Category Archives: Therapy

Cognitive Training

When looking at indicators for successful recovery from mental illness, I’ve sometimes seen intelligence, IQ or cognitive abilities mentioned. Personally, I haven’t often viewed my own intelligence with much favor. After all, what good is an above average IQ, if you can’t even manage to keep your own kitchen in order? Furthermore, if you’ve found your IQ score a little on the low side, don’t worry. Like your muscles, you can improve your “brain power” with training – and as I explain later, being good at puzzles doesn’t necessarily mean being good at living. But that too is a matter of training and practice.

So, when talking about cognitive training, what is it exactly we’re talking about?

Cognitive psychology covers everything from critical thinking to attention and memory. It is what we use when we read, write, remember tasks and shopping lists, follow conversations and work on puzzles and challenges among other things. When you recall items on your shopping list, search out a particular item on the shop shelves or spot a friend in the crowd, you use your cognition to do so.

Attention and memory in particular have been shown to suffer when a person is in a state of prolonged stress. You might notice that you forget more easily or have a harder time concentrating on tasks when you’re under great pressure, especially if you’ve been under pressure for a long time.

So, how does cognitive training work? Simply by using your brain. You can easily find several good “brain training” around. On the App store on my phone, I found Brain Training by Triangle Labs Inc., Elevate by Elevate Labs and Lumosity by Lumos Labs Inc. for free. Even well-known puzzle and memory games like crossword puzzles and the like can be used to train your attention, concentration and memory – or various video games for that matter. However, you can sit all day and “git gud” at a game, but then all you do is get really good at that one particular game. The trick is to combine several games to train different skills and then transfer those skills into everyday life.

I, for instance have struggled a great deal with concentration and memory. I couldn’t concentrate on my studies and couldn’t remember the texts I’d read. I’d also constantly lose focus and had trouble keeping track of conversations. And yet I had little trouble remembering every Pokemon and their types, attacks and weaknesses. Or follow the juicy development between the main characters of this or that cheap romance novel.

So, I joined a cognitive training group to try and figure out what exactly was going wrong and try and train my brain not only to remember Pokemons, but shopping lists and scientific articles too.

The cognitive training part of the group consisted of playing especially developed games on the computer, where you use various parts of your brain to solve problems. There’re attention and memory games, where you remember figures and where on the screen you saw them, names and faces, spoken messages and puzzles like the Tower of Hanoi. Each game started would start out easy, then slowly grow in difficulty.

The games themselves were a lot of fun, but the really helpful part of the group was spending time in the group as a whole talking about the similarities between the games and tasks in our daily lives.

Suddenly, the Tower of Hanoi wasn’t just neat little disks on pegs, but piles of boxes in a cramped room that need to be moved to create more space or the random figure somewhere on your screen became your keys located somewhere in your room.

We also spent a lot of time learning each other’s names, going over a couple helpful strategies. Names and faces are a real chore to remember, especially when you have to remember a lot at once. But you can help your memory along by creating connections or more meaning. Like, “Her name is Mary, like my aunt”, “Michael likes knit sweaters”, “Basil like the spice” or “Stella is a star”. Then, when you see the person, you can help your memory along. My aunt = Mary. Knit sweater = Michael etc.

The cognitive training didn’t only stay on the computer, but was pulled into daily living and chores. When you clean up your room, you locate objects, identify them and categorize them to place them in their rightful places. Granted, real life is three-dimensional and full of distractions, but the task in and of itself is the same. It’s just like the computer game, but in hard mode. Once your brain becomes accustomed to performing the task in simple 2D on the computer, it becomes easier to perform in real life. All you need is to make the connection between the game and the real life task and your brain will know what’s needed.

Over the course of the group, I found motivation and interest in the computer games waning, but I’m still using my brain every day, concentrating on tasks and chores, remembering said tasks and chores and how to perform them. It’s become a fun, little exercise when I’m playing a game to try and think of ways how the game translates into real life.

One really helpful technique I’ve learned from the group is to chop up big tasks into smaller tasks and steps. Dishes get divided up by category, so a big pile of dishes becomes smaller, more manageable piles by category: cutlery, plates, cups and finally pots and pans. Cleaning and tidying is similarly cut up into steps. When tidying my room, I start by sorting the trash, then the laundry. Then I usually lose momentum and end up in front of the computer until the trash and laundry piles up again. But once each item has a box, place or category, it becomes easier to deal with. Feels like I’ve mentioned something like this before on the blog somewhere… well, memory’s still not the greatest, but it’s getting better, I think.

Have I mentioned I also find lists and plans helpful? Writing down each step needed to perform a task and how to do it helps keep focus and reduces a big chore to simply following a set of instructions. Cleaning the bathroom starts with filling up a bucket with soapy water, gathering up the necessary supplies and then starting pouring some cleaning solvent into the toilet, then with washing the walls, the sink and shower finishing cleaning the toilet and then the floor. Like following a recipe when baking.

Nowadays, I’m maybe still not at the level of scientific articles, but I’ve slowly upgraded to more meaty texts than cheap romance novels and at least shopping lists aren’t a problem anymore.

Body Awareness Therapy

A little while ago, I took a class dubbed “Body Mindfulness”, which was a light exercise and meditation class employing elements from Yoga, Tai Chi, Qi Gong and mindfulness meditation. It turned out to be an exercise therapy called Body Awareness Therapy (BAT) developed sometime in the 70’s and used by physiotherapists to alleviate symptoms both in physical ailments such as chronic pain like from whiplash and mental illnesses like schizophrenia and the like.

This class caught my attention because I’ve had problems with feeling disconnected from my own body, feeling as if one or more bodyparts or in some instances my whole body isn’t really mine or fully under my control. I had an inkling that it was a problem that could be removed or alleviated by actually using my body, exercising and the like. But it’s incredibly difficult to get motivated and I detest the pains and aches and exhaustion that comes from exercising. So, a light exercise class that seems to focus on connecting body and mind by focusing one’s attention on the body and movements more than the movements themselves seemed like just the thing.

I often struggled with actually showing up for class, but once I was there, my experience was very positive. The exercises did indeed help not only with loosening up on some muscle-tension, but helped making me feel more connected to my body as well.

The exercises were very simple and fairly easy to do at home. Most of them only required a yogamat and enough room on the floor to stretch out. We’d start the class by taking note of how we’re feeling in the moment, our mood, various bodily sensations we might be feeling at the moment. I’d often feel a tension in my neck and shoulders, maybe some strain in my thighs, ankles and feet from the kneeling position. Sometimes I’d feel mostly happy and content, other times I’d not want to talk at all, and whether it was good or bad feelings and sensations, they were all valid and perfectly acceptable. There was always a relaxed atmosphere in the room, no one ever asked any more than you were willing to share and you were free to participate as much or as little as you were able.

Next, we’d do a lying down or sitting meditation exercise where we’d slowly move our attention first to breathing, then to various body parts one at a time. I’d often find my thoughts wander and might have fallen asleep once or twice during this exercise. It wasn’t uncommon to hear someone else snoring softly somewhere either. The point, I think, was to gently coax your mind and attention to focus on your body, let go of wandering thoughts without judgement and just be in the moment. The mindfulness part of the therapy.

Next, we’d do various standing exercises. The main focus was to visualize this center-line going through our bodies and slowly move it and our bodies back and forth, side to side, up and down, twisting around. If you’ve ever taken a lesson in drawing the human body, you might be familiar with the helping line often drawn straight down through the center of the face and follows the spine all the way down the body. That’s what I’d visualize – just more like a rigid thread or rod going through my body that I can move around and my body sort of just follows.

Then we’d do various exercises lying down, often times with a big sausage-pillow, filled with something like sand to give them weight and firmness. We’d use the weight, hugging it on top of our chests, use the firmness to lay our back or legs on it and relax into a stretch over it. Some of my favorite exercises were just lying down and moving the arms. One started lying on our backs, eyes closed, with the arms laying straight down our sides. Then we’d slowly, very slowly lift them up and sloooowly raise them up and then down to rest above our heads. It was always something of a surprise to note just how heavy my arms are. Sometimes we’d open our eyes when it felt like our arms were at their highest point above, to give some visual feedback on our physical sensations.

Another one we’d lie on our sides with one arm straight up into the air. Then we’d slowly swing it around in the shoulder-socket, first in tiny circles, then slowly widen the circles until the circle stretched as wide around as possible, practically dragging the hand on the floor at the front and back. Those exercises could really loosen up some muscles in the shoulders and back.

Finally, we’d finish up the class by repeating the starting exercise, noting how we’re feeling in the moment compared to at the beginning of the class. More often than not, I’d feel a definite improvement, if not in my mood, then in how my body felt overall. Sometimes, I’d note a tension in new muscles, sometimes I’d have more or less of a headache. More often than not, I’d feel much more relaxed and at ease compared to the beginning of the class.

It’s a bit of a challenge to actually keep up with the exercises, but I’m happy to say that I feel much more connected to my body these days and haven’t had any episodes of being unable to recognize it as my own. It doesn’t do much for the face in the mirror, but I don’t spend much time staring into mirrors anyways.