Dr Manju Rajaratnam explains, you are not meant to stay in a prolonged survival mode. If this is you or someone you know, it is important to seek support with a medical professional to discuss how to manage symptoms and restore healthy brain chemistry. Dr. Rajaratnam, is a GP with more than 29 experience helping people manage physical health, emotional and spiritual wellbeing, especially during life’s toughest seasons.

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GRAPHIC 1

Stress (fight or flight) chemicals

Adrenaline, Cortisol

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Feel good chemicals

Dopamine, endorphins, serotonin

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5 A Therapy

Anchor -Faith in God or greater power

Awareness- recognise negative thought and choose to change

Acceptance- Understand pain, loss and betrayal are a part of life.

Appreciation- Focus on what you have.

Amend- Where possible mend relationships.

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Centre for clinical intervention

www.cci.health.wa.gov.au

Virtual Hope Box APP

Now for a quick recap for building resilience in crisis.

When we are faced with a crisis, there is a chemical reaction in our bodies that equips us to act. Known as the fight or flight mode.

This is needed to act in an emergency however it is important we do not stay in the fight or flight mode.

Prolonged thinking on a stress episode causes changes to our brain and body leading to depletion in the necessary feel-good chemicals, like dopamine.

While this is complex, one way to calm and rebalance in these times is

to build resilience and emotional fitness drawing on strong foundations of close connections.

This is an overview of Dr Manju’s 5A therapy Framework for reference-

Anchor -by Faith in God or greater power

Awareness- by recognising negative thought patterns and decide to change thoughts to align with your values and true identity.

Acceptance- by Understanding pain, loss and betrayal are a part of life. Instead of reacting in anger or bitterness, make the choice to forgive.

Appreciation- by Focusing on what you have. Write out or think about the good things in your day. Write a note of thanks to someone you know. This impacts your thinking and helps others as well.

Amend- Where possible mend relationships. Humble yourself where needed with apology and accept disagreements will occur. Letting go of disagreements calms your brain and improves relationships.

Dr Manju draws this five A framework from evidence-based therapies and includes elements of the AA 12 step model.

These are some resources for you to support a healthy mind and build resilience.

Go to Centre for clinical intervention website

and the app, Virtual hope box.

0:05

Think. on good. Hello and welcome to Think on Good. Coming up, we check in on the essentials for

0:11

managing a crisis. In this program, we share inspirational stories and learn how to build a

0:17

healthy mind through treatments and resources. Today we explore something relevant to all of us

0:24

how to be resilient in a crisis. Joining me is Doctor Manju Rajaratnam, a medical doctor who

0:30

helps people manage not just physical health, but emotional and spiritual well-being, especially

0:36

during life's toughest seasons. Welcome, Doctor Manju. Hi. It's lovely to join

0:43

you all at last. After all these years, you have spent time in helping others build resilience in

0:50

crisis. How did you get into this? I've always been stuck. How people who even have seemed to have

0:57

everything, great careers, great life can crumble during personal crisis, and this made me

1:03

realise that crisis management and conflict resolution is just as important as treating

1:09

physical illness. That's what made me sort of get involved in this in the first place. Yeah. Yes. And

1:16

so you would see a lot of people over the years present with these complex problems. Yes. That's

1:22

right, though they don't directly. Even if they don't come directly with those saying they have a

1:27

crisis, they might have come. Symptoms that sort of lead me to think there may be an underlying

1:32

crisis that they're dealing with. Yes. So what's the science behind this? When we look at the body

1:38

and the brain, how does this work? What happens is when we go through crises or when we remember

1:43

painful moments, whether it is an abuse, a hurtful comment, or a scary diagnosis. Our mind

1:50

perceives those thoughts as a threat, and that triggers a emotional alarm system called the

1:56

amygdala. You find that we get into a fight and fight or flight mode, and then that sort of

2:03

pumps the stress chemicals. Like I do not even cortisol into our body. And then suddenly you find

2:09

yourself, your heart racing. Your palms are getting sweaty and you feel literally like running away

2:14

or ready to fight. The problem is we've been short term. It's okay. We recover from it. But if

2:21

the crisis drags on or we keep mentally replaying these negative thoughts, we will get stuck in

2:28

this survival mode. And this changes our body's chemistry. What happens is that stress chemicals

2:35

will constantly stay high at the same time. A natural happy chemicals like serotonin, dopamine,

2:41

they drops to the all time low. This changes the chemistry and changes. This change in chemistry

2:48

actually changes our mind and our body. So we feel exhausted. We feel tired. We feel anxious, depressed.

2:54

Our heart is overworking now. Digestion is slowing down. Our immune system is also weakened, and this

3:01

sort of leads to a lot of mental illness and physical illness as well. The the most important

3:06

part that we don't realise is the more we think about these thoughts repeatedly, our brain also

3:12

will start to rewire itself. This is this is what happens. And then literally our body and

3:19

our brain structurally start to change. How do we stop those thoughts though, if we've we've

3:26

experienced a crisis or in a crisis, what would you say to those watching and listening, how to

3:32

actually stop those thoughts from happening? To understand is a complex issue to solve, because

3:38

there's a lot of deeper issue that's going on. So to understand how to help us look at how if

3:45

you look at our grandparents, for our ancestors, for example, how they handle life, they actually

3:50

face deep loss, rejections and even poverty. Yet somehow or other, they remained resilient. They

3:56

didn't crumble emotionally. They most of us do struggle today. So do you know one thing that a

4:02

grandparents had? Something that not we are missing today is our grandparents, who

4:09

actually had close families and tight knit communities and a deep connection to faith as

4:14

well. And this gave them some a deep sense of belonging, an identity, a

4:20

significance, a purpose, and that sort of nourished their mind and built resilience to

4:27

withstand life's storm. So the problem today is we don't do relationships well, as you know, as

4:34

well as our ancestors did. And also we drifted away from faith as well. So this loss

4:41

of sense of belonging has become the issue that we, this generation,

4:48

has become the loneliest generation in history. So to build resilience, first we have to

4:54

restore this and have a deep, true sense of belonging. How do you build the

5:01

resilience before a crisis so that you're going to be a little bit stronger when you are in the

5:06

middle of it? Right. So like as I said, so we have to have a system where we integrate faith and

5:13

have the connection back. So for that sort of what I've developed is a simple sort of a holistic

5:20

framework in five steps. So I call it the five A's because each step starts with an A, just to

5:26

remember easily as well. The first step is anchor. So basically it's reconnecting to the greater

5:32

power which will give us security and sense of community as well. So so this also shifts

5:39

us from fear and loneliness and to trust and significance as well, and a

5:46

greater sense of belonging. We'll get this itself in our mind and our brain as well.

5:53

And also, we will start literally growing good trees in our mental garden and flourish and bear

5:59

good fruits as well. So the anchoring is a very important step to connect back what we've lost.

6:06

The second day is awareness. This means recognising your negative thought patterns and

6:12

then challenging and reshaping them into thoughts that align with your values and to identity. So

6:19

awareness is the second one. The third one is the acceptance. So this means accepting pain,

6:26

loss and betrayals are part of life and the people are going to hurt us. But rather than

6:31

reacting in anger and bitterness, we make a conscious decision to respond with kindness and

6:36

patience and forgiveness as well, which is very hard to do in reality. But we do it not

6:43

because the other person deserves it, but because we deserve peace. Don't want to be stuck in anger

6:49

or bitterness, right? So that's the only way we can not drink this poison of bitterness sort of thing.

6:56

The fourth is appreciation. So this is basically shifting our focus from what's

7:03

missing to what we already have and practising like practices like keeping a

7:10

gratitude journal, writing a thank you note, or a simple expression of appreciation to someone.

7:16

That's sort of though it sounds very simple, small and simple. It's very powerful. It impacts your

7:22

mind and our relationships. Plus the other person who's receiving as well, they feel good and their

7:27

relationships improves with us as well. The fifth day is the amend, which is it is the

7:34

is there amending relationships basically in a disagreement or in argument? What we feel is we

7:40

are 90% right and only maybe about 10% wrong, but unfortunately the other person thinks the

7:47

same. They think they are 90% right and maybe only 10% wrong. So we thought we were standing and

7:52

trying to sort of prove ourselves right, because nobody's going to win this discussion. It is main

7:59

thing is to mend the relationship, then trying to prove yourself right. So it is basically humbly

8:04

apologising for your 10% of a mistake. You think you are wrong and letting go and making

8:11

your relationship improve. This will not only will calm your brain, but also improves your

8:16

relationship as well. So these are the five ways that just are theories. As you know, they are

8:22

actually backed by neuroscience and widely used in evidence based therapies as well, including, as

8:28

you know, the 12 step model of Alcoholics Anonymous. Yes. So so that's good that you have

8:35

those five steps. But if someone can't make amends for someone that they want forgiveness or the

8:40

other way around and they've passed on or they're not able to contact them. Do you recommend

8:46

journaling that still or writing that letter? Or how does someone. Yeah. Because for different

8:51

people it yeah it helps differently. Journaling is definitely a good thing because when you're

8:56

journaling you are thinking, you're processing and you're writing it down. Yes, that is the good step

9:01

as well. Yes. If you can't speak because they either they have your they are not with you

9:06

anymore. Or still is. The process of healing is. Is journaling and trying to sort of write it right.

9:13

What you think? Yes. Yeah. Can you give an example of where someone's demonstrated forgiveness?

9:20

Um, so when when I think to resilience or true forgiveness, the Abdullah

9:27

family family comes to mind. I don't know whether you remember this. The three kids, they lost three

9:32

kids while they were just tragically, was killed by a drunk driver while they were just

9:39

walking to get some ice cream. But what now? What happened there? How they responded was amazing.

9:46

Instead of allowing the allowing the crisis to define them, they chose a different path. They were

9:53

anchored into something much greater, God and faith, and that had planted good trees in their

9:58

mental garden. And they had good fruits as well. And that sort of made them respond from a place

10:05

of wholeness and with love and humility and forgiveness. Yes they were. Amazingly, after a

10:12

couple of days of the tragedy, they publicly forgave the driver. So this made them stand

10:18

strong in absolute tragedy and be resilient and not crumble. Can you also share with us

10:25

some briefly, some examples or resources that you know of that can help people build

10:32

resilience to be prepared for crisis? There's a good resource on a website called the centre for

10:38

Clinical Intervention. It's a free, evidence based resource and workbooks online so that hopefully

10:45

it's called the centre for Clinical Intervention. And it's it's a free website, as I said. And then

10:51

you can go into resources there and looking after yourself. And that has got all the different

10:56

categories that you can click on and get some information as to what that it is and how you

11:01

recover from that. And there are also an app, especially when you are in a crisis and when your

11:08

heart is racing and you can't unable to think you're in a distress mode, you need to. You need

11:14

calming tools for that. There's an app called virtual Hope box, which I often recommend to my

11:19

patients, and they found it very useful. It's got insights you can put on information words, and you

11:26

can also put some photos, videos and what he's got a meditation and relaxation and deep breathing

11:32

exercises as well. So it'll take you through those process. Yes. Briefly doctor Manju, before you go,

11:37

what's your favourite quote or saying? I think in this context what I would say is, um, you

11:44

are what you think, basically because what you think is going to define you as we discuss now.

11:51

And it also echoes the Philippians four eight, the Bible verse, it says, fix your thought on what is

11:57

true, honourable, right, pure, lovely and admirable, because this is what's going to sustain

12:03

you in crisis and also to be a better person. Thank you for joining us today. Thank you, Doctor

12:10

Manju. It was my pleasure. Thank you. When we are faced with a crisis,

12:16

there is a chemical reaction in our bodies that equips us to act. Known as fight or flight mode.

12:23

This is needed to act in an emergency. However, it is important that we do not stay in the fight or

12:28

flight mode. Prolonged. Thinking on a stress episode causes changes to our brain and body,

12:34

leading to depletion in the necessary feel good chemicals like dopamine. While this is complex, one

12:40

way to calm and rebalance in these times is to build resilience and emotional fitness, drawing on

12:46

strong foundations of close connections. This is an overview of Doctor Manjunath five A therapy

12:52

framework for reference. Anchor by faith in God or greater power awareness by recognising negative

12:59

thought patterns and decide to change thoughts to align with your values and true identity.

13:06

Acceptance by understanding pain, loss and betrayal are all part of life. Instead of

13:12

reacting in anger or bitterness, make the choice to forgive appreciation by focusing on what you

13:19

have. Write out or think about the good things in your day. Write a note of thanks to someone you

13:25

know. This impacts your thinking and helps others as well. Amend where possible. Mend relationships,

13:31

humble yourself where needed with apology and accept disagreements will occur. Letting go of

13:37

disagreements calms your brain and improves relationships. Doctor Manju draws this five way

13:43

framework from evidence based therapies, and includes elements of the Alcoholics Anonymous 12

13:48

step model. These are some resources for you to support a healthy mind. Go to the centre for

13:54

Clinical Intervention website and the app virtual Hope box. Think on good is

14:01

a program offering information for mind health and is not intended to replace medical treatment,

14:07

professional advice or diagnosis. If you or someone you know is experiencing mental health

14:13

14:20

We'd like to thank our contributors and sponsors. Until next time, we hope you have a good day.

14:31

Think. on good.