Narrator, Hey Psych2Goers, welcome back to another video Healing is not easy. There’s a lot of stigma regarding going to therapy and doing any independent inner self-work. It’s still seen as something that either weak or crazy people do, and that’s – just not true, It might not be 100 easy, but healing is a journey that leads to deep fulfillment that nothing outside of you could shake or take away. This process is very humbling, but with high risk comes high reward. During this journey, you will start to feel the growing pains of change and self-integration Keep moving forward. This discomfort is helping you move into a beautiful life in which you have a deeper sense of inner peace. Here are nine uncomfortable signs that you are healing Number one. You allow yourself to feel your emotions When you’re still stuck in survival mode. You are mostly focused on logic and what you see because emotions are painful for you to feel and process It’s hard for you to take the time and make room for your emotions to just be acknowledged and validated because it reminds you of the hurt that You would’ve liked to keep buried When you heal. You start acknowledging your negative and positive emotions because you realize that extreme focus on one is detrimental to your whole being and that you are a whole person. It’s uncomfortable at first, but as you are no longer suppressing or denying them, you see the value of your emotions and feelings and of just letting yourself sit with them and allowing them to pass Number Two. You’re getting better at expressing and maintaining boundaries When you’re not healed or in the process, you struggle with stating and enforcing boundaries because you’re afraid of rejection, feelings of shame and guilt from putting your interest first or saying what’s on your mind, It’s unusual to set firm boundaries when you’re not used to it, but once you start, it creates more healthy interpersonal dynamics, because you stated your opinions and emotions. You have the mental and emotional clarity and you are more capable of making your decisions Number three. You accept that you’ve, been through difficult experiences. Life is hard and unfair, and instead of suppressing all of the experiences that you have been through, you acknowledge and accept that they happened. You accept that these people’s place and things had a life-changing impact on you and probably still do Once. You have accepted that these uncomfortable events impacted you in their entirety. They start to hurt you less because you’ve accepted the truth and are in charge of the narrative of your life again Number four, you’re, less reactive and more responsive. When you’re in survival mode, Everything and everyone is a threat and is treated as such. Nothing is trusted and you, don’t have time to sit and logically think things through, because you are pure action needing to defend yourself constantly. Once you start healing your natural response of lashing out shutting down, running away, or people-pleasing is tested and slowly makes way for questioning your feelings and reactions. Regarding things, You even find yourself asking. Why do I think this way? Where does this thinking come from? You start practicing emotional self-regulation, self-analysis, and responsibility. Number five you realize that healing is not linear Healing is uncomfortable because you are unearthing and confronting things you would’ve preferred to keep suppressed. Once you get into the rhythm, you realize that part of that healing is that this distress is okay and normal, because it’s not a straight road to inner peace and healing You understand and has experienced the highs and lows of healing and know that the feeling of today will not match the feelings of tomorrow or even later, on Number six. You begin to step out of your comfort zone Here,’s the thing about healing It:’s, not something everyone will do. However, if you decide to it has far-reaching benefits beyond the acceptance and acknowledgment of the traumatic experience Once you are in the healing process, you are developing bravery around your emotions and your mind With this newfound conscious control. You are no longer scared by things that scared you before Scared of making a living situation change. You now are redecorating your bedroom and experimenting with paint colors. You never thought you would Go to a party you don’t know Before you would’ve recoiled at the thought, but now it’s a little less anxiety-inducing and you have a bit more confidence Number seven. You easily accept disappointments and take them in stride. Life is a balance of success and failure, light and dark ups and downs. When you’re not healing disappointments hit, you like a freight truck to the chest, knocking all of the motivation and passion out of you With healing you understand that bad days do happen and can’t be avoided, but are also temporary Any disappointments or unmet Expectations are accepted and taken in stride. You respond in better healthier ways that are less reactive Number. Eight you have more inner peace Healing brings about self-integration. If you’re a Harry Potter, fan it’s as if Voldemort brought back all of his Horcruxes and decided on becoming a better complete person who accepts the natural way of life on a soul level. And if you’re, not a fan. It’s like taking inventory of all of your experiences painful or not, and seeing yourself as the whole person You develop this inner peace because you deeply forgive yourself and you can readily forgive others too. By having this peace and integration, you are less likely to self-sabotage because you’re no longer a warring country within yourself with conflicting desires and emotions. You reconcile your inner differences. You no longer criticize and dismantle your character in your mind And number nine. You welcome help and support The independent survivor. Has a don’t ask for help mentality, maybe because they never got it when they needed it or because of the harsh rejection when they spoke up, They shut down to get by and decided to do it by themselves because they had no choice With healing You start to realize that as strong as you are, you can’t carry and do everything by yourself. You do need help and we all do and it’s available out there for you. You are more open to support and less afraid of having this need for assistance met. The pride and shame you might feel for asking for help are gone, because you know that it’s, okay, to let go of the heavy burden on your shoulders and have someone to lean on. Did you relate to any of these points? Do you feel that you are beginning to heal As rewarding as the first step of healing? You will run into the discomfort of your healing and this will try to make you stop to lessen or ignore the pain, but whatever you resist you prolong. If you are in the healing process, well done, I’m proud of you for doing this work and I hope you can find peace through it And if you’re not that’s, okay, because healing is a long process that takes time you’re still living and doing what you can Applaud yourselves. Did you find this video valuable, Tell us in the comments below Please like and share it with friends that might find use in this video too, and make sure to subscribe to Psych2Go and hit the notification bell for more content. All the references used are added in the description box below. Thank you for watching and see you next time…As found on YouTubeSeanCooper🗯 The Shyness & Social Guy ⇝ The 3 WORST Mistakes You Must AVOID If You Want To Overcome Shyness (PLUS: 1 weird trick that targets the root biological cause of shyness so you can stop being nervous, awkward, and quiet around people…) By Sean Cooper, The Shyness & Social Anxiety Guy. The fact that you’re reading this article tells me you may have already reached a point where you feel your shyness is NOT going away on its own… or you fear it’s getting worse and worse. And I don’t want you to waste one more day living a life where you feel left out, bored, or depressed because you don’t have the relationships which would make you happy. That’s why I’ve put together this page to help you avoid the worst mistakes that keep many people stuck with shyness for years… http://flywait.darekw.hop.clickbank.net/ often giving up hope of ever improving as you watch other people have interesting “normal” lives without you. Yet this doesn’t have to happen.
Do you think you might have anxiety or know someone who does if not What’s the first image you have and you imagine someone with diagnosed anxiety? The popular comical image may have popped into your head with the frazzled jittery expression unkempt hair and profuse sweating the truth is some people go on to be successful and accomplish great things despite their battle against this mental illness This is known as high functioning anxiety isn’t a diagnosable condition And so it can be difficult to identify because those who have it don’t appear anxious However, the calm appearance doesn’t make it any less real serious or painful for those who have it Wondering now if you might fit in with this category Here are 12 things. You may not realize you’re doing this because of your high functioning anxiety 1 you turn down things you want to go to You eagerly await events and get-togethers with friends, but when the day finally comes you often decide not to go at the very last minute sound familiar Even though you were looking forward to it for so long You’ve talked yourself out of attending because the thought of going out leaves you wracked with worry and dread – you dislike having to meet new people When someone says to you, there’ll be so many new people you can network with. How do you feel? Mingling and social functions just aren’t your thing not due to shyness or introversion. You just don’t want to meet new people Sticking to your close-knit group of friends is comfortable and happy for you Introducing yourself or being introduced to someone else makes you feel self-conscious and worried about making a good first impression This worry is so intense that it sucks any enjoyment or intrigue out of meeting Someone new 3 you’re uncomfortable with slow responses The moment you send someone a text or leave them a voice message Do you start counting the seconds waiting for a response and the longer you wait? The more you feel anxious you overthink about why they haven’t replied yet and somehow take it to mean that you did something wrong Take a breath they probably like you just fine and their phone might be on mute For you get very little sleep We hear eight hours of sleep is required Can you remember the last time you got eight hours of sleep? We mean all at once not spread out over a few days You may be able to look at anxiety as the reason it may wake you up early and keep you from having a deep and relaxed sleep and also keep you up at night with thoughts racing through your mind Being shortchanged on both ends is why sleep deprivation is such a common complaint amongst those of us who suffer from high functioning anxiety Five you fixate on the tiniest details Is there any little thing you think about what’s keeping you up at night and depriving you of sleep Like how you said you to to the waiter when they told you to enjoy your meal? Or maybe why that person replied to your long text simply, okay? Logically, you realize this isn’t going to hugely impact your life. The waiter won’t remember you and that other person was probably just busy Still you examine it this fixation is a common feature for people with high-functioning Anxiety you tend to obsess over trivial things Especially social interactions you analyze everything and spend hours and hours wondering what it could all mean and why? Six you get hung up on old conversations Speaking of social interactions. Do you find yourself playing back old social scenarios in your head thinking about different actions? You could have taken or Not Taken Things like maybe I shouldn’t have texted him or maybe I should have given that witty reply High-functioning anxiety makes you overthink every single social interaction You’ve ever had big or small and it’s not unusual for people who struggle with it to get hung up on the past regardless of how long ago it was 7 your unforgiving to yourself Do you feel upset at yourself when you make a mistake? Mulling over it and scolding yourself for months even years Well high functioning anxiety can often resemble perfectionism With one of its most problematic characteristics being that it turns us against ourselves whenever we mess up Your anxiety makes that mistake bigger in your point of view than it was in reality. So getting over it feels difficult Eight you constantly compare yourself to others It’s normal to occasionally compare yourself to others but those with high-functioning anxiety. Take it to an extreme Are you overly concerned with how you measure up against your peers? Do you constantly worry that you’re not fulfilling your full potential? No matter how much you accomplish. Do you never feel like it’s enough? If so, you might be struggling with high-functioning anxiety 9 You’re a constant people pleaser Do you work hard to make others feel happy, even if it comes at the cost of your well-being Do you feel like you’ll never be good enough until you attain it? Everyone’s approval If you have high-functioning anxiety you may have convinced yourself that the only way others will ever accept you is if you go above and beyond what everyone expects of You all the time. 10 You need to keep yourself busy all the time Now we’re not talking about creating great Renaissance artworks or intricate business plans We just mean busy not necessarily productive If you’re not busy you feel Restless and tense. So you try to occupy yourself with just about anything during your nails. Yes Alphabetizing your games. Okay, cleaning your perfectly working computer fan with a toothbrush It’s sure the truth is you don’t mind doing anything as long as it helps distract yourself from your thoughts and worries 11 You get very anxious whenever you think about the future What does the future mean to you for many in the future is the light of possibility something to eagerly look forward to? then for some, it can feel like Scrooge and that last spirit of Christmas who looked like the Grim Reaper if You’re not feeling hope but terror and dread for what’s to come This could be a sign of high-functioning anxiety can paralyze you with fear about the unknown and what’s not in your control it can keep you from truly living your life to the fullest because you always expect the worst to happen and 12 you always focus on the worst-case scenario Do you like to prep my prep? We mean do you say to yourself? Okay, so this is the worst possible outcome I’ll be ready for it. If I’m ready for it. I can handle anything else. Do you then continue to expect the worst-case scenario? They might be high-functioning anxiety laying the plans This might lead people to misjudge you as a pessimist because ultimately you may try to share with them your preparations Where you see anticipating and being proactive they see a downer Unfortunately being so prepared often doesn’t allow you to just enjoy the moment Do you relate to any of the things listed here living with high-functioning anxiety is never easy? But most people may not see the emotional toll it can have on a person if you’re starting to feel overwhelmed with your anxiety There are many professional certified resources to reach out to Please like share and subscribe to the site to go for more psychology content.We hope to see you in the next video and as always Thanks so much for watching.As found on YouTubeSeanCooper🗯 The Shyness & Social Guy ⇝ The 3 WORST Mistakes You Must AVOID If You Want To Overcome Shyness (PLUS: 1 weird trick that targets the root biological cause of shyness so you can stop being nervous, awkward, and quiet around people…) By Sean Cooper, The Shyness & Social Anxiety Guy. The fact that you’re reading this article tells me you may have already reached a point where you feel your shyness is NOT going away on its own… or you fear it’s getting worse and worse. And I don’t want you to waste one more day living a life where you feel left out, bored, or depressed because you don’t have the relationships which would make you happy. That’s why I’ve put together this page to help you avoid the worst mistakes that keep many people stuck with shyness for years… http://flywait.darekw.hop.clickbank.net/ often giving up hope of ever improving as you watch other people have interesting “normal” lives without you. Yet this doesn’t have to happen.
[Music] hi everyone we it’s like to go would love to thank you for making us a digital family of more than 2 million it’s with your continued support that we’re able to bring you new content regularly our mission is to help everyone become more self aware of the various psychological factors that affect our lives one such factor that we hear about on a daily basis is anxiety but it’s important to know when it’s anxiety only and wanted to become something more so let’s find out anxiety in general is our normal reaction to stress in fact it can be a good thing anxiety motivates you to accomplish your assignments to study harder for a test and it can warn you when you’re in a dangerous situation it informs you to be extra vigilant about your environment the fight or flee generalized anxiety disorder or GED on the other hand is a full-fledged anxiety disorder that involves intense and excessive anxiety as a key factor along with other debilitating symptoms differentiating between normal anxiety and generalized anxiety disorder or di D can be tricky how do you know especially if you’re a little more anxious than others whether or not your anxiety is significant enough to qualify as a disorder so let’s begin with an introduction to the main concepts revolving around the – one normal anxiety is more of a friend than a foe according to the anxiety and depression Association of America anxiety is a normal and often healthy emotion which is characterized by feelings of tension worried thoughts and physical changes like increased blood pressure when we face potentially harmful or worrying triggers feelings of anxiety are not only normal but necessary for survival since the earliest days the approach of predators an incoming danger set off alarms in the body and allowed evasive action these alarms were in the form of a raised heartbeat sledding and increased sensitivity to surroundings danger causes a rush of adrenaline a hormone in the brain which in turn triggers the anxious reactions in a process called the fight-or-flight response this prepares humans to physically confront or flee any potential threats to sea all these are classic characteristics of normal anxiety such traits came in handy for our predecessors but we don’t have to be in a constant state of fight-or-flight anymore so running from larger animals is a less pressing concern in present times than it would have been for early humans anxieties now revolve around work money family life health and other crucial issues that demand a person’s attention without necessarily requiring the fight-or-flight reaction the nervous feeling before an important life event are during a difficult situation is a natural echo of the original fight-or-flight reaction it can still be essential to survival anxiety about being hit by a car when crossing the street for example means that a person will instinctively look both ways to avoid danger when the duration or severity of an anxious feeling is out of proportion to the original trigger or stressor physical symptoms such as increased blood pressure and nausea may also develop these responses are what moved normal anxiety beyond into gid generalized anxiety disorder GA D is when the trouble starts generalized anxiety disorder involves persistent and excessive worry that interferes with daily activities people with symptoms of GA D tend to always expect disaster and can stop worrying about health money family work or school in people with GID the worry is often unrealistic or out of proportion from the situation daily life becomes a constant state of worry fear and dread eventually the anxiety so dominates the person’s thinking that it interferes with daily functioning including work school social activities and relationships there are several key differences that make them distinguishable here are a few ways you can tell the two apart one presence of a stressor usually a normal anxiety occurs in response to a stressor such as an exam an upcoming interview a fight with a friend or a new job when you struggle with GID you’re anxious most or almost all of the time even when you can’t spot the source of the stress for instance people a generalized anxiety disorder can have a difficult time just getting through the day even seemingly small responsibilities like paying the bills make them feel anxious – intensity and length gid produces intense and excessive emotional responses even if you’re reacting to a stressor your anxiety is disproportionate to that stressor many people are on the edge before an exam but a person with jad might be anxious several weeks beforehand and will experience intense symptoms right before and during the exam also normal anxiety is fleeting while gid is ongoing and the feelings can last weeks or months three physical symptoms of jad excessive anxiety and wary aren’t the only symptoms that accompany GID there are physical symptoms – dizziness lightheadedness sweating trembling heart pounding headaches and nausea you feel like you can’t breathe can’t talk or have to go to the bathroom frequently people at jad also report feeling detachment and disconnected from reality they feel like they can’t think straight and have difficulty concentrating psychological symptoms are also present individuals experience racing or negative thoughts and are unable to concentrate and have worries about day to day things or impairment when you struggle with GID it affects your entire life it impairs or interferes with your schoolwork job and daily life avoidance is a symptom of jad and can be quite debilitating in other words excessive anxiety can cause you to avoid normal activities you might skip class miss a test stop going to work procrastinate grocery shopping or avoid anything that makes you feel anxious and 5 no control most people can reduce and control their anxiety through a variety of coping techniques and the ability to calm oneself however people at GID have significant difficulty finding relaxation calm and time away from their worries if you have more difficulty than other people you know in controlling your anxiety it may be more than normal anxiety did you often find yourself confused about these two conditions do these factors easier to differentiate between the two do let us know in the comments below if you are struggling with overwhelming anxiety and you can relate to some of these factors don’t hesitate to seek help from a mental health professional and subsequent treatment also remember to share this video with someone you think might benefit from these as well don’t forget to click the like button and subscribe for more content as always thanks for watching As found on YouTubeSeanCooper🗯 The Shyness & Social Guy ⇝ The 3 WORST Mistakes You Must AVOID If You Want To Overcome Shyness (PLUS: 1 weird trick that targets the root biological cause of shyness so you can stop being nervous, awkward, and quiet around people…) By Sean Cooper, The Shyness & Social Anxiety Guy. The fact that you’re reading this article tells me you may have already reached a point where you feel your shyness is NOT going away on its own… or you fear it’s getting worse and worse. And I don’t want you to waste one more day living a life where you feel left out, bored, or depressed because you don’t have the relationships which would make you happy. That’s why I’ve put together this page to help you avoid the worst mistakes that keep many people stuck with shyness for years… often giving up hope of ever improving as you watch other people have interesting “normal” lives without you. Yet this doesn’t have to happen.
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 can’t 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 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 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 to think 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 excellent 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
child’s needs what does that communicate to the child 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 if their fault at they 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 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 then 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 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 emotionally unavailable caregivers
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 to 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 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 I can 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 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 because of work because
of the 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 the present day if in early childhood caregivers were consistently 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 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 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 other trauma and introduction of a new less
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 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 with 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 helps
people walk through the logic in some of their cognitions and identify some known as 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 to 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 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 stupid well 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 an angry look on his face okay what are some other possibilities what
else might have been going on with him then 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 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 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 around them so nobody can hurt them they may have fears about their own
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 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 does it mean 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 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
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 have 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 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 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 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 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 where I would 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 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 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 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 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 a 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 it would help if you were grateful that I’m in your life recognizing and seeking to get attention and 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 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 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 always to 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 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 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
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 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 daily 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 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 to be loved and be a
good relationship you know you’re going to be successful in a relationship if you’re
but do you have to be financially successful and powerful 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 we
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
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 this relationship is fixin’ to end questions 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 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 and finally what
would be a helpful reaction that would move me more toward my goals and 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 loved me don’t leave me are two 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
a 20% discount off your order this month you As found on YouTubeSeanCooper🗯 The Shyness & Social Guy ⇝ The 3 WORST Mistakes You Must AVOID If You Want To Overcome Shyness (PLUS: 1 weird trick that targets the root biological cause of shyness so you can stop being nervous, awkward, and quiet around people…) http://flywait.darekw.hop.clickbank.net/ By Sean Cooper, The Shyness & Social Anxiety Guy. The fact that you’re reading this article tells me you may have already reached a point where you feel your shyness is NOT going away on its own… or you fear it’s getting worse and worse. And I don’t want you to waste one more day living a life where you feel left out, bored, or depressed because you don’t have the relationships which would make you happy. That’s why I’ve put together this page to help you avoid the worst mistakes that keep many people stuck with shyness for years… often giving up hope of ever improving as you watch other people have interesting “normal” lives without you. Yet this doesn’t have to happen.
“Lavender for Generalized
Anxiety Disorder” Lavender oil,
distilled from lavender flowers, is most often used
in aromatherapy and massage. Despite its popularity, only recently have scientifically-based
investigations have been undertaken into its biological activity, however. There have been small-scale studies
suggesting a benefit from lavender massage, but maybe it’s the massage,
not the lavender. There was a study on patients
in intensive care comparing massage with odorless oil
to massage with lavender oil, and through patients
massaged with lavender oil did say they felt less anxious
and more positive, there were no objective differences
found in terms of blood pressure, breathing, or heart rate. Frankly, maybe the lavender was just
covering up the nasty hospital smells. Subsequent studies
using more sensitive tests did find physiological changes, though. We know, for example, the smell
of lavender changes brain wave patterns, but what effect does this have? Well, it makes people
feel better, and perform math better, faster,
and more accurately, whereas the smell of rosemary,
for example, seemed to enable folks
only to do the math faster —not necessarily
with greater accuracy. What if you
eat lavender flowers, or in this case take capsules
of lavender-infused oil so you could double-blind the study
to compare lavender head-to-head to a drug like valium,
lorazepam, known as Ativan, for generalized anxiety disorder? Generalized and persistent
anxiety is a frequent problem and is treated with benzodiazepines,
“benzos”, or downers like valium. Unfortunately, these substances not only
make you feel like you have a hangover, but have a high potential
for drug abuse and addiction, so they decided to give lavender a try. The drug Ativan certainly
reduces anxiety… but so does lavender. By the end,
you couldn’t tell which was which! And in fact, among those
that responded to either, the lavender
seemed to work better. Since lavender oil has no potential
for drug abuse and causes no hangover effects, it appears to be an effective
and well-tolerated alternative to benzodiazepine drugs for the amelioration
of generalized anxiety. One cautionary note, however. There was a case series published
in the New England Journal of Medicine. Prepuberty gynecomastia
linked to lavender. Reports of young boys exposed
to lavender-containing lotions, soaps, hair gel, and shampoo,
starting to develop breasts, which disappeared after these
products were discontinued, suggesting that lavender oil
may possess hormone-disrupting activity. Indeed, when dripped on estrogen receptor
positive human breast cancer cells, lavender does show estrogenic effects
and a decline in male hormone activity, though it’s unknown if similar reactions
occur inside the body when lavender flowers
or lavender oil is ingested.As found on YouTubeSeanCooper🗯 The Shyness & Social Guy ⇝ The 3 WORST Mistakes You Must AVOID If You Want To Overcome Shyness (PLUS: 1 weird trick that targets the root biological cause of shyness so you can stop being nervous, awkward, and quiet around people…) By Sean Cooper, The Shyness & Social Anxiety Guy. The fact that you’re reading this article tells me you may have already reached a point where you feel your shyness is NOT going away on its own… or you fear it’s getting worse and worse. And I don’t want you to waste one more day living a life where you feel left out, bored, or depressed because you don’t have the relationships which would make you happy. That’s why I’ve put together this page to help you avoid the worst mistakes that keep many people stuck with shyness for years… often giving up hope of ever improving as you watch other people have interesting “normal” lives without you. Yet this doesn’t have to happen.
CEUs are available at AllCEUs.com/CBT-CEU This episode was pre-recorded as part of
a live continuing education webinar. On demand CEUs are still available for this
presentation through ALLCEUs. ALLCEUs.com/CBT-CEU I’d like to welcome everybody today
to cognitive behavioral therapy addressing negative thoughts. Now a lot
of us took courses and cognitive behavioral therapy we’ve worked with CBP
for many many years so some of the this is just going to be a refresher and
others you know you may pick up a few new tips or tools as we go along so
we’re going to define cognitive behavioral therapy and its basic
principles just get a really basic refresher on what was that original CDP
about well identify factors impacting people’s choices behaviors because you
know they always have a choice we’ll explore causes and the impact of
thinking errors whether you call them cognitive distortions irrational
thoughts or when I work with my clients I try to call them unhelpful beliefs or
unhelpful thoughts because distortions and irrational seems sort of pejorative
to me so I try to avoid those words as much as possible and help clients see
them as not incorrect necessarily but unhelpful and then we’ll identify some
common thinking errors and their relationship to cognitive distortions
and some of our just very basic fears why do we care
well because cognitive distortions or irrational thoughts or unhelpful
thoughts whatever you want to say really impacts people on a physical level a
mental level and an emotional level a person who perceives the world is
hostile unsafe and unpredictable will tend to be more hyper vigilant until
they exhaust the stress response system so think about you know a bottle ship
and you’ve got a bunch of new people on this battleship and all the sailors
every time there’s the least little thing they send off the
all-hands-on-deck so a big bird flies over and I mean literally a bird and
they freak out found me all hands on deck and this goes
on for a week or two or six months you know let’s think about our clients they
don’t usually come in right away where everything is set to OFF that startle
response everything sets off that fight-or-flight response the staff
starts to get exhausted all the rest of the sailors that have to drop everything
and run to their battle stations after a little while they’re like really no no
we just we can’t even do this and it also reminds me of the boy who cried
wolf anyhow I digress sticking with the battleship metaphor so eventually the
captain says you know what let’s retrain on what is worth setting off the all
hands on deck because everybody here is exhausted and nobody’s even really
responding anymore when they come to their battle stations they’re just kind
of dragging their butts in like whatever it’s probably another false alarm the
same sort of thing is true with us when we’re on on high alert for too long our
brain says you know what we got to conserve some energy in case some really
really big threat comes along so it turns down what I call the stress
response system it turns down the sensitivity so you don’t get alerted for
every little thing that would cause you stress but you also don’t get alerted
for those little things that would cause you happiness either anything that would
cause the excitatory neurotransmitters to be secreted you’re just not getting
those anymore which a lot of people kind of refer to as depression it’s just kind
of like the F whatever and only the biggest most notable things actually
cause an emotional effect we don’t want people to get to that point that’s no
way to live so we need to help them learn how to sort of retrain their
spotters to figure out what is actually stressful a person who perceives the
world is generally good and believe they have the ability to deal with challenges
as they arise will be able to allow their stress response system to function
normally there are going to be times you have all hands on deck whether it’s a
real emergency or whether it’s just a drill but it will happen and they can go
they can you know do what they’re going to do they have that adrenaline rush
they have the energy and the focus to do their jobs and when it’s over they
go back to their quarters they can relax refresh you know just kind of chill for
a while and then there’s a low where their body rebalances before the next
one and this is kind of what we want in life I mean ideally we wouldn’t have
super high peaks very often but we want to make sure we give our body time to
rebalance after there’s a stressor and not have to stand on on edge not be
hyper vigilant constantly just waiting for the next one to come along so what
is the impact of these thinking errors well whenever we have that stress
response system activated the body is saying we either need to fight or we
need to flee so you’re dumping all kinds of adrenaline and other neuro chemicals
so there’s anxiety there can be stress when people start having this reaction
you know they start having muscle tension sweating heart rate increases
breathing increases people will call that anxiety some will label that as
anger either way they’re both sides of the same coin
they need to do something but if it lasts too long then we start moving into
depression and they just they don’t have to get up and go anymore there’s just
not any excitatory neurotransmitters really left they need some time to rest
and rebalance behaviorally think about it if you go somewhere and you are just
constantly on guard are you going to keep going there or are you going to
withdraw so people who have a lot of thinking errors unhelpful thoughts tend
to withdraw more they may turn to addictions to kind of numb or blunt some
of the inputs sleep problems and changes when you are hyper vigilant when you
have this stress response going even if it’s not a full-bore if it’s still there
somewhat if you’re stressed out you’re not going to sleep as well you’re going
to maintain higher levels of cortisol so you’re not going to get that restful
rejuvenating sleep you may kind of goes on and off eating changes you know
depending on the person some people eat the self food that some people can’t eat
it all but we do see that the hormones Guerlain
and lets them get all out of whack not under stress but also when sleep
gets out of whack when your circadian rhythms get out of whack so we’re
starting to see the Cascade effect where it’s emotional and behavioral physical
you’ve got stress-related illnesses that start coming up if you’re on that lunch
you’ve got muscle tension for that long it starts to hurt I mean you start to
get migraines your back starts to hurt wherever you store your stress so to
speak it starts to come out and most people when they’re under a lot of
stress for an extended period you know a day is not a big deal for most people
but for an extended period become more susceptible to illnesses they start
getting sick easier headaches GI distress you know some people store
their stress right in their gut socially think about the last time you were
stressed were you patient and tolerant and just a pleasure to be around you may
have tried to be but you’re more prone to irritability and impatience and again
wanting to withdraw all of these affects contribute to fatigue and a sense of
hopelessness and helplessness which often intensifies thinking errors so
you’ll see this negative reciprocal interaction if somebody feels stressed
out and overwhelmed and that they withdrawal then they may start feeling
like they have no support and they don’t and they lose all their social buffers
to the stress so they feel even more stressed so they want to withdrawal even
more so we’re going to talk about how to prevent that now I like this little
diagram maybe because it’s got a heart in the center I don’t know
but behavior feelings and thoughts this is the outside of the circle all three
of these impact diecuts each other when you do something
it often impacts your feelings and your thoughts about a situation when you when
you’re thinking if you think positively you’re probably going to choose more
positive behaviors and more have more positive feelings you’re thinking
negatively obviously you may choose more of an escape behavior
Protection behavior and may have more feelings of anger anxiety depression etc
so these things are going on and they’re all interacting the one really cool
thing is if you break this chain somewhere or this circuit then you can
stop that reciprocal negative downward spiral so cognitive behavioral helps
people who are willing to show up or who are willing to address their thoughts
not everybody is willing to start addressing their thoughts right away
maybe they want to start addressing their sleep problems in their eating
problems or something that’s more physical okay that’s fine because
anywhere we interrupt this circuit is going to have positive effects assuming
the intervention is positive it’s going to have positive effects on the other
ones so what about the triangle well yourself
so you’re feeling thoughts and behavior impact you it impacts how you feel and
you’re like well yeah okay just stay with me but the way you feel think and
act impacts your future and it also impacts how you interact with others so
you know that kind of affects things because remember social support is a big
buffer for us now core beliefs and you can do this inward to outward or outward
to inward but either way it comes down to core beliefs if you have positive
thoughts and positive feelings and you generally engage in positive behaviors
to keep that cycle going you will probably feel pretty good about yourself
have good relationships have a somewhat optimistic feeling about the future and
your core beliefs may be more like people are generally good I can do this
you know very self affirming and other affirming positive core beliefs about
yourself in the world now if your thoughts or feelings are negative then
you have this negative outer circle you don’t feel so good you start questioning
the goodness and Trust ability and dependable
of other people you have more of a bleak look in the future so what do you think
is going to happen to the core beliefs the core beliefs may change too if
someone doesn’t love me I am completely unloveable they may
change to being more extreme more negative and more difficult to rectify
if you want to have somebody who’s happy I mean you’re not going to have somebody
who’s happy who thinks the world is an unkind unpredictable scary place going
it’s just wonderful roses today so we have to help people try to adjust
eventually start adjusting those core beliefs and when we get into causing
that behavior remember the ABCs your automatic but
well your automatic thought then your and beliefs are what happened as soon as
that event occurs and those you don’t think about that’s why they’re called
automatic so when you have the ABCs these core beliefs are those things that
pop up that we need to address so what factors affect this and whoops you know
there’s a lot of stuff right here and EBP they call them vulnerabilities you
know we’re just going to talk about in general different factors that affect
the choices our clients make in terms of behaviors so negative emotions if they
are not if they’re feeling angry if they’re feeling anxious they’re feeling
depressed they’re probably not going to be really motivated to get up and engage
in a whole lot of self affirming activities they’re not probably not
going to be having a lot of positive self affirming thoughts they’re going to
be focused on whatever is causing that distress and maybe escaping from that
physically pain and illness when you don’t feel well it’s harder to be Susie
sunshine I don’t think many of us are just a barrel of monkeys when we don’t
feel well so if our clients have pain this is one
of those if you want to put it in behaviors behavioral areas physical
areas we can address and have them go see their physician have them go see
their physical therapist and get recommendations so they aren’t feeling
physically painful physically and distress all the time because physical
distress and emotional distress both mess with sleep unfortunately sleep
is the first thing to usually go and I’m not talking about quantity I know a lot
of clients who when they get depressed they’re in in bed for you know days
they’ll get up they’ll maybe shower and you know go back to bed and they’re
sleeping a lot but it doesn’t mean it’s quality sleep so what we need to look at
is what is the quality of their sleep are they getting that rejuvenation the
time for their brain and neural chemicals to rebalance so they can feel
happy so they can have that nice balance of all the the neurotransmitters they
need to feel happy poor nutrition well no matter how much sleep they get if
they don’t have the building blocks to make the neurotransmitters and the
hormones that are needed to prompt the feelings the physiological sensations
that we’ve labeled happiness or excitement or you know even depression
and anxiety those are all caused by different neurotransmitters being
secreted in different combinations if your body doesn’t have the building
blocks to make those then it doesn’t matter how much sleep you get you’re not
going to get any benefit from it an intoxication and this can be uppers
downers anything that is psychoactive if you are messing with that
neurotransmitter balance you’re going to get it out of whack and you may either
use up too much of the excitatory or cause us a lot of it or you may use up
too much of the depressant either way there’s usually a rebound effect which
we call withdrawal so you’re not going to be in a good space either during the
intoxication sometimes but definitely when you’re sobering up
there’s a period where there’s going to be negative emotions negative feelings
environmentally yeah your environment can even make you grumpy
introduction of a new or unique situation some people love new
challenges love going to new places other people not so much depending on
the person taking on going somewhere new may be really stressful for them so if
they’ve already got de-stress going on because of having to go to this new
situation then their thoughts may be a little bit more on the anxious side
about a lot of things and they may have less patience and tolerance to deal with
other stuff that comes their way because they’re already kind of on edge and
exposure to unpress you know going places that you just really don’t want
to go maybe and one of the places I used to work we had this meeting once a month
and it was literally an eight-hour meeting and we would all sit in there
for eight hours and one person at a time would get up and give their staff
reports or whatever but it tended to be a relatively dreadful sort of
environment or eight hours and we all knew we had to be there and that was
fine but it was an unprecedented were grumbling on the way in they were
getting their coffee and going well I better do this because I’m not getting
out for another eight hours we need to help our clients obsess what is it in
your environment if anything that is making you already feel grumpy or not as
happy and likewise what can you put in your environment to make you feel
happier you know I keep pictures of my kids and my animals on my phone that way
if I’m having a moment or not sometimes I just like looking at them I can take a
look at it it makes me smile and I’m like okay life is good you know this
moment may not be so wonderful but it’s just this moment then we move on to
stress of a social nature peers or family who
convey irrational thoughts as necessary standards for social acceptance nobody
wants to associate with those people or nobody’s going to like you when you’re
like this or you read if you really want to be successful then you need to change
fill in the blank it’s always a something needs to change you are not
okay for who you are how you are and a lack of supportive peers to buffer
stress because we all have negative people in our life it happens but if you
have negative supportive peers that you can call afterwards and go yeah I had
just had to meet with someone so for an hour and it was just dreadful and that
person can go well I’m sorry or be there make you laugh or whatever they do it
helps buffer the stress if you don’t have those positive social supports then
you’re left walking out of it you’re kind of feeling shell-shocked and then
you also at the same time have to figure out for yourself all right what do I do
next now it doesn’t mean you can’t do it you
know people do it all the time but it is good it is awesome to have supportive
peers to buffer your stress so when cognitive therapy clients learn to
distinguish between thoughts and feelings realizing that thoughts will
trigger feelings but they don’t have to cause continual feelings and behaviors
and feelings can cause certain thoughts but they don’t have to you can unhook
from them and you can just say this is how I’m feeling right now now where am I
going to go from here and we talked about that on Tuesday with
unhooking from unhooking from your thoughts and stepping back and going
what is the next logical action to get me to where I want to go become aware of
the ways in which the thoughts can influence feelings in ways that are
sometimes not helpful being critical being jealous envious maybe you just
don’t like somebody and you know there’s a whole lot of reasons for that but you
don’t like everybody most people don’t like everyone
and so it’s you know that’s okay but recognize how that affects your
interactions with that person and your thoughts about that person
learn how thoughts that seem to occur automatically affect emotions so
recognize start getting down to what are these core beliefs that happen every
time it’s a negative incident that make me feel angry or anxious constructively
evaluate whether these automatic thoughts and assumptions are accurate or
perhaps biased evaluate whether the current reactions are helpful and a good
use of energy or unhelpful and a waste of energy that could be used to move
toward those people and things important to the person so again back kind of to
that ACP sort of thing is this a good use of your energy to help you achieve
your goals and be the person you want to be and develop the skills to notice
interrupt and correct these biased thoughts independently like I said you
don’t always have to call somebody you can do it on your own but sometimes it’s
nice to have that buffer in that middle moment so what causes these thinking
errors how can we even start helping people address their thoughts and until
we start thinking about well what caused them information processing shortcuts as
we grow up we learn things you know when you were knee-high to a grasshopper you
didn’t have a lot of experience so you learned things but things you learned
when you were a kid unfortunately because you were
cognitively a child are either our dichotomies they’re all or nothing it’s
either this way or no way at all so things that you have things that you
learn back when you were a child may not have been challenged if you heard
something from your parent maybe your parents said you’re a bad girl or you’re
a bad boy it’s all or nothing well I am a bad girl so I guess that
means I’m not okay and if I’m not okay right now I’m never okay that can stick
with a person so these outdated amis schemas can really trip somebody up
once the person gets into you know middle schoolish the thoughts aren’t
nearly as dichotomous there’s a lot more formal operational thought if you will
but up until then I mean you’ve got a child who’s experiencing a lot of stuff
and taking in like a sponge everything they hear and it gets sorted into a yes
or a No pile there’s there’s no kind of middle
pile that there’s no yes and so what we want to do is help people look at those
thoughts now and say okay if they’re all or nothing is there a way to find both
and so for example we’ll take that exam scenario I gave you earlier if a child
hears you’re a bad girl when they’re young they take that to mean always
everything about me is bad I’m unlovable so what is the both and compromise as an
adult we can look back and go you know I’m a good person I may not make may
make poor choices sometimes I may make bad choices but I’m a good person
so there’s that both and you know I’m not perfect but I’m good so that it’s
not all or nothing and I encourage my clients to really always look for that
middle ground how can it be both or does it have to even be that negative one but
most of the time there’s a little bit of something on both sides the brain’s
limited information processing capacity and limited responses when children are
young you know they hear something you know mom comes in and says you’re a bad
girl and child hears I’m totally unlovable and it just crushes the child
they don’t have experiences to go moms having a bad day she kind of tends to
say things she doesn’t mean when she’s having a bad day it’s just it’s
devastating to that child when you’re older if somebody says something that’s
not necessarily tactful you know you can look at it and go yeah that really
wasn’t nice but that person probably did not intend to be hurtful they may have
something else going on children have fewer experiences so what
was devastating or overwhelming as a child may not still have have to feel
that way when you’re a child if your best friend moved away oh that was
devastating it was the end of the world now as an adult you can go visit them
you can call them and with the internet and everything you can email them you
can still stay in touch so there are ways to do it yeah you can’t go out and
swing swing on swings together all the time but it doesn’t have to mean the end
of the end of time things will change and there’s a little process of grieving
that has to go along with that but to an adult a friend moving away is less
devastating than say to a six-year-old your parent being angry with you if you
grew up in an alcoholic or addicted household you learn don’t talk don’t
trust don’t feel when the parent came in if the parent was angry with you you
could have been in a lot of hurt you know there could have been some actual
danger to your physical or emotional person so it was scary as a 26 year old
or however old your client is is it that threatening you know if your parent gets
angry with you you don’t depend on them for food and shelter anymore you don’t
have to be an inner household if they were violent towards you so is it as
terrifying when your parent gets angry yes there’s lots of issues with wanting
acceptance from your parents that’s over here there’s a whole nother issue but
when your parent is angry do you have to have that person’s approval when we’re
in crisis we don’t process much when you’re in crisis your body is worried
about surviving if you’ve been in a car wreck if somebody has gone to the
hospital whatever the case is you’re not
processing all of the data in order to make it in for
decision you’re processing what’s right in front of you because when we’re in
crisis we generally have tunnel vision and really crappy memory so if something
happened when someone was in crisis that hurt their feelings made them angry you
know fill in the blank some sort of dysphoric emotion we want to say well
let’s look back at that and see if there’s a pose and let’s look back at
that and see if there was something that you missed that might help you
understand why this person reacted that way but understanding that in crisis we
just generally don’t make the most informed decisions so emotional
reasoning helping clients understand that feeling or not facts and helping
them learn to identify feelings and separate them from facts so if they say
I’m terrified all right so you’re terrified got that about what are you
terrified you know tell me what are these things that make you feel like the
world is such a scary place and let’s list them on the whiteboard or a flip
chart what is the evidence that those are present dangers right now that
they’re actually impending threats so tell me about what the evidence is in
what ways is this similar to other situations where you felt terrified and
how did you deal with those situations I have a friend who actually went this
morning on an airplane flight and she hates flying totally terrified of it so
what is the evidence that this plane is going to crash you know what is the
evidence that it is likely that this plane will crash and there really she’s
flying on an american-based commercial airliner there really isn’t any when you
look at the proportions so okay there’s there have been a couple of crashes over
the past 20 years and in a couple of those there were some fatalities no
doubt but looking at the proportions and running the numbers
what’s the likelihood in what ways this is similar to other situations that you
have felt terrified you know maybe there haven’t been any other situations where
she’s flown and gotten through it and been like score I did that but what
other situations have you had to get through that you were terrified and how
did you deal with those help people develop distress tolerance skills one of
the things I told her was when you’re sitting on the airplane and you know the
airplane starts up don’t wait til you start getting really stressed
necessarily but when we were little on the car when we’re in the car we used to
find things on the drive find something that starts with a and everybody would
find something that started with a and then find something that starts with B
and you know so on and if you couldn’t find something that started with that
letter you were out so I mean she’s going on this trip with her kids and I’m
like why don’t you try doing that because there are some letters that
you’re going to have to work really hard and it’s kind of like the game apples to
apples you end up finding something really inane in order to get that letter
and you laugh and you’re so busy focusing on that you’re not focusing on
all of the things that could possibly maybe go wrong other distress tolerance
skills you know you can go through the whole DBT curriculum and learn some of
those the biggest thing is if you have to face the terror if you have to go
through it figure out a way to not have to focus on it and fight it and go I
shouldn’t be afraid I shouldn’t be because that doesn’t work if it worked
we wouldn’t be talking about it and develop emotional regulation skills so
prevent those vulnerabilities set yourself up so you are as prepared as
you can to not feel stressed to not feel anxious she has her spouse with her who
can help diffuse some of it she’s got her kids with her she downloaded some
movies she’s prepared to endure the distress she’s you know trying to go
into it with a positive mindset as much as
possible and focusing on the destination which you know is ultimately the reason
she’s getting on the plane social causes of stress and thinking errors
everybody’s doing it well that’s not true there’s very real that everybody
does so correcting misinformation how the client gather objective information
about you know if they say well everybody else that I know has succeeded
okay well let’s gather objective information about that who do you know
and tell me if they’ve succeeded if I want to be liked I must do it
this need for approval or low self-esteem can cause a lot of problems
in thinking errors and fears of rejection so we say okay let’s look at
developing some self-esteem so you don’t need to worry about if somebody likes
you what would it be like if you woke up in the morning and you didn’t care if
so-and-so liked you I mean we all want to have friends don’t get me wrong I’m
not saying you want to be her moving out in the woods but if we’re talking about
a particular so-and-so what would it be like in the morning to get up and go you
know what if that person messages me today or call us me today that’s great
and if not I’m okay with that how liberating would that be to get your
power back and how people develop social supports that share their same values
and goals at least mostly or at least can respect yours so for example when
you know I work with people with co-occurring disorders and they don’t
drink and they don’t use drugs so they may be around people family friends who
drink if you’re going to be in that situation do you have to drink and can
you be around do you have social supports that can be supportive of your
choice to not drink doesn’t necessarily mean they’re it’s not going to not going
to not drink in front of you but at least they’re not trying to get you to
drink so the social causes of irrational
thoughts if I want to be liked I must do this
why can’t you be like for who you are cognitive bias negativity mental filter
focus on the negatives and worry about the future most of us know some people
like that most of us have had a moment where we felt like this we’ve just
gotten ourselves in a tizzy and spun out of control but you can bring it back so
you want to ask yourself or have your clients ask themselves what’s the
benefit to focusing on the negative if you know that this is going to go south
really fast what’s the benefit to just focusing on
that could you focus on alternatives or Plan B’s what are the positives to the
situation most people who have mood issues who present to us in counseling
don’t focus on both sides yes every side you know has a little bit of negative to
it if you really want to look hard enough but every side also has a silver
lining if you really want to look hard enough so we need to balance the the
positives and the negatives so encourage people to look for the positives in the
situation yeah this really sucked but and what are all the facts what are all
the things going into it sometimes people will go to work and not know or
wonder if they’re going to get laid off because you know you’re not necessarily
always guaranteed a job anywhere there can be layoffs but if somebody is going
to work every day worried about this focusing on the negative up yep I’m
definitely going to be the one that’s going to get the pink slip and they go
to their mailbox each time looking for that pink slip expecting it to be there
how is that going to affect their mood as opposed to alright there may be
layoffs coming what can I do to make myself really valuable or and what are
my options if I do get laid off let’s make a plan B and C so I don’t just feel
like the rug was pulled out from under me coin toss activity if
somebody tends to be stuck in negativity have them flip a coin every morning if
it lands on heads they can just see their normal selves to their heart’s
content if it lands on tails they need to act as if they are a happy positive
optimistic maybe even a noxious ly optimistic person for the entire day you
know we want them to be farting rainbows and when I say that they usually look at
me and laugh and but that’s okay I’m like every time you start having a
negative thought I want you to see a unicorn farting rainbows and take it
from there and then have them process how they felt at the end of the day if
they weren’t constantly focused on negativity and worrying and only seeing
the bad stuff disqualifying or minimizing the positive if something
happens when somebody says well I just got that promotion because they didn’t
have anybody else to give it to okay if your best friend just got a promotion
would you say that to them what is scary about accepting the positive about
accepting the fact that maybe you got the promotion because you’re awesome
sometimes we disqualify the positive because it fails to meet someone else’s
standards so might that be true here you know maybe you got this promotion and
you’re actually down deep down inside kind of proud of it but you know that
your mother had always wanted you to be this over here and you’re never going to
meet that expectation so you minimize it that way nobody else could say well you
know better than nothing and take away your thunder egocentrism my perspective
is the only perspective take different perspectives I always say three if
something happens and you know maybe somebody was rude to you
anyone they were rude to me okay they were rude to you what are three reasons
what are some alternate perspectives why that person might have been rude maybe
what you did something that triggers them maybe they were
having a bad day and it’s got nothing at all to do with you you know there are
options that we can look at personalization and mind-reading what
are some alternate explanations for the event that didn’t involve you if you
think well that person that person just really doesn’t like me and you know I’ve
got to work with them every day and they hate me my question to my client would
be what what’s the evidence for that and what are some alternative explanations
for why that person may be behaving that way
I had a staff member that a lot of my other staff members had difficulty
getting along with and ultimately you know we had to sit down and look when I
had some different staff meetings with people and say you know what gives you
the idea that she doesn’t like you what gives you the idea that it’s about you
and you know they cited all kinds of behaviors and I had to come back to well
what are some alternate reasons why somebody anybody not just her might be
expressing those behaviors could it be something besides you and of course they
came back – yeah availability heuristic remembering what’s prominent in your
mind if somebody was if you’re a supervisor for example and you’re doing
evaluation for the year what are you really remembering when you’re doing
that evaluation the whole year or the last three months and that’s the event
fail ability heuristic so when you’re talking to somebody about their
relationship with their best friend or their spouse or their kids and if
somebody says well that that child has always been a problem okay let’s look at
that you know the child is 18 and you’ve had a lot of problems with him lately
but what about three years ago so was he always a problem or is this something
that’s relatively new that something might have changed
magnification people getting stuck on fearing the absolute worst so you want
to ask them is this a high probability or low probability outcome if they’re
magnifying something that happened like oh my gosh that is the worst thing in
the world is this going to matter six months from now maybe you totaled your
car and yeah that is a huge bummer and you’re safe in six months is this really
going to matter that much you know there are going to be some bills and
everything but the big scheme of things is at the end of the world what have you
done in the past to tolerate events like these when something really really
unpleasant has happened and then if they’re looking at dichotomous ways of
thinking which a lot of our clients still do they’re like someone so it
always does this or never does this have them look at the differences between
love versus hate perfection versus failure and all good intentions versus
all bad intentions because a lot of our dichotomies fall in one of these three
categories this person always does this or Never
or does it intentionally or you know just doesn’t care belief in a just world
the fallacy of fairness encourage people to look for for good people they know
that have had bad things happen attributional bearers are labeling
yourself not a behavior such as saying I am stupid instead of I don’t have good
math skills I am is difficult to get rid of I can’t get rid of stupidity if it’s
part of me but if it’s a thought or a skill I can either get rid of it or
improve it stable I am means I am right now and I probably always will be stupid
verses I can change this thought or skill I can learn math and internal
attributions mean it’s about me as a person versus about a
skill or skill deficit or something completely unrelated so when somebody
makes a global internal negative statement we want to help them challenge
that global internal positive statements I’m all about but the negative ones I
want to say let’s take a look at that is that true that this is about you all of
the time and it means that there’s something wrong with you so we want to
ask them how are these thoughts how are these ways of thinking impacting your
emotions health relationships and perceptions of the world we want to
increase motivation to start looking at these spanking errors because it’s a lot
of work to start changing the way you automatically think because you’ve got
to stop you’ve got to become mindful and then you’ve got to decide well what are
the alternative thoughts because this is what I thought for so long how may have
this thought has been helpful in the past most of the time thoughts we have
came from somewhere and whether it was a thought we had when we were a child
something we learned when we were a child that is dichotomous and not quite
applicable anymore it may have been helpful in the past to help you navigate
situations doesn’t mean it was wrong it means it’s not helpful in the present
asking them to always ask themselves is this thought or feeling bringing you the
client closer to those people and things that are important to you it’s hanging
on to this negativity bringing you closer and and I like the energy
philosophy if you will when you are unhappy you are letting this person have
your power you are letting this person make you angry when you decide you are
not going to give them your power then you may start feeling happier and I
don’t always use that with clients but sometimes the power metaphor help
when we talk about thinking Ayers asked them are there examples of this not
being true and and or how can a statement be made less global stable and
internal is it about you or is it about what you do at work is it about you or
is it about your relationship with this particular person so the last couple of
slides focusing on some of the irrational thoughts or unhelpful beliefs
our basic fears are rejection and isolation failure loss of control the
unknown and death generally the things that cause people to have this
fight-or-flight reaction fall into one of those categories so some of the
unhelpful beliefs that we hear a lot coming up when we do the ABCs is that
mistakes are never acceptable so if I make one
I am incompetent so we’ve got dichotomous thinking and we’ve got a lot
of internal global labeling here rejection and isolation when somebody
disagrees with me it’s a personal attack against me well sometimes it is what
does that mean it’s about you we’re helping them address the rejection and
isolation fears we want to ask them you know if they disagree with you were they
attacking you and saying you were stupid or were they attack attacking you want
to use that word or were they attacking the thought and saying they disagreed
with the thought there’s a little bit of a difference it’s somewhat semantics but
it’s a difference because they may have a lot of respect for you but they may
disagree with what you just said if someone criticizes or rejects me there
must be something wrong with me again that’s one of those internal global
negative statements to feel good about myself others must approve of me we want
to make sure our clients can self validate and they don’t rely on external
validation because they’re setting themselves up for a world of hurt if
they are not their own best friend to be content in
life I must be liked by all people and thanks for a second are you liked by
everybody I know I’m not liked by everybody so does that mean that I
should not be content in life and what does it say to give people that power to
say if you don’t like me that I can’t be content because I’ve got to be liked by
everybody sometimes with clients I’ll help them look at what may be going on
with the other person why that person might like them because a lot of times
other people’s reactions towards you are more about their stuff than about you
and helping them see how that might be true my true value as an individual
depends on what others think of me so these other unhelpful beliefs pertain to
those thoughts of failure and loss of control none of us likes to fail don’t
get me wrong it’s not pleasant but it happens and there is a saying out there
that says if you haven’t failed you haven’t tried which means we need to get
beyond our safety envelope we need to push ourselves behind beyond our
boundaries and when we do sometimes we’re going to stumble and fall and we
pick ourselves up and we learn from it but to expect to never fail at anything
is not realistic so nothing ever turns out the way you want it to how many
times have you heard that from your clients I won’t try anything new unless
I know I’ll be good at it I’m in total control and anything bad that happens is
my fault so let’s look at this locus let’s control thing here you’re in total
control so you can make it rain you know it was unpleasant today because I had to
come to work and it was raining outside so that was bad it happened was it your
fault pointing out and depending on your relationship for your client you’re
probably going to be more or less snarky when you present some of these but a lot
of times I have a semi joking relationship if you will with my clients
and they’re like yeah I see your point that kind of didn’t make a lot of
since other times you know if they’re more serious I’ll ask them to identify
things that happened that were bad that they had nothing to do with if I feel
happy about life something will go wrong or I’m always waiting for the other shoe
to drop helping people stay focused in the moment with mindfulness and
something’s going to go wrong down the road somewhere sometimes yeah it’s true
this will happen let’s enjoy what we’ve got for right now the past always
repeats itself it was if it was true then it’s true now so what was true when
you were ten is true now that you’re forty always is that true it’s not my
fault my life didn’t go the way I wanted everybody conspired against me and
there’s no gray area so for people who feel the need to hold on to control its
dichotomous it is or it isn’t it’s got to be that way there’s no gray area and
it can make life be seem very uncomfortable because they’ve got to put
things in one of two buckets and sometimes things don’t fit nicely in
buckets what happens if we add a third bucket that both an bucket so a quick
note about irrationality the origins of most beliefs were rational and helpful
given the information the person had at the time and their ability to process
that information because of their cognitive development so things that we
identify as unhelpful or automatic beliefs now came from somewhere and they
made perfect sense whenever they were formed they may not be healthy or
helpful now which is why we want to look at them and either adjust them or just
throw them out the door but when they were formed they were on point
irrationality or unhelpful nasaw thoughts comes when those beliefs are
perpetuated without examination so again we need to look at them continually look
at what you’re telling yourself and go is this still accurate
and continue to be held despite causing harm to the person sometimes you’re
going to look at a thought an automatic thought and you’re going to go yeah that
is still spot-on now is holding on to this helping me
achieve my goals you know yet the world right now is kind of a scary place is
holding on to this fear and terror helping me and be a happy productive
yada-yada whatever kind of person you want to be or is it causing me to feel
anxious and angry and scared sometimes it’s more productive for clients to
think of thoughts as unhelpful instead of irrational because like I said I feel
like irrationality and distortions seem very pejorative to a lot of clients so
questions clients can ask themselves when they are faced with a situation
what are the facts for and against this belief is this belief based on facts or
feelings just because you feel scared is it a scary situation does the belief
focus on just one aspect or the whole situation does the belief seem to use
any of those thinking errors we talked about and if so you know what do I need
to do about it what are some alternate explanations for this belief what else
could have caused this to happen besides whatever I’m afraid of what would you
tell your child or your best friend if they had this belief
what would you took what would you want someone to tell you about this belief
you could have somebody tell you something that would make you feel okay
what would you want them to tell you and how is this belief moving you toward
what and who is important to you remembering that beliefs are a
combination of thought and fact and personal interpretation of those
thoughts and facts I tend to when I talk you know you see me I kind of I’m all
over the place with my arms I am a animated talker now if you are seeing me
from a hundred feet away and you are seeing me talk
might think I was angry because I make a lot of really big gestures because if
you had grown up in a situation where there was domestic violence or something
but if you had grown up in a household like I did where you had a first
generation Italian first generations of ten Italian Americans talk big they talk
real big with lots of gestures and sometimes loud and that doesn’t
necessarily mean any anger a lot of times it’s just pure excitement so
understanding that there’s thoughts in facts you know you see this going on but
your personal interpretation can really affect what you get out of it or what
you perceive that situation to be so we need to look at how is your personal
interpretation maybe adding a negative bias and what what do we do about that
it may be 100 percent accurate what do we do about it so it doesn’t keep you
miserable thoughts impact behaviors and emotional and physical reactions
emotional physical reactions impact thoughts and your interpretation of
events irrational or unhelpful thinking patterns are often caused by cognitive
distortions my two favorite words in that same sentence cognitive distortions
are schemas or shortcut ideas or memories if you will which were formed
based on faulty inaccurate or immature knowledge or understanding of the event
you know little kids may not have quite understood what was going on they just
understood that mommy and daddy were screaming identifying the thoughts the
hecklers I call them those negative voices inside your head that are
maintaining unhappiness helps people choose whether to accept the thoughts
and say yeah you know that’s right I really am not good at that or whatever
the negative thought is and change it or let the thought go are there any
questions you you thank you miss Benson well thank you all
if you come up with any questions you know you’re mulling it over later and
you think you know that yet I’ve worked with a client and with something similar
and I did this or you know you have a question about something I said feel
free to email me the easiest one to remember is support at all CEUs com
there’s only two others in the office so either my husband gets it err I do so
it’ll get to me and I guess that’s it so I will see you all on Tuesday if you
have any types of courses that you want to see added to the list please let me
know I’m always interested in doing what you want to learn about not necessarily
just where I pull out on my rabbit hat yes you can print the slides in the
golly golly golly when you go into the class there’s a link that has a PDF of
the slides that you can print if you want to print go ahead and print those
out the video version of this will be up on YouTube by tomorrow morning maybe
later this afternoon you okay everybody have an absolutely
amazing rest of your day and weekend 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 dr. Schneider by subscribing at all CEUs
calm / counselor toolbox this episode has been brought to you in part by all
CEUs calm providing 24/7 multimedia continuing education and pre
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coupon code consular toolbox to get a 20% discount off your order this month.As found on YouTubeSeanCooper🗯 The Shyness & Social Guy ⇝ The 3 WORST Mistakes You Must AVOID If You Want To Overcome Shyness (PLUS: 1 weird trick that targets the root biological cause of shyness so you can stop being nervous, awkward, and quiet around people…) By Sean Cooper, The Shyness & Social Anxiety Guy. The fact that you’re reading this article tells me you may have already reached a point where you feel your shyness is NOT going away on its own… or you fear it’s getting worse and worse. And I don’t want you to waste one more day living a life where you feel left out, bored, or depressed because you don’t have the relationships which would make you happy. That’s why I’ve put together this page to help you avoid the worst mistakes that keep many people stuck with shyness for years… often giving up hope of ever improving as you watch other people have interesting “normal” lives without you. Yet this doesn’t have to happen.
(upbeat music) – [Narrator] Hey Psych2Go
Welcome back to another video, before we start, we’d
like to thank you all for the support that you’ve given us. Psych2Go mission is to make psychology and mental health more
accessible to everyone, and you help us do that, so thank you, now back to the video. Are you always insecure
about your relationships? Do you need constant reassurance from your partner or loved ones? Attachment theory
categorizes the way we act in relationships into three-man attachment styles, in today’s video, we will be focusing on the anxious attachment style, which according to mind-body green is a type of insecure attachment
style rooted in a fear of abandonment and insecurity
of being under-appreciated. The anxiety or insecurities you may feel in your relationship today may be due to an anxious attachment style
you developed as a child. Remember if you find yourself relating to the points we mentioned,
be kind to yourself, and know that you can always work towards improving your behaviors, with that said, let’s
look at the eight signs of an anxious attachment style. Number one is feeling
insecure in relationships. Are you always worried
about not being good enough for your partner? Does it get in the way of your happiness? A sign of an anxious attachment style is feeling insecure in your relationships, and this insecurity may
manifest in several ways. For instance, you may find
yourself very reactive to your partner’s words and actions, or find that you need constant reassurance from your partner to feel okay. Number two is, the looming fear of abandonment. Are you scared that your
partner will leave you even when nothing is wrong? This fear of abandonment
is pretty common for people with an anxious attachment. It’s likely stemming from
feelings of abandonment and insecurity about your
parents when you were a child. According to how Healthline
this fear and worry that your partner will leave you, often results in a tendency to become overly
dependent on your partner, which may negatively
impact your relationship and your emotional wellbeing. Number three is trust issues. You have a hard time
trusting your partner. Maybe you find it hard to
believe in your partner when they say they won’t leave you, or when your friends tell you that they truly care about you, whatever it is, this
difficulty to trust others may stem from a combination
of feeling insecure about your relationships, and fearing that your
partner or your friends are going to abandon you in time. If it gets out of hand,
this distrust of others may result in losing your relationships. Number four is clinginess. Have other people called you clingy when it comes to you
and your relationships, maybe you’re over-reliant, or
overdependent on your friends, family, or partner. Unlike some of the other signs, clinginess can be a common
coping mechanism for fears that come with the
anxious attachment style. According to the attachment project, people with anxious
attachment develop clinginess because they’re afraid of being alone. Number five is emotional neediness. Do you always need other
people’s attention? According to Abby Moore from
Mindbodygreen many people with an anxious attachment
style are emotionally needy because they did not receive the proper emotional nurturing
and security as a child. And this emotional neediness
may manifest into behaviors where they constantly seek reassurance, soothing, and attention from
the people in their life. Number six, harsh reactions to criticism. Are you the type to
take criticism to heart? Does it have a strong
impact on your self-esteem? While it is not uncommon to
be sensitive to criticism those with an anxious attachment style might view criticism more intensely. Instead of seeing criticism
as a way to help you grow, you may take it as a rejection, and let it amplify your
fears and insecurities, which may ultimately
lead to low self-esteem. Number seven is ambivalence
towards intimacy. Do you crave intimacy, or
do you find it overwhelming? Some people with anxious
attachments walk this fine line between craving and fearing
emotional and physical intimacy. And this perception of intimacy may be due to emotional neglect
during your childhood. So while you have a deep
craving for intimacy, you may not know how to, or be comfortable with accepting it. And number eight, feeling unworthy. Do you feel unworthy of love, or that you aren’t good
enough for your relationships? People with an anxious attachment may have low levels of self-esteem, and a negatively distorted
view of their self-worth. This lack of self-esteem is
likely to stem from insecurities and fears of being abandoned, or unwanted by your parents or loved ones, which may lead to a belief
that you’re not worthy enough for your relationships. We hope you enjoyed learning
about some of the signs of an anxious attachment style. Do you relate to any of the
things we’ve mentioned above? Let us know in the comments below. If you found this video helpful, be sure to like and share this video with those who might benefit from it. Don’t forget to subscribe and
hit the notification bell icon to get notified whenever I
decide to go post a new video. The references and
studies used in this video are added in the description below. Thanks for watching, and we’ll
see you in our next video.As found on YouTube
SeanCooper🗯 The Shyness & Social Guy ⇝ The 3 WORST Mistakes You Must AVOID If You Want To Overcome Shyness (PLUS: 1 weird trick that targets the root biological cause of shyness so you can stop being nervous, awkward, and quiet around people…) By Sean Cooper, The Shyness & Social Anxiety Guy. The fact that you’re reading this article tells me you may have already reached a point where you feel your shyness is NOT going away on its own… or you fear it’s getting worse and worse. And I don’t want you to waste one more day living a life where you feel left out, bored, or depressed because you don’t have the relationships which would make you happy. That’s why I’ve put together this page to help you avoid the worst mistakes that keep many people stuck with shyness for years…
often giving up hope of ever improving as you watch other people have interesting “normal” lives without you. Yet this doesn’t have to happen.
This episode was pre-recorded as part of a live continuing education webinar on demand. Ceus are still available for this presentation through ALLCEUs Register at ALLCEUs com, CounselorToolbox, Hi everybody, and welcome to your review of the Process of Screening. In this presentation, we’re going to review key skills for engagement, discuss factors impacting engagement, define screening explore how to do a screening, and identify types of screening instruments. Now screening is one of those steps that a lot of people will do, especially as a job. An entry-level job in mental health, if you’re working towards your hours for certification or licensure as an addiction counselor, you’re, probably going to be in a position at some point where you’re doing a fair amount of screening. So let’s learn how to do that. The first step in screening and assessment and even counseling is developing engagement and engagement means that you need to develop verbal and nonverbal skills to establish rapport and promote engagement. So how do you establish rapport? How do you connect with somebody when they walk into the office? Do you sit down with a clipboard and start writing right away? No, you want to be able to be open to being warm to make eye contact to respond to them in a culturally appropriate and culturally sensitive way. So you know you got to be aware of the people that you’re working with, whether you know how much eye contact is enough, how much is too much, etc. You want to be able to talk to people, and you know a lot of people when they’re coming in for a screening. You know, may not know what’s going on. You want to be able to put them at ease. So hopefully you know those are the skills that you already have, which is one of the reasons that you’re getting involved in this field. But screening means you know, first and foremost developing that relationship because the quality of the relationship with you is going to determine in many cases whether somebody goes on for the assessment and treatment if needed, you want to discuss with the clients the rationale, purpose, and procedures associated with screening an assessment so sit them down and say you know we’re going to do a screening for substance use, so we’re going to do a screening for depression. This is why we do it. You know because we know that whatever percentage of people in this area struggle with depression and that early intervention is a whole lot more effective than late intervention, so the earlier we can help people arrest the problem, then the better off they’re going to be, And this is what screening is going to, be you know, so they know if they’re going to get there, not going to get their blood drawn. They know you’re just going to sit there. You’re going to. Ask them five or six questions, and they’re going to be done because they may be thinking that you know they need to lay on the couch and tell you their deepest darkest secrets and they’re not ready to do that. Well, of course not they just met you, so let them know this is what screening is assess. Client’s immediate needs, including detoxification. If you’re meeting with somebody – and you know you notice that they’re under the influence of substances, then they may need detoxification. If you’re assessing them for substance, use or substance use disorders, and they admit that they have been using consistently or they’re under the influence, they may need detox, administer evidence-based screening and assessment instruments to determine clients, strengths, and needs, and we’re going to talk about some of those evidence-based instruments later, but you know you can use the cage you can use the Sassi. You can use a variety of different instruments, and obtain a relevant history to establish eligibility and appropriateness of services. Wherever you are, you know you probably accept some insurance. Don’t accept others. You may have private pay, or you may not. We want to make sure that once we scream we can get the person into services that they may need. You know. So we need to determine: where can they go? You know if they’ve got Medicaid if their private pay if they’ve got private insurance. You know where could where’s the best referral place for them, and to do that, we need to get that relevant history. Other things that affect eligibility appropriateness for certain treatment programs, some treatment programs will work with people who are on benzodiazepines, while others won’t. Some treatment programs will work with people who have co-occurring mental health disorders. There won’t. So this history is important to figure out. Does this person need a specialized program? Are they dealing with specialized issues like LGBTQ issues? Are they if they’re an adolescent? They’re going to need an adolescent program, so we need to get all of this stuff. You know when we’re doing the screening we’re, going to get a little demographic data there and we’re going to do. The screening screen for physical needs, medical conditions, and co-occurring mental health issues. So, while a screening for substance use may be five questions, a full screening is probably going to take 20 or 30 minutes. So we’re going to ask them a variety of questions. We’re, not going to get super in-depth, but we are going to get sort of an overview of how this person is doing. That way. We can look at it and say you know: maybe they’ve got medical conditions that are contributing. If we’re screening for depression, maybe they’ve got medical conditions that are contributing to their depression. If they have a substance, use disorder, you know: are their medical conditions being made worse by their substance use? And if so, what do we need to do so? We want to you, know, the screen we want to screen for co-occurring mental health issues. It does not matter if the person had depression or anxiety or bipolar before they started using or they develop depression or anxiety after they started using right now they’re. If they have depression or anxiety, it needs to be addressed, because you can’t, have somebody sober up and still feel miserable and expect to stay sober for long. Likewise, you know you can’t just treat their mental health issue and expect substance use. Just to go, oh so, if they, if you’re screening for one is really important to screen for the other substance, use will monkey with the neurotransmitters that can contribute to depression and anxiety. So you know they’ve got substance. Use we want to screen for that mental health issues. Sometimes people will self-medicate to try to numb the pain of mental health issues so again always screen for both of them because the likelihood is if one exists, the other exists at some level as well as interpret the results of the screening and assessment and integrate information to Formulate a diagnostic impression and determine the appropriate course of action, so you’re not doing a full diagnosis, but you’re going to go through and you’re going to look at the screening results and say yep. You know, technically, this person meets the criteria for substance use disorder, so we need to send them on for an assessment to see what may need to be done and what our options are to help them deal with it. If you’re screening for depression, the same things going to be true. This person meets the criteria. You know, we suspect that they may have a major depressive disorder. So let’s refer them for an assessment. So we can figure out what’s causing the depression and what options we have for helping the person deal with it. We want to develop a written integrated summary to support our diagnostic impressions and you’re going to do more of that with assessment, but in the screening, you know the Assessors going to want to know. Why did you send this person, you’re going to present a summary of the information that you gathered. That told you that this person may need to be assessed for substance, abuse, or mental health issues. You know it. Doesn’t have to be a dissertation, it can be a paragraph, but you do want to kind of put it all together in a nice little package. So the Assessor doesn’t have to go back and read through everything and try to figure out what you saw establish, rapport and an effective working alliance in which the client feels heard and understood you know to be respectful, and make eye contact and smile. You know don’t go directly to your paperwork and make them feel like a number, be punctual that’s important non judgmental if they’re talking about their substance, use don’t act shocked like oh, my gosh. I can’t believe that you drank while you were pregnant or oh, my gosh. I can’t believe that you’re using that much of that substance, or you did that to get your drugs, no, they did what they did to survive. They did what they did to survive, and given the tools that they had then we weren’t in their shoes. You know they’re by, but the grace of God goes so we want to remember that people did what they had to do and it got them here and it helped them survive until now, and we want to be attentive if we see that the Person starts moving around in their seat a little bit. You know, ask them, you know, are you uncomfortable? Is there something I can do to make you comfortable? They may be uncomfortable about what you’re talking about. They may be, you may be running late, and you know you’ve been in the session for 30 minutes and they need to go or they may need to go to the bathroom or they may be thirsty or cold. You know if you see them starting to become a little bit fidgety and not necessarily even agitated ask them. You know it seems, like you’re, becoming a little bit anxious or something I’m wondering if there’s, something you need something I can do to help that will go a long way to helping them feel like you care about them, motivate and Engage the client and identified service needs, so if you determine that they need an assessment, you’re going to have to motivate them to go so help them see how going to an assessment could be beneficial to them. How it help could help them meet their life goals. Engagement puts the clinician in the best position to negotiate with the client about what to do and how to do it. So assessment is usually done at whatever treatment center that you’re, hoping the person is going to be enrolled in. So we want to talk with them during the screening about what is it. What type of Center do you want to go to? Is there a place that you have in mind? Are there particular characteristics of treatment that you’re, hoping to experience, or likewise not experiencing some people, who don’t want to be in a hospital-type environment or whatever so start talking with them about what their options are and negotiate with them. You know if you think they need an assessment and you’re likely going to need to go to residential. You know you might want to start moving them toward the four or five options that offer that service and encourage them to go, and if they don’t think they have a problem, they may not be willing to go yet if they think they’ve Got a problem make sure that the handoff goes well to that agency. If it’s not within your same agency, make sure that that referral goes really well and that they are received equally warmly by the Assessor at that agency. Help them feel comfortable going to do this. If you give them a referral and just say here, go to this place and they’ll take care of you. The person may be like I don’t know where it is. I don’t know who this person is if you hand them this and say you know, go down to this place and do you know how to get there? So let me draw you a map and that help them know how to get there and then you’re going to meet with Jane at this facility and she’s. Going to do your assessment. I’ve worked with Jane for years. She’s, really awesome. You know she’ll take her time listening to what you have to say and what your want. Is she not going to force you into anything you don’t want? That goes a whole further to motivating the client to go because they’re not apprehensive about what in the world am i walking into engaged clients are more likely to participate, willingly, be treated, be compliant, and complete treatment. Now, engagement doesn’t stop when they leave the screening that’s just the beginning, but you are the face of the mental health system so to speak because you’re the first person that they interface with so you kind of set the tone for Their experience most of the time create a welcoming environment that’s pleasant and sensitive to age. If you’re working with kids, don’t have a sterile environment with only big people chairs, you know, have little people chairs and have you know books that are appropriate if it’s, have it be sensitive to gender? You know men, aren’t 39, t going to be wanting to sit in an office where everything is pink and frilly and whatever likewise adults, aren’t going to want to sit in a playroom to do counseling. So you know make sure you’ve got age. Appropriate stuff in the room that you’re working with, makes it sensitive to disobeying ability. If people have hearing disabilities, you know make sure that you can talk loudly enough, that they can hear you make sure you minimize extraneous noise that may keep them from hearing you make sure the area is compliant with the Americans with Disabilities Act. So people who are physically disabled can get through doorways and things like that. The physical environment should be sensitive to sexual orientation, so have little clues around that you are accepting of the LGBTQ lifestyle, so a rainbow flag on your desk or something doesn’t have to be huge, you know just little things in the environment that say hey. You know I’m cool with whoever you are cuz. You’re an awesome person same thing with religion. You know try to make sure the assessment environment is friendly and not necessarily oppressively religious. You know, if you have you know across here or prayer there or something you know that’s, fine, that’s, your expression of who you are, but we want to make sure that people who are of a different religion or who are atheist. Don’t feel oppressed in that environment. Likewise, people who’ve been traumatized potentially through their church in some way or another may be off-putting if they see that so be cognizant of the things that seem benign to you and what they may mean to the people who are coming in for Screenings and make sure your environment is sensitive to socioeconomic status, and what I mean by that is, you know, have a pleasant environment for everybody, but people who are from a higher socioeconomic status, for example, are probably going to affect. Expect a plusher environment and a much different experience more concierge-type services than somebody who is of a middle class or lower socioeconomic status. Now, does that mean you can just throw folding chairs out for other people? No, we want to make sure everybody is comfortable and they feel kind of like it,’s their living room. You know we don’t want them to feel like it,’s, a stair-scary environment, but you do need to pay attention to it. What is this person, or what are the people in my community expecting when they come in factors impacting engagement, can include stigma about the diagnosis or even about help seeking not everybody is cool with counseling some cultures say you know, counseling disgraces the family. Some of you know older people like my grandmother,’s, age back then, and in the 1940s and 50s you didn’t tell other people your stuff, so be conscious of the fact that just being there may be overwhelming for people’s, expectations about The effectiveness of treatment can impact their engagement if they’ve been in treatment before or they’ve known. Somebody who’s been in treatment before and it just never seems to work. Then they may be there because they have to be for some reason, but they don’t expect you to be able to help them, so their engagement going to be low. One of the things you can do with those people is to make sure you have some tools in your toolbox that are brief interventions that can help them start feeling better. Today, you know tomorrow, something like that. So talk with them, sleep is one of the first and easiest things to start addressing. You know talk with them about their sleep hygiene patterns. You know, because people’s, inability to relax, can contribute to depression and anxiety and a whole bunch of other stuff, so learn about sleep hygiene and how to create a good sleep routine and encourage them to start doing that or encourage them to make a List of the people and things that are important to them, so they can figure out where they’re going from here, and they can figure out why they’re doing all this so find a couple of tools that you can give people, so they can Focus on the fact that yeah, this might help me and it might help me move towards my goals and, oh by the way I’m, starting to figure out what my goals are. People may have expectations about their role or power in the treatment process, so we want to make sure that clients understand that they are in charge. They are in charge of their treatment, make them. You know unless I have to do an involuntary commitment, but that’s something a therapist or is going to do or psychiatrist, but 99 99 of the time you want to work with the client and they’re going to be the ones to tell you what 39, s worked in the past. What hasn’t worked in the past? What’s working right now even a little bit, and you’re going to talk about ways to enhance that. You know we’re not going to force them to do things that they don’t want to do, and they may have certain expectations about the treatment itself. So we want to dispel any myths about what treatment is like. We want to help them know what our facility or the facility we’re, referring to can provide in terms of treatment, and we also want to just help them understand what to expect so. They’re not apprehensive, and you’re likable nests. I hate to say it, but you are likable enough sand. They’re likable near in pact engagement. If somebody comes into your office and you’re doing a screening and they are just, they have no social skills, they’re not attentive. They’re not attractive, they’re, not happy, they’re just mean and cantankerous it’s, going to be hard to engage them and it’s going to take an extra effort on your part to try to hear where they’re. Coming from and hearing what’s important to them and forming a bond, the client’s social skills will impact engagement. If they don’t have great social skills. You know you got to work with it and you know if they’re. I had one client that bless his heart. He was in college and he would still pick his nose and eat it, and you know I had a hard time focusing when he was doing that. So you know I got to the point where he would do it and as soon as he pick his nose, I pick up a tissue and hand it to him and go here. You go looks like you need that, but those are things that you can run into when you are working with clients and you need to keep that from causing a barrier in your ability to engage with them if they’re, not attentive. Ask them why you know or try to look for reasons why they’re, not attentive. You know you seem to be kind of distracted. Is there something I can do to make you more comfortable? And you know it’s just human nature that we tend to be more engaged with attractive people. Not everybody’s attractive. So you know focus on what the person has to say and what their heart has to say to engage, and you know likewise, you may not be written off the pages of Vogue either, but try to present yourself well, try to you know, dress appropriately Don’t show up all disheveled and smelly clothes like looking like you haven’t bathed in a week that that’s not helpful so make sure that you’re presenting your best face and you’re dealing with whatever face the client brings And still trying to build that engagement remember the way a client presents. This tells us a lot about what’s contributing to their presenting issues: poor social skills, and ADHD pain. You know there are a variety of things that can contribute to depression, anxiety, and substance use. So try to look at it from that way, even if it’s not your ideal client understand what’s causing this person to be negative and just argumentative and frustrating try to get under there and figure it out. Why is this person so unhappy? What’s motivating is that first impressions impact engagement, so your professional presentation is promptly courteous and smooth handling paperwork. If you walk in there with 15 sheets of paper – and you’re shuffling them around and it seems like you, don’t know what you’re doing. You’re like just a second. I know I had that form around here somewhere, they’re not going to feel very confident in anything. You have to say so and put on a good first impression. Put it together and make sure your paperwork is put together ahead of time. If you have an electronic medical record, make sure you know how to use it because it’s disturbing to people, even though it happens when you’re, using an electronic medical health record to do a screening and you get stuck and you’ve got To call somebody else in to help you figure out how to get on the next screen make sure the environment is calm, clean and comfortable, not too formal or informal like we talked about it, avoids interruptions and provides the appropriate level of privacy. You don’t want clients sitting in the waiting room being able to hear other clients that are in the therapy, rooms or screening rooms. If you’re doing screenings, you may not even be in an office, you may be out at a festival or something so make sure that you’ve got. You know little pull-around screens or something, if appropriate, to give people privacy other people, shouldn’t be hearing their responses to what you are asking them, even if it’s, you know like I said, even if it’s at a Workplace festival or something other people should not hear their answers. So how can you give them privacy if there’s, no way to do that where they can have auditory privacy put as much as possible on check sheets and forms that they can fill out? And then you can point to something and go so help me understand your answer to this right here. Most of the time you want to try to do a screening in a private room. In the initial interview you’re, developing trust and rapport so be empathetic. They’re nervous, probably or they don’t want to be there or maybe they do want to be there and they’re, just hoping that you can help paraphrase that to them whatever vibe you’re getting off of them, paraphrase that and work With it convey warmth and respect and explores the clients, strengths, and skills, you know you’ve been dealing with this depression or this addiction for a long time. I’m wondering how you’ve survived until now. What has helped you deal with it? And keep on keeping on facilitating the clients, understanding the rationale, purpose, and procedures of the screening and assessment exploring the clients, problems, and expectations regarding treatment and recovery, and determining whether a further assessment is needed. That’s your screening. So the definition of screening is the process by which the counselor, client, and significant others, when possible, review the current situation, symptoms, and collateral information to determine the probability of a problem. So we’re going to sit down and we’re going to go okay. What brings you here today? What makes you think you got a problem, you know, and then we’re going to start asking questions or using instruments to try to determine whether we think that there’s a probability that that problem exists screaming is used by all types of Human Service Personnel to determine eligibility and appropriateness of services and needed referrals, so it may be used by a physician by a nurse by a counselor by a caseworker to determine how can we best help this person achieve their goals and their maximum quality of life? It’s not unusual for caseworkers at the Department of Children and Families. If people are coming in to get their food stamps or EBT that month, or they’re enrolling in the process to do a screening to determine how can we best help this person? You know be able to start earning more money, you know, maybe they just need a better job, or maybe they’re not able to maintain employment because their depression is so oppressive. So you can see where screening may be used in a lot of different systems and situations to help people figure out how to help their customers. Screening determines the immediacy of the need. You know you could be doing a screening with somebody who’s like on the fence, or they don’t think they’ve got a problem and it you know there or their problem is minor, so the immediacy may not be great or you could Be screening somebody who is you know heavily intoxicated was just kicked out of his house is facing three DUIs. You know they have a much more immediate need for their safety as well as, hopefully, they’re. More motivated screening needs to be a trance process. We don’t want to sit there with a clipboard and be asking questions and scribbling things down and going uh huh. Well, I think you need to go for an assessment that’s not transparent. The clients like, where did you come up with that I usually use screening instruments, and I talk with people when I’m writing things down. I tell them at the end. If you want to see anything I wrote down, I would encourage you to know I don’t write well, and I’ve got poor penmanship, but I encourage you to read what I wrote and we’re going to talk about these instruments after you Take them so you know you know why were we asking these particular questions? What does it mean to me as a therapist doing your screening, so they understand how you’re arriving at your conclusions? Screening does require informed consent. You know it. Doesn’t have to be a big thing, but it does have to happen before you start screening somebody you need to go. You know I’d like to screen you for depression or anxiety, or this is a wellness screening that your agency is offered, but have them ideally have them sign a sheet acknowledging that they know that they’re being screened for whatever and screening identifies Early warning signs and helps provide early intervention, services and resources, so you know think about high blood pressure or diabetes or any of those physical things doctor screens for that regularly, and if they see that there might be a problem creeping in, they can do something right. Then, to keep it from becoming a full-blown problem. Mental health screening is the same. We notice people are under a lot of stress. We know that that’s probably going to wear them out after a while, and it might lead to depression. So we can start helping them, develop stress management skills, for example. They may not need to go to treatment, maybe they need to go to psychoeducation and learn about stress management, or maybe you’ve got a book. You can let them read or something. But screening is a method of determining what the person needs. Screening is the first opportunity to engage the client in the therapeutic relationship and treatment process, sometimes based on observations or other circumstances. People may be referred directly for assessment, for example, if people come into the detoxification unit we kind of bypass screening. We know there’s a problem and jump straight into assessment, so screening doesn’t always happen, but a lot of times. It does because of that referral source – you know if you’re an Assessor that person came from somewhere. You know their lawyer could have screened them. Their doctor could have screened them whatever, but somebody along the way, probably screen them to determine yeah. You probably need to go over to this facility and talk to an Assessor of the clients. Internal motivation is the primary reason for engaging in treatment. So if they’re there because their wife told them they had to be or their boss or the courts that got them there, but to get them actually engaged in treatment and not just going through the motions they have to have internal motivation. There has to be something in it for them, and that’s, what we want to work on developing throughout the whole process, help them see how this benefits them, what’s in it for them, how can it help them accomplish and get closer to their goals for their life, internal motivation may be fleeting, so rapid engagement is vital. If you see a spark of interest or a spark of willingness, we kind of need to pounce on that spark and go alright. It seems like you know you want to get on with this because you’re sick and tired of being sick and tired. So let’s get you enrolled. Now, if you have to make an appointment for an assessment that’s six weeks out, you may lose the person. You know that engagement doesn’t last for long. The engagement lasts while they’re in your office, and then you know you got to have somebody else, pick it up and keep that momentum going. Screening should be brief. You know twenty-thirty minutes you don’t want to have somebody in there for three hours, that’s the assessment conducted in a variety of settings by a range of professionals on persons deemed to be at risk. Some things we do Universal screenings for like domestic violence, other things you may do selected screenings for – and it also depends on your setting and all that kind of thing. But the take-home point is that screenings are conducted in a variety of settings, whether it be a Health Fair at an employer,’s, a doctor,’s office, sometimes churches will even set up wellness days and do screenings screening represents the first part of a Collaboration among the multidisciplinary team because the screener is going to say, okay, I think I’ve identified that this person probably has an issue with this and needs to be referred to assessment over here, but they also need help with housing and food and affording their Prescriptions, so the screener will kind of link them to other team members in the multidisciplinary team. Screening needs to be sensitive to racial, cultural, socio, economic, and gender-related concerns, so make sure that you’re, culturally responsive and it needs to be developed from information gathered from multiple sources when possible. When you’re doing a screening a lot of times, the only person you’ve got to do. The screening is the person sitting right in front of you, but if you’ve got other information. When I do screenings on people in the criminal justice system, I want to see their criminal records. You know that gives me some objective. Information on you know how many times have they been caught? Dui, whether or not they’ve been convicted? How many times have they been caught DUI, that gives me a little bit more information than just what that person is telling me if they’ve been involved with the Department of Children and Families. I want them to bring their case report, especially if they’ve got an open case going on. Screening assesses signs and symptoms of intoxication and withdrawal. Three key elements: we want to verify that the behavior deviates from the norm and rule out all non-drug related causes. So if somebody is having difficulty focusing or they’re agitated, we want to rule out ADHD and schizophrenia and some other things that might cause that, to rule in, if you will stimulant abuse, for example, you want to verify that there. This is not how they normally behave. You know some people are agitated and a little bit more bouncy or fidgety or whatever you want to say most of the time. If that’s how they are, then you know that’s how they are and it’s not a drug, wants to rule out the drug-related causes, including physical causes. You know if they’re in chronic pain if you know etc. There are a lot of reasons somebody could be excessively sleepy have difficulty concentrating be overly agitated. There are a lot of things that use diagnostic procedures to determine the types of drugs being used. So in screening, we’re going to ask them what they’ve been using. But ideally, you can also do an on-site drug screening. You know having a pee in a cup and the on-site. Screenings are not super reliable, but it gives you something to look at. You know most cases, it’s anywhere between 60 and 70 percent reliability, which is why, if it comes up positive and the person says, I didn’t use that it needs to be sent off to a lab for mass spectrometry. To determine what happened, because you can get false positives and you can get false negatives, they may have used something and it doesn’t show up on the test. So you don’t want to just trust the on sites as being a hundred percent, but it is a good tool to identify whether the person is telling you the truth about how much or what their current, whether they’re currently using or not assess Clients, mental health and trauma history. You’re not going to get deep into the weeds here, just ask them if they have a history of depression, anxiety, or abuse of any sort and move on to their safety or environmental needs. Do they have a safe place to sleep? You know if they have an address, you know, do they feel safe in their home? Do they eat well, how’s their nutrition? Do they have any physical health needs that are not getting met? Do they have any other wraparound needs? If they’ve got kids, do they have access to childcare? Are they having problems with transportation? Are they able to afford the medications that they’re already prescribed, etc? So we want to ask them about some basic things like that, and then we’re going to assess the danger to themselves and others. Are they talking about harming themselves or someone else? And we also want to ask if they’re thinking about hurting themselves or someone else. Screening methods include interviewing the clients and significant others using screening instruments and lab tests like urinalysis that we talked about signs of substance, use disorders or mental health issues. We want to look for number one, the circumstances of contact. If the person was referred by the court, then that’s a pretty good sign that there may be a substance use disorder going on if they’re referred because of a DUI. For example, if they’re referred because of a fight they got into, but they weren’t using at the time their blood alcohol was zero. We want to look maybe for mental health issues and things like intermittent explosive disorder. You want to look at the clients, demeanor, and behavior. Are they acting like they’re under the influence when they come in for the screening? Are they showing signs of acute intoxication or withdrawal? Are there any physical signs of drug use or self-injury? Needle injection marks, if they have a get frequent bloody noses, you know if they get bloody noses, while they’re in your office or if they have signs that they’ve been picking. Those can be all physical signs of drug use. Emaciation and malnutrition are also signed some drugs will cause the pupils to be dilated. Other drugs will cause the pupils to be pinpointed. So you want to know what the signs of different drugs are for drugs of intoxication and different signs that people have been using, especially injection, but, like I said, sometimes, drugs will cause people to pick or itch, and that will show indicate to you that there might Be an underlying issue and information spontaneously offered by the client or significant others can give you information about whether there’s a substance, use or mental health issue, and sometimes the significant other. Let me just kind of back up: there may be the significance the spouse brought the person in and when you go out to meet them you, the person, the person being interviewed. Doesn’t want their spouse in there. They want. They want to go back by themselves, okay, that’s cool, you go out and meet the person and then, if you can, with permission, bring the spouse back after the screening to give them both the results, and at that point the significant other the spouse may Spontaneously say: oh well, why didn’t you tell them about? You know the DUI you had three years ago or whatever. So sometimes spouses will just kind of blurt things out because they suspect that the significant other didn’t already say it during the interview. So if you can get that person in a private place where they have an opportunity to say something wonderful but remember you know you do have to have the client’s permission. Screening instruments can be developed by the agency or use standardized instruments. The cage is a common one and you ask a person: have they tried to cut down unsuccessfully, do they feel annoyed when people talk to them about their substance use, do they feel guilty about the substances about using their substances and do they sometimes have to Use first thing: in the morning to kind of wake up we call it an eye opener if they say yes to one or more of those, there’s a chance that they may have a problem. The gain is another tool that you can use, as is the Michigan alcohol screening test or the Sasi. So all of those are standardized instruments, and some of them cost money. Others, like Kay, don’t, so it may depend on your agency and what kind of budget you’ve got. What instruments you’re using any instruments you do use must detail what action should be taken based on received scores. So if a person takes the cage – and they say yes to one but not any of the others, does that mean they should be sent for a referral if they say yes to two, when at what point should they be sent for a full assessment? You want to screen when screening for mental health you want to screen for acute symptoms such as hallucinations, delusions or depression or anxiety, suicidal thoughts and behaviors, and other mood and thought disturbances. So you’re going to ask them about time, place, purpose, and person. Do you know what time it is? Do you know where you are? Do you know why you’re here and do you know who I am you’re going to ask them about short and long-term memory if they can tell you about something from their childhood great, but you’re also going to ask them If they can tell you about what they had for lunch, another thing you want to assess or another way to assess short term memory is to tell them. I’m going to tell you four words and I want I’m going to. Ask you in a few minutes to recall those four words for me and then tell them four words: make them easy words like dog cat, bird, and fish. You know not something hard to remember and then in five or ten minutes. Ask them what were the four words I told you and see if they can remember you’re going to ask them about prior involvement in mental health treatment. What worked and what didn’t if they have been in treatment? What prescription medications do they use, and this includes all prescriptions because physical health prescriptions can have mental health side effects? Ask them about recent traumas again, don’t get into it, but ask them if they’ve been victimized or experienced any sort of abuse and a family history of mental illness. If they have a family history of mental illness, the chances of them developing mental illness are a little bit greater. When screening for mental health, you’re going to use the modified mini screen, the Mental Status exam, the mini Mental Status exam. The brief symptom inventory, a brief psychiatric rating scale, or the symptom checklist 9 t r. So those are the ones that you’re, typically going to use a lot of times. They’re already in your electronic medical record, so you’re not going to have to figure out what to use in terms of you know, knowing what the instruments are for certification and testing purposes. These are the six that you want to be aware of. So you can google each one of them and find out more about what each screening test can provide. Your screening is the initial contact to decide if a person may need a more in-depth assessment. Screening is brief but requires the person to be engaged in the process to get an accurate result. How well the person is engaged in the screening process is a direct predictor of whether he or she will continue in the process. 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 YouTubeThis solution reverses kidney disease! Guaranteed to be effective or your money back: Beat kidney disease. Just by following a simple treatment plan, you can reverse kidney disease. No matter how old you are! Just listen to what people who have tried this solution have to say. “Thank God I came across your solution by accident! Dad’s kidney function decreased from 36% to 73% in just two months. He’s 90 years old! 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You can easily begin to recognize the causes of your anxiety symptoms. If you have ever experienced being uncomfortable and feeling that something just isn’t right when it comes to your breathing or the way your body seems to be failing you, it is entirely possible you could have been experiencing an anxiety attack symptom. Let’s take a look at some of the symptoms that usually come with anxiety attacks.One of the more common of an anxiety attack symptom is a pounding heart. This symptom can be caused by several different anxiety attacks, from mild to severe. Many people who do have an attack tend to clutch at their chest in fear of a heart attack or other ailment when in reality they are experiencing anxiety.Shortness of breath is another anxiety attack symptom that is seen a lot because of someone feeling panicked due to other symptoms they are experiencing. The shortness of breath can seem like your world is caving in, but by being able to recognize the symptom as part of an anxiety attack, you can more easily control this.Becoming lightheaded is one anxiety attack symptom that happens a lot in crowded areas. Many people have a phobia about being in crowds and becoming lightheaded or fainting is a common symptom that they experience. People will sometimes think they have a more serious issue, but in reality, it’s only one of the symptoms that are associated with anxiety attacks.Another anxiety attack symptom that is almost always present in an attack is the fear of losing control. This fear comes from the seemingly uncontrollable symptoms that precede like becoming lightheaded with a racing heart, and shortness of breath. It is a natural feeling for us to feel as if we are losing control of our bodies.Anxiety attack symptoms vary and are not isolated to just one group of people. Everybody is different and may experience varying symptoms based on what their fears may be. Anxiety is a treatable problem and many people live normal lives once they learn to control their attacks. In the end, by visiting a physician to talk about the anxiety attack symptoms that bother you, a plan can be put in place as to how you can effectively overcome the symptoms as they occur, making it possible to ensure anxiety attacks do not have precedence over your life. As these may be some of the most common symptoms I always recommend that you see your doctor. Your doctor will make sure and confirm your symptoms. Once you have done that you can begin to find techniques and methods to eliminate your anxiety attacks.Feel free to visit some of my sites Stop Anxiety Attacks and Stop Anxiety Now
You may not realize it, but you may suffer from something that can take over your whole world if you let it. You’ll recognize the symptoms, but you’ll have no idea what’s behind them.Panic attacks are debilitating. One moment, you’re living your day-to-day lifestyle, and the next, you find yourself paralyzed with the feeling that you’ve lost all control. You worry about the possibility of something happening to you. It all comes on so quickly and unexpectedly, that you’re blown away and the only thing you want to do is go right back home.
While they can be caused by a number of things – heredity, biological forces even exaggerated thinking – the main culprit is usually stress. As stress plays such a huge factor in our day-to-day lives, we don’t realize just how profoundly we’re affected until something highly stressful approaches and we’re stuck with a panic attack, afraid of absolutely everything that may come our way. Finding proper stress relief is crucial in order to help limit the number of panic attacks a person has at any given point in their life. If stress is controlled before panic and anxiety set in, there is a better likelihood of being able to stop panic attacks before they start.The symptoms of a panic attack are obvious enough: the rapid heartbeat, difficulty breathing, the feeling of dizziness and dread, trembling, sudden chills, and the pins and needles feeling in your fingers and toes are only a few of many symptoms. In any given year, their millions of people who experience a panic attack – some of which experience repeated panic attacks.The best course of action for panic attacks would be to talk to your doctor, who can prescribe medications and forms of therapy to assist with the treatment of those feelings of panic. Only your doctor would know the treatment that is best for you. While a panic attack may leave you feeling the need to hide and can feel as though it controls every aspect of your life, it doesn’t have to. With proper treatment and reduced stress, you can reduce the number of panic attacks you have, and can even eliminate them! A happy, healthy life is once again within your reach.