7 Signs You Have Abandonment Issues

Hey Psych2go family, welcome back to another video. Do you have an overwhelming fear of losing your loved ones? Do you distrust other people or have anxiety about being abandoned? Abandonment issues typically arise in childhood but can develop later on in life as well. The fear of abandonment is a serious type of anxiety that often stems from a traumatic experience. Some aren’t even aware of their expressed emotional trauma. But it can manifest into unhealthy behaviors over time. So, here are 7 Signs You may Have Abandonment Issues. One: you’re a people pleaser. Do you want to impress everyone you meet? Whether it’s your friends, acquaintances, or family members, you try to meet their expectations to get on their good side. You’re the one who tries harder in your relationship, and you’re willing to put everyone else’s needs ahead of yours, as long as it gets them to stay. If you have a strong need to please people and gain their approval, you may still have some unresolved abandonment issues.Two: you struggle with insecurity. Do you sometimes think that someday, the people closest to you will get sick of you and leave? People who are afraid of being abandoned often struggle with feelings of insecurity and inadequacy because someone you love has walked out on you in the past. You’ve internalized the emotional trauma. You may have wrongly believed that it was YOUR fault that they left. This can result in low self-esteem and a need for constant rereassuranceThree: you find it hard to trust people Do you find it hard to trust others to keep their promises or to be there for you? Do you want to be in control of your relationships and know everything that’s going on with your loved ones? Because you’ve been hurt in the past, you have a strong fear of being left alone.In certain cases, it can lead to feelings of unreasonable jealousy, suspicion, and possessiveness over your friends and romantic partners. Four: you’re afraid to be vulnerable Do you feel uncomfortable during moments of emotional intimacy and honesty? Are you scared of getting close to someone or needing them too much? Your deep-seated fear of abandonment may manifest into a fear of intimacy and emotional vulnerability. You may unconsciously sabotage your relationships by pushing people away just as you start to care for them. You may struggle with commitment, and act detached and indifferent when you do care.Five: you look for reasons to leave. Do you always look for reasons to leave in fear of getting too attached to someone? You hold your loved ones to unrealistically high standards and you only focus on their flaws. You don’t give them any room for mistakes. You do this knowing that they’re bound to disappoint you. And when they fail to meet your expectations, you use it as an excuse to give up and leave. Six: you move on too quickly Do you have difficulty forming meaningful relationships that last because of a deep-seated fear of abandonment? When you cycle through relationships one after another and move on too quickly, you’re not allowing yourself the time and space to deal with the emotional fallout.Instead, you dive into something new and exciting to distract yourself. You never want to be alone, because it would force you to confront the personal issues you’ve been repressing for so long. And number 7… you cling to unhealthy relationships Do you find yourself gravitating towards all the wrong people? Have you stayed with someone knowing they’re bad for you? The trauma of being abandoned, especially at a young age, can stay with you for a long time. And since we’re all hard-wired to recreate our early childhood experiences for comfort and familiarity, your childhood taught you the wrong things about love. It’s not uncommon for you to be drawn to people who treat you poorly. Do you relate to any of the signs mentioned here? I know I did… Is a fear of abandonment harming your relationships and keeping you from being happy? 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 to Psych2go for more videos! Thanks for watching, and we’ll see you in the next one! Do you have an overwhelming fear of losing your loved ones? Do struggle with trust issues or have anxiety about being abandoned? Abandonment issues typically arise in childhood but can develop later on in life as well. The fear of abandonment is a serious type of anxiety that often stems from a traumatic experience. Some aren’t even aware of their repressed emotional trauma, but it can manifest into unhealthy behaviors over time. Here are 7 signs that you may have abandonment issues. If you want to learn more about how your childhood trauma may cause you to have abandonment issues, be sure to check out our video “7 Ways Childhood Trauma Follow You Into Adulthood”:    • 7 Ways Childhood Trauma Follow You In…   #abandonment #issues #psych2go ᵛᶦᵈᵗᵒᵒⁿ™ ².¹ ᴏɴᴇ ᴛɪᴍᴇ ᴏꜰꜰᴇʀ – ᴛʜᴇ 2ᴅ ᴀᴍɪɴᴀᴛɪᴏɴ ᴠɪᴅᴇᴏ ᴍᴀᴋᴇʀ After The Massive Success Of VidToon™ 1.0 And More Than 10ᴋ Happy Customers…WE ARE BACK ON Popular Demand! Redefine Profitability With The World’s Easiest & Most Popular Video Animation Software It’s ʙɪɢɢᴇʀ. ʙᴇᴛᴛᴇʀ. ᴀɴᴅ ꜰᴀꜱᴛᴇʀ.

Sociological Approach to Reducing Risk and Increasing Resilience Addiction Certification Exam Review

 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. I’d like to welcome you to today’s presentation on the sociological approach to reducing risk and building resilience. As I was putting together This presentation it was kind of like right in the wake of when Harvey hit. And then you know recently we’ve had the shooting in Las Vegas, and some of the counselors, especially counselors in training that can’t be practiced independently yet that are in some of my social media groups and in my professional groups have been talking about how frustrating it is and even some of us who are licensed but just can’t wake up and go help the Red Cross right now about how frustrating it is not to be able to help and how much we want to help so what I usually do because you know I I’m generally not upwardly mobile where I can just drop everything and go to a crisis what I did after 9/11 was look at what things in that situation could I positively impact and how could I do it in a way that made sense but you know for my life because I can’t you know at that point I for 9/11 I had an infant at home and you know other stuff so we’re going to look when we’re talking about addressing issues like the opiate epidemic or the major problem of depression almost I guess anxiety almost one in four people has anxiety issues and we’re gonna look at some of that and try to figure out what can be done what can we do from where we are in a way that makes sense because yes we can influence politics and advocacy but what can we do with small chunks of time that are beneficial to helping the cause as well as you know could help the clients we have currently so we’ll define the socio-ecological not model which is Broth and Brenner’s model we’re going to apply it to addiction and mental health issues and explore different variables in this model and then discuss how this framework can be used in prevention and treatment of co-occurring or independently occurring disorders so we’re going to talk about how it may sense to conceptualize not only the development of addiction but also the development of things like eating disorders and mood disorders in terms of a socio-ecological model and even some things like bipolar and schizophrenia can be a person being genetically predisposed or whatever but there could be certain environmental factors that could you know trigger that first psychotic episodes so we want to look at what might be going on and how can we help prevent or treat now prevention can take the form of three different activities if you will prevent the problem so helping people not get depressed at all ever so starting to provide those skills and tools when people are knee-high to a grasshopper hopefully preventing worsening of the problem so people don’t get severely clinically depressed where they can’t get out of bed so the early intervention services and effective you know frontline resources and preventing associated fallout okay the person gets to press gets clinically depressed well let’s see if we can help them avoid losing their job because they can’t get out of bed to go to work develop additional health problems from being depressed or developing an addiction in order to self-medicate that depression so we’ve there are three different methods or avenues we can take in prevention and you know we want to look at them all because when you’ve got somebody who’s becoming clinically depressed you know they’re depressed you know situationally whatever something happened and it started to turn into something more than just a couple of days it’s going to start having associated fallout early and you know it’s not going to be huge they’re not going to lose a job right off they’re not going to start having major family problems right off but they are going to start having little hiccups because that depression causes an imbalance in their in their environment and we know environments like to maintain homeostasis and you know the kids are gonna be like well Mom why aren’t you getting up and doing these things and what’s going on and you know things are going to start changing and the person will need to be able to deal with that so the socio-ecological model explores and explains human behavior as the interaction between the individual and environmental systems there’s a fifth one that is more of your longitudinal but we’re going to talk about the four main ones today the micro the meso the EXO and the macro systems the microsystem involves well let’s start before that the individual if you look at the model is sort of the bull’s eye here and the individual is not considered a system but it involves all of the things about the individual including biology and personal learning that make people who they are okay so this person exists within a microsystem and that micro system is their family peers School Church synagogue whatever and health services things that they probably interface with regularly work should also be on that but it’s for some reason it’s not on this diagram anyway the mesosystem is the interconnection between microsystems so how do family and peers interact I don’t know about you thankfully my family might be very accepting of most of my peers but I know other friends of mine who brought home peers who were not as well accepted by their family so there was some conflict between the the family and the peers and we know how much peer pressure and peer relationships are important in an adolescents’ lives which creates conflict and consternation how does the family interface with school how does Pierce how does your peer group interact with school and do they see it as a good thing to do they see it as worthwhile you know etc so when we’re talking about the microsystem and the mesosystem we’re talking about things that people interface with daily so I want you to think about how the mesosystem and you can feel free to chime in on the chat room if you want how does the mesosystem family peer school church you know recreational activities health services impact the development of mental health or illness now you notice I’m trying to kind of switch ears for health because we want to promote health and we can look at the opposite for mental illness but you know if you have positive family peer interactions it’s probably going to support mental health it’s probably going to support decision-making in the adolescent it’s probably going to I mean and I’m thinking adults and adolescents here but family and friends you know if you want to think about you know how do you get along with your significant others peer groups and do they interface well or is it kind of like oil and water how does the how does your family interface with your work how do they deal with how many hours you have to work whether you’re getting called in at night or getting emails or text messages at 8 p.m. or you know what are their expectations and how does that influence if there’s a conflict you know if the family doesn’t like what’s going on at work or the fact that you know your boss is emailing you at 8 p.m. then it can create conflict within the environment which can lead to increased anxiety and depression and Yabadabadoo now how does mental health or illness impact the mesosystem so again thinking about how if someone is clinically depressed how does it impact their family how does it impact their peers and if you have a family member who has you know clinical depression or generalized anxiety how does it impact how your family interfaces with everything else because you know you end up having somebody or somebody in the family who may be caretaking for the person who has depression or anxiety or whatever the mental health issue is who’s not able to do the stuff that they were able to do so the rest of the families kind of pick slack so how does that affect how they interface you know the rest of the family members interface with school and work you know maybe they end up showing it more exhausted so it’s important to look at the mesosystem the exosystem involves links in a social setting in which the individual does not have a direct active role so for example how would I impact my spouse’s work and again if I am the identified patient and I’ve got clinical depression and I’m calling my spouse to come home because I just can’t be alone or my spouse is late to work or unproductive because he’s always exhausted when he gets to work because he has so much to do since I am you know not able to do as much right now then it could negatively impact his work and so we want to look at how that impacts how the home environment impacts work and how work impacts the home environment the macro system describes the culture socioeconomic status poverty ethnicity etc so what we’re looking at in the macro system is really the larger you know not just within your city maybe or even closer to your neighborhood we’re looking at what you see in the media what you see on national TV your your statewide elections your national elections your state laws and culture and what’s being communicated if you are a religious person what your religious culture communicates because you know religion generally is not just in one little area it’s international or national so what types of things does that communicate to to the person and how does that influence the development or not development if you will of depression anxiety or addiction so again think about how the exosystem of the social setting in which the individual doesn’t have a directive or an active role think about how much people were influenced after the elections I mean yeah we had a role if you went out and voted you had a role but you don’t decide the election so once that happens how do you know the exosystem impact you know your your emotions your other community events employment etc and how those things impact the family I know you know there was a lot of consternation and concern among some of my friends who are Jewish after the last election so their families experienced a high ink or a great increase in anxiety development of mental health or mental illness how does all this stuff that’s going on in the exosystem and stuff that you don’t have direct control over how does it impact the development of mental illness you know or mental health and we’re going to talk more specifically in a couple of minutes and again likewise how does mental illness or mental health impact the exosystem if you have a healthy workforce if you have healthy people who are actively participating in work and going to community activities voting to participate then you’re probably going to have a healthier outcome than if you have people who are not able I mean they’re so depressed they’re not able to even get out and participate so we want to look at the reciprocal nature it’s not one way the community doesn’t just affect us you know it may affect us but then how we react affects the community how does the attitude of the culture impact the community if you’ve got a a culture that is accepting of certain ideologies they’re accepting of LGBTQI they’re accepting of people who are Muslim in their religion they’re accepting of people who are Christian and their religion they’re accepting of you know fill in the blank if the culture is accepting of that how does that affect the community and those people within the community who might you know otherwise not have been accepting does it kind of pressure them in or does it cause anxiety and consternation in those people how does the attitude of the culture for example about premarital sex and marriage affect the family how does it affect the development of and again we’re thinking about anxiety depression and addiction so how does it affect the development of stress which may lead to mood disorders or problems and how did the community families and individuals with mental health or mental illness impacts the culture you know so we have an impact on our culture we get together we see you know we have Generation X Generation Y but the baby boomers all had their sort of or we all have our sort of unique cultures and things that we bring to the table and things you know that was given to us we said no we don’t want to thank you very much so there is a give-and-take among the individuals within the culture and that’s good because that means we can start small you know start in our locale and create this positive mesosystem and then build from there if If you have a positive community then that’s probably going to spread think about when a company goes and dumps fertilizer for example into a waterway it doesn’t just stay there over time that fertilizer bleeds out and you start having algae blooms everywhere things don’t stay I mean in our society things don’t stay in one place for very long they tend to move they tend to migrate so positive will migrate that’s awesome negative can also migrate so we want to look at how can we enhance the positive migration and keep down the negative if you will so now let’s start talking about what can we do and how can we operationalize all of this we realize that if we affect the individual it’ll have a positive effect on the meso system which can have a positive effect on the exosystem Yabadabadoo so great we also realize that one of the only things we have a lot of control over is the individual ourselves so a lot of people come to counseling individually score so this is where we’re going to start so what things contribute I start by listing risk factors for the development of mood disorders and addictions and then we talk about capital you know what you have in order to you need to have to prevent these things and then prevention strategies so that’s kind of how we’re going to go it’s not going to stay depressing individuals with chronic pain are at higher risk of mood disorders or addiction addiction because of the pain management you know drugs that are out there and you know once they start taking payment management drugs opiates a lot of times the brain quits producing endogenous opioids the natural painkillers so when they first come off the body doesn’t automatically pick up so it takes a little while for the person’s pain tolerance to build back up which keeps some people from wanting to get off the medication among other things but chronic pain can also be debilitating it can make people lose some abilities that they used to have or crush some dreams if you will you no, I think I’ve told you before that I have a bad shoulder and carpal tunnel so I can’t garden the way I used to you know I still go out and do it but I’ve got to pay attention and only be out there for an hour too instead of spending six hours out on the farm which is frustrating to me it was only mildly frustrating but my grandfather when he started developing Parkinson’s couldn’t make his miniatures anymore and he made gorgeous miniatures and I know that’s not chronic pain but it’s kind of the same thing if you’ve got rheumatoid arthritis he couldn’t make his miniatures and he became devastated and became withdrawn so understanding that pain has multiple influences that can cause depression that may trigger a grief reaction that we need to help people address now the things I put in bold are things that we as clinicians can easily help people prevent or/or address chronic pain we can help For people with low self-esteem that’s a no-brainer if people don’t feel good about themselves and they’re looking for external validation they’re going to be at a higher risk for anxiety fear of abandonment fear of not being good enough fear of failure and depression a sense of hopelessness and helplessness substance use especially early substance use can cause changes in the prefrontal cortex leading to problems with impulse control and decision-making but it can also disrupt the balance of neurochemicals leading to symptoms of depression and/or anxiety so it’s important to understand that especially the earlier the substance use starts the greater the chance that it’s going to cause some sort of brain changes and we’ve also found that a lot of people, not the majority but there is a percentage a significant percentage of people that when they start using early they kind of quit developing coping skills after that they find something that works they’re like oh I like this I think I’ll use that from now on when we start talking about people who started drinking or smoking marijuana when they were you know 9 10 11 12 you might see more mood issues or addiction issues in those people than people who didn’t start using mood-altering drugs as early as a history of abuse can contribute to the development of PTSD but not everybody who is abused develops PTSD but there can be episodes of anxiety and depression as well as it increases the chances of the development of addiction genetic vulnerability we know that mood disorders and addictions tend to run in families and they’ve done studies that have shown that there is a genetic component doesn’t mean it’s going to happen it just means you have this gene there that could be triggered so we don’t want we want to make sure that clients know that they are not just doomed you know they can prevent triggering that but they need to be aware that they may be more vulnerable inappropriate coping responses if we are not born with coping skills so if somebody doesn’t know how to cope with life on life’s terms because either because they’ve always been shielded or because they’ve never had anybody helped them maybe they were kind of on their own from the get-go so they learned to lash out and get angry or withdraw and get depressed but they never really learned how to deal with the stuff they’re gonna be at higher risk of mood and addictive disorders we can help people develop coping responses are one of the things you want to look at when people are using seemingly unhelpful behaviors is to remember to ask what is the cause of this so we want to look at what is the root cause of what is prompting this behavior and what is the benefit of the current behaviors and I’m going to keep reminding you of that as we go through this violence and aggression you know again what’s the cause of the violence and aggression did people do this person learn that’s how you cope with distress in their family of origin is it a protective mechanism because they’ve experienced situations where that has helped them deal with conflict before what prompts this and what the benefit to it when they act out when they’re violent and aggressive what is the benefit it gives them power it pushes people away they just enjoy hurting people hopefully that’s the minority but we want to ask that because we can’t figure out an alternative until we know what the function is same thing with risk-taking and impulsivity there are certain theories that says some people need more stimulation than others they get bored easily so they tend to be higher risk-takers and maybe more impulsive than you want to ask if this person doing this you know I have a friend who is an adrenaline junkie you know skydiving rock climbing you name it he’s done it and you know more power to him I don’t see a purpose of jumping out of a perfectly good airplane but he he thrives on that and when he can’t get out and do those sorts of things he feels good so what is it about this risk-taking and what kind of risk-taking it risk-taking as in holding a balloon liquor store or is it risk-taking as in doing something like skydiving which is theoretically safe and what’s the benefit it makes gives them a rush makes they feel good helps him you know escape or whatever great that’s fine the rebellious nests you know again what is and this is a key for adolescents especially but even if you’re a supervisor working with employees if they’re being rebellious you want to look and say what’s the point what’s the benefit to being rebellious what are they holding on to and refusing to let go of that you want them to let go of or what are they refusing to do that you want them to do and what’s the benefit to it if they are being rebellious and they’re staying like think again adolescents staying out all night OK well what’s a motivating factor is it to get under their parent’s skin probably not is it to conform to peer pressure you know oftentimes that’s maybe the case but you have to look at the individual and say ok how can you do this in a way that helps you move forward rejection of pro-social values if the people who espouse the pro-social values are the people that the person rejects then they’re probably going to reject those values so we want to look at you to know if you’re rejecting those what values are you espousing and why are those important to you and why are you rejecting these over here you know not saying it’s right or wrong I’m just trying to understand where you’re coming from and you know that’s something that we’ve got to be sensitive to and different people are going to hold different values lack peer refusal skills to stay out late to get into trouble to use drugs to have early sex whatever it is those things a lot of times indicate poor communication skills and low self-esteem need to be accepted you know all that stuff that’s challenging during during teen and early adolescent years those are things we can help with being bullied you know that’s a risk factor when people are bullied they tend to get depressed and when they’re bullied they may turn to substances to try to make themselves feel better to numb the pain they make self-injure there’s a lot of different things might happen we can help people develop skills to deal with being bullied since we don’t understand a hundred percent why people bully we need to help the victims become survivors we need to help them have the tools to be able to deal with it and understand why it happens without letting it hurt them early and persistent problem behaviors that’s just so broad but again look at why the person’s child acting out an early sexual activity could be a history of sexual abuse could be a dysfunctional family of origin and the child is trying to get out I worked with a 14-year-old who once told me she was gonna get pregnant as soon as she turned 15 because that’s when she could get into housing on her own so she was intentionally going to get pregnant at 15 and there was a reason for it she was very clear about her logic a lot of times it’s peer pressure and acceptance but uh asking what is that what is the cause and is this cause going to keep the person from developing healthy coping skills and being happy is potentially going to lead to depression peer rejection you know that hurts so helping people figure out how to navigate peer rejection because you’re not going to be liked by everybody academic failure we can help with now not necessarily as clinicians but we can advocate for the person we can help them find tutors resources etc lack of information on positive health behaviors put it out there most of the time youth these days have a pretty good idea of what’s healthy and what’s not they just aren’t motivated for it they’re motivated for something else when addictive behaviors are you used to cope with stress or unpleasant feelings I said coping skills may fail to develop or when they’re used to enhance self-confidence such as drinking before going to a party then they may start to develop anxiety and self-consciousness when they don’t have a drink on board so it may start prompting the development of some mood disorders in addition to the fact that repeated use especially in a young brain can cause some neurotransmitter imbalances using addictive behaviors also to enhance other experiences ties it to those experiences making them person more likely to use those and similar situations desensitizing the brain’s pleasure centers so what am I what do I mean I mean if you typically drink when you are watching football then you’re going to be more likely to drink every time you watch football it’s just one of those things you do when you watch football if you’re one of those people who eat when they watch TV then when you watch TV you’re more likely to eat when you go to the movies because that’s a similar situation you’re more likely to want to have popcorn or eat so it’s important to understand that with addictive behaviors if you have something that produces pleasure it can be triggered you know the person can start thinking about it in a similar situations using repeatedly can cause neurochemical imbalances in genetics you know you can’t be born with a neurochemical imbalance not enough serotonin too much whatever and poor health behaviors as I’ve talked about a bunch of times not enough sleep quality poor nutrition and high stress can also cause neurochemical imbalances so we can educate people about some of the things that can cause depression and anxiety so they can prevent it we can educate parents so they can start coaching their kids from the get-go so personal recovery capital to develop what we need to be happy and healthy human beings we have to have certain things to help us along the way we need to have the things to enable us for physical health think about Maslow’s pure hierarchy bottom level is all your health and biological needs we need to have our physical health and that includes nutrition Slee and you know not being in pain all the time sometimes you’re gonna feel pain that’s being human that’s being alive but we need to have our health for the the most part we need to have financial assets to get our basic needs met you now get that food keep clothing on our back transportation roof over our heads health insurance and access to medication and there are two different things health insurance covers theoretically going to the doctor and the mental health counselor etc access to medication is not covered under a lot of insurance so remember that most pharmaceutical companies have patient assistance programs that can help clients access their medication if they can’t afford it because some medication is a really expensive safe housing conduct that’s conducive to recovery and that’s not just addictions if you’ve got somebody who is clinically depressed or highly anxious living in a radically dysfunctional household where there’s lots of yelling or arguing or other people who are similarly dysfunctional it’s probably not going to prompt those positive cognitions and mindfulness and everything that we’re trying to establish doesn’t mean they can move unfortunately a lot of people can’t so we got to talk about how can you create an area in your housing environment that’s safe people need to have adequate clothing to stay warm to be able to dress for work and you know go to their job and be dressed appropriately and transportation to get their needs met most of us don’t live in a city where we can just walk but walking I guess is a form of transportation we need to be able to access the resources that are out there whether it be food or going to work so we can pay our light bill or whatever it is values awareness people need to know what’s important to them to figure out what they need to do to be happy a sense of purpose helps people keep going and we can help people with this I mean these are easy exercises when you give them a values activity worksheet you know what are your top five values when you look at the sense of purpose what is your purpose in life and a lot of us don’t know but we know what we want it to be or we can start theorizing about what is the purpose of what I do as a job on a day-to-day basis, what is the purpose of this activity that I’m doing so they can start to see some meaning in the stuff they do we can help people develop hope and optimism and we’ve talked about that one people need to have a perception of their past present and future they need to be able to look over the past and it may suck or it may be great but they need to be able to look back over it and go yep that’s it they need to be able to look at their present and realistically assess what they’ve got and maybe what they don’t have but realistically assess what they’ve got and look at their future and go where do I want to go from here because you’re here and you don’t want to stay here forever you can’t stay here forever because times gonna move on what next people need to be able to see but understand that they’re not necessarily controlled by their past or stuck in the present that they have the ability to make choices every single moment to work toward what they want for the future education training and job skills people need to be able to make a living that’s just the way it is you need to be able to feed yourself and put a roof over your head so we can make referrals to job training agencies we can make referrals to social service agencies problem-solving skills interpersonal skills and self-esteem are all things that we are super skilled at teaching and we can teach these in chunks they don’t have to be these long groups don’t have to be big drawn-out sessions we can provide people snippets you can provide somebody with the concept of distressed tolerance and the improve acronym in a handout and have them look at that or in an email you know if you email your clients once each day or on your blog there are a lot of different ways, you can just get that information out there and in front of people so I can look at it I call I tell my clients it’s bathroom reading you know I usually give them a handout or two and I just put it on the back of the toilet and when you’re in there you know take a look at it if it’s useful great if not bottle it up and throw it in the the trashcan I’m good with that but there’s no pressure and I’m not putting extra assignments on them I’m just providing information about a skill and then if they want to pursue it further when they come back to counseling we can talk about it so what can we do we can promote positive health and wellness behaviors by educating people about why they’re important and what to do and where to find more information you know because some of these things like nutrition we can’t be prescriptive but we can point people in the direction of where to get good advice and information and we can also model this you know in our treatment plan at least in mind I try to make sure that people are putting a print emphasizing getting enough quality sleep eating well and maybe exercising at least moving around if they don’t want to call it exercise but taking care of themselves and getting some relaxation and recreation in their bonding to a pro-social culture is difficult for us to do for people or do with people we can talk about what are your hobbies what are things that you enjoy doing and encourage people to try out volunteering or get involved in meetups to engage in activities with other people but that’s something that they’re going to have to do on their participation in extracurricular activities again kind of the same thing we can point them in the right direction of volunteerism meetups things through their through their church or their synagogue or their you know whatever clubs that they’re involved in positive relationships with adults now obviously this is more important if we’re working with children or teenagers we want to help children and teenagers kind of see where adults don’t have their head that far in the ground but we also want to help adults learn how to more effectively communicate with teenagers because a lot of adults lecture at and I know this and you’ll you’ll understand when you’re older and you know lots of that kind of stuff so things that we can do to enhance relationships with adults is to educate people about you know how to effectively communicate with teenagers for example who are trying to find their way and trying to assert independence and resisting some rules how do you deal with that how do you communicate with them in a way because a lot of parents have difficulty navigating that boundary between friend and parent so we can help with that active workshops in the community workshops you can do at churches at libraries those are things you can do there you can put them on for like an an hour once a month it’s good if you’re it’s free but it’s a good promotion for your practice if you know you go out and do it and people come to learn something from you, they’re like hey that might be helpful social competence it’s another one of those things that we can do in little snippets we can provide tips and tips and tools whether infographics on an Instagram page are really useful for a lot of teenagers they want something that’s you know in a picture and fast it’s a snapshot so social competence checklists are another really good thing if you’re teaching different types of skills for communication or how you’re supposed to use different forks I know the first time I went to a formal dinner I was looking at all the silverware going I have no idea what to do with this stuff the sense of well-being and self-confidence we can help people develop this by encouraging them to focus on what they do well we want to make sure they have plans well that means goal setting and since a lot of people don’t know how to goal-set they don’t have goals, so they’re just kind of floating out there not looking at the future we want to help people look at the future and figure out how they’re going to get there so they’re like wow this is doable this is attainable this is another thing you can put work put worksheets on your website you can do short workshops to help people figure out how to look at how to define or learn how to define a rich and meaningful life and figure out how they’re going to define their goals and achieve their knowledge about risks associated with addictive behaviors now a lot of kids you know think back to the old dare programs I had a lot of clients tell me that those programs only taught me how to you safely I was like well that’s not what they were intended for but we do want to educate youth about you know still about the risks of some of those drugs and even adults not just youth educate people about how dangerous or how potentially addictive opiates for example can be after three to five days your body has already started to build up a tolerance that’s kind of scary so helping people understand that but also addictive behaviors like pornography a lot of teens don’t think about it a lot of adults don’t think about it until they’re stuck in it or online gambling you know those are some things that can kind of catch people unawares because they didn’t think about it wasn’t a substance we typically think of addictions as substances since it’s not a substance they didn’t think about the effect that the pleasure from those activities were going to have on our neurochemicals and create a a situation where they didn’t feel okay they didn’t feel normal they didn’t feel happy without having that in their life because their dopamine receptors had been blunted individual prevention strategies the big summary is we want to promote attitudes beliefs and behaviors that ultimately provide the person with healthy coping skills whether it’s through health class whether it’s through workshops I know at organizations I’ve worked at before the Jaypee would come in and do periodic workshops that’s a great way to connect with people and reduce utilization if you do psycho-educational prevention group because an ounce of prevention is worth a pound of cure we want to make sure that they’re aware of positive health behaviors and how to access those resources in Gainesville I don’t know about up here but I know in Gainesville the mall used to open at six o’clock in the morning so people could walk inside in a safe place and you know be out of the elements and yadda-yadda so just letting people know that that existed was a big step because they were like well I don’t want to join a gym and go to the mall with effective interpersonal skills we want to make sure people know how to effectively communicate set boundaries all that stuff that we talked about this can be taught it’s nice if your local news is willing to use you to do you know wellness minute I find one of the best places to do that is either right before or right after the weather because most everybody Tunes in for the weather, I may not stick around for the animal of the day or whatever well I always do but I’m always tuned in for the weather so if you get either right before or right after that you tend to get higher viewership and reach more people and a minute gives somebody a chunk of something that they can use today-specific approaches may include education and life skills training in schools you know is provided to the kids and have them share it with their parents through the media and community center or library workshops those are all great ways to get stuff out I encourage you if you want to get into providing prevention and helping to help your community helping people to prevent getting depressed or anxious or developing other problems to look at doing some of these very time-limited things because you don’t want to lose a lot of billable hours but we still want to be able to do more than we’re doing at least that’s what a lot of a lot of us tend to feel like the mesosystem so we’ve been talking about the individuals so far because that’s where we can have the greatest effect the mesosystem examines close relationships that may increase the risk of experimenting with high-risk behaviors or developing mood disorders people’s closest circle of peers partners and family members influence their behavior and contribute to their range of experience if you’ve got a child that grows up in a household where the parent or parents are clinically depressed they’re not able to model effective coping skills where they model cognitive distortions guess what jr. Is gonna pick up if you are in a household where you know you’re in college and you’ve got four other roommates and all of your your other roommates tend to be negative and naysayers you’re either probably going to move or you may that might start wearing off on you a little bit likewise if they are you know all kinds of go-getters that can wear off on you too so you know there’s going to be an impact risk factor is peer and family reinforcement of negative or unhealthy norms and expectations so if your family says you know people suck they’re always going to take advantage of you what are you going to take away from that and is that going to contribute to you probably having difficulties with trusting and maybe developing depression possibly so we want to look at what kind of messages is the peer group or family sending to the individual that may contribute to the development of mood or anxiety disorders early sexual activity among peers could communicate that well this is the norm so everybody’s doing it ties to deviant peers and gang involvement you know especially at that particular group there’s a lot of pressure to conform or there’s a negative consequences family members who don’t spend much time together and this could be because parents work a lot this could be because everybody’s you know involved in all kinds of other stuff but they found that when families are disengaged the parents tend to miss out on subtle cues when families are disengaged even if they don’t have children in the mix that there tends to be a weakening of those bonds supportive bonds so people are at higher risk for development of depression and anxiety because they don’t have that you know everybody’s behind me sort of feeling parents who have trouble keeping track of youth can indicate that the youth may be at risk for developing substance or more mood disorders lack of clear rules and consequences you think about even just being at work when there’s a lack of clear rules and consequences you don’t exactly know what you’re supposed to do I know for me that creates doodles of anxiety I like manuals and to date pretty much every job I’ve ever taken I’ve walked in and there hasn’t been a manual and I’ve been like okay there must be a manual written and that’s been my first thing now I’m kind of on the structured side so I don’t expect everybody is that way but most of us tend to experience a little bit of anxiety about failure about acceptance if we don’t know what’s expected so it’s important whether it’s a family or a job situation to make sure there’s clear rules and consequences you know what’s expected and what’s going to happen if you mess up or if you don’t meet this expectation there also needs to be consistent expectations and limits you know when people especially children but a lot of us tested our limits when we were kids and even as adults you know I know you know going back to working in organizations I would have staff who would test limits and see how long they could go without turning in a progress note before I’d be knocking on their door going paperwork it’s natural for people to kind of test limits especially with stuff they don’t want to do stuff that’s not rewarding family conflict and abuse can cause a high risk of depression and anxiety whether adults or children I mean if there’s a a lot of conflict and chaos it’s exhausting and it can cause a lot of dysphoric emotions and loss of employment that’s kind of self-explanatory protective factors close family relationships so as clinicians we can encourage people to identify who they consider their family it may not be their blood relatives or their family who are there for them who can they call it 2:00 in the morning and how can they nurture those relationships encourage people to develop relationships with peers that are involved in pro-social activities like hiking or volunteering in the community consistency of parenting is important in terms of producing children who are who are stronger healthier more resilient encouraging education and parents who are actively involved can help prevent future depression because they’re creating children who can join the workforce and have that individual capital to prevent depression and anxiety and cope with stress positively and this is a family protective factor and a peer for protective factor why because we learn from observation so if our peers cope with stress positively by prayer or exercise or whatever it is they do and our family has other positive ways of coping with stress and we’re going to have a greater venue of stuff to choose from supportive relationships with caring for adults beyond the immediate family is encouraged so we want children to grow up being able to interact with teachers coaches with you know Scout leaders whomever and start seeing that people outside of the nuclear family are trustworthy sharing and family responsibilities including chores and decision making and that’s true for children teenagers and even adults you know if you’re living in the same household it important that everybody feels like they have a say in what’s happening and participates in the upkeep of the family environment and family members are nurturing and support each other and this is one where I tend to stop and I do a love languages little mini class to help people remember that we don’t always experience nurturance in the same way so understanding one another’s love language is really important to be able to nurture in a way that’s meaningful to that other person peer and family interventions are designed to identify norms goals and expectations in the family foster family problem-solving skills so there’s not just one person always fixing it develop structure and consistency within the family unit promote healthy relationships and engage peers and family of choice in the recovery process so if somebody’s already depressed we need to be able to hopefully engage everybody that’s involved in this person’s immediate environment in helping them move towards recovery and you know preferably not dragging them back down so we want to engage them and make sure that people have a supportive others school and work risk factors lack of clear expectations both academic or performance-wise and behavioral lack of commitment or sense of belonging at school or at work if you just kind of go and you feel like a number you punch in punch out that may not make you feel appreciated which can contribute to depression and you know just bad feelings high numbers of students failing academically at school and work translates to high amounts of turnover if you never know who’s going to get laid off it increases stress and anxiety and parents and community members who are not actively involved in keeping kids in school and helping make sure that the workforce workforce is strong but we want to make sure that people have access to how when it’s needed we want to make sure that people have access to tutoring in school if they need it to prevent failing school they have access to transportation to get to work now those are things those are meta concepts that are more on the community level but it’s important that as a community member you know we look at different things that we may be able to participate in advocacy and say you know it’s really important to get a bus system going I live out about 30 miles east of Nashville and we must have the the train that goes from my city out to Nashville so people have access to more jobs so that was important for us to get past the City Commission protective factors school and work positive attitudes gotta find a reason why you’re doing this you know and sometimes it’s hard to find a reason for algebra but we need to help kids find a reason for that we need to help adults find a reason for why they’re going to work why are they doing what they’re doing regular attendance shows you know it is associated with higher mood less less risk of mood or addictive disorders because you’re able to get up and do it and interface with people and get that social support hopefully from your colleague’s high expectations are communicated effectively in setting and positive social development is encouraged you know whether it’s at work or at school, there are goals there are things you’ve got to accomplish there are performance objectives but we also want to encourage morale and positive social bonding whatever the setting having a positive instructional climate again whether at work or school, I know we learn things when we’re on the job we learn things and I don’t want people to feel like they’re having difficulty like they’re stupid I want people to feel like anything that we teach them as a challenge and something that may be beneficial down the road leadership and decision-making opportunities are really important again for students or employees to prevent burnout keep morale up reduce anxiety and increase a sense of personal empower and connection and active involvement for everybody is fostered and the school or organization is responsive to the student’s needs making sure that in school in the case of school they have access to tutoring resources it’s a safe environment for them to be in and the children that are going to that school have enough food in their bellies you know they can’t learn if they’re hungry all the time workplace is a little bit different but we still need to be responsive to people’s needs in terms of you know family requirements whether they need to if they’re going back to school shifting schedules a little bit we need to try to work with people instead of being completely rigid and it’s my way or the highway when possible to promote the best mental health characteristics of settings in which relationships are often associated with the development of mood disorders and addictive behaviors so we want to look at the characteristics of schools that are they safe are they positive environments are they cheering squads or are they places where people know they’re gonna go and get thrown under the bus same thing with workplaces you know when you walk into a place you get most of we get a sense and you’re either like oh this is a cool place to work or oh I can’t wait til I can get out of here you know we want to go toward the other end and neighborhoods when you go into a neighborhood – people take care of their environment do they or do they have trash strewn all over their lawn all of these things communicate how people feel about their environment and generally how they feel about themselves and whether they have the energy to take care of stuff or they just feel completely disenfranchised and don’t care more about community risk factors no sense of connection to the community neighborhood disorganization rapid changes high unemployment a lack of strong social institutions lack of monitoring of youths activities imbalanced media portrayals of safety health and appropriate behavior misleading advertising and alcohol or drugs readily available a lot of stuff we do we’re not going to be able to affect on the community level so much but we’re gonna hit them real quick we want to improve the climate process and policies within community schools and workplaces to make it safe and promote positive health behaviors prevention strategies are designed to reduce social isolation reduce and address stigma increase awareness of local recovery models you know who’s out there that has recovered and can serve as a role model improve economic and housing opportunities so people have a house a safe roof over their head and they can you know earn money and feel good about themselves increasing the accuracy and improving the positivity of media messages and increasing physical and financial ability availability of recovery so like I said I live in a little town so it’s nice that we have a community mental health center here so people don’t have to rely on going into Nashville but also making sure that services are financially available whether you have a free clinic once a month or you know make sure you’ll you take Medicaid but there are still a lot of people who have no insurance so where do they go the socio-ecological model identifies how the end the individual impacts and is impacted by not only his own characteristics but also those of family peers community and culture prevention takes the form of preventing the problem preventing the worsening of the problem and preventing associated fallout like I said as clinicians a lot of what we’re going to do is target the individual providing them with resiliency skills to deal with some of this adversity that might be around them and to help them sort through some of those media messages and go yeah that’s not even true you know if I drink this vodka I’m not suddenly going to have 14 supermodels hanging on me or whatever it is that’s being communicated so encouraging people to be informed and Wylie consumers any change in the the system will affect other parts of this system so if it’s a positive change is probably going to have positive changes negative has negative changes addressing addictive and mood disorder behaviors require a the multi-pronged approach we need to look at the individual and you know provide provide as many skills as possible there because that’s where we’re going to have a lot of our impact especially in prevention but we also need to realize that this person resides within a family you know whether they live alone which sometimes is less problematic or they live in a household with other people, we need to make sure that where they lay their heads at night where they spend their non-working hours feel safe and is conducive to recovery where they work or go to school also needs to feel safe and be conducive to recovery and that’s part of the community so we need to kind of look at these areas and if they aren’t safe or they don’t feel safe or aren’t conducive to recovery, we need to help people how to figure out how they can fix that or address it like I said they may not be able to move so what can you do to set some boundaries to create as much safety as you can how can you do this and there are a lot of different techniques that I’m sure you already have that you used to help people but it’s important again not to just focus on the individual because they don’t live in a bubble we need to look at everything right and are Are there any questions now we have or I have added a Wednesday class, so you don’t don’t have to come but if you have unlimited membership same time same station Wednesday so Tuesday Wednesday and Thursday we have a class from noon. CST 1 p.m. EST 2 for an hour all righty I will talk to y’all maybe tomorrow maybe on Thursday have a great day 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 YouTubeI thought my anxiety disorder was for life… $49.⁰⁰ But I Discovered How Hundreds Of Former Anxiety Sufferers Melted Away Their Anxiety And Now Live Relaxed, Happy Lives – With No Trace Of Anxiety Or Depression At All! http://flywait.anxiety4.hop.clickbank.net We’ve seen so many people go anxiety-free that we have no hesitation in guaranteeing this program. So… If at any time within 60 days of you purchasing ‘Overthrowing Anxiety’, your anxiety hasn’t completely evaporated then you can have all your money back. No questions asked! You can do this for yourself today. You can start making a difference in your life right now. Click on the button below and you’ll receive your copy of Overthrowing Anxiety in just a few minutes. It’ll be one of the best decisions you’ve ever made – guaranteed! http://flywait.anxiety4.hop.clickbank.netOIP-29

7 Signs You Have Abandonment Issues

 Hey Psych2go family, welcome back to another video. Do you have an overwhelming fear of losing your loved ones? Do you distrust other people or have anxiety about being abandoned? Abandonment issues typically arise in childhood but can develop later on in life as well. The fear of abandonment is a serious type of anxiety that often stems from a traumatic experience. Some aren’t even aware of their repressed emotional trauma. But it can manifest into unhealthy behaviors over time. So, here are 7 Signs You may Have Abandonment Issues. One: you’re a people pleaser. Do you want to impress everyone you meet? Whether it’s your friends, acquaintances, or family members, you try to meet their expectations to get on their good side. You’re the one who tries harder in your relationship, and you’re willing to put everyone else’s needs ahead of yours, as long as it gets them to stay. If you have a strong need to please people and gain their approval, you may still have some unresolved abandonment issues. Two: you struggle with insecurity. Do you sometimes think that someday, the people closest to you will get sick of you and leave? People who are afraid of being abandoned often struggle with feelings of insecurity and inadequacy because someone you love has walked out on you in the past. You’ve internalized the emotional trauma. You may have wrongly believed that it was YOUR fault that they left. This can result in low self-esteem and a need for constant reassurance. Three: you find it hard to trust people Do you find it hard to trust others to keep their promises or to be there for you? Do you want to be in control of your relationships and know everything that’s going on with your loved ones? Because you’ve been hurt in the past, you have a strong fear of being left alone. In certain cases, it can lead to feelings of unreasonable jealousy, suspicion, and possessiveness over your friends and romantic partners. Four: you’re afraid to be vulnerable Do you feel uncomfortable during moments of emotional intimacy and honesty? Are you scared of getting close to someone or needing them too much? Your deep-seated fear of abandonment may manifest into a fear of intimacy and emotional vulnerability. You may unconsciously sabotage your relationships by pushing people away just as you start to care for them. You may struggle with commitment, and act detached and indifferent when you do care.  Five: you look for reasons to leave. Do you always look for reasons to leave in fear of getting too attached to someone? You hold your loved ones to unrealistically high standards and you only focus on their flaws. You don’t give them any room for mistakes. You do this knowing that they’re bound to disappoint you. And when they fail to meet your expectations, you use it as an excuse to give up and leave. Six: you move on too quickly Do you have difficulty forming meaningful relationships that last because of a deep-seated fear of abandonment? When you cycle through relationships one after another and move on too quickly, you’re not allowing yourself the time and space to deal with the emotional fallout. Instead, you dive into something new and exciting to distract yourself. You never want to be alone, because it would force you to confront the personal issues you’ve been repressing for so long. And number 7… you cling to unhealthy relationships Do you find yourself gravitating towards all the wrong people? Have you stayed with someone knowing they’re bad for you? The trauma of being abandoned, especially at a young age, can stay with you for a long time. And since we’re all hard-wired to recreate our early childhood experiences for comfort and familiarity, your childhood taught you the wrong things about love. It’s not uncommon for you to be drawn to people who treat you poorly. Do you relate to any of the signs mentioned here? I know I did… Is a fear of abandonment harming your relationships and keeping you from being happy? 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 to Psych2go for more videos! Thanks for watching, and we’ll see you in the next one!As found on YouTubeI thought my anxiety disorder was for life… $49.⁰⁰ But I Discovered How Hundreds Of Former Anxiety Sufferers Melted Away Their Anxiety And Now Live Relaxed, Happy Lives – With No Trace Of Anxiety Or Depression At All! http://flywait.anxiety4.hop.clickbank.net We’ve seen so many people go anxiety-free that we have no hesitation in guaranteeing this program. So… If at any time within 60 days of you purchasing ‘Overthrowing Anxiety’, your anxiety hasn’t completely evaporated then you can have all your money back. No questions asked! You can do this for yourself today. You can start making a difference in your life right now. Click on the button below and you’ll receive your copy of Overthrowing Anxiety in just a few minutes. It’ll be one of the best decisions you’ve ever made – guaranteed! http://flywait.anxiety4.hop.clickbank.netmaxresdefault-1

Cognitive Behavioral Therapy (CBT) Skills and Counseling Techniques with Dr. Dawn-Elise “Doc” Snipes

 CEUs are available for this presentation at AllCEUs.com/CBT-CEU Hi everybody and welcome to today’s presentation on cognitive behavioral therapy skills. Like the other The presentation we did on assert not assertive community treatment acceptance and commitment therapy, which is also based on providing information about skills that can be used not providing an evidence-based practice We couldn’t cover that in a full hour or just an hour so over the next hour we’re going to define cognitive behavioral therapy and its basic principles a lot of us are familiar with this but it’s going to be a good review and it also may highlight some nuances that you didn’t know about will identify factors impacting people’s choice of behaviors explore causes and impact of thinking errors and identify common thinking errors and their relationships to cognitive distortions so why do we care well as therapists we want to help people figure out the best way to live a happy healthy meaningful goals-driven life for some people that’s going to mean using some cognitive behavioral interventions that can be in addition to mindfulness that can be in addition to a lot of other things but it’s important to help people understand that the way we believe things to be the way we interpret things is going to affect our reactions so for example think about a situation you know you’ve walked into and maybe you walked into it with a small child and it was a different situation it was a new situation but you know it was no big deal you walked in it was not a threatening situation to you because you were like hey I got this the little kid walks in and goes oh wow there are a lot of people walking around here, this is really scary same situation as two different perceptions you probably didn’t have much of a stress reaction going on whereas the little child probably had this fight-or-flight thing going on grabbing onto your hand like please don’t let go Atlanta Airport is a perfect example if you’ve ever taken a little kid through Atlanta Airport it gives you an idea about how People can perceive things differently and when you enact that fight-or-flight reaction you’re going to have all those stress hormones you’re going to have all either anxiety or anger or whatever that goes with it it may serve to exhaust the person and leave them feeling hopeless and helpless so what we want to do is help people see that but we also want to help them see that when They’re depressed when they’re tired when they’re sick things are going to seem a lot worse a lot of times because they don’t have the energy to perceive it differently I mean when you’re sick it’s overwhelming to think of going through Atlanta Airport so this is what we want to help people start understanding is it’s two sides of the same coin they interact if one is you know kind of going wonky is going to affect the other one the good thing is If one’s going really well the other one’s going to go well if you’re Having positive thoughts you’re probably going to feel pretty good there’s an activity and I think we’re going to talk about it later it’s called the coin flip activity and I asked client clients to flip a coin in the morning and in the morning if it turns heads then they have to be the most positive Pollyanna all day long look for the silver lining and everything smile walk with their head up hold those nonverbals up and see how they feel at the end of the day besides a little sore because there are muscles they’re using they haven’t been used in a while if it lands on tails they can just be their normal selves which generally if they’re seeing me means that they are depressed anxious stressed out angry about something in the negative realm then we Talk about how things seemed different on the days when you were feeling better when you were walking taller when you were smiling even our nonverbals it doesn’t even have to be sickness it can be our nonverbals that can make us feel or make our body feel heavy and tired and make it seem like it’s a whole lot harder to deal with life as a person who perceives the world generally good and believe they can deal with challenges as they arise that good old self-efficacy will be able to allow their stress response system to function normally so if they’re like you know what I can deal with whatever life throws at me I’ve got it and maybe I need help with it maybe I’ll need to ask for support but I’ve got it it’s not going to completely overwhelm me with people who see the world as hostile unsafe and unpredictable You know for a variety of reasons whatever happened to make their scheme as such that they don’t believe that people or the world is trustworthy are predictable They are always on guard they’re always kind of like a hamster in a cage that has Have you ever had a hamster hamsters doesn’t recognize you and goes Hey that’s my own Or human contact score hamsters go run under their little house And you just kind of open the cage and stick your hand in there and flip over their house and you’re like come here and give me cuddles and you’re like you know 200 times bigger than they are so the little hamster is like freaking out this is what it’s like for people and obviously, I’m exaggerating but this is what it’s like for people who have a negative perspective a negative view or a hostile view of the world so kind of keep that little hamster in your mind cognitive behavioral therapy we have core beliefs those things that are in our hearts when I talk with my clients about honesty step one and that’s what they’ve got to do to start recovery is get honest with themselves first and then other people we talk about head heart and gut honesty do you think it’s right does it seem like the right thing to do does it feel right in your heart you know does it make you happy it doesn’t make you feel good and then the Spidey senses is your gut saying and or Is your gut fine if one of those is saying this might not be the right choice and we need to think about what’s going on so we have those core beliefs and I put them in the heart just because that’s the middle of the head heart and gut but you have core beliefs about yourself whether you’re good with You’re bad whether you’re effective at certain things yadda You have core beliefs about other people same thing good bad effective predictable and you have core beliefs about the future and a lot of that goes with locus of control but also your past experiences if the world in the past is seemed unfriendly and uncontrollable and you’ve perceived it that way then you’re going to expect the future to be uncontrollable so what we want to do is help people look at their schemas and their core beliefs about themselves others in the future and figure out kind of what they want it to look like these schemas are going to affect your behavior your thoughts and your feelings and you know you can pick wherever you want to start it doesn’t matter because all three interfaces with one another so if you haven’t let’s Start with negative thoughts If you have negative thoughts then you might feel anxious angry stressed dysphoric which will affect the behavior you’re going to do different things than if you have positive thoughts about something you feel excited and energized you’re going to have different behavior the best thing example I can give you is if you’ve ever done public speaking or had to present something Some people detest public speaking it’s just terrifying for them to get up in front of a group of people so their thoughts are I’m going to trip up I’m going to forget what I’m going to say I’m going to make a fool of myself I’m going to you know it can go on forever that when you get on a roll you can get on a negative roll and go on forever or positive hopefully get on that roll with those thoughts you start holding onto Those thoughts remember as we talked about in a CT the other day when you hold those thoughts and you kind of mush them around in your mind and you come to believe them that you’re going to make a fool of yourself and it’s going to be awful you’re going to start feeling terrified which is going to likely affect your behavior if you go out on the stage and you’re terrified You’re going to probably stutter you’re probably going to get foggy-headed You’re going to have that fight-or-flight reaction so there’s an adrenaline rush and you start sweating and you can’t focus and you can’t concentrate you want to away as opposed to somebody like me who loves public speaking and I’m just like cool I get to go out there and try to engage however many people are in the audience it’s a game for me because when I can see your faces I enjoy trying to figure out and make eye contact with people and figure out what it is that they’re there for what is it that’s going to make them tick what resonates with them so my behavior as You can kind of see right now when I go out there I’m excited and I want to engage people and it’s a fun experience for me again just like the airport the same experience for two different people and two very different interpretations and reactions to it so what effects I don’t like the term rational but when We’re talking about CBT irrationally comes up a lot I like to replace it with helpful because every behavior in its weird sort of way is or probably was rational at one time that being said we’re going to get back to that stress affects our behavioral choices if we’re under stress we can have negative emotions negative emotions will affect our thoughts if we’re feeling sad we’re probably going to look at the dark side if we feel sad we’re going to look at the bottom falling out if we’re happy we’re probably going to look for that silver lining physical factors if you’re in pain sick sleep-deprived poorly nourished so your body can’t produce the neurotransmitters it needs to or heaven forbid intoxicated you’re probably not going to make the same decisions as you would if you were comfortable healthy well-rested nourished and not Intoxicated any of those things can impact how you perceive a situation or how you react in a situation, especially the intoxication whereas in your intoxicated State in your sober state, you may think that you want to do something but then you’ve got that filter that does not not a good idea in an intoxicated State or even in a manic state if you’re you know if you have somebody with bipolar that filter kind of goes away so the behaviors that someone may normally not do because they have a rational filter That goes you know punching this guy out is probably not the best idea right Now the filter goes away when you’re sleep-deprived you’re less generally People are less patient generally people don’t have as much of a filter thing about watching your children if you have children or your grandchildren or even yourself I know myself when I’m sleepy I am giddy as all get-out and things I wouldn’t normally say because they’re you know stupid I’ll just come out and say anyway and my kids just roll their eyes or the mom you’re overtired could go to bed, uh but that’s okay You know I’m okay with that In that situation now if I acted that way at work it would be a worse thing environmentally if you’re introduced to a new or unique situation and you perceive it as stressful because the unknown we know can be stressful then you may not make as rational of a choice or as helpful of a choice because you Maybe trying to escape the same thing as exposure to UNPROFOR bellowing for a word here but UNPROFOR ball is the best I could come up with we all prefer certain situations some people like I said would rather do just about anything then get up in front of a lecture hall of a hundred and fifty people and talk but if they have to do it then they’re going to be under stress which may affect how they do things so we want people to understand that their perception and their feelings are affected by a lot of other things not Just you know an emotion here or a particular memory there’s a lot that goes into it and social if peers your family convey irrational thoughts as necessary very standards for social acceptance people may tend to cling more to it to those unhelpful thoughts and unhelpful behaviors you know in CBT they say irrational because quote nobody wants to associate with those people you know who are those people and why can’t we associate with them there are a lot of things if you think back think high School you know high school is pretty rough if we’re going to talk about having irrational thoughts and cognitions if you have to be part of this particular group to be accepted you have to do this you have to do that but do you do you do those kinds of all-or-nothing statements are cognitive distortions and while they may have served a purpose in some way shape or form in the past we need to encourage our clients to take a look at them now and go are they still helpful ways of thinking is it still helpful for me to think that I am only successful if I live in a million-dollar house in a gated community and do this that and the other or can I be can I define success as a different way or do I define success differently and lack supportive peers to buffer stress so we had those peers who caused stress by talking about the half dues and categorizing and lots of attributions but then there’s Also not having somebody to go you know does this make any sense because sometimes we are our own worst enemies and if we go to a friend and we go you know this is what I’m thinking and I think I have to do this in order to be acceptable to be loved or you know whatever the case may be Most people are not going to use those exact phrases A good friend is probably going to listen and go yeah you’re right or no that’s way off so supportive peers are essential to reminding us to consciously regularly check in with our cognitions to make sure that they are hopeful and rational so a note about irrationality and this is mine this is not from CBT the origins of most beliefs for rational and helpful given the information the person had at the time and their cognitive development their ability to process that information so concepts schemas and core beliefs that people formed when they were five are probably going to be very egocentric you know the person is going to feel like everybody sees it my way because this is how I see it you know just like A five-year-old does A five-year-old doesn’t think Well you know let me take Johnny’s perspective is no he assumes that Johnny sees it the same way so it’s going to be egocentric It’s probably going to be focused on only one aspect of the situation because small children can’t focus on multiple aspects and it’s probably going to be dichotomous it’s all-or-nothing Mommy loves me mommy hates me and it could be personalized you know Everything a lot of kids think that everything has to do with them so if something happens something bad happens many times Children will take it personally or be afraid it’s going to happen to them Again you know if Hurricane Katrina hurricane Andrew those sorts of things you know we saw a lot of trauma in children and they developed very real fears about thunderstorms and hurricane season And if you’ve watched Florida hasn’t had a notable hurricane in years now but There’s a lot of stuff that goes into that but young people During some of those really bad hurricane seasons perceive those situations differently okay so we need to help people understand that if we especially if we use the term irrational those thoughts you form when you are knee-high to a grasshopper and they made perfect sense to you back then but now that you’re an adult you’ve got more experience and you’re able to take different perspectives your brain is more developed Let’s take a look at it and see if you can look at different perspectives and Come up with something a little more helpful maybe a different way of perceiving this situation the irrational irrationality or unhelpful Nosov Fox comes when those beliefs are perpetuated without examination so something a the belief that you formed when you’re five you’re still holding when you’re 35 and you’ve never questioned it you’ve never gone you know does this make sense is This is helpful to getting me toward where I want to be Most of us don’t know We form these attitudes and beliefs when we’re you know growing up when we’re in elementary school middle school high school from watching TV to being around our peers from being around our family in our community and we get all This input of the way things should be and a lot of times people don’t stop to question and go and go Well does this make me happy Is this really what I want and they can be irrational if they continue to be held despite causing harm to the person so the person continues to hold this belief even though it is causing them general emotional cognitive harm is making them miserable we need to look at what’s motivating them to hold on to that belief why is that belief so important and how can we make it so they can live a happy values-driven life with an emphasis on the harness and how can we make it less harmful sometimes it’s more productive for clients to think of these thoughts as unhelpful or helpful instead of irrational sometimes when I say irrational to clients and you know I’m the same way if somebody says you’re being irrational I’m like oh I’m not it elicits this instantaneous defensive reaction it’s like when you tell them they’re being resistant they’re like I am NOT resistant so helpful or unhelpful and then we talk about why it is unhelpful in getting them toward their goals basic principles of cognitive behavioral therapy we teach or help clients learn to distinguish between thoughts and feelings I can think something is scary I’ll probably feel it but if I have an automatic you know feeling I walk into Atlanta Airport and I see yeah I went to an airport in New York I can’t even remember which one it was because my plane was diverted and I got off and I walked out there and I have never seen so many people packed in his place like sardines before in my life I was just completely overwhelmed that was kind of an automatic feeling now that was a feeling based on you know who knows it was overwhelming to be surrounded by that many people so then I had to separate the thoughts and go Okay what am I thinking that’s making me feel so overwhelmed and at that point you know I didn’t know how to get to my gate and all that other sort of stuff with traveling I don’t travel well but encouraging clients to stop and go okay why am I feeling this way what are my What thoughts am I having that are contributing to these dysphoric feelings CBT helps people become aware of how thoughts can influence feelings in ways that are sometimes not helpful We have hecklers in our gallery the automatic tapes that we plaything memories that we have whatever you want to call them when you try something When you are just going through daily life you hear these voices in the back of your head and not real voices but that is saying you’re never going to make this or if you would have just blah blah blah then you’d be a better person helping clients become aware of those thoughts and how they’re Negatively influencing their feelings and keeping them kind of stuck is a huge part of CBT we help them learn about thoughts that seem to occur automatically without even realizing how they may affect emotions again those thoughts from the they’re saying you’re not good enough You’re not smart enough and nobody’s going to like you Where did that come from and do you believe it you know maybe it came from somebody When you were in high school so was that a valid was that a valid source Maybe it came from somebody yesterday on Facebook was that a valid source taking in those thoughts and then figuring out is something I’m going to hold because it makes me happy or is this something that I’ve got to deal with because I’m having a negative reaction constructively evaluate whether these automatic thoughts and assumptions are accurate or perhaps biased the other thing to remember is a lot of our clients not all of them but a lot of them hold themselves to a standard there’s like up here and they hold everybody else to a standard that’s down here so they are a failure if they don’t achieve this but Everybody else is successful as long as they achieve this so encouraging them to take a look at how accurate and biased or unbiased are the thoughts and like I said they may be their thoughts they may be telling themselves these things evaluate whether the current reactions are 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 not impotent important to the person road-rage you’re In the car you’re driving somebody cuts you off Okay natural reaction fight or flight reaction you’re just like slam on the brakes and do whatever you got to do aversive maneuvers you’re good so you could let it go at that point ago got Lucky on that one and keep driving most people not all but most found that 80% of drivers have reported incidences of road rage which is a high number but most people will start getting all fired up and irritated and grumpy and we and just rageful and so my question would be I hear that and I hear that it made you angry In retrospect did screaming at the person as you pass them at sixty miles An hour in your car with the windows rolled up does any good Did it Did any good at all what else could you have done with that energy if you wouldn’t have expended it all yesterday we had to wait for the vet to come by and my daughter just completely wore herself out worrying about when the vet was going to get there what he was going to say about her donkeys and was beside herself so by the time it got to evening and it was time for her to go to her martial arts class she didn’t have the energy to go she’s like um wiped out I just want to go to bed in retrospect we’re looking back and saying okay now Tell me what it was that you were so stressed out about and let’s talk about whether that was a realistic and helpful line of thought to perseverate on all day long and what could you have done differently because she didn’t bother to mention any of that to me yesterday and then developed the skills to notice interrupt and correct these biased thoughts independently causes of these thinking errors information processing shortcuts when we form schemas and we encounter a situation that reminds us of something in the past like when I go to my grandmother’s house I have a schema I have a belief system I have you know stuff that I know about my grandmother’s house so when I go to my grandmother’s house it’s kind of a shortcut to knowing what to expect when I walk in and how to behave how to do different things and it helps me plan and predict if you’re Using outdated or dichotomous all-or-nothing schemas may cause thinking errors because you may be now incorrectly processing current events mental noise some of us have it a lot of us have it Not everybody thinks about trying to focus and study for a final exam in the middle of a really busy sports bar okay this is a cause of thinking or you’re going to miss important things you’re not going to be able to focus you’re not going to necessarily attend to the correct things because there’s just so much else going on your attention is drawn in 17 different directions and or the brain’s limited information processing capacity due to age we talked about that before young kids think all or nothing they think dichotomously egocentric ly middle school-aged kids and older start developing the ability for abstract thinking, by the time we get older, you know as adults theoretically We’re able to you know think pretty well and think pretty clinically about different events but if we’re in crisis when someone is in crisis it could be like what we think of clinically as a crisis or it could be they’re just completely overwhelmed and burned out and have been burning the candle at both ends for three months they’re not going to process information quite as well They’re not going to take in all this stuff because they’re just like shell-shocked have you ever seen teachers in the hallway of like an elementary school Oh at the end of the second nine weeks they just kind of stand there with this blank look on their face they’re not processing as much as they were the first day of school and you know God loved them they have a lot to deal with but we need to help our clients understand that there are some times that they are going to have to really stop and focus write things down so they can remember or they can make decisions A little more my guess is most of us have times in our lives when we’ve been able to think through complex problems but then there are other times where you just can’t keep it all in your head and you’ve got to put it on a Whiteboard maybe that’s just me but we want clients to understand that they are not broken they’re not faulty they’re doing the best they can with the tools they have and the knowledge they have and our job is to help them see where some of this might have gone a little awry other causes of thinking errors and emotional motivations I feel bad therefore whatever I’m thinking must be bad if I’m scared that means whatever it’s coming on the other end of the phone is bad news moral motivations I did it because it was the right thing to do and that can be an excuse for doing wrong behaviors as well it can also be you know you can argue on The moral one social influence well everyone else is doing it so it must not be bad set that again a lot of times and this is where the frames approaching the Motivational interviewing is helpful It stands for feedback about the reality of what’s going on is everybody doing it let’s look at statistics you know not subjective information let’s look at objective information so the impact of these thinking errors makes people want to fight or flee when they get upset and we use upset as a kind of this all-encompassing garbage term emotionally they get depressed or anxious we don’t want to feel that way Anxiety and anger are flee or fight fight or flee it’s our body saying there’s a threat you got to do something depression is your body going I give up I just don’t I don’t even have the energy to do it anymore behaviorally some people withdraw because they Shut down We all know people get frustrated when they get overwhelmed When they start feeling hopeless or helpless they just kind of withdraw from Everything and everyone’s addictions numb that out so they don’t have to feel the dysphoria sleeping problem and changes when we start being on that constant fight-or-flight hyper-vigilant sort of thing going on in the body is always sort of turned on which means you’re not going to sleep as well then The circadian rhythms get messed up which starts causing exhaustion and lethargy and then everything seems harder because you’re sleep-deprived and then you start thinking more negatively and more hopelessly you see where this is going it’s a downward spiral and eating changes some people eat a lot more because they’re eating comfort foods some people eat a lot less because Their stomach is so torn up from the stress they can’t even think about holding anything down physical stress-related illnesses fibromyalgia gastrointestinal problems headaches neck aches backaches you know the whole the gamut of it when you start feeling bad when you start hurting generally it gets frustrating after a while and that frustration makes it kind of raises the bar brings you up a little bit so you’re That thatch closer to kind of just kind of being overwhelmed as you do You have as much of a cushion as you would if you were happy healthy well nourished not in pain and socially a lot of times we will get irritable or impatient with other people or withdrawal when we’re having these negative cognitions these thinking errors that are keeping us in a dysphoric state these effects of thinking errors contribute to fatigue a sense of hopelessness and helplessness which intensifies thinking errors This is an important concept that I want my clients to understand and I want to drive home in this presentation so thinking errors what are they emotional reasoning feelings are not facts and we want to help people learn to identify feelings and separate them from facts so if somebody says I’m terrified okay that is a feeling what are the facts supporting that feeling why are you are terrified what is the evidence that you are in some sort of danger Right now you know that danger may not be the right word for your client at that a particular point in time but what’s the evidence that there’s a threat in what ways is this similar to other situations maybe it’s triggering something from the past that was scary or you know you were too little to be able to handle it but you can handle it now and how if you dealt with similar situations Like in the past, we wanted people to just step back and get some distance between their feelings and their thoughts and try to figure out you know which thoughts are helpful and productive and even if a sought makes people anxious or angry it can be helpful it may be telling them hey dude you need to get your butt up and get out of there if it’s helpful it means it’s moving them toward where they want to be happy healthy safe and values-driven life so happy and helpful developed a stress tolerance skills when people use emotional reasoning they feel emotions which then they start attributing finding the facts to support those emotions instead of looking at all the facts we want to help them learn to tolerate their distress so they can kind of let that subside for a second they can accept their feeling they can name them They say I’m scared I’m stressed I’m angry and whatever but they don’t have to act on it right then they can tolerate the distress for a minute without having to try to make it go away and emotional regulation skills they can feel a feeling without having to make it go from zero to 120 You know if they feel sad they go I feel kind of sad instead of grabbing onto it and going I wonder what I feel sad about I must feel sad about all these sad things now I’m going to be sad and devastated so we want to help people learn how to regulate their emotions identify them accept them Whatever word you want to use tolerate them because feelings are there for a reason they’re there to tell you your brain thinks something’s going now thankfully we have that higher-order cognition stuff going on so We can contradict our brain and we can go you know maybe that’s not true in this situation cognitive bias negativity mental filter whatever you want to call it people who focus on the negative they walk in they get up in the morning and They look outside and it’s partly cloudy They get to work and they say instead of saying there was it was very light traffic they said there was a fair amount of traffic everything is always the flip side of what somebody who’s optimistic would say so asking them what’s the benefit to focusing on the negative in what ways is this helpful to you know some people say Well it keeps me from getting disappointed because I know It’s going to end up negative anyway so we can trap challenges that know that whatever it is they think they know and see if there have been exceptions when It hasn’t turned out that way What are the positives to this situation I give the example a lot of you know I wash my car or it rains and maybe I wanted to go out on a run that day but I can perceive it I can look at the positives you know the rain washed my car for me so I don’t have to do it now score it watered my garden all the better it knocked down some of the pollen out of there even better I can find and I can encourage people to find positives in a situation yes there are negatives there are negatives to every situation if you want to find them you’re going to find them but if you want to find the positives you can too which takes us down to what are all the facts there’s the positive and the negative and the neutral I told you Earlier about the coin toss activity having people toss a coin on the heads days they act like it is just the greatest day to be alive and see how Things are different when they do their journal because you know I have my clients do I’m sort of a mindfulness check-in in the morning and in the evening and preferably at lunchtime how are they feeling what’s their emotional state what’s their energy level on the happy days a lot of times it can be less and sometimes they need a little coaching throughout because some of those old patterns kick in but I want them to start challenging some of their automatic thoughts that we’re going to talk about in a minute disqualifying or minimizing the positive most of us can probably say we’ve had a bunch of clients that do this they are more than happy to tell you about all the things that they mess up but then when they do something right they minimize it encouraging people to hold themselves to the same standard they would hold everyone else to and I know I talked about that earlier ask them things like would it minimum would you minimize this.If it was your best friend’s experience your best friend came to you and said I just got into such-and-such college would you say awesome or would you say anybody can get in there how would that go ask them what is scary about accepting these positive things that you might have had an accomplishment for some people it means that it might mean other people expect more of them for other people they just don’t know how to accept the positive They don’t know how to accept compliments they don’t know how to be the center of attention and they don’t like it and then we want to look at why that is sometimes we disqualify the positive because it fails to meet someone else’s standards so as people might that be true here you know I know When I was growing up and going through college and going through school and everything got my doctorate but I will always not being not a real doctor because a Ph.D. is not an MD and I’m like really So is it somebody else’s standards or can I feel good about having a Ph.D. egocentrism My perspective is the only perspective I’ll being egocentric but it doesn’t work most of the time so encouraging people to take alternate perspectives Maybe you’re texting with someone and they say something that is not what you interpret as not the nicest thing and this happens in text messages a lot and they get upset now an egocentric thinking error would say that purse is just grumpy today Someone who’s taking other perspectives would stop and go back and read the text and go I wonder if maybe this could have been taken some other another you know obvious reaction is not what I intended So egocentrism if you hold on to that I don’t understand anybody else because You know I don’t see a problem with anything personalizing and mind-reading This is when you assume that everybody’s frowning because of something you did your boss walks down the hallway and looks at you and grimaces and continues to walk on oh I must have done something wrong No maybe he just got out of his senior management meeting that was five hours long and he’s got to go to the bathroom you know there could be a hundred different explanations for why that happened so encourage clients to ask themselves what some alternate explanations for this event that are doesn’t involve me you know why this might have happened if they hold on to that, I must have done something wrong but as soon as their boss calls them up and goes hey can you come to my office for a second you know where their thoughts are going to go I’m getting fired I’m going to get laid off I don’t know what it was that I did wrong but he walked by me two weeks ago in the hallway and grimaced and I’m just I’m the worst person in the whole world But where did that come from so encouraging people to not necessarily assume they know what’s going on in someone else’s mind and not automatically attributing every person’s negative behavior to something they did How often and then ask them how often has it been about you now think about the last 10 times you’ve taken something personally how many of Those 10 times has it been about something you did versus something with the other person then the availability heuristic remembering what’s most prominent in your mind so asking clients what the facts ah the most obvious One that we talk about is plane crashes You know it is very dangerous to fly on a plane because you hear about all those plane crashes well yeah you hear about the airlines crashes but don’t hear about the 20,000 every day that land safely so you remember it and it seems more dangerous because that’s what is in your mind that’s what is available to you that’s what you’ve based your thought processes on because maybe you didn’t know that 20,000 planes or more fly and land just perfectly every day this can also be true with people remembering what’s most prominent in your mind sometimes and this can be very very true in domestically violent relationships if somebody falls in love with someone and that person is just the greatest person since sliced bread for the first four months and then the cycle starts and there’s this little tiny a sliver of the honeymoon period after the battering cycle and the person’s like That’s the person I fell in love with that’s what I remember and they try to focus on that that’s most prominent in their mind and they ignore the rest of the stuff so we need to encourage people to look objectively at the facts magnifying high and low probability outcomes what are the chances that this is going to happen how Many clients have worked with have gone to the doctor and gotten into a physical or get a test run and then the doctor had to call them back and This could be true for you too and the doctor had to call them back two or Three days later when the tests came back from the lab and that whole three days they were just in a panic because they were afraid they were going to get some terminal diagnosis so thinking about high and low probability outcomes another instance or example of magnification is somebody that thinks this is the end of the world whatever it I think I’ve told you before my little story about um tripping when I was walking down the hall at work and falling and yeah it was embarrassing my folders went everywhere and yeah but in that big scheme of things will it matter That much from now you know are people going to think Oh she is such a clutch she must be a ditz too no I mean they may have thought that at that time I don’t know but you know in six months nobody’s going to remember and then ask them in the past when something like this has happened when you’ve had to get a test done and you’ve had to wait on results or if you’ve done something that was embarrassing and you didn’t think you thought everybody was going to remember it forever how did you tolerate it how did you learn to deal with it building on those strengths that they already have all-or-nothing thinking errors These are things like love versus hate I love them or I hate them it’s all or Nothing she does this all the time or she never does it if I’m going to do it I’m going to do it perfectly or I’m not going to do it at all thank you all good intentions or all bad intentions you know sometimes we do things with good intentions that have some bad repercussions so did we do it with all Bad intentions are all good intentions and the answer is neither most of the time life is kind of in that middle-ground gray area encouraging clients to Look and find examples where something hasn’t been one of the polls when have they done something that they’re proud of that wasn’t perfect or when again When has somebody else done something that they were proud of that wasn’t perfect remembering that with availability heuristic remembering how often something happens and how long it’s been since you’ve seen that behavior and remember that sometimes good times are amazing but how frequent are they compared with the bad times another thinking error is a belief in a just world or a fallacy of fairness I just asked clients to identify for good people you know who’ve had bad things happen and in in reality we all have bad things happen good people do bad people do in between people do attributional errors and this is a pet of mine you know labeling yourself is not a behavior so global versus specific and I am stupid versus I’m stupid at math I don’t have good math skills it’s not about me it’s about the skills I can change skills stable I am and I always will be versus it’s something I can change it’s something I can learn internally It’s about me as a person versus it’s about a skill deficit or something I could learn or change and there’s you know lots of information on attributions out there on the internet if you need a refresher on it but we find that a lot of people who have dysphoria have negative global stable internal attributions so questions for clients remember the beliefs equal thoughts and facts plus personal interpretation another way of saying it is reality is 10% perception is 10% reality and 90% interpretation so what are the facts for and against my belief is the belief based on facts or Feelings Does the belief focus on one aspect or the whole situation Does the belief seem to use any thinking errors what are alternate explanations what Would you tell your child or best friend if they had this belief how would you want someone to tell what would you want someone to tell you about this belief so If you’re telling somebody about this what are you hoping they’re going to say in return and finally, how is this belief moving you toward what and who is important to you or moving you away from what or who is important to you now they can do a worksheet and have all of these or you can pick one or two of these questions that are most salient for your clients but they can have kind of at their fingertips so as they’re going through the day and something happens They can ask themselves ok what’s an alternate explanation Or you know Whatever it is this salient for that client’s irrational thoughts how do these thoughts impact the client’s emotions health relationships and perceptions of the world you know this is what we want to ask them How is this thought impacting you globally how may this thought have been helpful in the past Where did it come from How does it make sense from when you formed it in the past when you’re dealing with it ask the person if the thought is bringing you closer to those that are important Are there any examples of this thought or belief not being true and how can the statement be made less global less all-encompassing so it’s about a specific incident a specific situation less stable which means you can change it and less internal which means it’s not about who you are as a person but maybe something that you do or a skill that you have so we’re going to go through some of these thoughts real Quickly here mistakes are never acceptable and if I make one it means that I’m incompetent well never is kind of stable and I am incompetent is kind of global, that’s also that extreme all-or-nothing thinking so you can see where these cognitive distortions end up leading to unhelpful beliefs When somebody disagrees with me it’s a personal attack Well there’s Personalization If I ever heard it before maybe it’s not about you may be They’re having a bad day and you just happen to be the unlucky target or maybe they’re disagreeing with you because they have a different point of view and It’s not a personal attack it’s just their point of view If someone criticizes or rejects me there must be something wrong with me personalization all-or-nothing thinking global stable and internal something wrong with me as a person to feel good about myself others must approve of me Now this is one we’ve talked about external validation before and we can’t control other people to feel good about yourself how can you do that Besides necessarily requiring other people to approve of you to be content in life I must be liked by all people Wow I’ve never met anybody who’s liked by all people I’ve never even met anybody who’s been hated by all people but it’s important to help clients see how this is dramatic to say all people and for them to be content everybody has to like them I mean I like to be liked but if everybody doesn’t like me you know That’s pretty understandable My true value as an individual depends on what others think of me I would challenge this one this is all you know Also very personally I would challenge people to look at and say it so your child’s value as an individual depends on what other people think of Most people would say no but the perspective thing nothing ever turns out the way you want it to okay all-or-nothing thinking and probably availability heuristic if something bad just happened then they may be focusing on that which causes them to focus on all the other bad things in the past that have happened not to focus on that is okay you know bad thing happen but look at all these good things I won’t try anything new unless I will be good at it this fear of failure fear of rejection It just really paralyzes a lot of people when they get stuck with that thinking the area that they have to be perfect I am in total control of anything bad that happens is my fault well that’s egocentric and personal if They think they’re in total control that’s their perception of how the world Do they think if they’ve got everybody on marionette strings anything bad in the world that happens is their fault how powerful are they I feel happy about uh if I feel happy about life something will go wrong It happens sometimes but let’s look at times when you’ve been happy that something hasn’t gone wrong you know let’s get rid of that all-or-nothing thinking it’s not my fault my life didn’t go the way I wanted could be true but it seems like that’s making you unhappy so what do we do about that if I’m not in an intimate relationship I’m alone No, again that’s pretty extreme I’m either in an intimate relationship or I am alone and a loner and you know it’s just me and my 17 cats which follows with there’s no gray area so encouraging people to look at what these beliefs are saying important thoughts impact behaviors and emotional and Physical reactions emotional and physical reactions impact thoughts and interpretations of events so if you do something and it’s pleasurable and you have a great physical reaction you know let’s take bungee jumping or Skydiving if you go out there and it’s scary but you do it and you’re just like Whoa what a rush Your interpretation of that is probably going to be good which means you’ll probably do it again if you go out there and it’s just the most horrible experience you’ve ever had you’re probably not going to do it again and your interpretation of it is going to be not good which is going to make it hard to understand why other people would do it irrational thinking patterns are often caused by cognitive distortions so let’s just look back at some of those because there are a lot fewer cognitive distortions or general ways of thinking about the world then there are thinking errors because There are lots and lots of thinking errors Cognitive distortions are often schemas which were formed based on faulty inaccurate or immature knowledge or understanding and by identifying the thoughts of the hecklers you know the automatic tapes that maintain our unhappiness the person can choose whether to accept those thoughts or change them.As found on YouTubeNatural Synergy $47.⁰⁰ 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Addressing Vulnerabilities to Prevent Anxiety, Depression and Pain

 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.com/counselor toolbox I’d like to welcome everybody to today’s presentation we’re going to return to   talking about vulnerabilities and this is a topic We’ve covered it before, but you know I don’t seem to   be able to say enough about it so we’re going to talk some more about it we’re going to define   what vulnerabilities are and you know I expand the definition more than what occurred in   dialectical behavior therapy because I think there are a lot of other resources or vulnerabilities   out there sorry I’m trying to read two things at Once anyhow we’re going to identify some of the   most common vulnerabilities as I define them so We’re going to go beyond sleep in nutrition and we’re going to look at environmental vulnerabilities…
 
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Dr. Dawn-Elise Snipes is a Licensed Professional Counselor and Qualified Clinical Supervisor. She received her PhD in Mental Health Counseling from the University of Florida in 2002. In addition to being a practicing clinician, she has provided training to counselors, social workers, nurses, and case managers internationally since 2006 through AllCEUs.com A direct link to the CEU course is https://www.allceus.com/member/cart/i…
#vulnerability #DBT CBT #somatictherapies #counselingtechniques AllCEUs provides #counseloreducation and CEUs for LPCs, LMHCs, LMFTs, and LCSWs as well as #addiction counselor precertification training and continuing education. Live, Interactive Webinars ($5): https://www.allceus.com/live-interact…
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Nurses, addiction and #mentalhealth #counselors, #socialworkers, and marriage and family therapists can earn #CEUs for this and other presentations at AllCEUs.com #AllCEUs courses are accepted in most states because we are approved as an education provider for NAADAC, the States of Florida and Texas Boards of Social Work and Mental Health/Professional Counseling, the California Consortium for Addiction Professionals and Professions.
As found on YouTubeAFFILIATE MASTERY BONUS: 6-Week LIVE Series Has Begun! FunnelMates $46.⁹⁵ Replays are Instantly Available. Want A Profitable Mailing List But Not Sure Where To Begin? We’ll Guide You, Equip You, and even PAY You Cash To Do It! OIP-2 ☃in 5-10 Minutes A Day Using Automation Software and our Time-Tested Strategy See How Your New Site Can Be Live In Just 27 Seconds From Now!

Best Practices for Anxiety Treatment | Cognitive Behavioral Therapy

 This episode was pre-recorded As part of a live continuing   education webinar on-demand CEUs are still available for this presentation   AllCEUs.com/Anxiety-CEU I’d like to welcome everybody to today’s presentation on best practices for the   treatment of anxiety I am your host, Dr. Dawn Elise Snipes now not too long ago we did a presentation on strengths-based biopsychosocial   approaches to addressing anxiety while Those are wonderful you know I thought maybe   we ought to look at you know what’s some of the current research so I went into PubMed which is   I don’t know it’s a playground for me it’s where You find a lot of journal articles and you   can sort I sorted by articles that were done and meta-analyses that were done within   the past five years so that gives us an idea About current research I mean there’s a lot   of stuff that is still the same like some of The medications that were known to work ten   years ago are still known to be you know good first-line treatments but there are also some   newcomers that we’ll talk about and there are also some changes that we’re going to talk about so we’re going to explore some common causes for anxiety symptoms in order to treat it, we   really need to and of course, this does play into the biopsychosocial aspect we really need to   understand kind of what causes it because anxiety that’s caused by for example somebody having a   racing heart may be different than anxiety that’s caused for somebody who has abandonment issues so we’re… …It can be incorporated in a lot of various places   again where they’re not applying it or ingesting it in any way all they’re doing is smelling it   they’ve used it in defusing aromatherapy in hospital emergency rooms and they found that it   reduces stress and irritability the people in emergency rooms and I’ve been to enough emergency   rooms over the course of the years to know that People who are in emergency rooms typically are not in the   best mood so if it can help those people then It’s probably going to have some sort of an   effect so psychologically helping clients realize that their body thinks there’s a threat for some   reason that’s why it triggered the threat response system which is what they call anxiety, so they   need to figure out why is there really a threat You know sometimes it’s like the fire alarm going   off in my house it just means that the windows are open and there’s a strong breeze there is no fire   there is no problem there’s just a malfunction It’s a false alarm A lot of times clients get this threat reaction they get this stress reaction and it’s not a big deal right now so they   can start modifying what their brain responds to and again, those basic fears that a lot of people   worry about failure rejection loss of control the unknown and death and loss distress tolerance is   one of those cognitive interventions that has taken center stage in anxiety research and   it isn’t about controlling your anxiety you know helping people recognize their anxiety acknowledge   it and say okay I’m anxious it is what it is How can I improve the next moment instead of   saying I’m anxious I shouldn’t be anxious I hate being anxious and slang with that anxiety let it   go just accept it is what it is have the client learn to start saying I am feeling anxious okay so distracted don’t react because I explain to them The whole notion of feelings comes in crest and go out   in about 20 minutes It’s like a wave so once they acknowledge their feeling if they can distract   themselves for twenty or thirty minutes you know Obviously, they figured out there’s no real threat if they can distract themselves for twenty or thirty minutes those emotions can go down and then   they can deal with it in their wise mind and encourage them to use distancing techniques instead of   saying I am anxious, or I am terrified or whatever Have them say I am having the thought that this   is the worst thing in the world I am having the thought that I could not handle this because thoughts   come and go and that comes from acceptance and commitment therapy functional analysis makes it   possible to specify where and when with what frequency with what intensity and under what circumstances   the anxious response is triggered so it’s important that we help clients develop the   ability to do functional analyses on their own so when they start feeling anxious, they can stop and   say okay where am I what’s going on how intense Is it what are the circumstances, and they start   really trying to figure out what causes this for them so they can identify any common themes from   their psychoeducation about cognitive distortions and techniques to prevent those circumstances or   mitigate them can be provided so if the client knows that they get anxious before they go into   a meeting with their boss and it’s usually a high intensity of anxiety okay so we can educate them and help them identify what fears that may be related to techniques to slow their breathing calm   their stress reaction and help them figure out times in the past when they’ve handled going in   and talking to their boss and it really wasn’t the end of the world you know there’s lots of   different things we can do there for them there but the first key and it gives them a lot of   a huge sense of empowerment to start becoming detectives in their own life and going okay now   under what situations does this happen positive Writing this was another really cool study each   day for 30 days the experimental group and this was high school-aged youth in China but you know   the experimental group engaged in 20 minutes of writing about positive emotions they felt that   day so they’re writing about anything positive that make them happy that made them enthusiastic give them hope whatever long-term expressive writing positive emotions so after 30 days it   appeared to help reduce test anxiety by helping them develop insight and use positive emotion   words so it got them out of the habit of using the destruction and doom words and encouraged them   to get in the habit of looking at the positive things and being more optimistic it’s a really cool activity that clients can try it’s…The Market WeekSign Up For The Free Newsletter No nonsense, no spam, unsubscribe anytime You can unsubscribe at any time. Read our privacy policy. Financial disclaimer: The Market Week is a general interest newsletter that is not liable for the suitability or future investment performance of any securities or strategies discussed. Readers are advised that the material contained herein should be used solely for informational purposes. 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Abandonment Anxiety – Video doctor Snipes

 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.732d01adf780998f105af3460737a431

Best Practices for Anxiety Treatment | Cognitive Behavioral Therapy

 this episode was pre-recorded as part of a live continuing   education webinar on-demand CEUs are still available for this presentation   AllCEUs.com/Anxiety-CEU I’d like to welcome everybody to today’s presentation on best practices for the   treatment of anxiety I am your host, Dr. Dawn Elise Snipes now not too long ago we did a presentation on strengths-based biopsychosocial   approaches to addressing anxiety while those are wonderful you know I thought maybe   we ought to look at you know what’s some of the current research so I went into PubMed which is   I don’t know it’s a playground for me it’s where you find a lot of journal articles and you   can sort I sorted by articles that were done and meta-analyses that were done within   the past five years so that gives us an idea about current research I mean there’s a lot   of stuff that is still the same like some of the medications that were known to work ten   years ago are still known to be you know good first-line treatments but there are also some   newcomers that we’ll talk about and there are also some changes that we’re going to talk about so we’re going to explore some common causes for anxiety symptoms to treat, we need to and of course, this does play into the biopsychosocial aspect we need to   understand kind of what causes it because anxiety that’s caused by for example somebody having a   racing heart may be different than anxiety that’s caused for somebody who has abandonment issues so   we’re gonna treat the two things differently so we want to look at some of the common causes we’re   gonna look at some common triggers for anxiety Do you know what are some of these common themes that   we see in practice I will ask you to share some of the themes that you see that underline   or underlie a lot of your client’s anxiety and identify current best practices for anxiety   management including counseling interventions medications physical interventions and supportive   treatments so we care because anxiety can be debilitating and a lot of our clients   have anxiety a lot of our clients have anxiety comorbid with depression and they’re looking at   us going how can I feel anxious and stressed out and like I can’t sit still and be depressed at the   same time you know when you’re depressed you’re supposed to want to sleep well a lot of times   people who have both issues want to sleep but they can’t so I want to help clients   understand that also sometimes anxiety when people are anxious for long enough the body   starts kind of holding on to the cortisol the body recognizes at a certain point this is a   losing battle I’m not going to put energy into this anymore so it starts withdrawing some of   its excitatory neurotransmitters so to speak and people will start to feel depressed the   brain has already said this is hopeless this is you’re helpless to change the situation so   then people start feeling hopeless and helpless which is sort of the definition if you will of   depression low-grade chronic stress and anxiety arose energy and people’s ability to concentrate   so if we’re going to help them become their uber selves we need to help them figure out how to   address anxiety not just generalized overwhelming debilitating anxiety but also panic social anxiety   and those minor anxiety triggers that come along that may not meet the threshold for diagnosis   anxiety is a major trigger for addiction relapse if you have a client who is self-medicated before   or had an addiction for some reason anxiety is a major trigger increased physical pain when anxiety   goes up people tend to tense their muscles when they tense their muscles they tend to feel more   pain I mean think about when you’re stressed you tend to have more pain like in your neck your   back and things that already hurt may hurt more why because serotonin which is one of our major   anti-anxiety neurotransmitters is also one of our major pain modulators so when serotonin levels are   too low because anxiety is high then our pain perception is going to be more acute and people   can have sleep problems if they’re stressed out your body thinks there’s a threat you’re not   going to be able to get into that deep restful sleep you may have you may sleep you may sleep   a lot but it’s probably not quality sleep which means your neurotransmitters may get out of whack   your hormones make it out of whack and your body is going to start perceiving yourself in a   persistent state of stress when you’re exhausted the body knows that we may be the weakest link   in the herd so it continues to secrete cortisol to keep you on alert a little bit so you   may again you may be resting kind of like when you have a new baby at home those first couple   of months that my children were home from the hospital I slept but I didn’t sleep well I mean   the slightest little noise and I was awake and I was looking around and you know I felt it I felt   exhausted and a lot of new parents do so triggers for anxiety abandonment and rejection and we’re   going to talk about ways we might want to deal with these things but some of the underlying   themes that I’ve seen in a lot of clients and when I do the research and a lot of what themes that   come out include low self-esteem if someone has low self-esteem they’re looking to be externally   validated oftentimes they’re looking for somebody else to tell them you’re lovable you’re okay so   that can lead to anxiety about not having people to tell them you’re okay which makes   their relationships tenuous and can make them dysfunctional irrational thoughts and cognitive   distortions may lead people to believe that if I’m not perfect for example I am not lovable so we’re   going to look at some irrational thoughts and cognitive distortions unhealthy social supports   and relationships when you’re in a relationship it takes two to tango and even if your client is   relatively mentally and physically healthy if they are in a dysfunctional relationship they can fear   abandonment and rejection if that other person is always saying if you don’t do X I’m going   to leave you or if that other person is always cheating on them or whatever so relationships   can trigger abandonment anxiety and ineffective interpersonal skills can lead to relationship   turmoil and social exile if our clients are in relationships even if they’re not completely   dysfunctional if our clients are not able to ask for what they need and set appropriate boundaries   and manage conflict effectively because conflict happens in every relationship then they may start   to argue more which may lead to fearing may lead to relationships ending in the past and them going   well every relationship I get into ends which means I must not be lovable so they start fearing   abandonment and rejection these are four areas that we can look at one more assessing clients   another issue is the unknown and loss of control a lot of times negative self-talk and cognitive   distortions can contribute to that if I don’t have control of everything then it’s all going to be a   disaster negative others when clients hang out or when people hang out with negative people it   kind of wears on you after a while you notice that people who tend to be more negative   pessimistic conspiracy-minded tend to hang out with people who are also negatively pessimistic and   conspiracy-minded so if you’re hanging out with somebody who tends to be anxious then the anxiety   can be palpable and it can kind of permeate physical complaints can lead people to be   anxious because they don’t know what’s causing it like I said earlier sometimes if your heart starts   to race if you don’t know what’s causing it you can start thinking I’m having a heart attack or   I’m gonna die when people have panic attacks for the example they truly think they’re having a heart   attack and it’s I’ve had them they are very very unpleasant experiences but when people   start having physical complaints and it can be you know they have a weird rash that they can’t get to   go away or whatever but when they don’t know what it is and they can’t control it they can’t   make it go away they start thinking about all the worst-case scenarios and going online and   getting on WebMD which usually gives you all the worst-case scenarios um so physical complaints   are important we need to normalize the fact that nobody’s pain-free all the time and you know the   fact that you may have an ache or a pain or a lump or a bump or you know a cough most likely you know   when we look at probability the probability of it being something significant is pretty small now   do you want to get it checked out probably but you know the probability that is anything to be   worried about is relatively small and a sense of powerlessness can trigger fear of the unknown   and loss of control for somebody who doesn’t feel like they have any agency in their life   if they have an external locus of control or if they felt victimized all of their life then   they may fear not being in control they may be holding on and saying okay this is the one area   of my life I can control when I grew up you know I grew up in a very chaotic environment I had no   control I was bounced around in the foster system yadda yadda yadda now that I’m an adult you know I   can control these things and I am going to hold on with white knuckles and if I can’t control   everything then that terrifies me to death and loss are other triggers for anxiety and it can   be people or pets and pets are important I don’t want to minimize pets because you know they are   little parts of a lot of our families so making sure we check that my daughter’s dog for example   is it’s getting old she’s getting older she’s 14 now I think and you know she’s in decent health   we took her to the vet and the vet said yeah she’s got a little heart murmur but that’s expected for   a 14-year-old dog and but when she goes out if she doesn’t come back when I call her I have this rush   of anxiety for a second oh my gosh I hope this wasn’t the day so anxious around losing people   and you know if she when she crosses the bridge she will and you know I’m okay with that I’m   I have a harder time dealing with my daughter’s emotional turmoil when that happens and because   she’s grown up with this dog so you know those are the types of things that we want to talk about   with our clients what things are weighing on you that you may not even be thinking about because I   know in the back of my mind there’s always that worry about one of our donkeys and her dog jobs   and promotions can trigger anxiety if people are afraid they’re gonna lose their job if they’re   always afraid that you know they’re gonna walk in and get a pink slip or get fired you know we want   to help them look at how realistic they are you doing what you need to do to achieve   and keep your job and sometimes it’s not easy to answer I mean the first thought that a lot of us   have is well you know if you’re doing the right thing so just do it but there are those bosses   out there and I’ve had some amazing bosses a lot of them and I’ve had two horrendous   bosses and those two bosses I could never I never felt like I was able to do anything right   and so going to those jobs there was always this anxiety about what I’m what am I going to get in   trouble for today so you want to talk with people about does your job cause anxiety what can you   do to moderate that anxiety the same thing with promotions people may get anxious about whether   they’re going to get promoted to safety and security you know when you lose safety and security you can   feel anxious so if there’s a break-in at the house next door or shooting down the road   or you start watching the news you can feel very unsafe and insecure quickly so we want to   help people figure out how safe and secure are you really and a lot of it goes back to really looking   at facts when people lose their dreams and hopes or fear that they’re going to lose their dreams   and hopes they can start to get anxious you know they have this dream that they’re going to be   a doctor or I just finished the presentation on helping high school students transition to college   and a lot of high school students for example start college with these wide eyes and hopes   to save the world and they want to be doctors and engineers and this and that and they get   into it and they realize that it’s a lot harder then they thought or they realize that you know   what I don’t like this but I’ve already committed to it so what do I do I want to help   people but I can’t I can’t cut it doing this you know for me I figured out in my second year that   I wasn’t going to medical school because I wasn’t going to pass calculus and that caused a lot of   anxiety it was like okay what am I gonna do now Do you know what career should I choose to help people figure out do they have dreams that have maybe kind of crashed and burned and you have to   find new ones you know okay that one we’ve got to accept it figure out that it’s not going to be and   what can you do now people may also have dreams about relationships, they get into relationships   and see themselves with this person forever and then this relationship ends and or starts to   get rocky and they’re like but that’s my dream what happens if that’s got to happen because   it’s my dream I don’t know how to function if that goes away we want to help people be able to   rewrite their narrative and then sickness spiders and other phobias kind of go in with death a lot   of times when people get sick they start getting anxious that oh my gosh what if this is terminal   oh my gosh what if this is you know incurable if I get bit by a spider it’s gonna kill me and   which is rare you know there are very few spiders that is that poisonous same thing with   snakes going over bridges I’ve shared with you all that is not one of my irrational fears you know I   am just terrified that you know something’s going to happen and I’m going to get pushed off the side   of the bridge which is completely irrational but we need to help people look at those and identify   the thoughts that they’re telling themself about those phobias and dealing with that anxiety failure   is another trigger for anxiety especially in this culture our culture American culture is   in large part puts a high premium on success and perfectionism so when people realize that   they’re not perfect they may start to get anxious because they feel like if I’m not perfect then I’m   a failure you know those cognitive distortions of all-or-nothing thinking and they start with that   negative self-talk you know you can’t do anything right so those are some of the issues that you   know we often see in counseling sessions so what do we do you know somebody comes in and is like   I can’t live this way doc anxiety depression and substance disorders as well as a range of physical   disorders are often comorbid so this is the first the thing we need to realize is that   we’re very rarely dealing with a very simple diagnosis you know when somebody comes in we need   to figure out you know if they come in and they’re presenting with depression all right let’s talk   about that and then we start realizing that there depression started to occur after a long period   of being anxious okay so we need to deal with that but we also need to help them   with their sense of hopelessness and helplessness we need to develop that sense of empowerment and   then substance disorders we know that substance use is often a way of self-medicating but we also   know that it monkeys with the neurochemicals in the brain and can contribute to anxiety and   depression the same thing to physical issues pain from physical disorders anxiety about having   physical disorders medications you’re taking for physical disorders can all contribute to anxiety   so we need to look at the person as a whole and go what are all the things that are contributing to   the anxiety and what are all the things that the anxiety is contributing to so we have started having this big list of stuff that needs to be addressed and then we can start figuring out okay   where we start so knowing that these things are comorbid helps researchers explore pathways   to mental disorders so they can start figuring out you know what little string can we pull to   unravel this blanket of anxiety so it doesn’t suffocate somebody and for us as clinicians it   provides us key opportunities to intervene in you know sometimes clients will come in and start talking about their anxiety and their physical issues you   know maybe their anxieties about you know heart palpitations and because that’s a common one we   may want to encourage them to go see the doctor to get that ruled out you know rule out anything that   has to do with hormone imbalances or you know heart conditions or anything else that might be   contributing to it which can help them address it and if they do have physical disorders let’s   go with hormone imbalances that are contributing to the heart palpitations then they can start to   treat that if they don’t start to treat that then no amount of talk therapy we do is going to get   them to the quality of life that they’re looking for because they’re still gonna feel those so   we want to make sure that we’re addressing them holistically anxiety disorders should be treated   with psychological therapy pharmacy therapy or a combination of both and what they found and this   is no surprise this is kind of old news is that counseling Plus pharmacotherapy tends to have the   best outcomes but separating the two have similar outcomes in many cases but that’s just   looking at and I hate to call it simple anxiety but we’re just looking at anxiety symptoms here   we’re not looking at the full quality of life and we want to make sure that we’re also including any   medical issues behavioral therapy is regarded as the psychotherapy with the highest level   of evidence, there are a variety of cognitive behavioral approaches ranging from acceptance   and commitment therapy to dialectical behavior therapy to CBT to debt you know any of those that   deal with the thoughts and the cognitions that fall in that realm and it is effective in the current conceptualization of the etiology of anxiety disorders includes an interaction of   psychosocial factors such as childhood adversity or stressful events and a genetic vulnerability   so the psychosocial factors and these are other things when we do our assessment we want to pay   attention to because our approach to treatment is going to be different for people for example   who have trauma-related brain changes maybe then for somebody who doesn’t so, we want to   look at childhood adversity and stressful events that it may have caused basically what I tell clients is like rewiring of the brain there are trauma-related brain changes in soldiers and   especially in children or in people who’ve been exposed to extreme trauma that is designed to   protect them but it also can cause complications kind of later on in dealing with anxiety coping   skills that were learned that are ineffective you know sometimes people grow up in a household or an   environment or a situation where they don’t learn effective coping skills so we need to kind of help   them unlearn those and learn new ones build on their strengths and trauma issues that may still   need to be dealt with such as domestic violence you know if they grew up a lot around a lot of   domestic violence they may think you know I’m out of that situation it’s over I don’t want to   think about it it’s not bothering me anymore or a parental absence and I put absence because it can   be death it can be a parent that just packed up and left it could be a child that got put up for   adoption whatever put the child in a position of feeling like they were rejected by a parent can   be very traumatic and bullying among other things but there are a lot of trauma issues that people   once they’re out of that situation often say you know I’m out of it it’s not a big deal I dealt   with it let’s move on and they don’t realize the full ramifications and how that’s contributing to   their current anxiety and their current self-talk and cognitions of current stressors if somebody has   a lot of current stressors that’s also going to impact whether they develop generalized anxiety   you know we’re kind of stacking the deck here and the current availability of social support if they   don’t have effective current social support then they’re gonna have difficulty bearing the weight   of everything on their shoulders so we want to look at all these psychosocial factors when   we do our assessment now going back to the trauma issues if you’ve taken the trauma courses at   all CEUs you know that some people are not ready to acknowledge that the trauma is still bothering   them or work on the trauma and that’s okay we can educate them that it might be an issue and   then let them choose how to address it but we want to bear in mind the fact that you   know this could be sort of an underlying force motivating some of the current cognitions and genetic vulnerability so you take any three people and you put them or 300 people and you   put them through roughly the same psychosocial situations they’re all probably going to react   a little bit differently based on their prior experiences but also because of their genetic   makeup there are certain permutations and they found four we’ll talk about later that make the   brain more or less responsive to stress and more or less responsive to serotonin which   is your calming chemical so brains that are less responsive to serotonin isn’t going to you know   send out as much or send out serotonin as easily so people can stay kind of tensed and wired that’s an oversimplified explanation but that’s all you need for right now so genetic   vulnerability impacts people’s susceptibility to the effects and development of dependence   on certain substances which can increase anxiety when people are detoxing from alcohol when they’re   detoxing from benzos when they’re detoxing from opiates they can feel high levels of anxiety when   they take opiates some people find that opiates have wonderful anti-anxiety properties not that   I am advocating for the use of opiates I’m just client experiences have shown that that   can be true so some people are going to be more susceptible to the anti-anxiety effects   of certain substances and some people are going to be Cerrone to become dependent on substances   where others may not and that part of that is genetic vulnerability and they estimate about   30% the predictability of the development of anxiety disorders is genetic and genetics   also impact which medications are effective if you have genetic makeup then SSRIs might   be helpful then atypical antipsychotics may be more effective   and SSRIs might not do anything which is why a lot of our clients get so frustrated because they know there’s no way to figure out exactly what I guess there is now that there’s genetic testing   out there but up until then it was harder to figure out which medications to start with and   most physicians matter of fact I don’t know of a single physician that starts by   saying well let’s do a genetic profile to see what med to start you out with most we’ll start with events as with an SSRI or some other anti-anxiety medication some sort of Benzo that’s been my experience so we may want to encourage clients to consider genetic   testing if they’re having difficulty finding a medication regime that works for them and they   are feeling like they have to have medication genetic vulnerability also affects what’s going   to make somebody more vulnerable now than all of you in class today you know thinking about sleep you   know sleep may not be a big deal for some of you I know people who can go days or weeks with four   or five hours of sleep and they feel fine it’s not a big deal, not me I need eight or nine hours   of sleep so genetically for whatever reason I am programmed to need a lot of sleep so when I don’t   get that much sleep I tend to be it tends to be harder for me to deal with life on life’s terms   and I know that that makes me more vulnerable to being irritable so genetic vulnerability affects   who can become addicted and affects what medications work best and affects what situations are going   to tend to make somebody more vulnerable to anxiety so our medications and I know the type   on here is small but we’re going to go through the first-line drugs are the SSRIs selective   serotonin reuptake inhibitors and SNRs is selective norepinephrine reuptake inhibitors   now the names are a little bit deceptive because selective norepinephrine reuptake inhibitors also   increase available serotonin but the mechanism of action is different the mechanism of action   for each SSRI is a little bit different as well which is why you can put somebody on Prozac and   they have an awful experience and you can put them on Zoloft and they have a much better experience like I said earlier a lot of the research pre five years ago had been done on medications and Zoloft paxil luvox lexapro celexa and their generics have all been found to be effective   at treating anxiety in certain people no one medication works for everybody in the last five   years effexor has come on the radar and it has been found effective according to the Hamilton rating scale for anxiety so that’s another one to consider if clients are not successful or getting   the treatment effect that they need for on some of the other medications obviously, none of us   probably are prescribers but we do need to educate clients about why the first drug or even the third   drug that the doc tries may not work so they don’t start feeling helpless and hopeless like   I said earlier there are at least four different genetic variations which are correlated with the   development of generalized anxiety disorder and different medications are more or less effective   depending on the genetic makeup of the person there’s a high mortality rate moving on to two   benzos the recommendation has switched to back off from the use of benzos now for   some doctors will prescribe an SSRI and for the first, four weeks while the SSRI is building up   in the system they will also prescribe a Benzo to be taken as needed to moderate the   anxiety and you know you could argue on either side of that, if somebody has a history of substance   use or substance dependence benzos are really a bad idea because they do have a high rate of   dependence but the other reasons that they are now cautioning against the use of benzodiazepines is   that there’s a higher mortality rate among benzo users compared with non-users there’s an increased   risk for dependence with use for more than six months and that’s a long time to be using Benzo and when we’re talking about dependence and six months we’re talking about somebody who uses it   like every four hours or every eight hours depending on your Benzo every single day, not   a PRN user if somebody’s using it at night to help them go to sleep or you know three or four   times a week when the anxiety gets high the risk of dependence is relatively low but a   lot of people with anxiety because if they find the right Benzo makes them feel so much better   they may not want to be off of it and for a lot of people when that benzo reaches its half-life and   starts getting out of the system even more their anxiety spikes you know they have rebound anxiety   which they want to medicate with more benzos that’s gonna be an issue for them to discuss   with their doctor there’s also an increased risk of dementia identified in long-term benzodiazepine   users again this is for the people who use you know throughout the day every day for six months   or relatively every day for six months or more and it doesn’t matter if it’s you know we’re   talking about somebody who’s 65 or somebody who’s 35 who’s been using Benzos for you know   six months a year two years the risk of later life dementia is greatly increased according   to the research benzodiazepines also don’t treat depression okay so if you’ve got somebody who has   concurrent anxiety and depression there’s a much higher suicide risk if they’re on benzodiazepines   so being aware and generally that suicide risk comes from overdosing on benzodiazepines but   not always other treatment options you know if the benzos aren’t something that people want to touch   you know they scare the living daylights out of I SSRIs and SNRIs don’t seem to be working   then tricyclic antidepressants can be tried on those your older generation antidepressant seroquel   is used a lot and there are some there’s some research that shows it can be effective   with anxiety like some of the antidepressants and depending on the person the benzos seroquel can   make people very very very sleepy so you know it may not be the side effects of the Seroquel   the weight gain and the fatigue and you know sleepiness may be an unacceptable side effect for   some clients and boosts perón is the third option boost Barone works more like an anti-depressive   serotonin reuptake inhibitor and that it takes you know four weeks or so to kind of build up in   the system studies have shown that there’s really no long-term benefit to taking it but after six months   to eighteen months of use it has been shown to be effective in talking with clients a lot of   clients report that boost bar when they take it doesn’t necessarily help them stop being anxious   like a benzodiazepine does but it helps them not go from zero to 200 in 2.3 seconds it kind of you   know keeps them from having this gush of a freak out reaction every time something goes wrong which   a lot of clients report helps because they feel more stable throughout the day after remission   medication should be continued for six to twelve months and during that last six months first six   months keep it as is last six months you know they say that tapering is best it’s best not   to stop somebody cold turkey on any of these but it’s important for people once they’re   in remission to not just suddenly go okay I feel better I don’t need any of this anymore they need   to work into it and make sure they’ve developed the skills and tools that they need to deal with some of the anxiety that is going to happen in life so physical signs and symptoms   of anxiety may include fatigue irritability muscle tension or muscle aches try laying feeling twitchy   being easily startled trouble sleeping nausea diarrhea irritable bowel syndrome headaches so the   first thing we want to do with clients when we’re talking to them well second thing first thing is   say get a physical let’s rule out physiological causes of this but we can also help clients   look at you know what might be causing these things that you can do to mitigate it what might   be contributing to your fatigue what might be contributing to your irritability and your muscle   tension or your muscle aches I mean let’s look at economics did you recently get a new bed or do you   need to get a new bed what about your desk chair I know you know I get more muscle tension and muscle   achy when I do a lot of mousing because I have deplorable posture being becoming aware of that   helps and then I’m like okay well I know it caused unfortunately, it’s unpleasant but it’s not a   big deal trembling or feeling twitchy you know that can be caused by low blood sugar that can   be caused anxiety that can also be caused by early onset Parkinson’s symptoms you know   there’s you know it can be worst case scenario or it can be something benign so we want   to have people figure out you know when you start trembling or feeling twitchy is there something   that it’s related to you know I know when my son gets excited he’s he just sits there   and you can see him almost shake because he’s so excited about something so we want to have people prevent misidentification we don’t want them to jump to that worst-case scenario we don’t   want them to go onto WebMD and go oh my gosh I’ve got cancer I’ve got this debilitating disease and   I’m going to die in six months probabilistic Lee speaking it’s not gonna happen yes get a doctor’s   opinion I’m certainly not going to tell them it’s all in your head I want them to get an   evaluation but I do want to in the meantime help them think about how likely is   this and other things for headaches and this is one another one of those that can be frustrating   as we get older our eyesight starts to go and you know there was a period there I did fine   and then after I hit 45 my eyesight just started to like steadily and kind of rapidly in my mind   decline so I have to get my eyeglass prescription changed every couple of years and that can cause   headaches so instead of starting to worry about oh my gosh I’ve got a headache all the time   maybe I’ve got a brain tumor you know I know that it’s probably my glasses or I’m grinding my   teeth so other biological interventions that have been evaluated there’s something called   the floatation rest system that reduced environmental stimulation therapy reduces sensory input into   the nervous system through the act of floating supine which is on your back in a pool of water   saturated with Epsom salt you know I’m looking at this going sounds good and you can’t   quite get the same experience in a bathtub because you’re not floating you’ve got pressure points and   you’re still hearing stuff clients can sort of simulate it with you know earplugs or whatever   but it’s if they can access this it’s been shown to be effective the float experience is   calibrated so that sensory signals from visual auditory olfactory gustatory thermal tactile or   tactile vestibular gravitational and preceptive channels are minimized which means you don’t see   here taste touch smell feel anything as is most movement and speech so you want people to lay just   like completely motionless and not talk which can be hard for some people with anxiety in the study   the study I looked at fifty participants reported significant reductions in stress muscle   tension pain depression and negative effects and it was accompanied by significant improvement in mood   characterized by increases in relaxation happiness and well-being I read the study I’m like where can   I sign up you know it sounds in looking at some of the research this was more effective for   addressing anxiety than something like a massage Tai Chi also produced significant reductions in   anxiety there was approximately a 20% treatment effect 25% treatment effect in patients with   anxiety and fibromyalgia who practiced twice a week for a year now you know we want to look at   the confounding things here is it the Tai Chi itself or is it learning to control the muscles   and becoming more in tune with your body and learning to control your breathing helps   people reduce their anxiety either way you know Tai Chi helps people do that and it was shown that   after a year after the first six months, there was a significant treatment effect but after a year   you know it kept growing and after a year it was about 25% so Tai Chi can be effective acupuncture at the HT 7 median Meridian can attenuate anxiety-like behavior induced by   withdrawal from chronic morphine treatment through the meditation of the GABA receptor system   what does that mean that means if you if the acupuncture is done in very certain places the anxiety behavior the GABA a receptor system GABA is your main calming relaxation   neurochemical that is triggered and causes your body to sort of flood that receptor system and   this research was done on people who were detoxing from morphine treatment but we can look at   generalizing the results and I would be interested to see further studies on it pain other things we   need to do to help people with anxiety when people are in chronic pain they often have anxiety that   oh my gosh this is getting worse or It’s never gonna get better or I just can’t take this pain   anymore or they may get anxious that they’re going to be rejected because they can’t do some of the   things they used to do because they’re in so much pain so there’s a lot of guilt and anxiety that   can kind of revolve around pain what can we do to help clients guided imagery is generally very   helpful if we can help them imagine you know if that pain in their shoulder imagine the pain is   like the color red flowing out of their arm or other focus mindfulness so you know when you   think about something you know when you get a shot if I don’t think about it it doesn’t hurt near as   much as if the nurse says okay now one two three and you know she’s counting down and I’m getting   prepared and I’m focused on it I had another nurse one time who she was just talking   to me and you know put the alcohol on my arm and just kept on talking and didn’t tell me she was   getting ready to give me a shot and before I knew it she had given me a shot and she was like okay   we’re done I’m like you didn’t give me a shot yet she said yes I did it’s like oh so not focusing   on it and next time you have an itch for example if you’ve ever been driving on the interstate and   you can reach on your foot I get those on the bottom of my foot sometimes and I’m like okay   I’m not going to pull over to each my foot if you focus on something besides the itch eventually, it   goes away I’m not saying the pain is gonna completely go away but the more people focus on it the more   it hurts physical therapy can help so encourage them to get a referral and encourage them to do a   self-evaluation if nothing else of ergonomics in their car at work where they watch TV and spend   most of their time at home and they’re sleeping so those are the four places that they spend most   of their time what do their ergonomics look like and that can help a lot of people mitigate   a lot of pain hormones are another thing that we need to look at imbalances of estrogen and   testosterone can contribute to anxiety symptoms heart palpitations fatigue irritability having   people get a physical we can’t as clinicians do anything about it but doctors can rapid heart   weight rate sweating palpitations are not uncommon in women in perimenopause or menopause so a lot   of women start feeling like they’re developing generalized anxiety and/or something’s going wrong   when they start reaching that mid-40s to mid-50s area and they start having some of these symptoms   again we’re not going to diagnose it but we do want them to recognize that it may not be anything   you know is catastrophic this is something that a a lot of women experience and help them figure out   how to deal with that supportive care biologically now you know this isn’t gonna treat anything but   we can help them minimize their vulnerabilities help them create a sleep routine so their brain   and body can rebalance this can help repair any adrenal issues that may be going on and improve   energy levels people with anxiety don’t sleep well so helping them figure out how to get some quality   sleep is important nutrition minimizing caffeine and other stimulants are going to be a big help   because those make people feel anxious and encourage them to work with a nutritionist to try to prevent   spikes and drops in blood sugar which can trigger the stress response when your blood sugar goes way   up or way down you can start getting kind of shaky and feel weird and that can cause people anxiety   because they might think oh my gosh I’m having a stroke or a heart attack or you know I don’t know   what these tremors are so it’s important that they don’t miss identify symptoms and encourage   them to drink enough water dehydration can lead to toxic Ardea which is increased heart rate   sunlight vitamin D deficiency is implicated in both depression and anxiety mood issues   vitamin D has been found in those main areas where serotonin receptors are found vitamin D receptors   are found so we know the serotonin and vitamin D have something going on sunlight prompts the skin   to tell the brain to produce neurotransmitters and set circadian rhythms which impact the release of   serotonin your calming neurochemical melatonin which is made from breaking down serotonin and helps you sleep and gaba so sunlight actually helps increase the release of GABA when it’s   time to start calming down and going to sleep exercise studies have shown that exercise can   have a relaxing effect and encourage clients to start slowly there’s not a whole lot of new research   on exercise and anxiety aromatherapy has been used a lot, especially in other countries in   the treatment of people with anxiety people with hospital anxiety people women who are giving birth   and they have some birth anxiety there they’ve been found to be effective in a lot of   those studies essential oils for anxiety include lavender rose Bedevere ylang ylang bergamot   chamomile frankincense and Clary sage encourage clients to just go to a health food store and   you know sniff some of these and see if it makes them feel happy and calm and content the aromatherapy   molecules enter the nasal membranes and they will start triggering neurochemical reactions   and so you don’t need to apply it you don’t need to ingest it all you need to do is so encourage   clients if they’re open to it to think about this because aromatherapy can be integrated into their bedroom for example with an atomizer or a Mr. It can be incorporated in a lot of different places   again where they’re not applying it or ingesting it in any way all they’re doing is smelling it   they’ve used it in defusing aromatherapy in hospital emergency rooms and they found that it   reduces stress and irritability the people in emergency rooms and I’ve been to enough emergency   rooms over the years to know that people who are in ers typically are not in the   best mood so if it can help those people then it’s probably going to have some sort of an   effect so psychologically helping clients realize that their body thinks there’s a threat for some   reason that’s why it triggered the threat response system which is what they call anxiety so they   need to figure out why is there a threat you know sometimes it’s like the fire alarm going   off in my house it just means that the windows are open and there’s a strong breeze there is no fire   there is no problem there’s just a malfunction it’s a false alarm a lot of times clients get this threat reaction they get this stress reaction and it’s not a big deal right now so they   can start modifying what their brain responds to and again those basic fears that a lot of people   worry about failure rejection loss of control the unknown and death and loss distress tolerance is   one of those cognitive interventions that have taken center stage in anxiety research and   it isn’t about controlling your anxiety you know helping people recognize their anxiety acknowledge   it and say okay I’m anxious it is what it is how can I improve the next moment instead of   saying I’m anxious I shouldn’t be anxious I hate being anxious and slang with that anxiety let it   go just accept it is what it is have the client learn to start saying I am feeling anxious okay so distracted don’t react because I explain to them the whole notion of feelings comes in the crest and goes out   in about 20 minutes it’s like a wave so once they acknowledge their feeling if they can distract   themselves for twenty or thirty minutes you know they figured out there was no real threat if they can distract themselves for twenty or thirty minutes those emotions can go down and then   they can deal with it in their wise mind and encourage them to use distancing techniques instead of   saying I am anxious or I am terrified or whatever have them say I am having the thought that this   is the worst thing in the world I am having the thought that I cannot handle this because thoughts   come and go and that comes from acceptance and commitment therapy functional analysis makes it   possible to specify where and when with what frequency with what intensity and under what circumstances   the anxious response is triggered so it’s important that we help clients develop the   ability to do functional analyses on their own so when they start feeling anxious they can stop and   say okay where am I what’s going on how intense is it what are the circumstances and they start trying to figure out what causes this for them so they can identify any common themes from   their psychoeducation about cognitive distortions and techniques to prevent those circumstances or   mitigate them can be provided so if the client knows that they get anxious before they go into   a meeting with their boss and it’s usually a high the intensity of anxiety okay so we can educate them and help them identify what fears that may be related to techniques to slow their breathing and calm   their stress reaction and help them figure out times in the past when they’ve handled going in   and talking to their boss and it wasn’t the end of the world you know there’s lots of   different things we can do there for them there but the first key and it gives them a lot of   a huge sense of empowerment to start becoming detectives in their own life and going okay now   under what situations does this happen positive writing this was another cool study each   day for 30 days the experimental group and this was high school-aged youth in China but you know   the experimental group engaged in 20 minutes of writing about positive emotions they felt that   day so they’re writing about anything positive that make them happy that made them enthusiastic gave them hope whatever long-term expressive writing positive emotions so after 30 days it   appeared to help reduce test anxiety by helping them develop insight and use positive emotion   words so it got them out of the habit of using the destruction and doom words and encouraged them   to get in the habit of looking at the positive things and being more optimistic it’s a cool activity that clients can try it’s not gonna hurt anything if you have them journal each day   for 30 days mindfulness also came up in the research and was shown to be effective in   a meta-analysis of six articles about mindfulness based stress reduction four about mindfulness-based cognitive therapy and three about fear of negative appraisal and emotion regulation were   reviewed all of these showed that mindfulness was an effective strategy for the treatment of   mood and anxiety disorders and is an effective in therapy protocols with different structures   including virtual modalities so you know if you’re doing it via teleconference mindfulness can still   be helpful mindfulness helps people start learning how to observe what’s going on and become aware of   what’s going on more aware of those circumstances which will help them complete their functional   analysis but it also helps them become aware of vulnerabilities and head off things in the past   and if they’re taking better care of themselves that they’re living more mindfully then they may   not experience as many situations that trigger their anxiety mindfulness also encourages clients   to learn acceptance that radical acceptance of it is what it is I’m not gonna fight it I’m angry   right now I am anxious right now however I’m feeling right now is how I feel and that’s okay it’s hard for clients to get to that but once they get a hold of that and they truly believe it   and they can say all right it’s fine I’m not gonna feel this way forever I’m gonna do something else   until the feeling passes it helps and that’s where the labeling and letting go comes in mindfulness   can also help them identify trigger thoughts what thought were you having right before you   started feeling anxious if people are mindful or let’s start back when people are not mindful they   often notice or don’t notice that they’re getting anxious until they’re like super anxious   when people are mindful they become more aware of subtle cues address unhelpful thoughts when they   say or believe it’s a dire necessity for adults to be loved by significant others for almost   everything they do always running gonna happen why is it a necessity what we can encourage them   to do is concentrate on their self-respect on winning approval for practical purposes you   know for promotions or whatever but it’s not about me being lovable it’s about me getting a promotion   and making more money and focusing on loving rather than being loved because when we give   love we generally get love back with unhelpful thought number two people feel they aren’t able to stand   it if things are not the way they want them to be or are not in their control so encourage clients   to focus on the parts that are in their control and other things in life which are going well and   to which they’re committed number three misery is invariably externally caused and is forced   on us by outside people and events just by reading that makes me feel disempowered so encouraging   clients to focus on the fact that reactions such as misery or happiness are largely caused by the   view that people take of the conditions so if you see it as a tragedy and devastating then   it’s probably going to produce misery if you see it as an opportunity and a challenge it’s   probably going to produce a different emotional reaction if something is or may be dangerous or   fearsome people should be upset and endlessly upset about obsessing about it a lot of   people with anxiety get stuck on this you know if I feel like it’s fearsome I need to worry about   it getting on a plane for example if I fear that that’s dangerous that I need to think about it   and worry about it that’s not going to do any good so encourage clients to figure out how to   face it and render it harmless if possible and when that’s not possible accept the inevitable   so looking at airplanes you know facing it means researching to figure out how dangerous   is it really and realizing that it’s not that dangerous so that helps render it a little   bit harmless in their mind it proves to them that it’s not as dangerous as it could be and when   it’s not possible accepting the inevitable you know you got a fly so getting on there figuring   out how you’re gonna get through it hurricanes are the same way people especially in places   like Texas Louisiana Florida may obsess as soon as it starts coming to hurricane season or if a   hurricane is spotted out in the Atlantic somewhere they start checking the weather every hour or more   wondering what the path is going to be and you know what there’s you can’t change the path of the   hurricane so all you can do is board up your house evacuate if necessary and deal with the fallout child driving is just another example I’ll give you know my children are learning how to drive and   that’s kind of scary and fearsome you know what’s gonna happen when they’re out there you know you   see crashes all the time well render it harmless by making sure they’ve got good training on how   to drive make sure they’re good drivers and then accepting that some things are just not within   my control it’s easier to avoid than face life difficulties and responsibilities Well running   from fear is usually much harder in the long run so encourage clients to look back at times when they’ve avoided difficulties and responsibilities and the eventual outcome you know what happened   there people believe they should be thoroughly competent in achieving in all possible respects   or they will be isolated rejected and failures we need to encourage clients to accept themselves as   imperfect with human limitations and flaws and focus on what makes them loveable human being   what qualities like courage and intelligence and creativity and those things that can’t be taken   away what inherent qualities do they have that make them awesome people because something once   strongly affected people’s lives they should indefinitely fear it if you got lost you know   when little kids get lost it’s terrifying when you’re grown up if you get lost you turn on the   GPS and you figure out your way but some people still, you know freaked out about getting lost if   they got lost once so we want to help people look back at past episodes that may be contributing to   the current anxiety and compare the situation’s you know are you the same person or is this not   a big deal now that you’re older wiser stronger encourage them to learn from past experiences   but not be overly attached to or prejudiced by them yeah you could have maybe got lost in the   past and it was a horrible experience well you were six I can see where that would be terrifying   and a horrible experience but it doesn’t have to continue to impact you that way now when you’re   you know 26 getting lost you know could be an opportunity to try a new restaurant or something   people must have complete control over things well this doesn’t happen so encourage clients   to remember that the past and the future are uncontrollable we can’t change the past it is what   it is we can learn from it so it doesn’t repeat but we can’t change it and the future is largely   uncontrollable I mean there are a lot of things I can do to stay moving toward a rich and meaningful   life but life is going to throw me curveballs sometimes and there’s nothing I can do to plan for   or control that we can control our actions in the present to stay on our preferred path and general   develop general skills to deal with adversity should it arise so we want to help clients   develop those general problem-solving skills and the general support system so when they are thrown   a curveball you know it doesn’t knock them upside the head people have virtually no control over   their emotions and cannot help feeling disturbed by things well encourage them to think about the   fact that they have real control over destructive emotions if they choose to work at improving the   next moment and changing inaccurate thoughts then they’re not going to experience the destructive   emotions as intensely or as frequently when you feel an emotion you feel how you feel but again   you don’t have to wrestle with it fight it and nurture it you can say this is how I feel how   do I improve the next moment when it comes to cognitive distortions encourage them to find   alternatives when they start to personalize things if somebody laughs when you walk out of the room   then the and the person starts getting anxious thinking oh they were making fun of me I wonder   what they thought I wonder if I had something stuck to the back of my dress and they start   getting all panicked about it that doesn’t do any good encouraging them to think you know what   our three alternate explanations that hadn’t but had nothing to do with you for why they laughed   magnification of the worst thing you know taking something and saying if this happens then it’s   going to be a catastrophe and minimization going along with that a lot of times when people magnify   and see a catastrophe they minimize not only their strengths and resources but all the   other stuff that they’ve got going for them all they’re seeing is this catastrophe so encouraging   them to focus on the facts of what is actually happening and what is the high probability   event and encourage them to get information and look at the broader picture you know yes you   got into a car crash and your car is totaled and that is unfortunate you know it sucks but   you know that is not going to cause you to lose your job and then become homeless and penniless   and yadda-yadda it might cause your insurance to go up but okay so you don’t have a car but what   are the resources that you have who can Who do you work with that might be able to give you a   ride to work you know let’s look at the resources you have and work around so problem-solving helps   with magnification and also focusing on you know let’s be grateful for what didn’t happen you know   you could have been killed but you weren’t the car was totaled it’s replaceable all or nothing   thinking again have them think about what else could have been happening like Brittney suggested   finding the exceptions instead of saying she always does this look for exceptions when has   she not done that what else has she done instead of this selective abstraction and filtering is   when people look for the good the bad and the ugly a selective abstraction means you kind of   see what you expect to see so if you expect something to be devastating you see only the   devastating aspects of it which kind of goes with the magnification and minimization you filter out   the stuff a lot of times when people are in a bad mood or are anxious they see the negative because   that’s the state of mind they’re in so encouraging people to complete the picture alright there’s   all this bad stuff now what’s the good stuff you know to encourage them to look at the good the bad   and the ugly so they get a wide view of exactly what’s going on and encourage them to remember   that hindsight is twenty-twenty when people have something embarrassing happens or they get anxious   about something that happened they look back and they go I should have or I could have or Oh I   wish I wouldn’t have when you were in that situation you did what you did and you know   maybe you may have had a reason for it or you know you may have not had other options or it may have   just been a bonehead thing to do but okay so you made one mistake hindsight is 2020 that’s gonna   that mistake is gonna stand out just like the great big letter on the eye chart because you’re   thinking back and you’re looking at it and that’s all you see but encouraging clients to remember   that other people are too busy worrying about themselves to remember what they did jumping   to conclusions encourages clients to remember to get all the data if your significant other male   significant other comes home and is smelling like perfume don’t just jump to the conclusion that he   was cheating on you maybe he went to the mall to get a new tie and walked through the   perfume area and got spritzed or bought you some perfume or who knows maybe the person sitting next   to him at work sprayed her perfume on the desk and some of it filtered on there are all different   reasons that that might happen so encourage people to get all the data mind reading we can’t do it   you know you can’t read somebody’s mind you don’t know what they’re thinking so ask them what you think about this don’t assume anything and emotional reasoning encourages people to step back   from a situation and ask themselves am I feeling anxious about this because I’m feeling anxious and   I’m looking for reasons that it should be scary or am I feeling anxious about this because it’s   really scary for some reason there are facts support my anxiety a lot of times when we go into   new situations we may feel anxious because it’s a new situation but when we step back we say you   know what there’s nothing to be worried about here you know no big deal I got this and   move on so instead of rolling with it and trying to figure out okay I feel anxious so there must   be a reason not necessarily very likely a false alarm other psychological interventions relaxation   skills encourage people to learn how to relax not only physically but mentally diaphragmatic   breathing helps encourage them to breathe through their stomach and put their hand on their   belly and feel their belly expand and contract slows breathing down which triggers the rest and digestion reaction in the brain which is calming meditation can be helpful for some people some   people find trying to quiet their minds too frustrating because they’ve got too much   monkey mind going on that can be later or maybe never for some people we don’t want to increase   their anxiety with interventions cute progressive muscular relaxation also has a lot of research   support and remembers with cute progressive muscular relaxation we’re Sakura getting them   to attach a cue AK you word like relax or breathe with the relaxation response so they tense their   muscles and then relax their muscles and as they relax their muscles they say their “querk”-word   like relaxed and they work from head to toe or from toe to head tensing and relaxing different   muscle groups so they become more aware of what a tense muscle feels like versus a reactive relaxed   muscle there are great scripts that are online that people have already recorded that can walk   people walk clients through CPM are I highly encourage it because once they get used to it   then they can just think that cue they can think relax and as they exhale they will start to feel   their entire body kind of relaxing because it’s trained when it hears that just like when you hear   the word pop quiz when you were in high school you had a stress reaction well we want to use   it in reverse and train the body so that when it hears a cue word relaxes helps them develop   self-esteem because fear of failure and rejection a lot of times come from needing other people’s   approval to help them develop a rational idea of their real self develops compassion self-talk   instead of saying I’m an idiot or I’m stupid or I’ll never measure up to anything encourage them   to talk to themself like they would talk to their child or hopefully their best friend and encourage   them to spotlight strengths whenever they feel like they’ve got an imperfection to identify these   three strengths that they have so they’re you know balancing out the imperfections and the strengths of cognitive restructuring reframes challenges in terms of current strengths, not past weaknesses   so if you’re going to give a presentation in front of 60 people and you hate public speaking instead   of thinking about you know this is terrifying because the last time I went up in front of people   I forgot everything I was going to say and drop my note cards well that’s a past weakness what   is your current strength you’re prepared you know the material you Jabba-dada so encourages people   to look at all the strengths and resources they currently have them develop an attitude of   gratitude and optimism because like I said with that the positive writing exercise when people   are in a grateful optimistic frame of mind they tend to see more of the good stuff they see the   bad stuff too but they can also see more of the good stuff and some of the bad stuff they see   opportunistically instead of as a devastation acceptance and commitment therapy says that some of the reasons that we’re miserable are fear we get fused with our thoughts we think I   am terrified well if I am terrified then I can’t I mean if I am I can’t get rid of anything I am   if I’m having the thought that I’m terrified well I can get rid of a thought I can forget   things easily encourage people to evaluate their experience and empower them to look at things as   challenges and opportunities instead of hardships encourage them not to avoid their experiences so   things that are scary gradual exposure and finding exceptions like for me bridges you   know I love public speaking so that’s not a thing but when I go to a bridge you know when   I Drive to the bridge you know when I’m on the bridge somebody else is driving I get used to   doing that when I Drive over a bridge than when I Drive over one of those bridges that opens up   I hate those bridges um I know y’all are just like oh my gosh yeah it’s an irrational fear I realize   that but instead of going straight for the bridge that opens up going for the little bridges first   and then thinking back over times that I’ve gone over bridges and there’s been no problem you know there are exceptions nothing happened it wasn’t a big deal Sometimes I didn’t even notice it until   somebody pointed out hey look down there at that pretty water and I’m like oh we’re on a bridge so   encourage people to not avoid their experiences get used to them embrace them and learn that they   have the power to deal with them and stop reason giving for behavior you know use the challenging   questions if something is fearsome let’s look for at the evidence for and against it instead   of you know making excuses for social interventions improve their relationship with their self which   goes with self-esteem improvement people are going to feel less anxious about getting their needs and   wants to be met if they know what their needs and wants are so part of that is becoming mindful cuz a lot   of our clients don’t know what they need and want they just want to feel better but they don’t   know how they don’t know what they need to feel better so helping them identify their needs and   wants to encourage them to be their own best friend you know when they get a promotion take themselves   out to dinner pat themselves on the back whatever it is don’t rely onother people to do it because   other people it’s not that they don’t care but other people are often very involved in thinking   about their stuff and they may not notice encourage them to develop a method of internal   validation so they can feel like they are all that ‘no bag of chips and they realize why they   are lovable human beings and they accept the the fact that everybody is not going to like them   and nobody is gonna like them all the time and that’s okay you know my kids don’t like me all   the time my husband doesn’t like me all the time I’m okay with that I know I can be challenging but   you know most of the time you know they like me and that’s okay and there are some people you   know who don’t like me at all and okay there’s nothing I can do about that helping our clients   develop an okayness with that helps relieve a lot of anxiety because a lot of people feel like they   have to be liked by everybody and if somebody doesn’t like them it’s like what did I do wrong   oh my gosh encourage them to develop healthy supportive relationships with good boundaries   develop assertiveness skills so they can ask for help when they need it anxiety a lot of times you   know that’s the body saying there’s a threat well if there’s a threat maybe you need some help you   know dealing with it so people need to be willing and able to ask for help and not feel like that’s   going to lead them to be rejected and allow them a certify this will allow them to say no to requests   again without feeling like that’s going to result in them being fully rejected describe the ideal   healthy supportive relationship and encourage them to separate the ideals from the reals you   know let’s look at if you had the best relationship what would it look like okay you know Warden June   Cleaver we got that now how realistic is that you know let’s look at you know rephrasing this   a little bit so it’s less extreme you know warden June Cleaver never fought their kids were perfect   you know all those extreme words let’s look at what’s real what happens in real relationships encourages people to identify who would be a good partner in supportive relationships   I’m not meaning necessarily romantic I’m meaning friends and where they can be found you know where   would you find people that you could be friends with and encourage them to play through what it means when gaming cuz a lot of times again this goes with my reading you know what it means when your friend doesn’t return your text right away what does it mean when your friend cancels   dinner on Friday night what does it mean when you see where I’m going with this and a lot of   times clients with anxiety and rejection issues and low self-esteem will go to the worst-case   scenario so encourage them to go back to finding the exceptions what else could have been happening   what else could it be that caused this and it’s not about you so anxiety is a natural emotion that   serves a survival function excessive anxiety can develop from lack of sleep nutritional problems   neurochemical imbalances failure to develop adequate coping skills cognitive distortions low   self-esteem and a variety of other stuff recovery Ambala involves improving health behaviors making sure your body’s functioning and making the neurotransmitters it needs and you know release   them as needed to identify and build on current coping strategies address cognitive distortions   and develop a healthy supportive relationship with self and others 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.  Snipes by subscribing at all CEUs comm slash counselor toolbox, this   episode has been brought to you in part by all CEUs calmly provide 24/7 multimedia continuing   education and pre-certification training to counselors therapists and nurses since 2006 have used coupon code consular toolbox to get a 20% discount on your order this month.As found on YouTubeBrain Booster | Blue Heron Health News ⇝ I was losing my memory, focus – and mind! And then… I got it all back again. Case study: OIP-73 Brian Thompson There’s nothing more terrifying than watching your brain health fail. You can feel it… but you can’t stop it. Over and over I asked myself, where is this going to end? What am I going to end up like? And nobody could tell me. Doesn’t matter now. I’m over it. Completely well. This is how I did it!

Cognitive Behavioral Therapy (CBT) Skills and Counseling Techniques with Dr. Dawn-Elise “Doc” Snipes

 CEUs are available for this presentation at AllCEUs.com/CBT-CEU Hi everybody and welcome to today’s presentation on cognitive behavioral therapy skills. Like the other the presentation we did on assert not assertive community treatment acceptance and commitment therapy, which is also based on just providing information about skills that can be used not providing an evidence-based practice we couldn’t cover that in a full hour or just an hour so over the next hour we’re going to define cognitive behavioral therapy and its basic principles a lot of us are familiar with this but it’s going to be a good review and it also may highlight some nuances that you didn’t know about will identify factors impacting people’s choice of behaviors explore causes and impact of thinking errors and identify common thinking errors and their relationships to cognitive distortions so why do we care well as therapists we want to help people figure out the best way to live a happy healthy meaningful goals-driven life for some people that’s going to mean using some cognitive behavioral interventions that can be in addition to mindfulness that can be in addition to a lot of other things but it’s important to help people understand that the way we believe things to be the way we interpret things is going to affect our reactions so for example think about a situation you know you’ve walked into and maybe you walked into it with a small child and it was a different situation it was a new situation but you know it was no big deal you walked in it was not a threatening situation to you because you were like hey I got this the little kid walks in and goes oh wow there are a lot of people walking around here, this is the really scary same situation as two different perceptions you probably didn’t have much of a stress reaction going on whereas the little child probably had this fight-or-flight thing going on grabbing onto your hand like please don’t let go Atlanta Airport is a perfect example if you’ve ever taken a little kid through Atlanta Airport it gives you an idea about how people can perceive things differently and when you enact that fight-or-flight reaction you’re going to have all those stress hormones you’re going to have all either anxiety or anger or whatever that goes with it it may serve to exhaust the person and leave them feeling hopeless and helpless so what we want to do is help people see that but we also want to help them see that when they’re depressed when they’re tired when they’re sick things are going to seem a lot worse a lot of times because they don’t have the energy to perceive it differently I mean when you’re sick it’s overwhelming to think of going through Atlanta Airport so this is what we want to help people start understanding is it’s two sides of the same coin they interact if one is you know kind of going wonky is going to affect the other one the good thing is if one’s going really good the other one’s going to go good if you’re having positive thoughts you’re probably going to feel pretty good there’s an activity and I think we’re going to talk about it later it’s called the coin flip activity and I asked client clients to flip a coin in the morning and in the morning if it turns heads then they have to be the most positive Pollyanna all day long look for the silver lining and everything smile walk with their head up hold those nonverbals up and see how they feel at the end of the day besides a little sore because there are muscles they’re using they haven’t been used in a while if it lands on tails they can just be their normal selves which generally if they’re seeing me means that they are depressed anxious stressed out angry about something in the negative realm then we talk about how did things seem different on the days when you were feeling better when you were walking taller when you were smiling even our nonverbals it doesn’t even have to be sickness it can be our nonverbals that can make us feel or make our body feel heavy and tired and make it seem like it’s a whole lot harder to deal with life as a person who perceives the world generally good and believes they can deal with challenges as they arise that good old self-efficacy will be able to allow their stress response system to function normally so if they’re like you know what I can deal with whatever life throws at me I’ve got it and maybe I need help with it maybe I’ll need to ask for support but I’ve got it it’s not going to completely overwhelm me with people who see the world as hostile unsafe and unpredictable you know for a variety of reasons whatever happened to make their scheme as such that they don’t believe that people or the world is trustworthy are predictable they are always on guard they’re always kind of like a hamster in a cage that has Have you ever had a hamster hamsters don’t recognize you and go hey that’s my own or human contact score hamsters go run under their little house and you just kind of open the cage and stick your hand in there and flip over their house and you’re like come here and give me cuddles and you’re like you know 200 times bigger than they are so the little hamster is like freaking out this is what it’s like for people and obviously, I’m exaggerating but this is what it’s like for people who have a negative perspective a negative view or a hostile view of the world so kind of keep that little hamster in your mind cognitive behavioral therapy we have core beliefs those things that are in our hearts when I talk with my clients about honesty step one and that’s what they’ve got to do to start recovery is get honest with themselves first and then other people we talk about head heart and gut honesty do you think it’s right does it seem like the right thing to do does it feel right in your heart you know does it make you happy it doesn’t make you feel good and then the spidey senses is your gut saying and or is your gut fine if one of those is saying this might not be the right choice and we need to think about what’s going on so we have those core beliefs and I put them in the heart just because that’s the middle of the head heart and gut but you have core beliefs about yourself whether you’re good with you’re bad whether you’re effective at certain things yada yada you have core beliefs about other people same thing good bad effective predictable and you have core beliefs about the future and a lot of that goes with the locus of control but also your past experiences if the world in the past is seemed unfriendly and uncontrollable and you’ve perceived it that way then you’re going to expect the future to be uncontrollable so what we want to do is help people look at their schemas and their core beliefs about themselves others in the future and figure out kind of what they want it to look like these schemas are going to affect your behavior and your thoughts and your feelings and you know you can pick wherever you want to start it doesn’t matter because all three inter interface with one another so if you haven’t let’s start with negative thoughts if you have negative thoughts then you might feel anxious angry stressed dysphoric which will affect the behavior you’re going to do different things than if you have positive thoughts about something you feel excited and energized you’re going to have different behavior the best thing example I can give you is if you’ve ever done public speaking or had to present something some people detest public speaking it’s just terrifying for them to get up in front of a group of people so their thoughts am I going to trip up I going to forget what I’m going to say I’m going to make a fool of myself I’m going to you know it can go on forever that when you get on a roll you can get on a negative roll and go on forever or positive hopefully get on that roll with those thoughts you start holding onto those thoughts remember as we talked about in a CT the other day when you hold those thoughts and you kind of mush them around in your mind and you come to believe them that you’re going to make a fool of yourself and it’s going to be awful you’re going to start feeling terrified likely which is going to likely affect your behavior if you go out on the stage and you’re terrified you’re going to probably stutter you’re probably going to get foggy-headed you’re going to have that fight-or-flight reaction so there’s an the adrenaline rush and you start sweating and you can’t focus and you can’t concentrate you want to away as opposed to somebody like me who loves public speaking and I’m just like cool I get to go out there and try to engage however many people are in the audience it’s a game for me because when I can see your faces I enjoy trying to figure out and make eye contact with people and figure out what it is that they’re there for what is it that’s going to make them tick what resonates with them so my behavior as you can kind of see right now when I go out there I’m excited and I want to engage people and it’s a fun experience for me again just like the airport the same experience for two different people and two very different interpretations and reactions to it so what effects I don’t like the term rational but when we’re talking about CBT irrationally comes up a lot I like to replace it with helpful because every behavior in its weird sort of way is or probably was rational at one time that being said we’re going to get back to that stress affects our behavioral choices if we’re under stress we can have negative emotions negative emotions will affect our thoughts if we’re feeling sad we’re probably going to look at the dark side if we feel sad we’re going to look at the bottom falling out if we’re happy we’re probably going to look for that silver lining physical factors if you’re in pain sick sleep-deprived poorly nourished so your body can’t produce the neurotransmitters it needs to or heaven forbid intoxicated you’re probably not going to make the same decisions as you would if you were comfortable healthy well-rested nourished and not intoxicated any of those things can go impact how you perceive a situation or how you react in a situation, especially the intoxication whereas in your non intoxicated State in your sober state, you may think that you want to do something but then you’ve got that filter that goes not not a good idea in an intoxicated State or even in a manic state if you’re you know if you have somebody with bipolar that filter kind of goes away so the behaviors that someone may normally not do because they have a rational filter that goes you know punching this guy outs probably not the best idea right now the filter goes away when you’re sleep-deprived you’re less generally people are less patient generally people don’t have as much of a filter thing about watching your children if you have children or your grandchildren or even yourself I know myself when I’m sleepy I am giddy as all get-out and things I wouldn’t normally say because they’re you know stupid I’ll just come out and say anyway and my kids just roll their eyes or the mom you’re overtired could go to bed, uh but that’s okay you know I’m okay with that in that situation now if I acted that way at work it would be a worse thing environmentally if you’re introduced to a new or unique situation and you perceive it as stressful because the unknown we know can be stressful then you may not make as rational of a choice or as helpful of a choice because you maybe trying to escape the same thing as exposure to UNPROFOR bellowing for a the word here but UNPROFOR ball is the best I could come up with we all prefer certain situations some people as I said would rather do just about anything then get up in front of a lecture hall of a hundred and fifty people and talk but if they have to do it then they’re going to be under stress which may affect how they do things so we want people to understand that their perception and their feelings are affected by a lot of other things not just you know an emotion here or a particular memory there’s a lot that goes into it and social if peers your family convey irrational thoughts as necessary very standards for social acceptance people may tend to cling more to it to those unhelpful thoughts and unhelpful behaviors you know in CBT they say irrational because quote nobody wants to associate with those people you know who are those people and why can’t we associate with them there are a lot of things if you think back think high school you know high school is pretty rough if we’re going to talk about having irrational thoughts and cognitions if you have to be part of this particular group to be accepted you have to do this you have to do that but do you do those kinds of all-or-nothing statements are cognitive distortions and while they may have served a purpose in some way shape or form in the past we need to encourage our clients to take a look at them now and go are they still helpful ways of thinking is it still helpful for me to think that I am only successful if I live in a million-dollar house in a gated community and do this that and the other or can I be can I define success a different way or do I define success differently and lack supportive peers to buffer stress so we had those peers that caused stress by talking about the half dues and categorizing and lots of attributions but then there’s also not having somebody to go you know does this make any sense because sometimes we are our own worst enemies and if we go to a friend and we go you know this is what I’m thinking and I think I have to do this in order to be acceptable to be loved or you know whatever the case may be most people are not going to use those exact phrases a good friend is probably going to listen and go yeah you’re right or no no that’s way off so supportive peers are essential to reminding us to consciously regularly check in with our cognitions to make sure that they are hopeful and rational so a note about irrationality and this is mine this is not from CBT the origins of most beliefs for rational and helpful given the information, the person had at the time and their cognitive development their ability to process that information so concepts and schemas and core beliefs that people formed when they were five are probably going to be very egocentric you know the person is going to feel like everybody sees it my way because this is how I see it you know just like a five-year-old does a five-year-old doesn’t think well you know let me take Johnny’s perspective is no he assumes that Johnny sees it the same way so it’s going to be egocentric it’s probably going to be focused on only one aspect of the situation because small children can’t focus on multiple aspects and it’s probably going to be dichotomous it’s all-or-nothing Mommy loves me mommy hates me and it could be personalized you know everything a lot of kids think that everything has to do with them so if something happens something bad happens many times children will take it personally or be afraid it’s going to happen to them again you know if hurricane katrina hurricane Andrew those sorts of things you know we saw a lot of trauma in children and they developed very real fears about thunderstorms and hurricane season and if you’ve watched Florida hasn’t had a notable hurricane in years now but there’s a lot of stuff that goes into that but young people during some of those really bad hurricane seasons perceive those situations differently okay so we need to help people understand that if we especially if we use the term irrational those thoughts you formed when you are knee-high to a grasshopper and they made perfect sense to you back then but now that you’re an adult you’ve got more experience and you’re able to take different perspectives your brain is more developed let’s take a look at it and see if you can look at different perspectives and come up with something a little more helpful maybe a different way of perceiving this situation the irrational irrationality or unhelpful Nosov Fox comes when those beliefs are perpetuated without examination so something a belief that you formed when you’re five you’re still holding when you’re 35 and you’ve never questioned it you’ve never gone you know does this make sense is this is helpful to get me to where I want to be most of us don’t know we form these attitudes and beliefs when we’re you know growing up when we’re in elementary school middle school high school from watching TV to being around our peers from being around our family in our community and we get all this input of the way things should be and a lot of times people don’t stop to question and go and go well does this make me happy is this really what I want and they can be irrational if they continue to be held despite causing harm to the person so the person continues to hold this belief even though it is causing them general emotional cognitive harm is making them miserable we need to look at why what’s motivating them to hold on to that belief why is that belief so important and how can we make it so they can live a happy values-driven life emphasis on the happy how can we make it less harmful sometimes it’s more productive for clients to think of these thoughts as unhelpful or helpful instead of irrational sometimes when I say irrational to clients and you know I’m the same way if somebody says you’re being irrational I’m like oh I’m not it elicits this instantaneous defensive reaction it’s like when you tell them they’re being resistant they’re like I am NOT rien resistant so helpful or unhelpful and then we talk about why it is unhelpful in getting them toward their goals basic principles of cognitive behavioral therapy we teach or help clients learn to distinguish between thoughts and feelings I can think something is scary I’ll probably feel it but if I have an automatic you know feeling I walk into Atlanta Airport and I see yeah I went to an airport in New York I can’t even remember which one it was because my plane was diverted and I got off and I walked out there and I have never seen so many people packed in his place like sardines before in my life I was just completely overwhelmed that was kind of an automatic feeling now that was a feeling based on you know who knows it was overwhelming to be surrounded by that many people so then I had to separate the thoughts and go okay what am I thinking that’s making me feel so overwhelmed and at that point you know I didn’t know how to get to my gate and all that other sort of stuff with traveling I don’t travel well but encouraging clients to stop and go okay why am I feeling this way what are my what thoughts am I having that are contributing to these dysphoric feelings CBT helps people become aware of how thoughts can influence feelings in ways that are sometimes not helpful we have hecklers in our gallery the automatic tapes that we plaything memories that we have whatever you want to call them that when you try something when you are just going through daily life you hear these voices in the back of your head and not real voices but that is saying you’re never going to make this or if you would have just blah blah blah then you’d be a the better person helping clients become aware of those thoughts and how they’re negatively influencing their feelings and keeping them kind of stuck is a huge part of CBT we help them learn about thoughts that seem to occur automatically without even realizing how they may affect emotions again those thoughts from they’re saying you’re not good enough you’re not smart enough and nobody’s gonna like you where did that come from and do you believe it you know maybe it came from somebody when you were in high school so was that a valid source maybe it came from somebody yesterday on Facebook was that a valid source taking in those thoughts and then figuring out is this something I’m going to hold because it makes me happy or is this something that I’ve got to deal with because I’m having a negative reaction constructively evaluate whether these automatic thoughts and assumptions are accurate or perhaps biased the other thing to remember is a lot of our clients not all of them but a lot of them hold themselves to a standard there’s like up here and they hold everybody else to a standard that’s down here so they are a failure if they don’t achieve this but everybody else is successful as long as they achieve this so encouraging them to take a look at how accurate and biased or unbiased are the thoughts and like I said they may be their thoughts they may be telling themselves these things evaluate whether the current reactions are a helpful and good use of energy or unhelpful and a waste of energy that could be used to move toward those people and things important not impotent important to the person road-rage you’re in the car you’re driving somebody cuts you off okay natural reaction fight or flight reaction you’re just like slam on the brakes and do whatever you got to do aversive maneuvers you’re good so you could let it go at that point ago got Lucky on that one and keep driving most people not all but most they found that 80% of drivers have reported incidences of road rage which is a high number but most people will start getting all fired up and irritated and grumpy and we and just rageful and so my question would be I hear that and I hear that it made you angry in retrospect did screaming at the person as you pass them at sixty miles an hour in your car with the windows rolled up does any good did it do any good at all what else could you have done with that energy if you wouldn’t have expended it all yesterday we had to wait for the vet to come by and my daughter just completely wore herself out worrying about when the vet was going to get there what he was going to say about her donkeys and was beside herself so by the time it got to evening and it was time for her to go to her martial arts class she didn’t have the energy to go she’s like um wiped out I just want to go to bed in retrospect we’re looking back and saying okay now tell me what it was that you were so stressed out about and let’s talk about whether that was a realistic and helpful line of thought to perseverate on all day long and what could you have done differently because she didn’t bother to mention any of that to me yesterday and then developed the skills to notice interrupt and correct these biased thoughts independently causes of these thinking errors information processing shortcuts when we form schemas and we encounter a situation that reminds us of something in the past like when I go to my grandmother’s house I have a schema I have a belief system I have you know stuff that I know about my grandmother’s house so when I go to my grandmother’s house it’s kind of a shortcut to knowing what to expect when I walk in and how to behave how to do different things and it helps me plan and predict if you’re using outdated or dichotomous all-or-nothing schemas it may cause thinking errors because you may be now incorrectly processing current events mental noise some of us have it a lot of us have it not everybody thinks about trying to focus and study for a final exam in the middle of a really busy sports bar okay this is a cause of thinking or you’re going to miss important things you’re not going to be able to focus you’re not going to necessarily attend to the correct things because there’s just so much else going on your attention is drawn in 17 different directions and or the brain’s limited information processing capacity due to age we talked about that before young kids think all or nothing they think dichotomously egocentric ly middle school-aged kids and older start developing the ability for abstract thinking, by the time we get older, you know as adults theoretically we’re able to you know think pretty well and think pretty clinically about different events but if we’re in crisis when someone is in crisis and it could be like what we think of clinically as a crisis or it could be they’re just completely overwhelmed and burned out and have been burning the candle at both ends for three months they’re not going to process information quite as well they’re not going to take in all this stuff because they’re just like shell-shocked have you ever seen teachers in the hallway of like an elementary school Oh at the end of the second nine weeks they just kind of stand there with this blank look on their face they’re not processing as much as they were the first day of school and you know God loved them they have a lot to deal with but we need to help our clients understand that there are some times that they are going to have to really stop and focus write things down so they can remember or they can make decisions a little more my guess is most of us have times in our life when we’ve been able to think through complex problems but then there are other times where you just can’t keep it all in your head and you’ve got to put it on a whiteboard maybe that’s just me but we want clients to understand that they are not broken they’re not faulty they’re doing the best they can with the tools they have and the knowledge they have and our job is to help them see where some of this might have gone a little awry other causes of thinking errors and emotional motivations I feel bad therefore whatever I’m thinking must be bad if I’m scared that means whatever it’s coming on the other end of the phone is bad news moral motivations I did it because it was the right thing to do and that can be an excuse for doing wrong behaviors as well it can also be you know you can argue on the moral one social influence well everyone else is doing it so it must not be bad set that again a lot of times and this is where the frames approaching the motivational interviewing is helpful f stands for feedback about the reality of what’s going on is everybody doing it let’s look at statistics you know not subjective information let’s look at objective information so the impact of these thinking errors makes people want to fight or flee when they get upset and we use upset as a kind of this all-encompassing garbage term emotionally they get depressed or anxious we don’t want to feel that way anxiety and anger are flee or fight fight or flee it’s our body saying there’s a threat you got to do something depression is your body going I give up I just don’t I don’t even have the energy to do it anymore behaviorally some people withdraw because they shut down we all know people who get frustrated when they get overwhelmed when they start feeling hopeless or helpless they just kind of withdraw from everything and everyone’s addictions numb that out so they don’t have to feel the dysphoria sleeping problem and changes when we start being on that constant fight-or-flight hyper-vigilant sort of thing going on in the body is always sort of turned on which means you’re not going to sleep as well then the circadian rhythms get messed up which starts causing exhaustion and lethargy and then everything seems harder because you’re sleep-deprived and then you start thinking more negatively and more hopelessly you see where this is going it’s a downward spiral and eating changes some people eat a lot more because they’re eating comfort foods some people eat a lot less because their stomach is so torn up from the stress they can’t even think about holding anything down physical stress-related illnesses fibromyalgia gastrointestinal problems headaches neck aches backache you know the whole the gamut of it when you start feeling bad when you start hurting generally it gets frustrating after a while and that frustration makes it kind of raises the the bar brings you up a little bit so you’re that is much closer to kind of just kind of being overwhelmed you don’t have as much of a cushion as you would if you were happy healthy well nourished not in pain and socially a lot of times we will get irritable or impatient with other people or withdrawal when we’re having these negative cognitions these thinking errors that are keeping us in a dysphoric state these effects of thinking errors contribute to fatigue and a sense of hopelessness and helplessness which intensifies thinking errors this is an important concept that I want my clients to understand and I want to drive home in this presentation so thinking errors what are they emotional reasoning feelings are not facts and we want to help people to learn to effectively identify feelings and separate them from facts so if somebody says I’m terrified okay that is a feeling what are the facts supporting that feeling why are you are terrified what is the evidence that you are in some sort of danger right now you know and danger may not be the right word for your client at that a particular point in time but what’s the evidence that there’s a threat in what ways is this similar to other situations maybe it’s triggering something from the past that was scary or you know you were too little to be able to handle it but you can handle it now and how if you dealt with similar situations like this, in the past, we want to help people just step back and get some distance between their feelings and their thoughts and try to figure out you know which thoughts are helpful and productive and even if a sought makes people anxious or angry it can be helpful it may be telling them hey dude you need to get your butt up and get out of there if it’s helpful it means it’s moving them toward where they want to be happy healthy safe and values-driven life so happy and helpful developed a stress tolerance skills when people use emotional reasoning they feel emotions which then they start attributing finding the facts to support those emotions instead of looking at all the facts we want to help them learn to tolerate their distress so they can kind of let that subside for a second they can accept their feeling they can name they can say I’m scared I’m stressed I’m angry and whatever but they don’t have to act on it right then they can tolerate the distress for a minute without having to try to make it go away and emotional regulation skills they can feel a feeling without having to make it go from zero to 120 you know if they feel sad they go I feel kind of sad instead of grabbing onto it and going I wonder what I feel sad about I must feel sad about all these sad things now I’m going to be sad and devastated so we want to help people learn how to regulate their emotions identify them accept them whatever word you want to use and tolerate them because feelings are there for a reason they’re there to tell you your brain thinks something’s going now thankfully we have that higher-order cognition stuff going on so we can contradict our brain and we can go you know maybe that’s not true in this situation cognitive bias negativity mental filter whatever you want to call it people who focus on the negative they walk in they get up in the morning and they look outside and it’s partly cloudy they get to work and they said instead of saying there was it was very light traffic they said there was a fair amount of traffic everything is always the flip side of what somebody who’s optimistic would say so asking them what’s the benefit to focusing on the negative in what ways is this helpful to you you know some people say well it keeps me from getting disappointed because I know it’s going to end up negative anyway so we can trap challenges that know that whatever it is they think they know and see if there have been exceptions when it hasn’t turned out that way what are the positives to this situation I give the example a lot of you know I wash my car or it rains and maybe I wanted to go out on a run that day but I can perceive it I can look at the positives you know the rain washed my car for me so I don’t have to do it now score it watered my garden all the better it knocked down some of the pollen out of there even better I can find and I can encourage people to find positives in a situation yes there are negatives there are negatives to every situation if you want to find them you’re going to find them but if you want to find the positives you can too which takes us down to what are all the facts there’s the positive and the negative and the neutral I told you earlier about the coin toss activity having people toss a coin on the heads days they act like it is just the greatest day to be alive and see how things are different when they do their journal because you know I have my clients do I’m sort of a mindfulness check-in in the morning and in the evening and preferably at lunchtime how are they feeling what’s their emotional state what’s their energy level on the happy days a lot of times it can be less and sometimes they need a little coaching throughout because some of those old patterns kick in but I want them to start challenging some of their automatic thoughts that we’re going to talk about in a minute disqualifying or minimizing the positive most of us can probably say we’ve had a bunch of clients that do this they are more than happy to tell you about all the things that they mess up but then when they do something right they minimize it encouraging people to hold themselves to the same standard they would hold everyone else to and I know I talked about that earlier ask them things like would it minimum would you minimize this if it was your best friend’s experience your best friend came to you and said I just got into such-and-such college would you say awesome or would you say anybody can get in there how would that go ask them what is scary about accepting these positive things that you might have had an accomplishment for some people it means that it might mean other people expect more of them for other people they just don’t know how to accept the positive they don’t know how to accept compliments they don’t know how to be the center of attention and they don’t like it and then we want to look at why that is sometimes we disqualify the positive because it fails to meet someone else’s standards so as people might that be true here you know I know when I was growing up and going through college and going through school and everything got my doctorate but I will always be ever and always being not a real doctor because a Ph.D. is not an MD and I’m like really so is it somebody else’s standards or can I feel good about having a Ph.D. egocentrism my perspective is the only perspective I’ll being egocentric but it doesn’t work most of the time so encouraging people to take alternate perspectives maybe you’re texting with someone and they say something that is not that you interpret as not the nicest thing and this happens in text messages a lot and they get upset now an egocentric thinking error would say that purse is just grumpy today someone that’s taking other perspectives would stop and go back and read the text and go I wonder if maybe this could have been taken some another way you know cuz their reaction is not what I intended so egocentrism if you hold on to that I don’t understand anybody else because you know I don’t see a problem with anything personalizing and mind-reading this is when you assume that everybody’s frowning because of something you did your boss walks down the hallway and looks at you and grimaces and continues to walk on oh I must have done something wrong no maybe he just got out of his senior management meeting that was five hours long and he’s got to go to the bathroom you know there could be a hundred different explanations for why that happened so encourage clients to ask themselves what are some alternate explanations for this event that doesn’t involve me you know why might this have happened if they hold on to that, I must have done something wrong but as soon as their boss calls them up and goes hey can you come to my office for a second you know where their thoughts are going to go I’m getting fired I’m going to get laid off I don’t know what it was that I did wrong but he walked by me two weeks ago in the hallway and grimaced and I’m just I’m the worst person in the whole world but where did that come from so encouraging people to not necessarily assume they know what’s going on in someone else’s mind and not automatically attributing every person’s negative behavior to something they did how often and then ask them how often has it been about you now think about the last 10 times you’ve taken something personally how many of those 10 times has it been about something you did versus something with the other person then the availability heuristic remembering what’s most prominent in your mind so asking clients what are the facts ah the most obvious one that we talk about is plane crashes you know it is way dangerous to fly on a plane because you hear about all those plane crashes well yeah you hear about A few planes crash but you don’t hear about the 20,000 every day that land safely so you remember it and it seems more dangerous because that’s what is in your mind that’s what is available to you that’s what you’ve based your thought processes on because maybe you didn’t know that 20,000 planes or more fly and land just perfectly every day this can also be true with people remembering what’s most prominent in your mind sometimes and this can be very very true in domestically violent relationships if somebody falls in love with someone and that person is just the greatest person since sliced bread for the first four months and then the cycle starts and there’s this little tiny a sliver of the honeymoon period after the battering cycle and the person’s like that’s the person I fell in love with that’s what I remember and they try to focus on that that’s most prominent in their mind and they ignore the rest of the stuff so we need to encourage people to look objectively at the facts magnification are you confusing high and low probability outcomes what are the chances that this is going to happen how many clients have we worked with that have gone to the doctor and gotten in a physical or get a test run and then the doctor had to call them back and this could be true for you too and the doctor had to call them back two or three days later when the tests came back from the lab and that whole three days they were just in a panic because they were afraid they were going to get some terminal diagnosis so thinking about high and low probability outcomes another instance or example of magnification is somebody that thinks this is the end of the world whatever it I think I’ve told you before my little story about um tripping when I was walking down the hall at work and falling and yeah it was embarrassing my folders went everywhere and yeah but in that big scheme of things will it matter that much from now you know are people gonna think oh she is such a clutch she must be a ditz too no I mean they may have thought that at that time I don’t know but you know in six months nobody’s going to remember and then ask them in the past when something like this has happened when you’ve had to get a test done and you’ve had to wait on results or if you’ve done something that was embarrassing and you didn’t think you thought everybody was going to remember it forever.

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How did you tolerate it how did you learn to deal with it building on those strengths that they already have all-or-nothing thinking errors these are things like love versus hate I love them or I hate them it’s all or nothing she does this all the time or she never does it if I’m going to do it I’m going to do it perfectly or I’m not going to do it at all thank you all good intentions or all bad intentions you know sometimes we do things with good intentions that have some bad repercussions so did we do it with all bad intentions are all good intentions and the answer is neither most of the time life is kind of in that middle-ground gray area encouraging clients to look and find examples where something hasn’t been one of the polls when having they do something that they’re proud of that wasn’t perfect or when again when has somebody else do something that they were proud of that wasn’t perfect remembering that with availability heuristic remembering how often something happens and how long it’s been since you’ve seen that behavior and remember that sometimes good times are amazing but how frequent are they compared with the bad times another thinking error is a belief in a just world or a fallacy of fairness I just asked clients to identify for good people you know who’ve had bad things happen and in reality we all have bad things happen good people do bad people do in between people do attributional errors and this is a pet of mine you know labeling yourself is not a behavior so global versus specific and I am stupid versus I’m stupid at math I don’t have good math skills it’s not about me it’s about the skills I can change skills stable I am and I always will be versus it’s something I can change it’s something I can learn internally it’s about me as a person versus it’s about a skill deficit or something I could learn or change and there’s you know lots of information on attributions out there on the internet if you need a refresher on it but we find that a lot of people who have dysphoria have negative global stable internal attributions so questions for clients remember the beliefs equal thoughts and facts plus personal interpretation another way of saying it is reality is 10% perception is 10% reality and 90% interpretation so what are the facts for and against my belief is the belief based on facts or feelings does the belief focus on one aspect or the whole situation does the belief seem to use any thinking errors what are alternate explanations what would you tell your child or best friend if they had this belief how would you want someone to tell what would you want someone to tell you about this belief so if you’re telling somebody about this what are you hoping they’re going to say in return and finally, how is this belief moving you toward what and who is important to you or moving you away from what or who is important to you now they can do a worksheet and have all of these or you can pick one or two of these questions that are most salient for your clients but they can have kind of at their fingertips so as they’re going through the day and something happens they can ask themselves ok what’s an alternate explanation or you know whatever it is this is salient for that client’s irrational thoughts about how to do these thoughts impact the client’s emotions health relationships and perceptions of the world you know this is what we want to ask them how is this thought impacting you globally how may this thought have been helpful in the past where did it come from how does it make sense from when you formed it in the past when you’re dealing with it ask the person if the thought is bringing you closer to those that are important are there any examples of this thought or belief not being true and how can the statement be made less global less all-encompassing so it’s about a specific incident a specific situation less stable which means you can change it and less internal which means it’s not about who you are as a person but maybe something that you do or a skill that you have so we’re going to go through some of these thoughts real quickly here mistakes are never acceptable and if I make one it means that I’m incompetent well never is kind of stable and I am incompetent is kind of global, that’s also that extreme all-or-nothing thinking so you can see where these cognitive distortions end up leading to unhelpful beliefs when somebody disagrees with me it’s a personal attack well there’s personalization if I ever heard it before maybe it’s not about you may be they’re having a bad day and you just happen to be the unlucky target or maybe they’re disagreeing with you because they have a different point of view and it’s not a personal attack it’s just their point of view if someone criticizes or rejects me there must be something wrong with me personalization all-or-nothing thinking global stable and internal something wrong with me as a person to feel good about myself others must approve of me now this is one we’ve talked about external validation before and we can’t control other people to feel good about yourself how can you do that besides necessarily requiring other people to approve of you to be content in life I must be liked by all people Wow I’ve never met anybody who’s liked by all people I’ve never even met anybody who’s been hated by all people but it’s important to help clients see how this is dramatic to say all people and for them to be content then everybody has to like them I mean I like to be liked but if everybody doesn’t like me you know that’s pretty understandable my true value as an individual depends on what others think of me I would challenge this one this is all you know also, very personally internally I would challenge people to look at and say it so your child’s value as an individual depends on what other people think of he or most people would say no but the perspective thing nothing ever turns out the way you want it to okay all-or-nothing thinking and probably availability heuristic if something bad just happened then they may be focusing on that which causes them to focus on all the other bad things in the past that have happened not to focus on that is okay you know bad thing happen but look at all these good things I won’t try anything new unless I will be good at it this fear of failure fear of rejection it just really paralyzes a lot of people when they get stuck with that thinking the area that they have to be perfect I am in total control of anything bad that happens is my fault well that’s egocentric and personal if they think they’re in total control that’s their perception of how the world are they think if they’ve got everybody on marionette strings anything bad in the world that happens is their fault how powerful are they I feel happy about uh if I feel happy about life something will go wrong it happens sometimes but let’s look at times when you’ve been happy that something hasn’t gone wrong you know let’s get rid of that all-or-nothing thinking it’s not my fault my life didn’t go the way I wanted could be true but it seems like that’s making you unhappy so what do we do about that if I’m not in an intimate relationship I’m alone no, again that’s pretty extreme I’m either in an intimate relationship, or I am alone and a loner and you know it’s just me and my 17 cats which follows with there’s no gray area so encouraging people to look at what these beliefs are saying important thoughts impact behaviors and emotional and physical reactions emotional and physical reactions impact thoughts and interpretations of events so if you do something and it’s pleasurable and you have a great physical reaction you know let’s take bungee jumping or skydiving if you go out there and it’s scary but you do it and you’re just like whoa what a rush your interpretation of that is probably going to be good which means you’ll probably do it again if you go out there and it’s just the most horrible experience you’ve ever had you’re probably not going to do it again and your interpretation of it is going to be not good which is going to make it hard to understand why other people would do it irrational thinking patterns are often caused by cognitive distortions so let’s just look back at some of those because there are a lot fewer cognitive distortions or general ways of thinking about the world then there are thinking errors because there are lots and lots of thinking errors cognitive distortions are often schemas which were formed based on faulty inaccurate or immature knowledge or understanding and by identifying the thoughts of the hecklers you know the automatic tapes that are maintaining our unhappiness the person can choose whether to accept those thoughts or change them As found on YouTubeThe Destroy Depression ꆛ System-Cure Depression Naturally YOUR DEPRESSION HAS BEEN IN CONTROL LONG ENOUGH. It’s Time to Fight Back ☂🗯 “Depression Sufferer Of Over 20 Years Reveals His Simple 7-Step System That Gives You The Power To Destroy Your Depression, End Your Feelings Of Sadness And Hopelessness, And Get Your Life Back.” “This didn’t just change my life, it saved my life.

How to Release Fears and Traumas with Hypnosis

 Alright, we are living. Welcome, guys. Welcome to the journey within It’s a journey of deconstruction and reconstruction of death and rebirth and today, I’ve got a very special hello hypnotist the founder of Twin Ravens Hypnotherapy and Research J Robert, Parker, In The House. Thanks for having me, man. Thank you. Thank you, dude. I think this will be a fun conversation cuz I mean, we. Absolutely. We both study hypnosis and I’d be very interested to get your perspective, you know, and how you got into this. So, um yeah, if you can share a little bit about who you are, how did you even get into this strange world of hypnosis? Uh, that’s an odd story. Um so, previously before the pandemic had been working as a chef uh that restaurant was actually where I met my partner. We did the stereotypical line cook ends up with the waitress thing. Interesting. And uh the the pandemic hit. And I had kinda seen the writing on the wall long before it had an effect. Long story short, you’ll say we both ended up out of jobs and it failed me to kinda pull something out of my bag of tricks to make money. I live in a very, very small town and there’s not a lot of ways to go about that. So, I ended up reading tarot cards professionally. And I was making a pretty good living doing that. And I noticed that I was reading people’s fortunes so to speak. And more using the archetypes of the tarot cards. Uh reframe their problems to them and help change their perspective And I got a lot of satisfaction out of that. And I started looking into what is a way that I can do only that. Uh and of course in an abnormal way. That I can do that cuz why not? And the Facebook algorithm. uh that one random point but HMI in front of me. previous to that, I hadn’t had any experience with hypnosis. I wasn’t even sure if it was real. I was in that camp And I talked to someone from admissions and they intrigued me. I figured why not give it a shot? This seems very interesting. And I think I was about two classes into 101 before I got my mind blown. The first time I saw the physiological responses of hypnosis. The things that can’t be faked. That is just reactionary. it just blew my mind. And then eventually I got to perform hypnosis and then, eventually, I got to experience it and that was a profound thing because uh going to that school, taught me a lot about myself and one of the things I came to learn is uh a lot of what I considered to be unusual behavior in myself. Uh wasn’t and a lot of what I consider to be unusual behavior in others, was it? I was just very extreme on one end of the suggestibility scale and I remember in class, they were explaining the traits of the intellectual suggestible of it’s like, oh, cool. That’s me and I took the suggestibility test and I scored like, eighty-two, my first time I wanna say. Jeez, man, that’s such an interesting thing because you’re, I mean you’re so rare and for you to be in hypnosis and experience hypnosis, uh I’m curious like who hypnotized you and how do they do it, right? Because you’re like the hard type. it was actually in a practice and it was with somebody I mean, I guess I should mention, this guy named Paul Villa Real and he’s since graduated, I believe. And uh, I told them what my suggestibility was and he said, cool. Can I try something? And he did what’s called an auto dual induction and that was the first time that it happened to me and that got me. It got me well enough that the next day, I wrote my custom version of that script uh based upon what worked for me and that was a very unusual thing because Previous to that, II did most of my experience with trance with self-hypnosis. Like, I can kinda help people along whenever they’re practicing on me because I was very aware of that state in myself and where I’d been there in the past, all that stuff. but in terms of outright just being hypnotized by somebody, uh that was the first time, and uh That was profound. Uh, the things that I learned and saw in that first time still kind of uh guide a lot of what I do for my clients. Because one of the things cuz I don’t remember too much of what was addressed. But one of the things that stands out to me as I was introduced to the future version of myself like 5 years in the future or so And that was profound to me. And that person that I saw kind of sticks out in my head and every day I think about what I can do to get to that point. And I have used that to a very great therapeutic effect with certain clients. Uh, I got the specialization in transgender hypnotherapy And one of the things I found with my transgender clients is that that class made me realize so much that it wasn’t just a psychological thing that it was a it was a physiological thing. And in that, that means that your brain is telling you that you look one way. And what you’re seeing in the mirror is telling you something very different. What if you were able to meet who you know you are? What if you were able to meet the person that looks how you know you’re supposed to look? And I find that having that, giving that to that person is substantial to their sense of self and their sense of well-being. Interesting. So, that does sound intriguing for so for someone who is, you know, they’re looking to meet their future, you know, 5 years from the future self. How how can we do that? Um, do you do that through self-hypnosis? Is this a visualization? Um. Um. Visualization. Visualization. I tend to use the LAL. Uh the uh for anyone listening that doesn’t know what that is. It’s a type of hypnotic induction or deepener where you start at a certain floor on an elevator and go down. The elevator opens and you meet this person and I make no attempt to describe this person. It is simply you in advance and II tell you to notice how this person looks, how they hold themselves, how they smell, like how, how they and depending on your suggestibility is kind of how profound that experience is. I um I don’t get hardly any visualization. Uh, I get weird flashes. Uh, I can’t smell anything. I don’t get anything auditory but I get a very heavy kinesthetic response. Uh. Interesting. Fuel things. Yeah. In imagination, right? In hypnosis. It’s not like you can’t smell things right now. Yeah. In the context of hypnosis. Right. Um. feel like if you tell me to walk downstairs, I will like to feel the stairs under my feet and things like that. That’s fascinating. Okay. So, uh for people who are listening, they’re like no idea like suggestibility type, intellectual, physical, you know, you know. Maybe like. Yeah, yeah. Yeah. Cuz like we know, we know exactly what we’re talking about cuz we’re from the same college but um I mean, you break that down and uh yeah. Yeah, just go from there. Okay. Well, you’re the host. Why don’t you explain suggestibility to your audience? I’m Good, man. I could, I could. So, I was like, yeah, why not and you can critique me. But I’m not the one So as you, like you were saying, right, we’re all, first of all, we all can go into hypnosis. That’s a very, very natural state. And um, we, but we’re just on this kind of this uh, scale of suggestibility and some people do better with certain suggestions. versus others, and I lean towards kinda where, where you’re at, where it’s like, we do the, the indirect stories, and then on the other side is the very more paternal, hey, you’re gonna feel this, this is gonna happen, you are now in hypnosis, X, Y, Z, right? And that still does, that can work for me and you know, for others, but, not honestly for you, right? Cuz you’re, you’re very objectively something. If you are literal with me, you just hit a brick wall. Yeah. So I mean like go ahead. Go ahead. I respond very well to stories and um that is so my entire life like I literally when I was a teenager my friends used to text me and just say tell me a story. I just make something up. And to this day if you tell me to make up a story, I can. Like, just off the top of my head. And I uh, a big revelation and it was initially thanks to the man that uh ended up being my mentor. uh, Joe Burns. Oh, dude. Yeah. Awesome. Yeah, and he told me, to throw the script away. Don’t work off script and I took that to heart because it’s much more intimate and so now, that’s what I do. I make up stories. Those same stories that I used to make up for my friends. I now just make up for clients that a lot of the paperwork that I have them do uh for their life history and the um the questions that I ask and the initial consultation and session are kinda getting to know like what story you wanna be told, how you want your story told, and for example, I have a client who recently came to me and this person is a software engineer. Uh a somnambulistic software engineer nonetheless and II just decided because this came at a time in my career I become very frustrated with pre-written scripts. Like I had thrown one away in the middle of a session. Hm. And those three sessions that I had that day I told myself like I’m not gonna prepare a script. I’m gonna figure out my inductions. I’m gonna ask some questions. And I’m just going to make myself go. And I did. And those were three of the best sessions I’ve done. And what I end up doing with the software engineer is I spoke to them with metaphors of code, visualizations of computers, and debugging. And um, Sure enough, that that that safe place in their head was represented as a computer bank. what the way they perceived that computer bank uh mandated where I took that therapy. Just to kind of adjust their visualization. And that’s had fantastic results. Right. So, it’s like when we tailor the therapy to the individual client who’s gonna have, you know, a different background. They’re gonna have different metaphors and um now, this is good cuz um the way I explain like the unconscious and the conscious is that the unconscious is just the realm of metaphors and emotions and it that that seems to be the reason why uh we humans love stories. It’s all. Yeah. Metaphors. Exactly and I ask people. One of the examples I give is, have you ever watched a movie and gotten angry or sad or happy? Uh based on what was on screen. Of course, the answer is inevitably yes. Yeah. So, yes, why? You consciously, logically know that you are watching a falsehood. You know these things aren’t happening. So, why do you feel these emotions? And the answer is that. Your subconscious does not differentiate fact and fiction. It’s a metaphor. It’s a and that’s all it sees that’s well, everyone but the high physicals. Uh, the high physicals don’t tend to dig the metaphor or anything like that. You just gotta tell them how they wanna be and it’s fine but uh for everyone else, it’s and at this point, because of this mentality I’ve taken with my I guess be hypnotic storytelling. Every time I watch a movie now or read a fiction book. I start noticing ways that I can retell that story for different applications or specific scenes. One of the most amazing movies I’ve seen recently is uh have you ever seen that Disney movie Inside Out? Yes. Yeah. Yeah. Uh. Yup. Have you seen it recently? No, that was like, wasn’t that like a decade ago? Yeah. You should rewatch that. Uh mental health professionals helped write that movie and it is still used in the mental. Well, that makes so much feel today. Yeah, that makes so much sense, dude. Yeah. When you rewatch it, with knowledge of the subconscious and metaphor It’s it blows your mind. So, okay. There’s that scene where they enter the subconscious and the critical mind is represented by those two idiot guards. And how do they pass by the critical mind? They confuse it. That’s my hat. No, that’s my hat. Wow. They do a confusion abduction to get rid of the gatekeeper of the subconscious. And more than, when they’re actually in the subconscious, and this speaks to a lot of what I say about fear. One of the first things they see is a giant vacuum cleaner. Um because the way that girl’s subconscious remembered that is because the way we remember our fears is in that moment in time. Frozen at that moment in time. So to that fear and that perception. That’s a giant vacuum cleaner because she was very small when she got that fear. And that has a lot to do with how I address fears and hypnotherapy. Because one of the things I stress is when we have a fear or a trauma which I argue is the same thing because we’re not afraid of something and we as we’re traumatized by it and if we’re traumatized by something, we have a fear. And what I it’s all where it happened at the time. For example, if you became afraid of a vacuum cleaner as a baby or a very small child, the vacuum cleaner would appear much larger because according to your memory and your perception, which cannot be changed until it’s addressed in hypnosis, that thing’s giant or maybe you were bitten by a dog when you were a child and you remember it as just Kujo, some giant, hell hound that almost tore your ankle off because it was so intense and traumatic. Where and hypnosis, maybe it’s just a Jack Russell Terrier that bit your ankle. Hm. When you were 6 years old and you had the emotional intelligence of a 6-year-old. So, you’re going to retain that memory as a 6-year-old until you readdress it and allow that person to uh gain a new subconscious understanding and association of that event. So, I’m gonna try to play advocate here and say, okay, I get it that, you know, when we were six, maybe we’re scared of a vacuum cleaner cuz it seemed very big or a dog or whatnot and we had to distort perception, right? But now that we’re adults and that we have developed our prefrontal cortex and our reasoning and now, we can go and we can experience that, you know, dogs are generally safe for the, for the most part, and happy and man’s best friend, or the vacuum cleaner, you know, it’s fairly harm is. Right and so uh why can’t we just maybe um do a little bit of exposure therapy, a little bit of cognitive behavioral therapy, and just say, hey, this is uh, this is false, this, you know, you can, sometimes. Um, and it depends on how traumatic the memory is. And really, a lot of the way that fears are addressed in hypnosis has to do with uh, desensitate, desensitization, that the same things you would do in the physical world you can do mentally. If you were afraid of dogs rather than go so far as to address that fear live and in person with the dog you could go through that same process of consciously and realize that you have control over that emotion. There’s uh as you know there’s something called circle therapy. Where in hypnosis you are presented with a fear or an anxiety and you are asked to recall that fear and the emotions associated with that fear. Consciously. So, you bring it up on purpose. And then it’s at the same time you tell them to bring it back down. And the purpose of this is for one, every time you tell them bring it back up. It’s a little less. But they gain the understanding that your emotion and your reaction is under your control. The way that you choose to react to this fear is 100% under your control. And once there is that realization, fear tends to fade. or it’s not yours. Uh, that’s an interesting thing I’ve encountered before. What do you mean? Oh, it’s not yours. just that. Um so, I did uh a podcast couple of months ago. Uh about fear. It was called fear. It’s run by two clowns and they were interviewing a German spy who had a fear of heights. And I uh and this is on my website by the way. Everything I’m about to say you can listen to this interview. But this person, this man, um not the shy away from it. He’s a government killer. Like he is what he did. He was in special operations. He went into places he couldn’t talk about and did things he couldn’t talk about. He was afraid of heights. As unusual as that is. And uh this was all done in about twenty minutes. I transit him. I took him back to that moment on the plane. Cuz he got that fear from his first training jump when he was seventeen. And in the process of just walking him through that moment. He realized something. That he had forgotten about until that moment in hypnosis obviously, this person was a very high physical. So, they said they could feel the vibration of the engines. They could smell the gas on the plane. They were there. Um, the kid that jumped before him screamed in terror and he went from being fine and calm to terrified. But he didn’t remember that. And so at this moment, he realized that this fear he had been carrying for decades wasn’t even his and I called him out of a trance, and within 5 minutes of that, he was hanging off the side of a balcony. Saying like, I don’t feel a thing. Huh. So, yeah. This is all in hypnosis. Yes. Um. And not the balcony thing. Yeah. That’s what’s interesting. So, he remembered in hypnosis the um. The other kind. Where’s my cause? Just got scared. And it wasn’t even his fear that that kid’s fear transferred to him and before he had time to process it, he was kicked out the door. So, this entire time, he’s been perceiving this event as his fear when as you know, if we’re around someone afraid or scared or happy, if but for a short moment, we feel that before we process it out as not ours but what if you didn’t get that chance? What if you feel that fear and before you could be like, man, that kid was scared. Somebody’s grabbing you by your collar being like, your turn. and he just perceived that as his fear. So, yeah, fear didn’t belong to him. Wow Yeah. So, I’d be curious um on your philosophy when it comes to trauma, right? So, for that particular case, I guess he just, he was able to kinda remember and and and bring up that unconscious material and then, oh, hey, this is not my fear. Um but do you think for trauma? Before we even get to that, what do you mean when you say trauma? Trauma is any event. leaves an impression later down the line. Usually negative. Uh, I guess it should be specifically negative. Um, something that leaves an imprint, something that uh like, okay, this would be just seen in the movie Inside Out. Trauma is when a negative memory becomes a core memory. that that it becomes a core memory is an aspect of your personality. So, it’s. Oh. Whenever something negative becomes a core aspect of your personality. Because of course, we all go through negative things but what if that negative thing is so extreme or its perception is so extreme that it formed every opinion and perception that you had after that event because it was a core part of your personality? Hm. That’s why that movie’s so good. Like, dude, I need to rewatch. You do. I took notes. I’ve got notes somewhere on that damn movie. Well, yeah. I feel like I’ve matured so much since then and then with the knowledge of hypnosis and now, parts therapy. So, I don’t know if you ever heard of uh internal family systems or any kind of parts therapy. I’m sure you, I mean, we, it’s, it’s been mentioned here and there in the college. Yeah. But um yeah, it’s so amazing now that I’m in like parts therapy and I’m sure it would, you know when you see all the different emotions like, oh, that makes so much sense. Like, yeah, we have all these different parts of us that sometimes different things and it gets into conflict, you know? So. One of the things that I’ve really kind of come to realize through doing this work and that I tell all of my clients is we are all at our core children. We are all scared eight-year-old kids. We’ve kind of got that cuz that’s when we form our core beliefs from zero to eight. So, by the time we’re eight, that’s our core self. Yeah. And that, that you, all exist and that what it means to be an adult is to learn how to parent yourself. How to parent your inner child. And that’s a perspective that I ask a lot of my clients to take. Because II asked them especially the ones that have children. Like the way, you talk to yourself. When you talk to your child like that. Yeah. But is that the way your parents talk to you? if you didn’t like that, why are you continuing to treat yourself like that? Why, why don’t you give yourself that same understanding? Because what, think about it. We all wanna stay up later than we should. We all wanna eat **** that we shouldn’t but we have that voice in our heads. Like, no, you have obligations in the morning. You have to get up or you know, that’s gonna upset your stomach or whatever have you and it’s the same things you tell a child but you have to tell yourselves. So, the way that you speak to yourself in that regard is very important. Yeah. Um what I’ve realized at least for myself, is that there’s even more than one inner child. Yeah. You know, there are lots of parts of us um that that have different goals and different perceptions and might get, you know, yeah, might get into fights or something. Um and so, it’s not even just the inner child but like, how do we parent all the different parts of us and realize that there is no bad part? You know, you wouldn’t call a child bad. You just would. Exactly. You know. Um, re-educate them. I heard something. I can’t remember if it was in class or in something I was watching. But it said that everyone has good intentions. Yeah. Everyone. No matter how evil or messed up. If anything there are always some manner of good intentions at their core. Yes. It could be wildly misperceived. It could be a mental illness. there are always even, even crimes of hate, even when somebody murders someone else, they’re trying to satisfy something in them. They’re trying to make something in them go away. So, they’re trying to take care of themselves. Yup. Or they feel some weird obligation to fulfill. It’s all manner of reasons but all all of these things boiled down to. They are for themselves or someone else or whatever have you. It’s good intentions. Just like your subconscious Yes. Always has your best intentions in mind. Even with traumatic things. Even with bad reactions. It is still just trying to protect you. Yeah. Just trying to preserve its homeostasis. It’s normal. yeah. Now, that’s powerful. And I think when we understand that, you know, I think sometimes we can like vilify the subconscious or vilify these different behaviors but they’re all serving some kind of purpose. So, you know, if you’re, if you’re traumatized, it’s trying not to get you into that painful situation. Yeah. Yeah. Yeah. So, if you have crippling anxiety, it’s you’re subconscious, it’s your mind trying to protect you. You just have this fear reaction that’s out of control. And It’s there’s a lot to be said in terms of healing just for the awareness of that. So much of my work and especially my breakthrough work with clients has been through subtle changes in perspective. And that’s it. It’s not much more than that. It’s sometimes there are some changes to behaviors or thoughts changes. But a lot of it has to do with um the way you look at a situation, how you perceive it, why you think this way, why you think this way about yourself Although it’s stereotypical in therapy, I find myself asking the question, why are you feel that way? Where does that come from? A lot. Right. And there’s always something. There’s always another layer deeper until you get to that aha moment. And you can tell whenever something has left their mouth that even they didn’t think of. They’d never even made that association before. And just by having that come into their conscious mind by being able to consider that logically. You’ve already gone so far in that healing. It’s like when we raise our awareness and take different perspectives, then, behaviors start to shift. Well, it’s like uh I’m not a big NLP guy but there are some aspects in neuro-linguistic programming that I like and one of those is the mindfulness aspect. The idea of being aware of what you’re thinking. Uh taking control over your thoughts. I thought Joe did a very good example when he talked about how he was crossing the road and he started getting this perception of these men in this car at this crosswalk about how they wanted to do him harm and he started getting anxious about this imagined situation and he stopped himself and he forced his thoughts to something ridiculous. I forgot what he said he pictured those guys in this car doing but immediately changed his thought pattern. Yeah. And he was able to just walk away and he looked back and he said, they’re just both on their phone doing nothing. And that’s right. He’s told me that story too. That’s right. Yeah. And II love that story. It’s hilarious But it’s a very good example. Because so so often we let our thoughts kinda run out of control. And it does us some good to stop and think like why do you think that? Why are you thinking that way? Why? Why do you believe like there’s something to be nervous about in this situation? Where is that coming from? Hm. All your trail back. Figure out why you’re nervous. So we’re so for somebody who likes you asked them that like oh why are you nervous? Why are you afraid? And they’re like I don’t know. No idea. Well. What? How did you ask? Mhm. What makes you nervous? How do you feel when you’re nervous or afraid? Um did you, were you always afraid of this? If you weren’t always afraid of this, when’s the last time you remember not being afraid of it? When is the first time you remember being afraid of it? most time in my experience, people haven’t taken that logical path back. They just stop with, I don’t know. They it’s that self-examination is difficult. Um, a good example of this is I had a client that said that They wish that they were able to perceive themselves as others perceive them, as strong as others perceive them and I said, well, why don’t you think you’re strong? got into a car wreck and I felt like I could have done better and I felt like I failed. Why do you feel like you failed? Well, because I couldn’t be there when my grandfather died. and there was just this dawning realization when they said that. And I was like, you never said that out loud, have you? No. There you go. So, that is currently on the table for the next time and uh it’s just a good example of just keep following the path back. If you do, there there’s always a reason for the behavior. It’s never an I don’t know. There’s an I don’t want to remember. There’s uh I choose not to know but. Yup. There’s not a mystery. There’s always a reason that Could be had through questioning, figuring out when and where, and all of that. Yeah. Yeah. So, I’m curious cuz there are different schools of thought and not even hypnosis but in therapy that maybe, hey, don’t go back to the cause.  You know, that’s just bringing up things that um that don’t necessarily need to be brought up or you can retraumatize people. X, Y, Z, focus on the solution, focus on the future, and more of like the positive thinking kind of approach. Um, I’m curious about what your thoughts on that are. It depends on the trauma Uh if it’s something like that they view as very grievous, it is something bad. I don’t ever ask people what their traumatic thing is. Like, you can just tell me that something bad happened in 2,000 seven. And that’s all I need to know. Uh, beyond that, all I, with, with that, I will, there’s a couple ways. But you, there’s no direct reexperience. You don’t take them back and make them live through it again. It’s antithetical to the goal. What you do is you take away that association. You make that not a core memory. They don’t focus on the events. They focus on the resolution. And the letting goes after that resolution. There’s a method that I very much enjoy that involves having them perceive this event on a screen. And they fast forward and rewind and fast forward and rewind until all that exists before the event and after the event. that that association is. And then after you establish that, you let them let go of that memory, of that association. And Trauma is very dependent on what happened. And uh sometimes it’s dependent upon um my referral. Because many times whenever it’s complex trauma uh I’m speaking to them on referrals from a mental health professional. Mhm. And a lot of it has to do with my communications with that mental health professionals. Whatever you learn. You know you’ve done. What do you need to be done? Um, it’s very important if you do find yourself working with uh medical doctor or mental health professional to get on the same page with them. Like involve yourself in that client and have them help you, help them, help that client. It’s a team effort at that point. It’s so dependent because II work with people with combat PTSD. I have uh postpartum depression. It’s just a matter of where this trauma and negative behavior come from. Often, uh with the combat PTSD, it’s always really heartbreaking to do those and I’m very happy that I get a chance to work with those men and women. there’s a lot that’s, for example, like what they’re not allowed to feel. Because you’re expected to, I literally soldier on. Hm. And there comes a time that that’s not a thing anymore. That you have to address what has happened to be able to heal. And I see a very similar thing in combat veterans that I see in people who suffer from trauma. they’ll go back to the closest safe save point in their head Uh it’s usually sometime when they’re a late teenager or soldier. It’s generally seventeen, or eighteen. And they’ll start adopting the traits that age. because they have all of these traumatic memories from older when they were older. So, it seems like psychologically, they just go back to the last time they were safe and untraumatized because it’s no longer safe to be an adult and I see that repeated time and time. Yeah, it’s. Wow. Interesting yeah, it must be very, very difficult to work with. Yeah, people who experience extreme, extreme trauma. Mm-hmm. So. I’m glad you are. But it’s one of those things like, once I realized what hypnosis was capable of and what it could do I kinda felt obligated to offer my services to them because it doesn’t matter what you think politically. It doesn’t matter what you think about war or the war or soldiers, the government, or anything like that. It has to do with these are deeply traumatized people who not getting the care and resolution that they need. I just feel obligated that if I have this toolset that allows me to give them that resolution, I should, that it doesn’t matter anything at all if I’m anti-war, pro-war, anti-government, pro-government, none of that. None of that matters. It’s just people. It’s just men and women who have seen things and done things that no one should be asked to see or do. And that’s it. That’s all it is. I’ve had a chance to see a wonderful change in those people because so much of it is it’s just difficult for them to deal with that, to face that. Whatever it is that they see. to do that is profound. To give them a safe place to do that. That is guided and secure. And it’s an interesting thing that for some reason people are hesitant to seek out psychotherapy. I have no problem with hypnotherapy. That. Really? Yeah, and I don’t know why that is. it’s fine and generally, I will encourage someone that if this isn’t something that they’ve seen a therapist for and they need to in the process of things, just be like, okay, now that we’ve kind of helped you through this, you need to consider bringing on someone else as well.

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And therapy isn’t the cure-all. It’s great for a bunch of things but sometimes you need other stuff. Yeah. Yeah. In fact, like, the way I see it is to attack it from every angle. Mm-hmm. Absolutely. Yeah. There’s no reason not to bring in everyone who could help. Yeah Perfect. So, uh I’m just going back to um you know, how you got into hypnosis and you talked about, you know, self-hypnosis and I’m sure that that has helped you and I mean, it’s helped me. I think it can help a lot of people where they can just utilize this modality, get over, get over some fears maybe, you know. Absolutely. I’m curious how, how you do self-hypnosis and what’s worked for you. So, that’s changed recently Longest time I did it as we were trained. And uh one of the things I’ve started to focus on recently. my self-hypnosis work and with my clients is nostalgia. This weird thing that exists in our minds seems to be separate from everything else. And what I do to self-hypnotize now is II focus on one of my far-off memories. Like one of my distant distant nostalgic childhood memories. Now form that as solidly as I can and just start doing breathing exercises. And focusing on that nostalgic moment and gets me right into a trance every time. Interesting. And do you think that would work with other intellectual suggestions? You know, high E note? Uh, I have clients that nostalgia has started to become a major part of our work. Because, um, I don’t even know how to define it. It doesn’t exist in a space like other memory. It’s it’s different. It’s more intense. It’s standard memory. It doesn’t have that feeling that’s associated with it. And I don’t know what that feeling is. Um actually, that’s one of the things that I want to focus on the most with research as that’s what nostalgia is and what its uses are about hypnosis. Yeah. Um and it’s, I’ve already started using it with a few clients, this notion of focusing on intense nostalgia to facilitate trance and I’ve had very good effects. Yeah. Well, that’s that reminds me of Erickson and I’m sure you know his story by the way, for people that are watching that and not familiar with Eric’s uh Milton Erickson, he was one of the greatest hypnotherapy of all time and did very indirect, artfully, vague, lots of metaphors and stories and god just brilliant results as a genius and um you know, when he was younger, he had polio, couldn’t move, thought about a memory of when he could and then all of a sudden 30 minutes later, he found himself Maybe. Well, that’s why a lot of the clients that I’m working with nostalgia are my clients that have self-perception issues and self-confidence issues Because nostalgia exists in a point of pure happiness. You don’t have negative nostalgic memories. Really? And yeah. This nostalgia by its very definition is positive. Huh, and it’s it may or may or may not be true because memory sucks but it doesn’t matter because your perception of that memory is nothing but positive. Nothing but happy. And so by recalling these memories, you’re able to recall this happiness. Uh, one of the more interesting bits of homework. That I’ve given my clients is uh sometime between now and our next session. Go on YouTube and look up an hour of old commercials or old cartoon intros from your childhood or something Like that. Um. Cartoon Network. Yeah. Something. I’ve uh I spent like 2 hours one night just watching intros to cartoons from the nineties. Like that’s it. And I’ve kind of become very focused on it. I very much love that sensation of nostalgia. I think it’s important therapeutically. That’s kind of why I put so much effort into exploring it myself. Yeah. Uh, Anytime I have like a nostalgic memory or thought, I kind of try to capture that and examine it and like figure out what I could do to bring myself back to that time and just that ponder ance alone has a hypnotic effect And I don’t know what it is about where nostalgia exists in the memory. it’s its present. there is an odd field of science. That’s kind of coming up now. That’s the quantum sciences. And there are some individuals doing work right now. or up to it including hypnosis that are fascinating. Um, the main person I’m speaking about is this guy named Doctor Dean Raiden who is the head of the Institute of Noetic Sciences. And yep I heard of them. Uh, he wrote a book called Real Magic. That is the scientific research and analysis behind certain processes. Like ESP whatever have you. Um, and it’s done strictly from the view of science and research. And These things are related to hypnosis because if the institute can be said to have any goal or direction, it’s consciousness research. Why? What are we? Why are we? I kind of think. Yeah. And the book doesn’t answer any of those questions but this book does provide uh an interesting indication of the direction of science and what we’re looking at in the next twenty years. One of the most fascinating things uh about living in this time certainly isn’t the plague or climate death but uh there is a concept called the singularity and there’s a version that exists in AI and there’s a version that just exists as humanity and the idea of the singularity in terms of humanity. Are that human technological eras exponential? That to get from the bronze age, the iron age was like two 2,000 years from the iron age to the industrial age like a thousand. Industrial age. It only lasts two hundred. Then, you get to the point now that the internet age only lasts twenty years. So. Oh, we’re not, are we, Oh yeah, you’re right. Uh-huh? I was just trying to think like, well, yeah. And. Previous to that, the computer age only lasted like fifty And so, now we are approaching this point in human evolution and development that um progress. The human era can no longer be measured. That each human technological era begins to overlap itself. And that progress became becomes foreseeable by the organic mind. we have a date for that. And it’s twenty-forty-five. Uh between twenty forty-five, 2055 is when the singularity is supposed to occur. And what? So what is that what is that mean exactly? That means human technological progress becomes infinitely fast. Every day there are new technological breakthroughs. Every day there is more progress. Um. How does even determine this state? Do you know? Well. I don’t know. Smarter men than me have done this math. Yeah. But it’s you see it evident in human evolution. These cuz there’s there were times in our history when thousands and thousands of years were spent the same. centuries were spent the same. There was no real development. It was just kind of an age. Living in the era that we live in now, it becomes very difficult to conceive of that. Because even if you’ve been around for twenty years, you’ve seen insane amounts of progress. And that simply just didn’t happen. Previously. Right. Ever since the industrial age for better or worse, we’ve sprinted towards this exponential progress, and as to what singularity looks like, oh no. Uh, I surely just hope it’s not a new iPhone a day. Uh, I’m hoping it’s not the AI, you know, um. Oh, god. Take me over the world and. The matrix. I uh. I’m kind of opposed to AI. Kinda not. Because to get AI, we have to first solve the consciousness problem, and we solve the consciousness problem. Good luck. That pretty much unlocked the singularity right there. But at the same time okay, let’s say if we unlock consciousness, let’s say we’ve created an artificial intelligence. We have created a thinking, feeling machine. The feeling of what? How do you know that consciousness implies emotion? What, how do you know what that emotion is? Right. Right. It’s defining consciousness. Mm-hmm. Which is the tricky part. So, and then one of the interesting questions I’ve, it’s been posed to me is does emotion evolve? Are we more emotionally intelligent now than we were 500 years ago? You gotta remember 500 years ago, what was considered fun was watching the local heretic gutted in the public square. So, I have to think that, yeah, we have grown. I, I do think we’ve owned in some ways, and at the same time, you know, there’s always going to be some kind of watching people get, you know, it’ll be a violent movie. Um. Yeah. Yeah. US, UFC, you know, we I mean II remember. Yeah. I don’t know how old you are but. I’m almost forty. There was a show on in the 90s called America’s Funniest Home Videos. That’s right. And it was hosted by Bob Saggett for some reason. And uh there used to be a rule. But it first came out. That no one could get hurt. And the video. It was an explicit rule. What? no1 could be injured. Yes. Well and then the dude getting hit in the nuts by a football One 3 years in a row. And they realized their entertainment value. Exactly. Cuz when I watched it, it was like 80% of people getting hurt. Yeah, absolutely. Yeah. And uh that’s an interesting aspect of humanity that to my knowledge, only the Germans have attempted to quantify. Uh, they have a word called uh Shodden Freuda. Which basically if I remember right, translates to the sad joy. And it is the pleasure that you get from other people’s pain. It is you who laugh at someone falling downstairs. It’s the reason you laugh at anything like that. Though the Germans have a word for it. It is Yeah. It exists Universally. And that is the very reason that um that that things like America’s funniest home videos or **** exist. Yeah. And it has to be II wonder really what is it psychologically that makes us like that? Is it a survival aspect of that ain’t me? Yeah. Yeah, I don’t know. Well because one of the weird questions I’ve never heard answered is uh why do we laugh? Like what even is laughter? Right. What is humor? Yeah. Uh-huh. and um because it wouldn’t exist for no reason. Laughter has to have a function the most interesting notion that I’ve heard is it was made as a diffused mechanism. The whole idea of why we find humor or awkwardness humorous. Because of like let’s say you were walking around the pack way back in the day. And you heard the Bush’s Russell. And everyone gets scared. You see the rabbit jumps out, so you laugh. And that signal which creates a neurological response in any human that hears it Is a way to signal the all clear. And maybe it’s a way to signal that hey that wasn’t me that just slammed into a **** curve on a bicycle or something like that. Like I don’t know what that is. I don’t define what humor is or why we laugh, to begin with. Right. Difficult question. And then you make it even more complex by the fact that some animals laugh. Really? Uh. Huh. Rats will laugh. Horses will laugh. Um, horses have displayed complex humor. Rats will laugh. Rats, you could tickle a rat. It’ll laugh. Giggle. That is so strange. Wow. They’re hyper-intelligent. Um, A horse. There’s some search horse prank on YouTube and you will get nothing but videos of horses taking revenge on people and laughing about it or playing a prank on their handler or something. it’s pretty. That’s always been the strangest thing to me because that implies very complex emotional intelligence to have humor. Yeah. Well, we’ve strayed. This is a very interesting topic for sure, man. Philosophical, psychological, like cultural, uh what’s called anthropology, anthropological questions. Um kinda tying it back to hypnosis. Well, I mean and you were talking about singularity and consciousness. Was that, were you going somewhere that in terms of hypnosis? Who knows? Um well, probably where I was going with that. Um if not, where I’m going now is that what we do is going if it’s not already it is going to become vital to consciousness research and what it means to have that type of increased development that we can analyze ourselves and others in ways that we haven’t been able to in the past. I’ve heard some theories that the notion of metaprogramming. Being able to actively change our thoughts and behaviors is uh an evolutionary step that is not something we’ve always had. That this ability to change everything about ourselves to suit our purposes is evolutionary. And I will take that one step further one of the things that I propose in many of my interviews is we don’t have free will. If everything of what we do is a product of association and learned behavior. How is that in any way an expression of choice? Now where free will comes in is when you choose to alter that behavior to suit your life when you choose how you want to view something. When you choose how you wanna act and react to something. Right, but aren’t those also dictated by past programming, by culture, um your knowns, so to speak? Yeah. You know. Could be. But it is the conscious choice of say if you have anxiety and you wish to resolve it. That is a conscious choice. Um. Right. Another example of a guess is if you don’t like a certain food, well, it stops. Like it. But you can’t. Okay, well, what if you could make that choice? What if you could just choose to make a certain food or like reading or like something in particular? What if your association was different? And that’s where the change comes in. That’s where the choice comes in. At least I think. That’s just uh the logical quandary that I like to present to people. Yeah. You know, this whole free-will discussion, man. That’s above my pay grade. I do mean on most days, I lean towards, you know, there probably is in free will but What I will say is I think it’s important for us to believe that there’s free will even if there’s not. Just to function in society and for mental health and yeah. Um, there are a lot of things like that that you don’t have time to get into today but it exists for you. You just have to play along to function. The biggest landmine in thought projects I could think of is simulation theory. Because you can neither prove it nor disprove it. So you could just continually fall that rabbit hole. So what is simulation The idea that we live in a simulation? Okay yeah, the matrix. Yeah. Yeah. Yeah yeah. There is no way to prove it. There’s no way to disprove it. Yup. And I have no couple of people that fell far down that hole. Yeah. So, now, this is not a lot of quantum physicists, okay? And obviously, I’m not anywhere near that realm and intelligence but from what I’ve heard and read and understand as a layman is that there is an interpretation that will lead to us being in a simulation, there are some quantum physicists who would say that, and um. Uh, who’s the deal? That it is. Yeah. Statistically more likely that we’re in a simulation than not. Is it? Yeah. Yeah. And it the singularity comes into that because it assumes that any civilization that gains enough technology to run a simulation will do so simply to gather information and that given our technological progress, it is more likely that we have reached that point and we are in a simulation, then, it is not. So, wait, maybe the similarities are just when our when our holes pop open and we all get to come to to play in the real world. You know what? I think this ties nicely into hypnosis. Yeah. Okay. Because our beliefs, our core beliefs, a lot of them, are just BS. Yeah. It’s all perception. Reality is perception and as hypnotists, we can help you change that perception. Yeah, I don’t know if you, if you’ve been part of like a stage hypnotist show, hypnosis show? No, I’m opposed to stage hypnosis. What? Uh. It’s something I’ve to develop and like, yeah, I get that reaction a lot but speaking to clients and speaking to podcasters doing interviews, Stage Hypnosis is responsible for 90% of the misconceptions and falsehoods about hypnosis. And I could say To me, hypnosis and hypnotherapy is a very, very, very powerful tool and it needs to be regarded as such and if we’re up on stage using what is supposed to be a powerful tool to make people stand on their head, that doesn’t allow people to view it with the, the gravity that they should because, to them, it becomes this, this parlor trick this and more than that, I’ve encountered people who’ve had negative experiences with stage hypnotists. Uh because of what they’ve experienced on stage, they would never get hypnotized again. I’ve thought about that a lot. Would I ever do stage work? And I think at this point, the answer is no. Uh, I would do parlor work within a small setting like Transing one person in front of a small group just as a demonstration. That’s fine but doing it as a spectacle in front of a crowd. I think personally, this is only my opinion that it robs hypnosis of some of the dignity that it deserves. Hm. And I understand why it exists cuz yeah, it’s a neat thing But like, given how important I feel that hypnosis is to, in the understanding of it is to our health. Did damages its capacity to do so, by it being a stage show. Here, here’s my kind of argument. Um, because if show somebody that, you know, hey, I can make you bark like a dog, cluck like a chicken, uh via the power of hypnosis. Imagine what it’ll do therapeutically. Imagine how easy it is for you to quit smoking or lose weight or you know. How many are to go to anxiety? Going to be convinced with that versus how many people are going to be convinced that it’s fake or that? Yeah, I know I get a process or that it’s mind control. Yeah. And that’s the contribution to the negativity that comes in. And the media doesn’t help because every time you see a movie where hypnosis is involved outside of uh black magic, that one movie from the forties. Um, it’s all **** Like it’s all just weird. if that’s not actually how that works. But it makes people believe it. That’s why you ask someone to imagine what a hypnotist is. The first thing they think is that. Yeah. I have one somewhere. Hey, it’s a legit induction man. It works. I know. That’s the whole reason I dug mine out is because like man if I’m a hypnotist I wanna trans someone with a pocket watch. Exactly. That’s why I got it too. Just for that. Yeah. Yeah. I got you. Oh, I feel like this might be a good stopping point, man. It’s been a fun conversation. I don’t know if there’s anything that you. Yeah, man. Thank you for coming on and um uh is there anything maybe you wanna end with before um you know, ask you how people can find you and work with you? Um well, one of the things I always like to end with, you’ve already mentioned that hypnosis is natural. It’s normal. It’s not a metaphysical thing that this is a natural function of the human mind and that there’s no reason not to utilize it for positive change. It’s there anyway. We’re not adding anything. So, it’s something that I believe anyone can benefit from But if anyone wants to get a hold of me, uh like I was so enthusiastically introduced, my name is Jay Robert Parker. I own Twin Ravens Hypnotherapy and Research LLC and you can get a hold of me through my website at WWW dot Ravens dot ORG. Very nice. And you are doing group hypnotherapy as well. Oh, yes. Um I, if you go to a meetup, uh meetup .com and search for twin ravens hypnotherapy. I have a bi-weekly group hypnosis that I’m starting up. Uh, just kind of as an experiment, see how well it catches on but it’s just uh every other week, just doing some general relaxation, motivation, just basic stuff, and way. Anyone that wants to be able to experience hypnosis gets the opportunity. It’s not the same as one-on-one but your results may vary. Some people get a very profound experience. Some people likely do but you always get something. You let them know what it is. Yeah. And awesome. Great talking to you man. Absolutely. And I just wanna vouch for Robert’s skill and his compassion and passion in this work cuz I’ve been in one of those group uh hypnotherapy sessions. And it was very powerful. So I recommend anyone who wants to experience the power of hypnosis, to change their lives, to go with, to with Robert and you’re in good hands. So, thank you, man. Thank you for coming on. Absolutely. Thanks for having me. Alright. Peace out, guys.As found on YouTubeHUMAN SYNTHESYS STUDIO 👀🗯 Attention: Have Real Human Spokespeople In Your Videos Saying Exactly What You Want In MINUTES! 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