Acceptance is the New Super Power

Acceptance really is a super power. Most of the time living with a chronic illness is hard. It is a journey into the dark unknown. A journey we did not want or plan for.

One of the hardest tasks in adapting to life changing illness is to get your head round the term ‘acceptance’: accepting that the illness is now an enduring part of life.

Most people struggle with this concept, because acceptance is frequently mistaken for submission, or giving up. The schema most of us hold is that giving up means ‘throwing in the towel’.

Culture itself increases the struggle. There is a false belief that to live fully we must be always pushing forward. Pushing forward usually means achieving and amassing, even if that pushing forward becomes harmful in some cases.

Yet acceptance of an illness, and of the impact it has on your life, is not giving up or submitting. In this case, acceptance is simply an acknowledgement that the disease or illness is there and, like it or not, it has an impact.

How Acceptance Can Change Your Outlook

The wonderful thing about acceptance is that when you reach it, a layer of suffering vanishes from the daily struggle. When you acknowledge the fact that an illness is present, instead of fighting against it, stress is lessened and some joy and autonomy returns. Now that is moving forward, and it can be a catalyst for growth.

This acknowledgement allows strategies to be developed to reduce the impact of the illness on both yourself and those close to you. Realistically, as well as lessening stress, you are gently but firmly taking control of your life, rather that coping with the extra pressure of fighting it.

Put simply, acceptance brings both freedom and peace. This is not a gloss-over. Chronic illness is very hard – often it is brutal – but acceptance paves the way to a different life, fully lived within the current reality. And if you wonder what a full life can mean in this sense, Psychology Today has some useful insight on living well with chronic illness.

Non-acceptance means a continued struggle with little chance of adjustment and a greater level of pain, physical and emotional.

Acceptance transcends hope or fear – it is simply seeing reality as it is.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk). 

If you’re looking to deal with pain management and negative thought patterns as part of your chronic illness, you may want to consider CBT (Cognitive Behavioural Therapy). Click here to find out about CBT with Christine Tizzard Psychology. 

Santa Claus: Myth or Lie?

Santa Claus is alive and well!  Myth or lie?

I recently reviewed a research report by a psychologist who claims that it may be dangerous for parents to ‘lie’ to their children about the existence of Santa Claus.

The article went further; it adopted the bold standpoint that parents run the risk of taking away a child’s trust in them by lying about the existence of Santa. The argument is, if we lie about Santa and children later learn the truth, how then can we ever be trusted?

Centuries ago, Plato believed a myth is a noble lie. Myth is a concept that unites a culture or tribe. Myth is a process that bonds us together as people. In these difficult times, it’s true to say we need cohesion and connection more than ever before.

It’s true one should never directly lie to a child. Engaging in and enjoying the Father Christmas myth is totally different to the practice of lying. The continuance of age old myths is precisely that which bonds us together through and across generations. Is the tooth fairy a lie? Are Apollo and Neptune lies? Is Hans Christian Anderson a scoundrel? Or is JK Rowling guilty of destroying trust? No – each of these is either a myth or a creator of myth.

There needs to be a clear distinction made between myth and lies.

A lie is an untruth, told to hide the reality of a situation for many reasons. Usually it is to deceive someone or to escape punishment. Sometimes it’s a ‘good’ or utilitarian lie, as described by Kant, told with the intention of preventing hurt. Nevertheless, it is still a lie and, in Kant’s view, wrong. A matter for one’s own conscience perhaps. My grandmother always said, “It’s better to be hurt with the truth than made a fool of with a lie”.

Myth is a different concept. It really does not fit into these categories.

Santa Claus, St Nicholas and Later Myths

Father Christmas, Santa Claus or Papa Noel, emerged from the character St Nicholas of Myra, a bishop believed to have originated from what is now southern Turkey. Popular culture morphed him into Santa Claus in America and then Father Christmas in the UK. He has been visiting children since the 1700s.

It’s interesting to note that in the first illustration of Santa Claus by Nast, in 1883 (during the American Civil War), he is wearing a star-spangled jacket and striped pants.

The myth has powerful social elements. It’s great how talk of Father Christmas bridges the gap between the young and the old, between social class and between faith groups.  Father Christmas is a common denominator between us. He binds us all together.

Myth Binds Culture

If we now remove myth from culture, we destroy common threads that bind us. We throw away imagination and we discard tradition. More worryingly, children lose childhood and memories. They also lose powerful generational models of parenting.

So much of ethics, conscience and morality is contained in myth. Lose a myth and the fun reduces. More importantly, the ability to think abstractly reduces.

Ask any child who no longer believes in Santa Claus whether they felt deceived by their parents over the issue. I think I know their response. What’s your view?

Bibliography

Guyer. Paul, (2006), Kant. New York: New York, Routledge.

Moravcsik.J, (1992) Plato and Platonism: Plato’s conception of appearance and reality in ontology, epistemology and ethics and its modern echoes. Oxford.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk). 

PTSD at Christmas: Hyperarousal

Christmas is the season of fun and good will, but having PTSD at Christmas means the reality is often very different. The Christmas countdown can be one of the worst times of the year. The reasons for this are many: an expectation of the perfect day, having to shop in packed malls, thoughts of entertaining… all these things can lead to feelings of being out of control. This is especially true when there is already constant overthinking going on in your brain. Christmas often feels too much. For those with hyperarousal, the run up to Christmas usually increases trauma triggers. A rise in triggers is associated with more frequent acts of self-harm and increased suicidal thoughts. This is very frightening.

For those with PTSD at Christmas, the season can and does ramp up perceptions of powerlessness. This may lead to increased numbing and depersonalisation. At worst, it can feel as if the Amygdala can’t and won’t take any more. In these moments, you may feel like fighting, running like hell or freezing. Sometimes, it’s all of these things together.

It’s also common for those with PTSD to increase their alcohol or substance use as triggers rise.  This not only hurts the person with PTSD, it causes unintentional pain to loved ones. It is crucial that you put some control into Christmas to prevent feelings of helplessness escalating.

Your Action Plan to Deal with PTSD at Christmas

1. Limit engagements. Accept invites only to those events that you really want to attend. Make sure you know what the set up will be. If there is a strong feeling of not wanting to go, listen to yourself. If you want to stay at home, allow yourself to. Banish negative self-talk about being weak by not going.
   If you do attend and feel the need to leave early, do just that. The people that matter will understand. Disregard the views of others.
2.  Structure plenty of downtime during the celebrations. Listening to music, walking or jogging are three undervalued and powerful tools.   Recent research findings are clear – activities that involve a strong rhythmic focus are proven to reduce hyperarousal in the Amygdala. These activities calm the hyperarousal element of PTSD much more effectively than the use of talking therapies which often do little to reduce core feelings of rage and distress. It is thought this maybe one reason why EMDR is so successful in treating PTSD.
3. Maintain a routine of meditation, progressive relaxation, yoga and visualisation. These tools can be truly lifesaving in an emergency, which may happen if you’re dealing with PTSD at Christmas.
4. Limit alcohol.  Alcohol is a depressant. It might feel as if it makes it easier to get out of the door. The reality is hyperarousal and depression are increased after the initial buzz goes. If you don’t want to go out, stay home and do something genuinely calming. Things will get better as hyperarousal reduce.
5. Lower expectations.  Having PTSD is very hard. Most people haven’t a clue what you are living. You are a survivor and a warrior.  Allow yourself to be discriminate in your wishes.  You are your ultimate cure.  Respect that.

Written by Dr Chrissie Tizzard  PsychD, MSc, BSc Chartered Consultant Psychologist and Chartered Scientist. Dr Tizzard has over 20 years experience working with the emergency services, the military and civilians who have experienced PTSD in their lives. She has researched, lectured and developed training programmes pertaining to PTSD vicarious traumatisation and post traumatic growth.

Autism at Christmas - Top Tips for Reducing Sensory Overload

Christmas can be great fun: it’s a time for good old-fashioned family time, when the usual routines follow Santa back up the chimney and melt in the snow.

Yet this is not usually the case if you have a son or daughter with a diagnosis of Asperger’s or Autism. You’ll know managing Asperger’s or Autism at Christmas can be a challenge for the whole extended family.

The change of routine – the carefree get-up-when-you-feel-like-it, and eat-when-you’re-hungry policies – usually cause havoc. That havoc leads to a visit from the Autism bad elves: Anxiety, Meltdown and Sensory Overload.

Kids with Asperger’s and Autism can have a great Christmas, too, but it takes a little preparation. The first consideration is to start planning early; this allows the child to take on board the necessary information that he or she needs to prevent a spike in anxiety as Christmas draws nearer.

How to Reduce Autism Sensory Overload at Christmas

1. If you visit  friends or family, take food you know your child will like. This also makes you a great house guest, as it minimises effort for your hosts, who will understand the need for you to give your child reliable favourite foods.
2. Don’t present your child with new clothes during the holiday: only use clothes that are well-worn and comfy. If necessary, bribe grandparents not to buy clothes as presents. Your son or daughter needs familiarity, but a new fabric or pattern will only increase sensory overload at an already stressful time.
3. Make a mind map of the Christmas celebrations with your child. Design the main days with him or her. Pens, coloring pencils and Post It notes are a must! Explain in full how things will work.  It’s a good idea to devise a strategy for the lack of structure which other family members need. You do this by describing the kind of things that might happen: Grandpa might fall asleep after Christmas dinner. Everyone might plan to go for a walk, but be too tired in the end. Mention that family members may get involved in a range of activities. This allows a mental map to be made in your child’s brain, and reduces anxiety.
4. Provide a safe space, free of sensory overload. Allow your child to take ‘time out’ there, especially when you notice their stress levels rising. There should be no decorations or trees in this place at all. It is fine to allow him or her to eat cheese straws or jam sandwiches in this den on Christmas Day. 25th December is not the day to press your child to eat different items.
5. Have a few of your child’s favourite activities ready. This is just as important as chopping the veg in advance. You might think this is boring at such a fun time, but the child will appreciate the familiarity and the routine.
6. Take your sensory kit wherever you go. This will reduce the chance of overload, whether you’re in a traffic jam on the way to see relatives, or you’re walking in the park.
7. Scale down expectations. Think: ‘It’s a normal day, with injections of joy’. Christmas can be magical, but it may not be the best day ever, and that’s perfectly okay.

Each of these little things will reduce sensory overload and help you all to enjoy the festive season. Have a very merry Christmas.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk). 

We  are providers of  independent autism assessments throughout southern England, via Treetops.

Walking Towards a Better Mood - New Research

It’s official: walking off a negative mood, and seeing quick results no matter what your speed, is possible.

A team of researchers at Iowa State University have confirmed that walking can blast away a negative mood. Better still, it does not need to be a fast aerobic stroll. Astonishingly, a 12-minute walk at speeds of just 3mph will raise a bad mood.

A study involving 400 undergraduates at Iowa State University and published in the Journal Of New Emotion has confirmed this amazing fact.

Surprisingly, the researchers also found that the walk location was unimportant. Forget the thought of the beautiful Sussex downs in autumn hues.  Participants who merely walked around an urban, drab and featureless university concourse (not to shame those at Iowa – many campuses aren’t easy on the eye) were just as likely to report an improvement in mood as those who had walked in beautiful surroundings.

Even students who walked on a treadmill for 12 minutes reported an increased mood. In contrast, those who sat at the end of the treadmill waiting for their friends felt worse than when they entered the gym.

Walking Off a Bad Mood: Why You Should Try It

Jeffrey Miller, study author and assistant professor at Saint Xavier University, said: “There seems to be something about that brisk, purposeful walk that is really good for you.”

The study increases the previously held view that even a short walk can be a valuable counter-measure in a difficult situation. So, what are you waiting for? You could take some of the heat out of that imminent meeting with the boss. It is certainly worth a try.

These findings also add weight to the already well-known physical benefits of walking.  Previous research has concluded that regular walking can slow dementia progression, prevent osteoarthritis, lower overall cancer risk and help in weight and blood pressure maintenance.

Try walking the next time you feel stress or worry clouding your thoughts: no matter the location, the walk itself could make a tangible difference to your mood.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk). 

Parents: Are you Nagging or Scaffolding?

Have you heard about the ‘nagging or scaffolding’ parenting debate? It’s several decades old, but a constant challenge for parents. Here’s a tale that explores nagging and scaffolding – two different parenting strategies…

I returned my three eldest grandchildren to their parents after their usual Friday tea.  Their brilliant mum’s smile quickly changed to a look of concern. She watched as each child discarded coat and bag to the floor rather than to the colourful child sized pegs in the hallway.

“Why”, she asked, “Can’t they remember to empty their lunchboxes or hang up their uniforms? Why must I remind them every day?”

She continued: “Everybody says they are lovely kids – so why do I constantly have to nag them to do these simple tasks?”  This may also sound familiar to you.

Showing true allegiance to the three amigos, I cautiously suggested she might be about to engage in a spot of ‘scaffolding’ instead of a bout of ‘nagging’.

Over half a century ago, the Russian psychologist, Vygotsky introduced the idea of the Zone of Proximal Development (ZPD), or ‘scaffolding’. Scaffolding is a process where an adult helps a child master something that the child could not otherwise manage alone. Tidying up after themselves does not seem to fit the definition… or does it?

Emotionally healthy children are usually totally caught up and immersed in the possibilities of their world. They are bubbling over with the potentialities of life, or they should be. In the few hours after school, they made clay fish in the studio (now drying for firing and glazing). Spellbound, they had silently watched a marsh harrier and two buzzard’s hunting field mice. They had noisily mastered a drum routine and provided the lowdown on Justin Bieber’s newest hairstyle. Over tea they’d debated truth and honesty. Is it ever ok to lie?  Specifically, “if you don’t want to go to tea at a friend’s house, is it better to tell a lie rather than hurt their feelings?”

Yes, they had to be reminded to wash their hands before tea, prompted to flush the loo and encouraged to wash hands again. They also needed prompting to remember to take their school clothes home. I believe the word ‘scaffolding’ trumps ‘nagging’.

Kids have busy brains. A preoccupation with their immediate interests ensures they lay down the pathways that leads to a rounded adulthood. The downside is that their cognitive and emotional processing can’t always keep up with their appetite for life.

Parents be reassured – your children won’t grow up to be lazy because they forget to put their lunchbox crusts in the garbage. Children’s frustrating forgetfulness usually means they are simply flying with the wonder of life. Parents are both blessed and cursed with having the job of getting their kids to touch down to earth long enough to do the housekeeping of life. Ironically, nagging is folly. A child isn’t primed to respond to a nag – they know the nag is on a loop, so there is no need to comply quickly. Positive reinforcement may be the way to go.

Now, whose are these trainers on the doorstep?!

Further reading: Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk). 

Chronic illness has secrets

Chronic illness has secrets

Chronic illness has secrets.  These secrets often don’t get aired by the daylight. Most people with a chronic illness or rare disease struggle with daily life. Those struggles are usually hidden from the world.  Popular psychology says that a positive attitude helps matters. It is true, being optimistic does help many things.  Let us be honest though. The British bull dog spirit often falls way short of helping those with chronic illness cope their new imposed reality.  At times the maxim can be simply patronising.

The secrets of chronic or rare disease

1. People with chronic illness are always trying to adjust to uncertainty about or change in their physical state. The sword of Damocles that hangs with an unknown prognosis causes anxiety. Individuals are often unable to talk about these fears. They are scared of being labelled moaners or  hypochondriacs.

2. Sufferers of chronic illness feel very alone.  This is also true in rare disease. The medical profession frequently does not understand their condition because it is so rare. The lack of knowledge by professionals about a rare disease usually results in the person researching all they can about their illness.  This is not a fixation but an attempt to maintain some control, a control that may even save their life. An awareness that there is a likelihood that you will have to advocate for yourself when vulnerable during a crisis in order to get correct treatment is scary.

3. People with chronic illness often try to micro manage life.  These real fears about a health emergency can make the person stop doing normal things.  This attempt to reduce the possibility of crisis can lead to further shrinking of life and a growing feeling of personal isolation.

4. Sufferers know that there is absolutely no certainty that the task or activity they did easily today will be able to be repeated tomorrow. The body is in charge and it can be mean abuser of the spirit.

5. People with chronic illness often feel angry, guilty or sad. This is because their hopeful plans made weeks in advance may need to be cancelled at the last moment because of a surge in symptoms. This weakens the individual’s support network further as ‘friends’ often don’t get it. Unwell people begin to be seen as unreliable rather than ill.

6. They may not get the support they need because they look  good on the outside when there is an invisible but major inferno going on inside.

If you are battling a chronic illness or rare disease.  It’s a pretty smart idea to give yourself a gentle pat on the back. Remember you are not alone, that you are a fighter.  Lastly, know that there are many others there in solidarity with you.

Bird's Nest Parenting - Friend or Foe?

In the UK we are beginning to hear more about a concept known as ‘Bird’s Nest Parenting’.  This practice became popular in the US and in Australia, where it has also been called ‘satellite parenting’, and it’s thought to originate from a US custody hearing in 2000. In the court case, a Virginia judge ruled that a divorcing couple’s two children should stay in the family home, and the parents should take it in turns to look after them.

Bird’s Nest Parenting is also creeping into TV dramas and pop culture, as The Telegraph noted earlier this year.

What is Bird’s Nest Parenting?

Bird’s Nest Parenting is an arrangement where the children remain in the family home after their parents have split up. Mum and Dad each take turns in living with them, and the parents move between the home and their own separate accommodation.

The belief is that the children will experience less disruption and anxiety if they stay in the family home. In practice, Mum and Dad might make an arrangement to stay in the house on alternate weeks. During this period, the resident parent provides all the care to their children.

Advocates of this method view the arrangement as a tool that can provide more stability to the children. In theory, the children do not have the stress of living in two places, moving their stuff around and perhaps getting upset. The goal of a Bird’s Nest Agreement is to cause less stress; less stress means the children will be less affected by their parents separation.  This may be true up to a point.  While there are clear advantages in a Bird’s Nest Agreement, there are also disadvantages that need to be examined.

The cons are that it can be very hard for the adults to find closure in their own relationship when they continue to inhabit space that was once a shared home.  This often causes stress and animosity.  This is distress the children will pick up on.

There are also temptations to use the ex-partner’s possessions as if they were still together. This usually causes resentment, and the children may become unintentional pawns. They can often be questioned by the other parent: ‘Did Mum or Dad do this or that’ or ‘Did Mum or Dad use this or that’.  This is not intended to harm their children, but it does.

A further problem is that as the children are always present in the home they may develop a ‘pseudo adult’ role.  This means they may assume more responsibility for the running of the house than they should.   This may also include keeping the adults informed about the other partner’s movements. This  loads the stress that the agreement was supposed to prevent. Extra distress may lead to emotional difficulties.

Should You Try Bird’s Nest Parenting?

Bird’s Nest Parenting may have a benefit in the early days after a separation – in the short term, it may prevent the children from experiencing too much upheaval.  Children do need time to adjust to their parents’ separation.

In the longer term, it may be more beneficial for children to spend time with both parents in separate houses, having their own room and cherished items in each house.  Children will adapt to this well, and usually without psychological difficulty.

The simple fact is: most children cope well after their parent’s separation.  What distinguishes the copers from the children who feel acute distress is this: the children who fare well are the ones whose parents are able to put aside their own feelings of hate and resentment towards their former partner.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist .  Dr Tizzard works with adults, children and families and is an experienced expert witness in criminal and family law. www.ctpsy.co.uk

 

Sleep Problems and ASD: Can CBT Help?

Sleep problems are an all too common headache for parents of a child with ASD (Autism Spectrum Disorder).  A lack of sleep in any child usually cause distress, but when a child has a diagnosis of ASD, the impact of poor sleep is usually much more of a problem.

If your child has autism, you may have noticed that when they go through a period of sleep difficulty, their symptoms often get worse. During these times, you may have also found that the trusted strategies which usually work well to manage ASD are much reduced. Sometimes, they don’t seem to work at all.

Could CBT help improve sleep in people with Autism Spectrum Disorder (ASD)?

Experts from the University of Missouri believe that a simple course of CBT may be really helpful in breaking free from the horror of sleepless nights.  They want to ease the misery of the ramped up behavioural issues that usually appear the next day.

Christina McCrae, the lead researcher in the study, maintains that CBT is the most effective way of improving sleep patterns in children with ASD.  Normally this involves keeping a sleep diary and working with the therapist to root out the issues that are interfering with sleep.

Despite this knowledge, the researchers feel there is still some uncertainty about how exactly to achieve more benefits for autistic people through the use of CBT.  They are eager to maximise results.

To better understand this process, McCrae and her colleagues are conducting a research study through the research core at the MU Thompson Centre for Autism and Neurodevelopmental disorders with children aged between 6 and 12 years old.

This is an exciting project and one that holds much promise. We eagerly look forward to reviewing their publicised findings, and hopefully incorportating them into our existing CBT protocol.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).

The Academy Fire Selsey - A Loss

THE SELSEY ACADEMY FIRE – Moving forward.  

The 21^st August 2016 was a sad day for Selsey.  The Selsey Academy fire will go down in the history of the town.

It will be remembered in a similar way to the tornado that ripped through roofs in January 1998.  After the tornado the stoical folks of Selsey pulled together.  Yesterday, some 18 years later, the ‘Selsey Spirit’ rose  again.  Social media helped mobilise the ‘troops’ who organised themselves efficiently to supply food and drink to the firefighters. The smoke has cleared. The reality has begun to bite.  Selsey has lost a focal point of the community.

Similar to Bereavement

The feelings that arise are similar to those of bereavement. Nobody has died yet a sense of loss hangs in the air.

There is initial shock. Statements are heard like ‘This can’t be true’, (Denial).  Quite quickly awareness widens to acknowledgement.  The Academy was destroyed by fire. It will leave a gap in the community. As the reality sets in, some people will express anger.  Already and without concrete evidence there have been claims that the fire must have been started by an arson attack.  When people feel helpless, the blame game is played. To play the blame game a  ‘scapegoat’ is needed.   You will hear questions like – Were the firefighters quick enough? and Were there sprinklers fitted in the building?

Each of these comments are normal when individuals feel powerless. The objective of the blame game is to feel less powerless.  Try not to buy into it. It divides us and delays the process of moving forward.  After this comes a sense of sadness for what was lost. Finally, acceptance will be reached and we will be able to move forward as a community.

The town is going through a process of disbelief, anger, blaming and sadness. All of this is normal and takes time until we reach acceptance

Possible effects on pupils

For students the process is more difficult. They need to adapt to the loss of their school. There is  likely to be a period of anxiety about the future and about where they will go to school. They will also worry about their friendships.

Parents may notice a quietness in their children or an increase in teenage moodiness. They need time to adjust. This is big news to them. Their cognitive systems need time to process this knowledge. Children who have experienced a change in family situation in the last 12 months may feel the uncertainty more. Take time to listen to your child’s concerns and respond with the actual knowledge you have.

At present the precise arrangements for the children’s schooling is not clear, it can’t be as yet.  It’s crucial that the children are supported at this time.

Parents can help by reassuring their child that clear plans are being made for their education. It may take a while to fine tune the details but what is certain is that a practical solution is being developed.

It is an unpleasant situation but if handled sensitively, your child will have developed important coping strategies and an ability to manage unexpected change. This lesson will be as important as any formal teaching of emotional intelligence.

 

Witten by Christine Tizzard Psychology