Regaining a sense of control

A glimpse of what some individuals with psychological conditions live with may include, overwhelming sadness, a sense of worthless, hopelessness, debilitating anxiety, hyper- or hyposomnia, depleted energy, mania, low motivation, guilt, nightmares, avoidance and potential suicidal ideation…

A concern frequently expressed by individuals suffering from a psychological condition is the limited understanding people have of what they are experiencing and how it would be simpler if it were a physical injury that is obvious to the naked eye, often referring to a broken bone. 

Unlike a physical injury, which more often has defined medical recovery timeframes, psychological conditions can be lifelong, at times undiagnosed and their course erratic. 

As an occupational therapist, this makes any reported or observed progress in those I work alongside with psychological conditions, all the more enthralling. 

The challenges experienced are real, individualised and can be debilitating and overwhelming. For those without a psychological condition, consider the impact of being unable to get out of bed even though there is no physical limitation, not being able to manage your emotional response of day-to-day activities or being so anxious that you are unable to attend your workplace. Comprosition’s Content Developer Maggies Young’s article ‘Colour the day’ provides further insights into these experiences.  The progress of those with psychological conditions may not be fully grasped by onlookers, where one has not developed the understanding of how incapacitating these can be:                    

It may be someone getting out of bed.

It may be someone making breakfast.

It may be someone grooming.

It may be someone making a phone call.

It may be someone going for a walk.

It may be someone driving in their car.

It may be someone going to work.

It may be someone engaging in a high conflict conversation.

It may be someone applying for a job or attending an interview.

It may be someone attending their treatment provider.

If you are a loved one, colleague, or employer of someone who does have a psychological condition, begin to recognise how significant and lifechanging this progress can be; a step towards regaining a sense of control.

Treatment of psychological conditions require a holistic approach and are often effectively managed through a biopsychosocial approach and supported by physicians, psychologists, psychiatrists, loved ones, community, support networks and employers. 

For a person living with a psychological condition,  they are a key player in their own treatment.  Utilising assistance where required (objectivity can be beneficial), they can begin to practice the skill of establishing specific, measurable, attainable, realistic and time-based goals. There is no required costs involved and one can simply use their mobile phone or physical calendar, a post-it note on their bathroom mirror or fridge, their diary / notepad - having this visible and front of mind. One’s goals will vary in content and complexity, dependent on their distinct challenge and comfort with goals setting; initially keep it simple. Examples of goals could be:

‘to get out of bed by 8.00 am on weekdays,’ with consistent achievement increasing to

‘to get out of bed by 8.00 am and not return to bed until 8.00 pm on weekdays’ or once improving your ease and skill of goal setting 

‘to respond in writing to my managers email addressing performance concerns before close of business today.’

It is best to limit the number of goals you set, to those that are realistically achievable; it would usually be recommended to restrict this to up to three goals at any given time. This gives one the best opportunity to set, strive towards and achieve their goals.

Ask someone reliable to be an accountability partner on setting and establishing your goals.

This is often the role, as an occupational therapist, I am invited to share in. For those partnering on this, ensure the nature of the goal itself is directed by the individual, as this brings meaning, engagement and a greater sense of achievement. For example, if the goal was directed by you, you may set a goal for them to vacuum the floors, but their goal may be to cook a meal; achievement of the latter is far more realistic given it is self-directed. When goals are effectively established and actively worked towards it can provide progress, engagement and hope. Goal attainment can be life changing to someone with a psychological condition.

Often individuals with psychological conditions may often feel that their life is outside of their control. Goal attainment allows them to regain more control of how they are responding to a specific area of their life. 

This was apparent for Carly , who developed an adjustment disorder following a workplace bullying incident. When I met her she was very passive, emotional and using the defence mechanism of avoidance in all areas of her life. It seemed that she was waiting for someone to tell her what to do. She received the required bio-psychosocial supports and treatment (in her case this included an employee assistance program, psychological treatment, hypnotics and a graduated return to work plan). As an occupational therapist and rehabilitation consultant I challenged her to take control and do something for herself through establishing a self-directed goal. She did this and chose to start with setting a goal of returning to work for two hours per day and increasing her work hours by one hour per day every fortnight; she was working full time at the time of the initial incident and had temporarily ceased working one month prior. Achieving this goal was so empowering to her and was life changing. She went on to establish self-directed goals in relation to exercising, reengaging with friends and going out with her partner.

Whether suffering from a psychological condition or not go ahead and set that first goal. Make sure it is specific, measurable, attainable, realistic and time-based; remember this is a skill in itself and will take time to achieve. This only comes with practice. If you feel you would benefit from more information and guidance, please link to our master class on goal setting.

Create a habit of setting and working towards achieving your goals and see how you can take a step towards regaining control of your life. As an occupational therapist, I have seen the life changing effects of this practice on so many individuals with psychological conditions and am excited to see the positive and motivating impact it can have for you.