Focus Areas
People consult a psychologist for many different reasons. Some individuals seek therapy for personal growth, enhancing self-awareness and self-insight, achieving goals, or simply to better manage various major life areas such as work, academics, and relationships.
Throughout life, everyone encounters changes, disruptions, or normative life transitions. While some transitions may be smooth, others can be more challenging to navigate. A therapist often works with individuals going through these transitions, providing guidance in a safe, supportive, and empathic space.
Other clients might seek the help of a psychologist for psychotherapy due to traumatic experiences, managing a mental illness, navigating relationship problems, or other issues that cause significant distress.
For many individuals, starting therapy with a psychologist can feel intimidating at first, while others may be more comfortable with the idea. Regardless, seeking support requires courage, self-awareness, and a belief that you, your life, and the lives of those you care about can improve, becoming more meaningful and fulfilling. Dr. Mariska’s passion lies in walking with you on the journey toward whichever destination you choose.
Focus
Depression
In the mental health field, depression could be considered to be the “common cold” of our time. It is a widespread condition that affects individuals of all ages, cultures, and nationalities. A psychologist would recognize depression as being characterized by a low mood and/or a reduced interest or pleasure in daily activities. Other associated symptoms may include fatigue, difficulty falling or staying asleep (insomnia) or sleeping too much (hypersomnia), weight changes, impaired thinking and concentration, thoughts of death, feelings of worthlessness, and excessive or inappropriate guilt.
Fortunately, depressive disorders respond well to proper therapeutic interventions. Research has shown that various psychotherapies are effective in managing depression. In some cases, a psychologist may recommend a combination of psychotherapy and psychopharmacological treatment for the best therapeutic outcome.
Anxiety
Anxiety is not simply a case of nerves or fear related to specific situations, like the common jitters someone might feel before giving a presentation to a large audience. A psychologist would define anxiety as an intense, excessive, and persistent worry and fear about everyday situations. It creates a profound sense of dread and apprehension, with the individual interpreting certain situations as fundamentally threatening on a personal level.
When anxiety becomes excessive and uncontrollable, it can lead to anxiety disorders, such as generalized anxiety disorder, panic disorder, and specific phobias. The persistent experience of anxiety over time can be deeply unpleasant and even disabling. However, much like depression, anxiety often responds well to appropriate treatments guided by a psychologist, and clients can experience significant improvement in their symptoms.
Social Anxiety & Loneliness
Social anxiety can lead to difficulties in forming healthy and supportive interpersonal relationships, which may result in feelings of loneliness and isolation. A psychologist plays a crucial role in addressing this issue, as the lack of such relationships not only contributes to distress but also impairs mental wellness. Healthy human connections are vital for psychological resilience, offering essential support that acts as a buffer against both everyday challenges and more severe difficulties, such as trauma, bereavement, loss of income, or mental disorders.
When social anxiety limits social support, individuals become more vulnerable to adverse psychological outcomes during life’s challenges. A psychologist can help by identifying the underlying patterns of thinking, feeling, and behaving, such as negative self-appraisals (e.g., “I am not likable”) or distorted perceptions of others (e.g., “People will reject me”). These patterns can be effectively addressed through psychotherapy, offering a path toward healthier social engagement and improved mental well-being.
Trauma
The experience of traumatic events is highly prevalent in South Africa due to the high rates of violent crime in our society. Contributing factors such as mass poverty, high unemployment, and financial insecurity further exacerbate the issue.
However, trauma is not limited to violent encounters. A traumatic event can be any situation in which a person experiences or witnesses an event involving actual or threatened death, serious injury, or a threat to the physical integrity of themselves or others.
When left unprocessed or untreated, traumatic experiences may lead to Post-Traumatic Stress Disorder (PTSD), a debilitating condition. PTSD manifests through distressing symptoms such as intrusive memories or dreams, flashbacks, and avoidance of stimuli related to the traumatic event. For instance, someone who has survived a serious car accident might avoid traveling by car. PTSD can also cause negative shifts in thinking patterns, including persistent negative beliefs about oneself, others, or the world. Additional symptoms may include irritability, anger outbursts, hypervigilance, exaggerated startle responses, and sleep or concentration difficulties.
Psychologists play a crucial role in helping individuals overcome trauma and PTSD through appropriate treatment and intervention. It is also essential for individuals to discuss their traumatic experiences with someone they trust, as social support is vital to recovery.
Those with limited social support, often due to social anxiety, are more vulnerable to adverse psychological outcomes following traumatic events. Social anxiety frequently stems from inaccurate self-perceptions, such as believing they are unlikeable, or distorted views of others, like fearing rejection. Fortunately, these patterns of thought, emotion, and behaviour can be effectively addressed through psychotherapy, guided by a psychologist.
Emotion Regulation & Distress Tolerance
Life invariably comes with its highs and lows, its ups and downs. We all experience pleasant emotions at times, while at other moments, we face challenging and painful ones. This is completely normal and expected. However, for some individuals, these difficult emotions can feel overwhelming, creating a sense of losing control. A psychologist can help in these situations, offering guidance when the emotional state seems to dominate one’s entire experience of themselves, others, and the world around them. Such overwhelming feelings are often referred to as emotional dysregulation, which is the inability to consistently use healthy strategies to manage negative emotions.
Psychotherapy, often facilitated by a psychologist, aims to foster emotional regulation through the development of healthier coping mechanisms. Dialectical Behavior Therapy (DBT), an evidence-based treatment modality, has proven highly effective in improving emotional regulation.
A closely related concept is “distress tolerance,” which refers to an individual’s ability to navigate emotional incidents without becoming overwhelmed. Distress tolerance skills equip people to handle emotional crises without exacerbating the situation. Those with better emotional regulation often exhibit greater distress tolerance, and DBT is an effective therapy for enhancing both of these areas. By improving distress tolerance, clients can manage emotional pain in a way that avoids harmful behaviours, providing short-term crisis survival skills to manage intense emotional experiences more effectively.
Stress
The World Health Organization (WHO) defines stress as “a state of worry or mental tension caused by a difficult situation.” Stress is a natural human response that prompts us to address challenges and threats in our lives and is not inherently pathological.
While stress is a normal experience, excessive exposure or a lack of effective coping mechanisms can lead to both physical and psychological health issues. Psychologists have found that chronic stress increases the risk of conditions like obesity, heart disease, Alzheimer’s disease, diabetes, depression, substance abuse, gastrointestinal problems, and asthma.
Stress also heightens vulnerability to mental illness and exacerbates existing mental disorders. Chronic stress can impede the effective treatment of these conditions.
Psychologists often address stress through psycho-education and therapy, helping individuals identify stressors and adopt healthier coping strategies. One specific treatment, Stress Inoculation Therapy (SIT), developed by psychologist Donald Meichenbaum, helps clients prepare to handle stressful events with minimal upset. This approach functions similarly to a vaccination, aiming to build resistance to stressors. Dialectical behavior therapy (DBT) is also frequently used to help clients tolerate distressing emotions and experiences.
With appropriate psychological interventions, stress can be managed without compromising a person’s health.
Confidence & Self-Esteem
Self-esteem, a key aspect of psychological health, refers to how we value and perceive ourselves. It is shaped by our opinions and beliefs about our abilities and attributes, often referred to as self-confidence. A psychologist would explain that self-esteem is influenced by a variety of factors, such as personality traits, formative experiences, interpersonal relationships, achievement levels, physical health, and environmental factors.
While everyone’s self-esteem varies naturally, some individuals may experience a level of self-esteem that causes significant distress or impairs functioning in social, occupational, or other areas of life. A psychologist can help when low self-esteem leads to feelings of uncertainty about abilities, doubts in decision-making, or a lack of motivation to pursue goals. Those with low self-esteem may struggle with relationships, expressing their needs, and may feel unlovable or unworthy.
Through psychotherapy, a psychologist can support clients in building a positive self-image, enhancing confidence, and challenging negative self-talk and limiting beliefs. Developing healthy self-esteem positively influences motivation, mental well-being, and overall life satisfaction, leading to better relationships, improved achievement, and greater resilience against adversity.
Tertiary Student Support
Access to tertiary education in post-apartheid South Africa has dramatically increased due to higher education (HE) access mandates. However, many students struggle to adapt to the HE landscape, which can undermine their academic performance and hinder successful degree completion.
These challenges may include, but are not limited to, navigating the transition from high school to HE regarding academic standards and requirements, social integration, cultural adjustment, perceived limited support from family, financial difficulties, and issues related to time management and study skills. Appropriate psycho-education, skills development, and psychologist counselling can significantly enhance HE adjustment and academic success.
Throughout my career, I have consistently worked with students, whether as a lecturer or in my role as a counselling within university student support services. My PhD research focused on establishing a psychosocial and needs profile of first-generation students in South Africa, providing me with a deep understanding of their experiences and the interventions that help them overcome obstacles and reach their full potential in tertiary education.
Career Guidance
Much of the waking life of an employed adult is spent at work, making it crucial to derive a sense of satisfaction from one’s career.
Whether someone is a young adult about to start tertiary studies, a post-matric individual planning to enter the job market, or a mature adult seeking a career change, Dr. Mariska Pienaar is available to discuss their options. As a psychologist, Dr. Pienaar looks at traits and attributes such as personality characteristics, abilities and talents, and career interests when making her evaluation.
Goal Achievement
Goal achievement is the process of reaching a specific, desirable goal through planning, effort, and execution. It is essential for any individual aiming for success. People can set goals in several areas, including career, financial, family, artistic, attitude, physical, pleasure, and public service.
Many individuals may not reach their full potential due to a lack of goal setting and a limited understanding of how goal setting relates to goal achievement. A psychologist works with clients to systematically identify their goals across various life domains. Once goals are identified, the psychologist helps set realistic expectations and deadlines for achieving them. They guide clients in goal setting to ensure that goals are specific, measurable, achievable, realistic, and timely. This process is followed by constructing an action plan detailing the necessary steps to reach the identified goals. The psychologist also focuses on strengthening and reinforcing the qualities and attitudes essential for moving from goal setting to goal achievement, including discipline, persistence, passion, focus, and organizational skills.
Goal achievement plays a crucial role in an individual’s overall sense of well-being, satisfaction, motivation, quality of life, and self-esteem. However, the facilitation of goal achievement will look different for each client. For instance, low self-esteem may hinder a person’s belief in their ability to achieve goals. In such cases, it may be necessary to first work on enhancing the client’s self-esteem. “Self-sabotage” is another complex dynamic in which a person unconsciously feels they do not deserve the rewards that follow successful goal achievement. In these instances, it is important to identify, understand, and address any deep-seated intrapersonal dynamics at play.
Finding & Making Meaning
Identifying the meaning of life can be perceived as an ambitious quest, one that has puzzled and perplexed the most enlightened thinkers for as long as humans have existed. The answers to this profound question often seem elusive, and it is easy to understand why. A mere observation of the world can prompt individuals to throw their arms in the air and exclaim, “What is the point?!”
Victor Frankl, a Jewish psychiatrist and existential theorist who survived the Holocaust in the 1940s, believed that humans possess an inherent need to find meaning in life. He presented the sobering notion that suffering is an inevitable part of the human experience. Yet, he contended that the presence of meaning in life is an objective reality, suggesting that meaning is inherent to existence. If suffering is unavoidable and life holds intrinsic meaning, it logically follows that there must also be meaning to be derived from suffering. Frankl’s thoughts on this topic are explored further in his writings on Logotherapy, which were shaped by his harrowing experiences in Nazi concentration camps.
Other psychologists respect the views Frankl proposed, recognizing that individuals innately strive for meaningful experiences in their lives, whether consciously or unconsciously. While Frankl suggested that meaning can be discovered in objective reality, it is also acknowledged that meaning is deeply influenced by personal perspectives, beliefs, attitudes, values, context, challenges, and strengths. Thus, individuals are not merely “meaning finders” or “meaning seekers,” but also “meaning makers.” This journey of creating and experiencing meaning is one that I am passionate about undertaking alongside clients. Frankl left behind valuable insights into how individuals can find meaning in life, emphasizing that meaning can not only be found in suffering but also serves as an antidote to the pain it causes, making difficult experiences more bearable.
This process is highly personal; what holds meaning for one person may differ greatly from what it means for another. The role of psychologists is to assist individuals in identifying what is meaningful to them and to support them in cultivating the capacity to create and experience that meaning in their lives. Such work is approached with the utmost respect and reverence for each individual’s subjective experiences and unique journey toward discovering and crafting their own personal meaning.
