Social anxiety is absolutely brutal to live with, but can this unconventional book help you out with your social anxiety, stay tuned as we discuss what is up everybody. This is Chris from the rewired soul, where we talk about the problem, but focus on the solution today,’s problem is social anxiety and I haven’t done a book review in a long time. I’ve been kind of just not even really slacking. I’ve just been like picking up books and going through them and not finishing them all the way because they get kind of and all this other stuff. But I’m back and I’m gon na be doing some book. Reviews like the book reading are reignited in me, so, like this book is gon na surprise you, but first let me preface this by talking about my history with social anxiety like so many people who meet me, like they’re, so shocked when I tell them That I used to have social anxiety as I did. It was brutal. My brain was constantly going a million miles a minute. I was so concerned about what I was doing. What I was saying when I was thinking where you were looking at and all these other things I was trying to read you and I didn’t know if I was making you uncomfortable and all sorts of stuff like. I was always worried about saying something that might offend or make somebody uncomfortable like. I was just extremely socially awkward and it made me fumble over my words, even more, which made it even more awkward, and it was just terrible. It was so terrible and, like I just couldn’t talk to people unless there was somebody like that, I knew and if you’re socially anxious, you know exactly what I mean. So what I try to do when I read books, no matter what book it is like, I try to see what we can learn from it and most of the books. I do read our mental health books and this book has been on my list for a while, but I haven’t picked it up. Cuz it’s, not a mental health book. I’m, like you know, I bet this book might be able to help people who are socially anxious and it’s interesting because I don’t think a lot of people’s. Social anxiety would pick up this book if they saw it in a bookstore or on Audible or Amazon or Kindle or whatever it is they might not pick it up, but it’s good. So I’ll be honest with you. I’m only three chapters in I’m, like you, everybody who subscribed to my channel, who has social anxiety, needs to read this book. No, you asked me, Chris. What are you talking about? What book is it? Well, it is called what everybody is Saying by Joe Navarro alright, so I listen to all my books on Audible. I just listen while I’m driving to work or if I’m doing some like tedious tasks at work. I just have an audiobook playing and like so just to preface this book, so this guy Joe Navarro. He is an ex-FBI agent and it was one of the best the reason why it was one of the best is that he’s amazing. Reading body language, this book blends neuroscience with the science of body language, so that’s, something that sold me on this book. For those of you who’ve been around for a while, I’m, really into neuroscience understanding how the brain works helps with understanding how we behave and how we think, and the way we do things in our mental health and all that kind of Stuff, so here’s the thing when it comes to social anxiety. A lot of it is this concern that we don’t know what people are thinking, what’s going through their mind, but think about it for a second. If we could better understand a person,’s body language and what certain things meant, then we could know if, if this person’s enjoying the conversation, if they’re, trying to get out of this conversation, if they’re uncomfortable, if they’re Nervous, like we can read all these different things and that’s just absolutely amazing. So I’m just going to give a few little things that are in this book so far, but I’m only about three chapters in and I’m hustling through it because I joined the psych book club with some buddies. Who I play fortnight with and I was super excited when they told me they were reading this book about you. I need to get this book. I want to join your book club because not many of my friends read you know what I mean, so I’m glad that I get to like talk and discuss this stuff with other people besides you. I love you, but I need some more human interaction, so anyways the book kind of starts with, and it goes through kind of like a curriculum of what this book’s gon na be about, but throughout it like Joe Navarro. He kind of gives some examples of these different cases. He worked and things that he learned and all sorts of stuff and kind of like his childhood and why he became fascinated with understanding body language because he came from another country and didn’t speak English. So he had to learn how to read body language to know if people liked him or didn’t like him, and this kind of helped him out before he learned English. So then, like one of the first chapters, I think it’s, chapter 2. They start to talk about the limbic system and the prefrontal cortex, and things like that. So the limbic system, which is the most primitive part of the brain, is the strongest part of the brain. It is your emotional part of the brain right so, like he talks about how you can’t always believe what’s coming out of somebody’s mouth or their facial expressions, because, like they’re, actually not a good indicator. You have to look at other cues on their body, which I’ll talk about in a second, and like for me like this book is kind of sold to people like you know, when you’re talking to your boss, you’re talking to A customer or you’re, talking to a client, we’re talking to a loved one or talking to your kids, but like for me. I’m like bad. This could help with social anxiety. You know what I mean so understanding these things. So what are the great things that I want to make some dedicated videos to? This is one of the first things it does. It talks about pacifying, behavior, okay, these are things that we do, unconsciously, that calm us down. Okay, so some people might rub the skin right below their neck or they might rub their neck like this because these are filled with a lot of nerves and it releases calming neurotransmitters in your body, so it calms you down it soothes, you, okay, so I want to make some more videos on that because if you’re somebody who just gets anxious or stressed there are some points on your body that you can touch that calm you down, so you could do it more deliberately. So this next chapter Armand, he talks in an earlier chapter about like what do you think the most telling part of the body is and a lot of people would say face and things like that. But if that was the truth, then why would a poker face even be a thing, so the feet are the best indicator for this, and this is something I’ve heard a very long time ago and it’s something that I noticed. I even notice myself doing it so just some quick examples: if somebody has their feet turned towards the door or an exit. This means that they’re either uncomfortable or they’re in our curry, or they want to leave okay because that’s just our natural fight-or-flight instincts. Okay, so like when, when we get in these situations like our feet, they’re prepared to do something. Okay, then it also talks about how having a wider stance is more confrontational. So we discuss how to kind of diffuse a situation to make sure that your legs are together, because even on that unconscious level, if you, if you have a wider stance – and you’re, like kind of in a heated argument with somebody, they’re, Getting more prepared to attack back right, even if it’s verbally, okay, so it also talks about other things about how, when you cross your legs, you feel comfortable, and the reason this is is is because the brain is not preparing you to leave. So when you cross your legs, you’re actually off balance. So if somebody’s crossing their legs near you, whether it’s, you know one leg over the other and in their lap or if it’s just crossing their ankles. Okay, because our center of gravity changes, so this means they’re very comfortable, so their brains not telling them hey, you might need to get out of this situation so like I find this very, very useful when like having conversations with other people noticing what their Hands are doing their arms are doing like there’s, one part where it talks about if somebody’s cupping their elbow. This is also something that means that they’re uncomfortable. If they move their hand, this means that they’re starting to relax. So there are a lot of great tips in here, and I hope that some of you read it the more you understand about the brain and what we do, the more you will improve your mental health. One of the reasons my mental health is so much better. These days are because I hate myself for this. I’m gon na link a video up in the info card about something called the brain mechanic. Okay, the more you understand about your brain, the better you’ll be able to handle a variety of different situations, whether it’s, anxiety, depression, and things like that. But I like this book because it’s how to tell if other people are uncomfortable or confrontational and all that kind of good stuff. So if you want to join me on this journey and read this book, I’m gon na put a link down in the description below that’s an affiliate link. So if you’re interested in it go ahead and buy it from Amazon, it doesn’t cost you anything and it helps support the channel. But I would love for you to read this book check it out and tell me your thoughts on it and then maybe I’ll do a full book review after I’m done with it. Alright, anyways that’s – all I got for you today. So if you like this video, please give it a thumbs up, and if you are new here, I’m always making videos to help you out with your mental and emotional well being go ahead and click that little round subscribe button and a huge. Thank you to everybody supporting the channel over on Patreon. I love you guys. Alright, you want to check out some more content on this channel. You can click or tap on one of those thumbnails. Alright thanks so much for watching, learn more about your brain today and I’ll see you.As found on YouTubeThe Destroy Depression ꆛ System-Cure Depression Naturally YOUR DEPRESSION HAS BEEN IN CONTROL LONG ENOUGH. It’s Time to Fight Back ☂🗯 “Depression Sufferer Of Over 20 Years Reveals His Simple 7-Step System That Gives You The Power To Destroy Your Depression, End Your Feelings Of Sadness And Hopelessness, And Get Your Life Back.” “This didn’t just change my life, it saved my life.“
– [Amanda] As a quick disclaimer, this video is made for
educational purposes only. And if you have further
questions or concerns about ADHD, please consult with your doctor first. With that said, let’s start. I’m sure you’ve heard of attention deficit hyperactivity
disorder, or ADHD before. It’s a neurodevelopmental disorder marked by an ongoing
pattern of inattention or hyperactivity that interferes with your functioning and development. Though ADHD is most commonly
diagnosed in childhood, it can also affect adults. Unfortunately, there’s a
significant lack of research into adults with ADHD. Many scientists believe that since ADHD is a
developmental disorder, it can not develop in adults
without demonstrating any signs during their early childhood. But, signs and symptoms of ADHD often persist into
adolescence and adulthood. According to the NHS, by age 25, 15% of those diagnosed will
still present symptoms. Of those diagnosed, 65% will have symptoms
that affect their lives. Here are six signs and symptoms of ADHD to look out for it if you
think it’s affecting your life or the life of someone you know. Number one is inattentiveness. One of the hallmark signs
of ADHD is inattentiveness. It goes beyond simply not
being able to pay attention. It can also look like the
inability to focus on a task, finding it hard to pay
attention to others, or overlooking details. Know these symptoms can
also be caused by stress. Pay special attention if you
find your focus shifting often. Number two, hyperfocus. On the opposite side of the spectrum, you can also experience
hyperfocus with ADHD. Hyperfocus can cause a person with ADHD to become so engrossed in a task that they forget about everything
else going on around them. It’s important to differentiate
between hyperfocus versus when you’re in a state of flow. Flow emerges from a state
of deep concentration or engagement in something, and being in flow produces
a positive feeling, like a sense of accomplishment. Hyperfocus, on the other hand, is a result of an inability to
regulate your attention span. With hyperfocus, you can’t
always choose what you focus on. You might be doing something
important like homework or hyper-focused
on scrolling endlessly through Kylie Jenner’s Instagram Feed. Hyperfocus can lead to setbacks in your relationships
with friends or partners, or hurdles at work and school. To help with this, you
could prioritize your tasks and accomplish them one by one, or ask your family and friends
to text you at specific times to help you shift your focus
onto more important tasks. Number three is impulsivity. Do you speak out of turn, or
do you regularly get yourself into socially inappropriate situations? Do you rush through tasks? And these all are signs
of impulsivity in ADHD. It runs a lot deeper than just making split-second decisions. ADHD impulsivity can
disrupt your life, and can potentially get you in trouble. You might others during conversations, making them less inclined
to talk to you again, or you can act without much or any consideration of
the possible consequences, and this can land you in hot water. Number four is disorganization. We all have hectic lives,
but for someone with ADHD, things may feel a bit
more chaotic than usual. If you have ADHD, you may have trouble
establishing order in your life, and it can be difficult to keep everything in the right place. And adults with ADHD may struggle with these
organizational skills. This can include, problems
keeping track of tasks, and trouble logically prioritizing them. Number five is mood swings. Because this symptom is present
in many other disorders, it’s not an inherent sign of ADHD, but if you’re someone with ADHD you may experience mood
swings or irritability. There may be days you
feel good and grounded, and other days when you’re
in the emotional gutter. You can try writing your emotions down, which can help you keep track
of your emotional patterns, and prepare you for the next mood swing. Setting a schedule will
help you establish a routine and avoid the possible
stress from disorganization. And number six, lack of motivation. Does it seem like you’re
doing everything at once, but feel unmotivated
to go about your tasks? Lack of motivation is a
common symptom of ADHD. A lack of motivation combined
with other symptoms like poor organizational skills is problematic when it
comes to accomplishing tasks or being engaged at work. There are many ways to help fight a lack
of motivation, though. For example, you could
break down your chores into manageable tasks, or write down the positive feelings you’re experiencing throughout the day. These techniques can help
you find the motivation to finish your tasks. Do you think you might have ADHD, or does someone you know
think they could have ADHD? Do you think these signs
will help you or a loved one? Go ahead and like and share
this video if it helped you, and you think it could
help someone else too. The studies and references used are listed in the description below. And don’t forget to hit
the subscribe button for more Psych2Go videos. Thank you for watching, and
we’ll see you next time.As found on YouTubeHUMAN SYNTHESYS STUDIO 👀🗯 Attention: Have Real Human Spokespeople In Your Videos Saying Exactly What You Want In MINUTES! REAL Humans, REAL Voices, With A NEW Technology That Gives STUNNING Results Choose Your Human + Voice Type What You Want Them To Say Render your “Humatar” What You Are About To See Is Unbelievable…
thank you [Music] I don't know I'm just gonna throw it out there guys do it see if Murph is watching Murph Jay's got three words for you let's go ranges baby that's four that was four it's all right it counted it counted though the first three are what matter what is up defects back live on a Monday night Jay's here it's we're just we're rolling now I feel like we're on almost every Monday now this is something new you know good to see you guys Big Show planned special guests let's just let's just get right into it but you know before we do that I gotta say one up to my boys Bush what up what up what are you doing what is up guys playoff hockey is upon us being here is brutal right now thank God we don't we aren't live tomorrow night when the ranges are on but excited to be here I think it's a great topic I think it's a topic that has definitely changed over the course of the last year especially so really excited to get into it excited about our guest as always tell them what up I I figured Murphy's not going to be watching because he's too busy watching the game right now so obviously what up defects thank you for stopping by tonight we all know we got playoff hockey so we're all excited about it but we're here with you very excited about tonight's show uh always love when uh the Haas the Haas shows up to the show and hangs out with us so you know he's coming in with some with some uh statistics him and Matt him and Maddie together make like a freaking all of a sudden I feel like I'm unlike the FBI and [ __ ] I see the reflection of the game in in guys uh glass and then tomorrow night when Jay goes live on whatnot if which we're all going to be there if this is still in the background you're gonna just have that on the background Jay or what I mean I think the game should be over by 9 45 but if it's not I'm gonna be pissed off and if I do bad on whatnot I'm really gonna be [ __ ] pissed that'll be the last that'll be the last time oh yeah that'll be the last that'll be the last but you'll you could throw it on behind you people will love it you can still hear it people will watch it I mean come on it's like you got the package set up for it bro I'm one of those guys I could only do one thing at a time and even and even that yep and even that is brutal we love you brother we love you let's get into some with some sponsors Jay a couple perfect games in a row ah let me Let Me Clear My Throat I got too much pressure on me now first up guys the best in the business e-rod 212 Express comic book pressing E-Rock will Blaze your books owning and pressing needs defects 10 gets you ten percent off not only that era broadcast as long as dgc and cbcs so hit him up attention next up everybody's favorite Beaver mutant Beaver comics for all online exclusive variants defects 10 gets you 10 off they ship worldwide that's right worldwide so tell Pat and the b-man the defects sent you almost [ __ ] that one up that was close I felt you just say [ __ ] it I'm gonna end it so I don't [ __ ] up that's it because it's still a perfect game guy Forge is looking super clear tonight did you notice that Jay he is looking clear is is there new equipment in the house guy Forge no this is the same computer I have not brought out the new the new laptop that that uh Maddie Forge you know was the brains behind listen you are looking maybe it's just because it's in the room you are just super crisp right now all right nice I like it I like it Speaking of Chris speaking of crisp guy Ford you want to bring in the guest well listen the guy the guy cuts his hair like us so he should hang out with us that's just my opinion so you know what he goes to the same Barber even though he's across the country um he listen if you ever watch his shows he sits in front of not only some crazy [ __ ] books yeah but the man's got an Emmy behind him okay sure it's true bringing the Haas what's going on welcome my friend thank you so much for uh bringing me back two times in in a month I think right there you go look at that irregular yeah you must be doing something wrong to be honest with you then I'm getting to that uh that number of appearances that no longer matters anymore like the collectibility is dropping off this is true this is true good to have you here brother um just to give people a quick recap of how this you know came to be like just a few days ago um you put out a video I I want to say it was uh what Friday was that a Friday video yes end of the week last week okay had a video that was basically an unboxing of uh awesome book and I'll let people go watch it if they won I don't wanna I don't want to spill all the all the details but the the second half of the video which you you rolled into very very nicely might I add was basically talking about you know Rose you know to simplify it basically raws versus graded and and what's the better buy right now and what's what are what where's the Demand right now and and and why um and I think you kind of gave a really good um insight into you know what 2021 caused you know with raw uh books being essentially at least priced the same as their graded counterparts now whether they sold that way I think a lot of times they did or close to it but almost every like listing you saw if the book was a near mint it was selling for almost like the nine six the nine six price you know and if it was a 7-0 it was selling you know they had it listed four the seven five price you know so it was like you know that's what 2021 did and I mean what was kind of your you know your quick kind of overall conclusion to kind of you're like just it was only you talked about it for about six or seven minutes and and kind of like give us like your kind of wrap up to that video and kind of lead us into where we're gonna talk about tonight yeah for sure I mean I'm glad you you guys wanted to talk about this because like you said you know in my video I only talked about it for a few minutes but I feel like there's so much more to unpack with the topic but my general thoughts going into it were you know a lot of people for whatever reason always kind of pegged me as a guy who was like the champion of the raw comic books even though that's really not The Stance I've ever had it just I happen to have more raws and then over time people would tease me because it's like oh swag you're buying all these graded books and my uh opinion on that was it's like it's not me that all of a sudden wants created books is that the market had changed you know in the last couple years where all of a sudden prices like you said were essentially the same so at a certain point it was like well why would I but before I used to be able to buy the raw book for you know you maybe save a little bit the grading fees and maybe a a little bit of I I don't know what you would want to call it like the the risk that it doesn't actually hit the right fee right and then over time like you said the price is kind of equalized and then at that point it was like oh I might as well just buy the graded book because it's already you know cgc fees are included in this um and now we're kind of just hitting a point where I feel like the demand for raws have started to come up more and a lot of the graded books especi I mean depending on what book you're talking about but especially like you know mid-grade level you know say bronze and silver books like those prices are really really hurting um and in the book that I was unboxing I just kind of had a situation where I was like yeah here here's me buying this raw book that now is way more affordable than my graded book or the graded book equivalent would be for it uh once again so that was kind of what the video was about and and uh to kind of sum it up very very well put together by the way which which most of your stuff is so I'm not really worried about when I go watch your stuff but um awesome book awesome oh yeah thank you yeah yeah and it's nice to have like obviously the two copies that you know that yeah that's that's that was the outcome obviously you wanted a raw copy too and and a slab copy right yeah yeah it was it was just was a it just became a thing where it's like I wanted to upgrade it and also I didn't mind getting a raw cut because like aesthetically you know it just yeah it bothers me when there's like a raw and then a grade and then a raw you know it looks all funky to me so I just wanted I didn't mind getting it so you like symmetry you're saying you know we gotta we you know as companies we gotta have our like I mean look at all our backgrounds you know it's like this is all deliberate you know that means you need an Emmy on for the other side though yeah yeah it happened anytime soon you gotta balance it out um so you know I think so much we've and not really on purpose um but the past two months we've really talked a lot about grading and cgc and some of the mishaps um and again not not the best as you see you know we try to put that out there every time but these things are happening and we have to cover them um and you know this is a conversation that kind of kind of leads to that you know I don't want to say and I know Jay has some some opinions about this so I'm going to throw it to him first but I think there's there is a lot of factors to you know that that are going to support the stance that you know maybe the values aren't equal as far as the dollar value but like you were trying like Mickey you were trying to say that maybe the not the numeric value but the actual value as far as how much is on the bone compared to how much you bought it for and what's your upside versus your you know a slab just being that price and it's not going to move much you know maybe there's other contributing factors to it and we've talked a lot about them on this channel with you know mistrust in some of the grading companies right Jay and and that being a factor as to why some people maybe the slabs aren't as desirable right now what do you think yeah 100 I mean we see what cg3 cgc ncbcs been going through in the last year maybe even longer than that and like we talked about on the show in the past we see you know we see mistakes and we hear about it in the community all being community members and you know um Everybody in the chat being a Community member I mean more mistakes now so than ever uh way longer waiting times no matter what tier you're sending in you're still not getting your books back when you're supposed to in in most cases right um defects books that are getting nine eight that shouldn't get nine eights with visible defects on the book even through the slab so I think in this conversation it it really does come down to the specific book and the specific grade just like Mickey said you know so we'll use examples and and we'll get into that as the show goes on but um me myself I've been leaning I haven't submitted a book in what Matt about a year a year and a half it's been about it's a little over a year for us and the reason being is I haven't bought many grills there's not I pretty much checked everything off my list as a collector I stopped buying so much of everything and just focused on the characters and the books that I wanted um when it comes to Grails listen I'm not going to keep a grill raw any book that's over you know fifteen hundred two thousand dollars I am going to submit to cgc I am going to send it to era to get pressed and cleaned up before that and all that is money um so I you know I'm a little on the fence I I still tend to think slab slabs are gonna fetch the higher dollar amount because it's it's your guaranteed grade right we'll say guaranteed in parentheses so but again man like I watch PJ Morris and morbius and I I get their point man with not slave in any of these books because who knows it depends on the grader is the book really a nine eight is it really a nine six is it really a 5-0 so so I get that but I do send in to like the bigger books to slab as an investment as something to save just in case and we've said this before something happens to me my wife my son they they have an idea what that book could sell for just by pulling it up on eBay but I'm I'm with these guys right now man I'm with more abuse I I'm with PJ I'm with all these other old school role collectors that don't want to submit their books I get it man I I get it um as far as moderns I'm not sending in any moderns to cgc anymore I'm not sending in any more minor Keys um it should this that's how I feel right we'll we'll get into price point yeah go on but yeah I mean you know and I think that is a whole the the slab to not slab is a whole except not that it's a separate conversation but that can be a separate conversation you could have a whole show just on that the reasons why to do one or the other um you know and like Jay said we do have a couple examples to kind of show you know maybe maybe like heat one of the examples is almost like a heat check like what's What's um what's hotter and I know Mickey during your video you kind of mentioned that like what is hot or not necessarily what's selling for more but what is more desirable at this time yeah and then there's another example that I have that is gonna show dollar for dollar um on a I don't want to say a Grail but a major Silver age villain key um so we're gonna we're gonna show those two things off and kind of dive into it now I saw a lot of com I got a lot of DMS and I saw some comments even before the show that people had a lot of um strong feelings about this even before I got slabs will always be more money slabs will always be more money and and while on the surface that's probably a statement I would agree with um I think there's some Nuance to it and I think there's there's a there's a little bit of a deeper dive as to you know again dollar for dollar may be right maybe on that nine eight maybe on those higher grades you're that's always going to be the case but what about you know the lower grade or what about the non-keys or what about you know um you know filler but you know so so that's why I said there's a couple of different examples and there's two specific books that I want to look at now it's hard to do this with um raws versus slab right because with slabs you have a grade scale and you have places to look that up sale for sale with the raw stuff it's it's very hard you almost have to you have to sit there grade the book out yourself and say I think this falls into a 9496 category and then compare it to uh the latest slab on that we can't do that for 12 books here it we would be on for four hours right yeah but the problem with that is especially when you're talking about like a nine six to a nine eight when you're looking at a raw book you may think you have a 9A but that price point from that 9 6 to that nine eight is so significantly different it jumps so high so there's the problem with that and yeah you send it in for that nine eight but when it comes back that nine six is it worth cracking it out so someone does the same thing you do oh maybe I could potentially get the 98 with this you know what I mean and who's to say they won't you might crack open a 9-6 sell to someone they submitted in and then boom there's the 98 and that's the problem with the Grading Company right there what do you got guy he's muted or frozen or something what do you got guy I was frozen I'm sorry I I missed everything you said uh what are you out there on the screen for Super Chat oh for me Supreme love he said thanks for making a list and my NC relaxing he said through rain sleet snow defects will show so I like that I like that little that little kid it always says man the books they look so nice in the mylord dude there's nothing you throw a 5-0 book and a mylar it could look like a NATO you know what I mean but true yeah and and another thing that comes into play is buying and selling raw verse slabs right because if if I'm buying a high grade a high dollar value book online I've been burnt too many times to buy a raw copy man if it's a Grail I'm I'm buying it slab yeah at the end of the day just because it's it it's safer um because you don't know what you know you may get pictures you might get this you might get that but you don't know what's going on on the inside of that book you don't know if there's water that stuff that the camera can't pick up so you know modern's different you buy a modern online you're all right you know you you're buying silver age and maybe even some Bronze Age books online eBay what not Instagram you know you don't know what you're gonna get so that's where I tend to I'll buy a celeb and spend that extra money knowing the guaranteed grade rather than rolling the dice yeah what were you going to say Mickey god well there's so many answers when you're bringing up uh the people who are instantly kind of reacting to the thumbnail and stuff and and I I'd say that I think we'd all agree like in a vacuum of course the graded book is always going to be more expensive I mean just grading fees alone just is always going to make it more expensive but I think what it is is it's like the demand aspect or like how like what's going to be easier to sell and and kind of like Jay what you're saying like there's there's definitely a price point where it's like yeah if it's above like fifteen hundred dollars like grade the book by all means but then when you get into that like it's a 500 book range all of a sudden you're in this weird spot you know if if like let's say there's a you got a 5-0 book that's graded and then you have what looks like a raw 50 book I feel like a lot of people would almost rather buy the raw one for whatever reason like maybe it's a psychological thing or like they just think oh I can just like I can press that one up or like I don't need it in a slab and that one might be easier to sell or be faster to sell now and I think that that's kind of maybe what what at least this conversation is too you know right and it's funny that you said that because I was going to kind of talk about the demand um you know you had said you know going it's taking a step backwards a little bit we had said that you know during 2021 and early 2022 There Was You Know The Raw books you know were were listed equal to the graded and and some of the sales they were really close um and do we do you think it's because because and I think the same goes for now but then the demand for everything was so high yeah and there's less places to look up a raw value than there is obviously a slab value and and it created almost like a frenzy where books were going so fast that you didn't really have time to think is this like am I getting the right price for this raw book you just saw that book somebody told you you had to buy it it looks like it's priced and a lot of new buyers not knowing that uh near mint book is not the same as buying you know uh nine eight or a nine six or even a nine four right technically shouldn't be um but do you think that the supply I mean excuse me the demand is what's really um driving some of these prices raw and slab because you even mentioned that the consolidation of certain grades where we are seeing higher grade books sell for less than lower grade books because at that time maybe just nobody was looking to buy that book maybe one was bought on a buyer now and one was bought on an auction when no one was really looking somebody's I and you showed a a book that a 5-0 sold for like eighty dollars less than it's count like then a 4-0 and not too far apart yeah so I feel like that's got to be demand causing that right yeah I think so for sure I definitely think that the the demand has cooled down so like it's it's uh not like there's any given day like any of these books just depending on who's watching you know could sell lower or higher so like there's just a lot of like volatility in that middle section and then but compared to 2021 and 2022 you know I think there was a point where it's like let's say you had a book that you know the graded version can get you a thousand and and then maybe it was like normal for you to sell the raw for I don't know like 700 bucks right but then all of a sudden I think people just started to kind of get greedy in 2021 when everything was going crazy and you're just sort of thinking to yourself well why would I sell mine for 700 when I know this guy's just gonna send it in to get graded and I'm leaving money on the table you know all of a sudden so that's kind of why I think people were raising those raw Book prices because they just knew that oh if you're just going to get it graded and it's going to double the value like why wouldn't I just sell it for that yeah and I like what you said about the the you know kind of the flip and you know I know some people it's like a bad word but not on this channel you know it's like you know if somebody buys that rule book they think there's more potential for it down the road and and again with an overall dip in the market you know maybe you're buying for a longer term hold maybe you're buying to try to you know maximize your value and I think I I think it was what we just talked about like the lower the higher grade selling for less one week apart this and that is just a result of a a big downward dip in in the market right so a lot of things are coming into play that are causing you know some of these weird prices on on slabs um sprinkle in some some really big missteps this year with with grading companies people's desire to have that that book in a mylar if it's an older book and now you're starting to see a little bit more demand for raw books than graded books which is just gonna naturally cause an increase in price I mean yeah again there's gonna always be those steadfast rules right the nine eights the modern nine eights nine sixes you know certain like books over a thousand dollars you're always going to see that but I mean for me just in the past three months since I've started kind of starting to buy comics again I've been paying attention to a lot more auctions of books that don't necessarily have anything to do with news or keys or anything like that and what I've been seeing is you know those lower grade Silver age books that aren't necessarily that expensive you know a four or five you know in this book in a four or five sells for seventy dollars but a raw four to five oh you know 4050 is selling for 90.
and and I've seen that my own personal experience and I've seen it over and over again and I think it's a reason it's it's because of all the reasons we've been talking about so I don't have a specific example it's just I have been seeing this time and time again over the last few months have you guys noticed something like that as well I mean because I I keep seeing it happen and it's kind of sometimes it doesn't Shock Me A lot of times it is because I'm like that's not really like a filler book like that's kind of like a book that I could see people having in that grade but obviously not to these group of buyers they'd rather have it for more money in a slab I mean in a mylar totally do you think there's like a is it like there's always the like I've kind of said it in jest in my video but it's like if my book is raw and I know it's a VG there's always like in my mind like well maybe it's a 5-0 right you know versus like when it has the number on it I know this is the number and like good point I don't know so do you think that there's like a weird collector psychology that's kind of coming into play these days even with the number on it is it really the number right that's what yeah yeah good point I don't know yeah I'm just a piggyback you Jay that's all yeah no and I like what Roy said in the in the chat and supreme said something that I I'm gonna disagree with that you know these graders are human and everybody makes a mistake and listen I get that but when it comes to money and collectibles and you're paying top dollar to have these books graded you're paying top dollar to get your books pressed and cleaned before all this happens I don't want to hear it's a mistake and I think it's a combination of people maybe smartening up with money a little bit and losing faith in these grading companies listen people aren't blind that cgc got so many artists coming in and they're so distracted by this and there's private signings and I get it listen me and Matt spoke earlier today and Matt said it if you live somewhere where there's not big cons where you can't get these books signed it it gives collectors a great opportunity to send your books in to get them signed but it seems like cgc pushes everything to the back burner for these signatures now I mean they're having kit Harrington there they're having the girl from Hawk like this it got to stop at some point focus on what what you're there for to grade books right I don't want to hear oh we made a mistake no I don't want to hear that because they don't refund you in any way yeah they really don't make things right and we've heard I have a horror story that we're going to talk about in a little bit um the person happens to be in litigation with cgc and we can't talk about it right now but when that's all said and done we're gonna talk about it and it has to do with them losing books and it and it's a disaster man like listen I don't want a mistake and if and if my book is I think it's a nine eight and they bring it back a nine two and nine four or even a nine six and there's no notes [ __ ] that I want to know why this book didn't hit that 9 8 at least give me that respect you know what I mean yeah so it's not even about respect you deserve to know you're paying right exactly yeah 100 you're paying for it take take respect out of the equation you're paying for a service so when you pay for something you expect the service in return especially if it's like like I think of like Amazing Spider-Man 300 like the price between a nine eight and a nine six is like yeah thousands of dollars right so like and you sent it in like you you need that explanation like why is you know yeah correct what do you got there and I just think I think overall is collectors and now you know everybody being in the community and being in a Facebook group or being on Instagram and seeing all these mistakes that are being made I think people are starting to lose faith in cgc and greater books and I think that's another main reason why people are gravitating towards raw copies if you get your hands on the raw then you can take your time and you have it and maybe when things get fixed or things get better you can send it in so that's another reason why they're gonna they're gonna grab them now while they can and then this way they have them in their hands in their possession but Dave Cerrone is yelling out and wants some Eva for swaggle house he said King of the charts and grass so give them a little Eva hey that defects guess who's back for some more Super chats yeah baby let's go defects let's go defects it's either going to terrificon possibly wow possibly he couldn't even say that with a straight face there could there could be something in the works yeah you never know oh spoilers all right I never know you never know that's all we'll say all right let's look at a little bit of data there's I didn't want to get too crazy with the detail on this because it is a little hard to work at so we're gonna give two specific examples where's that low Super Chat very good yeah he comes in a perfect timing look comes in perfect timing no like whatever he's always lurking he's got us on in the background while he's flipping through about 10 000 books at a time so let me bring so one book that came to mind that's been hot so it kind of doesn't give an excuse right it's a hot book so it kind of levels the playing field there's Kanan number six right we all know that's been in the news right for for uh one reason or another and I think that's that started around I think April 6th or 7th I think that's when the trailer came out so I tried to kind of look up uh I want to look up some raw copies so let me share my screen if I can [ __ ] do this share screen Chrome tab there we go okay now we could just bring it up all right so I wanted to bring it back to around the seventh and again I'm not you know some of these are best offer so it's not I guarantee that this this second one here sold for 120 but let's just assume it was close right so obviously this news I'm trying to get to the first raw copy this is right okay so right around here you have this 85 dollar sale for a very fine near mint you guys can still see me right yeah all right then we have this 140 Plus you know best offer obviously let's just assume it's somewhere between 125 and 130 for this this near mint book right on that first the first day um you know if I just kind of scroll up 115 120 100 let's go back to the first page sorry about that my screen's skipping a little bit uh let me bring it to the bottom for whatever reason my screen is not cooperating here we go it's kind of skip over the raws for now uh I mean the slabs for now you know this was an 80 copy near mint so that was a really good deal I would say 90 uh 80.
Back in the 80s now we're getting back up to the 117s you know we're back on the rise right 81 uh this was 175 uh best offer so that's I mean even if it was 140 that's still a definite jump this was 140 best offer so to me I mean you know this was a little lower that I look I think I looked at that earlier I had a spine tick this was like a VF near Main copy this 85.
basically anything near mint you can see this 160 for a raw wow you gotta assume that's near mint or better um you know you're you're over a hundred thirty dollars for these near mints and and that kind of the price was kind of set and it kind of just stuck around again this was an 88 book I looked at it had a spine tick uh 147. anything with no spine ticks was you know right in this 110 115 range to like 130 140 range right you'd see another one sold just under 140.
um so it's hard to you're not gonna really take a nine eight and say like Oh look The 98 is cheaper that's that's not what you're gonna see here right it's just this is a book that kind of has held its value for the last three years um but I wanted to just look at it compared to as far as the heat check like clearly a book sold today 145 Dollars near a minute so that that near mint price for raws is really holding strong right um so let's go over to the GPA for the 98 okay it seems like it seems I can get a better deal on on uh some other platforms other than eBay yeah I mean it's possible I'm just saying we're we're just saying can you see that this GPA you guys able to see that not yet can't see it okay hold on I should probably turn it on right there you go so GPA 9A Kanan number six um right here is when those 9 8 started selling and you can see 500 549 500.
okay those first two nine eight sales right after the news down to 450 down to 400 down to 388 jumps back up a little bit and then level is starting to level back down again 425. okay so not a ton of sales I mean it's a decent amount of sales one two three four five six seven eight eight nine eight sales in the last 10 days I mean it's not a cheap book right I mean it's strong right I mean if you look at the March 30th price let's just say let's assume that these people kind of knew something was happening right buying up these nine eights um but if this three you know this four to this 350 to 400 price range in this past month or two you know that's where where the price was so even at this later price we're obviously still above that but to me this does I mean to go from 549 to drop to 425 in less than 10 days while the raws have remained if anything have gone up you know I think the demand and again we're not talking dollar for a dollar we're talking right now in this instance Raw versus slab we're talking demand and where the value is it it looks like for this book it's people are looking for that raw book and that near me copy is still on the rise yeah I I think it may be it's just people because obviously if you can buy the book for 150 with the potential to get the nine eight I think people just would rather do that like just they just just the demand to be like you know what why am I gonna I do I really need to guarantee myself a 9 8 and spend 250 extra dollars I just think a lot of people kind of like I think what Jay you said earlier were just people just being more cautious with how they wanna do this you know I think that that's what you're seeing so people are like I'd rather just buy the raw and assume it's going to be a 9-8 or go for the nine eight or send it in and hopefully it hits and now especially with this book this book's going to be an all-time high um right you know everybody's buying up at the news I think yeah you know is the book gonna come down I think so so why invest whatever that was 569 and buy it at an all-time high when you could roll the dice and buy a raw copy and potentially get that 98 especially with a newer book like that you know but then there's other stuff going on eulers thanks for the shout out dude because I sold Oilers one of these books and he got a 9-8 on that from an old YouTube auction so thanks for that shout out dude nice um another thing man is don't forget now guys cgc is starting to give books purple labels for cleaning and pressing so that's something you gotta be on the lookout for too that's gonna change the game for a lot of people you know what I mean especially if they're hitting you with a purple label for a cleaning service that's you know we got to talk about that that's something like yeah another show but we gotta address that yeah and real quick some old school collectors like that they don't like the idea of a clean and oppressed they think they consider it restoration do I no I I don't but some people do and you gotta respect everybody's opinion on it and just like great adverse raw you got to respect everybody's opinion on it right if you look at a A Fantastic Four number five a first Doom whether someone has it raw or slab that's still a [ __ ] fantastic book man you know what I mean so I just think people are getting a little more hip to the game when it comes to cgc and you know reading the backlash and the horror story so I think that plays a big part in this too I wanted to give one more example because again you know people were immediately jumping saying the raw book is always going to be worth more I mean the the slab book is always going to be worth more and I found an example and again this wasn't hard to find it's not like I had to look forever to find this um an example of a pretty pretty big book I think um so Silver Surfer number three and this book I picked for a reason and maybe you'll see later on why but I'm not going to explain why right now um so this Silver age major villain key okay in a lower grade um sold for 3.95 best offer I looked it up it actually went for 365.
Okay um and let's look I don't know if I'm going to be able to show I'm gonna I'm gonna zoom in a little bit and then I'm gonna try to bring up a whole book let me see what that looks like I'm gonna have to use the magnifying glass a little bit so this corner can you guys kind of see that yep you know that spidering you know I'm just gonna go slow to me this looks like the back is pretty clean I mean to me this looks like somewhere between a four and a five probably five is on the very high side but if you just say if you just say maybe like a four or five just because of this corner here and The Tear at the top um but even if you want to go high and you want to say five I mean am I in the ballpark yeah I was gonna say a four right off the bat as soon as you started showing I was gonna say about a four but but you know what I'll even give the benefit of that and let's let's just say it's a five okay um now I wanted to see what a four or a five was selling for in a graded copy so remember this was 360.
This book which it's not like it had like a hidden defect that somebody can see these are like right in front this guy had a lot of pictures uh of every corner like you can really and this was I want to say it was best offer okay so again you're not under the gun to uh you know the auctions running down maybe you bid too much and then have that buyer's remorse this is a book that has been sitting out there okay so I want to go to GPA real quick and this will kind of be the last example of this but I had to I had to bring up something just to kind of say are we on to something here uh let me share it with you guys okay so right off the bat let's just say it's a five which again I think that's a little high last sale this month 380. okay um and let's just say it is a four last sale last month not too long ago 340. this raw book at 360. is I by all metrics is basically equivalent or more you're paying more by the time I mean you're paying more for it essentially for a raw book and you would that same book and it slabbed and it's in its slapped form um and this isn't like a tiny book this isn't like a book that nobody's gonna buy in that grade I mean there's been five five sales this year I mean excuse me there's been five five oh sales in this in this book this year that's I mean it's a lot of that's a lot for you know a 1968 you know for one grade it's been four months I mean that's you know in a book that it's not like it's super hot for any reason right now so I mean this is you know maybe it's the exception but this exception didn't take me more than five minutes to find so I feel like this is happening more than people realize expect more downward Trends on this book now that they're gonna [ __ ] gender swap my fist though so expect that book to come crashing down soon well Danner right that and that's the question was it an outlier and we could sit here for hours and look at every raw book and try to grade it out but again this this was literally the first rule book I found it's not like I cherry-picked it you know and I mean we can if you want I guess we could sit here and look for the next raw cell I mean I just want to take a quick look see if anything stands out so that's a good point too because that could be how many sellers does how many you know followers does the seller on eBay had what did he post it as exactly you know what I mean I think a lot of that comes into fact there too yeah I mean that one didn't it just said c I think it said c picks for the uh for for um for Whatchamacallit for condition right it's not like he was just I said if anything he showed every single defect it's not like you were he was getting one picture that maybe somebody didn't look close enough at he showed every picture so here I'm going to show you another one I mean this is actually this is even in a better example um just because that and appreciate you Dan Hart coming coming into the whatnot sale the other night uh where is it where is it let me get rid of that one uh but yeah no that was a good question and actually I'm glad that you made me look at this uh uh stick with me for a second there it there it is share that up okay so this was an election so different style this is an auction um 368 dollars so right in that same price range I want to say that this book is slightly nicer but it has a spine split all right you can't really see from that but that has a spine split right and a decent one um some some spine issues for sure you know that bottom corner is is not as bad as the other one um you definitely that's you know that's worse than the other book that that little Mark right there but that spine split you know one inch spine split you know you have that uh right in the v there you have uh that that cut right in the v or that slice that's that's color breaking um this looks like it presents nicer though it definitely presents better but I would say again though this is probably a Max 5-0 because you have a spine split that's at least an inch um now maybe not as many people know about that you can see that that bottom corner is chewed up you know but maybe not as many people know about a spine split like kind of wrapping your grade but I mean even if you want to say this is a 5'5 right like Max you know so the five fives you know the 5-0 selling for 380.
you know so it's like that they're still very very close right like so you have to assume someone would want to pay to press it and then send it in and do that so whatever that fee is on top you know so it's pretty close oh yeah I mean the great is if you're if you don't know someone and you're saying it let's say you're sending in a single book if you're sending in a single book graded clean pressed to an outside party and then shipped to cgc created that's a minimum and at this price point Silver age I'm just doing some round numbers shipping both way like you're looking at 90 to 100 dollars well unless for everything let's use an Express CBP which you have a discount code just throwing it out there you know so automatically that 360 turns to you know 460. so and again I know not everybody bidding on eBay is going to have that same knowledge of the spine split is thinking of the cleaning and pressing and the grating but again this is the the second book I found right if that second book that I found like is literally the second world sale on this book if that was the second book I found and it went for like two 260 I would say sure then then yeah maybe maybe it's just an anecdotal it's it's a single instance it's the it's the exception again I do think that moreover the slabs are going to sell more but I think you know in certain instances and it's becoming more apparent even in my eyes that the the the raw books are selling for equivalent if not even a few dollars more of their raw counterparts depending on like Jay said earlier depending on the grade depending on the book depending on the error so and guy could you throw up Fizzy's comment real quick because I I like that that's a great comment bottom line is who do you trust more do you trust C uh cgc cbcs more or some Rando on eBay who mindlessly props near mint in their listing title and that and that's a great Point dude and that ex that's exactly why I said in the beginning of the show if I'm buying a high priced book like ss3 um online from eBay from whatnot from Instagram whatever the case may be I gotta buy that book slap just for that reason alone so you're absolutely right when it comes down to that I do trust cgc and cbcs more than some dude posting it up on on eBay or whatever selling platform they're selling it on so I I'm gonna pose one more question to you guys and you just take take over and then we'll move on we'll talk about the Jonathan Majors thing but you know we can sit here and say bad buyer you know misrepresentation somebody overbid it somebody didn't realize that didn't think about the grading and this and that but at the end of the day doesn't that sale still count and doesn't it still set a price point doesn't it still affect the next sale like obviously when it's egregious people just throw it away but Mickey I mean it's it's still it's gonna like if you're looking at that and you see that that book sold for this price aren't you gonna still enter you know put that into your equation of what you should pay for the book 100 it totally counts you know and and I think you know you didn't pull up all of it but even when you were kind of saying like just just in peer it just is empirically true you know because I I agree with you it's we could talk about SilverStar for three but I bet if you pulled up Thor 165 out of Morlock you know you'd see the same types of things going on or if you pulled up like the Wonder first Wonder Man book you know you'd see this it's a lot of these types of you know they're big keys but they're it's not like an ASM one you know like a case point it's like ASM one shirt like you know that that's gonna be different but a lot of these types of things it happens a lot you know and and we're seeing it repeat itself again and again what do you think Jay final word yeah I mean I I pretty much you know spoke my piece on it um uh dependent on the book right just like make said is it is it a big key yeah it's a big key is it a Grail no it's not a grill um I think at the end of the day it all comes down to the buyer and the collector and and and what they want for their I do see a push and raw books being more uh more in demand now you know especially you know coming from King Khan and going more you know you see more people all the time buying these books raw and whether they're submitting or not but it's definitely you know cgc and cbcs they are a million you know big big companies but they are definitely catching backlash from collectors in the community without a doubt without a doubt I mean NJ without just just to kind of put like just an extra piece of evidence in there and again this is this is just our personal experience this is just what we're seeing you know like we've made it clear that we still think that you know slab books overall are going to be more valuable but again we're talking about demand which you know it's more than just a dollar right but Jay without saying any names without saying what book it was without saying the grade or anything like that didn't we just have a conversation with someone that said maybe I should just break out that book and sell it wrong because I'll probably get more money for it yeah 100 yeah you know so this is how right like so I don't know um it's an interesting conversation and as soon as I watched the video that Mickey did and if you guys want to check it out his link is in the description um it just so many ideas like it kind of brought to kind of to the Forefront what I had been seeing these past three few weeks you know just perusing eBay perusing whatnot you know just and and saying to myself I can't believe that raw book just sold more than what I just looked up a 5-0 to go for and I know this book isn't a 5-all you know like so I don't know I think it's an interesting conversation I saw a lot of good comments on there unfortunately there's four of us we I wanted to address every single one but then we'd be here for three hours and yep we can't do it we'd love to but um but don't go anywhere we're not done yet we still have more to talk about after we talk about a couple whatnot shows coming up uh Jay you selling tomorrow night brother yeah I am popping my cherry it's like I said every show for the last three weeks since we announced this I'm officially selling my soul officially tomorrow um YouTube just wasn't working dude I guess this is this is just the only way right now we'll check it out um I won't be selling a lot on there but I'll definitely be selling some cool books that I know are probably gonna go for a lot lower than I'm expecting get your deals it's a good time right it's getting books to you guys in the community everybody's winning I'm making a little bit of money maybe you're getting books you like we're gonna have a good time we'll all be up there chatting like a show so it is what it is right now right let's go that's it yeah Jay's going tomorrow night 9 45 we start off with e-rod seven o'clock at 8 30.
do you hear me I think my earbud died Mickey can you hear me yeah I can still hear you okay so both of you both here yeah it's just Jay then um yeah Jay goes on 9 45 tomorrow night e-rod first at seven very Gary at 8 30 and then we're starting at 9 45 probably go till about uh 10 30 10 45. a couple giveaways gonna be in there and like we said if you haven't been there yet it's all three of us hanging out just like here on YouTube so it's like a little mini show on whatnot we talk about whatever happened there will be something that seems to something that happens either Monday night or Tuesday morning and it's always after our show so we so we've been talking about that on whatnot as well so it's like you get like an extra show um and maybe you buy some books so links in the description even if you're not buying just come hang out with us it's something we can like we said we're giving books away we're bullshitting with you guys so it's more than just selling the books so the defects you're doing another show on another day just come by I mean it's I mean it's content maybe it's kind of what do you ask for that's it so be Supreme love a supreme love I think I still have that Thor 166.
I still have that Maddie right yeah I think so yes you do I think I do you want to DM me you have Instagram DM me there you go sliding that slide in that DM brother um the um so yeah what up thorough in the chat yeah um look at the shirt Link's in the description and the QR codes on the screen look at the shirt keep it thorough baby how did you know to wear that thank you Cog CLG in the house CLG we're gonna be talking about we're gonna be talking about CLG next week we just didn't have enough time this week but we got clg's got some we've mentioned it before on this channel but we got a giveaway for you guys next week so I'll just tease that and we'll leave it at that but make sure you're tuned in next week on YouTube because we got a nice giveaway and if you want a giveaway Jay's doing two [ __ ] awesome giveaways tomorrow and I was like you're giving those books away yeah Jay's in the chat because his earbuds died I don't know if he's gonna jump back in or he's done but we quickly just wanted to talk so tomorrow night what not 9 45 come hang out bookmark the shows that helps us out a lot links in the description or QR code on the screen tell us about the last thing we're going to talk about here well I mean this is just funny I I I obviously it was in the news there's some big chat big channels I mean we're like we're like this we're like this I mean there's some big channels throwing some videos up there about and uh Canyons having some you see what I did there with the words Kang is having some Majors issues we saw this with the ads got him you know got him that's all um I mean guys do you does this hold any I mean how about this I go to my cousin Vinnie does the defensive case hold water so um speaking on the hot mic podcast Insider Jeff Schneider I've heard his name before uh and I've seen I've read this I read this too so go ahead I'm excited for it um brought up uh the cat uh Idris okay and that's that um damson Idris who is set to play opposite Brad Brad Pitt in Apple's upcoming movie set in the world of formula one here's the quote here's here's one I wanted to talk about did you see who got cast in the Brad Pitt racing movie question mark Dame damson address and if you don't know where that is he's from snowfall uh actually I really like that show I think he's from and he says I think he's from snowfall and that's and so that's like a big part right that is the the young hot shot racer opposite Brad put Brad Pitt in this 150 to 200 million dollar racing movie that is a big deal that he got that he noted that the young Talent would be the kind of the kind of actor the studio is looking at if Jonathan Majors gets the boot as Kang and again quote even though there hasn't been any movement on the Jonathan Majors front I've heard that that's the kind of actor who like who like if Jonathan Majors got the Buddhas Kevin someone like damson Idris is the type of person that Marvel may look at to replace him so they literally said they want a devs and Idris like actor swag what the [ __ ] I mean is that that just seems like we want the young gonna be influential in Hollywood for the next 10 years actor right and I want the butcher-esque to be the third defect I wanna I wanna God forbid something that happens yeah yeah what did yeah it's interesting stories like does Disney see these like tests yeah how would fans react to this if we if we recast well yeah before you cut out into Jake can you hear us yeah yeah I'm good I'm good I know I know you wanted to talk I know you had like we have a little bit of a difference in opinion on this so go first just in case you get cut off again but tell me what do you think about this because I know you threw something in the chat I know this was coming from off the Jump I [ __ ] this the mouse don't play dude they're not gonna have a dude that allegedly you know involved in a domestic violence incident and whether it disappears or not they always disappear look at the NFL look at all look look at Sports in general these always disappear because the victim gets paid off in whatever the case may be Disney don't want to be associated with any type of domestic violence especially nowadays and think about all the money they're saving now but an actor that's not as big as Jonathan Majors um I'm surprised it didn't happen sooner I'm surprised it didn't happen when the news dropped but I guess they had to get their lawyers involved and see where they go from there and that's it and you know if if you've been following it whether it's on IG or in the news more people are coming forward that work with this guy's majors and said he has violent tendencies so before anything else bad happens right like Ezra Miller I just seen Lord Brooklyn put it in listen they stuck with Ezra right I mean and that dude allegedly held people hostage but who knows but too much money on the line yeah that's why exactly way too much money on the line I mean I like I like you know I haven't seen Ant-Man 3 yet so I can't tell you my opinion on Jonathan majors portrayal of Kang but I like Kang the Conqueror and if these kids get a step up to do a good job then there you go if there's not going to be any backlash or Disney you know what I mean if there's not gonna be a bunch of protesters outside with nothing better to do than protest a Marvel movie because of domestic violence they don't want that headache so Jay on a positive note I don't know if this was meant for you or not I was dying you want to just read that out loud oh there you go I like it um yeah man I you know they they don't want to be exactly and like Roy says is there any I mean there's people that still go out I'm excited for Guardians three it's gonna be the first movie I go see in the theaters in a in a long long time it's gonna be a fun night Cinco de Mayo think of the last Marvel movie we saw in the theaters um no we saw we saw DC movie in the theaters yeah we saw Batman um I couldn't even tell you the list oh wow Shang Chi we want and we both fell asleep yeah oh yeah yeah the second time I watched that on Disney plus I I liked it I did too you know what I mean um yeah so yeah you know Disney's not playing man you know they're good I don't know man see this is like me and Jay are on the opposite side we have been since the beginning we've got a little side back going honestly I think what like what SWAG said now I'm not saying that he won't get fired because if I think if more comes out or he does you know if the if the case goes 40 does go to trial then it's a different story my thing is I don't think it's gonna get that far I think what's Happening Here is they're definitely testing the waters like swag side but I also think they're also doing cover fire let's say they put this out and and the evidence has already come the the stronger evidence is on the opposite side so far they've all let like the last two weeks all you've seen is all this evidence being put out there in the news and I'll say evidence about how it it wasn't him he didn't do anything the girlfriend's text messages this thing and that thing that that's by design of course so but Disney now has kind of like a look we would have done this if something happened we covered our ass like if this if if this guy was guilty or we felt like he was guilty or it did go to trial we were actively looking for a replacement already so don't don't yell at us I really think this is just more cover they're still waiting to see what's actually going to happen I think if everything That Remains the Same as it is today let's say nothing changes nothing happens this doesn't go anywhere no new evidence you're not going to hear a word about this it's just gonna die off yeah this goes to trial that's a different story if honestly I don't even think it's going to make it that far but it is New York it's a little like if this happened in a different state you know this would be a slam dunk not going to trial New York's they're a little harsher with with the you know domestic abuse so we'll see I mean it'll be interesting I I don't think you're going to see anything happen anytime soon but like if a cell phone video comes out of him him beating him then it's game over so so if you're saying if they were in all of [ __ ] Bama and they killed a good old boy there is no way that this is not going to try it right for that's this equivalent of this yeah to be honest with you I don't even think this goes to trial yeah it can't it can't go to trial if you don't have a uh well we'll say a victim or someone alleging something to begin with and yes he did he did make the 9-1-1 call but you know how Disney is guys it's it's it's a very very mindful liberal company and they want to protect themselves say they don't fire him and something else happens which you never know could and do I feel bad for the guy if it's not his fault yeah absolutely but we all know this is how Disney functions man we it was it was how they functioned but now that they're losing money is it still how they function so that's going to be what's interesting this is a big play right here that's a big play and it's going to be it's going to be crazy to see what they're gonna do with it honestly I don't I don't think he goes anywhere if you don't hear any more about it I agree with Matt and who knows who knows what goes on behind the scenes with Disney they could be they could have been looking to out this guy before it happened he could have had problems maybe more creative references and they're like oh now we got our option to get rid of this guy we we don't we don't know but what what do you think Mickey well yeah I mean like Jay was saying you know you think not that Majors his case is at this level yet but like if you compare Ezra Miller it seems like Warner Brothers is willing to like stick with it versus like Johnny Depp Pirates of the Caribbean Disney brand it was like all right get this guy out like as soon as the the thing came out so Disney I think does have a shorter leash probably when it comes to this type of stuff which is crazy which I'm not to interrupt you I'm sorry but yeah which is crazy which is crazy to me because of Johnny Depp and how big Johnny [ __ ] Depp is yeah okay that that that's an enormous enormous and he he is that franchise no matter how you no matter how you cut it he is that Pirates of the Caribbean franchise and they're [ __ ] for what they did to him well and go ahead Mickey You're I'll let you finish because I'm probably gonna say what I was going to say well go ahead go ahead no no it just and my last little point will be I think it'll be interesting because they probably need to make the decision by Loki right like when we get a Loki trailer will he be in it you know just said in the chat will he be in it we'll know then we'll know before then yeah yeah that's a good point but is but I mean you guys brought up um Johnny Depp and just take it a step further is he the reason why they won't jump the gun this time because they clearly [ __ ] up with him they fired him and and crossed themselves a billion dollars because that's what that movie would have brought the next one it would have brought a million dollars a billion dollars and they cost themselves that because they just jumped the gun yeah I mean clearly there was some stuff there but all of the allegation as to really why they fired him all turned out to as far as we could see in court were false and listen my dog my dog stepped on a Beat what listen at the end of the day Disney doesn't give a [ __ ] about any of these actors they don't give a [ __ ] about fighting that's true if this guy continues to do what he's doing he's out they they have no lawyer none of these companies have loyalty to anybody so don't don't be surprised all they see is dollar signs it's just like they really do have oh sorry I was just gonna say and they really do have the easiest creative out compared to any of these other actors and all that stuff for sure yeah sure it this is a tough one though this isn't like an actor like that nobody knows or an actor on his way like kind of in the Twilight of his career this is a this is an actor that is literally breaking out in front of our eyes yep true right so like this is this is Disney's not gonna just wave a magic wand at this one like they have to be sure because of what happened with Depp what's happening with their bottom line the fact that the [ __ ] whole entire Saga is based around this guy this [ __ ] guy based on what's happening with Ezra Miller like they are this is literally on the their top of their desk every single day trying to figure out what's the best move they're not gonna just they're not gonna just say [ __ ] it and we'll deal with the consequences either way they're definitely not going to dismiss him lightly I'm not saying that they're definitely not going to dismiss them but this isn't just like you know what let's save face get rid of this guy and whatever it is it is like they can't afford to do that right now they are not in the position to be able to do that yeah because think think of all the other stuff that comes along with that toys right yeah merchandise yeah his likeness and all that exactly it's it's this this guy was set to this guy was said to be the next biggest [ __ ] actor dude yeah she still might be yeah he still might be but you know it's it's Disney's viewers and their perception of someone which is which isn't fair to him and just like it wasn't fair to Johnny Depp but listen I I have no faith in Disney and you guys know that who watch this channel so wait is it sorry jay no no go ahead if you guys are Robert Iger what would you do assuming like you've heard different things and you you're just you're clearly you don't know but what would you do right now innocent until proven guilty that's that's my opinion that's how it used to be right yeah that's the law isn't it no it is the law but can they wait that long with all this hinder teetering on it I'll go to jail on this Mr I am the Lord I don't know that's tough that's that's a really Jay makes a really good point because if they wait too long if you go too far down the rabbit hole I mean right now is the perfect time because if you didn't see Ant-Man spoiler alert three two one John the majors character we don't know what happened to him maybe he died maybe he did it maybe got sucked back into a different realm we have no [ __ ] clue but they could easily say he went away and it changed the face of every Kang variant I mean it's literally built into being the decision being made right [ __ ] now and that's what makes that's the problem with the easiest out they have the easiest out they always do they had it before problems like this with the Multiverse oh this is [ __ ] up let's just blame it on the Multiverse that's a lost my interest you know what I mean give me a character and let him stick around from this universe don't give me all these other guys and multiple oh [ __ ] a supreme love I got I gotta I gotta I know I know just said something too a supreme love yeah he's saying the projections are low but we'll see Mike Tyson for Kang all day it's in the Multiverse I gotta follow him I gotta follow him through the through the strategy all right guys I think we're gonna wrap it up you guys have anything else to add before we get out of here everybody what do you got going tell us you know I'm Mickey I know your your Kickstarter just wrapped up yeah you just wrapped up with the kickstarter uh give us a quick uh how did it go how was the experience yeah it was great uh you know last time I was on the show you know you guys helped me out and got the word out which I really really appreciate and we we hit our goal and so you know there's no turning back now now I gotta deliver and so I'm working on that so it's it's really exciting and and yeah I can't wait to to get the book out to everybody so and you want to you want to officially uh tell the people where you're gonna be in the next couple of months uh well tomorrow I'm going to be going to uh a what what not auction right the principal defect what not one oh look at that I'll be there right and then uh yeah I'll be at uh I'll be going to terrificon I think hopefully we all get to meet up in person for the very first time so that's that's definitely yeah I don't know if that's gonna be good for you but okay start taking your milk thistle now everybody buy stock in uh in uh Pedialyte I'll tell you that I love the rose comment I think Standalone films by Marvel and DC are the way to go so do I dude it's like a reading a One-Shot comic and you could do everything doesn't have to be intertwined I don't understand why they get this concept that every I I get why they do it a standalone movie dude would be awesome like I'd rather uh uh and not from Disney I'm not gonna say Disney but I'd rather a standalone Punisher movie I'd rather a standalone Daredevil movie like movies used to be then everything tied in and then you got to worry about this and that so great but but do they have to be absolutely Standalone I mean the model that worked in phase one two and three I mean those movies while they were intertwined they didn't necessarily feel like it until the end and if and if there was it was like one single point of the movie yeah that only a hand only a certain percentage of the audience actually understood that there was a connection that model worked it was proven right I mean they were putting the Avengers together to fight you know basically a common phone damn it Thanos in The Infinity Gauntlet but it worked but it's not working now it's not well I I feel like they've amped it up and right past the point of where it worked I mean why not a standalone movie every once in a while agree you know what I agree I mean still in the same universe there's still going to be that connection no matter what but like why you don't have to make it be like where does this fit in like you just said like a standalone Punisher yeah it doesn't necessarily have to fit into what they're doing right now I would definitely like to see that I feel like they probably should have done that was just the Standalone thing and then throw in the hey there's cap Shield Easter egg you know yeah in The Shield building that they walk into you know Chad Chad makes a good point he said the single greatest thing done in cinematic history there's 23 movies culminating with the last two it was epic and would probably never be done again and that's the problem so we're trying to looking like it yeah they're trying they're trying to yeah yeah they're trying to do it you're trying to recreate awesomeness like and you know what maybe you can and DC does it look at Batman you just get a Batman movie you know what I'm saying that's totally separate from everything else that's it just don't leave celestials in the ocean I think that's something you know just just like have smaller scale third act fights oh yeah seriously listen this is this is see like we're getting into a topic now another topic that we could talk about for hours and hours and hours but hopefully in two weeks we have good news well it would be yeah it would be two shows from now that maybe maybe Guardians changes things a little bit we'll see we'll see we'll talk about that next Monday but uh I think we're gonna get out of here this was a really great show Mickey swag I really appreciate you number one loaning us or giving us the the starter fluid to get to continue this conversation that you started uh make sure you guys are you subbed up the swag make sure you're watching his videos the link is in the description and I really appreciate you coming on here with us yeah thank you so much for having me on it was a lot of fun Jay guy appreciate you boys as always see you guys tomorrow night see you in the chat if you're going to be hanging with us and whatnot tomorrow night we're going to do a little bit more discussion while we sell some books all three of us so come come hang out all right boys and girls appreciate your defects we'll see you tonight if not
CEUs are available for this presentation at AllCEUs.com/CBT-CEU Hi everybody and welcome to today’s
presentation on cognitive behavioral therapy skills. Like the other
the presentation we did on assert not assertive community treatment acceptance
and commitment therapy, which is also based on just providing information
about skills that can be used not providing an evidence-based practice
we couldn’t cover that in a full hour or just an hour so over the
next hour we’re going to define cognitive behavioral therapy and its
basic principles a lot of us are familiar with this but it’s going to be
a good review and it also may highlight some nuances that you didn’t know about
will identify factors impacting people’s choice of behaviors explore causes and
impact of thinking errors and identify common thinking errors and their
relationships to cognitive distortions so why do we care well as therapists we
want to help people figure out the best way to live a happy healthy meaningful
goals-driven life for some people that’s going to mean using some cognitive
behavioral interventions that can be in addition to mindfulness that can be in
addition to a lot of other things but it’s important to help people understand
that the way we believe things to be the way we interpret things is going to
affect our reactions so for example think about a situation you know you’ve
walked into and maybe you walked into it with a small child and it was a
different situation it was a new situation but you know it was no big
deal you walked in it was not a threatening situation to you because you
were like hey I got this the little kid walks in and goes oh wow there are a lot
of people walking around here, this is the really scary same situation as two
different perceptions you probably didn’t have much of a stress reaction
going on whereas the little child probably had this fight-or-flight thing
going on grabbing onto your hand like please don’t let go
Atlanta Airport is a perfect example if you’ve ever
taken a little kid through Atlanta Airport gives you an idea about how
people can perceive things differently and when you enact that fight-or-flight
the reaction you’re going to have all those stress hormones you’re going to have all
either anxiety or anger or whatever that goes with it it may serve to
exhaust the person and leave them feeling hopeless and helpless so what we
want to do is help people see that but we also want to help them see that when
they’re depressed when they’re tired when they’re sick things are going to
seem a lot worse a lot of times because they don’t have the energy to perceive
it differently I mean when you’re sick it’s overwhelming to think of going
through Atlanta Airport so this is what we want to help people start
understanding is it’s two sides of the same coin they interact if one is you
know kind of going wonky is going to affect the other one the good thing is
if one’s going well the other one’s going to go well if you’re
having positive thoughts you’re probably going to feel pretty good
there’s an activity and I think we’re going to talk about it later it’s called
the coin flip activity and I asked client clients to flip a coin in the
morning and in the morning if it turns heads then they have to be the most
positive Pollyanna all day long look for the silver lining and everything smile
walk with their head up hold those nonverbals up and see how they feel at
the end of the day besides a little sore because there are muscles they’re using
they haven’t used in a while if it lands on tails they can just be their normal
selves which generally if they’re seeing me means that they are depressed anxious
stressed out angry about something in the negative realm then we
talk about how did things seem different on the days when you were feeling better
when you were walking taller when you were smiling even our nonverbals it
doesn’t even have to be sickness it can be our nonverbals that can make us feel
or make our body feel heavy and tired and make it seem like it’s a whole lot
harder to deal with life as a person who perceives the world
generally good and believes they can deal with challenges as
they arise that good old self-efficacy will be able to allow their stress
response system to function normally so if they’re like you know what I can deal
with whatever life throws at me I’ve got it and maybe I need help with it maybe
I’ll need to ask for support but I’ve got it it’s not going to completely
overwhelm me with people who see the world as hostile unsafe and unpredictable you
know for a variety of reasons whatever happened to make their scheme as such
that they don’t believe that people or the world is trustworthy are predictable
they are always on guard they’re always kind of like a hamster in a cage that has
Have you ever had hamster hamsters don’t recognize you and go hey that’s my own
or human contact score hamsters go run under their little house
and you just kind of open the cage and stick your hand in there and flip over
their house and you’re like come here and give me cuddles and you’re like you
know 200 times bigger than they are so the little hamster is like freaking
out this is what it’s like for people and obviously, I’m exaggerating but this
is what it’s like for people who have a negative perspective a negative view or
a hostile view of the world so kind of keep that little hamster in your mind cognitive behavioral therapy we have
core beliefs those things that are in our hearts when I talk with my clients
about honesty step one and that’s what they’ve got to do to start recovery is
get honest with themselves first and then other people we talk about head
heart and gut honesty do you think it’s right does it seem like the right thing
to do does it feel right in your heart you know does it make you happy it
doesn’t make you feel good and then the spidey senses is your gut saying and or
is your gut fine if one of those is saying this might not be the right
choice and we need to think about what’s going on so we have those core beliefs
and I put them in the heart just because that’s the middle of the head heart and
gut but you have core beliefs about yourself whether you’re good with
you’re bad whether you’re effective at certain things ya ya
you have core beliefs about other people same thing good bad effective
predictable and you have core beliefs about the future and a lot of that goes
with the locus of control but also your past experiences if the world in the past is
seemed unfriendly and uncontrollable and you’ve perceived it that way then you’re
going to expect the future to be uncontrollable so what we want to do is
help people look at their schemas and their core beliefs about themselves
others in the future and figure out kind of what they want it to look like these
schemas are going to affect your behavior and your thoughts and your
feelings and you know you can pick wherever you want to start it doesn’t
matter because all three inter interface with one another so if you haven’t let’s
start with negative thoughts if you have negative thoughts then you might feel
anxious angry stressed dysphoric which will affect the behavior you’re going
to do different things than if you have positive thoughts about something you
feel excited and energized you’re going to have different behavior the best
thing example I can give you is if you’ve ever done public speaking or had
to present something some people detest public speaking it’s just
terrifying for them to get up in front of a group of people so their thoughts
am I going to trip up I going to forget what I’m going to say I’m going
to make a fool of myself I’m going to you know it can go on forever that when
you get on a roll you can get on a negative roll and go on forever or
positive hopefully get on that roll with those thoughts you start holding onto
those thoughts remember as we talked about in a CT the other day when you
hold those thoughts and you kind of mush them around in your mind and you come to
believe them that you’re going to make a fool of yourself and it’s going to be
awful you’re going to start feeling terrified likely which is going to
likely affect your behavior if you go out on the stage and you’re terrified
you’re going to probably stutter you’re probably going to get foggy-headed
you’re going to have that fight-or-flight reaction so there’s an
the adrenaline rush and you start sweating and you can’t focus and you can’t
concentrate you want to away as opposed to somebody like me who
loves public speaking and I’m just like cool I get to go out there and try to
engage however many people are in the audience it’s a game for me because when
I can see your faces I enjoy trying to figure out and make eye
contact with people and figure out what it is that they’re there for what is it
that’s going to make them tick what resonates with them so my behavior as
you can kind of see right now when I go out there I’m excited and I want to
engage people and it’s a fun experience for me again just like the airport the
same experience for two different people and two very different interpretations
and reactions to it so what effects I don’t like the term rational but when
we’re talking about CBT irrationally comes up a lot I like to replace it with
helpful because every behavior in its weird sort of way is or probably was
rational at one time that being said we’re going to get back to that stress
affects our behavioral choices if we’re under stress we can have negative
emotions negative emotions will affect our thoughts if we’re feeling sad we’re
probably going to look at the dark side if we feel sad we’re going to look at
the bottom falling out if we’re happy we’re probably going to look for that
silver lining physical factors if you’re in pain sick sleep-deprived poorly
nourished so your body can’t produce the neurotransmitters it needs to or heaven
forbid intoxicated you’re probably not going to make the same decisions as you
would if you were comfortable healthy well-rested nourished and not
intoxicated any of those things can go impact how you perceive a
situation or how you react in a situation, especially the intoxication
whereas in your non intoxicated State in your sober state, you may think that you
want to do something but then you’ve got that filter that goes not
not a good idea in an intoxicated State or even in a manic state if you’re you
know if you have somebody with bipolar that filter kind of goes away so the
behaviors that someone may normally not do because they have a rational filter
that goes you know punching this guy outs probably not the best idea right
now the filter goes away when you’re sleep-deprived you’re less generally
people are less patient generally people don’t have as much of a filter thing
about watching your children if you have children or your grandchildren or even
yourself I know myself when I’m sleepy I am giddy as all get-out and things I
wouldn’t normally say because they’re you know stupid I’ll just come out and
say anyway and my kids just roll their eyes or mom you’re overtired could
go to bed, uh but that’s okay you know I’m okay with that
in that situation now if I acted that way at work it would be a worse thing
environmentally if you’re introduced to a new or unique situation and you
perceive it as stressful because the unknown we know can be stressful then
you may not make as rational of a choice or as helpful of a choice because you
maybe trying to escape the same thing as exposure to UNPROFOR bellowing for a
the word here but UNPROFOR ball is the best I could come up with we all prefer
certain situations some people as I said would rather do just about anything
then get up in front of a lecture hall of a hundred and fifty people and talk
but if they have to do it then they’re going to be under stress which may
affect how they do things so we want people to understand that their
perception and their feelings are affected by a lot of other things not
just you know an emotion here or a particular memory there’s a lot that
goes into it and social if peers your family convey
irrational thoughts as necessary very standards for social acceptance
people may tend to cling more to it to those unhelpful thoughts and unhelpful
behaviors you know in CBT they say irrational because quote nobody wants to
associate with those people you know who are those people and why can’t we
associate with them there are a lot of things if you think back think high
the school you know high school is pretty rough if we’re going to talk about
having irrational thoughts and cognitions if you have to be part of
this particular group to be accepted you have to do this you have to
do that but do you really so those kinds of all-or-nothing statements
are cognitive distortions and while they may have served a purpose in some way
shape or form in the past we need to encourage our clients to take a look at
them now and go are they still helpful ways of thinking is it still helpful for
me to think that I am only successful if I live in a million-dollar house in a
gated community and do this that and the other or can I be can I define success a
different way or do I define success differently and lack supportive
peers to buffer stress so we had those peers that caused stress by talking
about the half dues and categorizing and lots of attributions but then there’s
also not having somebody to go you know does this make any sense
because sometimes we are our own worst enemies and if we go to a friend and we
go you know this is what I’m thinking and I think I have to do this in order
to be acceptable to be loved or you know whatever the case may be
most people are not going to use those exact phrases a good friend is probably
going to listen and go yeah you’re right or no no that’s way off so supportive
peers are essential to reminding us to consciously regularly check in with our
cognitions to make sure that they are hopeful and rational so a note about
irrationality and this is mine this is not from CBT the origins of most beliefs
for rational and helpful given the information the person had at the time
and their cognitive development their ability to process that information so
concepts and schemas and core beliefs that people formed when they were five
are probably going to be very egocentric you know the person is going to feel
like everybody sees it my way because this is how I see it you know just like
a five-year-old does a five-year-old doesn’t think well you know let me take
Johnny’s perspective is no he assumes that Johnny sees it the same way so it’s
going to be egocentric it’s probably going to be focused on only one aspect
of the situation because small children can’t focus on multiple aspects and it’s
probably going to be dichotomous it’s all-or-nothing
mommy loves me mommy hates me and it could be personalized you know
everything a lot of kids think that everything has
to do with them so if something happens something bad happens many times
children will take it personally or be afraid it’s going to happen to them
again you know if hurricane Katrina hurricane
Andrew those sorts of things you know we saw a lot of trauma in children and they
developed very real fears about thunderstorms and hurricane season
and if you’ve watched Florida hasn’t had a notable hurricane in years now but
there’s a lot of stuff that goes into that but young people
during some of those really bad hurricane seasons perceive those
situations differently okay so we need to help people understand that if we
especially if we use the term irrational those thoughts you formed when you are
knee-high to a grasshopper and they made perfect sense to you back then but now
that you’re an adult you’ve got more experience and you’re
able to take different perspectives your brain is more developed
let’s take a look at it and see if you can look at different perspectives and
come up with something a little more helpful maybe a different way of
perceiving this situation the irrational irrationality or unhelpful Nosov Fox
comes when those beliefs are perpetuated without an examination so something a
the belief that you formed when you’re five you’re still holding when you’re 35 and
you’ve never questioned it you’ve never gone you know does this make sense is
this is helpful to get me to where I want to be most of us don’t know
we form these attitudes and beliefs when we’re you know growing up when we’re in
elementary school middle school high school from watching TV to being
around our peers from being around our family in our community and we get all
this input of the way things should be and a lot of times people don’t stop to
question and go and go well does this make me happy is this really what
I want and they can be irrational if they continue to be held despite causing
harm to the person so the person continues to hold this belief even
though it is causing them general emotional cognitive harm is making them
miserable we need to look at why what’s motivating them to hold on to that
belief why is that belief so important and how can we make it so they can live
a happy values-driven life emphasis on the happy how can we make it less
harmful sometimes it’s more productive for clients to think of these thoughts
as unhelpful or helpful instead of irrational sometimes when I say
irrational to clients and you know I’m the same way if somebody says you’re
being irrational I’m like oh I’m not it elicits this instantaneous defensive
the reaction’s like when you tell them they’re being resistant they’re like I
am NOT being resistant so helpful or unhelpful and then we talk about why it
is unhelpful in getting them toward their goals
basic principles of cognitive behavioral therapy we teach or help clients learn
to distinguish between thoughts and feelings I can think something is scary
I’ll probably feel it but if I have an automatic you know feeling I walk into
Atlanta Airport and I see yeah I went to an airport in New York I can’t even
remember which one it was because my plane was diverted and I got off and I
walked out there and I have never seen so many people packed in his place like
sardines before in my life I was just completely overwhelmed that was kind of
an automatic feeling now that was a feeling based on you know who knows it
was overwhelming to be surrounded by that many people so then I had to
separate the thoughts and go okay what am I thinking that’s making me feel so
overwhelmed and at that point you know I didn’t know how to get to my gate and
all that other sort of stuff with traveling I don’t travel well but
encouraging clients to stop and go okay why am I feeling this way what are my
what thoughts am I having that are contributing to these dysphoric feelings
CBT helps people become aware of how thoughts can influence
feelings in ways that are sometimes not helpful
we have hecklers in our gallery the automatic tapes that we plaything
memories that we have whatever you want to call them that when you try something
when you are just going through daily life you hear these voices in the back
of your head and not real voices but that is saying you’re never
going to make this or if you would have just blah blah blah then you’d be a
the better person helping clients become aware of those thoughts and how they’re
negatively influencing their feelings and keeping them kind of stuck is a huge
part of CBT we help them learn about thoughts that seem to occur
automatically without even realizing how they may affect emotions again those
thoughts from they’re saying you’re not good enough
you’re not smart enough and nobody’s gonna like you where did that come from
and do you believe it you know maybe it came from somebody
when you were in high school so was that a valid source maybe it
came from somebody yesterday on Facebook was that a valid source taking in those
thoughts and then figuring out is this something I’m going to hold because it
makes me happy or is this something that I’ve got to deal with because I’m having
a negative reaction constructively evaluate whether these automatic
thoughts and assumptions are accurate or perhaps biased the other thing to
remember is a lot of our clients not all of them but a lot of them hold
themselves to a standard there’s like up here and they hold everybody else to a
standard that’s down here so they are a failure if they don’t achieve this but
everybody else is successful as long as they achieve this so encouraging them to
take a look at how accurate and biased or unbiased are the thoughts and like I
said they may be their thoughts they may be telling themselves these things
evaluate whether the current reactions are a helpful and good use of energy or
unhelpful and a waste of energy that could be used to move toward those
people and things important not impotent important to the person road-rage you’re
in the car, you’re driving somebody cuts you off okay natural reaction fight or
flight reaction you’re just like slam on the brakes and do whatever you got to do
aversive maneuvers you’re good so you could let it go at that point ago got
lucky on that one and keep driving most people not all but most they found that
80% of drivers have reported incidences of road rage which is a
high number but most people will start getting all fired up and irritated
and grumpy and we and just rageful and so my question
would be I hear that and I hear that it made you angry
in retrospect did screaming at the person as you pass them at sixty miles
an hour in your car with the windows rolled up does any good did it do
any good at all what else could you have done with that energy if you wouldn’t
have expended it all yesterday we had to wait for the vet to come by and my
daughter just completely wore herself out worrying about when the vet was
going to get there what he was going to say about her donkeys and was beside
herself so by the time it got to evening and it was time for her to go to her
martial arts class she didn’t have the energy to go she’s like um wiped out I
just want to go to bed in retrospect we’re looking back and saying okay now
tell me what it was that you were so stressed out about and let’s talk about
whether that was a realistic and helpful line of thought to perseverate on all
day long and what could you have done differently because she didn’t bother to
mention any of that to me yesterday and then developed the skills to notice
interrupt and correct these biased thoughts independently causes of these
thinking errors information processing shortcuts when we form schemas and we
encounter a situation that reminds us of something in the past like when I go to
my grandmother’s house I have a schema I have a belief system I have you know
stuff that I know about my grandmother’s house so when I go to my grandmother’s
house it’s kind of a shortcut to knowing what to expect when I walk in and how to
behave how to do different things and it helps me plan and predict if you’re
using outdated or dichotomous all-or-nothing schemas it may cause
thinking errors because you may be now incorrectly processing current events
mental noise some of us have it a lot of us have it
not everybody thinks about trying to focus and study for a final exam in the
middle of a really busy sports bar, okay this is a cause of thinking or you’re
going to miss important things you’re not going to be able to focus you’re not
going to necessarily attend to the correct things because there’s just so
much else going on your attention is drawn in 17 different directions and or
the brain’s limited information processing capacity due to age we talked
about that before young kids think all or nothing they think dichotomously
egocentric ly middle school-aged kids and older start developing the ability
for abstract thinking by the time we get older, you know as adults theoretically
we’re able to you know think pretty well and think pretty clinically about different
events but if we’re in crisis when someone is in crisis and it could be
like what we think of clinically as a crisis or it could be they’re just
completely overwhelmed and burned out and have been burning the candle at both
ends for three months they’re not going to process information quite as well
they’re not going to take in all this stuff because they’re just like
shell-shocked have you ever seen teachers in the hallway of like an
elementary school Oh at the end of the second nine weeks they just kind of
stand there with this blank look on their face they’re not processing as
much as they were the first day of school and you know God loved them they
have a lot to deal with but we need to help our clients
understand that there are some times that they are going to have to really
stop and focus write things down so they can remember or they can make decisions
a little more my guess is most of us have times in our life when we’ve
been able to think through complex problems but then there are other times
where you just can’t keep it all in your head and you’ve got to put it on a
whiteboard maybe that’s just me but we want clients
to understand that they are not broken they’re not faulty they’re doing the
best they can with the tools they have and the knowledge they have and our job
is to help them see where some of this might have gone a little awry other
causes of thinking errors and emotional motivations I feel bad therefore
whatever I’m thinking must be bad if I’m scared that means whatever it’s coming
on the other end of the phone is bad news moral motivations I did it because
it was the right thing to do and that can be an excuse for doing wrong
behaviors as well it can also be you know you can argue on
the moral one social influence well everyone else is doing it so it must not
be bad set that again a lot of times and this is where the frames approaching the
motivational interviewing is helpful f stands for feedback
about the reality of what’s going on is everybody doing it let’s look at
statistics you know not subjective information let’s look at objective
information so the impact of these thinking errors makes people want to
fight or flee when they get upset and we use upset as a kind of this
all-encompassing garbage term emotionally they get depressed or
anxious we don’t want to feel that way anxiety and anger are flee or fight
fight or flee it’s our body saying there’s a threat you got to do something
depression is your body going I give up I just don’t I don’t even have the
energy to do it anymore behaviorally some people withdraw they
shut down we all know people who get frustrated when they get overwhelmed
when they start feeling hopeless or helpless they just kind of withdraw from
everything and everyone’s addictions numb that out so they don’t have to feel
the dysphoria sleeping problem and changes when we start being on that
constant fight-or-flight hyper-vigilant sort of thing going on in the body is
always sort of turned on which means you’re not going to sleep as well then
the circadian rhythms get messed up which starts causing exhaustion and
lethargy and then everything seems harder because you’re sleep-deprived and
then you start thinking more negatively and more hopelessly you see where this
is going it’s a downward spiral and eating changes some people eat a lot
more because they’re eating comfort foods some people eat a lot less because
their stomach is so torn up from the stress they can’t even think about
holding anything down physical stress-related illnesses fibromyalgia
gastrointestinal problems headaches neck aches backaches you know the whole
the gamut of it when you start feeling bad when you start hurting generally it gets
frustrating after a while and that frustration makes it kind of raises the
the bar brings you up a little bit so you’re
that is much closer to kind of just kind of being overwhelmed you don’t have as much
of a cushion as you would if you were happy healthy well nourished not in pain
and socially a lot of times we will get irritable or impatient with other people
or withdrawal when we’re having these negative cognitions these thinking
errors that are keeping us in a dysphoric state these effects of
thinking errors contribute to fatigue and a sense of hopelessness and
helplessness which intensifies thinking errors this is an important concept that
I want my clients to understand and I want to drive home in this presentation
so thinking errors what are they emotional reasoning feelings are not
facts and we want to help people to learn to effectively identify feelings
and separate them from facts so if somebody says I’m terrified
okay that is a feeling what are the facts supporting that feeling why are
you are terrified what is the evidence that you are in some sort of danger
right now you know and danger may not be the right word for your client at that
a particular point in time but what’s the evidence that there’s a threat in what
ways are this similar to other situations maybe it’s triggering something from the
scary past or you know you were too little to be able to
handle it but you can handle it now and how if you dealt with similar situations
like this, in the past, we want to help people just step back and get some
distance between their feelings and their thoughts and try to figure out you
know which thoughts are helpful and productive and even if a sought makes
people anxious or angry it can be helpful it may be telling them hey dude
you need to get your butt up and get out of there if it’s helpful it means it’s
moving them toward where they want to be happy healthy safe and values-driven
life so happy and helpful developed a stress tolerance skills when people use
emotional reasoning they feel emotions which then they start attributing
finding the facts to support those emotions instead of looking at all the
facts we want to help them learn to tolerate their distress so they can kind
of let that subside for a second they can accept their feeling they can name
they can say I’m scared I’m stressed I’m angry and whatever but they don’t
have to act on it right then they can tolerate the distress for a minute
without having to try to make it go away and emotional regulation skills they can
feel a feeling without having to make it go from zero to 120
you know if they feel sad they go I feel kind of sad instead of grabbing onto it
and going I wonder what I feel sad about I must feel sad about all these sad
things now I’m going to be sad and devastated so we want to
help people learn how to regulate their emotions identify them accept them
whatever word you want to use and tolerate them because feelings are
there for a reason, they’re to tell you your brain thinks something’s going
now thankfully we have that higher-order cognition stuff going on so
we can contradict our brain and we can go you know maybe that’s not true in
this situation cognitive bias negativity mental filter whatever you want to call
it people who focus on the negative they walk in they get up in the morning and
they look outside and it’s partly cloudy they get to work and they said instead
of saying there was it was very light traffic they said there was a fair
amount of traffic everything is always the flip side of
what somebody who’s optimistic would say so asking them what’s the
benefit to focusing on the negative in what ways is this helpful to you you
know some people say well it keeps me from getting disappointed because I know
it’s going to end up negative anyway so we can trap challenges that know that
whatever it is they think they know and see if there have been exceptions when
it hasn’t turned out that way what are the positives to this situation
I give the example a lot of you know I wash my car or it rains and maybe I
wanted to go out on a run that day but I can perceive it I can look at the
positives you know the rain washed my car for me so I don’t have to do it now
score it watered my garden all the better it knocked down some of the
pollen out of there even better I can find and I can encourage people to find
positives in a situation yes there are negatives to every
situation if you want to find them you’re going to find them but if you
want to find the positives you can too which takes us down to what are all the
facts there’s the positive and the negative and the neutral I told you
earlier about the coin toss activity having people toss a coin on the
heads days they act like it is just the greatest day to be alive and see how
things are different when they do their journal because you know I have my
clients do I’m sort of a mindfulness check-in in
the morning and in the evening and preferably at lunchtime how are they
feeling what’s their emotional state what’s their energy level on the happy
days a lot of times it can be less and sometimes they need a little coaching
throughout because some of those old patterns kick in but I want them to
start challenging some of their automatic thoughts that we’re going to
talk about in a minute disqualifying or minimizing the positive most of us can
probably say we’ve had a bunch of clients that do this they are more than
happy to tell you about all the things that they mess up but then when they do
something right they minimize it encouraging people to hold themselves to
the same standard they would hold everyone else to and I know I talked
about that earlier ask them things like would it minimum would you minimize this
if it was your best friend’s experience your best friend came to you and said I
just got into such-and-such college would you say awesome or would you say
anybody can get in there how would that go ask them what is scary about
accepting these positive things that you might have had an
accomplishment for some people it means that it might mean other people expect
more of them for other people they just don’t know how to accept the positive
they don’t know how to accept compliments they don’t know how to be
the center of attention and they don’t like it and then we want to look at why
that is sometimes we disqualify the positive because it fails to meet
someone else’s standards so as people might that be true here you know I know
when I was growing up and going through college and going through school and
everything got my doctorate but I will always be ever and always being not
a real doctor because a Ph.D. is not an MD and I’m like really
so is it somebody else’s standards or can I feel good about having a Ph.D. egocentrism my perspective is the only
perspective I’ll being egocentric but it doesn’t work
most of the time so encouraging people to take alternate perspectives
maybe you’re texting with someone and they say something that is not that you
interpret as not the nicest thing and this happens in a text messages a lot and
they get upset now an egocentric thinking error would say that purse is
just grumpy today someone that’s taking other perspectives would stop and go
back and read the text and go I wonder if maybe this could have been taken some
another way you know cuz their reaction is not what I intended
so egocentrism if you hold on to that I don’t understand anybody else because
you know I don’t see a problem with anything personalizing and mind-reading this is when you assume that everybody’s
frowning because of something you did your boss walks down the hallway
and looks at you and grimaces and continues to walk on oh I must have done
something wrong no maybe he just got out of his senior management meeting that
was five hours long and he’s got to go to the bathroom you know there could be
a hundred different explanations for why that happened so encourage clients to
ask themselves what are some alternate explanations for this event that
doesn’t involve me you know why might this have happened if they hold
on to that, I must have done something wrong but as soon as their boss calls
them up and goes hey can you come to my office for a second you know where their
thoughts are going to go I’m getting fired I’m going to get laid off I don’t
know what it was that I did wrong but he walked by me two weeks ago in the
hallway and grimaced and I’m just I’m the worst person in the whole world
but where did that come from so encouraging people to not necessarily
assume they know what’s going on in someone else’s mind and not
automatically attributing every person’s negative behavior to something they did
how often and then ask them how often has it been about you
now think about the last 10 times you’ve taken something personally how many of
those 10 times has it been about something you did versus something with
the other person then the availability heuristic remembering what’s most
prominent in your mind so asking clients what are the facts ah the most obvious
one that we talk about is plane crashes you know it is way dangerous to fly on a
plane because you hear about all those plane crashes well yeah you hear about
A few planes crash but you don’t hear about the 20,000 every day that land
safely so you remember it and it seems more dangerous because that’s what is in
your mind that’s what is available to you that’s what you’ve based your
thought processes on because maybe you didn’t know that 20,000 planes or more
fly and land just perfectly every day this can also be true with people
remembering what’s most prominent in your mind sometimes and this can be very
very true in domestically violent relationships if somebody falls in love
with someone and that person is just the greatest person since sliced bread for
the first four months and then the cycle starts and there’s this little tiny
a sliver of the honeymoon period after the battering cycle and the person’s like
that’s the person I fell in love with that’s what I remember and they try to
focus on what’s most prominent in their mind and they ignore the rest of
the stuff so we need to encourage people to look objectively at the facts magnification are you confusing high and
low probability outcomes what are the chances that this is going to happen how
many clients have we worked with that have gone to the doctor and gotten in a
physical or get a test run and then the doctor had to call them back and
this could be true for you too and the doctor had to call them back two or
three days later when the tests came back from the lab and that whole three
days they were just in a panic because they
were afraid they were going to get some terminal diagnosis so thinking about
high and low probability outcomes another instance or example of
magnification is somebody that thinks this is the end of the world whatever it
I think I’ve told you before my little story about um tripping when I
was walking down the hall at work and falling and yeah it was embarrassing my
folders went everywhere and yeah but in that big scheme of things will it matter
that much from now you know are people gonna think oh she is such a clutch she
must be a ditz too no I mean they may have thought that at that time I don’t
know but you know in six months nobody’s going to remember and then ask them in
the past when something like this has happened when you’ve had to get a test
done and you’ve had to wait on results or if you’ve done something that was
embarrassing and you didn’t think you thought everybody was going to remember
it forever how did you tolerate it how did you learn to deal with it building
on those strengths that they already have all-or-nothing thinking errors
these are things like love versus hate I love them or I hate them it’s all or
nothing she does this all the time or she never does it if I’m going to do it
I’m going to do it perfectly or I’m not going to do it at all thank you all good
intentions or all bad intentions you know sometimes we do things with good
intentions that have some bad repercussions so did we do it with all
bad intentions are all good intentions and the answer is neither most of the
time life is kind of in that middle-ground gray area encouraging clients to
look and find examples where something hasn’t been one of the polls when having
they do something that they’re proud of that wasn’t perfect or when again
when has somebody else done something that they were proud of that wasn’t
perfect remembering that with availability
heuristic remembering how often something really happens and how long it’s
been since you’ve seen that behavior and remember that sometimes good times are
amazing but how frequent are they compared with the bad times another thinking error is a belief in a
just world or a fallacy of fairness I just asked clients to identify for good
people you know who’ve had bad things happen and in reality we all have bad
things happen good people do bad people do in between people do attributional
errors and this is a pet of mine you know labeling yourself is not a behavior so
global versus specific and I am stupid versus I’m stupid at math I don’t have
good math skills it’s not about me it’s about the skills I can change skills
stable I am and I always will be versus it’s something I can change it’s
something I can learn internally it’s about me as a person versus it’s about a
skill deficit or something I could learn or change and there’s you know lots of
information on attributions out there on the internet if you need a refresher on
it but we find that a lot of people who have dysphoria have negative global
stable internal attributions so questions for clients remember the
beliefs equal thoughts and facts plus personal interpretation another way of
saying it is reality is 10% perception is 10% reality and 90% interpretation so
what are the facts for and against my belief is the belief based on facts or
feelings do the belief focus on one aspect or the whole situation does the
belief seem to use any thinking errors what are alternate explanations what
would you tell your child or best friend if they had this belief how would you
want someone to tell what would you want someone to tell you about this belief so
if you’re telling somebody about this what are you hoping they’re going to say
in return and finally, how is this belief moving you toward what and who is
important to you or moving you away from what or who is important to you now they
can do a worksheet and have all of these or you can pick one or two of these
questions that are most salient for your clients but they can have kind of at
their fingertips so as they’re going through the day and something happens
they can ask themselves ok what’s an alternate explanation or you know
whatever it is this is salient for that client’s irrational thoughts about how to do these
thoughts impact the client’s emotions health relationships and perceptions of
the world you know this is what we want to ask them how is this thought
impacting you globally how may this thought has been helpful in the past
where did it come from how does it make sense from when you formed it in the
past when you’re dealing with it ask the person if the thought is bringing you
closer to those that are important are there any examples of this thought or
belief not being true and how can the statement be made less global less
all-encompassing so it’s about a specific incident a specific situation
less stable which means you can change it and less internal which means it’s
not about who you are as a person but maybe something that you do or a skill
that you have so we’re going to go through some of these thoughts real
quickly here mistakes are never acceptable and if I make one it means
that I’m incompetent well never is kind of stable and I am incompetent is kind
of global that’s also that extreme all-or-nothing thinking so you can see
where these cognitive distortions end up leading to unhelpful beliefs
when somebody disagrees with me it’s a personal attack well there’s
personalization if I ever heard it before maybe it’s not about you may be
they’re having a bad day and you just happen to be the unlucky target or maybe
they’re disagreeing with you because they have a different point of view and
it’s not a personal attack it’s just their point of view if someone
criticizes or rejects me there must be something wrong with me
personalization all-or-nothing thinking global stable and internal something
wrong with me as a person to feel good about myself others must approve of me
now this is one we’ve talked about external validation before and we can’t
control other people to feel good about yourself how can you do that
besides necessarily requiring other people to approve of you to be
content in the life I must be liked by all people Wow I’ve never met anybody who’s
liked by all people I’ve never even met anybody who’s been hated by all people
but it’s important to help clients see how this is dramatic to say all
people and for them to be content then everybody has to like them
I mean I like to be liked but if everybody doesn’t like me you know
that’s pretty understandable my true value as an individual depends on what
others think of me I would challenge this one this is all you know
also, very personal internal I would challenge people to look at and say it
so your child’s value as an individual depends on what other people think of
he or most people would say no but the perspective thing nothing ever turns
out the way, you want it to okay all-or-nothing thinking and probably
the availability heuristic if something bad just happened then they may be focusing
on that which causes them to focus on all the other bad things in the past
that have happened not to focus on that is okay you know bad thing
happen but look at all these good things I won’t try anything new unless I will
be good at it this fear of failure fear of rejection
it just really paralyzes a lot of people when they get stuck with that thinking
the area that they have to be perfect I am in total control of anything bad that
happens is my fault well that’s egocentric and personal if
they think they’re in total control that’s their perception of how the world
are they think if they’ve got everybody on marionette strings anything
bad in the world that happens is their fault how powerful are they
I feel happy about uh if I feel happy about life something will go wrong
it happens sometimes but let’s look at times when you’ve been happy that
something hasn’t gone wrong you know let’s get rid of that all-or-nothing
thinking it’s not my fault my life didn’t go the way I wanted could be true
but it seems like that’s making you unhappy so what do we do about that if
I’m not in an intimate relationship I’m alone
no, again that’s pretty extreme I’m either in an intimate relationship, or I
am alone and a loner and you know it’s just me and my 17 cats which follows
with there’s no gray area so encouraging people to look at what these
beliefs are saying important thoughts impacts behaviors and emotional and
physical reactions emotional and physical reactions impact thoughts and
interpretations of events so if you do something and it’s pleasurable
and you have a great physical reaction you know let’s take bungee jumping or
skydiving if you go out there and it’s scary but you do it and you’re just like
whoa what a rush your interpretation of that is probably going to be good which
means you’ll probably do it again if you go out there and it’s just the most
horrible experience you’ve ever had you’re probably not going to do it again
and your interpretation of it is going to be not good which is going to make it
hard to understand why other people would do it irrational
thinking patterns are often caused by cognitive distortions so let’s just look
back at some of those because there are a lot fewer cognitive distortions or
general ways of thinking about the world then there are thinking errors because
there are lots and lots of thinking errors cognitive distortions are often schemas
which were formed based on faulty inaccurate or immature knowledge or
understanding and by identifying the thoughts of the hecklers you know the
automatic tapes that are maintaining our unhappiness the person can choose
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this episode was pre-recorded
as part of a live continuing education webinar on-demand CEUs are
still available for this presentation through all CEUs registered at all
CEUs comm slash counselor toolbox I’d like to welcome everybody today to the
presentation love me doesn’t leave me addressing fears of abandonment the purpose of this
presentation is really to help us help clients increase their awareness of their story including
beliefs about behavioral reactions to situations that trigger their fear of abandonment so how
do we do that well the first thing we need to figure out is what fear of abandonment is and how
can we identify it in a clinical set setting then we’re going to explore the concept of schemas or
core beliefs and these are things that are formed in early childhood you know if you remember
prior classes we’ve talked about early childhood cognition is generally very dichotomous in children
young children don’t have the ability to look at that gray area so these schemas if they’ve gone
unchecked can lead to some very extreme belief patterns which lead us into common traps in
thinking reacting and relationships if your schemas are based on all-or-nothing you either
love me or you’re going to leave me hence the name of the book then your reactions are going to
tend to be more extreme and more all-or-nothing which increases anxiety because then anytime
a person who perceives any amount of disapproval obviously is going to go to that extreme so we
want to talk about bringing it more toward the middle line and helping people learn to appreciate
and love themselves for themselves while they may not approve of the behaviors of other people they can
still love other people so just because somebody doesn’t approve of your behavior doesn’t mean
necessarily that they’re going to abandon you so we’re going to talk about that and then we’ll
learn skills necessary to help people accept their past as part of their story maybe they do
have a lot of abandonment issues and you know some people do and it really is painful it cuts
to the core especially when those abandonment issues occur in early childhood when kids going
what that does so we’re going to talk about that and help people learn how to integrate it into
their present and we’ll learn the skills necessary to acknowledge that their past does not have to
continue to negatively impact them in the present so if they were abandoned when they were a child
you know we need to deal with that however if they continue to expect that every significant person
in their life will abandon them notice I use the word every because we’re still in those extremes
then they’re going that the past is negatively impacting them in the present so we’ll talk about
how to sort of moderate those belief systems how does this impact recovery whether you’re talking
about addiction or mental health issues connection is a basic human need we are not meant for the
most part to be Hermits in the middle of the woods there are introverts and in my husband’s an
introvert he has a couple of really good friends he needs quiet time each day he doesn’t need to
be surrounded by people and he’s fine but I mean we’ve got human connection he’s not going to be
one that’s just going to you know move out to the middle of nowhere I’m an extrovert on the other
hand and I tend to have a lot of acquaintances and a lot of friends I draw energy from
being around other people so just because someone doesn’t have 150 acquaintances doesn’t
necessarily mean they don’t need connections so we want to recognize that connection is a basic
human need when infants are born they are put on their mother’s chest when we embrace each
other whether it’s mother and child or friends or whatever a chemical called oxytocin is released
and it’s our bonding chemical we are programmed we are hardwired for connection and oxytocin is a
very rewarding chemical so we want to recognize this that if people are so afraid of abandonment
that they push everybody away what are they losing as far as quality of life as infants and children
survival is dependent upon the relationship with the primary caregiver so if mom or dad wasn’t
happy if mom or dad was rejecting the young child was pretty much helpless to think about a child
who’s growing up in a family that’s just riddled with addiction and mental health issues and the
primary caregiver or caregivers are completely emotionally unavailable they may be physically
there but they may be so high or so depressed or so psychotic that they cannot attend to the
children’s need what does that communicate to the child feels abandoned the child
feels a sense of neglect for people’s beliefs about other people and relationships were formed largely
based on their interactions with their caregivers so if this child was going mom I’m hungry and
nothing happened or worse yet child was going mom I’m terrified and nothing happened or they
were just given a pacifier and told to shut up then that is they were told they were communicated
to that their beliefs their feelings their wants and their needs were not important so they were
being rejected healthy relationships serve up as a buffer against stress so even if they had all
these negative experiences in early childhood teenage years you know maybe up until
they walked into your office it doesn’t mean it has to continue and how much can they gain from
having healthy relationships with a lot of clients that I work with who have pretty significant
abandonment issues can’t even fathom trusting someone enough to be in a healthy relationship so
we’re going to talk about how to sort of ease into that because you’re not going to say don’t let
your past influence your future and we’ll wave a magic wand and they’re ready to trust people
even once you point out that what happened in the past was largely not their fault or maybe not
even their fault at all they’re still going to have difficulty not accepting responsibility
and going everybody leaves me so what talk about that addressing beliefs that formed as a result
of these relationships the past dysfunctional relationships we can help people create a
new understanding of events was mom or dad or caregiver really being rejecting were you being
abandoned emotionally and physically because of you or because mom or dad just was able to do what
they needed to do to be a caregiver at that point in time they were doing the best they could with
the tools they had but it wasn’t enough to meet your needs so we want to talk about alternate
explanations for why parents and caregivers may have behaved in that way if you have a young child well
an adult now but who was put up for adoption or abandoned by their caregivers at a young age the
a young child was probably very confused because one moment their caregiver was there in the
next moment they were in the system so they were trying to figure out what did they do wrong and why
doesn’t that person love me anymore it must be me because children really can’t see well you
know mom is not able to function as a parent right now or dad is having difficulty coping we
want to help people better understand themselves in their reactions so that when they start getting
this urge to just cut all ties and be like you know what fine you know I’ll take my ball and go
home no problem what does that mean at there’s a certain point in all relationships in all healthy
relationships that you know sometimes people have to distance themselves from one another because
it’s becoming dysfunctional but for the most part, people will in relationships encounter
hiccups will encounter disagreements but in healthy relationships, they can work through
them in relationships with people who fear abandonment there are going to be two extremes
there’s going to be complete compliance and please don’t leave me or complete disengagement
and whatever I don’t care the final thing we want to do is help make people more conscious of
what they’re doing so they can make healthy decisions in their current relationships so when
they get that urge to either comply or disengage is that a healthy normative reaction right now
or are you reacting out of your past experiences the abandonment experience in childhood survival
depends on caregivers a four-year-old left alone for five days is not going to do so well you
know they may be able to scavenge food but once the food runs out where do they get it you
know there’s only so much that a child can do an infant can’t even get their own food
so survival depends on their caregivers and if their caregivers fail to meet those needs there are
high levels of anxiety and I will refer regularly to caregivers who are emotionally unavailable
and emotionally absent in addition to physically unavailable or absent because some parents and I
worked in the field of co-occurring disorders for over two decades and some parents just they are so
overwhelmed and so paralyzed by life itself they can’t even attend to anything else that’s going
on they’re doing good just to be breathing but if they have a child and that child’s needs are
getting neglected and fear of abandonment is a natural survival response when your food source goes away
what happens you start to freak the freak out so this is normal we look at this and say that that’s
that’s natural if a child thinks about the first time you take a child to kindergarten or pre-k
or daycare or whatever it is and you drop the child off even if they’re securely attached what
do they cry because they’re afraid that mom or dad won’t come back and they’re afraid of
this new situation that’s changed securely attached children will you know adjust and then be happy to
see mom or dad when they come back but the point is there’s that initial oh crap reaction meeting
biological needs and safety are key triggers for anxiety at any age so we’re talking about housing
we’re talking about safety we’re thinking about Maslow’s hierarchy if somebody is not meeting the
child’s needs or if the person is not getting their needs met then they may have high levels
of anxiety and I add to the safety concept not only physical safety but also emotional safety
people need to feel safe in their own heads and they need to be free from emotional abuse when
focused on survival people can’t focus elsewhere so if they’re not getting their physical needs
met guess what you know if you take somebody who is in pain who is sick who is hungry and who is
homeless are they going to work on self-esteem are they going to work on relationship skills
no, they’re focused on survival they need to have those basic needs met they need to have a certain
sense of security if they are in a situation that is dangerous physically obviously they’re not
going to be focusing on how can I better myself when they’re worried about somebody coming in
and hurting them physically likewise it’s hard to focus on how can I better myself when everywhere
they turn they perceive someone telling us you’re not okay you’re stupid you’re lazy you’re bad
you were the worst decision I ever made in my life they can’t focus on personal growth when
all they’re getting is these verbal beatdowns all the time so people need to have acceptance if
they don’t have acceptance kind of the opposite of acceptance is abandonment two kinds of extremes
again we’ll bring it back to the middle every stressful situation becomes a crisis the in
securely attached child now you can go back to and read Bowlby’s work on secure and all that kind
of stuff great reading but for the short version of this presentation remember that certs securely
attached children feel anxiety when their parents leave but then they can adjust and they’re happy
to see the parents return in securely attached children feel a great amount of anxiety when
their parents leave and are terrified that mom or dad won’t come back and then when mom or dad does
come back it’s your very very clingy or very very rejecting so with this child that’s in securely
attached it’s just like one to a hundred as soon as something happens that they think they may be
abandoned you see this pattern again in adults who are still struggling with these abandonment issues
that schema that they’ve formed and I’m getting a little ahead of myself that schema that they form
says if you let this person at your site or if this person disagrees with you or if this person
criticizes you they’re rejecting you and they’re going to abandon you so we want to you know check
in with those cognitions and look for trying to make those thoughts a little bit more helpful in
infancy or early childhood if caregivers were away for long periods of time because of work because
of military, if they were in jail if they just chose to be away or if they passed away children
may experience some abandonment issues now if the parents are away because a parent is a way
because of work or military or even jail and the other parent can help the child work through it
there’s much less drama if you will there’s much less issue with abandonment issues in totality
now if it’s whatever parent it is if the pay, if the father happened to be the one, went away
that person may have some residual issues with adult figures in their life that they need to deal
with but they may not know I’m not saying that every child of a soldier or a service person
is going to have abandonment issues that are so not true however if the experiences of the time
apart was not handled in a way where the child felt secure then it could have consequences that
are going into present-day if in early childhood caregivers were inconsistently or unpredictably
physically or emotionally present so think about a parent who has major recurrent major depressive
disorder addiction or is just ill-equipped to deal with a child when I was working at the treatment
center in Florida I had 14 15 16-year-old young women coming in and having babies and you know
what does a 14-year-old know about giving birth and raising a child so it’s not that they weren’t
necessarily trying you know they didn’t have great role models raising them in most cases and so they
don’t have anything to work with they don’t know how to be a parent they’ve never been taught so
it’s not always I don’t want to pathologize or make the parents look like bad people because
I believe that people do the best they can with the tools they have at any given time parents
don’t choose to be sucky parents sometimes it happens but I really don’t believe they choose to
anyhow off my soapbox in later childhood as the child becomes elementary school middle school
age if they’re a poor family fit or they feel like they’re the black sheep they just don’t
have the same beliefs that the other people do they don’t seem to have the same interest that
their family does they may not feel accepted especially if the family’s going no that’s wrong
to believe and invalidate them so going back to that psychological safety if they’re constantly
being told their ideas are stupid they’re wrong they have the wrong point of view and they can
feel very isolated something can happen that ruptures the relationship with the primary care
giver whether it’s abuse or you know some kind of other trauma and introduction of a new less
an emotionally or physically safe caregiver can also lead to abandonment if the child feels like the
biological caregiver chose a new spouse over him or her say if you see where I’m going with that
because if this new person comes in and is less safe is abusive in some way emotionally physically
sexually it doesn’t matter the child is going to feel like they didn’t have a voice the child
is going to feel like the biological caregiver didn’t care and brought this other person in
any way which leads to feelings of rejection and abandonment so what are the reactions
fight-or-flight whenever there’s a threat we fall back to fight or flight or freeze but we’ll
talk about that when there’s a threat our anxiety goes up and we say in the past in these kinds of
situations, if I fought, did I succeed if so then we’ve got fights in the past did I succeed and if
the answer’s no then the response is to flee pretty simply so anger towards someone who’s unavailable
if they got angry and felt like it got them some sort of acceptance from somewhere that might
be the prevailing reaction sadness when someone goes away a sense of helplessness this person
just left me shame or self-anger about feeling needy or about pushing someone away fears related
to rejection and isolation, nobody will ever love my loss of control or the unknown everybody
always leaves see how I’m using these extreme words again and fear of failure I can’t maintain
a relationship nobody wants to be with me because I’m not good enough so the questions for clients
in these situations what caused these fears as a child so when someone starts to have these fears
about a relationship if the relationship starts to get rocking first question is what is it that
you’re afraid of in this situation if you stay together what is it that you’re afraid of if this
the person leaves what is it you’re afraid of and how likely is it that this person is going to leave
based on whatever is going on right now so let’s get some objective evidence here and another
the tool you can use is the challenging questions worksheet in cognitive processing therapy if
you google it challenging questions worksheet CPT or cognitive processing therapy really helps
people walk through the logic in some of their cognitions and identify some know unhelpful
distortions so then after you figure out kind of what the fear is then we say what caused that as
a child in the past when you felt like this what caused that and how was this reasonable or helpful
you know in the past when you felt like this and you reacted in anger what was the outcome and
how was it helpful in some sort of way you know did it get somebody to pay attention to you did
it gets somebody to come comfort you, okay so you were identifying the function of the current
behaviors and then we want to say what causes these fears now a lot of times it’s the same symp
or similar stuff but we could say how are these reactions now unhelpful because as independent you
know adult-type people we can fend for ourselves we can put food on the table we can go to work we
can do we can function independently whereas this is a child we couldn’t you know there were just
some barriers to that does that mean again that we should live in isolation and say well
I don’t need anybody no that’s not what I’m saying what I’m saying is is these fears that
are overwhelming about abandonment that causes people to push others away or cling on like you
know whatever clings on uh are these reactions helpful in the present day you know do you still
need to hold on to people like there’s no tomorrow temperament based on their temperament children
need different types and amounts of caregiver interaction um some children are wide open and
easily overstimulated you know my son was that way when he was born well to this very day um
when he’s awake he is like the Energizer Bunny on methamphetamine I’m he’s just going going
going and talking and talking to himself and he needed a lot of structure and he would get
overstimulated easily but we were able to help him figure out how to handle that instead of
getting mad at him for what seemed to be acting out we were able to help him channel and figure
out when he needed to take a break the introvert may not need as much one-on-one attention with
the caregiver may need a comforting word here and there but they may not need the amount of
the attention that an extrovert may need an extrovert tends to need more interaction with parents with
family with other people because they draw energy and they think while they talk and they think
while they talk with other people so they feel a lot more isolated if they are isolated so we
want to understand the person’s temperament and how they may or may not have gotten their needs
met how they may have been told they were wrong and invalidated when they were younger and you
can hear some of this is kind of going towards Linda hands DBT environment um but what we want to
look at what do you need now how can we create an environment that’s accepting and welcoming
to you now based on their needs and caregivers’ reactions children form schemas or core beliefs
about the world and others so if they state their opinion and it’s squashed or it’s ridiculed then
they’re going to form this core belief that it is not safe ever to share my opinions because I am
always wrong now we’re talking about children here but a lot of times think back for yourself there I
think most of us have at least some all-or-nothing dichotomous thoughts that come in every once in
a while and you know we can catch them but if these dichotomies go unaddressed the person starts
feeling very lost and very abandoned because it’s all-or-nothing important points about children
under 7 from 8 to 12 children are developing alternative cognitive skills they’re
starting to be able to think abstractly they’re starting to be able to see the gray area and
alternate explanations but even you know during that period so zero to 12 children are having
difficulty envisioning all the possibilities so anything that happens before that we want to
encourage them to look at the schemas that were formed and challenge them to examine whether they
are currently accurate and helpful children think dichotomously when they’re that young it’s all
or nothing it’s good or bad it’s not kind of sort of something it is what it is I mean even think
about thinking back to grades that we would get it was satisfactory or unsatisfactory there was
no ABCD F when we were in elementary school and I don’t remember middle school then it was a
dichotomous grading scale you either did it or you didn’t children are egocentric so whatever happens
they say what was it about me that made this happen if mom’s in a bad mood what did I do if
you know Mom is rejecting well that was stupid I’m stupid children are very egocentric so you take
all or nothing combined with all about me and you can see we’re creating the perfect storm of children
can only focus on one aspect at a time when I work with adult clients you know they come in and they
tell me that they had an interaction with their boss he was walking down the hall and he was in a
bad mood and I just knew I did something and so we talked about that and I’m like how do you know
that because he had it he had angry look on his face okay what are some other possibilities what
else might have been going on with him at that point in time and a lot of times we can brainstorm
ideas about a call he just got or where they just left a meeting that didn’t go so well or who
knows what else in this day and time when we’ve got our cell phones and PDAs and everything
there are a lot of things that can trigger a mood besides just whoever you pass in the hallway
children can’t think about those other things that might have triggered the mood they see somebody
unhappy and they’re like I’m sorry um so we want to encourage as adults we want to encourage them
to say all right what are the other possibilities even as children I try to work with my kids
to encourage them to look at alternate reasons why somebody may be acting a certain way children
can’t think abstractly and consider those possible options um even with kids you know knee-high
to a grasshopper, if you’re in a situation and maybe in a store and somebody behaves not kindly
to you, you can talk about that later with the kids and say you know that was kind of unpleasant to go
through what you think might have caused that and brainstorm three ideas my favorite number is
three I don’t know why but brainstorm three ideas for alternate explanations for why that person
may have been in an unpleasant mood if children learn to do this when they’re younger it’s a
a lot easier to transition to as adults schemas are a broad way of perceiving things based on
memories feelings and thoughts basically it’s our go-to perception of what something’s going
to be like we have schemas about everything if you go to church you have a schema about what’s
going to happen when you go to your mother’s house you have a schema about how mom’s going to
behave and what’s going to happen we form these it’s our brain’s short shortcut instead of having
to analyze every situation it says oh I remember this been here before it’s probably going to be
like X Y Z unfortunately sometimes things change and one of the things we see in addictions
treatment as is as caregivers into recovery and really get a hold on it and start working that
a new way of life and sobriety and all that stuff old family members or family members still expect
that old behavior they have that schema that when Jane comes in this is what’s going to happen
because they’re remembering how she behaved and acted in her addictive self so we want to help
people identify their schemas and check them sometimes they’re still accurate sometimes not so
much schemas that trigger abandonment fear center around the cell acceptability is this person going
to like me which is one of the reasons we do a lot of self-esteem work in reducing abandonment fears
because we want to reduce the need for people to solicit external validation we want them to say
I’m all that and a bag of chips and I would love to play with you but if you don’t want to play
I’m okay with that love ability if they were told they were unlovable if they perceived
they were unlovable then in the present they may fear isolation they may fear that they’re not
lovable so they will try to do whatever they can or likewise they will build a lead wall that is 5
feet thick all the way around them so nobody can hurt them they may have fears about their own
the competence you know thinking back to Erikson you never thought some of these theorists from the
past would keep coming up even in current practice but they do if a child going through that period
of industry versus inferiority Erik Erikson’s stages of psychosocial development and they felt
like a failure, all the time or they were never good enough the parents never recognized their
positive achievements then they may question their own competence and feel like a failure if they
feel like a failure they may feel they may believe that nobody wants to be around them so they will
leave so if I fail they will leave and fears may center around adaptability some people are not
able to tolerate any loss of control they’re just like that they’re holding on with a death grip to
the relationship to anything that’s going on and it starts to go wonky they are going to freak out
so we want to look at what it means if you’re not in control of everything what does it mean
if you trust that this person is going to do the next right thing if you are doing the next right
thing as well schemas that trigger abandonment fears can also be sent around center around others
if someone is rejecting distant cold or is unable to handle the person’s needs then the person may not
feel acceptable so if they are in relationships with people like this then we need to look at is
Is it you who’s not acceptable or is something else going on with that person that may be making
them unable to deal with anybody else’s stuff right now the person may feel isolated if other
people are absent if people fail to keep promises they may feel like nobody’s ever there for them
competence if other people are always critical then the person will question their own competence
and if others are unpredictable a lot of the time when people who have anxiety about abandonment
they come from situations where other people have not been predictable or if they were they were
unpredictably absent and relationship of self to others if they are afraid about their ability to
relate with others if they’re afraid of rejection if they’re afraid that if they start to love they
will be rejected and then they will be isolated forever if they are afraid of the unknown and they
I just want consistency more than anything and as soon as consistency starts to waver a little
a bit because as we grow things change and people with abandonment issues don’t like things to
change because that’s not predictable and that’s not consistent so they may have difficulty if one
the person starts to change what they do I see this a lot not saying that it’s an abandonment issue
necessarily but when law enforcement officers retire you know because they can retire after
20 years so they may start a new career and that causes a lot of change schedule changes
they’re not law enforcement anymore and the spouse sometimes has culty adjusting to it as
does the retired officer but controllability if the person holds on to relationships and
everything in their life with white knuckles because they’re so afraid if they let go of
control that they are going to disappear or disintegrate then if something seems like it’s not
in their control, it’s going to be a catastrophe so attachment Styles secure if there’s an
emotionally available caregiver the child will seek the caregiver for comfort and guess
what the caregiver will be there and will more often than not meet the need for comfort with the
the correct type of comfort so hungry cold scared kind of following the child’s upset when the caregiver
leaves especially in new situations but the child gets over it it’s not a child that’s going to sit
there and cry for eight hours and then the child’s happy when the caregiver returns in this kind of
attachment the child learns to trust others will be responsive to their needs and validate their
needs a child learns to be self-reliant and try new things but if they fail they know they can
return to the home base they can go out and go well that didn’t go as planned and the caregiver will be
there to say alright let’s figure out what to do next not you are such a failure the child learns
to adapt to a variety of situations because when they’ve been faced with something that’s a little
scary caregivers been there to kind of coach them on and go you got this it’s scary I got it but
you can do it the child learns to deal with stress because the caregivers are there to coach them
or to process it with them afterward because the caregiver is not always physically there but if
you’ve got children you know sometimes they’ll come home from school and they’ve had a really
bad day and you’d pull them aside and go you know what’s going on let’s talk about it so in this way
the child learns to deal with stress and the child learns to have accurate expectations of others
in the secure attachment, emotionally available situation remember children are egocentric so
if mom’s upset the child goes what did I do or oh my gosh I hope mom’s not going to leave in
a secure situation sometimes the parent has to say something like mommy had a really bad day at
work today has nothing to do with you I need to go take a timeout that helps a child understand
that you know what it’s not all about me and I can understand that sometimes moms upset for
something besides me and I can understand that if moms up said it doesn’t mean she’s going to
leave so obviously this is the ideal situation avoidant attachment styles the rejecting or harsh
caregiver the person depends less on the caregiver for security because every time they go saying, mom
mom, I had a nightmare can I come into bed with you they’re met with going back to your own bed and the
caregiver rolls over it’s not oh I’m sorry you had a nightmare let me walk you back to your room
when the child is separated from the caregiver there’s little response when the caregiver leaves
or returns because the kids like what uses that person to me the child learns not to depend on
a caregiver for comfort connection or security now imagine yourself a four-year-old child or a
six-year-old child thinking I can’t count on my caregivers for comfort connection or security
that must be a terrifying place to be and I can see why you would develop some pretty strong
defense mechanisms the ambivalent relationship between the cave caregiver is inconsistent or can bow can’t
talk caregiver is inconsistent or chaotic this is really true in a lot of homes where there are
at least one parent who is battling some sort of addiction or mental health issue so the parent
may or may not be available you don’t know what the good days are going to be you don’t know what
the bad days are going to be so the child may be anxious and afraid to try new things or explore
because they’re like things are going good right now I don’t want to top will be an applecart just
going to sit here and ride it out a child may be clinging and demanding trying to elicit a response
remembering negative attention is better than no attention at all and the child is upset when the
caregiver leaves but also inconsolable when the caregiver returns because you know I was upset
I was scared you went away but you came back and that’s good but I don’t know when you’re going
to go away again and if you’re going to come back so it’s this constant anxiety of abandonment
core abandonment beliefs all people leave so we want to challenge that by identifying exceptions
mistrust people will hurt reject take advantage of me or just not be there when I need them you
know what that’s true sometimes because people have their own stuff so when this happens let’s
look at whether it’s happening all the time and/or let’s also look at what else might be going on
with that person that caused them to hurt reject take advantage or not be there when you needed
the emotional deprivation I never get the love I need nobody understands me cares about me or even
ever tries to meet my needs here how dramatic and extreme that is so one of the things as clinicians
we can do is say if you are getting the love you needed what would it look like what
would be different what is it that you need that you’re not getting once we identify
then we can create a plan to get it but a lot of times other people don’t understand or may not
be able to interpret what you need so let’s help let’s try to figure out how to make this happen
nobody understands me alright let’s talk about why that might be and you know let’s look at some
people who’ve kind of gotten a grasp sometimes with clients with abandonment beliefs nobody
understands me translates to I don’t give a buddy a chance and I cut them off as soon as they become
confused and because they associate confusion with the rejection so we might talk about communication
skills we might work on what it is that people don’t understand and how to better communicate
that and where to find people who have similar interests nobody ever even tries to meet my needs
you know here I would really look for exceptions but I would also challenge the person and I would
say when do you meet your needs what do you do to take care of yourself a lot of times
clients with abandonment beliefs are so freaked out and afraid of being abandoned that they’re
not taking care of themselves either they’re just living and are paralyzed going back to fight
flee or freeze they’re living a paralyzed state of I want to be loved but if I love I’m gonna get
hurt and I don’t know what to do they don’t even love themselves so we want to start talking about
if you had your best friend you know create this best friend persona what would he or she say to
you what would he or she do right now let’s try to help you understand yourself with mindfulness exercises
are really good here because a lot of times these clients don’t understand themselves they’ve got
so much anxiety they’re so afraid and they don’t know where it’s coming from because a lot of
it has been going on for so long defectiveness if people knew me they would reject me you know
not everybody’s going to like you why do you need everybody to like you why is it important that
everybody likes you and failure I don’t measure up and I’m not able to succeed I usually put pull
out the obnoxious quote that if you haven’t failed you haven’t tried and we talked about what it
means to get outside your comfort zone and you’re not going to be perfect at everything you’re not
going to be Michael Phelps you’re not going to be the president of the United States that doesn’t
mean that you’re a failure that definitely doesn’t mean you’re a failure so what things are you
good at what can you and have you succeeded at and go back and look over things like you graduated
high school, not everybody does that you know raised a family not everybody does that so we
want to challenge all nothing’ languages we want to look for exceptions and we want to look
for in what ways can you provide yourself the validation so you don’t fear abandonment you don’t
need other people to tell you you’re okay because guess what you’re telling yourself I’m okay and
before I go on to unhelpful reactions I do want to point out that if we tell people to tell
themselves you know I’m okay that sounds great but if they don’t believe it if it’s not supported
with evidence, it’s actually probably going to slow their growth because they’re sitting there going
telling themselves I’m okay and in the back of their head going you know you’re not so we need
to get that internal critical voice to kind of hush up by providing the person with the objective
evidence of why they’re okay why they’re good enough and that’s a slow process it’s not going
to happen overnight but encourage people to figure out why they believe what they believe and then
you can work from there okay unhelpful reactions fighting with someone you don’t want to leave
me because so the person may engage in dominant sort of posturing behavior aggression hostility
blaming and criticizing trying to tear down the other person to say you know what I don’t care
and you should be grateful that I’m in your life recognition seeking to get attention validation
or approval so if they feel something’s going wrong in a relationship they may start trying to
do something to gain recognition to prove that they’re worthy of a relationship for what they do
versus who they are manipulation and exploitation said lying justifying I did this because you made
me so sometimes we all occasionally do things that aren’t the nicest people who fear abandonment
have difficulty saying you know what I screwed up and they’re more likely to go you made me do
I wouldn’t have done it if you would have X Y & Z people again who are worried about a relationship
is going to fall apart and may also make excuses for other people’s inappropriate behavior it’s like
you know I really hate what this person does but if I don’t make excuses for it if I condemn it
then this person is going to leave in counseling we can talk about the difference between loving a
person and loving a person’s behavior you know I love my kids to death there is no question about
that but some of their behavior makes me want to climb a wall I’m very clear to separate from them
the difference between the behavior that I dislike and them because you know like I said I love them
to pieces and we want to help people start making this differentiation if they don’t do it already
and clinging and chasing is the other fight reaction stalking and messaging somebody 47 times on
Facebook in an hour all these kinds of behaviors and even online bullying those sorts of things can
be fight reactions in response to feeling like there’s a threat of abandonment flight is more
of the I don’t care if you leave so the person will withdraw physically and emotionally and
maybe even numb themselves with some sort of addictive behavior or distract themselves with
something completely different or find a new person just proof that you know what I didn’t
need you because I’ve got this new person now questions for clients about core beliefs
all people leave okay so what does it look like if somebody’s available to you if they
don’t abandon you who in your past left you or was unavailable emotionally now a lot of
I find it helpful for mental health and addiction clients to have them write an
autobiography because then we can go back and kind of review it and identify the core
people at certain stages in a person’s life what did the person who left you do to make you
feel rejected or abandoned in retrospect you know it was hard to see the difference what
was going on back then because you were a kid in retrospect what are the alternate explanations
for why this may have happened was it really you or was it more about them who in your past
has been available to you emotionally most of the time people can point to one maybe two people
who have generally been there it’s unreasonable to expect someone to always be there who in your
present is available to you emotionally you know maybe they’ve only been in your life for six
months or a year but they are available and I say emotionally because you know not everybody can
be available physically all the time we’ve got jobs kids all that kind of stuff but can you pick
up the phone and call them or text them and say hey you know what I’m really struggling right now
what do you do in your current relationships that cause people to leave do you push them away if so
how what are alternatives to pushing them away cutting all ties and just saying fine be that way
I wipe my hands off you if you cling how do you do this in what ways do you perceive yourself as
being clinging and what are some alternatives to holding on with all desperation and mistrust people
will hurt reject or take advantage of me or just not be there when I need them so again what does
it looks like when somebody’s or what does it feel like when someone is trustworthy and safe who in
your past was untrustworthy or unsafe what do they do they taught you this and what are alternate
explanations who in your past has been trustworthy and safe who in your present is available and
trustworthy what do you do to yourself that is unsafe or dishonest that’s one of those tricky
questions you’re there talking about other people other people then it’s like what
do you do to yourself how do you lie to your self or how are you mean and hateful to yourself
how does your distrust of other people or even yourself impact your current relationships some
people distrust their own internal intuition so much that they don’t want to make friends with
other people they’re like I can’t tell who’s going to hurt me and who won’t so just yeah I’m
going to wipe my hands of it all what could you do differently what do you think you could do
in order to start building trust and what does it look like to build trust because Trust doesn’t
just appear it builds gradually emotional deaths deprivation I don’t get the love I need nobody
understands me so again what does it look like when somebody understands you and meets your
needs who in the past failed to meet your needs emotionally and how can you deal with that now
you know it may have been mom it may have been ex-husband it may have been you know who knows
how can you deal with it now yourself so you can put it to rest who in your past is understood
you who in your present understands you how can you start again better understanding yourself
because it’s hard for other people to understand us when we don’t even understand ourselves and
what can you do to start getting your needs met you one of the things was starting to get your own
needs met is to figure out what your needs are and this is one of the exercises I have people do as
a homework assignment they keep track of what is it they want on a daily basis keep a log and then
let’s talk about what common themes were seeing if people knew me they would reject me okay so how
do you know when you’re accepted or acceptable to someone who when you’re past may make you feel
defective are there alternate explanations and how can you silence those old tapes because
that person that statement stays as a heckler in the gallery we need to hush the heckler what
can you do part of it could be talking back and saying you know what I’m not going to listen
or I don’t have time for this right now who’s been accepting and supportive who is in your life
that’s accepting and supportive and how can you start accepting yourself and being compassionate
so some compassion focus training mindfulness work to help people understand themselves and start
being compassionate with themselves understanding their vulnerabilities and cutting themselves some
slack I don’t measure up I’m not able to succeed okay that’s a pretty big success you know what
is what success means success means different things to different people so what does it look
like to you to be successful let’s kind of hammer that out what is it if you are successful what
would be different what in your past has made you feel like a failure what are some alternate
ways of viewing it such as a learning experience or something I had to go through to grow or you
know brainstorming alternate explanations for why people fail they don’t have a response to
sometimes I ask them to kind of take on a flip role and say pretend you’re a parent and
your child comes home and they’ve tried out for the football team and they didn’t make the team
they failed what are you going to tell on what have you succeeded at doing in the past what are
you good at in the present and we really want to pay attention to minimization here because a
a lot of our clients are not good at identifying their strengths what does being successful mean in
terms of your relationship with others do you have to be successful in order to be loved and be a
the good relationship you know obviously you’re going to be successful in a relationship if you’re
but do you have to be financially successful and powerful all whatever you define success as in
order to be in healthy relationships who are three successful people you know and what makes
them successful in your eyes does success equal happiness you can do a whole group on that and
what do your kids need to do to be successful in life you know we want our kids to succeed in us
want our kids to be happy so what is it that I envision my child’s life to be 10 to 15 years from
now triggering relationships the abandoner is unpredictable unstable and unavailable the
an abusive relationship is untrustworthy and unsafe the deprived err depriving relationship the
a person is detached or withholding the Devastator is always judgmental rejecting and critical and
the critic is critical and narcissistic usually a lot of times people replay their past to try to
kind of get it right the second time so we want to look at do you have a habit of getting into
relationships with people who are not safe we can also ask them how do you exhibit these behaviors
in what ways are these behaviors present your current relationships and in what ways were these
present and your primary caregiver relationships behavioral triggers abandonment and mistrust
if somebody starts acting differently they change their behavior in some way a person who fears
abandonment goes oh that’s not good if they’re not getting constant reassurance that’s
that external validation can trigger abandonment fears so again we want to work
on internal validation and why is it that you feel you need constant reassurance from the other
person’s relationships feel threatening so work relationships those sorts of things the
a person who has abandonment issues won’t want their significant other around other people
and they become hyper-vigilant to rejection and disconnection even if it’s just somebody
going I had a really bad day I need 20 minutes and go into the room and shut the door
the person with abandonment issues will likely have a high level of anxiety so we want to ask
how these behaviors have threatened them in the past what are alternate explanations for why this
is happening with this person right now and what would be a helpful reaction to these behaviors
now so this is happening what would be a helpful reaction instead of assuming that the sky is
going to fall defectiveness and failure so if somebody is critical if they have unexplained time
apart there’s absent or inconsistent reassurance or if the person tells them they’re a failure
these or they fail at something these could all be behavioral triggers they could be like I
failed at something I’m not getting reassurance that this relationship fixing to end question how
is this threatened you in the past alternate explanations and what would be a helpful
reaction to this particular situation right now envisioning activity what does a healthy
the relationship looks like presence versus abandonment acceptance versus rejection emotional support
versus emotional unavailability trustworthy versus untrustworthy and safe versus harmful
these are extremes what does it look like to be a middle ground there are going to be exceptions
you know things are going to happen so what does a healthy relationship look like and how to do you
deal with exceptions if somebody’s not always present how can you create this relationship with
yourself that’s the big one and then how can you create this relationship with others’ mindfulness
questions what am I feeling what’s triggering it am I safe right now and if not what do I need to
is this bringing up something from the past if so how is this different how am I different
then I was when I was six or four and how can I silence my inner critic finally what
would be a helpful reaction that would move me more toward my goals and toward a positive
emotional experience summary core beliefs about the self and others are formed in early
life due to children’s lack of knowledge of other experiences and primitive cognitive abilities
these core beliefs are often very dichotomous core beliefs can be formed around events or
experiences outside of the conscious memory identifying and being mindful of abandonment
triggers in the present can help people choose alternate more helpful ways of responding in
the present in secure and loved me don’t leave me are two really excellent books
there are google previews if you want to look at them to see if it’s something that you like
but they do take what we talked about in this presentation and expand upon it a whole bunch
more if you enjoy this podcast please like and subscribe either in your podcast player or on
YouTube you can attend and participate in our live webinars with doctor Snipes by subscribing
at all CEUs comm slash counselor toolbox, this episode has been brought to you in part by all
CEUs com provides 24/7 multimedia continuing education and pre-certification training to
counselors therapists and nurses since 2006 used coupon code consular toolbox to get
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This episode was pre-recorded as part of a live continuing education webinar on demand. Ceus are still available for this presentation through all CEUs registered at allies com, counselor toolbox, hi everybody, and welcome to today’s presentation on emotional eating and making peace with food during the next hour.So we’re going to define emotional eating and differentiate it really from eating when to celebrate and when it’s a problem and also differentiate, differentiating it from eating disorders will explore emotional eating in terms of its, beneficial functions and rewards and discuss.Why restrictive diets, don’t resolve emotional eating a lot of times? People will say you know, I have been on this diet forever and it doesn’t seem to be working or I can’t seem to stick to any diet that I try and we’re going to look at different reasons why this might Be what is emotional eating and it’s exactly what it sounds like it:’s eating in response to emotions and feelings other than hunger.So if you’re eating, because you’re bored, if you’re eating at someone and sometimes especially if you are angry at someone or disappointed in someone, you may eat and sort of be eating and thinking you made me do this so eating At someone eating to forget or distract yourself eating, to feel better because when you eat, regardless of what you’re eating, but especially if you eat high sugar high-fat foods, you’re going to release serotonin and dopamine eating out of boredom.You know hand to mouth bang, eating out of habit and, as I said a few minutes ago, not all emotional eaters have an eating disorder um and we want to differentiate that.Does it mean that their eating is not problematic to them? No, not at all.If they’re telling you it’s a problem, then it’s a problem.They may not meet the criteria for binge eating disorder or bulimia, but it’s important to address it because they understand that they’re eating for a reason.Other than hunger, they want to stop because they want to eat, for hunger, but not otherwise, and for us as clinicians.The first thing we need to do is understand: why is it that they’re eating? Is it boredom? Is it a habit, so they need to keep a food log or a food journal for over a week or two weeks, and sometimes when people come in for an assessment, especially if that’s one of their main presenting issues? I’ll start by just doing a retrospective of the last three days to get an idea of what may be triggering some of their eating episodes.And then we can look at some of the habits or bad habits, maybe that they’ve gotten into, and start talking about ways to address those remembering that Rome wasn’t built in a day this isn’t going to go away overnight.But a lot of times, if you give people some tips, tricks, and tools to think about implementing when they walk out of your office after the assessment before the first official session, it provides them some hope and gets the momentum going and again you don’t Have to binge to be an emotional eater, some people graze all day long.Some people will eat and it’s not what would be considered technically a binge, but it’s more than they had anticipated.Maybe they go back for second helpings or third helpings when they weren’t hungry, but it was good.So why is eating so soothing? There are a lot of reasons.Now there’s obvious it’s, tastes good, so that’s.You know the big obvious bonus, but thinking about the function eating serves, we have to eat to survive.When you were an infant, it eating involved a closeness with your parental unit, which could release oxytocin, and I say, parental unit because even if it was dad feeding the baby a bottle there was that connection.There was that contact that caused the infant and the parent to release oxytocin. This is our bonding chemical, so eating was associated early on with bonding food may also have been associated with sleep.If the infant or child was given a bottle every night to go to sleep, then they may start thinking or they may be in the habit of eating to wind down or calm down, and we need to help them figure out different ways to do That as a toddler, what eating mean think about when you went from well, we probably don’t, remember that, but think about when your kids went from eating.You know food out of a jar to even their first Cheerios.That was a huge figure out.How to pick up that little cheerio and get it in their mouth and it involved exploration and mastery.They were discovering all different types of textures and tastes and figuring out what smell went with what taste, and it was a cool and exciting time for kids, and I mean think about it.They’re like a year old, so it doesn’t take much to amuse them, but this was the rewarding reward.Equals dopamine equals let’s do that again.It involved power and control of the child.At this point was starting to be able to feed himself or herself and was starting to be able to be somewhat independent of the parent when it came to the basic physiological function of eating. So eating itself had its rewards and it was self-esteem building because the child started learning.You know how to feed yourself and how to ask for what he or she wanted, at least in terms of food.There are formations of memories around foods, even as early as toddlerhood.You know we have celebrations, we have birthdays, we have different things and most children have certain foods that they like, and it could be because the first time that ate that food was a really happy experience or it could be just that’s, their favorite Food and that’s all they want to eat, but they remember that food and they remember when they ate it, they felt good.They felt happy so as an adult there,’s a part of their brain going chicken nuggets.Make me happy now that’s, how the toddler thought as an adult.We can understand that chicken nuggets themselves, aren’t making you happy, but you see the connections that we’re making.Here there’s been an association between happiness and chicken nuggets unhealthy foods, especially for children when, as adults, we’re still able to control what they eat.Your sugary foods and your unhealthy foods are usually reserved for treats or rewards.So when you’re feeling like you need to be rewarded when you’re feeling like you want to feel good, sometimes you’ll resort to those things. When you were a kid that made, you feel good like chocolate, chip, cookies, Haagen Dazs, or whatever it was for you.We’ve talked in the past, about associations and conditioning, and this is all coming back kind of full circle now because we need to understand that our brain has associated pleasure and reward with food for a lot of different reasons.Not just because of nourishment looking at the reasons why your patient eats is going to help you understand what underlying issues you may need to address in treatment.Culturally, we associate eating with caring and celebration and think about birthdays and holidays.What do we get together? We have buffets, we have pot Luck,’s.When someone passes away.What do you bring food over when somebody’s sick? What do you bring food over to in our culture? There is a lot of emphasis put on eating and nourishing, and that’s, true of a lot of different cultures.Low blood sugar can cause feelings of depression and anxiety which are quelled by food.So if somebody typically doesn’t eat well during the day, you know they go long periods without eating or if they have blood sugar issues, to begin with, and then they eat they feel better.So when they start feeling not so good, what do you think their first reaction is, let me eat and see if that helps evolution, predisposes the human body to crave high sugar, high fat, high-calorie foods for quick energy and to prepare for a famine. Our bodies are cool and frustrating at the same time because you know your body takes in this these foods and it says we’re going to secrete, the most amount of dopamine and the most amount of reward for these high-calorie foods because We want to make sure we’re prepared in case there’s a famine back.You know in the day many many many years ago, hundreds of years ago we couldn’t guarantee.We would have a meal every day, let alone three meals every day.So the body prepared – and it said alright – we need to get whatever we can when we can.So we’re going to make this higher fat higher calorie food more rewarding.Now I said it:’s also can be a blessing and a curse.Today, there’s still a little part of our primordial brain.That says, if it thinks there’s a famine, it will slow down your base metabolic rate, which causes people to gain weight.We see this a lot in people with eating disorders, who tend to not take in very many calories, or if they take them in they purge them.So the body goes well. I can’t guarantee I’m gon to get enough food.I’m going to get enough energy to survive.So I’m just going to turn down the thermostat a little bit and turn down the base metabolic rate, which compounds the problem for the person with the eating disorder.So it’s important to understand that the brain is somewhat active in what’s going on.So I keep saying we need to figure out what’s behind or underlying the craving.First, we need to rule out physical causes for some people.It’s as simple as this.If they’ve got low blood sugar because they’re not eating too often and obviously as counselors, we’re not going to diagnose this their doctor or their nutritionist will, but we can start exploring and go.It sounds like you might need to look at having your blood sugar checked or talk to your doctor about how frequently you need to eat because some people – and I know I’m – are very guilty of it.If I get into it into a groove doing something I’ll eat breakfast and then I’ll get into a groove and before I know it, it’s 3 00 in the afternoon and I haven’t eaten for like a whole bunch of Hours I’m not doing math today and my blood Sugar’s low and I’m starting to get foggy, headed and irritable and tired. So it’s a real, simple fix there in our society we are so driven and we are so.We get so caught up in things because that’s such a fast pace that it’s easy to forget to eat or is easy to avoid eating so that’s.The first thing we want to rule out.Are you eating in response to low blood sugar, which is making eating, seem more rewarding when you eat in response to low blood sugar a lot of times, people who do that end up eating more than they normally would because they start eating fast.It’s like I’m going to shovel, in as much as I can.Your brain doesn’t register you’re eating for 20 minutes or so so, before their brain, even registers.What’s gone on and gets the blood sugar back up? They’ve already eaten a whole ton of food.Why is this under-emotional eating? Well because generally, when they go in to just start eating, yes, they’re hungry, but they’re, also cranky and irritable, and most of the time they’re.Not thinking about I’m eating for the nourishment it’s, I’m eating, feel better lack of sleep, and this is so true for shift workers as well.As you know, new parents and college students, and anybody who’s not getting enough sleep. If we are surviving on sugar and stimulants, we’re going Peak and Lower Valley, Peak, and Lower Valley, and you just keep going up and down until you just crash, because every time you crash you crash a little bit lower.So if somebody’s on that roller coaster, they’re going to feel worse between you know: eating episodes they’re going to feel tired.They’re going to feel a flood of sluggish irritable fatigued and, to a certain extent, maybe depression, and they may be missing attribute those feeling, those emotional feelings to emotions versus physical causes, and likewise we also want to make sure that you know we’re addressing The emotional causes because there’s probably stuff there too, but if they’re not getting enough sleep and they’re living on sugar and stimulants their body is kind of in a state of hyper-vigilance, a lot of times it’s exhausted.So they’re going to be tired and cranky.So those are a couple of things that we want to look at.Those are relatively easy fixes or at least relatively easy things to point out and go let’s think about this.One of the things that I suggest for a lot of my clients is just to take a week and mindfully and it is difficult but try to eat healthfully.You know try to eat a few times a day.You know try to eat like three meals a day and get enough water and try to get enough sleep and try not to overdo it.On the stimulants at the, beginning I, 39, am not going to say cut out anything because that 39, is not, realistic and it’s not fair, and they 39, are probably already struggling if they’re coming in to see me, so if I go hey Let’s just turn your world upside down and guess what you’re not going to drink any caffeine anymore. It’s not going to create a happy person, so I asked them to try to make some small changes and see if that starts, to help dehydration causes fogginess and symptoms of depressionWe want to make sure that they rule that out and too many stimulantsAlso causes dehydration, so you know we’re looking at some of the physical causes of irritability and fatigue and cravings because again we’re going back to when I felt this way before not looking at it.Why I felt this way.But when I felt irritable depressed cranky, what made me feel better and generally food, and generally it’s, not good food.For me, it’s M Ms.I love my M Ms, especially the ones with almonds, but I digress.Nutritional causes of cravings, high carbohydrate, and high starch foods caused a greater release of serotonin and endorphins.So if you’ve got somebody who’s depressed for whatever reason that they may crave these kinds of foods to increase their serotonin level or increase the endorphins, their energy levels, chocolate people who crave chocolate may be low in magnesium.It also um the level of magnesium affects how much serotonin is available again. Just I keep saying this just for legal reasons.We want to make sure their doctor or nutritionist goes in and makes this diagnosis, but if there are particular foods that they do crave, they need to bring that up with their medical provider if they’re craving fatty foods.Now again, fatty foods are just good.I love fried foods, but it also could mean that they’re not getting enough Omega threes, Americans, typically don’t and interestingly, if they crave soda, they may be calcium deficient, who knew so?These are things to take a look at to ask people.You know if they’re craving soda, maybe cutting back on their soda a little bit and seeing what happens and or getting blood work done.Once we’ve ruled out the obvious physical causes.They’ve gone to the doctor.Gotten blood work done everything I’m coming back happy.They’re getting enough sleep, but they’re still eating when they’re, not hungry, we need to rule out habits. Is there a particular time or activity that makes you crave this food? When I was growing up, I would go to the grocery store with my mother, and on the way back home from the grocery store.She would always we would always get junk food and she would get a bag of chips and put them in the front seat.It was like a 20-minute drive from the grocery store to our house and by the time we would get back to the house.We would have put a good dent in those potato chips.That being said, I got into the habit of whenever I went to the grocery store.I would get something out of the bag and put it in the front seat and eat on the way home.Now am I paying attention to what I’m eating? No likely am I eating, because I was hungry, probably not so.We want to look at habits.A lot of people will eat when they are watching TV.It’s a huge one. So we want to not do that or if you’re going to eat when you’re watching TV make sure you sit at the table.At least that makes you a little bit more mindful so think about whether are there particular times or activities that you eat and you’re just not hungry.Are there particular times that you mindlessly eat, like, like, I said when you’re driving or when you’re watching television? Those are both habits and can be mindless because you’re not paying attention to how much is going in your mouth.You’re not probably paying attention to the taste and you’re not paying attention to whether you’re full or not.So if you’re mindlessly eating, then there’s going to be a lot more calorie consumption.In addition to the fact that you’re not eating because you’re hungry, you’re just eating to eat, are you going too long between meals than needing a sugar boost which leads to a sugar crash? So again that’s a physical cause? But we want to rule it out.These are bad habits that we can tend to get into other things that can be construed as bad habits are eating without putting food on a plate.If you eat straight out of the bag, you’re going to eat.More than if you put it on a plate, so put it on a plate, sit down, try not to watch TV, all the things that your grandmother would have told you.So what do we do about it? Emotional eating interventions? I talked earlier about the food diary. Do a retrospective during the assessment if they want to get a jumpstart on things, but have them keep a food diary, preferably for the duration of treatment, but at least for a week.What time did they eat? Were they craving just any old food or something salty, something that was sweet, something that was sour? This will give you a general idea and can give their medical provider a general idea if there are any nutritional imbalances or if there are particular associations.What emotion or state were you in, I say state because being exhausted is not necessarily really an emotion.Were you happy sad, mad glad exhausted drained whatever state feels like it would work, and then, because of why were you feeling this way it doesn’t have to be a dissertation? It can be short and sweet, but I encourage clients to write down everything.They eat before they eat it during the first week, or you know, like I said, preferably throughout the entire course of treatment why, before they eat it because it’s a stop, remember we’ve talked before about how we have an urge.We have a craving, we have an urge and then we engage in the behavior oftentimes without stopping mindfully.Think is this what we want to do this provides that stop.It says: okay, I’ve got it to write down the time, and then I’ve got to think about why I’m eating, and honestly a lot of clients notice, a reduction and their habit of eating when they have to do this, just because they don’t want to record-keeping that up for a month or two months helps break some of the habits, eating that they might do like.I said before when they’re eating, I encourage them to use a plate.Sit down. Don’t walk around don’t stand at the counter, eliminate distractions as much as possible and focus on the food you’re eating that goes with mindfully eating.What does it taste like? Is it good to take small bites when my son was young, I think I’ve shared this before he had gastric reflux and we would sit down at the table and I would shovel in food as fast as I could get it in my mouth because He couldn’t be put down for too long before he would start to get fussy, at least until we figured out that he had gastric reflux and Zantac was just a lifesaver.I developed that habit when he was little and I kept it up for a while.It took a while to learn for me to learn to go back to take.You know reasonable bites and tasting my food, and even today, if I’m not paying attention too much, I’ll eat my dinner fast and then I’ll sit there and I’ll be like well.Yes, I’ll taste that a little bit later, because I didn’t taste it when I ate it encourage clients to be aware of their eating habits, and try to avoid setting up a binge by restricting certain foods.Now.Does that mean you have to have cakes and candy and whatever your trigger foods are in your house all the time and in your face? No, I would encourage people not to do that, but to say you know, I said for me M Ms, is one of my favorite reward foods.If you will, I don’t keep them in the house, but I will allow myself occasionally to buy a small snack-size pack of M Ms, when I’m out or I will get a regular-size pack and I’ll share it with my daughter, so I’m not restricting it.I’m not saying I can never M. Ms again, I’m just not making it available to myself when I might have some unrestricted time, try to avoid buying a bunch of comfort foods and keeping them around the house, and when you’ve got kids when you’ve got family, it’s not entirely possible, usually to not have some of that stuff around but try to avoid having the things that you particularly used for comfort, because if it’s not readily available, then you’ve got to focus on guess what dealing with the emotions.Instead of stuffing them with food, try not to go too long without eating.Like I said earlier, if you go too long, then by the time you get to the food, your blood, Sugar,’s low and you’re just shoveling it as fast as you can initially distract.If you know that you’re getting you’re eating and you’re, like I’m – really not hungry, but I want to eat, take a bath, take a walk, call a friend, heaven forbid get on Facebook.Whatever it is, you can do to distract yourself for 10 or 15 minutes if, after 10 or 15 minutes, you’re still going, I want whatever it is, then you can decide what to do about it.Then, most of the time when people stop and go, I’m not hungry.Let me distract myself.They get caught up in that distraction and before they know it, they’ve forgotten about the craving, and identify the emotions.If you know that you’re not hungry, but you want to eat, then say: okay, what’s going on what’s going on with me? It doesn’t mean that the person is never going to eat when, when they’re upset, because a lot of people do, and is it the end of the world, probably not necessary if they can start reducing the frequency of times that they eat.In response to emotional distress that’s, what we want, we want to progress, not perfect if it’s, depression, what’s causing them to feel hopeless or helpless right now, if it’s, stress, anxiety, or anger, remember our big kind of lump together stuff. What are they stressing out about? Do they feel like they’re overwhelmed? Are they afraid of failure, rejection, and loss of control of the unknown? We’ve gone through those things.We want them to identify what’s going on with them, and then they can make better choices about how to deal with it.So general coping helps them develop, alternate ways of coping with distress.Distract we’ve, already kind of gone over that one.I encourage people – and you know it’s – one of those DBT things – that a lot of therapists encourage their clients to keep a list of things.They can do to distract themselves because it’s not always practical to get up and go on a walk.If you’re at work or it’s, you know two in the morning.So what else can you do to distract yourself? Talk it out with a friend with yourself with your dog? Sometimes you just got to get it out.People who are more auditory will prefer talking it out as opposed to journaling it now.If they talk it out with themselves, they can record it if they want to, or sometimes it’s just better to have a dialogue with themself. If it worked for Freud, it can work for other people journaling.If your clients are inclined to journal, encourage them to write it down.Sometimes just getting stuff out of your head and onto paper will help the feelings dissipate a little bit.So you’re not mulling them over and obsessing over them and getting stuck in those thoughts and feelings.Additionally, while you’re distracted talking it out or journaling, this is also your break.Your stop between the urge and the behavior make a pro and con list of the de-stress, not the eating whatever it is, that’s stressing you out and how can you fix it or what are the pros of this situation and what are the downsides To this situation, encourage them to focus on the positive.You know.If something stressing you out at work, you know you’ve got a big meeting coming up or something you don’t want to do or what it is.You can get stuck on focusing on that or you can focus on the positive that you do have a job.That meeting only comes around once a month. You can it’s time you don’t have to be doing paperwork whatever the pros are for that person encourage them to focus on the positive.If you’re distressed because of some kind of a failure or perceived failure, figure out what you learned from it, whether it was a relationship failure, or maybe you learned what not to do in a relationship anymore. Maybe you learned things that you may have ignored.Maybe you learned what you should have done instead, but how can it be a learning opportunity, instead of somewhere to stay stuck and finally, if something’s making you upset if something’s causing anxiety, depression, hopelessness, helplessness, whatever the negative feeling figure out.If it’s worth your energy to get stuck here, is it worth the turmoil? Is it worth you know having to pacify yourself with food or whatever? It is a lot of times people say you know what now it’s, just it’s, not even worth my effort.It’s not worth moving me away from my goals, because my goal is to stop emotional eating.My goal is to eat for hunger, so I can go to dinner with people and feel comfortable.I can be at a party where there’s a buffet and not feel stressed out that I’m going to go and eat half the stuff on the buffet that’s my goal so is holding on to whatever this de-stress is getting me Closer to being able to do those things and generally the answer:’s no develop alternate ways of coping with the stress the ABCs, the a is the activating event.What is stressing you out and what’s causing the de-stress C is the emotional reaction.Angry depressed stressed, whatever be: are your behaviors? What behaviors or B are your beliefs? Sorry, what are the beliefs that are in there that may need to be addressed? What kind of things are you telling yourself, and, and how can you counter them? Cognitively eliminate your vulnerabilities.You knew we couldn’t get through a presentation without talking about vulnerabilities. If someone is well-rested.Well, the fed has a good social support network, not stretch timewise.Then it will be easier to deal with stress or stressors when they come your way.You’ll have more energy to deal with it, so there won’t be this overwhelming feeling of I just want to bury my head in a jar of peanut butter, be compassionate with yourself.Some days, you know you’re, just going to feel anxious.You’re going to feel depressed.You’re going to get angry.You can beat yourself up over it and you know a lot of people do.Is that the best use of your energy or can you be compassionate? Can you learn from it? Can you give yourself a break and go? You know what I’m having a bad day today and that’s okay, I’m not going to unpack and stay here, but I’m not going to fight.It either helps clients learn how to urge surf help. They understand that, just like a panic attack just like a wave just like a lot of other things in life, it will come, it will crest and it will go out again, so they can sort of identify where they are on the energy of that Urge other tools people can use close the kitchen once I have the kitchen cleaned and you know all the dishes are done and it looks pretty.I hate going in there and finding dishes in the sink again now I’ve got teenagers, so we always have dishes in the sink.But before I had children, you know at seven o’clock.I finished all the dishes and closed the kitchen, and that would be enough motivation for me to not go in there and at least not use plates and stuff to eat.So if we’re saying that we’re going to only eat using utensils plates and sitting and all that stuff that we already talked about, then once you close the kitchen, you’re not going back in, there turn off the light.That also helps so you’re not being attracted to the pretty lights, and you know all the goodies that are in the kitchen to brush your teeth.This is something my grandmother used to do and it works.There’s some research behind it.Minty flavors reduce our appetite.So if you brush your teeth, you get all the other flavors out of your mouth and it reduces your urges to eat because it again it’s clean and fresh. And do you really want to brush your teeth again, and meditate, sometimes just getting in a space where you’re, not obsessing about anything, can help people get past that urge to self-soothe by eating a CT for emotional eating.What am I feeling or thinking about what’s going on with me right now? What is important to me? So if I am thinking I want to eat, I want to you know just dive into this jar of peanut butter, and then I think about what’s important to me.Is it important to me to get control of this? Is it important to me to you know, be able to fit into my clothes in six months or not? So what is it in? What way is controlling my eating habits and eliminating emotional eating important to me, and how does that get me closer to other things that are important to me, and what other things could I do? That would get me closer to my goals.So if the goal is to have improved relationships, be able to feel more comfortable around food reduce the stress around going out to eat, and just around food in general, what else can you do when you are stressed out? Somebody also suggested that adding a blue light in the refrigerator decreases the appeal of foods, which is interesting because yellow red and orange, and browns, I think Pizza Hut – are all foods that increase people’s, hunger and desire to eat.But blue is just a completely different primary color, and adding a blue hue seems like that would be effective, so cool thanks for that.Little tidbit there holiday help, and you know we’re coming into the holidays.So I’ve got to bring that up at every single glass and choose lower-calorie foods.If you tend to get stressed out or caught up or mindlessly eat when you are at family gatherings.Okay, you know cut yourself a break, know that that’s, probably going to happen, and fill up on the lower-calorie foods.The carrot sticks the broccoli, the white meat, turkey, anything that’s available, that’s, not like sweet potato pie or brownies, keep water or low-calorie beverage. In your hand, if you’ve got your hand full, you can’t eat at the same time.So you know if you walk around with a cup in your hand, it helps talk to people.Hopefully, you don’t talk with your mouth open or talk with food in your mouth.So if you’re talking to people, you’re not going to be as inclined to go and get something to eat because you’re wanting to stay engaged in that conversation.Stay away from the buffet, especially if you know that it could get stressful, or maybe you know for me, I turn into a pumpkin at like 7 30 at night.I get up at 4 00, but I turn into a pumpkin at 7, 30 and a lot of times holiday parties and those sorts of things are at eight, nine, o’clock at night, and you know I’ve already turned into a pumpkin.So I know that if I go to those I’m going to be more likely to eat just to kind of stay away because I’m tired and it’s a bad habit.It’s not because I’m hungry.So I know I need to stay away from the buffet during those times we rehearse refusal skills.If somebody says. Oh, you, I’ve got to try it by two.This figure out how you’re going to address that ahead of time, because there’s generally probably a lot of really good foods, and you may really want to taste some, but sometimes people who emotionally eat know if they start eating.If they start eating high-fat high calorie foods, they’re going to want to eat everything.So if I start with one bite of a brownie, I’m going to want to eat every suit that’s on the table.If they know that, then they may want to choose to not even go down that road at that juncture, encourage people to stay mindful of their distress meter before they go back for another helping and ask themselves, am I hungry? Am I just wanting to taste what’s here and how do I feel about that? Or am I eating just because I don’t want to be here and I’m bored and I want to fill the time? Have people keep an index card with their coping mantra and two reasons they don’t want to emotionally eat, so I need to be here.I can do this whatever the mantra is that’s going to get them through the night, whatever they’re.Telling themselves that it’s going to help them plow through and make the right choices, but also two reasons that they don’t want to eat, or they’re going to get around it.Maybe they’ve got something at home that they can eat when they get home eating before they go to.The party may also help prevent some grazing holidays, bringing out a lot of emotions in people.Some people struggle with depression, anxiety, jealousy, grief, and anger. You know the whole gamut during this time and during this time there’s food everywhere I mean starting at Halloween when your kids bring home the Halloween candy, which usually lasts about a week in our house baby.Oh, Halloween candy followed by getting ready for Thanksgiving, followed by doing all the baking or whatever you do, and the holiday parties coming up on the December holiday season.There’s just food everywhere, so it’s really easy to cope.If you will, with stress being overwhelmed with being tired by not eating enough healthy food by binging on unhealthy and soothing food if you will so it’s, encouraged it’s important to encourage people to stay.Mindful of why they’re eating what they’re eating, when constantly bombarded with high-fat high carbohydrate foods, people are tempted to eat to feel calm yeah.I challenge anybody to say that they’ve never eaten and go okay.You know I’m.Just focused on this right now I’m not thinking about everything out here and it feels good um.I’m good now, good, probably not the word I should use, but it does help people distract themselves sometimes when they eat, especially those high-intensity foods.You feel happier serotonins are released. Dopamine is released.You’re, like oh, that’s good.I want to do that again or you just feel numb.You can get into a zone where you’re just eating and not caring about it’s.Not that you’re feeling calm, you’re just not feeling anything, and a lot of times when people get into that zone.They’re not tasting the food either.They’re just kind of on autopilot for emotional eating, like most other escape behaviors.Never addresses the underlying emotions and their causes, so we need to look at them.Are you feeling anxious? Are you feeling jittery? Are you feeling depressed because your blood Sugar’s low, because you’re nutritionally deficient because you’re not getting enough sleep or because there’s something cognitive going on, or all of the above emotional eating, often results in physical issues like weight gain Poor sleep and reduced energy weight gain, are you know in and of itself a few pounds here and they’re not a big deal, but some people can start emotionally eating to feel better.They gained a lot of weight. Then they start feeling less energetic.It starts being harder to move around.They get to the point where they are clinically obese.Then they’re going.I’m never going to take all this weight off.They feel hopeless and helpless.You see where this is going, so they eat some more.Can cause poor sleep apnea, it’s hard to get it’s also hard to get comfortable.Sometimes, if you’ve eaten a whole bunch of food right before you go to bed, you know your bellies are all full, and little you wake up.The next morning and your belly are still awful, which means you probably didn’t, sleep very well the night before and emotional eating often results in reduced energy because the foods we binge on the foods we eat for self-soothing often end up causing a sugar Crash some people try to undo emotional eating by restricting other calories which can lead to nutritional deficits and more cravings. I had a girlfriend when I was in high school and you know think back to I don’t know if they still do it, but when we were in high school there was always some kind of candy sale going on and she would always forgo all Other food, so she could have two chocolate bars each day and you know we’re not going to get into the all the other issues surrounding only eating two chocolate bars.But the point I’m making it right now is the fact she wasn’t getting protein.She wasn’t getting it.You know most of her vitamins and minerals and stuff that her body needed to make the neurotransmitter.So she could feel happy and she was contributing to a sugar crash, but I also know that it’s common around the holidays for people to do this.They’ll let go all day without eating because they know they’re going to a party tonight and there’s going to be a lot of really good food doing that once in a while.Not a big deal doing that 10 or 15 times in a month could start to have problems.Emotional eaters need to first find a way to stop before they eat, so, whether it’s writing in a journal or adding.There are a lot of apps on your phone that you can put your food in, even if you’re, not writing about your emotions and your cravings and all that kind of stuff.Sometimes it’s enough to make people stop before they reach. For the food – or you know, kind of an extreme way to go is to not keep pre-processed or prepackaged foods in the house.So anything that you’re going to eat you’ve got to make second identify the underlying reason for your eating figure out.Do I generally eat in response to and then address the thoughts and emotions leading to the urges?So if you figure out the underlying emotions for your eating or your depression, then what thoughts are maintaining that depression? And how can you address it once you address the underlying issues, some of the emotional eating will go away, but some of its habits?We’re going to have to break that habit and, throughout you know, the past couple of decades of working with people.My experience has been the majority of the time people don’t want to hear.Well, once you deal with your emotional issues, the emotional eating will go away now.They’re there because they want to stop that behavior right now.So, yes, we need to work on all the underlying issues but give them a tip or a trick or a tool whatever you want to call it to use before they walk out of your office after every single session.That way, they have something else they can put in their toolbox and feel more empowered to have control over what’s going on with them. And what’s coming their way, having the knowledge of what and why is 80 of helping them get to the recovery point now, if there’s co-occurring or if the eating issues are more than just emotional eating, if there’s, the person meets The criteria for binge eating disorder, bulimia or anorexia.There are a lot of other underlying issues they’re going to have to be dealt with.So I don’t want to trivialize that, but I do want people to feel like they’ve got some hope over what’s going on.Are there any questions? If you enjoy this podcast, please like and subscribe either in your podcast player or on YouTube, you can attend and participate in our live webinars with doctor Snipes by subscribing at all CEUs comm slash counselor toolbox.This episode has been brought to you in part by all CEUs com providing 24 7 multimedia, continuing education, and pre-certification; training to counselors therapists, and nurses, since 2006 use coupon code consular toolbox to get a 20 discount off your order.This month,As found on YouTubeAnimated Video Maker – Create Amazing Explainer Videos | VidToon™ #1 Top Video Animation Software To Make Explainer, Marketing, Animated Videos Online It’s EASIER, PRODUCTIVE, FASTER Get Commercial Rights INCLUDED when you act NOW Get Vidtoon™
– Hey, Psych2Goers. Do you have trouble paying attention? For example, zoning out
while watching this video? Do you think you have
ADHD because of this? Oftentimes, people mistake
symptoms of anxiety for ADHD because of some of the
similar traits they share. According to the Centers
for Disease Control and Prevention data, about 3 in 10 children
with ADHD have anxiety. So to help you get a better understanding of the difference
between ADHD and anxiety, here are six signs to look out for. Number one, you have poor focus because of worrying thoughts.
Are you always distracted by your worries, so much so that you’re unable to focus on the things you’re doing? When fear and apprehension
dominate your thoughts, it may cause you to become restless, and have trouble sitting
still, paying attention, or staying focused in class. According to John Waldrop, MD from Weill Cornell Medical College, when you experience anxiety, your prefrontal cortex, the part of the brain which is essential for thinking, learning, and
remembering, is shut down. Your brain is concentrated
on staying safe.In contrast with ADHD, you aren’t consumed by worrying thoughts. Instead, it has more
to do with an imbalance in your hormones: dopamine
and norepinephrine, which causes you to be distracted. Number two, you don’t tend to have as many problems with impulsivity. Do you often find yourself
speaking out loud in class without raising your hand? Perhaps you were even labeled
as the troublemaker in school because of the way you
can never sit still. According to Dr. John, a
person with ADHD may feel as if there are dozens of controllers trying to control their
brains at the same time without checking in with each other first. So if you find that you
don’t appear to have as many problems with impulsivity but just struggle to speak up or stand up because of your nerves, then you may have anxiety rather than ADHD. Number three, you have trouble
completing your schoolwork because of perfectionism. Do you have trouble
completing your schoolwork? Perhaps you find yourself procrastinating even if you only have just
one assignment to you.This struggle could be because
you have so many points you wanna make in so many
ways to phrase the words that leave you wanting
to throw up your hands and ignore them. You’re avoiding starting your assignments because you can’t have
it is less than perfect. If you can relate to this, then it’s more likely you’re struggling with anxiety and not ADHD. Dr. John stated that
while people with ADHD may experience difficulty
completing their schoolwork or performing tasks, it’s often due to trouble
with concentration rather than perfectionism.Number four, you are
generally more sensitive to social cues. Are you very sensitive to how you come across to other people? Do you find yourself often uncomfortable with your social environment? Perhaps you find it challenging to eat in front of other people, or tend to avoid speaking in public because of an overwhelming fear that people will judge you negatively. According to Dr. John,
if your answers are yes to the above questions, it’s more likely that you
have anxiety rather than ADHD. This is because people
with ADHD usually struggle with understanding or missing social cues rather than being hypersensitive to them. Number five, you experience
a racing heart, clamminess, tense muscles, headaches,
nausea, or dizziness. Do you often experience
headaches, nausea, or dizziness? These are just some of
the symptoms of anxiety. Dr. John stated that anxiety comes from a tiny almond-shaped part at the back of your brain
called the amygdala.As a watchman for your brain, it is constantly watching out for danger. And whenever it detects danger, it triggers a fight or flight response. However, for anxious people, the amygdala is large and hypersensitive. Because of this, it ends up sending out
a lot of false alarms. You can think of it as a watchman
who cries wolf too often. As a result, your brain may sense threats even in non-threatening situations. And number six, you are unlikely
to show problem behaviors when you’re feeling calm, safe,
and doing things you enjoy.How do you act when you’re having fun? Whether it’s listening
to your favorite music or playing video games, you
may find yourself feeling calm and safe while doing the things
that you genuinely enjoy. You are neither restless nor feel like you need
to catch your breath. According to Dr. John, anxious
individuals are unlikely to display any problem behaviors
when feeling calm and safe and doing something they enjoy. On the contrary, people with ADHD will experience problem behaviors even when they engage in a particular fun or exciting activity. For example, a person with ADHD may become so engrossed
with painting a picture that they tune out or completely
ignore everything else. This behavior is known as hyperfocus. Did you relate to any of
the signs we’ve mentioned? Let us know in the comments below. If you found this video helpful, be sure to like, subscribe,
and share this video with those who might benefit from it. And don’t forget to hit
the notification bell icon to get notified whenever
Psych2Go posts a new video. As always, the references and
studies used in this video are added in the description below.Thanks so much for watching
and see you in our next video. (light music).As found on YouTubeAnimated Video Maker – Create Amazing Explainer Videos | VidToon™ #1 Top Video Animation Software To Make Explainer, Marketing, Animated Videos Online It’s EASIER, PRODUCTIVE, FASTER Get Commercial Rights INCLUDED when you act NOW Get Vidtoon™
this episode was pre-recorded
as part of a live continuing education webinar on-demand CEUs are
still available for this presentation through all CEUs register at allceus.com/counselortoolbox hi everybody and welcome to today’s presentation
on emotional eating making peace with food during the next hour so we’re going to define emotional
eating and differentiate it really from eating when to celebrate and when it’s a problem and
also differentiate differentiating it from eating disorders will explore emotional eating in
terms of its beneficial functions and rewards and discuss why restrictive diets don’t resolve
emotional eating a lot of times people will say you know I have been on this diet forever
and it doesn’t seem to be working or I can’t seem to stick to any diet that I try and we’re going
to look at different reasons why this might be what is emotional eating and it’s exactly what it
sounds like it’s eating in response to emotions and feelings other than hunger so if you’re eating
because you’re bored if you’re eating at someone and sometimes, especially if you are angry
at someone or disappointed in someone you may eat and sort of be eating and thinking you made
I do this so eating at someone eating to forget or distract myself from eating to feel better because
when you eat regardless of what you’re eating but especially if you eat high-sugar high-fat foods
you’re going to release serotonin and dopamine eating out of boredom you know hand-to-mouth bang
eating out of habit and like I said a few minutes ago not all emotional eaters have an eating
disorder um and we want to differentiate that it means that their eating is not problematic
to them no not at all if they’re telling you it’s a problem then it’s a problem they may not
meet the criteria for binge eating disorder or bulimia but it’s important to address it because
they understand that they’re eating for a reason other than hunger and they want to stop because
they want to eat for hunger but not otherwise and for us as clinicians the first thing we need to
do is understand why is it that they’re eating is it boredom is it a habit so they need to keep a food
log or a food journal over a week or two weeks and sometimes when people come in for an
assessment especially if that’s one of their main presenting issues I’ll start just doing
a retrospective of the last three days to get an idea of what may be triggering some of their
eating episodes and then we can look at some of the habits or bad habits may be that they’ve gotten
into and start talking about ways to address those remember that Rome wasn’t built in a day
this isn’t going to go away overnight but a lot of times if you give people some tips tricks and
tools to think about implementing when they walk out of your office after the assessment before the
first official session it provides them some hope and gets the momentum going and again you don’t
have to binge to be an emotional eater some people graze all day long some people will eat and it’s
not what would be considered technically a binge but it’s more than they had anticipated maybe they
go back for second helpings or third helpings when they weren’t hungry but it was good so why
is eating so soothing there are a lot of reasons now there’s obvious it tastes good so that’s
you know the big obvious bonus but thinking about the function the eating serves we have to eat in
order to survive when you were an infant it eating involved a closeness with your parental unit
which could release oxytocin I say parental unit because even if it was dad feeding the baby
a bottle there was that connection there was that contact which caused the infant and the parent to
release oxytocin this is our bonding chemical so eating was associated early on with bonding food
may also have been associated with sleep if the infant or child was given a bottle every night to
go to sleep then they may start thinking or they may be in the habit of eating to wind
down or calm down and we need to help them figure out different ways to do that as a toddler what an
eating means to think about when you went from well we probably don’t remember that but think about
when your kids went from eating you know food out of a jar to even their first Cheerios that
was huge figuring out how to pick up that little cheerio and get it in their mouth and it involved
exploration and mastery they were discovering all different types of textures and tastes and
figuring out what smell went with what taste and it was a cool and exciting time for kids
and I mean think about it they’re like a year old so it doesn’t take much to amuse them but this was
the rewarding reward equals dopamine equals let’s do that again it involved power and control of the child
at this point was starting to be able to feed him or herself was starting to be able to be somewhat
independent from the parent when it came to the basic physiological function of eating so eating
itself had its rewards and it was self-esteem building because the child started learning you
know how to feed himself and how to ask for what he or she wanted at least in terms of food there
are formations of memories around foods even as early as toddlerhood you know we have celebrations
we have birthdays we have different things and most children have certain foods that they really
like and it could be because the first time that ate that food was a really happy experience
or it could be just that’s their favorite food and that’s all they want to eat but they remember
that food and they remember when they ate it they felt good they felt happy so as an adult there’s a
part of their brain going chicken nuggets make me happy now that’s how the toddler
thought as an adult we can understand that chicken nuggets themselves aren’t making you happy but you
see the connections that we’re making here there’s been an association between happiness and chicken
nuggets unhealthy foods especially for children when as adults we’re still able to control what
they eat your sugary foods your unhealthy foods are usually reserved for treats or rewards so
when you’re feeling like you need to be rewarded when you’re feeling like you want to feel good
sometimes you’ll resort to those things when you were a kid that made you feel good like chocolate
chip cookies or Haagen-Dazs or whatever it was for you we’ve talked in the past about associations
and conditioning and this is all coming back kind of full circle now because we need to understand
that our brain has associated pleasure and reward with food for a lot of different reasons not just
because of nourishment looking at the reasons why your patient eats is going to help you understand
what underlying issues you may need to address in treatment culturally we associate eating with
caring and celebrating think about birthdays and holidays what do we do we get together we have
buffets we have pot Luck’s when someone passes away what do you do you bring food over when
somebody’s sick what do you bring food over so in our culture there is a lot of emphases
put on eating and nourishing and that’s true of a lot of different cultures with low blood sugar
can cause feelings of depression and anxiety which are quelled by food so if somebody typically
doesn’t eat well during the day you know they go long periods without eating or if they have
blood sugar issues to begin with and then they eat they feel better so when they start feeling
not so good what do you think their first reaction is let me eat and see if that helps evolution
predisposes the human body to crave high sugar high-fat high calorie foods for quick energy and
to prepare for a famine our bodies are cool and frustrated at the same time because
you know your body takes in these foods and it says we’re gonna secrete the most amount of
dopamine and the most amount of reward for these high-calorie foods because we want to make
sure we’re prepared in case there’s a famine back you know in the day many many many years ago
hundreds of years ago we couldn’t guarantee we would have a meal every day let alone three
meals every day so the body prepared and it said alright we need to get whatever we can when
we can so we’re going to make this a higher fat higher calorie food more rewarding now I
said it’s also can be a blessing and a curse today there’s still a little part of our primordial
a brain that says if it thinks there’s a famine it will slow down your base metabolic rate which
causes people to gain weight we see this a lot in people with eating disorders who tend to not
take in very many calories or if they take them in they purge them so the body goes well I can’t
guarantee I’m gonna get enough food I’m gonna get enough energy to survive so I’m just gonna turn
down the thermostat a little bit to turn down the base metabolic rate which compounds the problem
for the person with an eating disorder so it’s important to understand that the brain is somewhat
active to what’s going on so I keep saying we need to figure out what’s behind or underlying
the craving first we need to rule out physical causes for some people it’s as simple as this if
they’ve got low blood sugar because they’re not eating too often and obviously as counselors we’re
not going to diagnose this their doctor or their nutritionist will but we can start exploring and
go it sounds like you might need to look at having your blood sugar checked or talk to your doctor
about how frequently you need to eat because some people and I know I’m very guilty of it if
I get into it into a groove doing something I’ll eat breakfast and then I’ll get into a groove and
before I know it it’s 3:00 in the afternoon and I haven’t eaten for like a whole bunch of hours I’m
not doing math today and my blood Sugar’s low and I’m starting to get foggy-headed and irritable
and tired so it’s a real simple fix there in our society we are so driven and we are so we get
so caught up in things because that’s such a fast pace that it’s easy to forget to eat or easy to
avoid eating so that’s the first thing we want to rule out are you eating in response to low blood
sugar which is making eating seem more rewarding and when you eat in response to low blood sugar
a lot of times people who do that end up eating more than they normally would because they start
eating fast it’s like I’m gonna shovel in as much as I can your brain doesn’t register
you’re eating for 20 minutes or so so before your brain even registers what’s gone on and gets
the blood sugar back up they’ve already eaten a whole ton of food why is this under emotional
eating well because generally when they go in to just start eating yes they’re hungry but
they’re also cranky and irritable and most of the time they’re not thinking about what I’m eating
for the nourishment it’s I’m eating feel better after lack of sleep and this is so true for shift workers as
well as you know new parents and college students and anybody who’s not getting enough sleep if we
are surviving on sugar and stimulants we’re going Peak and Lower Valley Peak and Lower Valley and
you just keep going up and down until you just crash because every time you crash you crash a
a little bit lower so if somebody’s on that roller coaster they’re going to feel worse between you
know eating episodes they’re going to feel tired they’re going to feel a flood of sluggish irritable
fatigued and to a certain extent maybe depressed and they may be missing attributing those feeling
those emotional feelings to emotions versus physical causes and likewise we also want to make
sure that you know we’re addressing the emotional causes because there’s probably stuff there
too but if they’re not getting enough sleep and they’re living on sugar and stimulants their
the body is kind of in a state of hyper-vigilance a lot of times it’s exhausted so they’re going
to be tired and cranky so those are a couple of things that we want to look at those are
relatively easy fixes or at least relatively easy things to point out and go let’s think about this
one of the things that I suggest for a lot of my clients is just to take a week and mindfully and it
is difficult but try to eat healthfully you know try to eat a few times a day you know try to eat
like three meals a day and getting enough water and trying to get enough sleep and try not to overdo
it on the stimulants at the beginning I’m not going to say cut out anything because that’s not
realistic and it’s not fair and they’re probably already struggling if they’re coming in to see me
so if I go hey let’s just turn your world upside down and guess what you’re not going to drink any
caffeine anymore it’s not going to create a happy person so I asked them to try to make some small
changes and see if that starts to help dehydration causes fogginess and symptoms of depression we
want to make sure that they rule that out and too many stimulants also causes dehydration so you
know we’re looking at some of the physical causes of irritability and fatigue and cravings because
again we’re going back to when I felt this way before not looking at why I felt this way but when
I felt irritable depressed cranky what has made me feel better and generally food and generally
it’s not good food for me it’s M&Ms I love my M&Ms, especially the ones with almonds but I digress
nutritional causes of cravings high carbohydrate and high starch foods caused a greater release
of serotonin and endorphins so if you’ve got somebody who’s depressed for whatever reason that
they may crave these kinds of foods to increase their serotonin level or increase the
endorphins in their energy levels chocolate people who crave chocolate may be low in magnesium it
also um the level of magnesium affects how much serotonin is available again just keep
saying this just for legal reasons we want to make sure their doctor or nutritionist goes in and
makes this diagnosis but if there are particular foods that they do crave it’s important for them
to bring that up with their medical provider if they’re craving fatty foods now again fatty foods
are just good I love fried foods but it also could mean that they’re not getting enough Omega threes
Americans typically don’t and interestingly if they crave soda they may be calcium deficient
who knew so these are things to take a look at to ask people you know if they’re craving soda
maybe cutting back on their soda a little bit and see what happens and or getting blood work done
once we’ve ruled out the obvious physical causes they’ve gone to the doctor gotten blood work done
everything I’m comes back happy they’re getting enough sleep but they’re still eating when they’re
not hungry we need to rule out habits is there a particular time or activity that makes you crave
this food when I was growing up I would go to the grocery store with my mother and on the way back
home from the grocery store she would always we would always get junk food and she would get a
bag of chips and put them in the front seat it was like a 20-minute drive from the grocery store
to our house and by the time we would get back to the house we would have put a good dent in those
potato chips that being said I got into the habit of whenever I went to the grocery store I would
get something out of the bag and put it in the front seat and eat on the way home now am I paying
attention to what I’m eating no likely am I eating because I was hungry probably not so we want
to look at habits a lot of people will eat when they are watching TV it’s a huge one so we want
to not do that or if you’re going to eat when you’re watching TV make sure you sit at the table
at least that makes you a little bit more mindful so think about their particular times
or activities that you eat and you’re just not hungry are their particular times that you
mindlessly eat like like I said when you’re driving or when you’re watching television those
are both habits and can be mindless because you’re not paying attention to how much is going on in your
the mouth you’re not probably paying attention to the taste and you’re not paying attention to whether
you’re full or not so if you’re mindlessly eating then there’s going to be a lot more calorie
consumption in addition to the fact that you’re not eating because you’re hungry you’re just
eating to eat are you going too long between meals than needing a sugar boost which leads to a
sugar crash so again that’s a physical cause but we want to rule out these bad habits that
we can tend to get into other things that can be construed as bad habits are eating without
putting food on a plate if you eat straight out of the bag you’re gonna eat more than if
you put it on a plate so put it on a plate sit down try not to watch TV all the things that your
grandmother would have told you so what do we do about it emotional eating interventions I talked
earlier about the food diary do a retrospective during the assessment if they want to get
a jumpstart on things but have them keep a food diary preferably for the duration of treatment
but at least for a week what time did they eat were they craving just any old food or something
that was salty sweet sour this will give you a general idea
and can give their medical provider a general idea if there are any nutritional imbalances or if
there are particular associations with what emotion or state were you in and I say state because being
exhausted is not necessarily really an emotion where you are happy sad mad glad exhausted drained
whatever state feels like it would work and then because of why were you feeling this way
it doesn’t have to be a dissertation it can be short and sweet but I encourage clients
to write down everything they eat before they eat it during the first week or you know like I
said preferably throughout the entire course of treatment why before they eat it because it’s a
stop remembering we’ve talked before about how we have an urge we have a craving we have an urge and
then we engage in the behavior oftentimes without stopping to mindfully think is this what we want
to do this provides that stop it says okay I’ve got it to write down the time and then I’ve got to
think about why I’m eating and honestly, a lot of clients notice a reduction and their habit of eating
when they have to do this just because they don’t want to record-keeping that up for the period of a
a month or two months helps break some of the habits eating that they might do like I said before when
they’re eating I encourage them to use a plate sit down don’t walk around don’t stand at the counter
eliminate distractions as much as possible and focus on the food you’re eating that goes with
mindfully eating what does it taste like is it good take small bites when my son was young and
I think I’ve shared this before he had gastric reflux and we would sit down at the table and
I would shovel in food as fast as I could get it in my mouth because he couldn’t be put down
for too long before he would start to get fussy at least until we figured out that he had gastric
reflux and Zantac was just a lifesaver I developed that habit when he was little and I kept it up
for a while, it took a while to learn for me to learn to go back to take you to know reasonable
bites and tasting my food and even today if I’m not paying attention too much I’ll eat my dinner
rest and then I’ll sit there and I’ll be like well yes I’ll taste that a little bit later
because I didn’t taste it when I ate it encouraging clients to be aware of their eating habits and try to
avoid setting up a binge by restricting certain foods now does that mean you have to have cakes
and candy and whatever your trigger foods are in your house all the time and in your face no I
would encourage people not to do that but to say you know I said for me M&Ms is one of my favorites
reward foods if you will I don’t keep them in the house but I will allow myself occasionally to buy
a small snack-size pack of M&Ms when I’m out or I will get a regular-size pack and I’ll share it
with my daughter so I’m not restricting it I’m not saying I can never M&Ms again I’m just
not making it available to myself when I might have some unrestricted time to try to avoid buying
a bunch of comfort foods and keeping them around the house and when you’ve got kids when you’ve got
family, it’s not entirely possible usually to not have some of that stuff around but try to avoid
having the things that you particularly used for comfort because if it’s not readily available
then you’ve got to focus on guess what dealing with the emotions instead of stuffing them with
food try not to go too long without eating as I said earlier if you go too long then by the
the time you get to the food your blood Sugar’s low and you’re just shoveling it as fast as you
can initially distract if you know that you’re getting you’re eating and you’re like I’m really
not hungry but I want to eat take a bath take a walk call a friend heaven forbid get on Facebook
whatever it is you can do to distract yourself for 10 or 15 minutes if after 10 or 15 minutes
you’re still going I rant whatever it is then you can decide what to do about it then
most of the time when people stop and go I’m not hungry let me distract myself they get
caught up in that distraction and before they know it they’ve forgotten about the craving to identify
the emotions if you know that you’re not hungry but you want to eat then say okay what’s going
on what’s going on with me it doesn’t mean that the person is never going to eat when they’re
upset because a lot of people do and is it the end of the world probably not necessary if they can
start reducing the frequency of times that they eat in response to emotional distress that’s what
we want to progress, not perfect if it’s depression that’s causing them to feel hopeless
or helpless right now if it’s stress anxiety or anger remember our big kind of lump together
stuff what are they stressing out about do they feel like they’re overwhelmed are they afraid of
failure rejection loss of control of the unknown we’ve gone through those things we want them to
identify what’s going on with them and then they can make better choices about how to deal with it
so general coping helps them develop alternate ways of coping with distress distract we’ve already
kind of go over that one I encourage people and you know it’s one of those DBT things that
a lot of therapists encourage their clients to keep a list of things they can do to distract
themselves because it’s not always practical to get up and go on a walk if you’re at work or it’s
you know two in the morning so what else can you do to distract yourself talk it out with a friend
with yourself with your dog sometimes you just got to get it out people who are more auditory will
prefer talking it out as opposed to journaling it now if they talk it out with themselves they
can record it if they want to or sometimes it’s just better to have a dialogue with themself if
it worked for Freud it can work for other people journaling if your clients are inclined to journal
encourage them to write it down sometimes just getting stuff out of their head and onto paper
will help the feelings dissipate a little bit so you’re not mulling them over and obsessing
on them and getting stuck in those thoughts and feelings additionally while you’re distracting
talking it out or journaling is also your break stop between the urge and the behavior
make a pro and con list of the de-stress, not the eating whatever it is that’s stressing you out
and how can you fix it or what are the pros of this situation and what are the downsides to
this situation encourages them to focus on the positive you know if something stressing you
out at work you know you’ve got a big meeting coming up or something you don’t want to do
or what it is you can get stuck on focusing on that or you can focus on the positive that you
do have a job that meeting only comes around once a month you can it’s time you don’t have to be
doing paperwork whatever the pros are for that person encourage them to focus on the positive
if you’re distressed because of some kind of a failure or perceived failure figure out what you
learned from it whether it was a relationship failure maybe you learned what not to do in a
relationship anymore maybe you learned things that you may have ignored maybe you learned what
you should have done instead but how can it be a learning opportunity instead of somewhere to stay
stuck and finally if something’s making you upset if something’s causing anxiety depression
hopelessness helplessness whatever the negative feeling figure out if it’s worth your energy
to get stuck here is it worth the turmoil is it worth you know having to pacify yourself with
food whatever it is a lot of times people say you know what now it’s just it’s not even worth
my effort is not worth moving me away from my goals because my goal is to stop emotional
eating my goal is to eat for hunger so I can go to dinner with people and feel comfortable
I can be at a party where there’s a buffet and not feel stressed out that I’m gonna go and eat
half the stuff on the buffet that’s my goal so is holding on to whatever this de-stress is getting
me closer to being able to do those things and generally, the answer’s no develop alternate ways
of coping with the stress the ABCs the a is the activating event that is stressing you out what’s
causing the de-stress C is the emotional reaction angry depressed stressed whatever we are your
behaviors what behaviors or B are your beliefs sorry what are the beliefs that are in there that
may need to be addressed what kind of things are you telling yourself and how can you counter
them cognitively eliminate your vulnerabilities you knew we couldn’t get through a presentation
without talking about vulnerabilities if someone is well-rested well-fed has a good social support
the network does not overstretch timewise then it will be easier to deal with stress or stressors when they
come your way you’ll have more energy to deal with it so there won’t be this overwhelming feeling
of I just want to bury my head in a jar of peanut butter be compassionate with yourself some days
are you know you’re just gonna feel anxious you’re gonna feel depressed you’re gonna get angry you
can beat yourself up over it and you know a lot of people do is that the best use of your energy
or can you be compassionate can you learn from it can you give yourself a break and go you know what
I’m having a bad day today and that’s okay I’m not gonna unpack and stay here but I’m not gonna
fight it either help clients learn how to urge surf helps them understand that just like a panic
the attack is just like a wave just like a lot of other things in life it will come it will crest and it
will go out again so they can sort of identify where they are on the energy of that urge other tools people can use close the kitchen once I have the kitchen cleaned and you know all the
dishes are done and it looks pretty I hate going in there and finding dishes in the sink again now
I’ve got teenagers so we always have dishes in the sink but before I had children you know at
seven o’clock I finished all the dishes and closed the kitchen and that would be enough motivation
for me to not go in there and at least not use plates and stuff to eat so if we’re saying that
we’re going to only eat using utensils plates and sitting and all that stuff that we already talked
about then once you close the kitchen you’re not going back in there turn off the light that
also helps so you’re not being attracted to the pretty lights and you know all the
goodies that are in the kitchen brush your teeth this is something my grandmother used
to do and it works there’s some research behind it minty flavors reduce our appetite so
if you brush your teeth you get all the other flavors out of your mouth and it reduces your
urges to eat because it again it’s clean and fresh and do you want to brush your teeth
again meditate sometimes just getting in a space where you’re not obsessing about anything can
help people get past that urge to self-soothe with eating a CT for emotional eating what am I
feeling or thinking about what’s going on with me right now and what is important to me so if I am thinking
I want to eat I want to you know just dive into this jar of peanut butter and then I think about
what’s important to me is it important to me to get control of this is it important to me to you
know to be able to fit in my clothes in six months or not so what is in what way is controlling
my eating habits and eliminating emotional eating important to me and how does that get
me closer to other things that are important to me and what other things could I do that would
get me closer to my goals so if the goal is to have improved relationships and be able to feel more
Being comfortable around food reduces the stress around going out to eat and just around food in general
what else can you do when you are stressed out somebody also suggested adding a blue light
in the refrigerator decreases the appeal of foods which is interesting because yellow red and
orange and browns I think Pizza Hut are all foods that increase people’s hunger and desire to eat
but blue is just a completely different primary color and adding a blue hue seems like
that would be effective so cool thanks for that little tidbit their holiday help
and you know we’re coming into the holidays so I’ve got to bring that up at every single glass
choose lower-calorie foods if you tend to get stressed out or caught up or mindlessly eat when
you are at family gatherings, okay you know cut yourself a break know that that’s probably gonna
happen to fill up on the lower calorie foods the carrot sticks broccoli the white meat turkey
anything available that’s not like sweet potato pie or brownies keeps water or low calorie
beverage in your hand if you’ve got your hand full you can’t eat at the same time so you know if you
walk around with a cup in your hand it helps talk to people hopefully you don’t talk with your
mouth open or talk with food in your mouth so if you’re talking to people you’re not going to be as
inclined to go get something to eat because you’re wanting to stay engaged in that conversation stay
away from the buffet especially if you know that it could get stressful or maybe you know for me I
turn into a pumpkin at like 7:30 at night I get up at 4:00 but I turn into a pumpkin at 7:30 and a
a lot of times holiday parties and those sorts of things are at eight nine o’clock at night and you
know I’ve already turned into a pumpkin so I know that if I go to those I’m gonna be more
likely to eat just to kind of stay away because I’m tired and it’s a bad habit it’s not because
I’m hungry so I know I need to stay away from the buffet during those times we rehearse refusal
skills if somebody says oh you’ve got to try it by two this figure out how you’re going to address
that ahead of time because there’s generally probably a lot of really good foods and you may
want to taste some but sometimes people who emotionally eat know if they start eating if they
start eating high-fat high calorie foods they’re gonna want to eat everything so if I start with
one bite of a brownie I’m gonna want to eat every suite that’s on the table if they know that then
they may want to choose to not even go down that road at that juncture and encourage people to stay
mindful of their distress meter before they go back for another helping and ask themselves am i
hungry am I just wanting to taste what’s here and how do I feel about that or am I eating
just because I don’t want to be here and I’m bored and I want to fill the time have people
keep an index card with their coping mantra and two reasons they don’t want to emotionally
eat so I need to be here I can do this whatever the mantra is that’s gonna get them through the
night whatever they’re telling themselves that it’s gonna help them plow through and make the
right choices but also two reasons that they don’t want to eat or they’re going to get around
maybe they’ve got something at home that they can eat when they get home eating before they go
to the party may also help prevent some grazing holidays bring out a lot of emotions in people
some people struggle with depression anxiety jealousy grief anger you know the whole gamut
during this time and during this time there’s food everywhere I mean starting at Halloween when
your kids bring home the Halloween candy which usually lasts about a week in our house baby
Oh Halloween candy followed by getting ready for Thanksgiving followed by doing all the baking
or whatever you do and the holiday parties coming up on the December holiday season there’s just
food everywhere so it’s really easy to cope if you will with stress being overwhelmed by being
tired by not eating enough healthy food by binging on unhealthy and soothing food if you will so it’s
encouraged it’s important to encourage people to stay mindful of why they’re eating what they’re
eating when constantly bombarded with high-fat high carbohydrate foods people are tempted to eat
to feel calm yeah I challenge anybody to say that they’ve never eaten and go okay you know I’m just
focused on this right now I’m not thinking about everything out here and it feels good um I’m good
now goods are probably not the word I should use but it does help people distract themselves sometimes
when you eat especially those high-intensity foods you feel happier serotonins release dopamine
is released you’re like oh that’s good I want to do that again or you just feel numb you
can get into a zone where you’re just eating and not caring it’s not that you’re feeling calm
you’re just not feeling anything and a lot of times when people get into that zone they’re
not tasting the food either they’re just kind of on an autopilot emotional eating like most other
escape behaviors never address the underlying emotions and their causes so we need to look
at it are you feeling anxious are you feeling jittery are you feeling depressed because your
blood Sugar’s low because you’re nutritionally deficient because you’re not getting enough sleep
or because there’s something cognitive going on or all of the above emotional eating often results
in physical issues like weight gain poor sleep and reduced energy weight gain is you know in and
of itself, a few pounds here and they’re not a big deal but some people can start emotionally eating
to feel better they gained a lot of weight then they start feeling less energetic it starts being
harder to move around they get to the point where they are clinically obese then they’re going I’m
never going to take all this weight off they feel hopeless and helpless you see where this is going
so they eat some more can cause poor sleep apnea it’s hard to get it’s also hard to get
comfortable sometimes if you’ve eaten a whole bunch of food right before you go to bed you know
your bellies all full and little you wake up the next morning and your belly still awful which
means you probably didn’t sleep very well the night before and emotional eating often results
in reduced energy because the foods we binge on the foods we eat for self-soothing often end up
causing a sugar crash some people try to undo emotional eating by restricting other calories
which can lead to nutritional deficits and more cravings I had a girlfriend when I was in high
school and you know think back to I don’t know if they still do it but when we were in high school
there was always some kind of candy sale going on and she would always forgo all other food so she
could have two chocolate bars each day and you know we’re not going to get into the all the other
issues surrounding only eating two chocolate bars but the point I’m making it right now is the fact
she wasn’t getting protein she wasn’t getting you to know most of her vitamins and minerals and stuff
that her body needed to make the neurotransmitter so she could feel happy and she was contributing
to a sugar crash but I also know that it’s common around the holidays for people to do this they’ll
let go all day without eating because they know they’re going to a party tonight and there’s going
to be a lot of really good food doing that once in a while is not a big deal doing that 10 or 15 times
in a month could start to have problems emotional eaters need to first find a way to stop before
they eat so whether it’s writing in a journal or adding there are a lot of apps on your phone
that you can put your food in even if you’re not writing about your emotions and your cravings
and all that kind of stuff sometimes it’s enough to make people stop before they each
for the food or you know kind of an extreme way to go is to not keep pre-processed or prepackaged
foods in the house so anything that you’re going to eat you’ve got to make a second identity
the underlying reason for your eating figure out do I generally eat in response to and then
address the thoughts and emotions leading to the urges so if you figure out that the underlying
emotions for your eating or your depression then what thoughts are maintaining that depression
and how can you address it once you address the underlying issues of some of the emotional eating
will go away some of its habits we’re going to have to break that habits and over the course of
you know past couple of decades of working with people my experience has been the majority of the
time people don’t want to hear well once you deal with your emotional issues the emotional eating
will go away now they’re there because they want to stop that behavior right now so yes we need to
work on all the underlying issues but give them a tip or a trick or a tool whatever you want to
call it to use before they walk out of your office after every single session that way they have
something else they can put in their toolbox and feel more empowered to have control over what’s
going on with them and what’s coming their way knowing what and why is
80% of helping them get to the recovery point now if there’s co-occurring or if the
eating issues are more than just emotional eating if there’s the person meets the
criteria for binge eating disorder bulimia or anorexia there are a lot of
other underlying issues they’re gonna have to be dealt with so I don’t want
to trivialize that but I do want people to feel like they’ve got some hope over
what’s going on are there any questions if you enjoy this podcast please like and
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(soft instrumental music) – [Amanda] Hey Psych2Go
family, and welcome back. If you’re new to this channel and by the end of the video
you enjoy our content, do consider subscribing and
joining the Psych2Go fam. Now, let’s begin. Narcissistic victim syndrome is a term that collectively
describes specific and often severe side effects
of narcissistic abuse. Many experts acknowledge
narcissistic abuse can have a serious long-lasting
impact on emotional health, although it is not recognized
as a mental health condition. As a result of chronic abuse, victims may struggle with
symptoms of PTSD or complex PTSD. If they had additional trauma such as being abused by
narcissistic parents. (beeping) (upbeat music) With that in mind, here are
10 signs that might suggest you have narcissistic victim syndrome. Number one, you felt like you
had a perfect relationship with that person in the beginning. When you’re in a romantic relationship, this type of abuse usually begins slowly and it creeps up on you
after you fallen hard and are in love with your partner. In the early stages of the relationship, this is when the love
bombing usually occurs. They may shower you with
gifts and affections and it can feel very intense. Then slowly, manipulative tactics start to invade the relationship and will replace the love bombing. In the case of narcissistic parents, they might also offer
love, adoration, praise, and financial support, until you do something to displease them and lose their favor. They use tactics such as
gaslighting and silent treatment which can leave you
questioning your own sanity. And this is something that sticks with you even after you’ve cut
ties with that person. Number two, you feel like
you’re walking on eggshells. A common symptom of trauma
is avoiding anything that might make you relive
that particular trauma. Whether it be people,
or places, or activities that pose the threat to you, you may feel like you’re
constantly worrying and being careful about what
you say or do around people because that is how you used to behave when you were around your abuser. You may present as
anxious and introverted, especially when in the
presence of other people, though you’re simply
acting out of extreme fear. Number three, you may have
experienced smear campaigns once the relationship ended. When breakups happen, it’s
common for people to take sides. This is no different when it
comes to a narcissistic abuser. They will twist your words and tell their version
of the story to others to try and get them to
feel sorry for them. They can often drum up
support from your loved ones by insisting that they only
have the best interest at heart. Then when you try to talk
about the abuse that happened, your loved ones might side
with the abuser over you. This can drop barriers between you and the people
in your support network and leave you feeling isolated. Number four, you feel
isolated and vulnerable. When no one will listen
to you or your concerns, this can leave you
feeling very much alone. When you feel alone, you’re vulnerable to further
manipulation from your abuser. They may pull you back
in with fake apologies, a hand of kindness, or by brushing their past
abuse under the rock. This tactic, which is called hovering, is the perfect time to pounce when you’re lacking in support since you are more likely
to doubt your perceptions of the abuse when you can’t
talk to anyone about it. Number five, you’ve developed
a pervasive sense of mistrust. Are you hypervigilant? Do you worry and get anxious
over other people’s intentions? The gaslighting techniques
used by the narcissistic abuser may have contributed to
how you view the world. And you may find that you have
a hard time trusting anyone, including yourself. Number six, you may
engage in self-sabotaging and self-destructive behavior. Victims often find themselves
ruminating over the abuse. This can enhance the frequency
of negative self-talk and the tendency towards self-sabotage. Malignant narcissists
will try and program you, conditioning you for self-destruction. This could potentially lead you to engaging in risky
behaviors such as self-harm or even suicidal ideation. You might’ve developed a
knack for punishing yourself because of the toxic shame you carry, put there by the hypercriticism and verbal abuse of your abuser. If you feel like you’re
lacking in any motivation to pursue your dreams and goals, then this could be a result
of narcissistic abuse. Number seven, you may experience unexplained physical symptoms. Narcissistic abuse can trigger
anxious and nervous feelings that can trigger physical symptoms. The stress of chronic abuse may send your stress
levels into overdrive. And as a result, your immune
system may take a severe hit leaving you vulnerable to
physical ailments and disease. You may notice symptoms such
as appetite changes, nausea, stomach pain, muscle aches and
pains, insomnia, and fatigue. Number eight, you may have
issues setting boundaries. The experience of narcissistic abuse can often leave you with
little respect for boundaries. This may be because when you tried to set
boundaries in the past, you may have been met with
challenges from the abuser who gave you the silent treatment until you did what they wanted. Once you end the relationship or gain distance from
a narcissistic parent, you promise yourself that
you won’t answer their calls or physically see them at all. However, even if you’ve tried to cut ties, your abuser is confident that they will eventually wear you down because you’ve set aside
your boundaries with them so many times before. If you’ve experienced narcissistic abuse, you might also have trouble
setting healthy boundaries in your relationships
with others in the future. Nine, you may be questioning
your own identity. When facing abuse, many people
adjust their self-identity to accommodate an abusive partner. You may have stopped
doing things you enjoy or spending time with friends and family in order to better appease your abuser. These changes can often
lead to a loss of identity during and after the abuse. It’s not uncommon for
victims of narcissistic abuse to experience dissociation and attachment from the physical world. Dr. van der Kolk writes
in his book titled, “The Body Keeps The Score”: Dissociation is the essence of trauma. The overwhelming experience
is split off and fragmented so that the emotions,
sounds, images, thoughts, and physical sensations
take on a life of their own. Oof! Number 10, you may find
it hard to make decisions. When there has been a negative pattern of devaluation and criticism in your life, you might have very little self-esteem and confidence in yourself. Narcissistic abusers can make statements that imply that you are
unable to make good decisions. Abusive partners may have called
you’re stupid, or ignorant, or they might’ve insulted you with a false and affectionate tone. They can manipulate you into believing you
imagine parts of reality making it seem less important
than it actually is. This type of controlling and deceitfulness can affect the way you
make future decisions. So, did you relate to any of the signs? Let us know in the comments below. I wanted to take a second
to say that I definitely… Um, sorry. Hi, it’s Amanda, the voiceover voice. I’m reading the script for the first time and I really related to it. So I wanted to add a point that, in you taking the time to learn about narcissistic
victim syndrome, you’re empowering yourself. Once you know you can grow. Acknowledging the effects of being in a narcissistic relationship is the first step to healing from one. As we close out, we wanted to say that not all
abuse is linked to narcissism, and not all people with a diagnosis of narcissistic
personality disorder will engage in abusive behavior. However, if you feel you might be a victim of this type of abuse, we encourage you to reach out for help. Talk to someone you can trust, like a good friend, a family
member, or a therapist. It’s not easy to leave
an abusive relationship, but with the right support,
you can move on with your life and start to heal from your past hurts. Like and share this video if it helped you and you think it could
help someone else too. The studies and references used are listed in the description below. Don’t forget to hit the Subscribe button for more Psych2Go videos, and thank you for watching. We’ll see you in the next one... As found on YouTubeHuman Synthesys Studio It’s Never Been Easier To Create Human Spokesperson Videos. No Learning Curve, So Easy To UseSo Easy To Use
Welcome to the Addiction Counselor Exam
Review. This presentation is part of the Addiction Counselor certification
training. Go to http://www.ALLCEUs.com/certificate-tracks to learn more about
our specialty certificates starting at 149 dollars Hi everybody and welcome to this
presentation of Documentation Principles and what you're supposed to do in
documentation. Over the course of the next hour or a little bit more yeah
buckle in guys it's going to be a while we're going to discuss the elements of
good documentation we're going to talk about different types of documentation
that you need to know how to do this is not a instructional manual or
presentation on how to write good treatment plans or good progress notes
this is really hitting the highlights so if you hit or you get to a place where
you hear about a type of documentation you don't feel comfortable with
especially treatment planning from what I've been told on the current
certification exams treatment planning plays a big role so you want to make
sure that you know how to identify effective interventions but that's a
different class today we're just going to hit the highlights of what you need
to know about documentation so documenting the treatment process the
client record is the most important tool to ensure continuity of care that's
going to help every person on the treatment team collaborate and
coordinate that's going to help you track progress remember what you did
last week and what you're doing in the future you know what your goals are it's
going to help the client visualize what's going to happen so documentation
is really important and remember if it doesn't get documented it didn't happen
and that's true in terms of billable services you know don't not document
something because you make a mistake because that'll still come back to bite
you but in terms of reimbursement and you know showing that you did what any
good therapist would do in order to prevent liability document document
document it's your best friend there are ways to shorten documentation there are
a lot of times that you can use check sheets and things create check sheets in
private practice to make it a little bit easier for
yourself but it is important to have that documentation documentation
contributes to service delivery by reducing the replication of services so
if I look and I see that jimbob's already been referred to a psychiatrist
well then I don't need to make a referral for Jim Bob to a psychiatrist
if I look and I see that he's already interacting with workforce development
services then I don't need to refer him there because it's already been done so
it saves some effort on everybody's part it presents a cohesive longitudinal
record of clinically meaningful information which is gibberish for
saying you can see the clients progress you can see what's worked you can see
what hasn't worked you can see incremental changes and more importantly
sometimes the client can see incremental changes so they can look back you know
six weeks and at what you were talking about back then and how they were
presenting and how they were feeling and then look at today and you can compare
and contrast so they can see that yeah everything may not be coming up roses
but there has been a significant improvement documentation helps ensure
reimbursement for services you don't ever want to say is going to ensure
because the people who are reimbursing have the right to not reimburse you know
they can deny claims so but you know you're not going to get paid if you
don't document so you have to document in order to have any hope of
reimbursement and good documentation will reduce the number of denials that
you get and it assists in guarding against malpractice because you're
documenting what was done by whom and if they were adequately credentialed you
know if you're referring somebody for a nutritional assessment to a dietitian a
registered dietitian you're going to note that in the record if you are
providing nutritional assessment and information yourself you're probably not
a registered dietitian which means you're not adequately credentialed so
you know you could see the difference but you're showing that you're referring
to other professionals and you're taking adequate precautions in the event that
somebody's in crisis or you know needs some other sorts of assistance clinical
documentation records professional services you do an intake we all know
what intakes are differential diagnosis it shows how you arrived at your
conclusion that this person has substance induced depression or or
whatever you're going to show how you ruled out some of the medical conditions
you're going to show how you ruled out underlying
mental health pathology placement criteria are used in decision making so
you have the a Sam generally sometimes it's the locus and you can use that to
show you know the powers-that-be if anybody ever comes and look at looks
at the record why you made the recommendation for residential or
outpatient or or whatever recommendation you made you can show your clinical
justification by the patient placement criteria which is really awesome now
sometimes the client is gonna say no you know you're recommending residential but
I'm not willing to do that and you're gonna document that in the chart what
your recommendation is and what the client chooses to do because they do
have the ability to choose but again you know you're showing that you made a good
honest effort to put them in what appears to be the best placement it
documents treatment and other services provided so we can see what's going on
if I'm looking at a record and of somebody and I'm hearing that they're on
medications but I have no record of any sort of a doctor and you know I've read
assessments before and it just drives me batty where they talk about a client
being on antidepressants for example but then the client never gets any sort of
mental health diagnosis and I'm like well what are they on the meds for if
the doc is prescribing meds the doc clearly thinks that they have some sort
of mental health issue so you want to identify what's going on what services
you're providing what refer you're making the response to any
interventions think about it this way you know if that client comes back for
another episode of care and we know in recovery oriented systems of care that
treatment is episodic and you may not be there the next time JimBob comes back
but the next therapist can go back and review the record and figure out what's
worked what didn't where the kind of where you left off and build upon that
instead of having to recreate the wheel which saves a lot of frustration a lot
of time and it enhances client engagement if they feel like they can go
in and kind of hit the ground running instead of having to you know start back
at square one it identifies referral services and the outcome not all
referrals are going to go swimmingly but generally they do and you want a
document that you're attending to the clients biopsychosocial needs if they
need housing you're referring to the appropriate agency that can help them
get housing if they need you know food stamps you're referring to the
appropriate agency where they can get that there's a little bit of case
management sort of stuff going on here because a lot of times you don't have a
case manager but it's important because a client who is homeless hungry in pain
and sick is not going to do really well on dealing with their depression or
their self-esteem because they're not getting their basic needs met so you
want to show that you're you know taking everything into account
it shows the clinical course the record can help you identify and look back
retrospectively and see you know what things may trigger an episode what
things may trigger a relapse what things tend to mitigate it and help it you know
not become so severe what sorts of interventions worked and looking at the
course you can see when it started and whether it's continuing to get worse or
whether it's starting to get a little bit better and instead of having long
relapse periods you have shorter episodes maybe of lapses and it shows
reassessment and treatment plan reviews people change you know as they get
better that's awesome they're changing and the treatment plan will need to be
updated to reflect their current needs and wants we want to do reassessments at
least every 90 days but preferably every 30 days a lot of insurance companies and
if you look at the level of care guidelines it's really important because
they can deny payment if you're not doing a treatment plan review every
single week for people who are in intensive outpatient partial
hospitalization or residential that's not true of every insurance provider but
it is true of a lot of them so you need to know how frequently you need to do
these things in order to prevent denial of payment records compliance with state
accreditation and payer requirements so you know clinical documentation helps
you you know document exactly what's going on in Florida for example the
state tells you certain services that have to be provided at the IOP level and
at the residential level and you need to be able to document that if you're
getting state funding you need to be able to document certain things if
you're accredited by Jayco are you're gonna have to be able to show in the
record that your treatment is you know in line with their guidelines you know
they're going to look around at what's going on now but they also want to look
at the charts to see you know how you actually follow through an entire course
of care and it helps you maintain payer compliance
I can't state this enough and we are in it to help people don't get me wrong and
I hate to harp on dumb reimbursement however if you don't get reimbursed you
don't keep your doors open so it's important to know what each payor
requires in terms of you know how quickly does the intake need to be done
how quickly does the treatment plan need to be done some payers say three days
some payers say a week how frequently does the treatment plan need to be
updated does the person have to see a psychiatrist within a certain period
of time for your high levels of care the answer is yes so all this stuff is in
what's called the level of care guidelines and each independent
insurance provider has their own level of care guidelines so my recommendation
and what I do in my practice is identify all of the providers that I accept and
then I take the most stringent requirements for everything from all the
different providers so I'm going above and beyond for some but I'm at least
meaning every single providers minimum requirements and it takes a little while
to do the crosswalk but it is well worth it because it helps you have a clinical
record that applies whether it's Blue Cross and Blue Shield or Aetna or United
or you know whomever documentation eases the transition to other programs and to
referral sources if you call up a referral source and say you know maybe
you're working with a client who has trauma issues and you're referring to an
EMDR therapist and you call them up and say hey I got this person coming over
and who's gonna need EMDR services sending them your way well that doesn't
give them anything to work on so instead of again having them rip open that wound
and go through you know a bunch of stuff that they've already talked about with
you that was painful and distressing the clinical record can help ease that
transition so the receiving therapist the EMDR therapist can review it and
kind of know what they're dealing with and then start a little bit ahead of the
game and it prevents duplication of information gathering when possible you
know everybody seems to have to get demographic information well if there's
a centralized clinical record that has the demographic information then
everybody can add to that instead of having to get the same demographic
information from clients every single time it facilitates quality assurance it
documents the appropriateness clinical necessity and effectiveness of treatment
when you are writing your integrated summary
you are going to identify things in the intake that you did that support your
diagnosis and support your intervention so you're gonna identify I'm doing this
because in order to meet this need we're going to use this intervention so it
identifies the clinical necessity you'll talk about appropriateness and that's in
terms of diagnosis that's in terms of treatment setting and that's also in
terms of age and culture so you're gonna if you use different interventions maybe
use cognitive behavioral for some things and you use experiential for something
else or maybe you refer to IOP for one thing for one client and you refer
another client to outpatient or residential the appropriateness can be
defended with your integrated summary and your patient placement criteria and
then the effectiveness of treatment is going to be seen in your progress notes
and your reassessments so you're going to be identifying okay we accomplish
this goal accomplished that goal accomplished the next goal and you're
gonna hopefully be marking them off and if you're not marking them off you're
you're going to have addendums where you did you know an adjustment to the
treatment plan in order to help the client start making progress towards
that sometimes you're gonna scrap a goal because something else comes up that's
more important I worked with one client who was just an amazing woman but she
found out when she was in treatment with us that she had breast cancer well you
know getting housing and getting a job those kind of goals kind of went out the
door when that came up and the one of the main focuses of treatment for awhile
became remaining clean and sober managing her anxiety and managing her
feelings and you know recovery from the breast cancer and she went into
significant chemotherapy and we were blessed enough to be able to keep her on
our unit while she was going through chemo because she didn't have any family
but you can see how sometimes you know there's a great treatment plan but then
life happens and you got a drop back in punt
and the treatment plan is going to show and the reassessment is going to show
why you changed gears or changed directions so nobody goes well what in
the world happened there you know I thought she was gonna discharge and then
three months later she's still on the unit what's going on well you know we
can we were able to justify why that was important
it substantiates the need for further assessment and testing if you have a
client who comes in who may have fetal alcohol spectrum issues you know because
we know that alcoholism runs in families it's not uncommon for clients to have a
mother who was an alcoholic now you know I'm not saying that every mother's an
alcoholic and every person who has an addiction has a parent a mother who's an
alcoholic but I'm saying the likelihood is higher if you're working with
somebody with an addiction that their mother and for fetal alcohol spectrum
disorders this has to be the mother because it's taint damage to the fetus
that's done in utero so you know dad doesn't have anything to do with that so
if you think the person has FASD or an F ASD you can refer because you need to
get neurocognitive testing and all kinds of other things done but that will help
them get set up for higher level services and reimbursement on multiple
levels through SSI potentially if they have significant impairment its
documentation supports termination or transfer of services if they've reached
maximal gains at this level of care it's going to show or and kind of along the
same thing if something happens and they can't participate in this level of care
right now they need to be transferred to a crisis stabilization unit
documentation will show why they were discharged from one place and sent to
another it identifies problems with service delivery by providing data to
support corrective actions when I worked at the facility I worked out we had
multiple programs we had case management and outpatient residential and detox and
crisis stabilization and yada yada yada and sometimes there would be too
cooks in the kitchen so referrals wouldn't go off as planned or one person
would think they were running the master treatment plan while another program
would think they were running the master treatment plan and then reimbursement
would get messed up so we were better able to figure out who was the single
point of contact for this client and what the treatment plan was adding two
methods to improve and assure quality of care so if we figure out that yeah this
is working really well but you know we have this great intensive outpatient
program but our aftercare program is really non-existent and it's it's
imperative to have an aftercare program let's look at how we can do this in
order to help people stay clean and sober it provides information that's
used in policy development program planning and research another example
that we used during the time that I was working at the at that clinic we
realized that there was a need for a mother baby unit there wasn't one in our
13 County region so we wrote a grant and we created a unit that reached out to
mothers who were still pregnant ideally didn't have to be but ideally
still pregnant we helped them stay clean and sober until they delivered and then
they stayed with us for another six months so we identified a gap in
services you know because pregnant and postpartum women were really not getting
a lot of services and we met that need and documentation provides data for use
in planning professional development activities it helps you see what might
be a need if you've suddenly got a lot of people coming in who have trauma
issues then staff maybe need to be trained on trauma focused cognitive
behavioral or cognitive processing therapy in order to better serve that
particular population or you may have an influx of clients from a different
culture you know right now in Florida there are a lot of people that have come
into Florida from Puerto Rico after the hurricane so there's a need for services
that are truly sensitive to people from Puerto
Rico so it helps you identify who's coming through our doors what are their
needs and what kind of training would benefit our staff so they can serve them
more effectively and it fosters communication and collaboration between
multidisciplinary team members a lot of times I would never see the doctor or
the psychiatrist when they would come to see the clients that were on residential
but I knew that they were reading my notes and they knew I was reading their
notes because we had to initial so it made sure that all of the people in the
team are at least communicating via the chart if not a team meeting unfortunately when you get into
documentation you also get into big sticky issues with confidentiality and
with substance abuse you need to be really aware of the Code of Federal
Regulations 42 part 2 or CFR 42 part 2 and this handles the confidentiality of
alcohol and drug abuse page patient records 42 CFR part 2 applies to all
records relating to the identity diagnosis prognosis or treatment of any
patient in a substance abuse program in the u.s.
So this is in addition to HIPAA
and hi-tech and all of those substance abuse clients have additional
protections there's a prohibition data that would identify a patient as
suffering from a substance use disorder or as undergoing substance use disorder
treatment you can't identify that information unless you have a specific
release of information so if you're seeing somebody for mental health issues
but they've also got you know a substance use disorder
you can't divulge that that's separate information and their record is extra
protected 42 CFR part 2 allows for disclosure where the state mandates
child abuse and neglect recording sometimes the child abuse and neglect is
directly related to the substance use or you're the only provider and you're in a
substance abuse treatment program and you have to make a mandated report
yeah it's allowed it allows for disclosure when cause of death is being
reported so if you have a client in your program who dies and you have to report
the cause of death you can disclose at that point or if the
client passes away when they're on your on your facility and unfortunately it
happens sometimes then you know obviously people are going to know where
that person died because the everybody's going to come pick them up and do the
investigation and you can disclose when there's an existence of a valid court
order sometimes the courts will say this is
important to know and that's varies by jurisdiction so in order to release
information you have to have a written release and a written consent requires
10 elements and this is so important because so often I see releases of
information that don't contain all ten elements number one do not ever have a
client sign a blank release of information you know saying you know
just in case we need it just sign it so I haven't know that's a big big big big
no-no so anyway the release of information to be valid and if it's not
valid then technically you can't release the information so it has to have all
ten of these elements the names of the program's making the disclosure the name
of the individual or organization that will receive the disclosure the name of
the patient who is the subject of the disclosure you know that's all pretty
standard the specific purpose or need for disclosure that gets a little bit
you know why are you making this disclosure because the client requested
it because of a court order in order to coordinate care what's the need a
description of how much and what kind of information will be disclosed generally
it's not everything you need a special release of information according to
HIPAA in order to release progress notes as opposed to release other information
so you know on ours we have we'll check boxes so you can identify
whether its assessment attendance drug trip drug testing results etc you have
to have a patient's right to revoke the consent in writing and the exceptions so
there has to be a paragraph somewhere that lets the patient know that they
have the right to revoke consent in writing you know at any time unless and
there are a few exceptions but there they're few and far between and your
legal department will handle that some agencies say clients can revoke consent
verbally however the requirement is only that it
has to be done in writing so if a client wants to revoke consent they need to
write it down and give it to you showing that they want the consent revoked and
then you know if they're there you cross through the the consent form you write
void you date it you put your initials on it and they put their initials on it
that's the ideal situation they can mail in a letter revoking consent as well you
have to have the date or condition when the consent expires if not previously
revoked now my program we always did a standard one year or 90 days depending
on the program unless the client revoked consent however your program may be
different or the client may choose the wind' the timeframe the signature of the
patient and/or other authorized persons so if the patient is a minor or is not
able to sign for themselves and they have an authorized representative
you know you need those signatures your signature and the date on which the
consent is signed so generally you have a witness there and you have the date
that the witness and the person signed it so it has to have all ten of these
things when used in the criminal justice setting expiration of the consent may be
conditioned upon the completion or termination from a program so when Jim
Bob gets released from jail this consent expires is can happen
information can be shared within an agency on a need-to-know basis only with
people on the treatment team only so it need to know you know if you're not on
the treatment team then you don't need to know so we used to have this big
medical records room and you would walk into it and there were literally
thousands of files could I have pulled a file off the off-the-rack and looked at
it and read it yeah I could have but that's not okay that is a violation of
HIPAA as well as a bunch of others because I have no need to know about any
random patient that is being seen so it's important to make sure that you've
got good control over who can access records information sharing can be done
with the release it can be done to the client you don't have to have a release
to give the information to the client or under specific circumstances and that
goes into confidentiality we'll talk about a little bit later agencies
generally have policies for who is allowed to release information so the
lady at the front desk probably can't release information it probably has to
come from the therapist or from the risk manager clients have the right to review
and amend their records if they request to view or amend the record is denied
then we must provide a written explanation to the client so you know
generally write your notes and write your everything assuming the client is
going to read it use objective information don't be you know derogatory
in any sort of way explain your findings and you know keep the client involved if
they request to amend the record and and the agency denies it for some reason it
says no you can't see your record or no you can't amend it there has to be a
really really good reason we had some circumstances where the client wanted to
amend the record and our executives decided that the amendment they were
going to make was not didn't seem to really have a good grounding in reality
the client was allowed to submit their amend
in their handwriting and it was added to the case file and noted that this was a
client amendment to the case file so your agency may handle it multiple ways
but unless you provide them really good reason they have the right to review and
amend the record now that doesn't mean take out something that you put in there
because once something's in the record it's in the record henceforth and
forevermore but they can add an addendum and so can you all right HIPAA and
hi-tech these protect insurance coverage of workers when they're when they change
or lose their job this is the idea what it was supposed to be for its safeguards
the privacy of their information so if you're changing jobs or whatever you
know nobody can really access your information to find out anything about
you before they hire you etc it combats waste in healthcare delivery because it
insures or hope hopefully ensures that we're communicating and the portability
part of HIPAA means clients can take their record from one place to the other
so you don't have to duplicate the intake and all a bunch of the other
stuff necessarily and it simplifies administration of health insurance
those were the that was the hope of HIPAA it kind of ballooned out of that
so what do we need to know about HIPAA medical records are legal documents all
states have policies regarding record retention medical records of adults are
retained for seven years medical records of minors may be retained for longer so
you need to know what your state requirements are agencies and solo
practitioners should have policies identifying retention and storage
policies so how long do you store it how do you store it how do you keep it safe
who has access to it yada yada yada back to CFR 42 all
records must remove patient identifying information and sanitize software
printer ribbons FAQs hard drives and printer hard drives when you're talking
about disposing of files you need to dispose
of them in a way that removes patient identifying information and if you use
hard copy still if you have software and this includes the hard drive in your
copier a lot of people forget that one that has to be wiped and printer ribbons
have to be destroyed fax hard drives have to be destroyed and
printer hard drives have to be wiped and I guess wiping is really what we're
calling it you don't have to actually physically destroy it but it has to be
completely wiped don't just delete the file if you delete the file it goes in
bits and pieces into your computer's never-never-land so to speak but people
can put those pieces back together that's actually what my husband does for
his you know career is find those pieces that have had been lost or somebody
tried to delete something and he gets it back all client records and identifying
information must be kept out of sight of unauthorized personnel well we know that
so we keep our records behind to close to closed and locked doors okay that's
great we have passwords in order to get into
computer systems that's great but there are other things like lists and rosters
you know sign-in sheets technically are supposed to be kept out of sight and
people aren't supposed to be identifying information attendance records you don't
want have want to have clients coming up and signing their own attendance record
where they can see who and their groups been there for the past five days and
who hasn't appointment schedules you don't want to be a client a client to be
able to see what your schedule is for the week and who's coming in to see you
computerized information must be on an encrypted hard drive full encryption of
the whole hard drive not just that one folder client records need to be kept
you know secure and phone messages you don't want to have the secretary
sitting there with 17 phone messages across her desk while other people are
coming in and checking in and then looking and going oh I didn't know Bob
Jones was the client here so you need to make sure that phone messages are kept
you know if they have the little message sheets keep them in a like a cigar box
or a pencil box and then disseminate them to the therapists as appropriate
therapists do the same thing don't have receipt books or phone messages just out
where any client can see them if you discontinue your program you decide to
close your practice or your practice gets bought by somebody else it must you
must remove patient identifying information from your records or destroy
your records including sanitizing any associated hard copies or electronic
media to render the patient identifying information non retrievable in a manner
consistent with the policies and procedures established under CFR 42 part
2 unless the patient gives written consent to transfer the records to the
acquiring program so if somebody buys your program your your practice you have
to keep those files for that 7 year period or whatever but and you're not
going to transfer those unless you have written release from the client or if
there's a legal requirement that records be kept for a period specified by law
which doesn't expire until after the discontinuation or acquisition of the
program so again if you haven't met your 7-year requirement that's generally a
legal requirement you still have to hold on to those records but you're not going
to pass them on and definitely not pass them on with
patient identifying information to the new program unless you have a written
release records which are paper must be sealed in envelopes or other containers
and labeled as follows records of insert name of program required to be
maintained under insert the statute or regulation until a date no later than
insert the appropriate date so basically it says I have to hold on
everything in this box or in this envelope that is sealed until XYZ date
and time at which time it will be destroyed all hardcopy media from which
the paper records were produced also need to be sanitized in order to render
the data non retrievable records which are electronic must be transferred to a
portable electronic device with implemented encryption so a hard drive
that has that is encrypted so there's a low probability of assigning meaning
without the use of confidential processes or key so you know what's on
that hard drive it's encrypted so nobody else can access it even if you know they
were to put it into a computer but you still have the client information there
the electronic records must be transferred along with a backup copy to
separate electronic media so that both records and the backup have implemented
encryption so you don't want to just have one hard drive because hard drives
can fail you need to have backups in order to say you're securely sir
securely saving the data within one year of the discontinuation or acquisition of
the program all electronic media on which the patient records or patient
identifying information resided prior to being transferred must be sanitized so
again you want to check with your legal department to see where the seven year
rule falls but if it's outside of that seven year rule then definitely within a
year after that the information needs to be destroyed portable electronic vise
device or the original backup electronic media must be sealed in a container
along with any equipment needed to read or access the information this is
important because technology moves quickly and you know back when I started
working on computers we had those you know five and a quarter floppy disks you
can't find a computer now that can read those most computers don't even have CD
drives in them anymore everything has to be on a thumb drive so you need to make
sure that not only is the information there
but it will be readable in the future and then there's a special thing records
of this program required to be maintained under this legal authority
until a date not later than duh so you want to label everything so you know
what it is when it's to be destroyed okay so many agencies govern the content
scope and quality of documentation the single state authority or SSA in your
state has state service and licensing rules so it's important to communicate
with your SSA and that's generally also the agency that does your licensing so
when you get licensed as an independent provider you'll know what the
regulations are the SSA may set forth time frames for documentation completion
and who needs to sign and credential the documents so if you're a registered
intern or you're not certified yet who has to co-sign on your documentation
accreditation bodies also put their two cents in about documentation and they
addressed quality from an organizational leadership and client care perspective
so generally accreditation bodies are looking at quality of care and quality
of documentation so good quality documentation will hopefully show good
quality care many agencies govern the content scope and quality of
documentation including third-party payers who set the guidelines through
their level of care guidelines and other provider agencies so if you are when I
worked with the Department of Corrections for example they had certain
very specific requirements for the documentation of my clients so what
types of documentation are there there's lots screening is the first type of
documentation and good screening identifies the referral source the
presenting problems background biopsychosocial information and this
isn't going to be an in-depth everything but it's going to get a general idea
about what's going on so we can rule out or rule in physical issues social
relationship interpersonal issues as well as psychological issues is going to
note the person's emotional and mental status at that time it will note their
strengths and preferences for treatment for recovery for interventions and it
will make a recommendation for assessment or other referral as needed
so sometimes screenings just happen like it workplace affairs the screening
happens and it's like yep you seem to be fine
no further action needed by the bank and that chart is closed for others you may
determine that the person may need a physical to rule out you know things
like hyperthyroid that may be causing symptoms that look like hypomanic
symptoms or look like stimulant intoxication you may need to refer to
detox you may there are a lot of referrals that may need to be made but a
screening is not a diagnostic interview it's when you identify whether there's a
likelihood that the person may have a problem that needs further assessment
intervention documentation so intervention is like your entry level
services intervention documentation includes client identifying information
the source of the referral client placement information you know why were
they put into your program when were they put in how long are they going to
be there the screening information that got them to that point informed consent
for services including any drug testing that may be required and drug testing
has its own form that needs to be signed dated credentialed by the client and
counselor and witnessed and if you've done drug tests you know all this but
it's important to get that informed consent for intervention services
there's a release of information that has all the ten necessary components as
needed so if you need to talk to a referral source get a release of
information signed the intervention plan which is a lot broader or whatever you
want to say than a treatment plan is signed dated and credentialed by the
client and counselor and witness so you know
you know this with your documentation you've probably done this already you
know with intakes and everything else the client signs it you sign it you both
date it and you have to make sure your credentials are on it if you're not
already certified or licensed then you have to have somebody who is certified
or licensed cosign on it most of the time intervention documentation also
includes copies of correspondence or reports with referral sources and a
transfer or discharge summary at the end of the intervention service
administrative documentation in general this is going to be the stuff that's
used for billing it's not the clinical it needs to be accurate concise include
recommendations referrals case consultations legal reports family
sessions and discharge summaries what you're like well that's kind of clinical
isn't it a little bit but in order to get reimbursed the administrative side
of things we have to have good documentation in all of those areas
administrative documentation is conducted at admission and specified
intervals throughout care so your administrative documentation is going to
be a reassessment it's going to be your treatment plan updates it's going to be
all of those things so types of administrative documentation your client
identifying and demographic information referral source name and address
financial information assigned client rights document assigned informed
consent for treatment document any releases of information that you need
assigned orientation to the program indicating that the client did receive
orientation outcome measures that help identify whether your program is being
successful and when you know when JimBob meets these criteria he or she is going
to be ready for discharge and client placement information that goes back to
your a sam or your locus medical documentation which is often in another
section of the file includes the medical history the nursing assessment the
physical exam the lab tests which almost always have to include
a TB and pre-admission physical records of medical prescriptions and changes in
medications that occurred you know what prescriptions were the person on when
they got there and what what did they take while they were in your program
even if you're not residential you need to know what meds they're on and any
changes that their doc may make or your doc and what are they discharged with
your medication administration records so if you're in residential then the
client is probably going to or may receive medication while he or she is
there so the medication administration records need to become part of the chart
to show you know when Jim Bob took his medication who administered it and
yadda-yadda and nursing notes so any notes that your staff nurse makes
regarding the client's progress now clinical documentation is the stuff that
we enjoy doing screening assessment treatment planning progress notes and
your discharge summary so we're going to get into those in the
in a few minutes I do want to mention electronic health records really quickly
because you know you have all this administrative medical and clinical
documentation a lot of times now it's going into an electronic health record
health information technology is the secure management of health information
on computerized systems it helps track data over time track progress of those
who leave treatment and monitor quality care within practice just like
documentation does but when it's on a computer it's a whole lot easier to run
a program and get pretty little charts spit out behavioral health lags in
adoption of these electronic health records because of cost technical
limitations you know there's a lot of different players who want different
things so creating a standardized electronic health record for behavioral
health has been really difficult lack of standardization of data elements lack of
interoperability of systems between you know doctors and therapists and whatever
you know you have to have if your doctor has a system made by X Y Z and you have
a system made by Acme they still have to be able to talk it's kind of like
getting an apple or a Mac computer and a Windows computer to talk doesn't always
happen so we need to make sure that the different electronic health records out
there can communicate with one another attitudinal constraints we don't like
change an organizational lack of expertise in health information
technology management most programs don't have a technology director
especially smaller programs so integrating this is really overwhelming
and it can be really costly if everybody has to have a computer in order to put
in there their client information general elements of clinical
documentation whether it's administrative clinical or medical must
be clear concise accurate written in ink time stamped or dated so you have to
have all that information in there if you write
I've had some staff members their handwriting was atrocious you could not
read their notes or their assessments to save their life that is not good
clinical documentation because it doesn't help anybody documentation is an
ongoing responsibility for all professionals and should be completed as
soon as possible after the contact don't wait until Friday to do all your notes
for the week ethically you need to do it as soon as possible and I'll give you a
little hint when I do groups oftentimes I will have a sheet that I pass out at
the end of group has the client identify three things they got out of group and
then you know a couple other questions about you know how they're feeling if
they feel like they need a treatment plan reassessment and just a few other
things to give me information then I have something in the clients
handwriting to put in the chart but I also have the brunt of the progress note
kind of done already and if you use soap notes or DAP notes you can kind of put
that on there and have the client fill out what they think they would put for
their notes that's helpful in group for individual individual sessions are
generally supposed to be 45 to 50 minutes so I end right about 45 minutes
maybe a little longer tend to run late and the client and I create the progress
note together that way they review what we talked about they review the progress
they've made they review what they're supposed to be doing in the upcoming
week and they know what's going in the chart so it's not mystical and magical
you know they are an active participant and I have the note done before the end
of the hour so it's kind of a win-win-win all around
okay documentation of sure's accountability the responsibility for
accurately representing the client situation rests with the counselor and
the clinical record not the client so like I'm saying we can get all of this
input from the client but making sure that it's accurate when we put it in
there and you know pulling it all together is incumbent upon us
good clinical documentation spares the client from repeating painful details so
we're not going to have them you know if you're talking with a client about a
trauma situation you're gonna put enough in your clinical record that you don't
have to have them remind you you know remind me again about what happened when
your house burned down or what no that's rude um so you want to have enough
documentation that gives you an overview or the next counselor sort of an
overview of what happened and then if they need to delve into details later
they can language language must be objective but descriptive so if you're
saying that the client is decompensating well that doesn't tell me anything
in what way as evidenced by you know the client is I diagnosed with the client
with depression because they have these symptoms as evidenced by that is your
best friend phrase as evidenced by documentation must identify persons
places direct quotations and sources of information so if the client says you
know I'm really feeling off my game you can put that in there so we know kind of
where the clients coming from we want to use direct quotes from collateral
sources that we get and identify who gave us this information clinical
documentation is a legal record and the clinicians signature and credentialing
indicates the truthfulness of it so if you sign it then it happened the
treatment plan good treatment plans are hard to come by they're really easy to
write if you don't overthink it but I find that most people overthink it so
there's a hole that's actually a couple of classes on treatment planning because
it is so important not only to guide treatment but to help clients learn how
to set goals and achieve them treatment plans are a contract between the client
counselor and treatment team each being responsible for its development and
implementation the clinician needs to recognize that treatment occurs in
different settings over time so you know treatment may be happening but you know
counseling is only part of what going on there also in maybe case
management or vocational rehabilitation or you know so treatment occurs medical
in different settings and we need to be able to integrate all that into the
treatment plan much of the recovery process occurs outside of or immediately
following formal treatment when people do their homework assignments and they
have their aha moments when they generalize their progress when they
create that support system on the outside treatment is often divided into
phases engagement stabilization primary treatment and
continuing care treatment planning plots out a roadmap for the treatment process
treatment plans are completed once a diagnosis is made a level of care is
determined and the client is admitted to the program now after the initial
assessment there's usually an initial treatment plan done but the real
treatment plan generally needs to be completed within three to five days
after admission once the clinician has finished the assessment paperwork and
everything level of care is determined based on diagnosis and the clients
strengths and assets so if you're familiar with the a Sam for example
recovery environment is one of those dimensions that we look at and if
they've got a really strong recovery environment then the option may be or
decision may be made to refer the person to eiope instead of residential whereas
if they have a really poor recovery environment then we may opt to refer the
person to residential so they have a better chance in the first 30 to 60 days
of you know getting a handle on things treatment plans address all
biopsychosocial needs not just mental health they establish what changes are
expected through achievable goals clarifies what interventions and
counseling methods will be used to help the patient achieve those goals sets the
measures that will be used to gauge success and that's where we go with as
evidenced by again so if the client says you know instead of saying I'm going to
quit using drugs they may say I'm going to develop a healthier life
so how do we know when the client has developed what he or she defines as a
healthier lifestyle well as evidenced by I'm going to develop a healthier
lifestyle as evidenced by getting eight to nine hours of sleep a night eating a
relatively nutritious diet as decided upon but between myself and the
dietitian developing healthy support systems yada yada
you see what I'm getting at so you're going to be able to go through and
anybody would be able to go through and Mark off and say either yes or no
achieved it achieved it achieved it achieve the goal so it's kind of a yes
or no thing treatment planning incorporates the clients strengths needs
abilities and preferences and I'm big on this you all probably know that if you
took our addiction counselor certification training course
temperament is huge extroverts and introverts have different needs judgers
and perceivers have different needs auditory and visual learners have
different needs and people in general based on their culture and just their
cognitive aptitudes are going to have different strengths and needs so we want
to form the treatment plan around the clients strengths and build off what's
already there what already works referrals are made to other agencies as
needed when referrals are made collaboration is essential to keep
clients from falling through the cracks so treatment planning is going to
identify you know client will get enrolled for Medicaid well you're
probably not going to do that so you're going to identify who the client is
going to see at whatever office they've got to go to in order to get enrolled in
Medicaid but that's going to be part of the treatment plan treatment planning
information even within the agency is restricted to need-to-know and treatment
plans may have to be co-signed by a clinician who is already certified or
licensed the function of the treatment plan well treatment planning is an
action-oriented process that lays out logical goal directed strategies for
making positive changes just like if you're going to make
lasagna from scratch and you're gonna follow a recipe same sort of thing here
and based on your preferences you know when I make my marinara sauce I use roma
tomatoes that is my preference I know other people who use different kinds of
tomatoes so different preferences I know that I want to do it in a shorter period
of time so I'm not going to make the the noodles from scratch that's a need that
I have because I don't have the time to make noodles from scratch so my recipe
is going to be slightly different than my stepfather's recipe but that's okay
and treatment planning is the same way just think of it very very
simplistically like a recipe don't get too overwhelmed and tried trying to make
it too complex because clients aren't going to be able to make complex
treatment plans and treatment planning establishes a collaboration between you
and the client so you can mutually prioritize agreeable goals you figure
out what do you want I've worked with clients who were involuntary and you
know they didn't really want to quit using however they were on probation and
they wanted to get off probation well I wanted them to get off probation but I
wanted him to quit using in order to get off probation they had to be clean
during the time they were in treatment so that became our goal because that was
mutually agreeable you know it's like well your goal is to get off probation
in order to do that you got to stay clean so let's work together to make
that happen during the next 16 weeks and generally it worked that way achievable
goals are selected by assessing and prioritizing client needs and taking
into account their level of impairment if you've got a client who is
significantly impaired they've got major clinical depression they're detoxing
from five years of stimulant abuse they're not going to be going out and
getting a job next week that's you know well down the road so the goals we're
looking at now are more like stabilization and engagement you want to
take into account motivation what does the client want to achieve because
they're not going to be real motivated to achieve what you want
to achieve unless they want to get out they want to get discharged from the
program successfully and in order to do that they've got to meet your goals but
ideally help them identify goals that are meaningful to them and you're going
to look at the real world influences on needs so if they're going to be
discharged in 30 days even though they may not be quite ready to start looking
for housing if they need to have housing when they get out in 30 days then that's
probably going to be a high priority treatment plan goal because you don't
want them being discharged to the street treatment plants consider client needs
readiness preferences and prior treatment history looking at what did
and didn't work because there's no sense repeating something that you've done
four times that hasn't worked yet we're going to look at their personal goals
and then we'll look at obstacles like transportation and childcare and those
sorts of things that might preclude someone from going into residential or
make it difficult for them to get the evening IOP for example treatment plans
have SMART goals specific measurable achievable realistic and time limited
these goals are broken down into smaller objectives so you know think about it
like you want to climb a staircase well that's great that's your goal you want
to climb a staircase in the next 45 days wonderful you're gonna be taking a
little while at each step but each step is an objective so your end goal is the
top of the staircase what is the first thing you need to do to start moving
towards the top of that staircase what's your first step all right once you get
that done what's the next thing you got to do again think of the recipe first
thing you've got to do is find the recipe then you've got to figure out
what you've got on hand then you've got to figure out you know what you need
from the store then you've got to go shopping you know one step at a time
don't make it too complex treatment plans anticipate the type duration and
frequency of services so you know a lot of times we may say if they're in IOP
there's going to be three hours a day five days
week for the first month and then once they accomplish certain goals then they
can step down to three hours a day three days a week
etc treatment plans identify who's responsible for what so if the client
has to go do something it's going to be clearly indicated that the client needs
to make the appointment with social services to get enrolled in programming
versus the counselor will make the appointment for the client to go to
Social Services you know whoever supposed to do it it needs to be noted
and there has to be a timetable you know this needs to be accomplished by X date
if it doesn't get accomplished by X date it's not the end of the world however
you need to do a reassessment and go okay why didn't this happen
what do we need to adjust it incorporates client input and
participation in development it helps the client prioritize presenting issues
so I mean they come in and generally there's a whole litany of stuff that
they need to work on and it can feel really overwhelming
but I liken it to a woven blanket for clients that woven blanket is over your
head right now you can't breathe you can't see it's miserable it's hot any
string you pull on is gonna start making air holes in that blanket and making it
lighter and eventually you will unravel the whole blanket so let's figure out
you know of the issues that you've got going on right now which are most you
think are most important to work on and which are you most motivated to work on
what string are you willing to pull first you get input from client on their
goals and objectives so what is there as evidenced by look like you know if I am
happier as opposed to being depressed what is that going to look like if I am
healthier as opposed to unhealthy what is that going to look like how am I
going to know when I'm living a healthier lifestyle and both the
counselor and client sign the plan the clinician may also facilitate and manage
referrals because oftentimes we don't have case management that we can rely on
at minimum the plan is a flexible document that uses a stage match process
to address identified substance use disorders
so stage match process if you think back to the stages of readiness for change
pre contemplation contemplation preparation action and maintenance each
stage requires different interventions so that's tip 35 from Samsa if you need
to refresh it looks at the recovery support environment
it addresses potential potential mental health conditions you know based on
readiness for change for that issue you know somebody may be in the action stage
of readiness for change on their substance use but not you know ready to
do a lot about their anxiety it's usually the opposite but whatever so you
need to make sure that you stage match by issue because the person is not just
going to be globally in the action stage of change there are going to be some
things that they're not really that ready to work on yet you want to
identify potential medical issues employment education spiritual issues
social needs and legal needs and there are other things like childcare and
other wraparound services that can go into this too but these are the big ones
initial treatment plans are done an admission or within 24 hours based on
information from the assessment and screening and serves as the initial
roadmap they include presenting problems preliminary goals type frequency and
duration of service and the signature and date of the client and counselor
with counselor credentials so again this is the initial treatment plan as you get
into treatment and start to know the client a little bit better you're going
to formulate a more in-depth treatment plan this one has to be done either at
admission or within 24 hours an individualized treatment plan has the
problem and a problem description that answers the question why are you here
that's the problem not the goal I'm here because I have a substance use disorder
what's my goal to not have a substance use disorder it identifies the clients
strengths you know we are going to build on strengths so client will build on his
to stay clean and sober yada yada it has concrete measurable goals concrete means
you can observe them you can see them you can either say yes it was done or no
it wasn't not yeah it was probably accomplished it's yes or not the
objectives are there so that big goal is broken down into those smaller steps
it has strategies for achieving those smaller steps so you know if the first
step is to start building a recovery support network well that's wonderful
how are you going to do that strategies answer how you start going to a a
meetings you know start going back to church call up your five closest friends
that are healthy supports whatever the treatment plan includes the diagnosis
usually that's up at the top the signature of the client and counselor
and the signature of the clinical supervisor if required ongoing
assessment and collaboration is used to regularly regularly review the treatment
plan and make necessary modifications many IOP and residential programs have
to review the treatment plan once a week with the client and get the client to
sign off sometimes you get a 30-day reprieve but you need to know what your
payers and your state requires review should be completed at minimum at major
or key points in the client's treatment course including admission obviously
you're going to develop it readmission you know maybe they discharged and they
were out for three months and then they relapsed and they're back well you may
be able to look at their treatment plan and see where they're supposed to be
because they were in an IO P program and work with that but you're gonna need to
reassess it at readmission at transfer at discharge if there's a major change
in their condition such as you know they'd have a manic episode or they're
admitted to the crisis stabilization unit for suicidal ideation you're gonna
do a reassessment and after 12 months regardless of what's going on after 12
months progress notes document the clients progress in relationship
treatment plan goals and objectives each progress note should have the problem
name and number because most clients will have like three treatment plan
problems and then multiple like say eight objectives underneath it so maybe
substance abuse recovery is the first treatment plan problem okay so that's
problem number one and goal number a if you will the first goal is to start
developing a recovery support system so in the treatment plan if I talk with the
client about developing that recovery support system then I'm going to
identify that we talked about problem 1a and what we what we addressed the
progress note identifies what the client says and does generally I mean you're
not going to do it verbatim it puts in counselor observations and assessments
if the client seems to be doing really well as evidenced by and the clients
observations and assessments I always put those in there too how do they think
they're doing and what's their evidence as evidenced by and continued plans to
address the presenting problem you also may need to document any new information
if they get into a new relationship get a new job breakup
whatever that will go in the progress notes the format for most people is the
soap format the first part is the specific objective information and the
last part is the assessment the interpretations and the plan for how to
proceed you want to document the clients progress progress notes are based on
what the client says and it does what the clinician observes the clients
attitude demeanor nonverbals you know how compliant they are with treatment
the counselors knowledge and experience so counselors are going to be able to
differentiate between a lapse and a relapse for example they're going to be
able to differentially diagnose if the client starts presenting with some
symptoms of depression for example the clinician is going to rule out
the use of depressant substances they're going to rule out detoxification from
stimulants they're going to rule out hopefully medical conditions and they
may rule in mood disorders or something so differential diagnosis is important
to look at the physical and other potential causes for symptoms and danger
to self or others I encourage my staff at every single treatment meeting to
identify whether the client had any suicidal or homicidal ideation espoused
I mean if they said I'm suicidal or I wish I could end it all that needs to be
documented and to identify if the client had future plans was oriented to place
and time you know just a general Mini Mental Status exam at every contact is
really good to protect you and even in group I mean you're looking at people
and are they bright and are they oriented and are they talking about
future things or they withdrawn and sad and tearful and talk about how you know
there doesn't seem any point in being there well you know if you hear that you
probably need to pull them aside and talk to them more in depth so you know
get a some documentation that you had good contact with the client and you
have a good kind of idea about the pulse of things progress notes are not a
verbatim transcript but a cohesive summary so one page you know don't write
a dissertation the discharge summary discharge planning begins at admission
discharge planning begins at admission okay I know I said it twice because it's
that important you see client Jim Bob and you know your things are going well
but then client Jim Bob goes out and relapses and never comes back
well he's discharged at that point you don't know when the client is going to
discharge necessarily so if you begin discharge planning at admission which
actually is required by most insurance companies then you have a plan and you
and Jim Bob have made a plan for this is how you're going to progress
these are the options and resources available to you so Jim Bob has
something to work off of in case he never returns you want to
summarize in your discharge summary the service is delivered you know the
discharge summary is done when Jim Bob is actually discharging discharge
planning begins at admission so the discharge summary summarizes any
services you did deliver how well the client accomplished goals and objectives
and any discharge recommendations including referrals continuing care etc
the elements of the discharge plan include the referral source you know
because this is going to go back to the referral source saying Jim Bob
discharged this is the summary of what happened presenting problems and the
reason for services treatment goals methods and outcomes outcomes generally
pertain to the person's ability to attain recovery build resistance and
work learn live and fully participate in the community of choice so discharge
summary is basically a big summary of the entire treatment episode it's going
to indicate the condition of the client at discharge your prognosis and you know
that's a little subjective but we got to make it follow up recommendations
including continuing care and the aftercare plan and the counselors
signature date and credentials you want to include the reasons for discharge on
the discharge summary but reasons for discharge can be varied treatment
completion that's the idea they may lead leave AMA or against medical advice
that's not so ideal but it happens treatment non-compliance they're just
not getting with the program or they're showing up and they're under the
influence or you know a variety of reasons that it's therapeutically
indicated to discharge them or treatment was just incomplete you know again they
left before treatment finished they just it wasn't some what treatment incomplete
is a lot like AMA but those are the four main reasons for discharge identified
for the review exam organization of documentation is gonna
vary a little bit between each agency but each page has to have the clients
name and some sort of identifying number all entries must be signed if you make
an error in documentation you line through it once you don't scratch it out
you line through it once initial it date it and write error above it notes of any
sort should never be removed from a file if you have late entries or Corrections
they're put in as a separate document and noted as an addendum to you know
progress note from to one of 18 or whatever so clinical document character
at documentation characteristics need to be written knowing that others will read
it it needs to be objective you know stay away from vague terms like client
is doing well if you use a vague term then explain it as evidenced by uses
descriptive behavioral terms client is oriented to person place and time not
client seems to be with it today you know you want to use descriptive
behavioral kind of clinical terms it avoids jargon so you don't want to
overuse clinical clinical terms and it keep it simple again remember the client
may read this it's concise and it's positive you know these are the steps
the client is making this is the progress the client is making yes the
client has had a setback but hey he returned for treatment and you know
we're picking up and figuring out what we did wrong you don't want to be
doomsaying and talking about how the client is non-compliant and resistant
and just doesn't seem to want to be here and you want to keep it as positive as
possible focusing on the strengths and the progress and making lemonade
whenever you your client gives you lemons all right well that was a lot
that we covered and I know documentation is not the most interesting thing but
that kind of hits the highlights of what you need to know for
your addiction counselor certification exam if you need more training we have
lots of training at all CEUs calm and we have a full addiction counselor
certification track that is a little over 400 hours and of multimedia
information and that's for one hundred and forty nine dollars alright thanks
for participating today or listening today and I will talk to you again soon