How-to « The AI-Therapy Blog

Launch

Our July/August 2012 launch exceeded our expectations. We’ve had over 3500 visits so far, so thanks to everyone for checking us out and helping spread the word. We’re still actively promoting the site, so please contact us if you have any ideas about how we can reach more people. Any links, blog reviews, etc. would be great.

New free online social anxiety symptom assessment

Shortly after launch we added a free symptom test for social anxiety.

Blog

We will put out a new blog every week (give or take) on a wide range of topics. Some recent entries include:

Anger myths and facts – how to prevent future outbursts

How Excel can help you achieve goals

How to avoid the “Top 5 regrets of the dying”

The problem with self help books – they can make social anxiety worse!

Social phobia vs Spider phobia

Spider phobia (aka arachnophobia)

Future

We’ve got lots of exciting ideas in the works, so please keep an eye on the blog and come back soon!

Thank you for visiting! As always, we’d love to hear from you as our goal is to be constantly improving our site.

Fjola Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety

The original title of this blog was “How Excel helped me run 4 marathons, climb Mt Kilimanjaro, travel the world, and complete 4 university degrees”, but I thought that was a little wordy. However, there really is some truth to it.

“Really?”, said with an sarcastic undertone, is a common response when I tell people how much I rely on my Excel file. In fact, it’s a running joke with my friends and family. My friend Isgerdur wrote a song for my hen’s night including the line “My Excel file is with you!”. This is true romance in my world. Also, there’s even a crack about this nerdy habit of mine in an article in an Icelandic newspaper, and the Telegraph in the United kingdom here!

Despite the jokes and well meaning mockery, I’ve decided to share my Excel usage with the world. However, before I continue I should point out that there is nothing magical about Excel. You can do this same thing with a pencil and paper, and there’s also lots of iPhone/Android apps for exactly this purpose.

How does Excel planning work to achieve goals?

My Excel file is probably one of the simplest documents you will ever see. Basically, it has three spreadsheets: Now, Finished, and Future.

In the Now part, I write short-term goals, and all my day to day activities. This helps make me feel productive because it feels great to finish a recorded task, no matter how small it is. When a task is complete I move it from the Now page to the Finished page. Nothing is too small. For example, even moving “take clothes to dry cleaner” between tabs gives me a sense of accomplishment.

I find colour coding items useful (adding significantly to the nerdiness of the document). For example, anything related to studies might be purple, work is green, and fun/travel is pink. The colour coding helps me to focus on one thing at the time, and I always have a sense of how much time to allocate to each category, which drives me to get things done and out of the way.

The Future page of the spreadsheet is really the important one. It’s not about your day to day life, but recording what you want to achieve in the medium to long term (e.g. the next 2-30 years). However, by having it in the same file as your day to day activities, it helps to connect the two, and you chip away at your long term goals in small, manageable steps.

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I’ve recorded my goals in my Excel spreadsheet for almost 15 years, and when I look back at early versions, it is amazing how it looks like I “predicted” my own future. For example, I included many things that I’ve now done, such as complete a PhD in psychology, travel to more than 40 countries (I’m now at 65), run my own clinical practice, run a marathon in under 4 hours, climb Mt Kilimanjaro before 30, etc. (To be fair, I didn’t reach all my goals – I still haven’t learned Korean, or attended pizza school in Italy. However, there is still lots of time for those things.) I honestly don’t think I would have done all this without careful planning in advance. Knowing what I want keeps me focused and working towards my goals.

The Future page is basically just a calendar. You set a date for a goal (e.g. run my own business by 2015), and set key milestones along the way (e.g. find partners, create business plan, get investors, etc.). That’s all there is to it – I told you it was simple! However, even though everyone knows how important it is to have goals, many people just seem to have them floating around in their head. This whole blog boils down to one sentence: keep a written record of your goals, and a plan about how to achieve them. It is amazing how powerful this little piece of advice is.

A quick disclaimer: There are many things in life that you cannot plan for, such as health problems, or other things that are out of your control. Furthermore, your priorities will naturally change as you get older. Therefore, it is important to be flexible with your planning, and don’t become a slave to goals that no longer make sense. For me, this means that about 3 times every year I sit down and re-evaluate the Future page, and make sure I’m still on the right track.

I’ve put a copy of my Excel file here if you would like to download it. You can use this as a basis to create your own, customized version. I like to keep it in my Dropbox folder, so I can always access it from home, work, by phone etc. I’ve actually given it to a lot of friends and people I meet who have become “Excel life planning” converts.

I’d like to leave you with a favourite quote of mine:

A dreamer is one who can only find his way by moonlight, and his punishment is that he sees the dawn before the rest of the world.”
-Oscar Wilde.

fdh

In February 2012 the guardian published an interesting article. A nurse asked people who were dying about their top regrets in life, and what they would do differently if they had the opportunity to live again. The top five follow, along with some of my thoughts about how to avoid these regrets:

1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.

How to avoid it: Figure out what you want from life. We all make choices about the type of lives we live. Listen to people in your life who can give you helpful and constructive advice, and ignore advice from family members or friends who think they know what you want.

2. I wish I hadn’t worked so hard.

How to avoid it: Personally, I find this one difficult. On one hand, we all need to earn a living, and sometimes we need to put in long hours just to make ends meet. Also, when someone is running their own business, or does charitable work for the good of others, working hard can be very satisfying. However, in many cases, people work 50+ hours a week at jobs they don’t enjoy, and their quality of life suffers. If you find you are in this situation, you should ask yourself why. Is it money? Status? The need to impress someone? Next, ask yourself if the long hours are actually helping you achieve this goal. Finally, ask yourself if you do achieve this goal, are you sure it will make you a happier person? When looked at it from this perspective, many people realise that no one is benefiting from time spent unnecessarily at work.

3. I wish I’d had the courage to express my feelings.

How to avoid it: This one is pretty straight forward, but also incredibly hard for those who have never expressed their true feelings. Even though this might be very very difficult at first, it gets easier with practice. Take small steps, and in time anyone can gain the confidence to express them self.

4. I wished I had stayed in touch with my friends

How to avoid it: This is an interesting one. Obviously, the many of the people interviewed for the article mentioned above were from a different, pre-Internet, generation. One can’t help but wonder if 40-years from now, will people at the end of their lives will still feel the same way? I suspect they will. In fact, some people today report feeling more disconnected from people in their lives than ever before. I like to call it the “Facebook effect”.

When I was growing up I used to call my friends and family on a regular basis. Email largely replaced phone calls, but they were still genuine and full of unfiltered news and gossip. However, with Facebook I’ve noticed how easy it is to let a deep and meaningful relationship be reduced to the occasional Facebook “Like”. I bet I am not alone with this – Facebook makes it too easy to have superficial connections with people. Also, as fun as it is to get countless one-line birthday wishes on my Facebook wall, I do miss the personal emails and phone calls I used to get.

Anyway, the point with this regret is to not rely on technology to keep you close to your friends. It takes a little more effort to pick up your phone, but at the end of your life I bet you’ll be glad you did.

5. I wish that I had let myself be happier.

How to avoid it: We really have to take a stock every now and then and figure out what makes us happy. This sounds obvious, but without a conscious effort, this self-reflection does not always happen. Once we know what we like, make time for it, and stop worrying about what everyone else thinks. We only have one life, let’s live it!

fdh

Internet CBT treatment for social phobia. What is it?

A man [woman] who does not think for himself [herself] does not think at all.
-Oscar Wilde

I added the brackets to remind you, my dear reader, that it is 2012.

Internet CBT treatment for social phobia

I have created a video to help explain Internet CBT treatment for social phobia. One goal of this treatment is finding out what type of thinking people use. The video is designed to help people become more aware of these thoughts. Thinking about thinking is the first step.

Social phobia is characterised by an inflated threat perception in social situations. Sufferers experience intense fear of negative evaluation and see amplified threats in being judged by others. This exaggerated fear response has a marked impact on their relationships with others, in both public (e.g. work) and private life (e.g relationships). Frequently people suffer from low mood and exhaustion due to the distress the problem causes. Sufferers fear, avoid, or endure with significant stress the following: conversations, meeting new people, expressing a controversial opinion or disagreement, being assertive, speaking in front of a group, being the centre of attention, eating, drinking, or making mistakes in front of others.

Our Internet CBT treatment for social phobia (http://www.AI-Therapy.com) is a professional website incorporating a computerised CBT practitioner that we have been building since 2007. CBT, or Cognitive Behaviour Therapy, is a well known treatment approach supported by several hundred controlled experimental trials. Our Internet CBT treatment for social phobia offers you a fully automated computer psychologist that tailors your treatment to the specific symptoms that you report to the system. The database it uses is derived from a wealth of psychological data gathered in major anxiety and mood clinics over the past 20 years.

Your subscription lasts for 6 months, and includes the following online treatment procedures: (1) cognitive restructuring exercises; (2) mindfulness tasks; (3) exposure exercises and behavioural experiments; (4) education about the nature of anxiety and depression; (5) quizzes to test your growing understanding of your condition and its treatment; (6) emails to motivate and remind you to access the program; (7) online assessment tools to measure your improvement; and (8) voice overs by me Fjola and Ross explaining each treatment procedure covered in the program.

AI-Therapy is an Internet-based CBT treatment for social phobia comprising 7 sections. Section 1 helps the user get in the habit of becoming aware of their thoughts and behaviours. Sections 2-6 teach strategies to address unhelpful thinking and behaviours. Section 7 is focused on relapse prevention so that the user can maintain their changes in the long run.

Try a 10 questions free social phobia symptoms test

What is therapy or psychotherapy?

I’m often asked by friends, family, and people I meet, “what is therapy or psychotherapy?” so I figured it would make a worthwhile topic for a blog.

Psychological therapy, or psychotherapy, is probably one of the more misunderstood concepts around. Its popularity is evident by the vast amount of coverage it gets in popular movies and TV. As a clinical psychologist, I often cringe when watching “therapy” scenes in pop culture. For example, I watched the last episode of the 6th season of Dexter last night, where the therapist proposes an untrue/untested/completely-bullocks theory about how Debra Morgan must be in love with her brother! Fun twist for a TV show, but this theory is horrible PR for the field of evidence based clinical psychology.

This example from Dexter provides a great illustration of why a good therapist needs to be a good scientist too. Why should someone called a “therapist” have the authority to tell people things that aren’t based on evidence? The expectation for professional standards for therapists should be no less than when you go to see your family doctor. You have the right to trust that your therapist is acting in your full interest, and acting in accordance with the latest scientific findings from clinical psychology research field. Sadly though, science isn’t trendy.

Back to the original question, what is therapy or psychotherapy?

The first few sessions of therapy involve answering many questions, and filling out some standardised assessment questionnaires. Next, the psychologist uses their clinical knowledge and experience to determine what is the problem. If it is anxiety, the therapists figures out what type of anxiety one is experiencing. There are many different types of anxiety. For example, anxiety can be social anxiety, generalised anxiety, obsessive-compulsive symptoms, panic symptoms or phobias for almost anything under the sun. Each of these diagnoses need a specialised and tailored individualised treatment. Therefore, it is highly individualised what type of treatment one can receive under the general umbrella of “anxiety” or “worry problems”. Once the therapist understands the problem and has prioritized what needs to be tackled, the actual therapy can commence.

Cognitive behaviour therapy (CBT) is the state-of-the-art therapy for many psychological problems. On average it takes 12-18 sessions, where a person meets with a therapist on a weekly basis. During this time, the therapist and the client work collaboratively on understanding the thoughts and behaviours that are contributing to everyday life problems.

This may sound straightforward, but it can be incredibly tricky to think about your own thinking, and understand your own behaviours, as well as the functions they serve. You learn to assess objectively what happens in every day life, and learn to tackle these using cognitive behaviour therapy strategies. In general, this leads to a more emotionally balanced lifestyle. The great thing about this type of therapy is that if it is done well, there are no side effects, and it continues to be effective in the long run. However, as opposed to many popular miracle cures popularised on TV and in movies, CBT takes work. However, as most people who receive the benefit from it will tell you, it is worth all the effort you put in.

Nobody sat down and decided to create the Internet

In March 1989 the blueprint for the Internet were sent by Tim Bernes-Lee to his boss at CERN. It had the humble title of: Information Management: A Proposal. The comment he got back was “Interesting, but vague”, but he was allowed to continue to pursue this Information Management System. It’s creation was motivated by Tim wanting to communicate with other researchers around the world. For this he created what we now know as the Internet. It certainly is not exclusive to nerdy researchers anymore, more accurately it takes up most of our waking lives!

The community needs better access to evidence based techniques

AI-Therapy.com came about in a bit similar manner. I was finishing my clinical psychology Internships in Sydney, Australia. However, before my last year had finished I was awarded a prestigious PhD scholarship at the University of Sydney. There was a major dilemma, do I miss out of this exciting scholarship award which was funded to respond to the need for evidence based treatments using the internet, or do I not finish my clinical psychology training/internships?

From this AI-Therapy was born.

My solution to this problem was to generate a fully automated computer psychologist which could be treating people online simultaneously with me working at the various hospital settings for my internships. It turns out, that to solve my problem of doing two things at once, I created a product which helped bridge the gap between the need for access to evidence based psychology techniques in the general community. After many years of hard work, I am pleased to announce that this service is now available to the general public under the name of AI-Therapy overcome social anxiety. You can see how it works here.

If you are interested in the original research for this computer psychology service, please refer to the following research and the associated publications