The AI-Therapy Blog «

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.

searching_over_there_400_clr_10485

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

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

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

There’s definitely, definitely, definitely no logic to human behavior
-BjÖrk

I tend to agree with Björk (my fellow Icelander) — especially when it comes to “common sense” approaches to self help for improving anxiety or mood issues.

Despite having about 1000 trials supporting the efficacy of cognitive behaviour therapy (CBT) in the long term, the average Jane or Joe still has not heard about CBT. CBT has consistently outperformed medication when you look at long term benefits. What you learn through the CBT sticks with you for life! First, it addresses the root of the anxiety by determining what is keeping it going in everyday life. Next, it tackles the underlying cause using experiments and exercises. With CBT you develop strategies that you can use for the rest of your life.

One of the most common ways for individuals to deal with symptoms of anxiety and depression is to purchase self help programs (books, e-books, CD/MP3s audio series, etc.). The quality of these programs varies widely. There are some very good programs out there written by experienced and qualified professionals. Some of the best programs walk the client through the principles behind CBT.

Unfortunately, for every high-quality program, there are many more poor quality programs created by “self-help gurus”. Sometimes these gurus are well meaning people who have managed to cure their own problems, and would sincerely like to help others. Other times they are created by people simply looking for a quick buck. The problem is that some techniques for dealing with mental health issues are counter-intuitive, so without proper training, self-help authors can actually make problems worse. Let’s look at an example.

A typical title for self help books might be: Successful small talk: Learn to be open, interesting and intelligent. The purpose is to advise individuals on how to better manage their impressions on other people in social situations. If only human behavior was that simple! It would be great if we could sit down and read a book that would transform us into interesting and intelligent super-humans. Unfortunately, many of the recommended strategies (e.g. rehearse what you say in advance, make constant eye contact, etc.) can actually maintain anxiety in the long run. I mentioned these processes in my last blog, and referred to them as safety behaviors.

For social anxiety, people often believe that their safety behaviors help prevent negative evaluation in social situations. However, they actually might be preventing them from learning the truth. For example, assume that I deal with my social anxiety by only telling people about the positive aspects of my life (like many of us do on Facebook!). Perhaps I believe that this will stop them from judging me negatively. The problem is that if I never test this hypothesis, I am never comfortable being myself. What is wrong with this?

Firstly, it is unrealistic. People are people, and everyone has their ups and downs. By putting this extra pressure on myself to always look perfect, I might start avoiding social situations, reinforcing the anxiety. Social situations become extremely stressful.

Secondly, this type of safety behavior might make people judge me negatively. For example, people may feel resentful about my “perpetually success”, or suspect that I’m not telling the whole truth. Also, this maintains my social anxiety in the long run since I can never test if people approve of me for who I really am!

On the surface, common sense advice like “people don’t want to hear about your problems — focus on the positive” sounds great. However, as we’ve just seen this isn’t the case. Unfortunately, many self-help books are full of these sorts of recommendations.

There are some great self help books or programs out there. My advice is that if you do follow a self-help program make sure that it is (1) is created by a qualified professional with training in psychology/psychiatry, (2) uses CBT to tackle the core problems, and (3) does not promote behaviors that might end up making the problem worse.

Social phobia vs Spider phobia

In my last blog I talked about my personal “dislike” of spiders and other insects. In this blog we are going to look at the relationship between spider phobia and social phobia.

The major difference between specific phobias and social phobia is that people generally need to be around other people a lot the time. This is a bit similar to my unusual experience of moving from Iceland to Australia. I had to get used to being around spiders and other bugs all the time. After 6 years in the country, my fear of spiders had definitely decreased.

Social phobia and safety behaviours

With social phobia, you have to be around, and communicate with, other people on a daily basis. Therefore, the system that maintains social phobia is somewhat more complicated. People develop highly sophisticated mechanisms to prevent negative evaluation by other people. For example, imagine that I always wore pink socks while in Australia, and never got a serious spider bite. It’s possible that over time, I would begin to attribute my successful spider avoidance to the pink socks. This is known as a ‘safety signal’. As silly as this example sounds, we often learn ‘safety behaviours’ to help us deal with phobias and anxieties in day to day life.

The problem with safety signals is that I cannot always wear pink socks – can I? I would need to wear pink socks at all times to feel relaxed, and that could lead to some awkward social situations. I would feel anxious whenever I didn’t have access to pink socks. This is a little bit what happens with social anxiety – individuals have to be around and interact with other people on daily basis, so they develop ‘safety signals’ which prevent the feared social situation from happening.

Any behaviour can function as a safety signal. For example, both talking more and not talking can potentially function as safety behaviour to prevent the social fear of appearing boring, depending on the individual and the context. The distinction between adaptive coping behaviours and maladaptive safety behaviours is sometimes blurred, as the same behaviour can function as both. The category which the behaviour falls in depends on its intended purpose, the underlying belief, and the consequences from the situation.

Back to my example, wearing pink socks in itself isn’t that unhelpful (maybe a bit childish). However, it is only unhelpful if I think my socks have to be pink for them to protect me from a poisonous spider. If I believe in this “function” of the behaviour, I am preventing myself from learning that people rarely get bitten by poisonous spiders in Australia, regardless of the colour of their socks. Also, it makes me nervous to travel, given that one cannot have access to pink socks at all times. In social anxiety these behaviours have many detrimental effects such as increased self-focused attention and preventing dis-confirmation. In fact, these behaviours can even have the opposite effect, and can end up being the reason why someone would judge someone else negatively (once again, think of the sock example).

Common safety behaviours for social anxiety include:

carrying deodorant around at all times
always saying “yes” to other people’s requests
rehearsing what to say before entering a social situation
only telling other people about positive aspects of your life
laughing at inappropriate times
avoiding eye contact
saying little in group situations
re-reading emails many times before sending them

People may feel their safety behaviours are helping them, but they aren’t. On the contrary, several studies have reported the detrimental effect of such safety behaviours in social situations (Kim, 2005; McManus et al., 2008; Morgan & Raffle, 1999; Wells et al., 1995). Consequently, the current view is that safety behaviours can interfere with standard cognitive behaviour therapy techniques by inhibiting testing of hypotheses for socially anxious individuals.

In our online treatment for social anxiety (www.AI-Therapy.com) we explain these concepts in a lot more detail, and help people understand what their specific safety behaviours are. I hope you can see that social phobia is a much more complex issue than specific phobias, like spiders. You can now answer 10 questions, to see how you score on our free online social phobia symptoms test.

In an upcoming blog I will discuss the relationship between safety behaviours and one of my favourite topics – superstitious behaviours. My latest article on superstition was front page news in Iceland last week!

What is phobia? Spider phobia or arachnophobia

In my undergraduate studies we were asked to learn a list of phobias for an exam. Knowing obscure phobias was a fun party trick, and great for pub trivia! In clinical practice these types of phobias are all referred to as “specific phobias”. Instead of using “arachnaphobia” for the fear of spiders, it’s more often referred to as a spider phobia (sorry Holloywood!). In this blog I am going to talk a little about spider phobias.

Spider phobia

I am going to start with a personal disclosure. My first words as a child, were not “mum”, “dad”, “yes” or “no”. They were “Allt í lagi könguló”, which is Icelandic for saying “spiders are ok!”. The background is that when I was a toddler I would freak out each time a spider would run by, and my parents said those words to me so many times that they became my first! An interesting question is “was I born with an innate fear of spiders?”.

Early theorists (e.g. Seligman, 1971) would have said that I must have been bitten by a spider as a child. This is highly unlikely given the lack of big/dangerous/biting spiders in Iceland. Due to this influential theory in clinical psychology, therapists traditionally insisted that patients must have experienced at least one bad encounter with their fear-relevant stimulus (in my case a spider) in the original development of their phobia. However, it has since been observed that human beings are likely to have been born with innate fears. Menzies (my PhD supervisor) and Clarke (1995) emphasise that a goal for the treatment of phobias is to unlearn innate fears, as many are no longer relevant in a modern environment. However, it is possible that these innate fears served a purpose for the survival of the species 60,000 years ago. For example, it is conceivable that early humans who were anxious about lions and spiders while walking through certain areas in East Africa had an evolutionary advantage. In the picture below, you can see a lion hiding in the bushes, waiting for its prey to walk by?

If so, perhaps you would have lived another day!

Dangerous predators were a real risk in those times (I am sure the spiders they had to deal with were about 10 times the size of the Icelandic ones!), and a certain level of anxiety would help increase and maintain one’s guard against them. This model of innate fears became known as the non-associative model (see further, Menzies and Clarke, 1995). It can be understood as learning that has been encoded in the human genome.

Wherever people stand on the debate about the genetic basis of phobias and anxieties, it is clear that for adults with phobias, cognitive behaviour therapy is an effective treatment. A crucial ingredient is that you take small steps to expose yourself to the feared object – in my case spiders. My innate fear of spiders reduced significantly when I moved from Iceland to Australia. In Iceland there are hardly any spiders or bugs, but in Australia you have to deal with them on a daily basis. By being forced to confront my phobia, I made some progress towards decreasing my fears (although I still hate mosquitos, but that’s more of an annoyance than a fear). In the next blog I will look at the difference between spider phobia and social phobia.

fdh

I find it fascinating that our online psychology services have the potential to change the lives of people anywhere on the planet. No waiting list – you can simply signup and start therapy within minutes, using your own name or a pseudonym, making absolute privacy a reality!

After 7 years of development, we are finally launching our Internet treatment program to the world. Please take a look at http://www.AI-Therapy.com. Cognitive behaviour therapy is the leading treatment for social anxiety. Our service is unique.

Our service is unique in that we have have taken psychological data from major anxiety clinics, and used this data to detect common themes and patterns among those with anxiety. Next, we have used this information to write thousands of different evidence based clinical psychology treatments for social anxiety. All of these interventions have been incorporated into the system. This is how we can have an automated system, yet highly individualised at the same time. We have done our best to use simple, non-technical language that everyone understands. We have also done everything possible to make it as relevant as possible to each user.

Since the program is fully automated, it is tempting to think that it is just like a book that had been put online. However, AI-Therapy is so much more. Imagine a book that remembers you, and adapts its contents based on your thoughts and concerns. Imagine a book that allows you to hear directly the voice of the authors, who explain the principles behind all the exercises and concepts described on each page. Imagine a book that has decades of experience in treating people similar to you and giving you feedback based on that experience. You can have all of this and so much more with AI-Therapy.

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.

The AI-Therapy Blog

How Excel can help you achieve goals

How does Excel planning work to achieve goals?

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

Spider phobia (aka arachnophobia)

What is phobia? Spider phobia or arachnophobia

Spider phobia

Psychology service available worldwide

How does Excel planning work to achieve goals?

Social phobia vs Spider phobia

Social phobia and safety behaviours

Common safety behaviours for social anxiety include:

What is phobia? Spider phobia or arachnophobia

Spider phobia

Internet CBT treatment for social phobia

Try a 10 questions free social phobia symptoms test