Hello young people and we are back day two. I thought you should also meet the person who was looking at our back end and some of you were saying who's this who's deleting my messages and taking me off. Have a look at that person. Welcome to Mana Ka who is the our support system from the back end. She's an artbased therapist. She's the one who will be putting in your attendance uh link very soon. You write a message which is not very kind. Then she's the one who will say okay don't mind okay bye. And now we have Dr. Mimmansa sing who is going to take the session forward and there is some noise which is happening where somebody's typing who should just stop typing so that I am not distracted and yes hello good evening young future mental health professionals budding psychologists day two of our internship with the one and only one doctor Vimman answer saying that word and yes good evening hello to all of you we will continue our conversation but I thought if you have questions yesterday bring it on if you have questions from where's attendance is not a question I just showed you mana ma is going to give you the link very soon although uh in the part of the world where I am soon may happen in a very very long time oh it happened can you imagine And maybe we'll just think about pinning it also so that you may all not ask is there any attendance or something like that. Yes, there is an attendance and something like that which is our link uh logo theapy. uh so to pick up one particular kind of therapeutic intervention and say that it is either fully effective or not has role or not would probably not the best way to look at it. You will always need to understand irrespective of the kind of therapy you are talking about. The question needs to be based on guidelines, based on evidence, based on the clinical profile of the individual whether something would be more likely to help the person. And that's why you so you don't say CBT is effective. CBT is not effective. That's how you will need to understand this. Do psychology discuss patients amongst themselves like any other profession in the health field? We will discuss at times uh patients maintaining confidentiality because there are so many times you want to learn exchange uh exchange ideas and thoughts because a lot of times you may come across uh situations which may be let's say resistant patients difficult and some of those aspects need to be seen do psychologists analyze themselves u I'd like to believe they don't but then we can always ask uh Dr. Mimmansa Singh Tanver does Dr. Mimmansa Singh Tanver analyze herself or not but I can surely tell you Dr. Sing analyzes all of us right and that's a whole different story alto together uh so do a psychologist get overwhelmed by lots of emotions of their patients um I think the answer would be that it's a part of the training um you are trained to understand emotions and thoughts of individuals and that's how you see this at the same time there may be times when you may feel um some amount of uh let's say distress and that's when you need to decide whether you need to be with uh continue doing the sessions or refer this individual to someone else and you should bring it up in your supervision sessions as well. Do psychologist help train AI for mental health chat bots? Um I wouldn't know. I haven't trained anyone of these chat bots or they would have been doing a far better job. Uh what if psychologists themselves need therapy? Then they take therapy. I mean if I need meds, I will go to a colleague and ask for I mean ask for their opinion. Um would an internist uh not need treatment if they had a fever or would a cardiologist not need uh to take meds if they would have blood pressure? Why would our branch be any different? You were not able to fill the form yesterday. Will you still get a certificate? Of course you will. But if you were not able to fill in the form then uh I just told you it's just a it's just some of those things. It's criminal psychology. Um yes it's it's a field very much. I told you that yesterday how to feel the best field. It's what works for you the best. That's the way to look at it. And and those who have not been able to see the session yesterday it's still very much online and you can have a look at it and that'll be the right way to go about it. Uh yes, music would be a part of expressive art-based therapy. In fact, I we are going to talk about music during this uh series. In fact at our hospital at at um which is Adaiu um which is a fortus network hospital in Gurugra which is a dedicated psychiatry hospital we have music played on by a very very special uh uh individual and a very very talented uh Risha Brikam Sharma and uh his his brilliant sitar for mental health is what plays at at Adayou um and we we do believe that music is um is a can be very very effective as a part of the um holistic work that you do with individuals. We talked about skills of psychologist yesterday as well. But these are skills which can be learned. Do we need to have empathy? You'll need to learn to be non-judgmental. You'll need to look at the kind of communication patterns that need to be had. the one that mimmansa had to teach yesterday because I couldn't read them which is those clarification summarizing and some of those things that they mentioned. So how does one validate a person's emotions? Affirmation, recognition, your body language, your tonality. I understand. Uh the only thing is you will need to be genuine about this. Um it is not like the reactions you have on your social media platform where you just send a reaction of this. It it means nothing. Okay, criminal forensic psych would be the same thing. What are the career options in psychology? Lots of them. Counseling organizations, sport, uh, forensic, child, um, clinical. If there are some I've missed and I have missed them and that's why we have the the the expert here that's Dr. answer who's nodding which means I made a few mistakes but but that's okay right and then smile was the affirmation and validation that it's okay everybody makes mistakes it's it's it's quite fine so that that's what that's what these heads do just so you know I think the scope of psychology is very good in India clinical or otherwise best colleges uh I'm not going to give you names on that uh but I just believe that it's it's a combination of the self and the environment I I Don't subscribe to the idea of best this or best that in in this wide world with full of diversity and uniqueness. You really can't compare A to B. In my opinion on criminal psychology, it's an important branch and it's only going to grow in years to come. Can I be my own therapist? Uh no. Even my narcissism would not allow me to be my own therapist. >> >> doesn't apply to Mimmansa but uh I I wouldn't be able to it's okay keep a bit of humor in your life it's fine neurosychology the psychology of the interface of psychology and neurology so your executive functions your neurocognitive aspect work done in in for example in cognitive impairment uh ADHD those are areas where neurosych has a significant role to play. Can people with uh anybody who goes through the rigors of any branch and goes through the academic process and then goes through the experiential learning can be a good expert in that particular branch. uh to pick up uh psychology as a branch and say that because person would have had AB or C or D illness that makes them unfit would be stereotypical and unfair. How much does a well experienced psychologist doesn't tell me but I think the with all the all the the room that she has and given that I have and she has we can surely make out that psychologist well is it true that sensitive people cannot be good psychologist no it's not true human beings will have some sensitivity I mean that's what makes us human if you uh pin and the prick will hurt. I mean that's being human. Yes, psychology will continue to be in my opinion a very very important field even in this changing world of artificial intelligence. Um the mere fact that you call it artificial and you will need the original which is the human intelligence or the human feelings right? How do psychologist separate their work and personal life? Uh ma'am told me yesterday switch off the phone uh listen to some music, read, spend time with family, friends, uh your interests and you learn to take breaks. I mean I mean unless you work with me but yeah you otherwise learn to take breaks. No, I don't think AI would be replacing the the the human factor. I don't think that's possible. we will need the human. I think in fact I feel that the human component of psychology will become all the more needed given that we are using so much of AI in various aspects of our interface with life that I think there will be more role that you will need genuine empathy and not just an I understand bot psychiatrist or psychology well I'm a psychiatrist Dr. Master Singh is a psychologist. Can you be a neurosych and work in a hospital? Yes. Uh drop in a mail mental health at healthcare.com or you atalthcare.com once your certificate is done and somebody will call you. What's the highest salary in psychology? That's mimmansa salary but we don't know. I think we've had mim has just sent me a message that can you start the session it's or you'll just go on and on and on. So okay fine we'll start the session and we'll request mana.4care.com 94ka.com to give us the slide and we will obviously given that uh you know with yesterday's experience that I'll be able to read only certain slides and there you go even before I could reach the topic my man Mansa wants to get over with the uh Mana wants to get over with the day mana do you mind giving me the first slide also because it's nice to know the topic if you oh so kind I tell you sometimes kindness can do so much psychological intervention. Today we'll learn about therapeutic skills and approaches. Remember the one thing I told you yesterday, therapeutic skills, therapeutic interview, whatever we say do needs to have the therapeutic aspect to it. And now Man, you can change the slide. We talked about the interview yesterday and we talked about the MSE mental status examination. We talked about certain interview techniques. Today we'll be talking about I presume that's why it's orange assuming that you all call it orange because sometimes I've been told there are different uh colors and shades and um so yeah today we'll be talking about the therapeutic approaches which is the expertise of mimmansa new age approaches which is the expertise of mimmansa professional ethics uh I'm a bit particular about it so let's let's start with mmansa >> okay so we will start by First understanding what is psychotherapy. So psychotherapy as Mana will change the slide now is an evidencebased scientific treatment approach where we are working to see how the symptoms and the signs that the patient is bringing in can be reduced by one understanding the kind of emotional behavioral and psychosocial challenges that the patient is facing. Okay. By helping one understand and through the therapeutic techniques and the interviewing that we did the last time, we also understand the the 360 degree aspect of the patient which then allows us to see how can I now use my therapeutic skills to understand one which are the areas that the patient requires help and support so that I can build the right amount of skills so that the patient knows that the areas where they are having a challenge to be able to deal with in their day-to-day life. Whether it is the fact that the interpersonal aspect could be challenging, conflict resolution could be a challenging, the fact that one may be having a lot of anxiety in a social situation. All of these aspects can be dealt with the kind of skills that we work on. the evidence-based approach that we take in our therapeutic treatment so that the patient is able to develop the skills and that helps them promote a positive self-growth. So psychotherapy helps you to build growth by learning the right skills where there is a challenge and at the same time reducing the symptoms when in a safe therapeutic genuine empathetic approach the non-judgmental approach that we take to help you understand how to work and what are the triggers and how can we help you u deal better with the emotional conflicts that you're having as a result of the change that you're having and undergoing. >> So I think the more important thing if I was to say let's focus on the fact that this is a science and there is evidence and there is a process. It's not random. It's not anecdotal. It's not uh in my opinion or but I feel so it's a science and as buologists this is something that we must uh all of you must keep talking about because you will find people who will say like yesterday when we were talking about the myths uh can my friend do my counseling can anybody do counseling can anybody everybody can give advice but counseling and therapy are for the experts And so now we go on to understanding what are the various therapeutic interventions that we are going to talk about today briefly that a lot of psychologists like myself use in our practice. So there's a process to it like Dr. Parik said that it's not something that we just do like any other talking that you have with your friend or family but it requires engagement. It requires genuine empathy. What we spoke about in terms of the clinical diagnosis and understanding through our interviewing process. How do we assess? what are the goals that we establish along with the patient to see what is the treatment process that needs to follow and even after that so we see what is the follow-up care so that there is a relapse prevention so over here in psychotherapy we are looking at how we are going through this entire process from one starting from when the patient comes in to the fact that even after the treatment is over How do we look at at follow-up care? Which means that the patient reaches out to us whenever they require help and support. Let's say if the goals and the treatment has stopped. >> So before you continue, I'll just answer a few questions. Um combined treatment. Combined treatment would mean medicines plus therapy. So there are some conditions where you'll need to use both meds and therapy. Some conditions when only meds may be enough and some conditions where only therapy will be enough. It's not a must that you have one, you must have the other. That's not how it works. Right? So, I'm just answering these couple of questions that you mentioned. Okay. I think Mansa you can continue please. So this is just the names of some of the um therapeutic interventions that we are going to discuss today. We'll start with the one that is most favorite for all of us. Fro psychoanalytical psychotherrapeutic approach. One of the approaches that also came in quite early. Uh yes somewhere around the time of behaviorism as well. Um but yeah what do we do in psychoanalytical psychotherapy approach? We focus on the unconscious. We focus on the thoughts. We focused on past experiences. And that's where yes Freud played a significant role in developing psychoanalysis and from there on many modern age psychonamic approaches that also came in and we are going to talk about and first understand what is the timeline Mana. So first is yes sigman Freud who's also known as the father of psychoanalysis and spoke about some of the key aspect that we are going to look at the techniques in psychoanalytical psychotherapy. Then there was KL Jung who spoke about the collective unconscious the enema enemas approach the shadow all of that that we've heard uh in our psychology textbooks which I'm sure all of you are learning at this point in time Melanie Klein who played a significant role in developing the object relations theory which means if my parent is part of the environment and is also an object in the environment how do a transition from parent environment to a school environment. So, object relations theory. Anna Freud spoke about psychoanalytical child psychology and psychotherapy and was also um someone uh very significant spoke about play therapy uh and brought in the aspect of play therapy which is again used in art based uh expressive arts form therapy a lot. Then we have Eric Erikson who spoke about the theory of psychosocial development and the eight stages that we all know and I'm sure all of you are learning about that because they are still quite significant today in today's time for us to be able to understand how do we come out of uh the first stage and then we go on to the next and the identity diffusion that happens at the age of identity development and that's when we are struggling with our low sense of self-esteem. So sticking on to psychoanalytical psychotherapy, what are the basic principles of psychoanalytical psychotherapy? So what we look at basically is we've all heard about the id, ego and the super ego. It meaning our pleasure principle which means anything that we enjoy, anything that we like for our immediate instant gratification and our smartphones and the the world of social media playing on our ids a lot more than our ego and the super ego where the super ego is our morality principle. The morality principle which is what the society needs to be playing on but is certainly somewhere missing in today's time. And then the ego aspect which which is where we look at the good self-esteem and a good sense of self which helps us to navigate both the morality and the pleasure aspect in terms of how can we approach things in a much more mature integrated way and it's when there is an issue or a challenge that a patient is facing unconsciously in some of these aspects is when our defenses are playing in. And that's where we have defense mechanisms. So psychopathology and psychoanalysis is rooted in our early childhood experiences that we have with our significant others. And over here the significant others would mean our parents, anybody else in the family, in school, with our peers, our teachers and again anybody else who uh plays a important part in our formative years. So early childhood experiences and from there understanding the awareness of the unconscious conflicts and the defense mechanisms that we tend to use so that we are able to integrate ourself and cope better with our day-to-day challenges which means there is a lot that goes on which is which sits out of our awareness. We may not be aware right now that there is some form of stress or our pattern around interpersonal relationships with the way we react to our peers with the way we feel about ourselves in a social environment might be playing on as a result of an experience that we have had that you may have had uh in the family or you may have observed in the family and as a result of that that unconscious conflict is not allowing you to actually go past the challenge that you're facing in your interpersonal relationship. And that's why the defense mechanism where we tend to displace. You may be angry at someone, but your inability to talk to the authority or express your anger would lead to a dis being displaced on let's say a friend or your sibling who's younger to you because it's easy for you to get angry at them. So that's how our defense mechanisms um operate. So that's the basic principle for psychoanalytical psychotherapy and what are the techniques that are used free association which means we ask the patients to just start talking about whatever that comes to their mind. It could be something from the childhood. It could be something from the present. It could be something related to uh parents. It could be something related to an episode that happened with a friend. So that's free association. Transference is that in that therapeutic process when the patient begins to project some of those feelings and start talking about those feelings and project it onto the therapist that is transference for you. And the therapist's role is to understand those emotions and help the patient work through that emotional conflict that they're experiencing. So let's say you are angry with the parent and you're unable to resolve that because of course over here it's difficult to sort of be able to go to that authority figure and say that I feel upset about these things because they tend to feel a lot more upset with you and have a certain very authoritarian approach towards you. Now over here that anger which is suppressed which you're unaware of would get played out in a therapeutic setting and that's where the transference happens that where the patient feels angry towards the therapist maybe because the therapist was being a bit strict about the timing or something else that came in as a part of the therapeutic session and this is where the role of then the defense mechanisms comes in. So if the patient is angry and the then patient stops responding or conforming to the therapeutics uh uh to the timings to of the session because the patient feels angry and the patient stops responding there. So that is avoidance as a defense mechanism which is being used and we'll go on to some examples for that. Yes, pre analysis has also been a part of psychological psychotherapy. uh but if you've read about Freud's work then Freud after some time also said that dream analysis is way too subjective for us to come to any conclusive understanding but yes uh since Freud has written an entire book on dream analysis is it's interesting and it's good to read about uh what our texts and Freud says about dream and its interpretations and then there is resistance resistance Meaning that there is a difficult memory or an experience that we've come in in our therapeutic setting and approach in our treatment approach and the patient is now resisting to sort of talk about it and overcome it. Yes, nightmares can also be a part of uh unresolved conflicts that can happen. Nightmares also happen particularly in post-traumatic stress disorder which we're going to read about tomorrow. Dreams, yes, are part of our subconscious mind and a lot many times when you just try and understand your dreams, you will see it's just a a symbolic representation of what may be stressing you out in your day-to-day routine or your day-to-day life. So let's say for example there is a 17year-old person who is having difficulty trusting their friends feels or fears that they will be ignored and so there is emotional withdrawal after arguments they find it very difficult to sort of talk to the to their friends and resolve certain conflicts. So the moment that there is a conflict situation happens they want to not confront the friend or the person and so they withdraw. So after a fight with the close friend A says people always eventually tend to leave me so I stop getting attached. I don't want to get attached to them. Now over here the goal is to explore what are some of these past experiences that would have affected their present relationship and the reason why a person avoids talking about their emotions in a conflicting situation. And this is where then the role of defense mechanism and understanding those def defense mechanism comes in. Yes, avoidant attachment is a certain kind of an attachment style where you tend to avoid uh the attachment figure and that's how you tend to play it out in your relationships which are closer to you that the moment there is a confronting situation you tend to avoid. A situation where you feel a certain sense of pressure you may avoid. a a situation where you feel pressure of responsibility you may avoid. So we may say that yes whatever comes to your mind please feel free to talk about it and what the person talks about is relationships with friends in school and then remembers there's certain episodes that happened during younger school years and then from there some past memory where they felt left out in the middle school something may have happened over there and they feel felt that they were isolated they were rejected. And so the fear of rejection just continued to keep uh that the patient continued to keep feeling uh that feeling of rejection and the fear that came around it. And as a result of it, it affects the ability to trust in relationships even today. And also the fact that if they will express themselves then that may lead to somebody blaming them for having those emotions towards them. That's also something that the patient can feel. So over here the free association helps you uncover a lot of these things. So when discussing painful memories, one may say it wasn't a big deal. Again, this is a defense mechanism. Resistance is there. Avoids the next session. There's a difficult scenario that came in and so it felt emotionally threatening to the patient and the therapist over here tries to work around how with their own calm presence and an empathetic understanding they would allow them to deal with the resistance which can show up in forms when patient misses your therapeutic sessions without informing or keeps changing and changing without giving you a reason. So that's also a form of resistance. So that's just an example where the patient may feel that yeah I'm I thought maybe you'll stop caring too. That's a thought and that's something that came to my mind because that's what I felt because I was feeling angry in the session and so that was transference. My anger towards you made me feel that you may just eventually leave and stop caring and disconnect. And as a result of that transference that the patient started to avoid and this is how we try and work on the trans feelings that come in as a part of the transference and the defense mechanisms. So what are some of the defense mechanisms? rationalization and these is just example of some of the defense mechanisms which are psychological strategies that the patient uses to deal with conflicting internal conflict that they experience in a psychical way uh psychological way. So rationalization could be one where one would say well in any case I don't need people I don't need friends in my life that's one thing denial this means that experiences have never affected me that's not how when I deal with situations projection where you tend to blame others for the emotions they themselves feel that it's not me it's you who's feeling angry humor is a mature defense mechanism yes repression also happens where we consciously try to repress something and if Mana can help me go forward because defense mechanisms is something that we've spoken about and there are a lot more defense mechanisms that you would read if you go back into understanding a little more on the psychoanalytical psychotherrapeutic approach. Uh next is a behavioral therapy where you would have learned about the pablo experience classical conditioning operant condition conditioning. So over here the focus is on the behavior that is learned and can be changed. Yes, Watson was the one who developed behavior therapy. Then cave Pavlov who gave classical conditioning uh the famous rat experiment where you would the experiment in which you would keep the the food for the rat and then ring the bell. uh the operant conditioning over here that was given by Skinner and the Albert Bendura's uh experiment over here which is social learning theory on behavioral modeling uh specifically the Boba doll experiment if you've heard about that uh that's again your Bura's experiment on social learning So what does behavior therapy talk about? One that all the behaviors are learned and are conditioned as a result of how we interact with our environment. Which means if let's say I've had an accident on the road and that accident now has become that memory and an association that place has created that association for me where the moment I cross that area I do tend to You forb Um yes I am facing a little bit an issue with my am I audible now? Okay. And over here then we look at what are the reinforcement techniques which means the behavior therapeut uh behaviors which are influenced by positive and negative reinforcement. Um which means that the moment I give a certain kind of a reinforcement a positive reinforcement let's say you are a good person that's that's a positive reinforcement. you did your work today and I uh verbally give you a positive reinforcement or I give you a reward. That's a positive reinforcement. Negative reinforcement is something like a punishment which is used as a negative reinforcement. Extinction is also a kind of a negative reinforcement in which you remove the stimulus or you remove the positive reinforcements that you were giving to the person. And that's how we tend to use positive and negative reinforcement specifically uh when we use it in the classroom. Is my voice still cracking or is it okay? Okay. Right. So, going back to how do we uncondition? Unconditioning happens when we pair it with something uh which is a a completely neutral stimulus and so that we can get a desired response or let's say a change. Now let's take an example of um phobias over here and I was giving you an example of I went through a road and there was an accident over there and now there is an association and a conditioning that has happened as a result of um the fact that I felt anxiety and I felt fear because there was an episode of accident that happened in that particular space. Now one response would be I start avoiding it as a part of the conditioned and the association that has developed. The other is that slowly and steadily with somebody along with me which is again a neutral stimulus. uh I expose myself to that place and at the same time I continue to breathe and I and I just try to be as calm as possible and keep exposing myself to that particular area slowly and steadily with some interval and that will help me to uncondition that kind of response that I'm having to that particular area and the place of the accident. So that's how we response. So the techniques that we tend to use in behavior therapy and behavior therapy is particularly used in phobias is one relaxation techniques which is your Jacobson u muscle progressive muscle relaxation where we are from top to bottom or bottom to top. we tend to tense our muscles and then release it while we continue to keep breathing in and breathing out. guided imagery where you guide the patient to think about an imagery which is positive for them and you don't choose that imagery because we don't know what kind of an association that the patient may have with that particular image but you allow the patient to choose it while you're doing guided imagery along with that breathing as a form of relaxation invivo exposure where there is a direct exposure to the feared object so the example that I gave you was an example of invivo exposure Which means if I have fear of lifts then I am going to expose myself slowly and steadily to the lifts so that uh my claustrophobia can be handled and that is again then paired with relaxation techniques. Systematic desensitization it's a technique which is used particularly uh when it comes to going to the school for the first time. So all the schools uh when in in in nursery and primary and pre- primary or play school they tend to use systematic desensitization because for a young child being in a safe environment and at being at home to a new environment rather than making them attend school for the whole day long. It is then through systematic desensitization starting from one hour then two hour then three hour having a parent then not having a parent that's how the child is transitioned from a home environment to a school environment where the principle of systematic desensitization is applied. So phobia is something that we fear intensely with from one particular object. Trauma is an episode that would have happened uh that creates a certain kind of an emotional and a cognitive change for you. Uh traumatic post-traumatic stress disorder and what are specific phobias? We are going to read and learn about that uh tomorrow uh in our session on understanding spectrum of clinical disorder. So let's say N has phobia of dogs and because of this N avoids walking to the park streets and whenever they are confronted by the dog the one N tends to experience a lot of panic attacks. So as a part of the systematic desensitization, the therapist is going to first help and learn some relaxation while also in the guided imagery part expose them uh two different scenarios in which they are going to imagine being around the dogs. So first it's done in an imag imaginary way using relaxation pairing it with relaxation and then slowly taking them to situations in the environment where they would be exposed to scenarios where there are let's say dogs. So that's invivo exposure and that's how from a controlled environment one goes into an experimental environment or real environment rather and that's how we deal with phobias. So phobias lead to what? It leads to avoidance of behavior. Through desensitization we try and bring in relaxation. Gradual exposure helps us to reduce anxiety and first it is done in a safe and a controlled environment and slowly we bring in and pair it with the real environment in a long-term slow and steady way so that there is a coping mechanism which is built well enough in the patient. Now we go on to cognitive behavior therapy. One of the commonly known therapeutic forms which are read by people and a lot many times patient comes to us and say are you doing cognitive behavior therapy or not even though in our own therapeutic style we are doing cognitive behavior therapy but it's not always in the way how you read it in the books because when I'm asking those questions I am trying to help and understand what is the thought process what are the negative thought uh patterns that you're having how it is impacting your emotion and as a result leading to a certain behavioral change. So in my own therapeutic style in my own therapy session and um like my likewise with other psychologists you would see that they're applying cognitive behavior therapy but you may not always know how it is getting applied as a patient. So rational emotive behavior therapy was given by Albert Ellis, one of the key pioneers who spoke about automatic thought process. Aron T. Beck. Uh in fact he spoke more rational about the irrational beliefs and the emotions that are uh that patient experiences as a result of the irrational beliefs. Aaron T. Beck was the one who spoke about automatic negative thought process. So the basic principles of uh CBT are one the role of our thought process, the way we think, our ideas, our thoughts, our beliefs, how we tend to maintain them and maintaining of those thought processes leads to certain kind of a condition or even approach to to whatever challenges that we are experiencing. So if my belief system is that I am not good enough, if my belief system is people don't like me and people are not going to like me. So in a so social scenario I may begin to experience a lot of self-doubt. I may also engage in frequent conflicts because I may feel left out that may lead to certain kind of an anger episode sometimes or the fact that the feeling of rejection may come up so on and so forth. So that irrational belief which is absolute and dogmatic becomes an interfering factor. I should be smart and intelligent. I must always never make mistakes. I can't have this kind of a weight. All of these things are irrational beliefs. So anything that has a shoulds, must can't which is not becoming applicable or is leading to interference in your day-to-day routine is an aspect of um an irrational belief or a belief which is not working for you. Now cognitive triad is an important aspect over here. Again it's about the view that we tend to hold about the world, about oursel and about the future. It's also an important part that you read uh and learn about when it comes to depression and that's where cognitive behavior therapy also first came in as a form of treatment for in depression. Cognitive distortions these are some negative thought patterns and cognitive errors that we tend to make as a result of the fact that they are mispersceived. So fact is fact but we tend to in our own perception misperceive that fact and interpret it in a way that it confirms to our irrational belief than actually it being a fact. And this is where again why distortions happen. So a desire desired behavioral change will be achieved when we are making a change in the cognitive process and that's where we work on the cognitive change so that a resultant behavioral change can happen. So in behavior therapy you work on the behavioral part in cognitive therapy behavior therapy you work on the cognitive cognition and the cognitive part. So cognitive distortions all or none thinking which means black and white thinking either have to either it has to be perfect or I shall not do it. Either it needs to be great or I shall leave it in the middle. Overgeneralization, it's never going to happen. People are never going to like me. Blaming. It's because of them that I feel angry. It's not me who tends to feel angry. I don't have and I don't experience anger in me. Others bring in anger in me. personalization where anytime you feel that something is connected to you and as a result of that um is why things are not working out. So two people may be talking about in a group your friend may be talking about to another friend about somebody else but you may feel they're talking about you. Your friend may be giving you an example of somebody else and how somebody else upset them and you may start to believe that maybe in a certain point in time you also did something similar and so the friend in an indirect way is actually talking about you. So personalization catastrophizing nothing can be worse than this and the the situation could be something very small. Um or let's say you may have a cut and you may feel oh my god I don't know how I'm how am I going to walk tomorrow. So again catastrophization in your thought process jumping to conclusions which means you jump to a negative conclusion because we are thinking and our thought pattern is negative. So a lot many times we do tend to jump to conclusion which is more closedended and has a negative connotation to it. labeling and mental filtering. Again, when we tend to label people and uh when we talk about mental health disorders, again, there's a lot of labeling that happens over here. The kind of words that we use and the way we tend to use uh diagnosis as a means to label people again leads to a lot of distortions and misunderstanding about what mental health illnesses are. and mental filtering which means selective uh picking up of the information what you think would suit you you would pick that and you filter the rest so the cognitive trial over here we look at the thoughts with a negative thought you would experience a negative emotion which means if I am feeling that my friends don't love me that yes my emotion would be sad my emotion would be I'm feeling disappointed I am feeling um alone, isolated and as a result of that I will keep myself isolated. So I will um avoid going in a group. I will not talk to someone. I will not pick up my friend's call because somewhere this thought process is consuming me and my mood is not letting me then take the initiative to actually pick up the call and speak to them. So this is your cognitive triad. All these three have an influence on each other. So let's say this is an example. You have to present in the class and you're worrying that people will judge you and as a result of that you feel anxious you feel anxiety and so you start to make excuses and you want to avoid presenting in the classroom. Now the techniques over here will be let's say for example first identifying the negative thought pattern which is that people will judge me is a negative thought pattern where does the feeling of judgment is coming in over here again one would try and understand that part act uh cognitive restructuring using some of the techniques and we are going to go on to that for the next slides how we are going to work on these negative thought patterns over here. Blaming is when you tend to blame others for the problem or what you have done. Man, you can go on to the next slide. Personalization is when you feel everything is connected to you. Somebody is talking about something else, is giving you an example of something else, yet you feel somewhere it's about you. And a lot many times we tend to feel that it's something negative which is being spoken about me. Indirectly somebody's telling me about me or directly somebody's trying to say something about me. Now over here if the presenting concern is anxiety before the presentation you have a fear of judgment. You're already overthinking about the negative evaluation of the others. So the thought process is people will judge me. As a result of that my behavior is what? I'm going to avoid participating and I'm going to skip the practice. So here as a result of that now first we'll work on identifying the negative thought pattern. Catastrophizing is if I do this and if I present in the class I know I will end up making a fool of myself. So the fear that people will judge me and I will make an error will lead you to think it in in a big negative way that I know people are going to laugh so badly at me that I'm going to make a fool out of myself. Overgeneralization is something like I'm a failure. It's like a generalized belief that you tend to carry within yourself. As a result of this the negative thought pattern is maintaining. So my overgeneraliz overgeneralized belief system is I am a failure. I am incapable. I am incompetent. And this belief system is now being operating in every scenario that I am in in my academics in my social relationships. And as a result of that it is influencing my emotions and my behavior. So critic questioning which means over here we are going to ask you to test the evidence of this negative thought process. So over here we are asking you to critically think and evaluate the accuracy of this belief. So as a result of that what am I going to ask you? Okay give me the evidence to support this thought. When is the last time that people actually laughed at you? And judgment is again a part of people perception where we do not have control over or do you think you have control over? So has this happened every time that you've spoken in the classroom and people have laughed at you? Do you think everybody laughs at you? Do you feel there are one or two people with whom you have a certain kind of a relationship tend to laugh at you? And that's how then you try and bifocate that thought process by picking up evidence to work on why do you think that you are being judged by friends this harshly? Do you also tend to judge your friends this harshly? So sometimes the fact that I also judge somebody else so harshly makes me believe that people are also going to judge me harshly like that. So rather than directly saying oh what you're thinking is absolutely rubbish. That's not how therapy works. We in our own therapeutic style probe, question, challenge the thought, bring in the question to evidence, test the evidence, the fact and then that helps the patient to actually see what is the irrationality over here and where is it that they can work on the emotion part of it, the anxiety part of it. Well, personalization tend to have more of a negative connotation. Yes. But yes, sometimes there could also be a positive one two to it. Uh but because it is an error over here. Either ways what we are looking at that it is leading to an erraneous thought process. So you may be thinking about yourself too highly as well and something that you would again see uh let's say in a manic uh patient. uh but over here when you talk about largely when we look at anxiety, depression, uh personality issues over here then the personalization is more on a negative connotation guided discovery where we are then helping the patient work on building insight. So what you bring in what is the worst case scenario that is going to happen? What is the most realistic outcome out of this? Do you think everybody's going to laugh at you or do you think one or two people are going to laugh at you? Do you think that's variable? Do you think we can uh try and distract ourselves from that one or two people? What are the other alternative possibilities? And this helps um the patient to look at the new thought process that everybody will judge me and I cannot do it. I am incompetent. I will make a fool out of myself to yes, I may feel nervous but I think I can still do it. And so there is a more balanced thought process which is developed as a result of the techniques that we tend to follow over here. How can blaming be positive? Blaming is negative. When you blame, you blame. Whether you blame yourself or you blame the others. Yes. As a psychologist, it is very important that we avoid having biasness in our own thought process because that's an important aspect uh when we are working with patients. Our own biases needs to be completely out of the window. Behavioral experiment is another one where you ask the patient to let's test it in a way uh that this is an experiment for you and like I gave you the example do you think everybody will laugh? Do you think uh one question can be asked? Do you think everybody's going to ask you questions? Do you think some students can also respond normally and so on and so forth? And as a result of that, the intensity of fear because of the catastrophizing that was happening in the patient's mind that will reduce. So the real life evidence helps you to test the evidence of your own negative thought process. Now because there is also anxiety around the event which means if you have a presentation tomorrow today or maybe one week from the time of the presentation you may start to experience a lot of anxiety. So as a result of that that's important that we also engage and maintain a certain routine u let's say breathing exercises in the morning go for a walk listen to music a screenfree relaxation time all of these things also are important part to build and reduce the stress experience specifically when it comes to depression we work a lot on activity scheduling because of the patient Patient with depression find it very difficult to have the motivation to engage with anything that they are able to do in their day-to-day life. So you will see that there is a decline in their engagement in their day-to-day life. And this is where activity scheduling does play a lot of important role as well to monitor from today when we devised a schedule to next time that you meet me. Let's see what all were you able to do as a part of your day-to-day activity that we decided. Dialectical behavior therapy again is a form of therapy which was developed by Marsha Linheim which was particularly first developed for patients with borderline personality disorder or patients with which who had a certain kind of a self harm or a suicidality aspect. Over here it basically combines key aspects of cognitive behavior therapy, Buddhism and dialectics. Dialectic means two opposing forces combining them at the same time and using that principle. Yes, the mindfulness approach is from Buddhism uh that was taken in in this particular uh treatment approach. In fact, Marshall Einhan did train herself uh uh with a Zen monk to learn mindfulness-based techniques and that's how then she developed u dialectical behavior therapy. Anxiety does lead to overthinking and overgeneralization. Absolutely. So the basic principle over here is that all of us are actually trying to do best that we can. So let's say when you feel that or when the patient feels that they are trying their best and yet they are falling in the same pattern again and again and again and again and people in the environment would say well you're not putting your effort enough. Well I don't think I don't see you seeing the effort because there has been no change. Now no change has been as a result of the fact that uh because it is the skill that the patient is lacking or is having a challenge with is the result why despite their best effort a patient is unable to bring in the right change and that's why they need help and support in the form of therapy. People want to improve. All of us want to improve. Let's just believe um that at the core of our good human um us being good human beings, we want to keep improving and keep learning. And that's also one of the basic principles and assumptions of dialectical behavior therapy. All people need to do better. We need to try harder and keep motivating oursel to change. But before we change, we also need to accept that what we are trying is the best that we can try. People may not have caused all of our problems but we still have a solution to them. New behavior has to be learned in all contexts. So if I learn interpersonal uh relationship techniques or if I learn emotional regulation techniques, I should be able to apply them well in all the context in my life. All behaviors are caused and at the same time when we figure what is the cause of my dysfunctioning in a more effective way in a non-judgmental non-blaming way then I'll be able to learn in a more mindful and aware way where is it that I need to change. So it's not about them it's about me. I need to change over here and I need to build that awareness. Losing interest in things that you love are signs of depression key skills. Now over here that this is the dialectics. So in dialectical behavior therapy it brought in one the acceptance skills that before you even go on to change it's important that you first bring in acceptance and mindfulness and distress tolerance skills are the acceptance skills over here. Acceptance means being this is the reality of the situation and we need to accept it because situation is out of my control. So I need to first learn to be able to see reality as it is. That's the key. The chain skills are where I need to work on my emotions where I need to develop better coping skills to first understand what emotions I experience. How do I observe them? How do I calm myself up? And now, how do I respond in a particular situation and not react? By learning the emotional regulation skills. Similarly, how do I build my interpersonal relationships nicely in a respectful, dignified way without engaging into aggression or avoidance, but be able to communicate well with my people around me. So yes, these are some of the important skills. Now we're going to go on to how do we use it let's say in a patient. So the presenting complaints are emotional outbursts that the patient experiences and these outbursts can happen at a drop of a hat. the patient feels um somebody is not being able to understand me or the fact that I'm not being given attention um or somebody is not caring or tending to my needs. It may lead to an emotional outburst. It would lead to conflicts in friendship have been experiencing a lot of that because one feels that people are talking about me a lot more. So negative uh connotation in the relationship with the exchanges that are happening between you and the friend. Impulsive reaction as a result of it. 2 minutes you block. The next moment you unblock. Then you write certain things. Then you delete them. In your angry state you end up saying a lot of things you don't mean to say and then you profusely start saying sorry. All of this is part of impulsive reactions and that leads to further distancing and the similar kind of an experience is also happening at home. Now over here what is the thought process that can be there and this is just one aspect of the thought process when you work with the patient there are lot many other things everyone ignores me and as a result because there are obviously impulsive reactions and conflicts and outbursts that are happening people will eventually leave me so that's the belief that I'm carrying and as a result of that this belief is operating and so I tend to test this belief with people every now and then over here how would mindfulness based skills help the patient. We'll work on with the individual how to first begin to observe their negative thoughts without judging them. Let's say you have this negative thought. Let's just observe it. And as a result of this negative thought, you may experience anger or anxiety. That also something that we need to observe. So we pause, we observe our emotions, we observe the thoughts like it's a slide that is coming in and that is going in and pair it with breathing because mindfulness is about trying to be and build our awareness to the moment to the present moment in a much more calm mindful way. In a world where there is a lot of mind less scrolling and doom scrolling is happening we are doomed. um and our brains are doomed because we continue to just keep scrolling mindlessly. We need to bring in the aspect of how can we be mindful in our day-to-day lives. So over here what you're also learning how to be mindful of what we are thinking, how we are feeling and building that sense of presence in the moment because what you experience when these negative thoughts are there, it takes you in a completely different tangent. So mindfulness helps you reduce some of that impulse emotion because what you're bringing in is a conscious slowing down. Distress tolerance skills. Over here we help the patient to work on the survival skills over where the moment there is a crisis that happens and a lot many times we tend to see the in a crisis the person may call up uh the the person that they're trying to reach you reach to 50 times or may actually end up harming themselves. That's a crisis situation and which is where the distress a small stress can be so distressing that it turns into a crisis. So again over here mindfulness based skills are used where one looks at what are the techniques that can be used to self soo. So using your five senses to soo yourself how exercising can help you build that sense of emotional regulation. how the stop skill which is again a more technical aspect improve the movement stop skill are much more technical aspects of uh mindfulness based approach DBT where you stop you actually take a few steps back you observe and then you proceed that's what stop skill is for you so what we are actually trying to build in is a certain kind of a calming strategy to build your window of tolerance to the stress that you're experiencing so when we apply these skills and we practice them with the patient We help them develop those coping mechanisms in a much better way. What's emotional dysregulation? Let's first try and understand that emotional dysregulation is a small episode has happened and it leads to intense anger, a reaction. So you're driving and suddenly it hits your car hits or somebody hits you from the back and suddenly there is a lot of anger. the person gets out of the car and starts screaming, shouting and at the same time um you know creates a a scene on the on the road. So that's emotional dysregulation. Similarly, you're having a certain chat with your friend and suddenly you feel that there is a a conflicting situation that has happened and it has spitew anger and you start saying so many other things to the patient uh to the to the friend and as a result of that it also spoils your relationship with them. So in emotional regulation skills we identify the emotional triggers. We observe and accept what our emotions is. We see that for every emotion there is an action. When you feel angry you want to hit, you want to scream, you want to shout. And when we observe, we consciously try to do the opposite of what we are actually experiencing as a result of our emotion. And at the same time your sleep, your eating, your exercising, all of these aspects of a routine are significant small significant part that help you build emotional regulation. So that's what we then work with the patient to build emotional regulation skills in interpersonal effectiveness skills. These are your chain skills in which again we help the patient develop assertiveness skills training so that in an interpersonal scenario you're not always either avoiding or approaching the situation in with an aggression but you actually try and be more respectful express yourself in a much more assertive way to resolve the situation. So rather than saying you never cared about me in an angry state, you pull back, you calm yourself and you say well I felt anxious that you didn't reply and so I was reaching out to you again and again. So that's a healthy communication visi screaming, shouting and saying um how you never cared about me and how you want to leave me so on and so forth. acceptance and commitment uh therapy. Yes, it also has mindfulness-based approach that it uses over here. What we are looking at is accepting thoughts, committing and committing to some of the meaningful actions. Uh that's what the focus of this over here is and this is an integration of behavioral aspects the motivational interviewing which means working on certain elements of what brings our motivation down and then working with that with the patient on that and mindfulness based approaches along with it. So yes, some aspects of what you've just learned in mindfulness-based approaches um in the electrical behavior therapy is also applied in acceptance-based therapy. So over here what you're looking at is how do you accept your thoughts, your feelings, your memories again in a non-judgmental way. You observe them, you accept them and you try and understand what could be an alternative way to think. So all your behavioral aspects over here you look at over there that then you bring in the mindfulness based approach of accepting the reality as it is. Then you reach on to the aspect of how do I clarify and bring a personal connect u to the to the to what I want to change over here. So what is my value? My core value is something which is um defined by the patient along with the therapist with whatever they want to change. Yes, ACT and DBT have mindfulness-based approach as a correlated aspect but yet they are two different um therapeutic approaches that are taken and from there we take on the effective action to sort of work on reaching our goal. Yes, psychology is a good subject um and is applicable actually to anyone and in any field and which is why applied psychology uh is a field which I mean applied applied fields of psychology um does tend to have a lot of scope as well. If a patient suffer from something that can harm their life but doesn't want to tell the family to be involved uh then no as a therapist you have to involve the family because if there is any threat to them to their life or somebody else then the family needs to be involved. Stop skill stop skill the acronym stop is for S for stop T for take a step back O for observe and P for proceed. So you actually first stop the moment you're feeling a certain emotion. You take a step back. Um you can actually do it by taking a step back virtually or in your mind. Then you observe whatever thought or feeling that you're having and once you've calmed down that's how you proceed. That's how it is applied. So over here the presenting complaint let's say as an example is um yes a lot of young people have been experimenting with vaping in today's time because the belief that vaping is less harmful than smoking which is absolutely not true. Um, and that's a delusion which we learned yesterday. And we're going to learn more about cannabis used um uh disorder tomorrow. And it's important that we continue to spread awareness, the right kind of information than than conform to some of these belief systems uh that we tend to carry because those belief systems that make us feel that vaping is uh less harmful is a delusion. So 22 year old unable to cope inability to quit vaping is feeling a lot of anxiety and restlessness when they don't vape gives into the peer pressure and as a result of that they try to avoid either going into social scenarios because of the peer pressure that they would have uh be of vaping but at the same time because vaping is something that they are unable to avoid. they still keep going back to the same social circle as a result of that. And vaping also becomes as a means to cope. So if they have stress, if they have exam anxiety, if they have uh the presentation that is there in the office, so the 22year-old keeps using that as a means to cope. Unhealthy coping mechanism. It is harmful but not so so much. That's kind of a rationalization that the mind is um or the belief system is acting on. So that's rationalization your defense mechanism over there. So you identify the function of that particular act which means what is the function that this waping is actually fulfilling to me. That's the technique that you begin with and from the ACT lens what you see is how you help understand the patient. What is it that you're escaping and what is it that you're trying to manage? You're escaping what you're escaping stressful scenarios. What you're trying to manage anxiety and restlessness. So to reduce anxiety and to fit in a social scenario, you're using baby. So you're recognizing and helping the patient recognize that they're using this as an unhealthy coping strategy to deal with uncomfortable experiences. From there you help them build acceptance around the fact that craving is a craving and urge is a urge. So you need to first start noticing that urge. Notice the kind of a physical change that it is going to bring in your body. And as a result of that, now we need to bring in mindfulness-based approach to observe, breathe, makes room and space to this uncomfortable experience that you're having right now rather than simply jumping on to and acting on uh to your craving. So instead of having the thought um or instead of having or telling yourself I need my way you see a thought as a thought and that's how you create this cognitive diffusion that this is a thought this is a thought process and you need to see this as a thought rather than say I need my way I need to say this is my thought saying telling me that I should wait so this may make me feel restless but at the same time I can manage my craving and my urge. Now over here then again what is the value commitment? What is my value? My value over here is my health matters more to me. My value is my sense of freedom from something that is controlling me. My value is my selfrespect that I can say no and stick to a no when my friends pressure me into doing this and fitness is my value. So you help the patient continue to keep sticking to this value and then develop an action plan to turn this values these values into actions. So what you do next time you have the urge you delay. If there are cues around you, you remove, you pass those cues, you replace them with something else. And you take the ownership of the fact that you have to just put your value system in place that you've committed to. So craving is something that you particularly look at when it comes to smoking, uh, food, all of these things. Urge could be it's an impulse. Urge is an impulse that you could also have an urge to let's say pick up your phone an urge and both the things are used uh more in in craving is more used in an addictive way or a even an aspect of craving having craving for food. So smoking drinking all of these cravings is more like a something that you have as a part of your um satiation for hunger and urges urge could be for anything. Urge could also be urge to scream, urge to um pick up a phone. So more of an emotional aspect. Expressive art based therapy. So a form of therapy where you use art as a medium and a primary mode of communication. And a lot many times people tend to think that art therapy is more about just simply um doing some art or the fact that you just blow up a balloon you and with that um blowing up a balloon and just bursting the balloon you're just bursting away your stress like that. It's not something that you use it in that way. it has a more therapeutic connotation to you using a lot of these tools uh that are brought in as a part of the expressive art based therapeutic approach. So it's not merely just doing the act of whatever you call as art but how it is being integrated in a much more therapeutic way so that it becomes an experience a cathartic experience in itself for the patient to feel relieved. So some of the basic principles are one having access to experiences that they are not being able to talk about in a normal um talking therapy kind of an approach. It allows the patient to also have a certain form of an expression of self. It also helps them to build a certain kind of a mastery over certain experiences in a much more u joyful way because art all of these things bring in that aspect of uh positive experience, cathartic experience and as a result of that what is it that we use? We use creative visual representation. We use art as a reflection as a way to communicate and express a lot of our traumatic memories emotions uh that are coming in as a result of which are very challenging for the patient to talk about. So some of the common activities or rather tools I would call them tools that are used is uh let's say collage making using and asking the patient to make collage of what would represent them as a part of u you know traumatic memory that they had. Journaling how would they want to reflect on what happened in a recent episode? perspective drawing that you draw and take a bird's view to that timeline activity where you ask them uh to draw significant parts of their of their life. Let's say some positive experience then some transition and then some negative experience. So the timeline again gives you a visual representation and group creative task that can also be done as a part of group therapeutic approach. We have some of our young therapists in fact uh who do these drum activities as well as a part of uh group art therapy uh approach. Other tools are time yeah story based expression where you use stories as a way to communicate emotions emotion color mapping. Again some of some of these techniques simple things that we don't recognize how can be actually used as a therapeutic tool safe space drawing drawing a home and then you know creating a sense of calmness and safety and stability for a patient where they may have been feeling um you know unstable for a very long time. So what is it that they call a home as a space for themselves asking them to draw that so that in a psychological representation way we are able to bring in a positive association to something which is difficult and traumatic for them. So a case example uh d uh recently changed schools and has been finding it difficult to adjust to a new environment. They often feel isolated in class, miss their old friends, struggle to express their emotions openly and as a result of that have been experiencing lack of confidence. So in an expressive art-based session, you ask them to draw certain things, create a memory board with their friends, use colors to express a certain form of a of an emotional experience that they're going through and then start to help them experience um express their uncomfortable feelings. And then you slowly see a transition over a period of time. From there we go on to our last therapeutic approach which is grief therapy which has been developed by the pioneer in grief therapy Elizabeth Cuba Ross. So often we believe that grief is something which is experienced in stages. But what's important for us to understand is that it is not often in stages. Grief is a very very personal experience and um everyone goes through a different personal experience of grief. These are some of the um stages of grief but it's not necessary that you first go into denial and then into anger and then into bargaining or depression or acceptance. You may be in any stage in in grief and it may come in at a time when you don't even know how it is coming in. So denial is that yes um when it's very difficult for you to accept that this has happened and you've lost the loved one. Anger is when you start to feel anger towards life or the person who's left you or the pet who's left you. Bargaining is when you start to have uh you know why is it that this has happened and maybe let's say rather than them I could have gone and so on and so forth. You you start having that kind of a bargain with life in your own thought process. Depression is when you it's an early form of acceptance that yes this has happened and now I'm feeling sad about um losing the person and along with sadness there are so many other emotions that one may experience and finally we reach the stage of acceptance from where we start working on meaning making to build our purpose again basic principles of grief it's a natural human reaction to loss if we've lost someone, we are going to grieve. And to say grieve like this, you must cry, you must not cry. All these are myths. There is no one way to grieve. Everyone may have a different way to grieve. Yes, it's both universal and a very personal experience. There is a no there is no protocol that is followed over here. There is no right and wrong way to grieve. Loss is a loss and a loss does not exist in vacuum. Grief and loss is something that you experience and you can't skip that process when you've lost someone and it may not look the same for everyone. Some of the common myths time will heal it. Well, we don't know how much time this is and for time to heal it sometimes you may actually need some support. So, grieve alone not necessary. You may take your own time. You may want to do it alone. You may also want a friend to be there with you. You may want your family member to be there with you. You may want to sit around them and talk to them about the person that you've lost. Don't feel bad. Of course, never say this. Keep busy. Just keeping busy doesn't make it easy for you to not remember the uh the loved one or the significant one who's lost. Replace the loss. You don't just jump onto replacing the loss. And you don't replace, you rebuild, you reconnect. Be strong. We all have resilience within us, but we don't preach it. We don't tell someone to be strong um to in a grieving process. You allow a person to grieve. So an example over here let's say a student lost a grand uh grandparent and shortly before the board examinations yes a difficult time period and over here has been struggling now with low motivation emotional withdrawal difficulty concentration and is beginning to isolate themselves from friends and is feeling emotionally overwhelmed. So through grief sessions where a safe space is given to them without any pressure that you need to first start focusing on forget about this you can't grieve right now you need to first focus on your examination your studying that's not how it would work you would give the patient to talk about what they want to talk about you would give the student the time and the space to slowly come up to their sense of motivation to be able to work towards their examinations and even if let's say they feel less prepared you validate it as a natural normal experience of what they are going through as a part of the moouring process. So what grief therapy helps you with? It helps you with moaning or experiencing grief, expressing grief in a supportive safe environment. You encourage them to identify and express a range of emotions. You help them to deal and experience whatever effects that are happening as a result of that. Um please continue to ask your questions and I'll keep reading them from the sideways and answer your questions as well while since we also have to close this very soon. Allow yourself sufficient time to grieve bring normalization and at the same time over a period of time you see how do you build back your purpose with life even if you've lost a pet. I think we will all have our biases and it's a process. Uh most importantly it's about insight. The more I develop insight I will have less biases. I need to be aware. It's awareness and insight. That's how you work around your biases. Not just as therapists where it's a part of your training in life also as we are biases. They tend to impact our our relationships also. something that one needs to uh look at. Um psychologists typically would be choosing a form of therapy uh based on two ways. One is their own expertise. Um and the second would be also whether this particular individual and their clinical profile would need what kind of therapy. So let's say if you are doing a kind of therapy but this person may require B, you'll refer to the right person. Let's move forward. Um, which field is better, psychology or psychiatry? All together, Mimmansa is a psychologist. I'm a psychiatrist. Uh, telemental health is very much a digital India has transformed a lot of teleymental health. Co brought this understanding globally that telemental health is effective. AI is increasingly becoming a part of psychological interventions and virtual re virtual reality based therapies as well are increasingly coming uh especially for cognitive work. We've been using virtual reality based work for both cognition and mindfulness. Yeah. Uh we've talked about this earlier. ethics needs to be there. I think deep down if you want to be successful in your career, you'll need to have very very clear uh value system. I talked about conflict of interest earlier which is family and friends. Confidentiality which means you do not share any information. Boundaries we talked about in the context of what has been portrayed in in cinema times. Consent is integral and you will need to respect cross-cultural boundaries which means you may come from a different background that doesn't mean you impose your background on the individual. Ethics uh is at the core of your professional integrity and it's very very important that you maintain it. >> Yes, some of these aspects can you know our platform. Okay. Um, yes. And it's just about 6:30. You've been at it for an hour and a half. We'll take your questions tomorrow. We'll try and keep some time initially for the questions. And you unmute yourself, share, spread the information, right information, sensitive information. And yes, till we meet again tomorrow, hello young people, budding psychologists, Dr. Man Singh Tan shall meet you again with me tomorrow 5:00 p.m.