How Can Cognitive Behavioural Therapy (CBT) Assist Me? Unravelling the Maze of Thoughts
Imagine waking up each morning overwhelmed by a cloud of dread about the day ahead. You’re trapped in a vicious cycle of negative thoughts, each feeding into the next, building a formidable barrier between you and peace of mind. Whether it’s stress from work, anxiety about future uncertainties, or a lingering sadness that taints your enjoyment of life, finding a pathway to psychological well-being might seem akin to navigating a maze without a map.
So, what can you do? How can you break this cycle when you’re aware that your actions might be detrimental, yet you’re unsure of the alternatives? This is where Cognitive Behavioural Therapy (CBT) can make a significant difference.
What is Cognitive Behavioral Therapy?
CBT is a robust form of psychological treatment proven effective for a range of issues including depression, anxiety disorders, alcohol and drug misuse, marital problems, eating disorders, and severe psychological conditions. Extensive research demonstrates that CBT significantly enhances functioning and quality of life. It operates on the fundamental principle that our thoughts, feelings, and behaviours are interconnected, and that altering negative thought patterns can affect changes in both feelings and behaviours, and that changing behaviours can alter our feelings and negative thought patterns.
How Cognitive Behavioral Therapy Works
Many people associate therapy with lying on a couch, discussing one’s mother and traumatic past, receiving only nods or «mhms» from the therapist. However, encountering a CBT session can be quite a revelation, as it differs significantly from these traditional notions of psychotherapy. CBT sessions are interactive, practical, and structured. They focus on specific problems and offer direct tools and techniques to manage and overcome these problems. In CBT, the therapeutic process is normally divided into three key phases:
- Assessment: This initial phase involves a detailed examination of the client's problems. The therapist and client work together to identify specific problem areas. This could include understanding the situations, thoughts, and behaviours that lead to difficulties in the client’s life.
- Analysis: In this phase, there is a deep dive into understanding why these problems exist. The therapist helps the client to uncover patterns of thinking or behaving that contribute to their distress. This involves looking at how certain thoughts or behaviours are unhelpful, and exploring their origins and impacts.
- Intervention: This is the action phase, where strategies and techniques are applied to modify the problematic thoughts and behaviors. The interventions are practical exercises and tasks that the client undertakes, both within and outside of therapy sessions. These might include exposure therapy, thought records, or behavioural experiments.
For example, Ginny has sought therapy because she struggles to participate in social situations. Her job involves many important social events, and she has noticed that her inability to partake is affecting her relationships with her colleagues. She absolutely hates this and does not know how to stop being so afraid. She tried to go once. She prepaid and got ready to leave, but taking the step to leave her apartment proved too difficult, so she decided that Netflix and a glass of wine would be a better way to spend her evening, even though it felt terrible not to have been able to go.
- Assessment: The therapist and Ginny discuss everything she has been feeling, thinking, and doing when confronted with social situations to explore possible explanations for why it is too difficult to make the leap. They explore both the past and the present to understand.
- Analysis: When the CBT therapist understands what is going on, why Ginny started to struggle and why she is still struggling today, this information is shared and discussed between them. This is crucial because understanding the situation makes it easier to determine what needs to change. They do not want to guess how to intervene; they want to know.
- Intervention: Now it is time to make some changes. Ginny realizes that she anticipates a lot of negative scenarios that might occur if she goes to the party: “What if I say something weird?”, “What if my clothes are too formal or informal?”, “What if nobody talks to me, or they are bored when they do?” Her therapist helps her challenge these thoughts and prevent them from dictating her behaviour. Then, together, they create a plan to expose Ginny to what she fears the most, equipping her with all the necessary tools to manage the situation effectively.
The process of CBT is highly collaborative. Both the therapist and the client have active roles in the therapy sessions and in the work done between sessions. This collaborative effort helps to empower the client, making them an active agent in their process of change, also giving them the tools on how to manage problems in the future without the need of a therapist.
Moving Beyond the Past
While our past is crucial as it shapes who we are today, dwelling on it can impede our progress. CBT helps clients focus on the present and future, learning from the past but not being anchored by it. We discuss the past to understand our learning and experiences but shift focus to current actions and forward-looking strategies.
Benefits of Cognitive Behavioral Therapy
One of the key benefits of CBT is that it is short-term and goal-oriented, typically lasting anywhere from a few weeks to several months. We do not want to suffer longer than necessary! This does not mean the benefits are fleeting; rather, the changes are designed to be long-lasting. CBT provides clients with tools and techniques that are not just about coping in the moment but are skills that clients carry with them for life. This approach ensures that individuals do not have to rely on continuous therapy but can manage independently, reducing the likelihood of future relapses. The benefits of CBT include:
- Evidence-Based: CBT's effectiveness is backed by substantial research, making it a reliable form of therapy for various psychological problems.
- Skill Development: Clients acquire valuable life skills that enable them to effectively tackle a variety of life's challenges. These skills, learned within the therapy setting, can be generalised to address similar issues that may arise in the future.
- Sustainability: While the therapy itself is often short-term, the tools and strategies learned are enduring, helping ensure that the improvements are maintained long term.
Embracing Negative Emotions
Even though CBT talks a lot about change, it is essential to acknowledge that feeling bad is sometimes necessary. Negative emotions are a normal part of life; they teach us resilience and give context to our happiness. How would we recognise joy if we never experienced hardship? How would we handle danger without fear? Thus, not every problem requires therapy – many challenges can be managed on our own, even though we feel bad in the moment. However, when these issues persist and begin to impact our daily lives significantly, seeking therapy may be the appropriate step to take, and this is when CBT would be able to help us.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
The journey to clear communication: Improve your accent
Communication is the expression of a message by speaking, writing, or signing. When a message is not expressed clearly, it can be misinterpreted. Clear communication means that the receiver of the message understands exactly what the sender is intending. It is essential for being understood, building relationships, and communicating efficiently.
For many Spanish speakers, having clear communication when speaking English can be an important step when it comes to achieving their goals, whether that be in their careers, their social lives or just not having to repeat themselves and being understood. The purpose of accent training is to help you feel confident and to communicate as effectively as possible—not to sound like a native speaker or erase your individuality. This in-depth guide will go over what accent training is, how it works, and how one-on-one coaching can help with clarity, confidence-building, and successful communication in both professional and social settings.
What is Accent training?
Accent training is personalized coaching that helps individuals who want to address specific communication challenges. It focuses on pronunciations, appropriate intonation, rhythm, timing, and stress patterns. It helps speakers identify which habitual features they take from Spanish and use while speaking English. The goal of accent training is not to sound like a native speaker, it is to help individuals communicate clearly and confidently. Accent training is flexible and personalized to meet each individual’s needs.
What are accents?
Accents are made up of substitutions; the sounds, rhythms, and intonations from a person’s native language or region that he or she uses when speaking English. If these substitutions are not what the listener expects to hear in English, the listener hears an accent (The accent channel). Accents are a normal part of any language and reflect the cultural diversity of speakers. No accent is better than another; they are all valid forms of expression.
Accents only become noteworthy if they begin to interfere with someone’s communication at work or in social settings. They may cause confusion or prevent someone from achieving their goals. Some people may also feel that there are preconceived notions about their accent, which can lead to biases and stereotypes. The choice to change the way we speak is up to each individual. They may want to improve their communication and avoid embarrassing speech mistakes.
After accent training, most accents become difficult to associate with any specific location; they begin to sound very neutral and unidentifiable. Speakers become easily understood, which boosts their confidence and allows them to communicate clearly and as effectively as possible.
Benefits of Accent Training:
- Aids in clearer communication and pronunciation.
- Helps individuals work towards their career, social network, and life goals.
- Increases confidence and self-esteem.
- Reduces linguistic bias and discrimination.
- Improves customer satisfaction.
- Enhances listening skills.
- Expands professional opportunities.
- Nurtures better social integration.
- Increases cultural sensitivity and the ability to connect with diverse backgrounds.
- Improves credibility in professional settings.
- Decreases stress levels associated with speaking in a foreign accent.
- Enhances academic performance for students by facilitating participation in discussions and presentations.
- Strengthens personal relationships by reducing misunderstandings and fostering clearer interactions.
- Empowers individuals by giving them a sense of control over their communication and self-presentation.
Why personalized training instead of apps and videos?
Personalized accent training provides many advantages over apps and videos. It offers immediate feedback and allows the opportunity to correct mistakes instantly. It also helps the individual to recognize their personal challenges when communicating; not every Spanish speaker has to work on the same objectives during accent training. Unlike apps and videos, personalized training is tailored to each individual’s needs. Working with a speech trainer also ensures you are accountable and practicing consistently, which is important for progress. Immediate feedback from a speech trainer is much more effective and leads to better results.
The accent training process
The process of accent training begins with a speech assessment in order to identify the sound substitutions, rhythms, stress patterns, and intonations that are currently being used and would need to be replaced with those of the goal accent (General American English for example). Once the substitutions are identified, appropriate objectives can be set. It is important to note that new objectives may appear after the initial assessment as the speech trainer is constantly assessing their client as they work together. Each session targets a single objective and consists of a variety of tasks that are practiced multiple times. During these tasks, immediate feedback is given to help the client identify any substitutions and make the necessary corrections. In addition to these in-session practices, at-home tasks are assigned; it is crucial that the client practices consistently outside of sessions in order to make notable progress. Repetition is necessary for making adjustments in the accent, and frequent practice is required for permanent improvement. The goal of accent training is for the client to internalize the correct speech patterns and produce them fluently in a way that is easily understood by their listeners.
How long will it take?
Each goal takes approximately one session to be taught. It is recommended to have one session a week, and normally takes between 12-15 sessions to work through each objective (depending on the number of objectives of each student, could be more, could be less). It is important that the student is practicing at home at least 15 minutes a day to make notable progress. After the completion of their program, the client will have the option of maintenance sessions if they would like to continue practicing with a speech coach.
What will we work on?
To communicate clearly and confidently, we will focus on several key areas tailored to each client’s needs. We will address high-value sounds specific to English that are uncommon in Spanish and can lead to pronunciation difficulties. We will also work on rhythm and stress; English features vary in syllable length, some syllables are stressed and longer, while Spanish syllables are generally given equal time. Additionally, we will focus on vocabulary, predominantly common words used in daily life that are often mispronounced. We will use targeted exercises and practice to improve pronunciation, rhythm, and vocabulary, which will enhance overall communication skills.
Taking action to overcome communication challenges is an important step towards personal and professional development. Accent training is a powerful tool that can help you achieve effective and clear communication. It can help boost your confidence and enhance your interactions in all areas of life. Working with a speech trainer provides you with personalized guidance and support, and ensures that you reach your goals more effectively than through self-study tools alone.
About the author
I am Jarrisvette Villarreal, originally from South Texas. I have been living in Spain for several years, where I have worked as an English teacher and have taught young Spanish speakers. Through my experience, I have become familiar with the common mispronunciations and typical mistakes Spanish speakers make when speaking English. In addition to teaching, I have experience as a Speech-Language Pathologist Assistant, working with children on articulation through speech therapy. I have also completed a specialized training in accent coaching through “The accent channel”, which has equipped me with the skills to provide personalized accent training. I have also worked diligently to achieve a neutral English accent; I understand the challenges and preconceived notions about having an accent. I am passionate about teaching pronunciation and excited to help others reach their communication goal.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
How to Prepare Our Children for Life's Ups and Downs
What wouldn’t we do to protect our children, our most precious treasures? As parents, our instinct is to shield them from harm and negative experiences, fearing that difficult situations might cause pain or lasting trauma. We are driven by love and a deep desire to see our children happy and thriving. However, in our efforts to safeguard them, we might unintentionally prevent them from developing the resilience they need to navigate life’s inevitable challenges.
The Importance of Facing Challenges
Resilience is the ability to bounce back from adversity and cope with setbacks. It is a crucial skill that helps children manage the complexities of life. Shielding them from every challenge can leave them unprepared for future difficulties. Without encountering adversity, they may struggle to handle setbacks when they arise, potentially leading to a lack of confidence and problem-solving abilities.
Understanding and Accepting Emotions
One of the most valuable lessons we can teach children is that emotions—both positive and negative—are a natural part of life. Everyone experiences anger, frustration, or sadness at times, and that’s okay. Emotions are natural responses to situations and are not something we can directly control, but we can control how we express and respond to them.
It’s essential for children to understand that feeling sad, frustrated, or angry is perfectly normal. These emotions aren’t to be feared or avoided; rather, they are signals that deserve attention. For example, fear can alert us to danger, such as encountering a wild animal (we do not want to meditate when a lion is approaching us), prompting us to take protective action. Anger, when managed properly, can help us stand up for ourselves and advocate for a just world (we do not want to be taken advantage of). By teaching children to accept their emotions, rather than suppress or ignore them, we help them develop an understanding of their emotional responses—a cornerstone of resilience.
Teaching Healthy Emotional Expression
While understanding emotions is crucial, it’s equally important for children to learn how to express them in healthy and constructive ways. We cannot always run away from what scares us, nor can we lash out when angry. It is okay to feel emotions, but how we express them matters. Children need to learn effective ways to manage their emotions so they do not create new problems, which could intensify their negative feelings.
How Can I, as a Parent, Teach My Child to Cope with Negative Emotions Without Causing Trauma?
First, remember that your child is a keen observer. One of the most powerful ways they learn is by watching your behavior. If you model healthy emotional expression, your child is likely to emulate it. Conversely, if you respond to anger by hitting or breaking things, it becomes difficult for the child to understand that these behaviors are unacceptable.
A helpful guideline is to focus on teaching your child what to do, rather than what not to do. Instead of saying “Don’t hit” or “Don’t scream,” guide them toward alternative behaviors. For example, you might say, “I see you’re angry because of what happened. It’s understandable—it’s not fun when things don’t go your way. When you’re angry, use your words to tell me what’s bothering you, and we can figure out how to make things better.” This approach is easier said than done, especially when parents are short on time and energy. Many of us weren’t taught how to manage our own emotions, so learning to do so may be necessary before we can effectively teach our children. Remember, just like on an airplane, you need to put on your own oxygen mask before helping others.
Here are some strategies to help children manage and express their emotions effectively:
- Model Healthy Emotional Expression: Children learn by observing the adults around them. Demonstrate healthy ways to express emotions, such as calmly discussing what’s bothering you instead of yelling. This shows children that emotions can be managed without resorting to negative behaviors.
- Encourage Open Communication: Create an environment where your child feels safe to talk about their feelings. Encourage them to express what they’re feeling and why without fear of judgment. Listening actively and empathetically to their concerns helps them process emotions and strengthens their ability to communicate effectively.
- Teach Problem-Solving Skills: When children face challenges, guide them in thinking through possible solutions rather than stepping in to fix the problem for them. Encourage them to consider different approaches and evaluate potential outcomes. This builds their confidence and empowers them to tackle challenges independently.
- Set Healthy Boundaries: While all emotions are valid, there are appropriate ways to express them. Set clear boundaries around acceptable behaviors and help children find constructive outlets for their emotions, such as talking or engaging in physical activities.
Preparing Children for a Resilient Future
Building resilience in children doesn’t mean exposing them to unnecessary hardships; rather, it means equipping them with the tools they need to handle the challenges they will inevitably face. By teaching them to understand, manage, and express their emotions, we prepare them for the realities of life and help them build the resilience needed to thrive.
Resilient children are better equipped to cope with adversity, recover from setbacks, and continue moving forward. They understand that emotions are a natural part of life and that challenges, while difficult, can be managed. With these skills, they will be prepared to handle criticism at work or navigate conflicts in their personal relationships, confidently facing whatever life throws their way.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
The Importance of Connection, Rhythm, and Intonation in Accent Training
Accent training is a specialized form of language instruction designed to help individuals modify or refine their accent in a second language. It goes beyond working on your pronunciation and perfecting the sounds of individual words; it also involves the way we connect words, the rhythm, and the intonation that we use when speaking. Many speakers unknowingly carry over the speech patterns of their native langue when speaking English, this can sometimes change the meaning of what is being said and affect clarity. Personalized Accent training can pinpoint the specific aspects of speech a person may need to target, to ensure that they are conveying a clear message. This guide will explore how connection, rhythm, and intonation are essential to accent training and how they can help anyone who wants to sound more natural and confident when speaking English.
Who can benefit from accent training?
- Non-native speakers who want to improve their clarity and confidence when speaking a second language, particularly in professional, academic, or social settings.
- Professionals who need to communicate clearly with native speakers for work, such as in international business or customer-facing roles.
- Actors or performers who need to adopt a specific accent for a role.
- Anyone who feels their accent may be a barrier to effective communication or integration into a new language environment.
Why Focus on Connection, Rhythm, and Intonation?
Mastering connection, rhythm, and intonation is crucial for achieving natural and fluent English speech. While pronunciation is foundational, these elements ensure that speech flows smoothly and conveys intended meanings accurately. Effective accent training emphasizes these aspects to help non-native speakers overcome the influence of their native language and sound more natural in English.
Connection in Speech
Connection in speech refers to the way we blend words and sounds to create fluent communication. Without these connections, speech can sound unnatural or choppy, making non-native speakers come across as robotic. English speakers often link words that start with consonant sounds or blend vowel sounds between words, such as in phrases like «turn off» (which can sound like «turnoff») or «see it» (which can sound like «seeyit»). Enhancing how you connect sounds can improve pronunciation, rhythm, timing, and overall intelligibility. When speaking English, it is important to connect words smoothly so that entire sentences flow together. Pausing is natural and appropriate at the end of a sentence, when taking a breath, or when emphasizing a particular point.
Rhythm in Speech
Rhythm in speech plays an important role in effective communication. It involves the patterns of stressed and unstressed syllables and influences how messages are perceived. People are accustomed to hearing a certain timing during speech to fully comprehend a message. When the rhythm is off, the message can be difficult to follow or can cause confusion. “English is a stress-timed language, meaning, we don’t give equal stress to every syllable, but we spend lots of time on some syllables and we rush through other syllables” (The accent Channel). In English, when stressing a syllable, the vowel becomes longer, louder, and goes up in pitch. This can make it challenging for Spanish speakers to adapt to uneven stress patterns and can affect the natural sound of their speech.
Intonation in Speech
Intonation in speech refers to the variation in pitch that we use to convey different meanings in English. It helps distinguish between statements, questions, and commands. Intonation can also reveal emotions like sarcasm, uncertainty, or enthusiasm, and it highlights important aspects of a spoken message. When we vary in pitch, we can express a range of meanings and emotions.
Spanish speakers sometimes use repetitive intonation patterns when speaking English, this can make a person sound monotone and confusing. Without proper intonation, speech is flat and difficult to follow. Stressing different parts of a phrase can completely change its meaning, even when using the same words. Mastering intonation is crucial for clear and engaging communication.
Differences Between English and Spanish in Connection, Rhythm, and Intonation
English and Spanish differ significantly in their approach to connection, rhythm, and intonation. Spanish, being a syllable-timed language, maintains a steady rhythm by giving equal time to each syllable. In contrast, English’s stress-timed nature creates a more fluid and varied rhythm, with stressed syllables occurring at regular intervals. This difference can lead Spanish speakers to emphasize every syllable equally in English, disrupting the natural rhythm and clarity of their speech.
When it comes to connection, Spanish tends to maintain a more continuous flow between syllables, with each sound clearly articulated. English, however, often blends sounds together, making it sound smoother and more connected. Additionally, while Spanish vowels are precise and static, English vowels are longer and more dynamic, requiring greater mouth movement. Finally, when Spanish speakers speak English, they tend to use a repetitive intonation, and English requires varied intonation to convey different emotions and intentions. By focusing on these differences—strong syllables, elongated vowels, varied intonation, and fluid sound connections—Spanish speakers can significantly improve their clarity and fluency in English.
How a Speech Coach Can Help
A speech coach is essential for mastering connection, rhythm, and intonation which are critical for natural English communication. Through tailored exercises and real-time feedback, a coach can address specific challenges in blending words, managing syllable timing, and varying pitch. Coaches use practical techniques, such as listening drills and rhythmic practice, to improve speech flow and intonation. Personalized training ensures that learners understand and apply these elements effectively, leading to more natural and confident speech.
Mastering connection, rhythm, and intonation is essential for anyone looking to improve their English accent and communicate more effectively. These elements are the building blocks of natural speech, influencing how we are understood and how our messages are received. While pronunciation is important, it is the fluidity of connected words, the rhythmic flow of stressed and unstressed syllables, and the dynamic use of pitch that makeup language.
For non-native speakers, especially those coming from languages with different speech patterns like Spanish, focusing on these areas can make a significant difference in how natural and confident their English sounds. With the help of personalized accent training and a speech coach, learners can develop these skills, leading to clearer, more engaging communication. Whether for personal growth, professional development, or social interaction, refining connection, rhythm, and intonation can unlock a new level of proficiency in English, helping speakers to be not only understood but also to connect more deeply with others through language.
About the author
I am Jarrisvette Villarreal, originally from South Texas. I have been living in Spain for several years, where I have worked as an English teacher and have taught young Spanish speakers. Through my experience, I have become familiar with the common mispronunciations and typical mistakes Spanish speakers make when speaking English. In addition to teaching, I have experience as a Speech-Language Pathologist Assistant, working with children on articulation through speech therapy. I have also completed a specialized training in accent coaching through “The accent channel”, which has equipped me with the skills to provide personalized accent training. I have also worked diligently to achieve a neutral English accent; I understand the challenges and preconceived notions about having an accent. I am passionate about teaching pronunciation and excited to help others reach their communication goal.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
What is Speech and language therapy?
Speech therapy is the branch of science that focuses on the assessment, diagnosis, treatment and prevention of speech, language, communication and swallowing disorders. It is a discipline that serves people of all ages. Speech therapy is a profession that combines different areas, such as linguistics, psychology, biology and medicine.
In America, the Spanish Association of Speech Therapy, Phoniatrics and Audiology (AELFA-IF) is one of the main organisations of speech therapists in Spain. This association offers resources, ongoing training and support to professionals.
Areas of intervention in speech therapy
Speech therapists can work in a wide variety of settings, such as hospitals, private clinics, schools, nursing homes and early childhood centres, among others. Areas of intervention include:
- Speech disorders: this group of disorders encompasses difficulties in producing speech sounds, such as stuttering, dysarthria and articulatory disorders.
- Language disorders: this group of disorders encompasses difficulties in the comprehension and production of language, both written and oral. Within language disorders, we can distinguish expressive disorders, i.e. those that consist of difficulties in expressing oneself, and receptive disorders, which are characterised by difficulties in understanding the message.
- Social communication disorders: these are disorders that involve difficulties at the pragmatic level, i.e. with the use of language. They usually occur in social communication and are characterised by difficulties in communication skills. Communication skills are understood as those skills that are put into action and allow for an effective exchange between two or more people.
- Within these skills we can distinguish: the ability to communicate assertively, the ability to communicate a specific message, the understanding of non-verbal language, the ability to develop active listening, etc.
People with social communication disorders show difficulties in using these skills effectively. - Voice disorders: these are pathologies that involve vocal difficulties. This group includes problems such as aphonia (absence of voice) or dysphonia. These disorders are characterised by an impairment of the quality, tone and volume of the voice.
- Swallowing disorders: these disorders are commonly known as dysphagia and affect a person's ability to swallow. They may be caused by neurological disease, injury or surgery.
Speech therapy as evaluation
As mentioned above, speech therapy also encompasses the area of assessment. This is a multi-stage process. Speech therapists use techniques and tools to assess speech, language, communication and swallowing. Assessment can be carried out through standardised or non-standardised tests.
The first step in an assessment is an initial interview, in which detailed information about the patient’s development is collected. It is important to know the patient’s medical history and family history. In addition, it is very important to know about possible speech and language difficulties.
After this first step, assessment takes place. This may be through standardised tests, with specific tests that compare the individual’s performance in a given area with the norms established for their age group, or through non-standardised tests, which include observation of the user in their daily life or in specific activities to assess specific aspects.
This assessment allows the identification of the strengths and weaknesses of individuals, which enables the setting of specific goals for therapeutic intervention.
With the information extracted from the assessment, the speech therapist establishes intervention objectives. These goals can be short, medium or long term and allow the user’s progress to be monitored.
- Articulation disorders: the exercises that are implemented in therapy to treat these difficulties are focused on learning the way and place of articulation of sounds, to improve the emission of sounds, as well as exercises to improve the clarity of speech.
- Language disorders: Exercises to target language disorders are aimed at improving language comprehension and production. They may also focus on improving pragmatic and social skills.
- Voice disorders: to treat vocal difficulties, users learn techniques to improve breathing and phonation. These exercises improve their vocal quality.
- Swallowing disorders: THE intervention in this group of disorders is aimed at the user learning strategies to improve swallowing safety and efficiency. Exercises to work on the tone of the facial muscles, changes in diet and learning safe swallowing techniques can be found.
Recent advances in speech therapy
Speech therapy intervention is a dynamic process, i.e. it is subject to change, as each person has specific needs. It will be up to the professional who takes the individual to make these adjustments to the initial plan. This will be done on the basis of how he/she sees the individual in the sessions.
Speech therapy is a fairly new science. Moreover, it is a field that is continually evolving, which is why research within speech therapy is so important. Some of the recent advances are:
- Neuroplasticity: this is research into how the brain can reorganise its connections and form new connections in response to therapy.
- Genetics: research within genetics allows for the exploration of the transmission of different disorders and the observation of whether genetic inheritance influences the transmission of these disorders to offspring, as well as the likelihood of their occurrence.
- Evidence-based intervention: research allows for the development of new therapeutic practices. This allows speech therapists to implement these new techniques in their intervention, with the advantage of ensuring that they are effective and efficient treatments.
As a general conclusion, speech therapy is a profession that treats disorders related to speech, language, communication and swallowing through individualised intervention. The goals of the intervention are established on the basis of an exhaustive assessment carried out by the professional. The speech therapist has a very important role in improving the quality of life of individuals in need and seeks to develop skills and tools that enable people to communicate effectively.
It is an area in which research plays an important role in incorporating new techniques into interventions, ensuring their effectiveness.
Some sites that provide up-to-date information on speech therapy are:
- American Speech-Language-Hearing Association
- National Institute on Deafness and Other Communication Disorders
- Speech-Language-Therapy.com
- Understood
Written by:
Mariló Martínez
Sinews MTI
Psychology, Psychiatry and Speech Therapy
What is Academic Support and What Does a Support Therapist Do?
The educational field today faces significant challenges. After the COVID-19 pandemic, various studies have shown negative consequences on the cognitive development and academic learning of children worldwide. This has been reflected in the complexity and diversity of learning needs, requiring new approaches for each student. In this context, the role of the educational support therapist becomes crucial to ensure proper learning development and overcome any difficulties that may arise. We generally understand their professional work, but we are often unclear about the scope of their professional competence. So, what exactly is an academic support therapist?
The Importance of the Academic Support Therapist
Academic support therapists or psychologists are professionals specialized in the educational environment of children and adolescents, focusing on analyzing special needs and learning difficulties to design strategies aimed at acquiring skills and abilities. With this objective, the academic support therapist studies the difficulties encountered, determines, and provides a series of tools, which are individually adapted to help and foster the development of their learning.
The work of the educational support therapist begins with «Understanding,» which means identifying and understanding the underlying causes of the difficulties students face. This initial understanding is fundamental, as it allows for the precise design of procedures and strategies to effectively address these difficulties. To achieve a holistic understanding of the students, brief reports and evaluations are used, providing a broader view of the student’s educational needs.
This comprehensive approach is key to their professional execution, as it allows the support therapist to develop individual interventions that address not only the surface symptoms but also the root causes. From this point, strategy planning begins, adapting to the student’s academic curriculum. These strategies are primarily implemented in learning areas that pose difficulties and where the student lacks sufficient resources for proper coping. In this regard, the support therapist provides specific tools tailored to the identified needs.
Psychopedagogical Support: Beyond Cognitive Aspects
Psychopedagogical support has its roots in cognitive psychology, initially focusing on learning difficulties, especially those related to executive function regulation. However, after the COVID-19 pandemic, support needs have been significantly exacerbated.
Functions like planning, inhibition, and working memory have suffered cognitive deterioration after the confinement period. Additionally, new adaptation difficulties to education have emerged: anxiety became a significant trigger within the adolescent and even child educational landscape. This symptomatology impacted these functions, particularly working memory, due to anxiety caused by confinement, directly affecting reading and writing performance as they are key to processing.
Therefore, we must consider that today, psychopedagogical support is not limited exclusively to cognitive functions. It is essential to understand the relationship between emotional and cognitive factors that affect a child’s development. These factors constantly interact in the execution of their skills, directly reflecting on their performance. A clear example is the common situation of facing a difficult exam and experiencing what is popularly known as a «blank mind.» These paralysis symptoms, loss of control, and insecurity are nothing more than anxiety states caused by emotional symptoms, demonstrating how emotional management can facilitate or complicate the execution of our skills and the application of our knowledge.
Current Challenges in the Educational Field
The educational context reflects what develops outside of it. After the confinement period, the COVID-19 pandemic has imposed significant challenges on the educational system:
1. Impact on the Socio-Demographic Framework:
The adaptation effort of education during the confinement period relied heavily on technological resources, which were limited for part of the school population. This lack of access has hindered the schooling period, reflecting predominantly negative effects on learning and development processes, especially in contexts with fewer economic and cultural resources. This period has further highlighted social inequity, exclusion, and educational barriers that many children and young people face, underscoring the importance of education from a more inclusive and equitable perspective.
2. Role of Teachers:
It is crucial for teachers to reflect on how they can contribute to reducing learning barriers, both cognitive and affective-motivational. The pandemic has highlighted the importance of supporting teachers and strengthening the pedagogical use of technological tools. However, there is the challenge of improving the effectiveness of training, as many teachers find it difficult to use new tools. It is necessary to promote training programs that facilitate the use of flexible strategies for a variety of students and teaching contexts. Masland’s (2021) proposal on resilient pedagogy, which meets psychological well-being needs such as autonomy, competence, and affiliation, can be an effective model to increase motivation and engagement.
3. Challenges for Parents:
Parents also face challenges, such as reviewing and modifying practices that negatively affect their children’s learning experiences. The current most prevalent issue is the excessive use of video games, cell phones, and television, which can exacerbate learning and development difficulties. Conversely, practices that promote reading, sports, and the arts should be encouraged, as they facilitate other types of learning and improve self-esteem and self-concept by developing competence strategies. Additionally, reward mechanisms are highly motivated by prizes, neglecting the practice of intrinsic motivation. The practice and discovery of this motivation foster more resilient development and improve frustration management.
4. Preparation of Educational Institutions:
Educational institutions must prepare for the return to classrooms with flexible mechanisms to design recovery and learning acceleration courses, as well as emotional support programs for students and teachers. It is essential to implement policies that allow reasonable adjustments so that students can equitably access resources and opportunities, evaluating possible losses in learning and development. These adjustments should seek to level students in cognitive, emotional, and social aspects.
Future Lines of Action for Support Therapists
Given the current challenges in the educational field, it is essential for professionals to analyze new lines of action and reflect on the measures and practices implemented. The pandemic caused a readjustment of previously established routines, incorporating new methodologies and resources. It is crucial to critically evaluate how students are adapting to these changes. Some of these lines of action include:
- Evaluating the Use of Technology: Investigating whether teachers' efforts to use and adapt to technology have facilitated effective knowledge construction processes and whether this benefits all students. It is important to adapt technology as a tool and not as the primary basis on which educational quality rests.
- Sustainability of Adapted Practices: Examining to what extent changes and adjustments in teaching practices are maintained after returning to in-person learning. Developing a routine adapted to new student needs will be crucial for development.
- Learning and Psychoeducation in the Family: Investigating the informal learning that has taken place in families during the pandemic and post-pandemic, identifying which of these are beneficial or harmful to cognitive, social, and emotional development. Professionals must guide and provide orientation in dynamics to promote improvement in different parenting styles and offer psychoeducation on new needs within the educational framework.
- Experiences and Meanings of the Pandemic: Exploring students' experiences and the meaning of the pandemic and how it has affected them within the educational system to establish new support programs that improve their impact on learning.
The pandemic has transformed the educational landscape, presenting challenges that require innovative and adaptive responses. Academic support therapists play a crucial role in this new context, helping students overcome cognitive and emotional barriers exacerbated by the health crisis. By reflecting on these new needs and adjusting our practices, we can work towards a more equitable, inclusive, and effective education for all students. The role of the therapist goes beyond cognitive reinforcement; they are the support link that will help steer in the same direction.
Written by:
Paula Taguas Labrador
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Autism Spectrum Disorder and Pathological Demand Avoidance
What is “demand avoidance” and when is it pathological?
We all experience “demand avoidance” at times, i.e. we resist doing something which is either requested of us or expected of us. This article sets out to raise awareness of and explore a specific “condition” or profile which has been identified in the field of Psychology but about which there is still some controversy and lack of understanding. The focus here is on children. Recommended strategies to support PDA sufferers, both at home and in education, are also outlined.
Demand Avoidance in People with ASD
People with Autism Spectrum Disorder (ASD) sometimes avoid situations which cause them anxiety or give them sensory overload as well as activities which are not in their usual routine. They also sometimes resist transitioning from one activity to another or avoid activities which seem pointless to them. They may refuse, have an emotional crisis or try and “escape”.
How does Pathological Demand Avoidance differ from the above?
Individuals with PDA might avoid the above situations for the same reasons. However, PDA has some unique aspects:
- Many everyday demands are avoided simply because they are demands. It is the expectation (from someone else or yourself) which leads to a feeling of lack of control, and this feeling triggers anxiety increases and even panic.
- There can be an ‘irrational quality’ to the avoidance – for instance, a seemingly dramatic reaction to a tiny request, or the feeling of hunger inexplicably stopping someone from being able to eat.
- The avoidance can vary, depending on an individual’s capacity for demands at the time, their level of anxiety, their overall health/well-being or the environment (people, places and things).
What kind of everyday demands are we talking about?
- A direct demand (an instruction like “brush your teeth!” or “put your coat on!” or “do your homework!”).
- An internal demand (e.g. willing yourself to do something or bodily needs, e.g. the need to eat when you are hungry).
- An indirect or implied demand (including any expectation, for example a question that requires an answer, food that you are expected to eat, or a bill that needs to be paid.
Conversely, a demand that triggers stress or anxiety in individuals with PDA is not necessarily something unpleasant: it could be, for instance, opening your presents on your birthday.
When was the PDA profile first identified?
The term was originally coined by Elizabeth Newson in the 1980s but it took until 2003 for it to appear in formal scientific research (Newson et al., Arch Dis Child 88:595–600, 2003). Originally, PDA was a term used to describe a group of children who did not fit into the stereotypical presentation of autism recognised at that time but who shared certain characteristics with each other, the key one being a persistent and marked resistance to demands. According to Newson, autistic children display rigidity through rules, routine and predictability; in PDA their rigidity is in their need to avoid demands and control situations, which can often lead to the child appearing extremely impulsive in their emotions and behaviour, as they react to what they perceive to be demands.
Whilst autistic children often show little or no sociability, children with PDA display surface sociability. However, they often fail to recognise boundaries and struggle to understand the social norms of relationships. Children with PDA, like autistic children, often experience early language delay but often catch up later. They might have normal facial expressions and make eye contact; however their speech content can seem odd and, importantly, communication can be significantly affected by demand avoidance. The predominant characteristic of children with PDA is their continued resistance and avoidance of the ordinary demands of life. Whilst autistic children can be reluctant to comply, this is often in a non-social way; they lack the empathy to make excuses or develop strategies for avoidance. In contrast, children with PDA develop multiple strategies of avoidance, which they are able to adapt to the adult involved and can appear socially manipulative. (Newson, 2000).
Outside the UK, there is little awareness of PDA. However, in the UK, the term has been given some attention in TV and social media and this has led to an increase in pressure to consider PDA as a diagnosable disorder. Currently, while PDA is mentioned in latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) it is treated as a specific profile under the umbrella diagnosis of autism spectrum disorders (ASD). However, this does not mean that clinicians cannot use PDA as a descriptive diagnosis alongside a clinical diagnosis of ASD.
How common is PDA?
We don’t know. Because demand avoidance is currently understood as one characteristic in a person’s neurodevelopmental profile and is neither a diagnosable stand-alone condition nor is there a standardised assessment for the characteristic, there are no data to reliably indicate how common it may be. Research to date has been limited and often unreliable.
“Can’t” versus “won’t”: the difference between PDA and Oppositional Defiant Disorder
It is without doubt very stressful for parents to experience their child avoiding simple tasks or refusing to follow rules or basic routines. However, it is essential that we distinguish between PDA (Pathological Demand Avoidance) and ODD (Oppositional Defiant Disorder). Whereas PDA is an anxiety-driven need to be in control and avoid demands or expectations, ODD is characterised by angry and irritable mood, an argumentative and defiant attitude and vindictiveness.
Accurately identifying whether a child has PDA or ODD is key for implementing the right support strategies and can help others outside the immediate family to better understand the child’s needs. Some key characteristics of PDA which can help us with this distinction are:
- Difficulty tolerating uncertainty or unpredictability;
- Language delay and trouble with social interaction, which is common among autistic children;
- Mood swings and emotional dysregulation;
- Impulsivity and risk-taking behaviors;
- Obsessions and compulsions related to control or avoidance.
Tactics PDA children might use include distraction, making excuses, or shifting blame to avoid tasks and maintain a sense of control over their surroundings. Understanding these coping mechanisms is crucial for designing effective strategies to support them in managing their anxiety-driven behaviours.
How might a PDA child behave in a school environment?
It is possible that approaches used by teaching or special needs staff for autistic children can be ineffective for a PDA child and might even make things more difficult. In a school setting:
- They may have poor self-esteem, although this might not be obvious from their behaviour.
- Like many young people with ASD, they may behave very differently at home and school due to masking
- They may find regulating their emotions very challenging.
- A PDA learner may not seem interested in ‘doing well’ and may respond negatively to praise, for example by destroying work.
- They may say that the work is boring, or that they already know it.
- They may use charm, imaginative talk or attempt to shock to avoid demands.
- They are likely to want to build friendships with peers, but may find maintaining friendships difficult due to a need for control.
In terms of school attendance:
- They may have experienced school exclusions, even from an early age.
- A PDA child or young person may be absent from school altogether. 70% of PDA learners are either not in school or regularly struggle to attend. Many PDA children are home educated.
- Not every PDA child will have attendance difficulties – some may have slipped under the radar completely.
Support strategies for Parents at home
Unfortunately, there is limited research on support strategies. However, it is evident that people with PDA are best supported with strategies and approaches personalised to their specific strengths and needs.
The following advice is compiled from an American organisation called Trails Carolina (Trails Carolina – Leading Wilderness Therapy For Teens and Adolescents) and the Autism Society, U.K.:
- reduce and/or remove demands whenever possible;
- a collaborative approach is likely to work best, where the child is treated as an equal, rather than adults acting as an authority;
- use indirect communication styles (rather than making demands directly)
- avoid potential stressors such as eye contact, touch and confrontational postures/physical stances;
- if the child is distressed, give them space, remove spectators or move the child to a quiet space if possible;
- a coordinated approach to support is essential, involving the child, their family, school and health or social care professionals;
- In addition, it has been suggested that people with PDA may benefit from:
- identifying and understanding their demand avoidance and its triggers;
- sensory regulation and creating a sensory environment that works for them;
- therapy, counselling, mindfulness and meditation.
Support Strategies for School or Education
- Focus initially on building relationships and trust with a key adult before learning is attempted.
- Focus on the end goal rather than the means of getting there.
- Collaborate with the learner, adopting a child-centred approach focusing on their needs and strengths, and negotiating with them.
- Allow PDA learners to follow their interests and passions, and ensure learning topics are useful, meaningful and relevant to their lives.
- Provide choices and options over what work is completed, when, where, how and with whom.
- Try to recognise any signs of escalation of stress or anxiety and address them before the student reaches crisis point. Distress is usually caused by emotional, social or sensory overload; be aware of the child or young person’s potential triggers.
- Avoid direct requests; use a tone of voice and phrasing so that requests are made indirectly and allow for flexibility.
- Keep expectations to a minimum so that you can focus on the ones that are really important. This may mean having to be flexible about, for example, uniform, timetabling, homework expectations and the way results and progress are recorded.
- Provide a quiet area such as a calm corner for learners to use when they feel overwhelmed.
Some of these approaches may require significant adjustments on the part of the school, but they could be essential in ensuring that a PDA child continues to attend school.
The ongoing debate about PDA
Finally, it is necessary to highlight that, within the autism community (which includes autistic people and their families, autism researchers, health care professionals and education professionals) there is a great deal of disagreement about the validity and usefulness of the concept of PDA. However, one point on which there is broad agreement is that more and better research into Pathological Demand Avoidance is required.
Resources on PDA for Teachers and Parents
- Twinkl has partnered with the PDA Society to provide some helpful guidance documents (PDA PANDA Approach: Disguise and Manage Demands | Twinkl)
- The Autism Society (Demand avoidance (autism.org.uk). This page includes some real-life experiences in the form of quotes.
Abouth the author
Julia Jakubovics is from the UK. She has lived in Spain for over 20 years. She has a degree in Psychology and recently completed a Masters course in Interventions for Learning Difficulties in Children at ISEP (Instituto Superior de Estudios Psicológicos). She is currently working as a Shadow Teacher and Study Coach for Sinews, providing one-to-one and in-class support for children with special education needs.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
What is narrative therapy and how can it help me?
Narrative therapy is a form of therapy that is based on the idea that people are the storytellers of their own lives and that by changing the way they tell their stories, they can also change the way they perceive themselves and the world around them. In this article, we will explore in depth what narrative therapy is, how it works, and how it can help us.
What is Narrative Therapy?
Narrative therapy is a form of therapy that focuses on the narration of personal stories and the exploration of how those stories affect a person’s life and experiences. It was developed by Australian therapist Michael White and New Zealand therapist David Epston in the 1980s. Narrative therapy is based on the idea that people construct their identities through the stories they tell about themselves and that these stories can be modified to promote change and personal growth.
Key Principles of Narrative Therapy
Narrative therapy is based on several key principles that guide the therapeutic process:
- Externalization of the Problem: One of the central principles of narrative therapy is externalizing the issue. This involves separating the problem from the person, allowing the person to see the problem as something external to themselves and, therefore, easier to address and change.
- Co-construction of Alternative Stories: Instead of accepting a single narrative about their lives, clients are encouraged to explore and co-create new alternative stories that may help them reinterpret their experiences in a more positive and empowering way.
- Respect for the Client's Experience: Narrative therapy believes in respecting the client's experience and the importance of allowing people to tell their own stories in their own terms. This involves active listening, validating the client's experiences, and working collaboratively with them to find solutions that are meaningful to them.
Why is Narrative Therapy Healing?
Narrative therapy is considered healing for several fundamental reasons that are rooted in its approach and therapeutic practices. Here are some key reasons why narrative therapy is perceived as a healing form of therapy:
1. Identity Reconstruction:
Narrative therapy allows people to reconstruct their identity by challenging dominant narratives that may be contributing to their emotional distress. By changing the way personal stories are told, clients can develop a more compassionate and empowering understanding of themselves, contributing to a renewed sense of self-esteem and self-acceptance.
2. Empowerment Promotion:
Narrative therapy promotes empowerment by focusing on the individual’s strengths and resources. Through the co-construction of new alternative stories, clients discover that they have the ability to influence the direction of their own lives and to face challenges with resilience and creativity.
3. Redefinition of Past Experiences:
By rewriting past stories from a more positive and empowering perspective, narrative therapy helps people find new meanings and lessons in their past experiences. This can lead to greater acceptance and inner peace regarding past events that may have previously caused distress or emotional pain.
4. Encouragement of Self-Reflection:
Narrative therapy encourages self-reflection by inviting individuals to examine their own stories and narratives in a more conscious and reflective manner. This process of self-exploration can lead to greater self-awareness and self-understanding, facilitating personal growth and positive change.
5. Building Meaningful Relationships:
The therapeutic relationship in narrative therapy is based on respect, empathy, and collaboration. This genuine connection between therapist and client provides a safe and supportive space where individuals can explore their personal stories and work together to find meaningful and lasting solutions.
Applications of Narrative Therapy
Narrative therapy has been successfully used for a wide range of issues and populations, including:
- Depression and Anxiety: Helps clients reconstruct negative narratives about themselves and find new ways to relate to their emotions.
- Trauma: Allows trauma survivors to rewrite their stories of survival and resilience.
- Family Conflicts: Facilitates communication and conflict resolution within families by helping members understand and redefine their relationships.
- Identity Issues: Helps individuals explore and assert their unique identity in the face of social and cultural pressures.
Examples of Narrative Therapy Exercises
Here are some examples of tools employed in narrative therapy:
- Self-Compassion Letters: This exercise involves the client writing a letter to themselves from a compassionate and understanding perspective. In the letter, the client can gently express their feelings, acknowledge their strengths, and remind themselves that they are worthy of love and acceptance, even in times of difficulty.
- Strengths Family Tree: The therapist guides the client in creating a family tree that represents the strengths and resources that have been passed down through generations. The client can reflect on the strengths of their ancestors and consider how these positive qualities have influenced their own lives.
- External Observer: The client takes on the role of an external and objective observer to examine their own experiences from an emotional distance. This can help the client gain a new perspective on their problems and separate their personal identity from the events and circumstances that have occurred in their lives.
- Life Book Creation: The client creates a life book that includes significant moments, achievements, and experiences that have shaped their identity. By reflecting on these events and narratives, the client can identify common patterns and discover new ways to interpret their personal story.
- Gratitude Journaling: The client keeps a gratitude journal where they record things they are grateful for each day. This exercise fosters a more positive and appreciative approach to life and helps the client recognize the good things that exist amidst challenges and difficulties.
In conclusion, narrative therapy is a powerful tool that can help people reconstruct their life stories and find new ways to relate to their experiences. By changing the way they tell their stories, people can change the way they perceive themselves and the world around them. Whether facing depression, overcoming trauma, or navigating family conflicts, narrative therapy offers a client-centered approach that promotes meaningful and lasting personal change and growth,
Abouth the author
Verónica Sarria is a health psychologist at Sinews. She is specialized in eating disorders and obesity, working with adolescents and adults. She also treats other problems such as anxiety, depression, grief, self-esteem and interpersonal relationship problems, among others. Her orientation is cognitive behavioral but she integrates tools and techniques from other currents according to the needs of each patient, thanks to her training in mindfulness, mindful eating, attachment theory and systemic (family) therapy.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Improving Your Eating Habits: A Guide by an English-Speaking Nutritionist in Madrid
Food has undergone significant changes in recent decades due to a variety of factors, including changes in eating habits, technological advances, food availability and lifestyle changes. Added to this is the change in food consumption patterns. With the fast pace of life, many people are relying more on foods prepared outside the home, such as takeaways, fast food and restaurants. These foods are often convenient, but they also tend to be high in calories, saturated fat, added sugars and sodium, and low in essential nutrients such as vitamins, minerals and fibre. In addition, they can contribute to weight gain and related health problems. This way of eating is very in common in certain countries. However, in Spain, it is more common to eat home-cooked meals. As an English Speaking nutritionist my task is to adapt your foods to similar ones to make them as healthy as possible.
There are also several common mistakes people make when eating. Here are some of the most common ones:
Most common eating mistakes
- Eating too many processed foods: Processed foods are often highly palatable, tasty, but high in calories, saturated fat, sugars and sodium, and low in essential nutrients such as vitamins, minerals and fibre. Eating too many processed foods can contribute to obesity, heart disease, type 2 diabetes and other health problems.
- Consuming sugary drinks instead of water: Sugary drinks such as soft drinks, fruit juices and energy drinks can be a major source of empty calories and added sugars. Opting for water instead of these drinks can help reduce calorie intake and improve hydration.
- Eating fast and distracted: Eating quickly and without paying attention to hunger and satiety cues can lead to overeating. It is important to take time to savour food and be aware of when you are full.
- Not paying attention to portions: Many people are not aware of proper food portions and tend to overeat. This can lead to unwanted weight gain and make it difficult to control portion sizes in the future.
- Not including a variety of foods in the diet: It is important to consume a variety of foods to get all the nutrients needed for good health. By limiting yourself to a few foods or food groups, you run the risk of not getting all the essential nutrients. For a complete diet we should eat at least 20 different foods a week.
- Skipping meals or extremely restrictive diets: The belief in wanting to be in line with current beauty standards leads many people to believe that skipping meals or following extremely restrictive diets is the quickest way to lose weight. However, this can lead to nutritional imbalances and long-term health problems.
- Relying too heavily on supplements: Supplements can be helpful in certain situations, but they should not be used as substitutes for a balanced diet. It is important to get the majority of nutrients from food rather than relying exclusively on supplements.
Fortunately, in recent years there has been an increased awareness of the importance of a healthy, balanced diet to prevent chronic diseases such as obesity, type 2 diabetes and heart disease. This has led to increased interest in nutrition and greater availability of information on healthy eating habits.
How to improve our diet
There are several ways to improve the quality of our diets and eat healthier. Among them are:
- Incorporate more fruits and vegetables: these foods are rich in vitamins, minerals, fibre and antioxidants, and are fundamental to a healthy diet. Try to include a variety of different coloured fruits and vegetables in your daily meals and snacks.
- Choose whole grains: Opt for whole grains instead of refined grains to increase your intake of fibre and nutrients. Choose whole grain products such as brown rice, whole wheat bread, whole wheat pasta and oatmeal instead of their refined versions.
- Eat lean protein: Lean protein sources such as chicken, turkey, fish, tofu, legumes and low-fat dairy products are excellent choices for healthy eating. Try to limit consumption of processed and red meats, which can increase the risk of chronic diseases.
- Limit consumption of processed foods and added sugars: Reducing your intake of processed foods, such as packaged snacks, fast food and baked goods, can help you reduce the amount of added sugars, saturated fat and sodium in your diet.
- Cook at home more often: Preparing meals at home allows you to have more control over the ingredients you use and cooking techniques. Try to cook with fresh, healthy ingredients and limit the use of unhealthy oils, fats and seasonings.
Making better food choices is fundamental to maintaining a healthy and balanced diet. As a nutritionist, and specifically, as an English Speaking nutritionist I try to help people adapt their meals to their lifestyles while respecting cultural aspects as well as food preferences. Many times in my practice I find that people have barriers to, for example, finding certain ingredients that are very important in their culture, or that meal times are very different.
It is not always easy, but in my practice, I always try to help plan meals in advance so that we can make more conscious and healthier choices. Spending time each week planning menus and making a shopping list with the necessary ingredients makes our lunches and dinners more beneficial for us.
Once the menus have been drawn up, which should prioritise fresh and unprocessed foods, we should also read food labels. When buying processed foods, it is important to read labels for nutritional content. Pay attention to the amount of calories, saturated fat, added sugars and sodium contained in the products. Usually fresh and unprocessed foods (fruits, vegetables, whole grains, lean meats, fish and low-fat dairy products are excellent choices for healthy eating).
It’s not just a matter of meal planning but also portion control. Pay attention to portion sizes and practice moderation when serving yourself. Use smaller plates, share plates in restaurants or save leftovers to avoid overeating. Just as it is not good to eat 3 plates of pasta, it is not good to eat 3 oranges in one sitting.
Finally, drink water instead of sugary drinks. What you eat is just as important as what you drink. Water is the best choice for hydration and contains no calories or added sugars. Opt for water instead of sugary drinks such as soft drinks, fruit juices and energy drinks.
It is important to be aware of these mistakes and try to avoid them in order to maintain a healthy and balanced diet. By following these tips and gradually making changes to your eating habits, you will be able to make better food choices and enjoy the long-term health benefits. Remember that the key is to adopt a balanced and sustainable approach to eating. As I say in consultation, there has to be time for everything. To eat well and also to indulge from time to time. It’s OK to eat something less healthy from time to time, but be aware that you can’t overindulge.
About the author:
Adriana Martín is an English Speaking clinical nutritionist at Sinews. She treats adults, adolescents and children seeking to improve their health through nutrition. She specialises in public health and also treats ED, SIBO, chronic diseases and other pathologies, as well as muscle mass gain or weight loss. Her approach is not to prescribe closed menus, but to make people understand the importance of nutrition at every stage of life through different tools.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
The Shonagai philosophy: The power of acceptance in the face of difficulties
We live in the era of «chaos» forgetting our wallet, being stuck in traffic or our battery discharged can make us go into an emotional outburst. These situations beyond our control are part of the stress we face in our day-to-day lives. The ability to remain calm in the face of what we can and cannot control is fundamental to preserving a healthy mental and emotional well-being. Faced with this, in Japan the concept «shou ga nai» was born, which in our western version would be «what are we going to do». It is very easy to say, but how can we integrate the concept «shou ga nai» in our lifestyle?
Get to know the concept of "shou ga nai"
From the Japanese philosophy comes the expression «shou ga nai» part of a philosophy where many of those who practice it, recognize it as «the secret of happiness». The Shoganai philosophy has its origins in Buddhism, therefore, it reflects a style of coping from the acceptance of circumstances that we cannot control.
This ability to maintain serenity in the face of difficulties does not deny our emotions, indeed, it does not focus on the conformism of our reality but preserves our efforts to change that which we can transform. This direction of our energy is a great protective factor when considering the disease of the 21st century: stress.
This refreshing new perspective brings us a new coping strategy that takes us away from cognitive rumination, automatic thoughts or paralysis by analysis, to bring us greater peace in our daily life situations and in which we can find a point of support, to look at our concerns with a broad outlook.
The integration of shonagai into the western world
The Shoganai philosophy is based on the pillars of mindfulness, where the importance of living in the present is recognized, moving away from «what I could have done» in the past or «what I will do» in the future. This concept has been tried to be transferred within the Western world as (it is what it is) in English or the popularly known (C’est la vie) in French. In other languages such as Icelandic we find (Petta reddast).
Beyond the globalization of the concept, the real key to this philosophy lies in its integration into our daily lives. In the Western world, it may seem fatalistic or pessimistic to «throw in the towel» in the face of difficulties. The key has been practiced by the Japanese, who focus their efforts on respect and acceptance of good and bad cycles as part of the way.
This philosophy makes us see beyond the concept, a lifestyle completely removed from western standards of «productivity» and how little we are allowed to «stop». We can find different translations of «shou ga nai» but sadly it is very far from our integration in the face of difficulties. A good starting point to establish a new cognitive reframing in the face of difficulties focuses on the differentiation between: «Conforming» as a reactive attitude while «Accepting» is a mature and proactive attitude, which translates into emotional stability, a sense of inner control and self-knowledge.
How to practice the Shoganai philosophy? Here are 4 simple steps for its integration
Take an instance of things
Before starting to analyze a situation, it is key to take a step back and try to find a moment where our emotions are more settled. When we all receive bad news, we are flooded with negative and even catastrophic thoughts, we tend to put ourselves in the worst, going into a state of alert as a strategy of preparation for danger. A vital tool that can help us in practice is the puppy metaphor:
«We have a puppy and we see how it does not stop sitting on our sofa, chewing the cushions and even begins to leave us some gift around the house … through this metaphor, we will see how we will see how we sprout frustration and anger to have our house impeccable, however, we must be patient and focus our efforts on educating the puppy, since a scolding would not help us at all.»
Identify which are and are not in your control
Once the metaphor has been put into practice, we will begin to analyze those things that have disturbed our routine and have led to a state of chaos in our order. Before their appearance, we will take enough perspective to establish a critical judgment. We will differentiate between: Can I change it? Yes, we take action. Can’t I change it? «In this case, we should accept it and save our energy.
Practice gratitude
Gratitude is a crucial part of integrating this philosophy, so that when our efforts are focused on the things that inspire gratitude, we encourage the development of a positive attitude. In the term this attitude refers to the cultivation of our resilience as a tool for adaptability in the face of difficulties. In addition to this, an attitude of serenity in a «calm mind» makes us find new solutions in situations we had not previously contemplated.
The more practice, the greater the mastery
This type of strategies, like mindfulness, do not try to be established with a goal of hours of practice. The key lies in its frequency, i.e., if you have 5 stressful situations during the day and you practice these simple steps in the 5, you will be training the mastery of the flow of thoughts, seeing how they become less and less present and that you have much greater awareness and control over your emotions in front of these. This continuity of short time and high frequency is what really works our ability.
Know the 5 Benefits for your mental health through the practice of the "Shoganai" philosophy
- Reduce your cortisol hormone: As the hormone responsible for stress, cortisol is produced by our body in "emergency" situations in order to cope with those situations that are out of our routine. Cortisol is as necessary as any other hormone, since it is indispensable for those situations in which we are in real danger. However, its prolonged maintenance can be detrimental to our health, promoting emotional irritability, lack of sense of humor or provoking emotional outbursts of anger or sadness. Beyond this, our quality of sleep or our immune system is weakened by this continuity. In view of this, the practice of the Shoganai philosophy can reduce our reactivity to stress and thus establish a correct regulation of the hormone.
- Increase your ability of resilience: Resilience is one of the most important skills when facing the challenges of our life, and is that, bring serenity is also focus your inner energy to listen to you, understand you and especially recompose yourself from those setbacks that assail us without warning. The absence of this ability can cause fear or loss of control to paralyze us, leading us to a state of obsession or rumination of our own thoughts. It is clear that resilience will not make our problems disappear, however, it gives us the ability to see beyond them, to continue and to appreciate the good despite the difficulties.
- Improve the stability of your emotions: The Shoganai philosophy leads us to a greater state of consciousness by focusing on the acceptance of the present, that is, to focus our strength on what we really have, in order to be able to modify our reality. This makes emotions that lead us to frustration move away, establishing a greater mental balance and learning to manage those that appear to us with relativity to the facts.
- Promotes Self-knowledge: The practice of Shoganai leads us to a state of resignation which brings us to an encounter with our emotions, this encounter from the acceptance gives us a deeper understanding of ourselves and the recognition of where our limits of will are, being more aware of those things that predispose us in that state of alertness. This self-knowledge is a key ability to know how to work in these stressful situations.
- Improve your attention span with creativity: Controlling your focus of attention directly improves the quality of your attention. The Shoganai philosophy, not only helps us to establish this control, but, with the acquisition of this, we find new solutions through creativity. This valuable quality, as experts say, is blocked in those situations where there is an overactivation of certain brain areas. When we approach problems from worry or pressure, our brain goes into a "state of alert" trying to solve situations quickly and automatically and therefore limiting our ability to find creative solutions.
The importance of lifestyle for wellness
Having learned about the many benefits of this innovative philosophy, it is essential to recognize its practical application in order to integrate it as a pillar of our lifestyle. The concept of «shou ga nai» may begin as a simple expression, but it has the power to transform itself into a new way of perceiving life and every circumstance around us. Its adoption is not a passive process, but requires active commitment, willingness and awareness. However, the efforts invested in its practice bring us the peace and mental balance essential to face daily challenges with serenity. Now, I ask you: Are you willing to immerse yourself in the practice of the Shoganai philosophy?
Written by:
Paula Taguas Labrador
Sinews MTI
Psychology, Psychiatry and Speech Therapy