Clinical Psychologist Christchurch New Zealand. Dr Alice Boyes.

What Perpetually Irritates You About Your Partner?

Dr Alice Boyes — Fri, 06 Nov 2009 03:23:09 +0000

Consider that people have basic personality styles and then a range of different behaviors that stem from those basic styles.

Sometimes the personality styles we love most about our partners are a double edged sword – they lead to a mixture of desirable and undesirable consequences.

Often what perpetually irritates us about partners is behavior that stems from an aspect of their basic personality that we actually like a lot.

Imagine a fictional couple. Peter and Simone.

Simone is very consciousness and prides herself on being thoughtful, considerate, polite, and reliable.

Something that attracted Simone to Peter is that he’s a free spirit. He’s spontaneous, outgoing, enthusiastic and relaxed. He lives in the moment.

What really irritates Simone about Peter is that he makes lots of plans for them to see friends together and doesn’t leave much time for them to do things alone as a couple.

Simone has asked Peter not to commit her to plans without discussing it with her. However his behavior never changes. When they argue about it, Simone has thoughts that Peter doesn’t understand her, doesn’t care enough about how she feels, and doesn’t value them spending time together as much as she does. She doesn’t want him to see her as nagging, controlling or trying to ruin his fun and worries this might be the case. However, she also sees her wants as valid.

In Couples Therapy, often it helps people feel less irritated if they reframe some types of unwanted behavior as unwanted consequences of wanted basic traits. The unwanted behavior and wanted traits are two sides of the same coin, and although it would be nice to pick and choose, sometimes reality is messier. They learn to work around some types of unwanted behavior rather than fighting against it.

Lets look at some other examples:

1. Someone who is very ambitious > Someone who is in a constant state of change and finds it hard to relax

2. Someone who is conscientious > Someone who is nit picky, fussy, and at times critical

3. Someone who is extroverted and likes to please others > Someone who shows off at parties (e.g. acts the jokester) and is sometimes embarrassing

4. Someone who is easy going and doesn’t feel life is a pressure > Someone who’s not super ambitious or hard driving

5. Someone who is very stable > Someone who is set in their ways and doesn’t want to change

6. Someone who keeps a very even keel emotionally > Someone who is not prone to big romantic gestures and doesn’t get overexcited, seems to lack passion

7. Someone who is spontaneous and open to experiences > Someone who doesn’t like to make plans or commit

8. Someone who is optimistic > Someone who spends too much money and doesn’t save for the future

9. Someone who is smart, competent, goal-focused and efficient > Someone who can be rude

10. Someone who is very agreeable, kind and generous> Someone who is over focused on avoiding conflict or pleasing other people

What Perpetually Irritates You About Your Partner?

Depression Skills: Self Monitoring

Dr Alice Boyes — Wed, 04 Nov 2009 23:29:33 +0000

This is a Cognitive Behavioral Therapy (CBT) activity that might be useful for people to do as a self help activity.

It’s usually used as part of depression treatment but is potentially useful for anyone who wants to better understand their moods.

The activity involves doing ratings once an hour (which can be inconvenient but will take about 30 seconds to do the basic version). If you forget or get busy for a few hours you can catch up the last few hours’ ratings but your ratings will be more accurate if you do them in real time rather than from memory.

The basic premise is that activities that give you a sense of pleasure and/or mastery/accomplishment are important for positive mood. I’ll explain the instructions for doing the ratings and then what to look for in analyzing your ratings.

I recommend trying the activity for two weeks.

Instructions

Once an hour, write down

1. What you’re doing currently doing (just a word or two e.g. watching the news).

And 3 numbers:

2. How much pleasure you’re feeling doing the activity. (10 = as much pleasure as you can imagine ever experiencing while doing anything, 0 = no pleasure)

3. How much of a sense of mastery/accomplishment you’re feeling doing the activity (10 = as much of a sense of mastery/accomplishment as you can ever imagine experiencing while doing anything, 0 = no sense of mastery/accomplishment).

4. Your current mood on a scale of 0 to 10 (10 = as good as you can imagine ever feeling, 0 = as bad as you can imagine ever feeling)

The above is the basic procedure. Here are a couple of additions to make the data you get more useful.

5. If during the last hour, you had thoughts related to

a) anxiety (e.g. concerns about some aspect of the future),
b) shame (”there’s something wrong with me,” personal failure or defectiveness etc.)
c) anger, or
d) sadness/loneliness/disappointment

then also make a note of what thoughts you were having.

6. An optional rating that’s well worth doing is to also rate “degree of challenge” each hour (10 = extremely challenging, 0 = not at all challenging). Why I think this is a good inclusion is explained below.

What to look for in your ratings

1. This activity is about getting an accurate picture of how doing different activities makes you feel. What are your high points? Look for what your high points of mood/pleasure/mastery were each day and also across the week. If you learn that doing a particular activity was a high point of your day/week, would you enjoy doing it more often?

2. Understand your lows. The data you get from this activity will help you understand what triggers slumps in your mood. You might need to look back over the last day or two of ratings to find the factors that contributed to the slump. Subtle factors can contribute to triggering mood slumps and this activity will help you pick up on those, so that when they occur in the future you can manage them in ways that lessen the impact on your mood (e.g., by doing extra self care when they occur).

3. How much of your time is spent doing activities that are BOTH low pleasure and low mastery? What percentage? Would you feel better if you made changes?

4. Do you have a mixture of low/moderate/high challenge activities that provide a sense of mastery/accomplishment. Recognize that sense of mastery/accomplishment comes from both low and high challenge activities. For example, recycling might be low challenge but high sense of accomplishment.

5. What’s the balance like in your days? If you have stretches of time (e.g. whole mornings/afternoons/evenings) in which you’re only doing sense of accomplishment activities, only doing pleasure activities, or only doing activities that provide neither of these things, then could you get more balance?

For example, you might notice you have low mood in an afternoon and looking back on your ratings see your low afternoon mood comes after doing 5 hours straight of activities that gave you little pleasure.

Balance of degree of challenge is also important.

6. Sometimes hard data can give you the impetus to ditch activities you do (out of habit, psychological obligation, or compulsively) that are no longer pleasurable or no longer provide some sense of accomplishment.

7. Although its not what this activity sets out to do, monitoring your activities will probably change how you spend your time because you’ll be paying more attention to it.

Depression Skills: Self Monitoring

Ideas for Life Experiments

Dr Alice Boyes — Fri, 30 Oct 2009 03:13:44 +0000

I said in my last post that I would write some ideas for life experiments. There is also some info about reducing anxiety included later in this post (not particularly related to life experiments but you’ll see why I’ve included it here).

This list is mostly to stimulate your own ideas.

If these ideas seem boring I’m sure you can think of your own ideas that are more relevant for your life/interests. You can also make the experiments more or less difficult however you like. There are no rules.

6 Ideas for Life Experiments

1. Give your partner 5 unique compliments each day for a week. I like the idea of not announcing that you’re doing this and being curious about how long it takes your partner to notice something is up with your behavior. Or, if you’re someone who doesn’t do your share of the tasks at home, do one small task each day that your partner would normally do.

2. Each day for a week, try something you’ve wanted to try but haven’t tried (something different each day).

3. Act out some kind of sexual fantasy you’ve never acted on before – a different fantasy each weekend for a month.

4. Don’t use any power for a weekend e.g. Use your bbq for cooking. Or, no electronic entertainment for a week.

5. Try to find out something you don’t know already about everyone you interact with for a week. Or, try to compliment everyone you interact with at least once during a week. Try to work a compliment into the conversation.

6. Make lunches you’ve never made before, each day for a week. Or, cook a meal you’ve never cooked each night for a week.

The experiment I’m planning to try is unitasking (from the Guinea Pig Diaries book -see last post if you haven’t already). I’m going to start with trying to do it for one day, which I’m still expecting to be challenging, lol.

An aside:

Something that I didn’t mention in my previous post that I particularly liked from the unitasking chapter of A.J.’s book is relevant for treating anxiety. A strategy A.J. used to help himself become more aware of when he was accidentally multitasking was that he started to narrate his behaviour e.g. “I’m walking through central park”. One aspect of this strategy was that he started to narrate his thoughts “The thought has entered my mind that…” (A.J. treated thinking about stuff other than whatever he was currently doing as a type of multitasking).

In the book, he explains the neuropsychology of why speaking your thoughts aloud to yourself like you are an observer of your own mind (”I’m having the thought…”) makes you feel calmer. It activates the language centers of the brain which are in the most recently evolved/advanced part of the brain that specializes in rational thinking and reduces activation of the less rational/more gut level emotion brain centers.

Describing what thoughts you’re having can help you become aware of when you’re having thoughts that don’t make complete logical sense but at the basic brain level just the act of speaking your thoughts aloud to yourself like you are an observer of your own mind (”The thought has entered my mind that…) typically helps increase calm emotions and decreases negative emotions. Therefore psychologists often recommend this for people to use during moments they’re experiencing difficult emotions and want to decrease their emotional arousal.

Another aside:

Something else I didn’t mention from the Guinea Pig Diaries book is that it has a very nice chapter called “The Rationality Project” in which A.J. writes about an experiment in which he tried to avoid “cognitive biases” (cognitive biases are specific types of thinking errors that our brains are pre-programmed to make). Its a great chapter for students of psychology to read as a fun way of learning about how/why our brains have evolved to routinely make particular types of thinking errors.

I found some chapters of the Guinea Pig Diaries boring but there enough great insights in it that its absolutely worth reading.

(Note for regular regulars – that I use the term “life experiment/s” differently than I use the term “behavioral experiment/s” because in psychologist-speak they mean different things.)

Ideas for Life Experiments

Really Useful Psychological Principles From A Funny Non-Psychology Book (With Video)

Dr Alice Boyes — Thu, 22 Oct 2009 22:48:57 +0000

A.J. Jacobs is a journalist/author who does “life experiments” and writes about his experiences. His third book was published last month and he also has a day job as an editor at Esquire magazine in New York. I decided to blog about his experiments because they very nicely illustrate some extremely useful general psychological principles (which I’ll explain).

In his latest book each chapter is about a different month long life experiment. The experiments are things like “uni-tasking” which was a month in which he experimented with not doing any multitasking. In addition to only doing one thing at a time he tried to keep his thoughts focused on whatever one thing he was doing at the time he was doing it. Another month long experiment was “radical honesty” in which he experimented with saying the complete truth about whatever was on his mind (and suffering the social consequences!).

Here are what I consider to be the important psychological concepts you can learn from life experiments

1. Behavior causes changes in beliefs/thoughts and feelings

For example, one of A.J’s experiments was to do do everything his wife wanted for a month (to reward her for tolerating all his other experiments!). When we willingly do nice things for others (behavior), our brains tend to make the assumptions “I must be a nice/kind/generous person” and “I must like the person I’m doing caring actions for -> they must be a good person”. These thoughts feel good, promote future positive behavior and strengthen relationships. You might already have positive beliefs about yourself and the other person but the caring behavior strengthens the beliefs.

Another example of thoughts following actions was a year long experiment in which A.J. followed the rules of the Bible (which he wrote about in an earlier book called “The Year of Living Biblically”). Even though A.J. remained agnostic, he found that praying regularly (which was part of the experiment), made him feel more spiritual.

If you can understand the principle that thoughts and feelings tend to “catch up to” actions you can see when this might be causing wanted or unwanted consequences in your life. e.g. When you repeatedly avoid something, over time and repeated avoidances, whatever you’ve been avoiding seems more and more scary, difficult to cope with, and dangerous. And, you feel increasingly powerless and out of control.

I wrote a previous blog post about how the concept of behavior causing changes in thoughts and feelings relates to treatment for psychological problems – here

2. Doing novel activities (e.g. life experiments) stimulates the neurotransmitter Dopamine, which tends to feel good.

3. A.J. is often surprised about the unanticipated psychological benefits he gets from experiments.

For example, he felt much less anxious than usual during the uni-tasking experiment and he became much more aware of what specific thoughts he was having at the time he was having them.

Trying behavior changes often has flow on effects that we don’t predict e.g. changes in thinking, feelings, future behavior, and other people’s reactions to us. Part of the reason people repeat behaviors that are keeping them stuck and unhappy is because often its not until after we’ve tried alternative behaviors that we understand the benefits.To a large extent discovering the potential benefits of a new behavior requires trying the new behavior and seeing what happens.

4. There is something to be said for being “open to experience”.

Related to above – some of A.J’s experiments don’t work out or have aspects that are uninteresting or unpleasant.

When you keep doing the same thing, the consequences are more predictable than when you try new things.

Discovering new amazing life experiences involves tolerating that sometimes you’ll try things that don’t work out.

I’ll write some ideas for week long life experiments in a future blog post (out of time right now).

Free video

You can watch a video of a recent hour long talk A.J. gave about his experiments at the link below

Video link – http://fora.tv/2009/09/16/My_Life_As_An_Experiment_AJ_Jacobs

If you have difficulty watching it due to slow internet you can download either the audio or video version using the download tab above the video.

If you’re interested in the books

You can also get the audiobook versions of two of AJ Jacobs’s books for free using the offer described here (important to read my comment that some audiobooks are only available if you list the US as your address. I’m not sure about these ones).

Or, here are Amazon links

The Guinea Pig Diaries: My Life as an Experiment

The Year of Living Biblically: One Man’s Humble Quest to Follow the Bible as Literally as Possible

Really Useful Psychological Principles From A Funny Non-Psychology Book (With Video)

How to Change Thoughts and Feelings

Dr Alice Boyes — Tue, 20 Oct 2009 22:04:41 +0000

Most people understand that their thoughts and emotions influence their behavior.

Thoughts/Feelings -> Behavior

For example,

Jane believes “I have to be perfect for people to like and accept me” (thought), feels anxiety, shame and loneliness, and therefore strives to do everything perfectly (behavior).

Jane develops a problem with perfectionism.

1) She feels very anxious when she can’t meet her own standards,
2) When things go wrong in her life she thinks the problems occurred because she wasn’t perfect enough.
3) She compulsively works on minor things to make them perfect and misses the big picture.

One way to challenge dysfunctional thoughts is to do a written exercise to logically evaluate the validity of the thought:

1. What’s the evidence the thought “Other people will only like and accept me if I’m perfect” is true?
2. What the evidence the thought isn’t completely true?
3. What’s a more balanced thought that better reflects reality?

This is an effective technique for changing dysfunctional thoughts and behavior.

BUT

Generally (not just for perfectionism), the most effective way of changing thoughts and emotions is to change behavior first.

Just as

Thoughts/feelings -> Behaviour

Also

When you behave differently it causes you to think and feel differently.

Behaviour -> Thoughts and emotions

Example:

One of the strategies many psychologists recommend for combating perfectionism is to, on purpose, try experiments of not behaving perfectly and test the consequences.

e.g.

- Leaving typos in documents on purpose.
- Experiment with telling a friend about a mistake and observing how the friend responds. Does revealing the mistake cause the person to think less of you?

The goal is to observe

1. Whether anything catastrophically bad happens?

2. How you feel about yourself when you are imperfect on purpose.

- Do you feel a greater sense of being in control and having mastery over your own destiny?
- Do you feel less shame and anxiety after the experiment (even if initially your anxiety goes up)?
- Do you feel less of a sense of not being good enough?

3. Has your perception of the importance/desirability of being perfect changed? You might find out that being perfect is less important/desirable than you previously thought? You might learn that your thought has some elements of truth to it but isn’t completely true? You might learn that in some circumstances revealing your imperfections and vulnerabilities leads to other people liking you more rather than less?

There is lots of evidence from research studies that changing behavior is often the most effective way to change thoughts and feelings (i.e. the most effective way to feel better and have more positive self esteem).

A significant part of my job as a clinical psychologist is to help people figure out what their dysfunctional thoughts are (i.e. What thoughts are causing your problem emotions and behaviors?) and work together to find the best way of solving the problem. Together we decide what treatment strategies are most likely to help the problem and what’s achievable for the client to do (what’s practical and not too hard).

How to Change Thoughts and Feelings

Quick Tip for Getting Out of a Bad Mood

Dr Alice Boyes — Thu, 15 Oct 2009 21:36:05 +0000

This is a tip for when it seems like things keep going wrong.

Try thinking of 3 or 4 things that went right in the last 24 hours.

When people feel unhappy or stressed these emotions tend to lead to thinking biases – we pay extra attention to negative events and overlook positive events.

When we pay extra attention to thinking about what’s been going wrong for us, we tend to overestimate how likely it is that our future will be filled with negative events. Which in turn leads to us feeling worse. Thinking about “what’s gone right” has the opposite effect – we start to expect good things will keep happening to us.

A good and easy self experiment is to

a) try doing this next time you’re in a bad mood, or

b) try doing this at the end of each day for a week,…

…and see how it affects your thoughts and feelings.

In the long term it might be better to use this technique once a week rather than everyday to avoid getting bored with it. For example, each Wednesday try writing down 3-4 things that went right during the past week. An easy way to do this if you use email a lot is to write your list in an email and send it to yourself.

It’s also a good experiment for couples to do together (if both people are interested in doing it) – briefly tell your partner 3-4 things that went right during your day, and they tell you 3-4 things that went right in their day. Expressing positive emotions to partners tends to make us feel closer to them even when the “things that went right” aren’t relationship related. If you try this experiment with your partner, see whether doing it makes you feel closer to your partner and happier with your life.

If you like it, you might make it a weekly relationship ritual. For example, each Friday night tell each other 3-4 things that went right in the past week (to reiterate: they don’t need to be relationship related, just things that went right in any area of your life).

Written by: Christchurch Psychologist, Dr Alice Boyes.

Quick Tip for Getting Out of a Bad Mood

Your Secret Fears About Yourself

Dr Alice Boyes — Mon, 14 Sep 2009 01:00:05 +0000

Do you have secret (or not so secret) fears about yourself? Things you fear might be true about you? Or things you fear other people might think about you?

Common secret fears include:

I’m out of control
I’m weak
I’m defective
I’m needy
I’m fundamentally different from other people
I’ve failed a lot/made a lot of mistakes
I’m powerless
I’m vulnerable
I’m trapped/stuck
I’m unlovable
I’m ugly
I’m worthless
I’m controlling
I’m selfish
I’m not good enough
I’m incompetent

Secret fears about “other people” or “the future” are also common:

Other people don’t care about me
Other people can’t be trusted
If I’m not perfect, other people will reject me
No matter what I do, other people will reject me
I’m going to end up abandoned or alone
If people found out the real me, they wouldn’t like me
Bad things are going to happen to me in the future

Secret fears about yourself and other people/the future are often linked.

For example, I’m unlovable and therefore I’m going to be rejected by others and end up alone.
Or, I’m incompetent and therefore I’m going to screw up my life.
Or, I’m vulnerable and therefore bad things are going to happen to me.

How secret fears snowball

1. When people have these types of secret fears they typically try to not think about them, which makes sense but tends to backfire.

- When you try to block out a thought, your mind typically tries to be helpful by “reminding” you about it. (e.g. If I said don’t think about pink pandas it makes you MORE rather than less likely to think about pink pandas).

- When you try hard to block out a thought, your shame and anxiety about that thought tends to increase. Trying to avoid something is like extra evidence of how scary and awful it is.

- When you try to avoid thinking about a thought, you don’t give yourself the opportunity to logically test whether the thought is true.

2. People tend to pay more attention to evidence that “confirms” the secret fear than to evidence that the secret fear isn’t true (or at least isn’t true all the time/isn’t completely true)

3. Secret fears affect our behavior in unhelpful ways.

Sometimes people develop self-protective rules and behaviors that become self-fulfilling prophecies.

For example, someone who is fearful of being abandoned because they doubt their worth might sometimes behave in excessively reassurance seeking, mistrusting, or controlling ways, and this anxiety-induced behavior might end up causing the thing they fear (being rejected) to come true.

The first step

The first step in taking some of the negative psychological power away from secret fears is to realize that it’s common for (even very successful) people to have these kinds of secrets fears.

***Just because you have a particular thought (that you’re weak, incompetent, a failure, excessively emotionally needy, or whatever) doesn’t make that thought true***

Working with a psychologist about your secret fears

The next best step is to work with a psychologist to change how you respond when your secret fears pop up so that the fears don’t get in the way of your happiness and relationships. Sometimes people are interested in understanding how their secret fears might’ve developed but other times people just want to know what to do about them now.

“What to do about them now” usually involves:

1. understanding what current situations trigger the secret fear thoughts,
2. understanding how the secret fears affect your current behavior,
3. learning how to test the validity of the secret fears,
4. learning how to replace old “junk thoughts” with new balanced thoughts that better reflect reality, and
5. learning and practicing alternative coping behaviors for when the secret fears get activated.

Your Secret Fears About Yourself

Latest Magazine Article in Current (October 2009) Edition of Mindfood Magazine

Dr Alice Boyes — Fri, 11 Sep 2009 10:22:23 +0000

If you want more of my writing, I have an article in the current edition of Mindfood magazine.

It’s about “Letting Go of Friendships”. Pg. 86.

Here’s the cover so you can spot it. You should be able to easily find Mindfood at most supermarkets in New Zealand.

If you look closely you’ll see my article got mentioned on the cover which is cool!

Latest Magazine Article in Current (October 2009) Edition of Mindfood Magazine

Cognitive Behavioural Therapy/CBT Self Help Materials

Dr Alice Boyes — Fri, 11 Sep 2009 09:07:44 +0000

This post is for people who read or subscribe to my blog who might not have read all of the rest of my website (the blog is only part of the overall site – it’s the relatively informal part).

The links below are likely to be extremely useful for understanding and overcoming specific types of psychological problems that I see commonly in my practice (things like Depression, Panic Attacks, Excessive Worry, Agoraphobia, Social Anxiety and Social Phobia, Eating Disorders etc.). The information is based on Cognitive Behavioural Therapy (CBT), which is the main type of treatment I use for these types of problems.

I use CBT because it has lots of scientific studies supporting its effectiveness as a treatment for the kinds of problems indicated below. There are some other types of therapy that also have scientific support for particular problems but many types of “counselling” or “psychotherapy” don’t have the same scientific basis. Anyone thinking about therapy or counselling needs to understand that different types exist. As a psychologist, it’s really troubling to me that there is generally so little public awareness that some types of therapy have been scientifically studied and others haven’t. A big part of the job of a clinical psychologist is to keep up to date with what the studies say are the best treatments for particular problems and then offer those treatments to our clients.

I recommend working with a psychologist rather than attempting to overcome these difficult problems alone (even working with a psychologist it will still require hard work on your part!), but these materials provide great information to help you better understand your problems and the CBT treatment approach, and get you started on the process of feeling better.

Longer CBT Workbooks
CBT for Depression

Coping with Panic Attacks

Mastering Your Worries (Generalized Anxiety Disorder)

Others (Including Bipolar Disorder, Social Anxiety, Assertiveness, Perfectionism and Disordered Eating)

Shorter CBT HandoutsCauses and Treatment of Depression

Generalized Anxiety and Mindfulness

Causes and Treatment of Panic Attacks

Problem Solving

Others (Including Sleep, Unhelpful Thinking Styles, Social Anxiety, Bipolar Disorder and More)

Some more links – particularly aimed at GPs but potentially useful for others

Cognitive Behavioural Therapy/CBT Self Help Materials

Study Shows One Session Cognitive Behavioral Therapy Intervention Effective in Doubling Exercise Time

Restorative Practices

Dr Alice Boyes — Fri, 11 Sep 2009 04:35:39 +0000

Do you feel like the proverbial rat on the wheel (busy but not accomplishing much that’s important to you)?

I’ve written lots of on this blog about the psychological benefits of activities that provide a sense of accomplishment and/or mastery.

The flip side of this paying attention to your deeply restorative practices. Restorative practices help with pleasure and calm but aren’t challenging. They’re deeply relaxing and nurturing.

Doing deeply restorative practices might help you have the energy and brain space for: thinking about your deep goals and life dreams, putting your good ideas into practice, and/or doing something that’s actually effective about unwanted behaviors (if you have unwanted behaviors you want to work on).

Some ideas for deeply restorative practices to try:

- Moments of silence and stillness. Do you ever spend even 5-10 minutes not doing anything?

- Breaks from certain types of sensory input e.g. turning off technology for a few hours.

- Restorative Yoga aka Lazy Yoga. Is quite different from other types of Yoga. e.g. YogaNap: Restorative Poses for Deep Relaxation But you don’t need to buy a book. If you Google “Restorative Yoga” there is plenty of free info about this.

- Lovingkindness meditation. e.g. Lovingkindness: The Revolutionary Art of Happiness is a good basic book about this.

- 90 Seconds of Slow Breathing. Breathe in through your nose while counting 1, 2, 3. And out through your nose or mouth while counting 1, 2, 3. At 6 seconds per breath, 90 secs is 15 breaths.

- Having a bath.

- Massaging your own feet (without doing anything else at the same time).

- Going for a long walk.

Go forth and self-nurture readers! Lol.

Restorative Practices

Blowing Bubbles