3004 廚房

3004 廚房
為保障病人隱私,作者於心理學隨筆內並沒有在未經客戶的同意下,放置任何病患的真實故事,所有包含心理治療的故事內容都已經改編,忌對號入座。另外,本人不能在網上隔空治療,所以本網站並不提供任何形式的心理諮詢服務,如有需要,請到醫院或診所求診,敬請留意。All the psychotherapy stories are written in ways to protect clients' confidentiality and privacy rights. NO real and identifiable clients' stories are shared on this website without their permission. No psychotherapy consultation will be provided on this website. Please do see your local provider for any psychological consultation.

2012年3月31日 星期六

Cantonese Steamed Eggs 港式蒸水蛋

Cantonese Steamed Eggs 港式蒸水蛋 

My grandma used to make this dish for dinner while I was still living at home in Hong Kong. As a child, I was able to eat a big bowl of white rice with steamed eggs and soy sauce.  I can always remember how good it tasted. It is smooth like pudding and very easy to digest.

After I moved to the United States, I seldom make this dish on my own. I remember there was a time that I was sick and Honey K made this dish with congee (rice porridge) for me, along with all the Asian side dishes (e.g., pickles). It reminded me so much of grandma and her delicious food.

I an trying to replicate grandma recipe without adding the meat or salty duck eggs in to make it a healthier meal. As most of my Hong Kong and Taiwanese readers would probably be familiar with this dish, I am writing this for my American readers, colleagues and friends, who have asked  "What's steamed eggs?"

Serving: 2

Ingredients 

3 eggs
1/4 cup of vegetable stock or chicken stock*

*grandma told me to add chicken stock to add flavor to it, but Honey K said it is fine to use water

Optional ingredients to enhance flavor and for garnish
2 tbsp of (low sodium) soy sauce
1 stalk of scallions (chopped)
1 tbsp of sesame oil

Procedure
1. Whisk the 3 eggs in a bowl.
2. Add 1/4 cup of water/vegetable stock/chicken stock. Whisk again. Pour the mixture into a shallow dish or bowl.
3. Prepare a wok / a steamer / a rice cooker with water for steaming. Put the shallow dish or bowl into it and steam it for 15 to 20 mins. For best result, allow some air to go into the rice cooker/steamer/ wok, so that the egg will come out smooth without "wrinkles." You can place to 2 chopsticks in between the lid and the pot so that air can goes in.  Do not overcook or the eggs will become too dry and wrinkly to eat.
4. After 15 to 20 minutes, remove the bowl/shallow dish from the steamer/rice cooker/ work. Sprinkle scallions and pour soy sauce (and sesame oil) on the top of it and serve it with rice.

Steamed eggs served with rice (a mix of barley, wild rice, brown rice and white rice)

2012年3月11日 星期日

The Vow: The search of the self and for the self


"My theory is about moments, moments of impact. My theory is that these moments of impact, these flashes of high intensity that completely turn our lives upside down actually end up defining who we are. The thing is each one of us is the sum total of every moment that we’ve ever experienced with all the people we’ve ever known. And it’s these moments that become our history. Like our own personal greatest hits of memories that we play and replay in our minds over and over again." (The Vow, 2012) 

Honey K. and I watched The Vow a few days ago. The movie was fine but something got me thinking about our identities as human beings. As a psychology student, the above quote should not be surprising at all because this is what I do with my clients most of the time. My client and I search for these moments in their lives that impact who they are and who they want to become in the future. It is often in this very process we come to reject, struggle or accept what define us.

In the movie, Paige woke up from a coma with severe memory loss. She forgets who she had been for the past 5 years and her husband, Leo. As Paige cannot recall her marriage life and her identity as an artist and vegetarian, Leo decides to let go of Paige ultimately to allow her to develop who she wants to be and be happy. Paradoxically, by letting go, Paige rediscovers her passion to art and falls in love again with Leo. This is basically the plot of the movie, not surprisingly.

The idea that one can discover the self on his own still remains puzzling to me. It contradicts with the soliloquy in the beginning, "The thing is each one of us is the sum total of every moment that we’ve ever experienced with all the people we’ve ever known. And it’s these moments that become our history." For me, the idea illustrates the illusion that we have a complete control over our own identities. We can pick and choose who we are and who we want to become. I guess we like to believe in this way because of beneffectance (the tendency to take credit for success while denying responsibility for failure). When an identity is formed, it might be considered to be an achievement by the self, especially during the phase of emerging adulthood when the search of identity/self become a developmental task. Consider how most people tell you about their journey to define themselves. They say, "I finally find out who I am." They rarely say, "These people help me to find out who I am."  In a western and psychological perspective, it makes sense that human wants to take ownership of their self-enhancement. However, I do think our identities evolve from the sum total of every moment that we've ever experienced with all the significant people we've ever known. 







2012年3月4日 星期日

Doctor, I am not sleeping!


"I can't sleep. It takes me forever to fall asleep and I find myself waking up a lot. I feel fatigue in the morning and I can't go on like this anymore. If I don't get to sleep soon, I will not be able to work tomorrow and I have so much to do. Please help me sleep." It is not uncommon to hear patients complain about their sleep and the accompanied anxiety of not sleeping. In the United State, around 9% of Americans suffer from some form of insomnia, which can be characterized as difficulty falling asleep, difficulty staying asleep, non-restorative sleep or any combination of the above. Medical problems such as diabetes, restless leg syndrome and chronic pain can affect sleep, so as psychiatric conditions, including mood disorders, anxiety disorders and substance abuse (i.e., alcohol).  Additionally, acute stressors or hormonal changes (i.e., menopause in women) in life can negatively impact sleep quality. If, ruling out all of the above conditions and your patients are still having insomnia, it is possible that your patients might have developed heightened anxieties about not getting enough sleep which maintain and perpetuate their sleep problem(s). Such sleep difficulty associated with excessive worries is referred as psychophyiological insomnia. 

This type of insomnia might begin suddenly after a significant event or slowly developed over the course of time. If you ask the patient about what they think about when they can't sleep, they tend to tell you how much they worry about not being able to function well the next day. They may also have racing thoughts associated with other negative beliefs about not sleeping (e.g., I am going to look terrible tomorrow. I will fail my work tomorrow if I don't get sleep now. I will die of sleep deprivation.) These worries result in tensions and over-arousal that keep the brain working and the person from sleeping, creating vicious cycles. Battling with themselves, patients toss and turn in their beds until they are able to fall asleep. Their beds, in turn, are conditioned with worries, anxiety and negative thoughts etc... This makes it very difficult to fall or stay asleep. In some cases, patients might feel increasing agitation and anxiety as their bedtime approach and only find themselves awake in bed most of the time at night. In order to cope with daytime fatigue, these patients compensate by consuming too much caffeine during the day that further disrupt their sleep. In short, these patients usually "try too hard" to fall asleep and stay awake. Interestingly, however, these patients often have no trouble falling asleep when they are sleeping in a hotel room or sleep laboratory. 

What do we do with these patients who worry about not sleeping? Cognitive behavioral therapy (for insomnia), which often include stimulus control, sleep hygiene education, cognitive restructuring, sleep restriction and relaxation techniques, have demonstrated effectiveness with this population. Patients are explained the rationale of this treatment approach and introduced sleep hygiene to increase therapy compliance. To dissociate worries and anxiety with their beds, patients are instructed not to engage in any activity other than sleep and sex in their beds. If they find themselves tossing and turning in bed for more than 20 minutes, they have to leave their beds. They will go to another room and engage in a relaxation activity (e.g. deep breathing exercise) while not to look at the clock. Not until they feel sleepy (not tired), shall they return to their beds. It is important to distinct the difference between sleepiness (e.g., eye-lids dropping) and tiredness (e.g., exhaustion) to the patients. The latter state might increase arousal that prevents the patient from sleeping. The goal is to remove the negative thoughts and anxieties associated with the bed, as well as minimizing arousal in bed. When the patients are in beds, they should feel ready to sleep. As different people have different sleep needs, with the help of a sleep log, patients can collaborate with the healthcare providers to determine the best time for bedtime and wake time.

The other component of this approach is cognitive restructuring. Patients tend to engage in inaccurate beliefs and thoughts about insomnia without awareness. It is therefore important for the healthcare professionals to provide accurate sleep information to them. Inaccurate and negative beliefs are also to be challenged, so that maladaptive thoughts can be changed. For instance, the catastrophic thought that "I will fail my work tomorrow if I don't get sleep now" can be replaced with accurate statement such as, "I probably get more sleep than I think and I have many times able to work despite poor sleep." Using a mood-thought record, patients are taught to pay attention to their thought patterns on sleep and challenge these dysfunctional beliefs.
 
Not all the insomniac will benefit from this approach. If the patient has a primary medical condition or psychiatric illness that impacts their sleep, it is important to address these above problems to treat the sleep problem, rather than jumping into cognitive behavioral therapy for insomnia.  

Reference
Edinger, J. & Carney, C. (2008). Overcoming insomnia: A cognitive behavioral therapy approach. Oxford University Press, Inc. New York: New York. 
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