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Frequently Asked Questions about Psychologists and Psychotherapy

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Norfolk island Fitness and Health News

FITLOSOPHY:    Dark + Cold + Rain(?) = Group Exercise at Norfolk Fitness!!

                                What do our many classes involve?

  • Lots of fun and new "stuff"
  • Working with others in a Team environment
  • Compound functional movements which make you stronger for daily tasks
  • Interesting Equipment

and ... all done in an Interval (H.I.I.T.) format and run by our Qualified Trainers.

This style is best for Body Re composition ie changing shape for the better!!

FOODLOSOPHY:     Make peace with FOOD!!!

It should not be a battleground, a struggle, or a choice between GOOD and BAD!

ENJOY the variety and follow the K.I.S.S. principle ... "keep it simple sma

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Understanding the Mind – Obsessive Compulsive Disorder

It’s common to have finicky ways of doing things – washing up the glasses first, start dressing with socks, mow the lawn in straight lines, count the pegs as you hang up the clothes. These quirky habits don’t cause any problems…that is, unless something cuts across the ritual and causes a meltdown, or you just can’t snap off the thoughts. In the same vein, we all have times when our thoughts keep going back to something specific, maybe an idea we’ve had or something that isn’t yet solved. Again, this is not a problem as long as it’s easy to turn it off and re-focus onto something else.

When thoughts get stuck or quirky habits take up too much time and can’t be stopped, this is Obsessive Compulsive Disorder (OCD). It sits in the category of Anxiety problems because the person caught up by these rituals typically suffers high levels of distress when they are blocked from doing the rituals (compulsions) or they are exhausted from the constant thoughts churning around in the mind (obsessions). In some extreme cases, everything else in life takes a back seat to the obsessive thoughts or behaviour rituals.

Do I have OCD?

Worrying about something, or liking to do things a certain way, are not generally a problem. The DSM-5 defines OCD as “the presence of either obsessions or compulsions which are significantly distressing, time-consuming, or interfering with normal routines and social or occupational functioning”. That is, thoughts or rituals that interrupt our lives so we can’t function normally. A quick and easy online screening test is available at

What causes OCD?

The precise cause of OCD still isn’t known but like many mental health disorders, is likely to be a mix of genetic, biological, and environmental factors.

Brain scan studies show that certain areas of the brain function differently in people with OCD compared with those who don’t. Faulty wiring in the neural pathways between different parts of the brain, including the orbitofrontal cortex, the anterior cingulate cortex (both in the front of the brain), the striatum, and the thalamus (deeper parts of the brain) has been found in people with OCD. This is often linked to irregularities in key neurotransmitters – the chemicals that send messages between brain cells, such as serotonin, dopamine, and glutamate.

About 25% of people with OCD have an immediate family member with the disorder. Twin studies suggest that genetics contributes about 45-65% of the risk for developing OCD. This may be linked to a mutation of the human serotonin transporter gene (hSERT) which is then inherited.

Operant learning – having rewards or punishment linked to behaviours – also plays a part. People who are vulnerable to stress, where the sympathetic arousal system doesn’t settle quickly, seem to get an instant reward – relief – when they engage in rituals, either actions or thoughts. The disorder might start this way, as a means of self-soothing which is rewarding, but then it becomes almost like an addiction where the need for relief takes over everything.

Cognitive theories suggest that OCD starts with misinterpreting the meaning of certain thoughts, for example, over-personalising something another person has said, or exaggerating the meaning given to a thought. This triggers stress which is then relieved by doing certain compulsive actions. This is known as thought-action fusion.

Finally, OCD can develop from environmental factors. Having highly critical parents or experiencing trauma in childhood often underlie OCD. Some brain injuries trigger this disorder, and there is evidence that some severe bacterial or viral infections in childhood underlie the condition.

How is it treated?

There is no cure for the disorder, but there are effective, evidence-based therapies that mean the person with OCD can get on and still manage the condition so it has less impact on day-to-day life. Medications such as selective serotonin reuptake inhibitors (SSRI’s) may be necessary in extreme cases where the disorder is profoundly affecting quality of life or threatening health. In extreme cases, other medical treatments such as antipsychotics or tranquillizers, deep-brain stimulation, and brain surgery may be necessary.

Treatment plans should also include “talk therapies” to help the patient understand the disorder and develop better coping skills. This can include cognitive therapy – learning to think differently about rituals so they are given less significance. Paired with coaching in anxiety reduction techniques such as mindfulness, deep relaxation or self-hypnosis, this approach has a high success rate.

Danger Ideation Reduction Therapy has recently been shown to be highly effective. This treatment targets danger-related thoughts through a 6-step process aimed at restructuring faulty beliefs using techniques like attentional focusing, providing corrective and factual information, and cognitive restructuring.

Like all serious mental health problems, the sooner treatment is started the higher the chance of a good recovery. However, successful treatment depends on investing time and effort into getting well again and having a strong positive believe that the brain can be healed.

Dr Kate Lemerle, Psychologist

Chrysalis Counselling & Coaching, Norfolk Island


TEL: 52112 or email

Please 'contact us' for more information.

Understanding the Mind – Anxiety Disorders

Anxiety is probably the most common reason for people seeking help from psychologists. About 14 % of people have an anxiety disorder in any 12-month period. More women seek help for anxiety disorders than men (18% compared with 11%), but this doesn’t mean women are more likely to suffer from anxiety – it simply means they are more likely to get help. Surveys show that men tend to mask anxiety disorders more, or the symptoms are not recognised as anxiety. For example, men’s symptoms of anxiety more often come out as anger, they may self-medicate with alcohol to dull the symptoms. or push the anxiety down by working harder or playing sport. Old-fashioned beliefs that anxiety is only a “woman’s problem” often stops men seeking professional help early, so when they do it’s often a more complex set of problems.

Anxiety versus Stress

The term “Anxiety Disorder” covers different clusters of mental health problems and is different from stress. Stress is a short-term neuro-biological response to a threat. After the stress response is triggered, the body’s systems return to normal levels of functioning. In anxiety disorders, the activation of the stress response does not return to normal, or the reactions to triggers might generalise so the stress response happens more and more frequently to the point where it doesn’t automatically turn off. So stress is a normal alarm reaction whereas anxiety is typically far more intense and lasts longer, or may come on without any obvious trigger.

The other difference is that Anxiety Disorders are often paired with fears of future threat. Symptoms often arise in the absence of any real danger, or the perceived danger is grossly exaggerated, whereas stress happens in response to a real or perceived threat in the present. The sensations may be very similar, but Anxiety Disorders are more intense, overwhelming and persistent with the person having little or no control over it. Finally, anxiety symptoms cause a great deal of distress or impairment for much longer than stress.

Types of Anxiety Disorders

The international diagnostic classifications list 3 classes of Anxiety Disorders, each with their own set of diagnostic signs which have to be met for a diagnosis of “Anxiety Disorder” to be made:

1. Anxiety Disorders (separation anxiety disorder, selective mutism, specific phobia, social phobia, panic disorder, agoraphobia, and generalized anxiety disorder).

2. Obsessive-Compulsive Disorders (obsessive-compulsive disorder, body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation disorder).

3. Trauma and Stressor-Related Disorders (reactive attachment disorder, disinhibited social engagement disorder, PTSD, acute stress disorder, and adjustment disorder).

For children, we use the Revised Children's Manifest Anxiety Scale or the Multidimensional Anxiety Scale for Children to identify which disorder is present. For adults, we use the Beck Anxiety Inventory as a general screener, and other assessments for specific disorders like the Yale-Brown Obsessive-Compulsive Scale, Social Phobia Inventory, Penn State Worry Questionnaire, and Generalized Anxiety Disorder Scale. We also use specialised instruments such as the Structured Interview for PTSD and the Trauma Questionnaire to diagnose trauma-related anxiety problems. To measure outcomes from treatment we use scales such as the Self-Assessment of Resilience and Anxiety Questionnaire, and the Stress Profile. All these instruments have been validated with good research and give us objective measures to help guide treatment.

What treatments are effective for Anxiety?

Left untreated, anxiety disorders can cause a great deal of harm, not just physically due to the prolonged stress load on the body which can cause many illnesses, but also socially and emotionally. Untreated anxiety disorders leave people feeling helpless, fearful, and hopeless about the future. They often lead to social isolation as sufferers avoid going anywhere that might trigger their symptoms.

Accurate diagnosis is important especially to find possible causes (past and present), and then to develop the treatment plan. Therapy should cover coaching in techniques for “down-regulating” the brain’s autonomic over-activity, systematic desensitization to reduce the range of cues that set off the anxiety, and cognitive therapies to change the habits of worry or faulty beliefs that keep fuelling the anxiety. We often also treat secondary problems like sleep problems, poly-pharmacy (over-use of medications) or alcohol and substance abuse. Finally, treatment typically includes complementary medicine such as massage, yoga or Mindfulness which can all help relieve physical symptoms. The good news is that many people recover well from anxiety disorders once they commit to a broad-ranging treatment plan and put self-management skills into practice.

Dr Kate Lemerle, Psychologist

Chrysalis Counselling & Coaching, Norfolk Island


TEL: 52112 or email

Please 'contact us' for more information.

Norfolk Island Fitness and Health News

Winter is coming!!

Why not avoid the dark and cold and invest in one of our many Health and Fitness programs?

  • Gym Membership (free personalised program included for May)
  • Group Exercise ... buy a value pack of 10 and save $50. Vacancies currently in SPIN (Indoor Bikes). No number restriction in any other class.
  • 8 WEEK BODY BLITZ PROGRAM (2 month "intensive" which can be started at any time).
  • Personal Training ... one on one and small groups up to 3.
  • Nutrition Consultations

                Make the rest of 2018 YOUR YEAR to be a better and healthier YOU.

                        All NORFOLK FITNESS T SHIRTS ONLY $10 ... 1 Week only.

                        Want to be part of a Team for the triathlon on 13th May?                       

                                    Phone Kay on 52809.

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