it’s not dangerous. It will pass.”

Avoid avoiding: With panic especially, avoiding triggers makes the cycle worse. Small, supported steps help.

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When to Reach Out

If panic or anxiety attacks are happening often, interfering with daily life, or making you avoid things you care about—it’s time to seek support. Effective therapies exist, and sometimes medication plays a role too. You don’t have to live waiting for “the next one.”

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Final Thoughts

Both panic and anxiety attacks can limit life in frustrating ways. While people often use the words interchangeably, there are differences. Understanding them won’t stop the feelings overnight—but it can help you make sense of what’s happening, and more importantly, remind you that there are strategies (and people) that can help you through it.

How to Handle Relationship Conflict - Even If Your Partner Isn’t in Therapy

You can still build a healthier relationship — even if your partner isn’t ready for therapy.

When conflict starts repeating itself in a relationship, it can leave one partner feeling like they’re the only one trying to fix things. You might be reading books, listening to podcasts, or even coming to therapy — while your partner isn’t ready (or willing) to join you.

The good news is that meaningful change can begin with one person. Small shifts in how you show up in moments of tension can calm the dynamic and invite new patterns at home.

At Mind Harbour Perth, I often talk with clients about a simple idea drawn from relationship science:

“Healthy relationships aren’t built on constant agreement; they’re built on the ability to stay connected while staying yourself.”

That skill has a name — differentiation — and it sits at the heart of mature intimacy. When we can hold our own perspective without attacking, withdrawing, or losing ourselves, conflict becomes less about “winning” and more about understanding.

1. Swap mind-reading for clarity

When emotions run high, we often expect our partner to just know what we need. Unfortunately, this mind-reading contract fuels frustration on both sides.

Try expressing your needs clearly and specifically:

• “Could we plan the week’s chores together on Sunday for 15 minutes?”
• “When I’m quiet after work, I’m decompressing — not angry. Could we check in around 7 pm?”

Specific beats vague. One clear request beats five hinted complaints.

2. Use the Initiator voice

Most arguments derail because we start by defending or persuading. A steadier way to begin might sound like:

• “There’s something important I’d like to share — is now a good time?”
• “What I notice is … The impact on me is … What I’m asking for is …”

Say it once, slowly. Then pause. Allow space for a response instead of chasing or over-explaining. That pause is where respect and change start to grow.

3. Tell the kinder, truer truth

Many of us hide small truths to keep the peace. Ironically, avoidance creates distance.

Try a truth-upgrade:

• Inner truth: “I feel overwhelmed doing bedtime alone most nights.”
• Spoken truth: “I’m stretched at bedtime. Could we alternate Tuesdays and Thursdays for the next month and see how it goes?”

Telling the truth with kindness — and a specific request — is safer and more constructive than silence or blame.

4. Regulate before you relate

When your body is in fight-or-flight, your brain isn’t wired for empathy or logic. Before a sensitive discussion, slow your breathing, stretch, or take a short walk.

Afterwards, debrief privately: What did I handle well? What’s one thing I could improve next time?

Small improvements, repeated consistently, can transform the emotional climate of a relationship.

5. Practise small differences on purpose

Closeness doesn’t mean sameness. Try one gentle experiment each week that tolerates difference kindly — attending separate social events, keeping different bedtimes, or alternating choices for weekend activities.

These small steps build the muscle of being separate and connected at the same time — the hallmark of emotionally mature partnership.

If your partner won’t engage at all

Keep using these skills — and protect your boundaries. You can be both warm and clear: “I’m happy to talk after dinner; I’m not staying in a shouting match.”

If safety or emotional abuse is a concern, please reach out for professional support immediately.

When to consider couples therapy

If conflict escalates quickly, old hurts dominate every conversation, or you feel unsafe, couples therapy can provide structure and containment.

When one partner isn’t ready, individual therapy remains a powerful space to strengthen your boundaries, communicate more effectively, and reduce the emotional charge of recurring conflicts.

A note on the evidence

These ideas are inspired by the Developmental Model of Couples Therapy created by Dr Ellyn Bader and Dr Peter Pearson — a framework that views relationships as evolving through stages of connection, differentiation, and reconnection. Their work emphasises that growth in one partner often catalyses growth in the other.

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If you’d like guidance applying these tools to your own relationship, you can book an appointment with Mind Harbour Psychology — Fridays in Perth or via Telehealth anywhere in Australia.

For further reading, you might also enjoy:

• Anxiety and Imposter Syndrome
• How Therapy Helps You Let Go of All-or-Nothing Thinking

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Hopelessness in Our Times: Young People, Adults and Why So Many Feel Powerless

There’s something heavy in the air these days. Maybe you feel it too: watching climate change intensify, reading about social injustice, seeing governments stall when pressure mounts, seeing capitalism’s gap between rich and poor widens while suffering deepens. It’s easy to feel powerless—that all your efforts are merely drops in a vast, unchanging ocean.

No? just me? (Insert awkward silence o_o )

Well, I wondered what’s going on under the surface, what research tells us, and what can shift this sense of helplessness? That’s what I want to explore today.

What the Research Tells Us

Recent studies show that feelings of hopelessness aren’t just philosophical— they correlate strongly with anxiety, depression, and reduced wellbeing, especially among young people.

• A systematic review of eco-anxiety (anxiety or distress about climate change) found that among over 45,000 adults, higher levels of worry about climate change were positively correlated with symptoms of psychological distress, depression, anxiety, and stress.

• In adolescents aged 15-19, climate change concern was linked with worse psychological distress and more negative outlooks for the future.

• Emotional problems in adolescents (anxiety, hopelessness, sadness) have been rising, driven by inequality, school pressure, family stress, and societal messages about the environment and justice.

• Research into coping highlights how meaning, connection, and self-efficacy can buffer against despair.

Why Hopelessness Has Become So Widespread

From my work and from what these studies are showing, there are a few overlapping currents pushing many into hopelessness:

1. Scale feels overwhelming – Individual efforts feel like small ripples against global tides.

2. Visibility of failure, invisibility of progress – Media highlights disaster and injustice, rarely incremental change.

3. Uncertainty + lack of control – When the future feels unstable, planning ahead seems impossible.

4. Cultural messages of responsibility in impossible systems – Capitalism frames systemic crises as individual failings.

5. Isolation – Without space to share grief, fear, or anger, despair ferments and grows.

When Power Feels Corrupted

One of the hardest parts of living in this era is witnessing people who embody greed, cruelty, or disregard for others rise to the highest levels of influence. When those in positions of power openly display values that run counter to fairness, justice, and care, it can feel like the very idea of “good” leadership is collapsing. I don’t need to name names here…

Psychologists sometimes describe this as a form of moral injury—the distress we feel when those in authority betray the values we expect them to uphold. For many, seeing injustice rewarded or blatant misconduct overlooked intensifies a sense of hopelessness. The thought comes: “If people like that succeed, what hope is there for honesty, compassion, or fairness?” Or worse, “Maybe I should drop these values and become more dishonest, greedy, and selfish?”

The impact isn’t just political; it’s deeply personal. It can erode trust in institutions, make activism feel pointless, and leave people withdrawing from civic life altogether. That withdrawal may bring temporary relief, but over time it feeds the very helplessness that drives despair.

What Hopelessness Looks Like

To name what it can feel like (because naming is part of healing):

• Disengagement from the future (“What’s the point?”)

• Struggling to set or pursue goals

• Exhaustion from caring (“burnout” or “eco-fatigue”)

• Withdrawal from activism or interests

• Anxiety, guilt, grief, shame—often layered on each other

What Helps: Evidence-Based Steps Toward Hope & Agency

Research and clinical practice both suggest practical steps that can help move through despair. I’ve used the format here of;

Strategy

What it does…

How to begin…

Values clarification

Helps you reconnect with what truly matters to you—not what society says matters

Spend 10 min writing or talking about what you deeply want your life to stand for (connection, justice, creativity, kindness, etc.)

Small, values-aligned action

Builds self-efficacy; shows you can influence something

Join a local group, volunteer, change one habitual behaviour, even something small in your community or family

Meaning-centered coping

Balances anxiety with meaning, purpose, connection

Reflect on stories, art, connection; help someone else; gratitude routines

Community & collective action

Connects you with others, reduces isolation; systems change comes through many hands

Find groups with shared values; get involved in policy, advocacy, or local environmental / justice work

Regulating exposure to media

Reduces overwhelm; allows breathing space

Limit doom-scrolling; select trusted sources; set times when you consume news

Self-compassion + therapy

Allows rest, acknowledges pain without judging yourself, supports mental health

Be kind to yourself; talk to therapist about existential worries; use grounding, mindfulness, creative expression

What We Can Do as a Society

While personal action is powerful, we also need systemic shifts:

• Governments integrating mental health into climate and social policy.

• Schools giving space for discussions about climate and justice grief.

• Communities fostering cohesion and collective resilience.

• Policy that genuinely addresses inequality and corporate accountability.

Hope Doesn’t Mean Ignoring Reality

Hope is not toxic positivity or denial. It’s holding the reality of injustice and threat alongside the choice to still live in alignment with your values. It’s carrying grief and outrage and deciding what you will invest in—kindness, fairness, community—even when leadership feels corrupted.

Final Thoughts

Yes, the world feels bleak in many ways. But despair doesn’t have to be the endpoint. When you name what hurts, reconnect with what matters, and act in ways aligned with your values, hope returns in small but powerful ways. It’s not a destination—it’s a process, one step at a time.

ADHD, medication and quality of life: what the study really says (and what the headlines got wrong)

If you’ve seen recent stories claiming “children on ADHD medication have a lower quality of life,” you’re not alone. It’s a big, worrying headline—especially if you’re a parent already juggling treatment decisions. Let’s slow this down and look at what was actually studied, why the media framing is misleading, and how to make sense of it for your family.

The study in a nutshell

Australian researchers analysed data from the Longitudinal Study of Australian Children, following more than 4,000 children over 13 years. They looked at ADHD symptoms and health-related quality of life (HRQoL) across childhood and adolescence. As you’d expect, kids with significant ADHD symptoms had lower average HRQoL than kids without symptoms—no surprise given ADHD brings real challenges at home, school and with peers. The authors also explored factors linked with lower HRQoL (e.g., co-occurring conditions, caregiver mental health) and noted an association with being on ADHD medication. Crucially, they warned this medication finding should be treated with caution because the medicated subgroup was small. SAGE JournalsRACGP9News

Why “medication lowers quality of life” is not a fair takeaway

Three big reasons:

1. Correlation ≠ causation
   This was an observational study. It can spot patterns, not prove that one thing causes another. Kids who end up on medication usually have more severe ADHD and more impairment to begin with—a classic case of confounding by indication. If more-affected kids are the ones taking medicine, they may also start (and remain) with lower HRQoL for reasons unrelated to the medicine itself. The authors themselves flagged this nuance; several news pieces missed it or buried it. RACGP9News

2. Very small medicated sample
   The medication analysis was based on a small number of medicated participants in this dataset, especially in early childhood. Small cells produce unstable estimates—one or two children can swing results. The study and RACGP summary both caution against over-interpreting this point. RACGP

3. Multiple other factors matter—often more
   Lower HRQoL was also linked with co-occurring conditions (e.g., autism), being female, and caregiver mental health difficulties—all of which complicate the picture. In contrast, kids with two or more siblings tended to have better HRQoL—again highlighting that family and social context matter. Headlines that isolate “medication” ignore the broader ecosystem kids live in. RACGP

What does the wider evidence say about ADHD medication and quality of life?

When you zoom out to controlled trials (where groups are more comparable), medication tends to improve symptoms and shows small-to-moderate improvements in quality-of-life measures on average—especially as part of a multimodal plan that includes behavioural, educational and family supports. Recent meta-analytic work and major guideline summaries point in this direction, even while noting individual variability. ScienceDirectSpringerLink

How media coverage amplified worry

Some outlets ran with simple cause-and-effect language (“medication lowers QoL”) or led with alarming banners without front-footing the caveats above. Even where caution was mentioned, it often sat halfway down the page or in the final paragraph—well after the fear had landed. A more balanced summary (including the RACGP piece) noted the small medication subgroup and urged caution, but the snappier TV/online clips still tended to over-simplify. RACGP9News

What this does mean for families in Perth

• ADHD affects wellbeing. That’s real and worthy of support.

• Medication isn’t the villain. This study can’t tell us that medicine reduces quality of life. The “medication” signal is confounded by severity and small numbers.

• Whole-family, multimodal care works best. Address ADHD symptoms and the environment: school supports, routines, sleep, physical activity, parent wellbeing, and skills coaching. That’s where the gains add up. RACGP

Practical questions to ask your GP or psychologist

• “Given my child’s profile (symptoms, strengths, co-occurring conditions), what would a stepwise multimodal plan look like here in WA?”

• “If we trial medication, how will we measure benefits and side-effects (teacher/parent ratings, sleep, appetite, mood, school feedback)?”

• “What non-pharmacological supports can we add now (classroom accommodations, behavioural strategies, parent coaching, sleep and activity plans)?”

• “How can we support caregiver mental health and reduce family stressors that may be impacting our child?” RACGP

Bottom line

This Australian study adds to an important conversation about ADHD and wellbeing—but it does not show that ADHD medication causes lower quality of life. The medicated subgroup was small, and the children on medication were likely those with greater difficulties to begin with. Decades of controlled research suggest medication can help many children when it’s individualised and embedded within a broader support plan. Before headlines, always ask: Is there causation here? How big was the subgroup? What else could explain the finding? SAGE JournalsRACGPScienceDirect

Who is the Best Psychologist in Perth? The Question You Should Really Be Asking

If you've found yourself googling "best psychologist in Perth," you're asking an important question – just perhaps not the right one. As a practicing psychologist, I need to be transparent with you: I'm not the best psychologist in Perth. Neither is any other psychologist, for that matter. The concept of a "best" psychologist is not only misleading and against our advertising code of ethics, but potentially harmful to your therapeutic journey.

The truth is, there is no universal "best" when it comes to psychological care. What works brilliantly for your friend might fall flat for you. What transforms one person's anxiety might barely touch another's. This isn't a failure of psychology – it's the beautiful complexity of being human.

The Real Question: Who is the Right Psychologist for You?

Instead of seeking the "best," consider this reframe: "Who is the right psychologist for me, right now, for this particular challenge I'm facing?"

This shift in thinking opens up a world of possibility and puts you back in the driver's seat of your mental health journey. It acknowledges that you are the expert on your own experience, and the psychologist's role is to walk alongside you with their professional training and expertise.

The Power of Therapeutic Relationship

Research consistently shows that the quality of the relationship between therapist and client is one of the strongest predictors of therapeutic success. A landmark study by Lambert and Barley (2001) found that relationship factors account for approximately 30% of therapeutic change – more than specific techniques or theoretical orientation. This means that feeling understood, respected, and genuinely connected with your psychologist matters enormously.

"The therapeutic relationship is not just the context in which the real work happens – it is the work." - Dr. John Norcross

What Makes a Good Match?

When searching for the right psychologist, consider these factors:

Specialisation and Experience

Different psychologists develop expertise in different areas. Some might have have particular interest in trauma, others in relationship issues, eating disorders, workplace stress, or specific populations like adolescents or older adults. Look for someone whose experience aligns with your presenting concerns.

Therapeutic Approach

Psychologists work from various theoretical frameworks – cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), psychodynamic approaches, family systems therapy, and many others. While research suggests most approaches are similarly effective, you might find yourself drawn to certain ways of thinking about problems and change.

Personal Style and Values

Some people thrive with a direct, skills-focused approach. Others need more space to explore and process emotions. Some value a psychologist who shares their cultural background or life experiences. Others prefer someone from a completely different perspective. There's no right or wrong here – only what feels right for you.

Practical Considerations

Location, availability, fees, and whether they bulk bill or offer payment plans all matter. The most skilled psychologist isn't right for you if you can't access their services sustainably.

Red Flags vs Green Flags

Be cautious of psychologists who:

- Claim to be "the best" or guarantee specific outcomes

- Push their agenda rather than following your lead or are unable to take feedback

- Make you feel judged or misunderstood consistently

Look for psychologists who:

- Demonstrate genuine curiosity about your unique situation

- Explain their approach in ways you can understand

- Acknowledge when they don't know something

- Make you feel heard and valued as a person

The Perth Psychology Landscape

Perth is fortunate to have many skilled, dedicated psychologists working across the metropolitan area. From the CBD to the northern suburbs, from Fremantle to the hills, you'll find practitioners with diverse backgrounds, experience and approaches. Some work in private practice, others in community health centers or clinics.

Don't be afraid to shop around. Have an email or brief conversation with potential psychologists. I’m not a dancer but maybe think of it as finding the right dance partner – skill matters, but so does rhythm, timing, and that indefinable sense of connection.

Your Mental Health, Your Choice

Ultimately, you are the architect of your own healing journey. A good psychologist provides the scaffolding – the professional knowledge, evidence-based techniques, and therapeutic relationship – but you do the building.

Trust your instincts. If something doesn't feel right after a few sessions, it's okay to seek someone else or at the least, let them know. If you feel genuinely supported and understood, you're likely on the right track, regardless of whether this psychologist is considered the "best" by anyone else's standards.

Remember, seeking psychological support is an act of courage and self-compassion. You deserve to find someone who can meet you where you are and support you in becoming who you want to be.

The best psychologist in Perth? That's the one who is right for you, in this moment, for your unique journey toward greater wellbeing.

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Reference

Lambert, M. J., & Barley, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. *Psychotherapy: Theory, Research, Practice, Training*, 38(4), 357-361.

An interview with Men’s Insider Magazine

https://mensinsider.com/emotional-resilience-and-therapy-for-men-the-mind-harbour-psychology-journey/

Anxiety: Why Anxiety Can Make You Feel Like an Impostor

Anxiety: Why Anxiety Can Make You Feel Like an Impostor
By Tristan Abba – Counselling Psychologist, Perth

I’ve recently been in the process of applying for jobs — something I haven’t done in close to four years, and before that, not for over a decade. What struck me this time around was how different the experience felt. There was far less of that familiar undercurrent of imposter syndrome — that inner voice that whispers “You’re not good enough,” no matter how qualified or prepared you actually are.

It made me pause and reflect. For most of my life, imposter syndrome has been a constant companion in the darker corners — a kind of anxious echo that’s held me back, made me overcompensate or “mask,” and created a gnawing sense of unease in moments where I most needed clarity. And yet now, while I still experience self-doubt at times (I’m a reflective practitioner, after all), I feel more grounded and confident in my professional identity.

It made me wonder: What if we’ve got it backwards? What if imposter syndrome isn’t just causing anxiety… but anxiety is actually fuelling imposter syndrome?

Understanding the Link Between Anxiety and Imposter Syndrome

At its core, imposter syndrome is the belief that your achievements are undeserved — that you’re a fraud and it’s only a matter of time before others find out. These thoughts can be especially loud when you’re stepping into something new or challenging — like a job interview, a date, a presentation, or returning to study.

But what underpins that experience for many people is anxiety. When we’re anxious, our brain becomes hypervigilant — scanning for danger, looking for signs that something might go wrong. Anxiety magnifies perceived risks and minimises our internal resources. In this space, we often question ourselves more harshly and seek certainty where there is none.

That’s the trap: the more anxious we are, the more likely we are to doubt ourselves. Our brain becomes wired for threat detection, not realistic self-assessment. So, when anxiety shows up before a job interview or during a performance review, it’s no surprise that imposter syndrome often follows close behind.

Why Anxiety Feeds the Imposter Narrative

Anxiety has a few tricks up its sleeve that make it particularly good at fuelling imposter syndrome:

• Perfectionism: Anxiety often drives an internal belief that “anything less than perfect isn’t good enough.” This creates unrealistic standards that no one can consistently meet, reinforcing the sense that you’re falling short — even when you’re doing well.

• Black-and-white thinking: You might find yourself thinking, “If I don’t nail this, I’ve failed,” or “They haven’t emailed back — I must’ve messed it up.” This all-or-nothing mindset leaves no room for nuance or context and heightens self-doubt.

• Mental filtering: You might overlook positive feedback or progress and zero in on that one awkward moment or typo — reinforcing the idea that you’re not good enough.

• Avoidance: Anxiety can lead us to avoid situations where imposter syndrome might be triggered. But avoidance reinforces fear — and keeps you stuck in the belief that you’re not capable.

So What Helps?

Let’s be clear — you don’t have to “banish” imposter syndrome to live a full, meaningful life. But therapy can help you understand the relationship between your anxiety and self-doubt, and loosen the grip of the story that you’re not enough.

Some things that can support this work:

• Naming the pattern: Sometimes just recognising, “Ah, this is that imposter feeling again — fuelled by anxiety,” can create distance and reduce its intensity.

• Challenging unhelpful thinking: Therapy can help you identify those perfectionistic or black-and-white thoughts and work with them compassionately.

• Building emotional tolerance: Learning to sit with discomfort — rather than avoid it — helps reduce anxiety in the long term and creates more space for self-trust.

• Practising self-compassion: This doesn’t mean letting yourself off the hook. It means treating yourself with the same kindness and encouragement you’d offer a friend in your situation.

If imposter syndrome is something that regularly holds you back — particularly if anxiety is playing a big role — therapy can help. In our sessions, we won’t just look at surface strategies, but work together to better understand the deeper patterns driving your experience, and how to create a more spacious, grounded version of your life.

You don’t have to keep living at the mercy of the inner critic. There is another way.

Motivational Interviewing - A Post for GPs

Motivational Interviewing in General Practice: A Practical Psychotherapy Tool for Everyday Use

Motivational Interviewing (MI) is one of my favourite tools as a psychologist—and one that integrates seamlessly into the general practice consultation. While the name might conjure images of charismatic coaching à la Tony Robbins, the true spirit of MI is quite the opposite. It’s a calm, respectful, and collaborative conversation style that meets the patient exactly where they are—without judgement or coercion.

At its heart, Motivational Interviewing is about fostering change by enhancing intrinsic motivation. Developed by William Miller and Stephen Rollnick in the early 1980s in the context of substance use treatment, MI has since been applied widely across health settings. It is grounded in the transtheoretical model of change, recognising that people move through a series of stages:

Precontemplation → Contemplation → Preparation → Action → Maintenance

In clinical terms, this means that a patient’s readiness to change is dynamic, not static—and pushing for behavioural change before a patient is ready often leads to resistance or disengagement.

Why MI Belongs in the GP Consultation

General practice is often the first and only point of contact for individuals struggling with ambivalence toward behaviour change. GPs are uniquely positioned to initiate conversations that can gently nudge patients toward a more reflective stance—one that plants the seeds for change.

You may already use elements of MI without labelling it as such. But for those new to the approach, MI can be particularly useful for conversations around:

• Alcohol or substance use

• Smoking cessation

• Medication non-adherence

• Weight management and lifestyle-related change

• Chronic disease self-management

• Mental health engagement

• Follow-through with specialist referrals or allied health plans

The Dual Focus: Importance and Confidence

Motivational Interviewing centres on two critical themes: the importance of the change to the individual, and their confidence in being able to achieve it. Exploring both of these dimensions helps patients uncover their ambivalence and begin to resolve it.

Here are some foundational MI-style questions you might incorporate in brief consultations. They are not scripts, but conversation starters, useful when you notice resistance or low engagement in a care plan. These are great questions to ask yourself if you are journaling or reflecting on change.

Exploring Importance (Why change?)

• “What would need to happen for you to seriously consider making a change here?”

• “Why have you given yourself a [X] out of 10 for importance, rather than a lower score?”

• “What would it take for your importance score to move from [X] to [Y]?”

• “What are some of the upsides to continuing things as they are? And the downsides?”

Exploring Confidence (Can I change?)

• “What would make you feel more confident about giving this a go?”

• “Why did you score your confidence a [X] rather than zero?”

• “If you were to try, what might be your first step?”

• “Do you know of anyone who’s made a similar change? What did they find helpful?”

Closing Thoughts

In a time-pressured consultation, it's not always possible to walk through every ambivalent layer. But even a few well-placed MI-informed questions can shift a patient’s internal dialogue—from resistance to reflection, from passivity to ownership. This is especially powerful in chronic care conversations, where long-term engagement is the goal.

MI doesn’t require you to fix the problem in one go. It simply asks you to hold space for ambivalence and trust that change unfolds through respectful, person-centred dialogue. As Miller and Rollnick remind us: “People are more likely to be persuaded by what they hear themselves say.”

Sleep Strategies for Managing Anxiety in Adolescents and Young Adults

One of the most common co-occurring challenges for clients presenting with anxiety is disrupted or maladaptive sleep patterns. Poor sleep and anxiety often create a self-perpetuating cycle: anxiety contributes to difficulty initiating or maintaining sleep, while inadequate or poor-quality sleep exacerbates anxiety symptoms the following day. This is particularly due to reduced executive functioning and impaired emotional regulation, making it harder for individuals to suppress intrusive or distressing thoughts.

The gold-standard psychological treatment for sleep issues is Cognitive Behavioural Therapy for Insomnia (CBT-I). This structured, short-term therapy (typically 6–8 sessions) has strong empirical support, including evidence that CBT-I is as effective as pharmacotherapy in the short term for treating primary insomnia American Journal of Psychiatry, 2002. Importantly, CBT-I is also effective in reducing comorbid symptoms of anxiety and depression, particularly in younger populations.

Adolescents and young adults report the most benefit when sleep interventions are engaging and relatable. Digital sleep trackers, goal-setting with peers, and gamified routines help sustain motivation and compliance. Evidence consistently shows that multi-component approaches—those combining routine, relaxation, and cognitive strategies—are more effective than sleep hygiene alone. For anxious students in particular, consistent schedules, calming routines, cognitive reframing, and relaxation skills offer a practical, evidence-based toolkit.

Core Sleep Hygiene Strategies

Sleep hygiene provides the behavioural foundation for better sleep regulation. The following strategies are commonly used and easily introduced in primary care discussions:

• Maintain a consistent sleep–wake schedule, even on weekends.

• Establish a pre-bed routine (e.g. quiet reading, warm shower) to cue the body and mind for sleep.

• Ensure a sleep-conducive environment: dark, cool, and quiet. Remove or turn off electronic devices at least 30–60 minutes before bedtime.

• Avoid late-day naps, particularly those longer than 20–30 minutes.

• Eliminate stimulants such as caffeine, nicotine, and alcohol in the late afternoon and evening.

• Use the bed only for sleep—not for homework or screen use. If unable to sleep within 15–20 minutes, get out of bed and engage in a calming activity until drowsy.

• Encourage regular daytime exercise, preferably in the morning or early afternoon. Avoid intense exercise within two hours of bedtime.

Relaxation, Mindfulness, and Exposure Techniques

Evening relaxation strategies are particularly helpful for clients with anxiety-related sleep problems. Some techniques are simple enough to introduce in primary care, while others can be further supported through referral to a psychologist.

• Progressive muscle relaxation, paced breathing, and guided mindfulness help reduce somatic arousal at bedtime.

• Short, guided meditations (e.g. 5-minute “breathing space” exercises) can be effective immediately before bed.

• Mindfulness-based CBT-I has shown significant reductions in insomnia, anxiety, and depressive symptoms in teens and young adults.

• Graded exposure can help address sleep-related fears (e.g. fear of the dark or of being alone).

• Interoceptive exposure teaches tolerance of uncomfortable bodily sensations often interpreted catastrophically by anxious youth.

• Worry journals or scheduled “worry time” earlier in the evening can offload intrusive thoughts before bedtime.

• Nightmare rescripting—writing and mentally rehearsing a more positive dream outcome—can reduce night-time anxiety and improve sleep continuity.

Lifestyle and Circadian Regulation

Lifestyle factors also influence sleep outcomes and can be modified with basic psychoeducation:

• Morning light exposure (e.g. sunlight within 30 minutes of waking) helps stabilize circadian rhythms.

• Avoid bright lights and stimulating activities (e.g. gaming, studying, intense conversations) for at least one hour before bed.

• Limit technology use at night. Introduce a “digital curfew” and disable notifications to reduce night-time checking and FOMO-driven anxiety.

• Advance bedtime gradually (by 10–15 minutes every few nights) to increase total sleep duration in adolescents with delayed sleep phase.

• Encourage regular wake-up times, even on weekends, to support circadian consistency.

Tech-Based and Gamified Supports

For adolescents and young adults, digital tools can support behavioural change through engagement and accountability:

• Gamified sleep trackers like Sleepagotchi, Sleep Quest, and Pokémon Sleep provide incentives for bedtime routines.

• Mindfulness and meditation apps such as Smiling Mind and Headspace offer user-friendly support for sleep-related relaxation, especially when incorporated into wind-down routines.

Final Thoughts for GPs

For adolescents and young adults experiencing anxiety-related sleep difficulties, psychological interventions can yield significant improvements in both sleep quality and mental health. These strategies are safe, cost-effective, and evidence-based. While GPs can introduce foundational sleep hygiene and relaxation practices, referring patients to a psychologist trained in CBT-I or adolescent anxiety can offer more comprehensive and sustained support.

References (selected):

• Morin, C. M. et al. (2002). Cognitive Behavioral Therapy vs. Pharmacotherapy for Primary Insomnia, Am J Psychiatry.

• Barlett et al. (2024). Sleep Interventions in Youth with Anxiety Disorders, Frontiers in Sleep.

• Becker et al. (2020). CBT-I in University Students, Behavioral Sleep Medicine.

• Alvaro et al. (2023). Digital CBT and Sleep Hygiene Tools in Adolescents, J Adolesc Health.

Beginning Therapy - Some Starting Tips

Starting therapy can feel daunting, and that’s completely okay. You don’t need to have the perfect words to describe how you feel—many people don’t. Therapy is a space where we take the time to untangle thoughts and emotions together. Here are some ways to make the most of your sessions.

1. Be Honest—Really Honest

Therapy is a judgment-free zone. We understand that no one is their best self all the time, and we’ve heard it all. The more honest you are, the more effective therapy will be. We can’t help with something we don’t know about.

2. Expect Some Discomfort

Growth often happens outside of our comfort zones. If you find yourself feeling emotional, vulnerable, or even awkward in therapy, that’s usually a sign of real work happening. Therapy isn’t always easy, but it is worthwhile.

3. Have an Agenda

While therapy is a safe space for whatever arises, having an idea of what you’d like to discuss can be helpful. Life is unpredictable, and sometimes an unexpected event will take priority—that’s okay. We can adjust the session to focus on what’s most important to you.

4. Give Yourself Enough Time

Arrive with a few minutes to spare so you’re not flustered when the session starts. If possible, avoid scheduling something stressful immediately after therapy—giving yourself space to process can be invaluable.

5. Keep Momentum Going

Consistency matters. While finances and schedules can impact how often you attend, long gaps between sessions can make it harder to build on progress. For some, weekly sessions at first, then transitioning to fortnightly or monthly, can be an effective rhythm. Talk to your therapist about what works best for you.

6. Take Notes

A lot can be covered in a session, and it’s easy to forget key insights or strategies. Some people find it helpful to keep a therapy journal where they jot down reflections, questions, or techniques to practice between sessions.

7. Consider Therapist Feedback

Your therapist may notice patterns or blind spots that others don’t (or won’t tell you about). If they offer compassionate observations, it’s not to criticize but to help you grow. Change starts with awareness.

8. Do the Homework

Talking can be powerful, but real change often happens between sessions. Practicing strategies, journaling, or actively reflecting on insights will accelerate your progress and help make change sustainable.

9. Give Feedback

Your therapist’s goal is to understand you, but no two people are the same. If something doesn’t feel right or isn’t working, speak up. A good therapist will welcome your feedback and adjust accordingly. If they don’t, it may be worth finding someone who does.

If you’re unsure how to raise something, here are a few ways to start:

• “There was something from last session that didn’t sit right with me…”

• “I don’t think we’re quite on the same page.”

• “I’m not sure I understand how to apply this strategy.”

• “I feel like we haven’t talked about something that’s really important to me.”

10. Thinking About Leaving Therapy? Let’s Talk First

You can end therapy anytime—there’s no obligation. However, if you’re feeling stuck or uncertain, discussing it first can be helpful. Maybe something needs to shift, or maybe this is a pattern worth exploring. Either way, you have the choice.

11. It’s Okay If You Don’t Know Where to Start

You are not expected to have it all figured out. If you struggle to put your thoughts into words, we will take the time to help you express what you need. Therapy is a process, and there’s no rush.

Therapy is a collaboration. The more intentional you are about the process, the more you’ll get from it. But most importantly, be kind to yourself—this is your journey, and we’re here to walk alongside you.

Adapted from Dr. Angela Morans’ article in ANZMH Website