Psychology 101 – ABC’s of Modern Mental Health

Current Psychology is filled with acronyms, and these often stand for evidence- based treatment theories.  I thought it might be helpful to put some of the most talked-about, current theories in easy-to-understand language.

CBT- Cognitive Behavioral Therapy – This method aims to teach clients skills to modify dysfunctional uthinking.  We look at how the maladaptive cognition (harmful or unacceptable thought) was developed and correct the ensuing behaviors.  Example – Your spouse has moved out of the house, because of you yell and scream during every confrontation.  Your counselor helps you uncover that you yell and scream easily, because it was "normal" in your house of origin.  You don't even realize that you do it or how deeply it hurts others.  So now that your clinician has helped you uncover this “maladaptive thought pattern,” the two of you can work to train you to change your behavior using practicable techniques.

DBT – Dialectical Behavioral Therapy – This method works to teach emotional regulation and coping skills.  While it is important to understand where negative thoughts and behavioral issues come from, sometimes Clients need to understand what they are experiencing in the moment and have tools to deal appropriately.  You may have heard of “mindfulness” – being aware of your emotions in the moment.  Mindfulness is the core principle of DBT.   If you are aware of your emotions, you can learn to either control them – if they are emotions like anger or depression – or fully enjoy them – if they are emotions like happiness or contentment.  So let’s say you deal with anger issues.  You've lost relationships and had significan health issues, because you are easily angered and have little control over your reactions.  So one day after you've started counseling, someone cuts you off in traffic. If your counselor has worked with you using DBT, you become aware of your blood pressure escalating, your neck muscles clenching, and your stomach knotting.  You willuse the coping skills you have been taught to de-escalate yourself, to avoid the negative effects of your anger. 

EMDR – Eye Movement Desensitization and Reprocessing – This method was originally developed for soldiers suffering from Post-Traumatic Stress Disorder. It is used for Clients dealing with difficult current or past experiences that are causing them stress, anxiety, and/or depression.  Often, patterns can be found in multiple events that compound negative “core beliefs”.  EMDR uses the same method your body uses to process daily events – Rapid Eye Movement – to re-process negative perceptions of events and try to make them more manageable.  So let’s say you, as the client in this scenario,  were adopted at age 6, and your best friend moved away when you were 11, and your fiancé broke off your engagement at 25.  You could have a negative core belief such as “it is not safe to feel”, “I am defective”, or “I am abandoned”.  You are going to reprocess these events with guidance of a therapist to soften or disprove that core belief.  You're then going to work with the therapist to find positive experiences that disprove your negative core belief. Together, you will strengthen these more positive memories through EMDR processing.  Clients who have dealt for years with long-term difficulties report achieving relief and peace, after having worked with a trained EMDR therapist.

Of course, there are many other theories in the world of mental health counseling.  Some clinicians find benefit in focusing on one method.  Others (myself included) assess their clients and “mix and match” their treatment to the client’s needs and personality.  Hopefully, this blog gives you relatable descriptions of the ones being talked about the most, right now, so that you can choose the right clinician for you.

72 Days After Our Tragedy

I write this blog post from my perspective.  I am:

·       A Mom of a  Marjory Stoneman Douglas High School Student

·       A Parkland/Coral Springs Community Member

·       A Mental Health Counselor

72 days ago, a shooter took the lives of 17 Stoneman Douglas students, injured 17 others and changed the mental perspective of every student, teacher, worker, parent, and community member in our area.  Our once unknown little town – the one I always described to others as a modern day “Leave it to Beaver” kind of place – is now full of anxiety, tension and conflict.  There is healing that needs to happen, and in my own small way, I wanted to try to offer suggestions.  At the end of this post are some resources.

The Students and Staff – Each person experienced this traumatic day differently.  Some were directly in the line of fire, and some didn’t hear gun fire from their location.  This doesn’t necessarily correlate to the amount of mental health issues that will surface after the fact.  Each person processes events with different levels of sensitivity and resiliency.  One student may have been in the 1200 building watching the events transpire, and she is now back to playing soccer and excelling at school. Another student might have run off the campus at the start of the events, and he is not able to attend school most days.  There is no right or wrong, and there is no set amount of time that will “make it all better.”  Support, counseling, development of coping skills, processing through techniques such as CBT Trauma Training and EMDR, and time are elements that can help these people move forward. 

Family Members – I hear from friends and read on Facebook a high level of stress and anxiety from family members, especially parents.  As a parent of one of the students on campus that day, I can relate.  Our adrenaline kicked in, when our children were in immediate danger.  We did what we do best – we took care of them.  We picked them up, hugged them, got them counseling, called them in sick when they couldn’t go to school, etc. But now, the stress and pressure of almost losing our kids seems to be sinking in.  Our safe little haven seems scary and unsafe. 

It is time, if you have not already done so, to take care of yourself!  Your kids and you are being affected by your anxiety levels.  Please take advantage of the group counseling opportunities being offered or seek private counseling.  Get back to your exercise routine and practice relaxation techniques to get enough sleep.

Community Members – On a positive note, there are several groups trying to do good things, since the tragedy.  Some are trying to change laws and policies.  Some are increasing awareness for issues they believe are at the center of the problem.  Many are raising money to help victims, survivors, causes, changes and policies.  Here’s the problem: There are diametrically opposed views, they affect our kids and their schools, emotions are running high, and it is causing rifts and strains in our community, when there should be unity and support.

While I can end this post with resources for counseling and support, I don’t have an easy answer for this community issue.  I do have a request:  as we each consider responding to an idea with which we do not agree, could we please consider that the other person is trying to come from a good place?  There is no need for aggressive, disrespectful, personally hostile messaging.  It’s toxic to you, as you write it, and it’s toxic to our community.  Take a deep breath, when a post agitates you. Try to scroll past it.  And if you can’t, re-read your reply a few times before posting it.  Ask yourself, “is there any good that will come of my post?  Will it change the other person’s mind?  Could I hurt other people on the string of the post?”  Of course, there are people –and “robots” who try to insight us and stir the pot – we, as a community need to stop allowing it.  

This is for the healing of our little haven. 

Some Resources:

The school currently has 10 social workers on staff to spend time with the students, if they go to the media center. They do not need a teacher’s permission. They can go at lunch.

There are group counseling opportunities available for students and family members through the Parkland Resiliency Center. 754-321-HELP

Parkland Cares, website lists several non-profit community counseling resources. Parklandcares.org

Most private therapists in the area are offering reduced rates

Weebles Wobble, But They Don't Fall Down - the importance of resiliency

 Are you one of those people who can handle any adversity that comes your way?  Or have you noticed that sometimes you get kicked in the teeth and get back up again - and sometimes you don’t?  

Resiliency is a trait that some of us have in spades, but there are times when all of us wobble more than we would like.  Interestingly, it can’t always be measured by the size of the crisis.  In fact, I remember my mom was rock-steady during the “big issues” but had a hard time dealing with everyday hurdles.

Resiliency is developed through childhood support and experiences.  And yet, we’ve all known someone who was raised in a very challenging environment, who is extremely resilient – and vise-versa.    We know people who have been raised in “good homes” with strong support of parents who lead by example.  Even so, we can site examples where those folks can’t deal with even the small problems of life.  Factors may also be genetic and even hormonal.  In fact, it’s almost impossible to figure out who will turn out to be resilient and when resiliency will show itself or falter.

It’s important to realize that even the strongest person will have times, when their confidence, positive attitude and drive may lessen.  Of course, as a counselor, I am supposed to tell you it is the time to see a counselor – and of course, that is an option.  But just recognizing the problem, dissecting the reasons for it, and asking for support from friends and loved ones may get you through. 

The first step is to check your physical health.  Thyroid problems, hormonal issues, high blood pressure, low blood pressure, etc. can all cause us to feel less able to handle life’s problems.  The second step is to evaluate your responsibilities.  If you are the person everyone believes can handle “it all” – let me be the first to tell you, you can’t!  Are you taking care of children, of parents, of a job, of pets, of volunteer activities, of all your friends, of all your pets, of your house?  Even you may have taken on too much!

“No” is an extremely healthy word.  And “I need some help” is an even healthier phrase.  It is okay to ask more and expect more of your spouse, children, siblings and friends.  Honestly, the people around you may have gotten lazy and comfortable knowing you will take care of things.  But they love you – and will help you – if you let them know you need it.

And yes, the dreaded exercise is necessary.  Even when you are tired and have no energy, it must happen.  It does make you feel better.  You know it, and I know it.  Along the same lines, you have to look at what you are eating and drinking – too much sugar, caffeine, alcohol?  Not enough veggies and fruits?  Take it from me – I am a chocolate fiend and hate most vegetables.  When I catch myself letting good habits slip, I have to look at what I am consuming and do an about-face.  I hate to exercise but know when I don’t do something 4-5 days a week, my energy level and ability to deal with stress go down, dramatically. 

Conversely, you must take time for down-time. Whether it is reading a book, seeing a movie, going to yoga classes, painting a picture – whatever activity works for you – take time to calm down – re-set yourself – daily, if possible, a few times a week, at a minimum.

And yes, after all that, or in conjunction with it, don’t’ be afraid to get some help from a mental health professional.  We all need a little help, now and then.   It is not weak to ask for help – from friends, family and/or professionals.  It is actually a sign of strength – yes – of resiliency!

Why I became a Mental Health Counselor

I am often asked, “Why did you get your Masters in Mental Health Counseling and open a private practice?”

My whole life, I have listened to others’ problems, given support and offered advice.  This started on the playground and developed further during single life in Manhattan – in fact, there were six couples married through my matchmaking efforts.   As a married, mother of two, I still enjoyed being there for others and had experienced many of the difficulties and challenges facing my peers – marital struggles, child-raising difficulties and feelings of dissatisfaction, loneliness and frustration.

On the professional side, experience developed as a recruiter through working with hundreds of candidates on strength accentuation and goal pursuit.  Mentoring became part of the job in sales, as a corporate trainer – and I loved it.

I’ve never been shy and have always been full of advice and a desire to be helpful.  So, I could have done any number of things that combined my passions without going back for a master’s degree.  

But I realized I could be biased and over-zealous in my efforts to help someone.  I needed to learn to see things, not just from my point of view, but through demonstrated methods and researched techniques.  I wanted to learn from professionals – in school, during internship and through entry-level counseling jobs.

I also realized that sometimes, even with the best intentions, when given advice, it is human nature to fight against it – especially if we feel the other person isn’t being objective.   I needed to learn how to work with clients to help them solve their own problems.

Yes.  I am a very directive counselor.  I offer suggestions and scenarios.  “What if” scenarios are played out in many different directions.  Yes, sometimes clients know where I stand on an issue, but they know there is no judgment – no right and wrong.  We are collaborating to find the right solutions for that person.  In my practice, I get to work with people with their own, unique problems, and use life, school and work experience to help them have a happier more fulfilling life.  That is why I became a Mental Health Counselor with my own practice. 

Letter to a Substance Abuser's Parent

 

For the past 9 months, I have been working a few days a week as a Primary Therapist at a Substance Abuse Center.  So when I learned a friend of mine was struggling to help and understand her child who is a substance abuser, I wanted to help.

 

Dear Parent:

It must be so difficult to wrap your arms around what your child is feeling. I try to explain addiction to parents like this: say you're never allowed food or drink again. You can survive without it. In fact, you will die, if you go back to using it.  But you are still going to feel hungry and thirsty. You're still going to smell it and want it. You're going out with people who are eating all around you. But you can't touch it. Your mouth will still water. You'll get dizzy and headachy several terms a day, hunger pains, the whole deal. You'll get used to it, but it will take years. It will get worse out of nowhere. And out of nowhere, years later, you'll have those intense times. You can never let your guard down.

 

That's what an addict is feeling all the time, as best as I can describe it. They can succeed though.  I consider drug/alcohol treatment as a numbers game.  Yes, there are people who do it a different way or on their own. However, the people that are most successful at getting clean have all or most of the following:

• A strong treatment path that they step down from slowly - Detox to Partial Hospitalization to Intensive Outpatient to Outpatient
• 12 step involvement (AA, NA, CA, etc.) - which has to include several meetings a week,  a great sponsor, and commitment to work through the steps.  One recovering addict told me the only way he could stay clean was to trade the crutch of addiction for the crutch of NA 
• A great counselor that they can really trust, open up to, and WORK with after treatment  
• SELFISHNESS  - Their sobriety has to take priority over everything and everyone else.   They can't try to help their friends in treatment or their girlfriend. It has to be all about them, or they will get pulled down. Being a sponsor and/or working in the drug treatment industry should not come before AT LEAST A YEAR CLEAN!!!

Good luck to your child and to you.  Your loved one can do this!!! And life can be wonderful again. Your child has got to start valuing all the little wonders of life and allow them to add up to the  "highs" that used to come from drugs.  Maybe this time, they will have their "ah ha" moment. I don't believe in rock bottom, because unfortunately, they can go lower. I believe in a moment of clarity where a sober life means more to them than moments of being high wrapped in a lifetime of misery.  If one little thing a counselor says adds up on top of things they've learned at a different time, maybe this time it will click.

 

Take care. My thoughts are with you. 

Mindfulness for Dummies

What if life could be happier and more fulfilling with one simple technique? Perhaps you’re not flexible enough for Yoga.  Perhaps you can’t sit still long enough to meditate.  And maybe, for whatever reason, you’re not into formal religion.

Or maybe you’re into one or all those things. 

Either way, one change in your behavior can improve life for you – Mindfulness.

Mindfulness is being in the moment.  It’s like taking a quick video of what’s happening at that minute.  But you are not using your smart-phone – you are using your mind.  Let’s look at some examples:

You’re angry.  Someone just cut you in line, and you’re in a hurry.  Before you act – stop yourself.  Take note of what’s happening.  Are your hands clenching?  Is your heart beating faster?  Is your breath getting short?  Stop. Take a few deep breaths.  Consciously, relax your muscles.  And think about whether to act on your anger.  Is it worth it?  Could you get in a fight?  Are you elevating your blood pressure for something that really doesn’t matter?  Maybe it’s better to just let it go.

Now maybe, it’s a bigger issue.  Your spouse has just said something nasty to you.  And you take note of all those angry symptoms.  You de-escalate what is going on in your body.  And you are able to calm your spouse and have a reasonable conversation.  You save yourself from all kinds of negative physical symptoms, and you keep from having an argument that could have significant negative effects on your relationship.

You’re happy.  You are sitting on a park bench.  Your child is playing nicely with a friend.  The sky is clear, and there is a lovely breeze.  You’re drinking a good cup of coffee and enjoying a real conversation with your friend, the mother of the other child.  Freeze it in your mind.  Take in all the pleasant things that are going on in the moment and truly acknowledge it.  How often do we take these nice moments for granted and let the aggravating little moments eat at us?  If you allow yourself to enjoy the positive moments, the negative moments won’t have as much of an impact.

Think of a wedding, a great party or a night out with your buddies.  How often you stop and really take it all in?  Use all your senses and lock those moments into your memory as they are happening!!!

 

You’re sad.  Yep.  Even when you’re sad, this is a good practice.  Feel your tears.  Think clearly about what is making you sad, before you try to cure it or make it better.  Allow yourself to be sad in the moment, but be aware, if you are not able to lift that sadness after a time you feel is reasonable.  Again, it is being aware of the physical effects of an emotion, so you can deal with them, not allow them to overtake you. 

Mindfulness is particularly helpful, when you are grieving.  It is okay to feel the grief – to allow yourself to cry and remember and mourn.  Many of us try to brush those feelings away, but it is important to allow ourselves to honor our lost loved one.  If you don’t grieve, when a loss occurs, you will carry the negative parts with you for a very long time.

Hold on a second!  This all sounds so simple.  I know.  It’s not.  It takes practice.  It takes turning on your brain at times when it is often off!  But it’s worth it. And it gets easier – and oh so worth it. 

Happiness is a choice

 

Two guys work on a garbage truck, side by side.  One says, “I hate my job.  The truck smells, the weather is hot, it is hard labor, and I have to wake up at the crack of dawn.”  The other says, “I love my job.  I am out in the fresh air all day, it keeps me in tip-top shape, the pay and benefits are great, and I get done with work early, every day.”

What’s the difference between these two guys?

Attitude

Now, if it were really that easy, we’d be living in a world of sunshine and lollipops. 

You see, we are influenced by our genes, our upbringing, our social circles and our experiences.  All those elements came together in a positive way to create Garbage Collector Number 2.  But it doesn’t mean Garbage Collector Number 1 can’t change.  He just has to want to change enough to work on it.

Cognitive Behavioral Therapy (CBT) is one method/theory used by therapists to insight change. This theory explores how a person thinks and why they think that way. Techniques like exposure therapy, role play, skills training, and thought records are used to uncover maladaptive thoughts.  Maladaptive thoughts are those that we learn over time that misdirect us in our pursuit of a happy, fulfilling life.  These are some of the techniques that are also used to re-train the client to interact and react more positively.  CBT may be an effective therapy to help clients make attitude changes.

There are many other psychological theories used to help clients make the changes they desire.  There are also thousands of self-help books, countless self-improvement seminars, and endless on-line trainings.  You just has to want it badly enough, research methods, and then give it the energy and time your cause deserves.  Just think about it – how long did it take to get here? Getting where you want will take time and effort, but it’s worth it.  

What’s the difference between a Jogger and a Runner?

Attitude