{"id":152221,"date":"2024-03-03T14:57:00","date_gmt":"2024-03-03T19:57:00","guid":{"rendered":"https:\/\/effectsofanxiety.net\/archives\/152221"},"modified":"2024-03-03T14:57:00","modified_gmt":"2024-03-03T19:57:00","slug":"supercharge-your-therapy-sessions-35-essential-cbt-tools-for-trauma","status":"publish","type":"post","link":"https:\/\/effectsofanxiety.net\/archives\/152221","title":{"rendered":"Supercharge Your Therapy Sessions: 35 Essential CBT Tools for Trauma"},"content":{"rendered":"
https:\/\/www.youtube.com\/watch?v=PIPtMcieu4Q<\/div>CEUs are available at AllCEUs.com\/CBT-CEU everybody and welcome to this video\u00a0 on 35 trauma-informed cognitive\u00a0\u00a0 behavioral therapy techniques\u00a0 i’m your host dr donnelly snipes00:00:10<\/a>as the title implies in this video we’re going to\u00a0 review 35 cognitive behavioral therapy tools that\u00a0\u00a0 can be used to help people feel safer and more\u00a0 empowered now if you’re looking for a specific\u00a0\u00a0 tool there are time stamps down in the video\u00a0 notes just fyi because 35 is a lot of tools\u00a0\u00a000:00:28<\/a>so that can help you jump around\u00a0 a little bit more if you need to in terms of the principles\u00a0 of trauma-informed cognitive\u00a0\u00a0 behavioral therapy the goal is to use people’s\u00a0 strengths build on what they’re already doing\u00a0\u00a000:00:45<\/a>help people recognize that they are the experts on\u00a0 their own lives and tools and strategies they’ve\u00a0\u00a0 developed in order to cope with stress\u00a0 cope with life until now may not be the\u00a0\u00a0 most effective may not necessarily be the most\u00a0 helpful like in the case of addictions but they\u00a0\u00a000:01:05<\/a>were developed to help that person survive\u00a0 help them see the survivor in themselves\u00a0\u00a0 we want to help them identify secondary\u00a0 effects of trauma like depression\u00a0\u00a0 anxiety poor communication skills abandonment\u00a0 anxiety you know there’s a whole host of things\u00a0\u00a000:01:24<\/a>help them see how that’s maybe related to trauma\u00a0 and promote self-care help them develop tools\u00a0\u00a0 so they can start moving toward the rich\u00a0 and meaningful life that they envision the first and most basic tool is a behavioral\u00a0 one and that is to create safety we need to\u00a0\u00a000:01:46<\/a>help people feel like they are safe so their\u00a0 hpa access or their threat response system can\u00a0\u00a0 take a break we don’t want to have them feeling\u00a0 constantly hyper vigilant constantly being\u00a0\u00a0 on guard and have an exaggerated startle response\u00a0 so if we can help them feel safer and at home\u00a0\u00a000:02:09<\/a>in the car anywhere else they spend a fair amount\u00a0 of time it’s going to reduce the intensity and\u00a0\u00a0 maybe even the frequency that that stress response\u00a0 system is activated it’s going to help their body\u00a0\u00a0 start to recalibrate and that is wonderful when\u00a0 they start feeling empowered when they start\u00a0\u00a000:02:27<\/a>looking at environments at places and saying\u00a0 you know what there are things that i can do\u00a0\u00a0 to help myself feel safe that is huge now\u00a0 there’s a lot of types of safety though and\u00a0\u00a0 we need to help them create a sense of physical\u00a0 safety from self and others now physical safety\u00a0\u00a000:02:47<\/a>from others is pretty obvious we want them to not\u00a0 be afraid that they’re going to be assaulted or\u00a0\u00a0 hurt in some way physically by another person but\u00a0 safety from self is also important we want them to\u00a0\u00a0 feel like they have tools to deal with\u00a0 overwhelming emotions so they don’t engage in\u00a0\u00a000:03:10<\/a>self-injurious behavior or addictive behaviors\u00a0 or other behaviors that could potentially be\u00a0\u00a0 destructive affective or emotional and cognitive\u00a0 safety from self and others is another type of\u00a0\u00a0 safety we need to help them develop recognizing\u00a0 that that inner critic in their head can feel\u00a0\u00a000:03:32<\/a>very threatening can feel very intimidating\u00a0 a lot of times and can intensify trauma\u00a0\u00a0 helping them figure out how to deal with that\u00a0 inner critic is another aspect of creating safety\u00a0\u00a0 as well as helping them develop safety from\u00a0 others emotionally and cognitively being able to\u00a0\u00a000:03:55<\/a>set those boundaries and say this is how i feel\u00a0 these are my thoughts you don’t have to agree\u00a0\u00a0 but you can’t i’m not going to let you\u00a0 take them from me i’m not going to let you\u00a0\u00a0 invalidate my thoughts or feelings and then\u00a0 environmental safety from self and others\u00a0\u00a000:04:14<\/a>or from others and environmental safety\u00a0 is different than physical safety physical\u00a0\u00a0 safety has to do with my body and not letting\u00a0 people injure myself environmental safety means\u00a0\u00a0 creating an environment in which people don’t\u00a0 have to fear for the things that they cherish\u00a0\u00a000:04:34<\/a>their belongings they don’t have to worry that\u00a0 somebody’s going to encroach on their environment\u00a0\u00a0 that somebody’s going to take their environment\u00a0 from them maybe kick them out on the street for\u00a0\u00a0 example so we need to help them look at all\u00a0 aspects of safety and do as much as they can\u00a0\u00a000:04:53<\/a>to reduce their feeling of threat and increase\u00a0 their feeling of safety and empowerment i believe it’s also important that people create\u00a0 a rescue pack to have with them this safety rescue\u00a0\u00a0 pack can help people feel grounded safer more\u00a0 empowered in a variety of situations because\u00a0\u00a000:05:14<\/a>you can’t possibly plan for every situation\u00a0 and how you’re going to feel safer in you\u00a0\u00a0 know every single situation so a rescue pack\u00a0 can be helpful in that rescue pack i encourage\u00a0\u00a0 them to create a thought list that has distress\u00a0 tolerant mantras such as i can get through this\u00a0\u00a000:05:35<\/a>this will this too shall pass i have friends\u00a0 that can help me whatever distress tolerance\u00a0\u00a0 thoughts that they find helpful usually somewhere\u00a0 between three and ten thoughts that they can have\u00a0\u00a0 that they can just read over when they’re\u00a0 feeling distressed can be very very helpful\u00a0\u00a000:05:56<\/a>activities is something else they can do to\u00a0 trigger that vagus nerve trigger that relaxation\u00a0\u00a0 response or sometimes just help them stay grounded\u00a0 or turn their attention completely from whatever\u00a0\u00a0 is making them feel nervous breathing slow\u00a0 diaphragmatic breathing will help trigger\u00a0\u00a000:06:16<\/a>the vagus nerve bubble stuff blowing bubbles\u00a0 blowing up balloons or blowing bubble gum also\u00a0\u00a0 has the same effect because it slows breathing\u00a0 down and can help trigger the relaxation response\u00a0\u00a0 keeping a phone with them which most people have\u00a0 now so that’s not too outlandish is also important\u00a0\u00a000:06:38<\/a>so they have the ability to reach out to a friend\u00a0 to reach out to someone who can listen who can\u00a0\u00a0 provide support who can help them feel safer in\u00a0 the event that they don’t have anybody then making\u00a0\u00a0 sure they have the number of the local crisis line\u00a0 so they have somebody that they can reach out to\u00a0\u00a000:07:03<\/a>and narration is another activity that can\u00a0 be really helpful when people are feeling\u00a0\u00a0 unsafe if they narrate what they’re doing it\u00a0 can help them stay grounded avoid dissociating\u00a0\u00a0 and be more aware of what’s going on and how\u00a0 they are safe in the moment and sensations\u00a0\u00a000:07:25<\/a>essential oils or wax tarts are wonderful because\u00a0 sometimes just smelling something that promotes a\u00a0\u00a0 sensation of relaxation or brings back a positive\u00a0 memory can help trigger that relaxation response\u00a0\u00a0 and that can be really helpful likewise having\u00a0 something that they can smell that can displace a\u00a0\u00a000:07:50<\/a>trauma trigger a smell that triggers their\u00a0 trauma can also be helpful so if there’s a\u00a0\u00a0 particular cologne that triggers memories\u00a0 of their trauma when they’re in the store\u00a0\u00a0 if somebody walks by they have that cologne on\u00a0 then the person can reach into their rescue pack\u00a0\u00a000:08:10<\/a>and get one of those essential oils or wax tarts\u00a0 or whatever out and smell that so it displaces\u00a0\u00a0 that it turns their attention to something\u00a0 else if they want to for people who have a lot\u00a0\u00a0 of especially olfactory sensory triggers they\u00a0 may consider using something like fix vaporub\u00a0\u00a000:08:33<\/a>or some other type of rub that lotion or\u00a0 something that is scented and rubbing it right\u00a0\u00a0 below their nose so they are smelling that\u00a0 pleasant scent the whole time and they’re not\u00a0\u00a0 waiting until they might be triggered keeping an\u00a0 anchoring object with them something they can hold\u00a0\u00a000:08:53<\/a>something they can feel whether it’s a you\u00a0 know those little tiny um stuffed animals i\u00a0\u00a0 don’t know what to call them that kids used to\u00a0 attach to their backpacks when i was in school\u00a0\u00a0 those can be helpful because you can\u00a0 stick those in a purse or something\u00a0\u00a000:09:09<\/a>a worry stone or prayer beads or something\u00a0 else that the person can hold they can feel\u00a0\u00a0 that helps them feel anchored can be very very\u00a0 helpful sometimes jolting yourself if you will\u00a0\u00a0 out of a particular memory is can be really\u00a0 helpful you can splash cold water on your face\u00a0\u00a000:09:34<\/a>now i wear makeup so i am not inclined to go into\u00a0 the bathroom when i’m feeling stressed and throw\u00a0\u00a0 cold water on my face because that’s going to make\u00a0 my mascara run that’s not a good thing ice packs\u00a0\u00a0 can be helpful and this was one that you probably\u00a0 aren’t going to use a whole lot because they’re\u00a0\u00a000:09:52<\/a>not reusable but the instant ice packs can be\u00a0 used if you can’t access cold water to put on\u00a0\u00a0 your wrists on your neck or splash on your face\u00a0 to help jolt you out of a particular distress\u00a0\u00a0 spiral some people have particular music that they\u00a0 like to listen to or playlists that they listen to\u00a0\u00a000:10:14<\/a>that help them feel empowered that help them feel\u00a0 safer that help them calm down whatever feeling\u00a0\u00a0 they’re looking for and on the other end of the\u00a0 spectrum sometimes noise-canceling headphones\u00a0\u00a0 can be really helpful if for example one\u00a0 of their triggers is the sound of ambulance\u00a0\u00a000:10:33<\/a>sirens you can’t make ambulances not run therefore\u00a0 if they are feeling particularly stressed\u00a0\u00a0 having noise cancelling headphones can be helpful\u00a0 to block out the sound of that particular trigger\u00a0\u00a0 i know the other morning something was going on\u00a0 in our town and it was early morning so sound\u00a0\u00a000:10:58<\/a>was traveling but no joke for 30 minutes\u00a0 it was just siren after siren after siren\u00a0\u00a0 and for somebody who’s triggered by sirens that\u00a0 would have been pretty pretty intense for them the next cognitive behavioral technique is\u00a0 distress tolerance and if you’re familiar\u00a0\u00a000:11:20<\/a>with dialectical behavior therapy you’re\u00a0 probably familiar with distress tolerance\u00a0\u00a0 i have distilled the stress tolerance activities\u00a0 down from accepts and improves which is what\u00a0\u00a0 linehan uses and they’re wonderful but i’ve\u00a0 simplified it because a lot of people have\u00a0\u00a000:11:36<\/a>difficulty remembering all of those tags thoughts\u00a0 distress tolerant thoughts we’ve already talked\u00a0\u00a0 about those and having people develop a list of\u00a0 distress tolerant thoughts that can help them feel\u00a0\u00a0 safer and more empowered activities to reset\u00a0 the hpa axis and improve vagal tone that is\u00a0\u00a000:12:00<\/a>to trigger the rest and digest to trigger the\u00a0 relaxation response that can be that diaphragmatic\u00a0\u00a0 breathing that you do just breathing or\u00a0 blowing bubbles or blowing up balloons\u00a0\u00a0 it can be through a vagus nerve massage where\u00a0 you’re massaging one finger behind the ear\u00a0\u00a000:12:20<\/a>one finger right on the tragus the little flippy\u00a0 flop thing on the ear and just gently massaging\u00a0\u00a0 yawning is another thing and now that i\u00a0 rubbed my tragus i’m getting ready to yawn\u00a0\u00a0 yawning is another activity that stimulates\u00a0 deep breathing but it also triggers the\u00a0\u00a000:12:39<\/a>relaxation response guided imagery is\u00a0 another tool in the distress tolerance toolbox if you will and you notice on the recovery\u00a0 pack that we just talked about on the rescue pack\u00a0\u00a0 i had thoughts activities and sensations but i\u00a0 didn’t have guided imagery because when people are\u00a0\u00a000:13:04<\/a>feeling threatened when they’re needing\u00a0 that rescue pack they’re not wanting to\u00a0\u00a0 check out they’re not wanting to use guided\u00a0 imagery they’re not going to feel safe enough\u00a0\u00a0 to transport themselves somewhere else a lot\u00a0 of times however when they are in a safe place\u00a0\u00a000:13:21<\/a>if they’re having flashbacks if they’re having\u00a0 intrusive feelings sometimes it’s not even a\u00a0\u00a0 memory it’s this feeling that comes from out of\u00a0 nowhere guided imagery can be helpful and that\u00a0\u00a0 guided imagery can take the form of a mental\u00a0 vacation going to their favorite vacation spot\u00a0\u00a000:13:41<\/a>and identifying five things that they see when\u00a0 they get to that spot four things they hear\u00a0\u00a0 three things they smell two things they\u00a0 can feel that can really help people\u00a0\u00a0 turn their attention to something that\u00a0 promotes dopamine and relaxation chemicals\u00a0\u00a000:14:04<\/a>being released which can help down regulate that\u00a0 stress response which is what we’re doing with\u00a0\u00a0 the stress tolerance we’re not trying to avoid it\u00a0 we’re trying to down regulate the stress response\u00a0\u00a0 so the person can get in their wise mind another\u00a0 image people can use is one i just call it safety\u00a0\u00a000:14:25<\/a>whatever that looks like to them for some\u00a0 people they envision a force field around\u00a0\u00a0 themselves for other people they have an angel on\u00a0 their shoulder for other people they have their\u00a0\u00a0 god carrying them like you hear in the poem\u00a0 footprints in the sand whatever they envision\u00a0\u00a000:14:44<\/a>that helps them feel safer and the moment can\u00a0 be incredibly empowering and if they’re hurt\u00a0\u00a0 in some way distress tolerance can be helpful\u00a0 if they’re feeling pain especially physical pain\u00a0\u00a0 they can envision healing whether it’s\u00a0 you know nanobots or their immune cells\u00a0\u00a000:15:07<\/a>knitting together or healing the injured part\u00a0 they’ve actually done studies on people with\u00a0\u00a0 hiv and aids and found that guided imagery\u00a0 that focuses on the immune system actually does\u00a0\u00a0 increase the the number of t helper cells\u00a0 which i thought was kind of cool and sensory\u00a0\u00a000:15:30<\/a>we talked about that briefly here and we’re\u00a0 going to talk about it some more because\u00a0\u00a0 distress tolerance is sort of woven throughout\u00a0 cognitive behavioral therapy but sensory tools\u00a0\u00a0 can help people trigger that relaxation response\u00a0 so that can be smells that help them feel relaxed\u00a0\u00a000:15:50<\/a>it doesn’t have to be essential oils it can\u00a0 be anything that triggers a positive memory\u00a0\u00a0 or a positive feeling like coffee for me if\u00a0 i smell good coffee that’s just absolutely\u00a0\u00a0 amazing and it triggers that little bit of an\u00a0 endorphin rush and that relaxation response\u00a0\u00a000:16:10<\/a>sites whether it’s pictures of their kids or of\u00a0 their dog or of a beautiful landscape what is it\u00a0\u00a0 that they can look at that may help them feel\u00a0 calmer or more more safer in the moment sights\u00a0\u00a0 smells sounds what can they listen to that might\u00a0 help turn their attention away from their distress\u00a0\u00a000:16:34<\/a>for a moment we’re not ignoring it we are turning\u00a0 our attention away from it we’re taking a break\u00a0\u00a0 until the stress response can be dampened some so\u00a0 the person can address it through their wise mind breath work i already mentioned this a little\u00a0 bit but breath work is so incredibly important\u00a0\u00a000:16:57<\/a>in therapy and cognitive behavior behavioral\u00a0 therapy in just everything well we need\u00a0\u00a0 breathing we need oxygen to live\u00a0 but slow deep breathing especially\u00a0\u00a0 diaphragmatic breathing or belly breathing\u00a0 actually can help trigger the vagus nerve\u00a0\u00a000:17:16<\/a>they call it respiratory vagus nerve stimulation\u00a0 or rvns so square breathing we’ve talked about\u00a0\u00a0 in multiple other videos is when you breathe in\u00a0 for four you hold for four you exhale for four\u00a0\u00a0 and you hold for four and then you repeat that\u00a0 a couple of times when you slow your breathing\u00a0\u00a000:17:39<\/a>it automatically triggers your heart rate to slow\u00a0 down when your breathing and your heart rate slow\u00a0\u00a0 down your stress response system says oh guess i\u00a0 don’t need to be freaking out right now so you’re\u00a0\u00a0 manually overriding by slowing your breathing\u00a0 you’re manually overriding your stress response\u00a0\u00a000:17:59<\/a>now obviously if there is an impending threat\u00a0 right before you no matter how slowly you breathe\u00a0\u00a0 you’re going to be getting other feedback that is\u00a0 going to keep you from becoming completely relaxed\u00a0\u00a0 but even in the face of stress00:18:18<\/a>slowing your breathing can help mitigate\u00a0 that stress response so you can maintain\u00a0\u00a0 your quote wits about you um a little\u00a0 bit more effectively so square breathing\u00a0\u00a0 is ultimately the foundation of what we’re\u00a0 talking about but there’s a lot of ways to\u00a0\u00a000:18:37<\/a>slow your breathing down some people feel like the\u00a0 square breathing or taking a few deep breaths is\u00a0\u00a0 corny or they don’t feel comfortable doing it\u00a0 whatever okay fine as i mentioned yawning is\u00a0\u00a0 a wonderful way to slow your breathing and\u00a0 you can force yourself to yawn you can also\u00a0\u00a000:18:57<\/a>massage your vagus nerve and that may encourage\u00a0 a yawn you can do different vagus nerve\u00a0\u00a0 stimulation exercises that can trigger yawning\u00a0 laughter when we laugh especially again belly\u00a0\u00a0 a good old belly laugh you’re going to take a\u00a0 deep breath in and then you go fall until you\u00a0\u00a000:19:20<\/a>have exhaled so you’re doing a slower exhale you\u00a0 just don’t really pay attention to it i encourage\u00a0\u00a0 people to create a playlist on youtube or i don’t\u00a0 know if you can do playlists on tick tock or not\u00a0\u00a0 but create a playlist that stimulates that guffaw\u00a0 that stimulates that good belly laughter that they\u00a0\u00a000:19:42<\/a>can turn to when they need to um trigger their\u00a0 relaxation response i mentioned already bubble\u00a0\u00a0 gum when you blow a bubble you’re going to\u00a0 blow slowly so it doesn’t pop in your face\u00a0\u00a0 bubble stuff and you can get the little tiny uh\u00a0 bubble stuff containers that they use for parties\u00a0\u00a000:20:05<\/a>you can get that at target or walmart or online\u00a0 i’m sure and you can carry that with you and\u00a0\u00a0 so you can just pull it out and blow bubbles\u00a0 whenever now being 50 years old people look at me\u00a0\u00a0 like i’m a little odd if i pull bubbles out in the\u00a0 middle of the parking lot and start blowing them\u00a0\u00a000:20:23<\/a>but you know if you don’t care then no big deal\u00a0 balloons are another thing and you can do this in\u00a0\u00a0 your car or so if you’re having a bad moment maybe\u00a0 you can go to your car you’ve got a balloon there\u00a0\u00a0 you can blow it up again to blow up\u00a0 a balloon you’re going to inhale big\u00a0\u00a000:20:43<\/a>and there then you’re going to blow blow\u00a0 blow so you’re slowing your breathing\u00a0\u00a0 and those are things you can keep with\u00a0 yourself party noise makers and i don’t\u00a0\u00a0 know what else to call them they’re the\u00a0 little noise makers that you blow on and\u00a0\u00a000:21:00<\/a>they make that horrible screeching sound\u00a0 or whatever however you characterize it\u00a0\u00a0 kids especially love those because they’re loud\u00a0 and annoying but that can be one other option\u00a0\u00a0 or dragon breathers and that’s what i have\u00a0 a picture of here you can use a toilet paper\u00a0\u00a000:21:19<\/a>roll or you can use one of those plastic cups\u00a0 a red solo cup or something and then you cut\u00a0\u00a0 strips of tissue paper and glue it to one end\u00a0 and you cut out the other end so it’s a tube\u00a0\u00a0 if you’re using a cup and then when the\u00a0 child is distressed they can take a big\u00a0\u00a000:21:38<\/a>breath and then they can blow and let all\u00a0 that anger out through the dragon breather\u00a0\u00a0 and last but not least fitness trackers\u00a0 fitness trackers monitor your heart rate\u00a0\u00a0 so instead of thinking about breathing if\u00a0 you’re thinking about lowering your heart rate\u00a0\u00a000:21:57<\/a>well you’ve got to slow your breathing in order\u00a0 to lower lower your heart rate so some people\u00a0\u00a0 will use their fitness tracker and they will\u00a0 just sit back for a minute and then they will\u00a0\u00a0 intentionally slow their breathing so\u00a0 they can reduce their heart rate when your\u00a0\u00a000:22:15<\/a>relaxation response is triggered\u00a0 your heart rate is going to go down\u00a0\u00a0 so that is a clear indication that you\u00a0 have manually overridden that hpa axis another one of my favorite techniques is defining\u00a0 your rich and meaningful life for people to figure\u00a0\u00a000:22:38<\/a>out you know where am i going how should i use\u00a0 my energy what’s important for me to focus on\u00a0\u00a0 ultimately it’s important to know where they’re\u00a0 going or know where they want to go so what does\u00a0\u00a0 that rich and meaningful look life look like for\u00a0 them and this is just an example of a vision board\u00a0\u00a000:22:56<\/a>that i created you only have so much time and\u00a0 energy how are you going to use yours what people\u00a0\u00a0 are important in your rich and meaningful life\u00a0 how are you going to use your energy to nurture\u00a0\u00a0 those relationships what things like health are\u00a0 important in your rich and meaningful life and how\u00a0\u00a000:23:19<\/a>how much energy are you going to use to nurture\u00a0 that career is another one i’ve got on mine\u00a0\u00a0 how much energy am i going to use to nurture\u00a0 that and what does that look like in my rich\u00a0\u00a0 and meaningful life and then again this is mine\u00a0 so all my critters and my farm are on here too\u00a0\u00a000:23:39<\/a>but this gives people something\u00a0 to look at and they can start\u00a0\u00a0 every day looking at this and saying all\u00a0 right these are the things that are important\u00a0\u00a0 and this is how i’m going to allocate this is how\u00a0 i’m going to spend my energy today or this week\u00a0\u00a000:23:55<\/a>so it helps get them focused and then if they\u00a0 have to make a decision if something comes up\u00a0\u00a0 during the day they have the ability to reflect\u00a0 look at this again and they can just take a\u00a0\u00a0 picture and keep it on their mobile device they\u00a0 can look at that picture again and ask themself\u00a0\u00a000:24:13<\/a>all right is devoting energy to\u00a0 whatever this is that’s come up\u00a0\u00a0 helping me move toward my rich and meaningful life\u00a0\u00a0 or is it stealing energy from the things that\u00a0 are important in my rich and meaningful life\u00a0\u00a000:24:29<\/a>so i really love this vision board as\u00a0 a tool not only to have on the wall\u00a0\u00a0 but also to have on the mobile device to help\u00a0 people regroup and refocus throughout the day once they’ve defined their\u00a0 rich and meaningful life\u00a0\u00a000:24:48<\/a>then we move on to what haze in acceptance\u00a0 and commitment therapy calls purposeful action\u00a0\u00a0 mindfully acknowledging the present this is\u00a0 where i am right now this is what’s going on\u00a0\u00a0 it’s not good it’s not bad it just is and then how\u00a0 should i use my energy right now given my context\u00a0\u00a000:25:09<\/a>what is the most effective way to use my\u00a0 energy to deal with the current situation\u00a0\u00a0 that will help me move toward the things that are\u00a0 important in my rich and meaningful life do i need\u00a0\u00a0 to address it is it something that is in my way\u00a0 is it something that i need to do something about\u00a0\u00a000:25:27<\/a>okay if so then let’s make a plan is it something\u00a0 that really doesn’t matter i’m just getting all\u00a0\u00a0 tied up about it but in the big scheme of\u00a0 things it doesn’t keep me it’s not blocking me\u00a0\u00a0 from moving toward my rich and meaningful\u00a0 life i’ve just got gotten distracted by it\u00a0\u00a000:25:46<\/a>or should i change my reaction to the situation\u00a0 moving from anger for example to compassion\u00a0\u00a0 maybe somebody does something in my life that\u00a0 triggers my anger is holding on to that anger\u00a0\u00a0 is continuing to be angry at them helping\u00a0 me move towards my rich and meaningful life\u00a0\u00a000:26:06<\/a>or is it stealing energy that i could be using\u00a0 spending on nurturing other relationships\u00a0\u00a0 or even having compassion for them purposeful\u00a0 action is another tool of empowerment\u00a0\u00a0 because it helps people recognize that\u00a0 they have options and that is so important00:26:30<\/a>now symptom locks bear with me with the symptom logs because i’m\u00a0 going to show you a few different ways to do\u00a0\u00a0 it however you know i got some of my foundation\u00a0 knowledge i got my minor in behavior modification\u00a0\u00a000:26:45<\/a>so that gave me just enough knowledge to be\u00a0 dangerous sometimes but symptom logs were one\u00a0\u00a0 of the big takeaways that i got from that\u00a0 and symptom logs are important because you\u00a0\u00a0 know for example when you’re on a diet or if\u00a0 you’ve got small children or a puppy at home\u00a0\u00a000:27:05<\/a>when you are seeing that thing every day when\u00a0 you’re interacting with that thing every day\u00a0\u00a0 whether it’s yourself your kid your puppy you\u00a0 may not notice incremental changes and then all\u00a0\u00a0 of a sudden one day you’re like whoa you’ve grown\u00a0 up or whoa you’ve mastered the piano or something\u00a0\u00a000:27:26<\/a>um but so the same thing is true with\u00a0 mental health symptoms when people are\u00a0\u00a0 dealing with it day in and day out they\u00a0 may not notice the incremental changes\u00a0\u00a0 so symptom logs can be really really helpful\u00a0 not only for documenting those baby steps\u00a0\u00a000:27:45<\/a>toward their rich and meaningful life but\u00a0 also to help people see how far they’ve come\u00a0\u00a0 every couple of weeks you can look at it and say\u00a0 okay let’s look at the how far you’ve come and\u00a0\u00a0 it gives you the ability to look for trends you\u00a0 can look for triggers for particular symptoms\u00a0\u00a000:28:05<\/a>you can look for vulnerabilities what things\u00a0 or situations make a person more vulnerable\u00a0\u00a0 to reacting to situations with anger you know\u00a0 sometimes it something may happen and it may not\u00a0\u00a0 bother them at all they get cut off in traffic for\u00a0 example other times they get cut off in traffic\u00a0\u00a000:28:23<\/a>and they just fly into a rage what’s different\u00a0 why were they more vulnerable the second time\u00a0\u00a0 so symptom logs can provide us a lot of\u00a0 information because it gives us a better peek\u00a0\u00a0 into what happened in dialectical behavior\u00a0 therapy linehan talks about backward chaining\u00a0\u00a000:28:45<\/a>ideally the person completes the symptom log when\u00a0 it happens but you can do it at the end of the day\u00a0\u00a0 symptom logs need to at the very least include\u00a0 the date it happens the time is it eight in the\u00a0\u00a0 morning because some people are more irritable\u00a0 or in a better mood first thing in the morning\u00a0\u00a000:29:04<\/a>versus late at night and vice versa so what\u00a0 date does it occur what time does it occur\u00a0\u00a0 what triggered the symptom if known or if there\u00a0 were distressful thoughts what was the theme\u00a0\u00a0 what was the intensity of the experience if\u00a0 they’re having a flashback or if they’re having\u00a0\u00a000:29:25<\/a>an anxiety attack was it a one i noticed\u00a0 it but wasn’t a big deal was it a two\u00a0\u00a0 i noticed it it was uncomfortable but i managed\u00a0 to get through it was it a three it was really\u00a0\u00a0 difficult to keep moving forward while i was\u00a0 having this symptom or was it a four and in a\u00a0\u00a000:29:51<\/a>four the symptom is just all-encompassing\u00a0 and they can’t continue doing what they were\u00a0\u00a0 it kind of shuts them down for a minute\u00a0 how long did it last was it five minutes\u00a0\u00a0 or five hours how did it impact their energy\u00a0 mood productivity relationships said another\u00a0\u00a000:30:12<\/a>another way how did it impact those things that\u00a0 are important in their rich and meaningful life\u00a0\u00a0 what vulnerabilities and this goes to that\u00a0 backward chaining what vulnerabilities were\u00a0\u00a0 present if they had an anxiety reaction were they\u00a0 over caffeinated or dehydrated or was their blood\u00a0\u00a000:30:31<\/a>sugar low or were they in a particular environment\u00a0 that they tend to find stressful anyway\u00a0\u00a0 what did they do to cope was it effective\u00a0 and what do they want to try to do the next\u00a0\u00a0 time maybe they want to do the same thing\u00a0 the next time because it was effective\u00a0\u00a000:30:48<\/a>great if it wasn’t effective they may\u00a0 choose to try to do something else\u00a0\u00a0 if the symptom seems ever-present like anxiety\u00a0 some people feel anxious quote all the time okay\u00a0\u00a0 have them complete the log every hour\u00a0 that they’re awake now i know that seems\u00a0\u00a000:31:08<\/a>like a lot and if they’re working full time\u00a0 that might not be practical if they’re not\u00a0\u00a0 working it’s definitely doable if they’re in\u00a0 residential treatment it’s definitely doable\u00a0\u00a0 so you can adjust how often they do their\u00a0 check-ins but definitely every couple of hours00:31:30<\/a>once they get this information once they’ve\u00a0 got the data then it’s going to be important\u00a0\u00a0 to review the logs for themes in triggers and\u00a0 vulnerabilities i encourage people to make a\u00a0\u00a0 pictograph of the frequency intensity and duration\u00a0 of their symptom so they can get an idea of\u00a0\u00a000:31:50<\/a>how often is this happening and kind of how bad\u00a0 is it in this one you can see from 8 am to 9 am\u00a0\u00a0 the person was having an anxiety\u00a0 attack it lasted for a whole hour\u00a0\u00a0 which is why it’s as wide as it is and the entire\u00a0 time they were having it it was at a level of a\u00a0\u00a000:32:08<\/a>three so it felt pretty damn overpowering they\u00a0 still kept moving but it was really overpowering\u00a0\u00a0 and then at nine o’clock or 9 15 that went\u00a0 away and then at 10 30 they had another little\u00a0\u00a0 anxiety attack but that only was a one\u00a0 and it only lasted for about 30 minutes\u00a0\u00a000:32:34<\/a>and then at 12 30 12 45 whatever they had\u00a0 another one that was a big one i mean it was\u00a0\u00a0 all-encompassing full-out panic attack\u00a0 and that lasted for almost 30 minutes\u00a0\u00a0 so then when somebody brings this in\u00a0 i would talk with them and i would say\u00a0\u00a000:32:51<\/a>you know what were the triggers and maybe at\u00a0 8 a.m the person’s anxiety ramped up because\u00a0\u00a0 they knew they had to go to work and work is just\u00a0 really really a huge source of stress right now\u00a0\u00a0 or they knew they had to go to work and they were\u00a0 going to have to ride the subway and the subway\u00a0\u00a000:33:10<\/a>is one of their triggers from their trauma\u00a0 so their anxiety went up really really high\u00a0\u00a0 but then they got to work at nine o’clock\u00a0 everything was okay they de-escalated sweet\u00a0\u00a0 and then at 10 30 they had to go to a meeting\u00a0 with their boss and that was a little stressful\u00a0\u00a000:33:30<\/a>they got along with their boss fine so it’s not a\u00a0 big deal but it was a little bit stressful having\u00a0\u00a0 to do that and then at 12 30 that was after\u00a0 lunch was over and they were getting ready to\u00a0\u00a0 go back to work and they got cut off in traffic\u00a0 and it triggered an anxiety attack that lasted\u00a0\u00a000:33:54<\/a>20 or 30 minutes okay so by looking at this we\u00a0 can see how long they’re lasting and then we\u00a0\u00a0 can more granularly look back and go okay what’s\u00a0 triggering and see if there are themes that are\u00a0\u00a0 triggering anxiety at particular times of day or\u00a0 in particular places because that can help the\u00a0\u00a000:34:14<\/a>person gain more awareness and be better able to\u00a0 prepare or adjust in order to reduce their stress now you have a lot of these charts laying around\u00a0 that’s great you may be able to look at them\u00a0\u00a0 but it’s hard to really get see incremental\u00a0 progress when you’re still looking at four\u00a0\u00a000:34:39<\/a>or five episodes a day and they’re all\u00a0 still pretty high it’s hard to know\u00a0\u00a0 are we making progress are we reducing the\u00a0 frequency intensity or duration and you know\u00a0\u00a0 sometimes it may be obvious but sometimes it\u00a0 may not be i use a mathematical formula so\u00a0\u00a000:34:59<\/a>here the first block is 1.25 hours so for an\u00a0 hour and 25 minutes she was feeling you know huge\u00a0\u00a0 amounts of anxiety the intensity was at a level of\u00a0 a three so you can see 1.25 hours level of a three\u00a0\u00a0 and then the next one was at 10 30 that lasted\u00a0 half an hour it was an intensity of a one and\u00a0\u00a000:35:27<\/a>then we had this other one over here that was a\u00a0 half an hour that was in an intensity of a four\u00a0\u00a0 in order to take into account the frequency\u00a0 intensity and duration because we’re looking\u00a0\u00a0 for an overall improvement it doesn’t matter\u00a0 whether it’s frequency intensity or duration\u00a0\u00a000:35:46<\/a>i multiply the number of hours by the intensity\u00a0 and add it all up then their average anxiety\u00a0\u00a0 is the number of total hours\u00a0 they were feeling anxious\u00a0\u00a0 divided by the total intensity so the mathematical\u00a0 formula here was a 0.36 so if we had to\u00a0\u00a000:36:07<\/a>average out her anxiety over the entire day um\u00a0 what we would be looking at is a .36 remember one\u00a0\u00a0 is they’re they’re feeling it and ideally we\u00a0 don’t want people feeling anxious all day every\u00a0\u00a0 day so i’d like to see that a lot closer to a 0.0\u00a0 than a 0.3 but next week we would go through and\u00a0\u00a000:36:36<\/a>add up the data and do this again now for some\u00a0 people this could be too data-driven and i get\u00a0\u00a0 that so you can skip the mathematical formula if\u00a0 it’s not for you but i think the charts are at the\u00a0\u00a0 very least very helpful because people can really\u00a0 get a quick vision of do we see things going down00:37:02<\/a>now an alternative log if somebody feels like\u00a0 they are anxious all the time they’ve got\u00a0\u00a0 generalized anxiety then there’s not going\u00a0 to be any particular time that they have a\u00a0\u00a0 symptom or they have an episode it’s just kind\u00a0 of all the time so remember i said assessing it\u00a0\u00a000:37:21<\/a>on an hourly basis and this is a chart on an\u00a0 hourly basis if you do it every two hours then\u00a0\u00a0 it would adjust accordingly so each\u00a0 hour the person asks themselves\u00a0\u00a0 how am i feeling on a scale of one to four\u00a0 and we have three hours that it was a three\u00a0\u00a000:37:40<\/a>we have one hour that it was a three\u00a0 and a half and then you can see\u00a0\u00a0 that towards the evening towards the end\u00a0 of the day it actually went down to a one\u00a0\u00a0 we want to ask the person you know what\u00a0 was different at 3 pm then at 8 am what\u00a0\u00a000:37:58<\/a>was triggering your anxiety throughout the day\u00a0 and why did it go down at 3 pm but also why was\u00a0\u00a0 it still present at all at 3 pm what else\u00a0 is contributing or maintaining your anxiety\u00a0\u00a0 and maybe it’s just ruminating or anticipating\u00a0 having to go to work the next day i don’t know00:38:20<\/a>you can do the same mathematical formula here\u00a0 and for this person based on that chart their\u00a0\u00a0 average anxiety over the course of the day was a\u00a0 1.88 so they’re still feeling some pretty intense\u00a0\u00a0 anxiety and we would look for that number to\u00a0 gradually decrease over the course of treatment00:38:47<\/a>the next technique we’re going to talk about\u00a0 is systematic desensitization and ownership and\u00a0\u00a0 these are similar or similarly related techniques\u00a0 they’re not exactly the same but i lumped them\u00a0\u00a0 together systematic desensitization and ownership\u00a0 helps the person alter their reaction to triggers\u00a0\u00a000:39:04<\/a>or stimuli in the environment think about it\u00a0 like an allergy shot for cognitive allergens\u00a0\u00a0 it creates an environment of safety and\u00a0 empowerment when they start realizing\u00a0\u00a0 that things do not have to control them\u00a0 then they can start feeling more empowered\u00a0\u00a000:39:25<\/a>they mastered the ability to use breathing\u00a0 relaxation and distress tolerance skills to\u00a0\u00a0 down regulate their stress response when they\u00a0 feel triggered just because i smell this smell\u00a0\u00a0 just because i see this thing it may trigger a\u00a0 trauma feeling but i d it doesn’t have to consume\u00a0\u00a000:39:46<\/a>me i can address it i can help myself feel\u00a0 safe and i can get control of that situation so the example i use for systematic\u00a0 desensitization is snakes because a lot of people\u00a0\u00a0 have a fear of snakes but it can be anything the\u00a0 first step is to learn about the trigger learn\u00a0\u00a000:40:09<\/a>about whatever it is whether it’s snakes or flying\u00a0 or in the case of trauma triggers like the smell\u00a0\u00a0 of a particular cologne you may not have to learn\u00a0 a lot about that but you recognize that oh okay\u00a0\u00a0 the smell of this cologne triggers a trauma\u00a0 memory all right now what do i do about it\u00a0\u00a000:40:32<\/a>well we’re going to take away the power of\u00a0 that trigger we’re going to take away the\u00a0\u00a0 power of that stimulus so we have the person think\u00a0 about the stimulus and so think about the snake\u00a0\u00a0 or think about what that’s smelling that cologne\u00a0 and their anxiety is going to go up their stress\u00a0\u00a000:40:50<\/a>response is going to go up and then they’re\u00a0 going to use distress tolerance skills to trigger\u00a0\u00a0 the relaxation response to dampen that stress\u00a0 response so they can get into their wise mind\u00a0\u00a0 once they’re in their wise mind then they can\u00a0 effectively address the facts of the situation\u00a0\u00a000:41:10<\/a>in this situation at this time\u00a0 am i safe i smelled that smell\u00a0\u00a0 triggered my stress response all right i’m going\u00a0 to push down my stress reaction i’m going to\u00a0\u00a0 dampen my stress reaction get into my wise mind\u00a0 in this situation at this time does that smell\u00a0\u00a000:41:31<\/a>represent a threat to me or is it just\u00a0 somebody that walked past me in the store\u00a0\u00a0 the important thing is helping people\u00a0 get into their wise minds so they can\u00a0\u00a0 effectively evaluate the facts in the current\u00a0 context once they can think about a snake and\u00a0\u00a000:41:52<\/a>it doesn’t trigger that stress response they’ve\u00a0 been able to decouple that stress so just thinking\u00a0\u00a0 about it doesn’t trigger that response anymore\u00a0 then think about being in a room with a caged\u00a0\u00a0 snake so it’s not just some snake somewhere it’s\u00a0 a snake in the same room with you it’s in a cage\u00a0\u00a000:42:12<\/a>but it’s in the room and they go through the\u00a0 same process practicing imagining that and\u00a0\u00a0 down regulating their stress response until\u00a0 thinking about being in a room with a caged\u00a0\u00a0 snake doesn’t trigger that response think\u00a0 about being in a room with someone else holding\u00a0\u00a000:42:33<\/a>a snake so now the snake’s not even in a\u00a0 cage but somebody else is holding on to it\u00a0\u00a0 thinking about that we’re not nowhere\u00a0 near being in the same room with a snake\u00a0\u00a0 yet we’re just helping the person envision\u00a0 imagine these situations and learn how to\u00a0\u00a000:42:52<\/a>down regulate the stress response\u00a0 to their cognitions to their beliefs\u00a0\u00a0 think about petting a snake someone else\u00a0 is holding and then think about holding a\u00a0\u00a0 snake once a person can move through all\u00a0 of these things and it doesn’t trigger\u00a0\u00a000:43:11<\/a>their anxiety response it doesn’t trigger their\u00a0 stress response anymore then you can move toward\u00a0\u00a0 you know maybe going to a pet store where\u00a0 you’re in an environment with a caged snake\u00a0\u00a0 and again there would be more steps to\u00a0 desensitizing to that particular stressor\u00a0\u00a000:43:30<\/a>but it can be really helpful not again not only\u00a0 for snakes or spiders or planes or phobias but\u00a0\u00a0 also for other triggers so people can think about\u00a0 smelling that smell and then they can get to the\u00a0\u00a0 point where they can actually smell the smell and\u00a0 it doesn’t trigger that stress response for them00:43:56<\/a>in terms of ownership or immersion when\u00a0 you’re regularly exposed to something\u00a0\u00a0 and able to manage your response\u00a0 it loses much of its power\u00a0\u00a0 now this isn’t something that i recommend\u00a0 i don’t recommend flooding for people to do\u00a0\u00a000:44:12<\/a>on their own but it is a technique that people\u00a0 can use especially with what i call annoyance\u00a0\u00a0 triggers it’s not a trigger that triggers\u00a0 this cascade this flood of stress chemicals\u00a0\u00a0 but it’s enough to trigger a stress response\u00a0 it triggers their resentment their irritability00:44:33<\/a>if it is a smell or a saying\u00a0 sometimes people have have\u00a0\u00a0 success making it their own making it\u00a0 theirs to control so they start wearing\u00a0\u00a0 that particular perfume or they start using that\u00a0 particular scent to as a fragrance in their house\u00a0\u00a000:44:54<\/a>i had a client one time who had a significant\u00a0 other that had a particular saying\u00a0\u00a0 and every time he heard that saying after they\u00a0 broke up it just brought back a flood of memories\u00a0\u00a0 and just triggered his anger he’s like oh when\u00a0 people say that it makes me want to climb the wall\u00a0\u00a000:45:14<\/a>so i encouraged him for the next week\u00a0 to use it himself you start saying that\u00a0\u00a0 whenever you can you start saying that make it\u00a0 your own so it’s no longer associated with her\u00a0\u00a0 it’s something that you do and then if you don’t\u00a0 want to say it anymore after that that’s fine\u00a0\u00a000:45:32<\/a>associated with positive things like smells\u00a0 activities or holidays if something triggers a\u00a0\u00a0 stress response try to pair it with something else\u00a0 positive as much as possible and regularly expose\u00a0\u00a0 yourself to it while regulating your stress\u00a0 response and this is one i use for bridges\u00a0\u00a000:45:57<\/a>because i can’t get away from bridges where\u00a0 i live but i don’t like bridges however i’ve\u00a0\u00a0 gotten to the point where i can drive over them\u00a0 and they don’t really bother me that much anymore systematic desensitization\u00a0 should be undertaken with\u00a0\u00a000:46:15<\/a>care to prevent moving forward too quickly\u00a0 and causing additional anxiety or trump\u00a0\u00a0 re-traumatizing yourself it always starts with\u00a0 ensuring you feel safe and empowered and every\u00a0\u00a0 scenario needs to end with the person feeling\u00a0 safe and empowered so they feel safe and empowered\u00a0\u00a000:46:38<\/a>they imagine the stressful\u00a0 situation and then they de-escalate\u00a0\u00a0 before beginning any type of exposure\u00a0 even imaginary exposure it is essential\u00a0\u00a0 to have mastered the skills of distress\u00a0 tolerance and emotion regulation00:46:57<\/a>mindfulness is another wonderful\u00a0 cognitive behavioral tool\u00a0\u00a0 mindfulness means turning off autopilot\u00a0 and being non-judgmentally aware\u00a0\u00a0 of your thoughts feelings needs and behaviors\u00a0 in the present moment it helps connect thoughts\u00a0\u00a000:47:14<\/a>feelings and behaviors and promotes prevention\u00a0 and early intervention of distress think about\u00a0\u00a0 how operating on autopilot may contribute to\u00a0 sickness anger outbursts or relapses of depression so there are a lot of different kinds of\u00a0 mindfulness and the first one we’re going\u00a0\u00a000:47:37<\/a>to talk about is personal mindfulness start with\u00a0 being as being mindful as soon as you wake up in\u00a0\u00a0 the morning at each meal and before going to\u00a0 bed and for a lot of people that i work with\u00a0\u00a0 i encourage them to set push notifications to\u00a0 remind them to check in and be mindful i know\u00a0\u00a000:47:55<\/a>you need reminders to be mindful but\u00a0 each time they check in with themselves\u00a0\u00a0 throughout the day they ask themselves how do i\u00a0 feel physically how do i feel emotionally and why\u00a0\u00a0 what do i need right now to continue feeling great\u00a0 if they’re feeling awesome great keep it going\u00a0\u00a000:48:16<\/a>or improve the next moment if they’re\u00a0 feeling tired hungry run down anxious\u00a0\u00a0 checking in with themselves and figuring out what\u00a0 is it that i need to do to improve the next moment grounding can be thought of as another kind\u00a0 of mindfulness and it’s a technique to help\u00a0\u00a000:48:37<\/a>people feel connected to the present moment\u00a0 and not swept up by emotions or thoughts two\u00a0\u00a0 of the most common grounding activities\u00a0 are the 54321 and the describe an object\u00a0\u00a0 in 54321 when the person starts feeling stressed\u00a0 they identify five things they see four things\u00a0\u00a000:48:58<\/a>they hear three things they smell two things\u00a0 they feel and if possible one thing they taste describing an object can mean holding an object\u00a0 it can be your phone it can be your purse it can\u00a0\u00a0 be your grounding object and just describing it\u00a0 to yourself is it cold is it hot is it soft is\u00a0\u00a000:49:20<\/a>it bumpy whatever sensations you get from it but\u00a0 that encourages the brain to stay anchored in the\u00a0\u00a0 present moment which can help with dissociation\u00a0 it can help with anxiety and it can help with\u00a0\u00a0 triggering that relaxation response as\u00a0 people turn their attention away from the\u00a0\u00a000:49:44<\/a>anxiety provoking stimulus to what is helping them\u00a0\u00a0 stay relaxed in the moment i find the describing\u00a0 object is really helpful when i go in to get shots\u00a0\u00a0 because to this day i am terrified of needles\u00a0 but that helps me a lot i’ll be holding\u00a0\u00a000:50:02<\/a>a grounding object and thinking about\u00a0 what it feels like and all those things\u00a0\u00a0 so when i get the shot i’m not thinking about that\u00a0 i’m not anticipating it hurting i’m not tensing up general mindful awareness uh encourages\u00a0 people to be aware of the moment not just\u00a0\u00a000:50:26<\/a>themselves but the moment in general become more\u00a0 mindful in your actions as you’re doing them\u00a0\u00a0 what do you see what do you hear what do you smell\u00a0 when you’re out on a walk have that open awareness\u00a0\u00a0 where you’re just noticing anything that’s there\u00a0 it’s not necessarily good or bad you’re just\u00a0\u00a000:50:47<\/a>noticing it you’ll be surprised at all the\u00a0 things that you typically probably overlook and mindful reflection is an activity in which\u00a0\u00a0 people reflect on their activities at\u00a0 the end of the day by asking themselves\u00a0\u00a000:51:04<\/a>what did i do and for each of each thing that they\u00a0 did throughout the day was doing this an effective\u00a0\u00a0 use of my energy to move toward the things that\u00a0 are important in my rich and meaningful life\u00a0\u00a0 or was doing this whatever it was what a\u00a0 happy healthy successful person would do\u00a0\u00a000:51:26<\/a>some people like the rich and meaningful life\u00a0 you know does it help me move toward my goals\u00a0\u00a0 other people want to act as if fake it till\u00a0 you make it as they say so they ask themselves\u00a0\u00a0 was i acting like a person who was happy\u00a0 healthy and successful would have acted examples\u00a0\u00a000:51:48<\/a>you know when you’re reflecting on the\u00a0 day if you got sucked into video games\u00a0\u00a0 for three or four hours it’s easy to do asking\u00a0 yourself was this an effective use of my time\u00a0\u00a0 to move me toward my rich and meaningful life if\u00a0 you were playing video games with your best friend\u00a0\u00a000:52:06<\/a>and it was good bonding time well then maybe it\u00a0 was if not maybe it wasn’t you know it’s up to\u00a0\u00a0 each individual to decide was this important\u00a0 is this something that you really like doing\u00a0\u00a0 is it a hobby does it promote relaxation well\u00a0 then maybe it was an effective use of energy\u00a0\u00a000:52:25<\/a>you can do the same thing for dwelling\u00a0 on resentments or eating unhealthfully\u00a0\u00a0 was it effective at helping\u00a0 you move towards your goals\u00a0\u00a0 was it something that a happy healthy\u00a0 successful person would typically do00:52:43<\/a>an ounce of prevention is worth a pound of\u00a0 cure mindfulness is essential to health and\u00a0\u00a0 well-being because it can help you become your\u00a0 own consistently empathetic responsive best friend\u00a0\u00a0 it can help you become more aware of the situation\u00a0 and notice the good and the beauty in in life\u00a0\u00a000:53:02<\/a>in addition to the stressors and also become\u00a0 more aware of how how you’re using your energy\u00a0\u00a0 and whether it is moving you\u00a0 forward or keeping you stuck authenticity is the next tool we’re going to\u00a0 talk about and i love authenticity it means being\u00a0\u00a000:53:22<\/a>true to yourself people often become inauthentic\u00a0 because they’re trying to get approval from others\u00a0\u00a0 their self-esteem is low so they’re looking\u00a0 for somebody else to tell them they’re okay\u00a0\u00a0 they may be inauthentic because they’re afraid\u00a0 of being rejected abandoned or in today’s society\u00a0\u00a000:53:42<\/a>cancelled or they may be inauthentic because\u00a0 they’re just operating on autopilot they’re not\u00a0\u00a0 acting mindfully they have always just kind of\u00a0 done whatever happens and hadn’t haven’t really\u00a0\u00a0 stopped to think about is this me is this me\u00a0 being authentic or is this me just being impulsive00:54:04<\/a>i use the metaphor for chocolate\u00a0 chip cookies when i talk about\u00a0\u00a0 relationships and when i talk about authenticity\u00a0\u00a0 when you have chocolate chip cookies you’ve got\u00a0 sugar cookies and you’ve got chocolate chips\u00a0\u00a000:54:17<\/a>both of them are just fine on their own thank\u00a0 you very much one doesn’t pretend to be the other\u00a0\u00a0 they are authentic in who they are now if you\u00a0 put them together in relationships when you\u00a0\u00a0 have two authentic people that join together you\u00a0 can get something that is potentially infinitely\u00a0\u00a000:54:35<\/a>better than either one of those things all\u00a0 by themselves because they enhance each other\u00a0\u00a0 they don’t complete each other they’re already\u00a0 complete by themselves they enhance one another when you’re practicing on authenticity it’s\u00a0 important to become mindful of your thoughts\u00a0\u00a000:54:56<\/a>feelings and needs and act in accordance with them\u00a0 instead of being a chameleon so mindfulness is a\u00a0\u00a0 precursor to authenticity it’s also important to\u00a0 help people separate approval or disapproval of\u00a0\u00a0 behaviors from themselves not everybody’s going to\u00a0 like what you do if you’re behaving authentically\u00a0\u00a000:55:18<\/a>not everybody may like your choices but does that\u00a0 mean they dislike you or they dislike your choice it’s important for people to ex explore and\u00a0 address their fears related to being authentic and\u00a0\u00a0 a lot of people have fears about being authentic\u00a0 for very legit reasons these days unfortunately\u00a0\u00a000:55:41<\/a>and if it is an office because of that radical\u00a0 authenticity or being yourself a hundred percent\u00a0\u00a0 of the time may not be safe for everybody in every\u00a0 situation so it’s important that they practice\u00a0\u00a0 being assertive and authentic sharing themselves\u00a0 with safe other people first and then deciding\u00a0\u00a000:56:05<\/a>is it important for me to be authentic here is it\u00a0 important for me to be authentic on social media\u00a0\u00a0 is it important for me to be a hundred percent\u00a0 authentic at work and only the individual can\u00a0\u00a0 figure that out and if they can’t\u00a0 be a hundred percent authentic\u00a0\u00a000:56:24<\/a>is that an environment that’s\u00a0 healthy for them to be in\u00a0\u00a0 and again only they can decide but that’s part of\u00a0 the empowerment of cognitive behavioral therapy\u00a0\u00a0 helping people recognize that they are\u00a0 good enough they are deserving of love\u00a0\u00a000:56:40<\/a>they are in a position they are empowered to help\u00a0 keep themselves safe and that also means safe from\u00a0\u00a0 harm from others and safe from others being\u00a0\u00a0 mean to them if you will if they’re authentic\u00a0 from taking away their authentic selves00:57:03<\/a>authenticity means moving from what moving from\u00a0 being aware of thoughts wants and needs to acting\u00a0\u00a0 in a way that’s in accordance with them so if you\u00a0 know that you like italian over mexican food or\u00a0\u00a0 that’s what you want an authentic person would\u00a0 be mindful they would recognize hey i want to go\u00a0\u00a000:57:25<\/a>for italian food and they would tell people that\u00a0 they would assert that if you’re being inauthentic\u00a0\u00a0 then you may know that you have a craving for\u00a0 italian food but you know what no i don’t care\u00a0\u00a0 where we go i don’t have any preference well\u00a0 that’s inauthentic yes you do have a preference\u00a0\u00a000:57:45<\/a>being authentic can be scary at first and is\u00a0 often advisable to not advisable to suddenly\u00a0\u00a0 start practicing what i call radical authenticity\u00a0 which can make the person feel really vulnerable\u00a0\u00a0 not suddenly deciding that okay starting today\u00a0 i am going to be a hundred percent authentic\u00a0\u00a000:58:05<\/a>all the time that is a radical shift not only\u00a0 for the individual but for everybody around\u00a0\u00a0 them and it could upset the apple cart\u00a0 so to speak it may take people a minute\u00a0\u00a0 to get used to someone suddenly becoming\u00a0 authentic so which can set them up\u00a0\u00a000:58:26<\/a>for not so great reactions from significant others\u00a0 but also when you’re authentic you’re putting\u00a0\u00a0 your true self out there you’re making yourself\u00a0 vulnerable and making yourself vulnerable can\u00a0\u00a0 be extremely scary especially for people with\u00a0 a history of abandonment rejection or trauma\u00a0\u00a000:58:46<\/a>so it is important to use this with care\u00a0 yes it’s great when people feel like they\u00a0\u00a0 can be authentic but it’s something that\u00a0 a lot of times people need to build up to as people become more authentic have them notice\u00a0 how it impacts their mental and physical health00:59:09<\/a>thought stopping is the next tool thought\u00a0 stopping helps us redirect our brain and we can\u00a0\u00a0 engage in thought stopping by simply telling\u00a0 ourself no not now not thinking about it\u00a0\u00a0 sometimes that helps sometimes people need to\u00a0 replace the thought with a mantra a prayer or\u00a0\u00a000:59:30<\/a>grounding activities to sort of drown out whatever\u00a0 that thought is to turn their attention if the\u00a0\u00a0 thought keeps coming back okay then ask yourself\u00a0 what’s the benefit to ruminating on this thought\u00a0\u00a0 why does it keep coming back why do i keep feeling\u00a0 like i need to think about this is there anything\u00a0\u00a000:59:54<\/a>that the person can do to address the thought and\u00a0 improve the issue at this moment so for example if\u00a0\u00a0 you’re waiting on test results from the doctor\u00a0 that aren’t going to be in for another six days\u00a0\u00a0 what’s the benefit to ruminating on that why\u00a0 does it keep coming back is there anything you\u00a0\u00a001:00:12<\/a>can addre do to address the thought in the moment\u00a0 and the answer is no you just gotta wait and be\u00a0\u00a0 patient so sometimes people will write it down and\u00a0 put it into their thought box a lot of times it\u00a0\u00a0 can be helpful for people who have um persistent\u00a0 thoughts ruminations whatever you want to call\u00a0\u00a001:00:32<\/a>call it they write these things down and then they\u00a0 schedule 30 minutes a day that’s their worry time\u00a0\u00a0 so these thoughts pop up and instead of saying\u00a0 no i’m not going to think about it ever it’s\u00a0\u00a0 no i’m not going to think about that right now\u00a0 i will think about it this afternoon during my\u00a0\u00a001:00:50<\/a>worry period encourage people to start small\u00a0 try to stop having the thought for five minutes\u00a0\u00a0 and if they make it to five minutes then great\u00a0\u00a0 thought may come back let’s try 10 minutes now\u00a0 see if you can make it 10 minutes without thinking\u00a0\u00a001:01:06<\/a>about it and it can be empowering to the person to\u00a0 recognize that they are getting better at learning\u00a0\u00a0 how to stop some of those annoying thoughts\u00a0 or those annoying voices that want to chime in perspective taking is another tool look\u00a0 perspective taking means looking at the\u00a0\u00a001:01:30<\/a>bigger picture to understand the reactions of\u00a0 other people as sometimes as well as yourself you\u00a0\u00a0 know stepping back and trying to get a different\u00a0 perspective there are four p’s in perspective\u00a0\u00a0 taking predisposing what were the background\u00a0 factors that contributed to the behavior whether\u00a0\u00a001:01:49<\/a>it’s another person or yours if the client has a\u00a0 history of trauma that’s one of those predisposing\u00a0\u00a0 factors that may contribute to them reacting with\u00a0 fear or anger in particular situations for example\u00a0\u00a0 precipitating factors so\u00a0 you have somebody who’s been\u00a0\u00a001:02:13<\/a>exposed to trauma somebody who’s endured trauma\u00a0 and so they already have an hpa axis that’s\u00a0\u00a0 you know turned on they already\u00a0 tend to be more hyper vigilant\u00a0\u00a0 precipitating factors are vulnerabilities and\u00a0 contextual factors that precipitate their reaction\u00a0\u00a001:02:31<\/a>they have this history and then they’re in a\u00a0 situation in which they feel somewhat unsafe\u00a0\u00a0 they’re in this situation where there’s lots of\u00a0 hustle and bustle maybe they’re at the airport\u00a0\u00a0 and there’s just lots of people going around\u00a0 and bumping into one another and they start\u00a0\u00a001:02:46<\/a>feeling really stressed out because it is feels\u00a0 like an unsafe environment they feel vulnerable\u00a0\u00a0 provocations what provoked or triggered that\u00a0 behavior and if you’re talking about trying to\u00a0\u00a0 understand somebody else’s reaction then looking\u00a0 at your own behavior and saying in what way might\u00a0\u00a001:03:08<\/a>i have inadvertently provoked that behavior\u00a0 and i say inadvertently because a lot of times\u00a0\u00a0 we may trigger somebody’s anger and we didn’t even\u00a0 mean to we didn’t maybe we didn’t think clearly\u00a0\u00a0 before we said something or maybe we have no idea\u00a0 what we did to trigger that person’s behavior\u00a0\u00a001:03:27<\/a>but recognizing um that there\u00a0 may be something that we did okay\u00a0\u00a0 doesn’t mean we meant to and plans if you\u00a0 reacted with anger or anxiety and you regret it\u00a0\u00a0 recognizing where that came from and asking\u00a0 yourself well did i have good intentions did\u00a0\u00a001:03:50<\/a>i go into this situation saying yeah i’m\u00a0 just going to be kind of nasty about this\u00a0\u00a0 or did i have good intentions but the\u00a0 predisposing precipitating and provoking factors\u00a0\u00a0 led me in a different way same thing with\u00a0 when you’re dealing with somebody else\u00a0\u00a001:04:09<\/a>if you’re interacting with them and they react\u00a0 strongly to something that you say it’s important\u00a0\u00a0 to ask yourself you know why are they perceiving\u00a0 it differently than i am what predisposing factors\u00a0\u00a0 what historical or experiences might they\u00a0 have had that caused them to interpret this\u00a0\u00a001:04:27<\/a>situation differently in what way might have\u00a0 i have inadvertently provoked the behavior\u00a0\u00a0 and did the person really\u00a0 ultimately have good intentions\u00a0\u00a0 they may have not intended to get into an\u00a0 argument with you but it just it ended up there01:04:49<\/a>self forgiveness is the next tool we’re going\u00a0 to talk about remember that forgiveness does not\u00a0\u00a0 mean that you agree or condone the situation\u00a0 or what happened but you’re choosing to stop\u00a0\u00a0 using your energy to beat yourself up the\u00a0 four r’s of self forgiveness responsibility\u00a0\u00a001:05:11<\/a>yeah you need to take responsibility for\u00a0 the aspects that you’re responsible for\u00a0\u00a0 but that’s it only take responsibility for the\u00a0 aspects that you’re responsible for if something\u00a0\u00a0 happened between you and someone else as they say\u00a0 it takes two to tango there are probably a lot of\u00a0\u00a001:05:29<\/a>other factors that were out of your control take\u00a0 responsibility for what you’re responsible for\u00a0\u00a0 the second r is remorse well if you’re work\u00a0 working on forgiveness then you do feel remorseful\u00a0\u00a0 you feel guilty but just feeling guilty keeps\u00a0 you beating yourself up guilt is self-anger so\u00a0\u00a001:05:51<\/a>feeling remorse is your body’s way of saying okay\u00a0 here’s some energy now you can use this energy\u00a0\u00a0 to learn from this situation so you can stay safe\u00a0 in the future or you can fix the mistake you made\u00a0\u00a0 which takes us to rectifying or making\u00a0 amends what do you need to do to\u00a0\u00a001:06:12<\/a>fix this situation make amends or just learn from\u00a0 it sometimes you can’t fix it and the final r\u00a0\u00a0 is releasing past hurt and accepting\u00a0 imperfection forgiving yourself and\u00a0\u00a0 saying all right you screwed up it doesn’t\u00a0 make you less lovable it just means you’re\u00a0\u00a001:06:32<\/a>human you’re fallible you’re imperfect and\u00a0 you forgive yourself you’re going to choose\u00a0\u00a0 to not continue using energy beating yourself\u00a0 up for something that you have rectified and taken responsibility for01:07:00<\/a>forgiving others is very similar forgiveness\u00a0 still means choosing to stop giving energy\u00a0\u00a0 to that person or memory\u00a0 that is causing you distress\u00a0\u00a0 forgiveness can involve recalling the betrayal\u00a0 recal recalling what happened that is causing\u00a0\u00a001:07:19<\/a>you to feel angry or resentful explore why\u00a0 you might be afraid to forgive them why are\u00a0\u00a0 you wanting to hold on to this energy why\u00a0 are you afraid to learn and let go altruism\u00a0\u00a0 visualize forgiving this person as a gift to\u00a0 yourself and your significant others i’m forgiving\u00a0\u00a001:07:42<\/a>this person over here so i’m not tying all my\u00a0 energy up in it anymore which is great because now\u00a0\u00a0 i have all this energy freed up that i can give to\u00a0 myself and my significant others learn from it and\u00a0\u00a0 adjust your expectations sometimes people ain’t\u00a0 gonna change therefore recalling the betrayal\u00a0\u00a001:08:05<\/a>what happened and what do you need to\u00a0 learn so you don’t get hurt in the future living in the and is another tool\u00a0 that can be helpful for forgiving\u00a0\u00a0 you can have a rich and meaningful life\u00a0\u00a001:08:21<\/a>and not be able to trust this person anymore\u00a0 if that’s what has to happen it doesn’t mean\u00a0\u00a0 you’re going to continue to be angry at them you\u00a0 you’ve just learned that they’re not trustworthy\u00a0\u00a0 so living in the and means you can have a rich\u00a0 and meaningful life and forgive other people01:08:42<\/a>sometimes it’s easier to\u00a0 forgive smaller things first it can help to empathize without minimizing\u00a0 you can empathize and try to understand\u00a0\u00a0 why somebody did what they did maybe\u00a0 even have compassion or pity for them\u00a0\u00a001:08:58<\/a>but not minimize it you’re not saying oh i\u00a0 have pity for you i understand why it happened\u00a0\u00a0 and you know i guess it wasn’t really that bad no\u00a0\u00a0 i i can empathize with what you were going through\u00a0 and maybe why you reacted with such anger however\u00a0\u00a001:09:18<\/a>this is how it impacted me and i am not\u00a0 going to diminish the impact it had on me\u00a0\u00a0 just because you were going through a bad thing\u00a0 so i’m going to empathize without minimizing safely share your feelings this isn’t always\u00a0 possible but sometimes it can be helpful to safely\u00a0\u00a001:09:38<\/a>share your feelings with that person or maybe\u00a0 even with your higher power or just your journal\u00a0\u00a0 but sometimes you need to get them out sometimes\u00a0 there are things that quote need to be said that\u00a0\u00a0 are going to keep bouncing around in your head\u00a0 until you can say them so say them in a safe way\u00a0\u00a001:09:58<\/a>and then practice thought stopping even\u00a0 after you’ve chosen to forgive somebody\u00a0\u00a0 every once in a while that resentment or that\u00a0 anger is going to creep back up and you’re\u00a0\u00a0 going to remember what happened and that’s when\u00a0 thought stopping comes in handy and you can say\u00a0\u00a001:10:13<\/a>nope handled that already not going to revisit it and then the abcdes of cbt a and if\u00a0 you remember back to basic cognitive\u00a0\u00a0 behavioral therapy this is one of your basic\u00a0 tools a is the activating event what happened\u00a0\u00a001:10:38<\/a>c is the consequences of the activating event\u00a0 and we want to consider all of the consequences\u00a0\u00a0 not just your emotional reaction but your physical\u00a0 reaction your cognitive reaction how did it change\u00a0\u00a0 the way you think about people and the world your\u00a0 relationship reaction how did it change the way\u00a0\u00a001:10:59<\/a>you feel about your ability or the trustworthiness\u00a0 of people in the world so the activating event and\u00a0\u00a0 the consequences but between the time that\u00a0 something happens and you get angry or that\u00a0\u00a0 hpa axis that stress response gets triggered you\u00a0 have a litany of automatic beliefs that come from\u00a0\u00a001:11:19<\/a>schema come from past experiences your brain’s\u00a0 going okay let me tell you how to interpret this\u00a0\u00a0 a lot of times these beliefs because they’re\u00a0 based on past experiences may not be a hundred\u00a0\u00a0 percent accurate in the present context which\u00a0 is why we go down to d after you’ve identified\u00a0\u00a001:11:40<\/a>what those beliefs are then you dispute each\u00a0 one of them based on the facts in the current\u00a0\u00a0 context is this belief still a hundred percent\u00a0 accurate based on the facts in the current context once you’ve identified what is actually true\u00a0 in the current context then you can evaluate\u00a0\u00a001:12:02<\/a>the effectiveness of your reactions for helping\u00a0 you use your energy and time to move toward your\u00a0\u00a0 rich and meaningful life so okay maybe something\u00a0 happens it triggers rage in you you get really\u00a0\u00a0 angry that somebody did something you go\u00a0 through your beliefs and you dispute them and\u00a0\u00a001:12:22<\/a>you determine yeah you know they betrayed me it\u00a0 was a big hurt okay so evaluate the effectiveness\u00a0\u00a0 of your reaction is holding on to anger is\u00a0 dwelling and stewing on anger and holding\u00a0\u00a0 on to this resentment is that an effective\u00a0 use of your time and energy to help you move\u00a0\u00a001:12:43<\/a>towards your rich and meaningful life or would\u00a0 something like forgiveness be a more helpful tool cognitive distortions is another\u00a0 basic cognitive behavioral therapy\u00a0\u00a0 tool that we look at and there are five maybe six\u00a0 uh big ones that frequently come up when i work\u00a0\u00a001:13:08<\/a>with people and all or none thinking this person\u00a0 always does this or this person never does this\u00a0\u00a0 i encourage people to pay attention to their\u00a0 cognitive distortions to their um extreme\u00a0\u00a0 language and if they say always or never to\u00a0 reframe that and start saying sometimes or often\u00a0\u00a001:13:34<\/a>look for exceptions if you say that\u00a0 jane never calls when she’s going to\u00a0\u00a0 be late look back are there exceptions\u00a0 are there times when jane did call\u00a0\u00a0 personalization means taking what somebody\u00a0 else does personally it’s my fault\u00a0\u00a001:13:51<\/a>or they looked at me with this horrible\u00a0 look they must be angry at me what are\u00a0\u00a0 three alternatives that have nothing to do with\u00a0 you magnification or catastrophing which means\u00a0\u00a0 making a mountain out of a molehill or assuming\u00a0 that the worst case scenario is going to happen\u00a0\u00a001:14:10<\/a>look at the facts in the situation based\u00a0 on the facts how accurate is your belief\u00a0\u00a0 minimization is the same way and sometimes\u00a0 people will minimize the impact of drinking\u00a0\u00a0 for example and that can be faulty if they are\u00a0 having if they’re in recovery for alcoholism\u00a0\u00a001:14:33<\/a>they may also minimize their strength\u00a0 and their power and their ability to\u00a0\u00a0 move towards their goals they may\u00a0 minimize their own effectiveness\u00a0\u00a0 and so it’s important to look at the facts is\u00a0 it true that you are powerless in this situation01:14:54<\/a>and then assuming can be broken down into\u00a0 mind reading and jumping to conclusions\u00a0\u00a0 a lot of times when people grew up in\u00a0 dysfunctional environments they learn\u00a0\u00a0 to try to anticipate other people’s needs in\u00a0 order to get approval and prevent punishment\u00a0\u00a001:15:10<\/a>and they carry that with them into adulthood\u00a0 unfortunately it’s not common to be able to\u00a0\u00a0 effectively read other people’s minds open\u00a0 communication is a whole lot more effective\u00a0\u00a0 so if you are mind reading if you’re assuming\u00a0 that you know what somebody is thinking\u00a0\u00a001:15:31<\/a>or wanting check it out what are the facts what\u00a0 do you actually know versus what are you assuming\u00a0\u00a0 related is jumping to conclusions maybe your\u00a0 best friend doesn’t text you back or stands you\u00a0\u00a0 up for lunch a lunch date that you made three\u00a0 weeks ago you jumped to the conclusion that um\u00a0\u00a001:15:54<\/a>something terrible happened and she’s as my mother\u00a0 would always say lying dead in a ditch somewhere\u00a0\u00a0 um that’s jumping to conclusions so\u00a0 look at the facts based on what you know\u00a0\u00a0 you don’t know why they didn’t\u00a0 show up for your lunch date01:16:13<\/a>when i’m working with clients\u00a0 i have a cognitive distortions\u00a0\u00a0 worksheet that i give them and i encourage\u00a0 them to go through it when they have\u00a0\u00a0 stress when they feel anxious when they feel angry\u00a0 when they feel distressed they write down what the\u00a0\u00a001:16:30<\/a>activating event was what the trigger was and then\u00a0 b is the beliefs they write down those beliefs\u00a0\u00a0 and then they evaluate each one of\u00a0 those beliefs for cognitive distortions alternate problem formulation is another cool\u00a0 one or i think it is and i use the mnemonic\u00a0\u00a001:16:52<\/a>peace corps for this and this kind of puts\u00a0 together a lot of what we’ve been talking about\u00a0\u00a0 so the person identifies the problem they identify\u00a0 early experiences they’ve had that may impact how\u00a0\u00a0 they perceive the situation so maybe they have\u00a0 their um anxious around authority figures that’s\u00a0\u00a001:17:14<\/a>the problem early experiences we look back\u00a0 at early experiences with authority figures\u00a0\u00a0 well not so good so yeah it makes sense why this\u00a0 person might have anxiety around authority figures\u00a0\u00a0 a stands for assumptions rules and attitudes\u00a0 what are your assumptions about people who\u00a0\u00a001:17:34<\/a>are in authority positions based on your early\u00a0 experiences so you’re seeing how this is all\u00a0\u00a0 starting to connect our past helps us try to\u00a0 interpret the present but it’s not always a\u00a0\u00a0 hundred percent accurate so we need to understand\u00a0 why am i assuming this to be true c is core\u00a0\u00a001:17:57<\/a>beliefs what are your core beliefs about people\u00a0 if you have core beliefs that people are only\u00a0\u00a0 out for themselves and they’ll throw you under the\u00a0 bus any chance they get then you’re going to feel\u00a0\u00a0 less trusting and probably be more apprehensive\u00a0 than if you think that people are altruistic01:18:16<\/a>e stands for effectiveness of\u00a0 assumptions core beliefs and reactions\u00a0\u00a0 based on all this stuff in the current\u00a0 context how effective are my assumptions and\u00a0\u00a0 core beliefs at helping me function and then\u00a0 the core part is looking at that context in\u00a0\u00a001:18:35<\/a>with the facts that i have in this context at this\u00a0 time what are my options to handle the situation\u00a0\u00a0 what resources do i have to\u00a0 help me handle the situation\u00a0\u00a0 if i do the things that are within my control\u00a0 that i have options and resources for what’s\u00a0\u00a001:18:55<\/a>the probability that things are going\u00a0 to go well and where can i find support another technique that i really like is tragic\u00a0 optimism and this can be you um summarized in\u00a0\u00a0 the mnemonic crab grass and i like crabgrass\u00a0 because it is an example of tragic optimism\u00a0\u00a001:19:21<\/a>i don’t know if it grows in the northern states\u00a0 but in the southern states we have this weed\u00a0\u00a0 that we call crabgrass and it will take over your\u00a0 lawn it is just a bugger and a half to get rid of\u00a0\u00a0 but it tends to be very resistant to heat and\u00a0 weather and it stays green for a really long time\u00a0\u00a001:19:41<\/a>so if your goal is to have a green lawn crab grass\u00a0 can be really freaking awesome if your goal is to\u00a0\u00a0 have this perfect fescue or bermuda grass lawn\u00a0 then yeah crabgrass is not your friend but so\u00a0\u00a0 tragic optimism means embracing the good with the\u00a0 bad recognizing the current situation and saying\u00a0\u00a001:20:06<\/a>all right it is what it is what do i\u00a0 want is there hope that it can get better\u00a0\u00a0 and um so you start out by creating a vision what\u00a0 is your vision of your rich and meaningful life\u00a0\u00a0 tragic optimism doesn’t mean ignoring the\u00a0 bad it means acknowledging the bad saying\u00a0\u00a001:20:24<\/a>okay this happened this sucks maybe in my rich\u00a0 and meaningful life i would be able to work\u00a0\u00a0 on the farm until i was 80 years old but\u00a0 hey i had to have both knees replaced\u00a0\u00a0 okay so my vision of being able to\u00a0 work on the farm until i’m 80 years old\u00a0\u00a001:20:45<\/a>may not be doable anymore so radically acceptance\u00a0 right radically accepting what’s going on\u00a0\u00a0 all right i had to have my knees replaced\u00a0 it is what it is therefore uh how can i\u00a0\u00a0 have a rich and meaningful life and have\u00a0 some knees that don’t work as well anymore\u00a0\u00a001:21:08<\/a>and that is the our part of crabgrass so i see\u00a0 what i want i recognize what is and then i try to\u00a0\u00a0 figure out okay how can i mesh these two together\u00a0 how can i still have a rich and meaningful life\u00a0\u00a0 and accept this adversity a stands for anticipate\u00a0 the positive a lot of times we can get stuck in\u00a0\u00a001:21:34<\/a>the negative anticipating the positive means\u00a0 trying to find hope trying to find compromise\u00a0\u00a0 in what’s going on instead of anticipating the\u00a0 worst b stands for be present be aware be mindful\u00a0\u00a0 of what’s going on how you feel in the moment\u00a0 and then address it if like the example i gave\u00a0\u00a001:21:57<\/a>your vision for your rich and meaningful\u00a0 life suddenly took a hard left turn okay\u00a0\u00a0 well acknowledging that and radically accepting it\u00a0 living in the end that’s all well and good but you\u00a0\u00a0 may also have some grief that you’ve got to deal\u00a0 with so being present helps you identify and say01:22:18<\/a>i hear all that i see all that is logical but i\u00a0 also need to acknowledge how i’m feeling right now g stands for growth and learning this is\u00a0 an unfortunate experience how can i use it\u00a0\u00a0 as a growth experience what can i learn\u00a0 from it in order to improve my life\u00a0\u00a001:22:40<\/a>r is realistic goals and expectations okay well\u00a0 maybe i can’t work independently on the farm until\u00a0\u00a0 i’m 80 years old but what can i do i can still\u00a0 have chickens i may not be riding horses anymore\u00a0\u00a0 but i can still have chickens i can still do\u00a0 some gardening so those are realistic goals\u00a0\u00a001:22:59<\/a>based on the new reality radical\u00a0 acceptance of the new reality\u00a0\u00a0 a stands for affirm yourself one step\u00a0 at a time when something bad happens\u00a0\u00a0 we want it to go away we want to feel better but\u00a0 we generally don’t go from misery to exhilaration\u00a0\u00a001:23:18<\/a>like that so affirming yourself recognizes um\u00a0 and acknowledges the positive steps you’re taking\u00a0\u00a0 toward adjusting to this new situation s is find\u00a0 solutions to the problem any problems that come up\u00a0\u00a0 because you’re having to make some adjustments and\u00a0 then the final s is in serenity accepting what can\u00a0\u00a001:23:47<\/a>and cannot be changed you know in the example i’m\u00a0 using you can’t get back your 20 year old knees\u00a0\u00a0 so if you don’t have that you can’t get that\u00a0 back you have to accept that that cannot be\u00a0\u00a0 changed and potentially again process it\u00a0 through grief for whatever you need to do01:24:10<\/a>challenging questions face palm when we start to\u00a0 feel distressed when we start to feel overwhelmed\u00a0\u00a0 it’s important to evaluate our beliefs what\u00a0 are the facts for and against your belief\u00a0\u00a0 not your assumptions not emotional reasoning\u00a0 what are the facts for and against your belief\u00a0\u00a001:24:31<\/a>what additional factors need to be considered\u00a0 like the context like the other people that\u00a0\u00a0 were there like whatever what else contributed to\u00a0 the situation and how it turned out what is the\u00a0\u00a0 context of the situation and are you using extreme\u00a0 language are you using all or nothing words01:24:57<\/a>p stands for probability or likelihood\u00a0 if you’re having this belief that’s\u00a0\u00a0 catastrophic that’s stressful in nature\u00a0 what is the probability or likelihood\u00a0\u00a0 that the worst case scenario is going to\u00a0 play out a stands for alternate explanations\u00a0\u00a001:25:16<\/a>what are some alternate explanations for why this\u00a0 might be happening or what might have happened\u00a0\u00a0 because sometimes we assume we know what happened\u00a0 and why it happened and that’s not it i mean think\u00a0\u00a0 about a car you can take it into a mechanic and he\u00a0 says oh it’s the compressor and he changes out the\u00a0\u00a001:25:32<\/a>compressor and the air conditioner still doesn’t\u00a0 work and he’s like oh well what are some alternate\u00a0\u00a0 explanations learn from it and move forward and\u00a0 moving forward can be really difficult because whatever triggered that feeling triggered that\u00a0 stress response and it’s important to learn\u00a0\u00a001:25:56<\/a>how you’re safe learn what you have power over\u00a0 and recognize that you do have the power to\u00a0\u00a0 move forward it may come back and visit you\u00a0 occasionally but you can stop those thoughts radical acceptance and i love\u00a0 the mnemonic well i created it so\u00a0\u00a001:26:18<\/a>uh face it um f stands for fact for and against\u00a0 your belief radical acceptance means accepting\u00a0\u00a0 the moment as it is it is what it is and if\u00a0 that phrase bugs you you know you may want to\u00a0\u00a0 look at why but a lot of times that phrase bugs\u00a0 people because they don’t like accepting things\u00a0\u00a001:26:42<\/a>they don’t like not having complete\u00a0 control over things but sometimes you don’t\u00a0\u00a0 it is what it is okay so what are the facts for\u00a0 and against your belief what is going on right now\u00a0\u00a0 a is acceptance that radical acceptance\u00a0 embracing the present and acknowledging\u00a0\u00a001:27:03<\/a>that it is what it is and you don’t have to\u00a0 like it but you may not be able to change it\u00a0\u00a0 by recognizing this you eliminate should you\u00a0 eliminate saying well it shouldn’t be this\u00a0\u00a0 way or it should be this way it’s not it just is\u00a0 which also helps you reduce the amount of energy\u00a0\u00a001:27:24<\/a>wasted being angry over something that you don’t\u00a0 like in the moment and you have no control over c stands for control once you’ve identified\u00a0 the facts and accepted them then you can\u00a0\u00a0 identify which aspects of the situation\u00a0 you can control which ones you can’t\u00a0\u00a001:27:46<\/a>and the best way to use your\u00a0 energy to cope with the situation\u00a0\u00a0 continue to worry stay angry miserable is\u00a0 that helpful what aspects can you control\u00a0\u00a0 how can you change your situation or the\u00a0 way you feel about the situation and then e\u00a0\u00a001:28:05<\/a>stands for evaluate the effectiveness\u00a0 of your choices so you’re facing it successive approximations and scaffolding is\u00a0 another tool that i have used a lot and i really\u00a0\u00a0 love successive approximations means striving\u00a0 to get a little bit better or closer to the goal\u00a0\u00a001:28:28<\/a>every single time so maybe if you’re learning how\u00a0 to shoot free throws you know the first time you\u00a0\u00a0 shoot the ball and it just whiffs completely\u00a0 misses the backboard the rim everything all\u00a0\u00a0 together all right well then you practice and\u00a0 the next time you get the ball up there and\u00a0\u00a001:28:47<\/a>it grazes the rim that’s better it’s closer the\u00a0 next time it hits the backboard but bounces off\u00a0\u00a0 okay and then the fourth time you hit it up\u00a0 there and it actually sinks in the bucket\u00a0\u00a0 now for most people it’s not going to be a 1 2\u00a0 3 4 like that but you get the analogy that i’m\u00a0\u00a001:29:09<\/a>making successive approximations means looking\u00a0 for a little bit of improvement every single time\u00a0\u00a0 scaffolding goes along with\u00a0 successive approximations\u00a0\u00a0 and means letting somebody do something up until\u00a0 the point they need help the goal is to prompt\u00a0\u00a001:29:26<\/a>successive approximations so they get a little bit\u00a0 better and need a little less help each time think\u00a0\u00a0 if you’ve ever tried to teach your kid to tie\u00a0 their shoes you know tying shoes can be difficult\u00a0\u00a0 so the first you want to get them so they\u00a0 can slide the shoe on their foot that’s the\u00a0\u00a001:29:44<\/a>first step and then it’s crisscrossing the laces\u00a0 and pulling them tight and then making the bow\u00a0\u00a0 and then the rabbit goes around the tree and\u00a0 then pulling the ear through you know how it\u00a0\u00a0 goes when you’re trying to teach children to\u00a0 tie their shoes there’s a lot of steps in it\u00a0\u00a001:30:02<\/a>but you want to let them do as much as they\u00a0 can because that helps them feel empowered\u00a0\u00a0 that helps them feel more capable and that\u00a0 helps them learn how to do it and then once\u00a0\u00a0 they get to the point where they’re stuck then\u00a0 you can either talk them through it or take over\u00a0\u00a001:30:22<\/a>and then the next time hopefully\u00a0 they’ll get a little bit further\u00a0\u00a0 but this can be applied to things like tying shoes\u00a0 washing clothes learning a computer program school\u00a0\u00a0 work folding a fitted sheet one of the banes of\u00a0 my existence or even things like anger management01:30:43<\/a>heartiness is represented by commitment control\u00a0 and challenge and this is a concept that was\u00a0\u00a0 proposed way back in 1978 but it’s still true\u00a0 and useful today commitment means identifying\u00a0\u00a0 all of the things in your rich and meaningful\u00a0 life to which you are committed that you are\u00a0\u00a001:31:05<\/a>that are important to you that you\u00a0 want to devote your time and energy to\u00a0\u00a0 looking at that so you may have your house you\u00a0 may have your garden you may have your animals and\u00a0\u00a0 your kids and your friends and your job and you\u00a0 know all these things out here well that’s great\u00a0\u00a001:31:22<\/a>at any one point in time it’s likely that every\u00a0 single one of them is probably not going perfectly\u00a0\u00a0 but heartiness encourages us instead of focusing\u00a0 on the one sliver of the pie that’s going bad\u00a0\u00a0 to acknowledge the part of the pie that’s going\u00a0 bad and recognize everything that’s going well\u00a0\u00a001:31:44<\/a>which helps buffer so we don’t feel hopeless\u00a0 overwhelmed dejected sometimes people\u00a0\u00a0 will do this can chart this out using a\u00a0 pie chart where each part of their life\u00a0\u00a0 that’s going good is shaded in green and each\u00a0 part that’s not going well is shaded in red\u00a0\u00a001:32:03<\/a>other times people have used green and red\u00a0 solo cups you know the little plastic cups\u00a0\u00a0 and they’ve put marbles or rocks representing\u00a0 each thing that’s important to them\u00a0\u00a0 in the cups accordingly and hopefully the\u00a0 green solo cup ends up with filled up more\u00a0\u00a001:32:23<\/a>with a lot more rocks than the red solo cup so\u00a0 people have a visual representation of hey you\u00a0\u00a0 know yes this stuff over here is going crappy\u00a0 but look at all this stuff that’s going well c stands for control of those things the ones\u00a0 that are going crappy as well as the ones that\u00a0\u00a001:32:44<\/a>are going well what aspects can you control the\u00a0 things that are going well how can you continue\u00a0\u00a0 to use your energy to keep those things going\u00a0 well the things that are going crappy how can\u00a0\u00a0 you use your energy to help them improve if at all\u00a0 and challenge instead of seeing it as a barrier\u00a0\u00a001:33:08<\/a>that keeps you from moving toward your rich and\u00a0 meaningful life seeing things that are not going\u00a0\u00a0 so well as a challenge recognizing the ways that\u00a0 you’ve endured difficult situations in the past\u00a0\u00a0 and then like an athlete constantly strives\u00a0 to get stronger better or faster how can this\u00a0\u00a001:33:28<\/a>experience be seen as a challenge to help you\u00a0 strengthen the skills that you already have\u00a0\u00a0 to get around or over or under this\u00a0 particular obstacle that’s in your path playing the tape through is another one that\u00a0 i really like too often we make decisions or\u00a0\u00a001:33:50<\/a>assumptions based on emotions we feel angry\u00a0 we feel anxious we want to fight or flee\u00a0\u00a0 so we do things out of anger or anxiety\u00a0 instead of instead of our wise mind playing\u00a0\u00a0 the tape through means considering all\u00a0 the factors and options both in the short\u00a0\u00a001:34:07<\/a>and the long term so it’s kind of like\u00a0 playing a game of chess with in life it’s important to beta test\u00a0 before acting or reacting for example quitting a job maybe you hate\u00a0 your job and you want to quit your job and\u00a0\u00a001:34:29<\/a>in the short term oh my gosh that would\u00a0 be such a relief that’s that’s true but\u00a0\u00a0 play the tape through what are the long-term\u00a0 consequences of quitting your job right now\u00a0\u00a0 or maybe you have difficulty being around people\u00a0 places or things that are triggering or you you\u00a0\u00a001:34:51<\/a>choose to be around people places or things that\u00a0 are triggering maybe you’re somebody who’s in\u00a0\u00a0 recovery from alcoholism and you start minimizing\u00a0 and say and rationalizing and saying oh you know i\u00a0\u00a0 haven’t had a drink in two years so i can go meet\u00a0 my friends at a bar and i’ll just have club soda\u00a0\u00a001:35:10<\/a>that’s rationalizing you want to play the tape\u00a0 through you think you can but in the long run\u00a0\u00a0 how likely is that to happen what are the\u00a0 potential consequences of taking that risk decisional balance activities are it’s\u00a0 a chart that is proposed and used a lot\u00a0\u00a001:35:34<\/a>in motivational interviewing and when you\u00a0 practice decisional balance you encourage\u00a0\u00a0 people to look at the benefits and the drawbacks\u00a0 not only to change but also to staying the same\u00a0\u00a0 the benefits to change well helping them figure\u00a0 out why is it that they want to change that one\u00a0\u00a001:35:53<\/a>seems pretty obvious you know how is it going to\u00a0 help them feel better physically get more sleep be\u00a0\u00a0 healthier have more energy feel happier improve\u00a0 their relationships improve their finances you\u00a0\u00a0 know okay all those things so that one may seem\u00a0 pretty obvious but then we want to talk about what\u00a0\u00a001:36:10<\/a>are the drawbacks to change and sometimes people\u00a0 look at me like i’m crazy when i ask them that\u00a0\u00a0 but the goal is to try to figure out what things\u00a0 might get in their way what might prevent them\u00a0\u00a0 from changing what might make them decide you\u00a0 know what it’s not worth all this effort so what\u00a0\u00a001:36:31<\/a>are the drawbacks and we go again through what\u00a0 emotionally how are you going to feel what are\u00a0\u00a0 what’s scary or anxiety provoking about change\u00a0 physically when we’re talking about addiction\u00a0\u00a0 one of the drawbacks to change physically\u00a0 is the withdrawal symptoms okay well how\u00a0\u00a001:36:50<\/a>can we mitigate those so they’re not quite as\u00a0 intense so they don’t make you as miserable\u00a0\u00a0 interpersonally what are the drawbacks to\u00a0 change sometimes when people change it means\u00a0\u00a0 they lose some friends or change their social\u00a0 circle and that can be really intimidating\u00a0\u00a001:37:08<\/a>financially what are the drawbacks to change\u00a0 well we’re talking about addiction for example\u00a0\u00a0 residential treatment can be really expensive in\u00a0 the short term but in the long term um maybe not\u00a0\u00a0 and then legally if there\u00a0 are any legal consequences\u00a0\u00a001:37:28<\/a>and then you do the same thing for staying the\u00a0 same what are the benefits to staying the same\u00a0\u00a0 what do you like about what you’re doing now and\u00a0 then what are the drawbacks to staying the same\u00a0\u00a0 and by going through all four of these\u00a0 quadrants by breaking it down very granularly\u00a0\u00a001:37:46<\/a>you can help people identify\u00a0 their motivations for change\u00a0\u00a0 and then areas that you need to address\u00a0 that might serve as obstacles to change dialectics radical acceptance and cognitive\u00a0 restructuring means embracing the positive\u00a0\u00a001:38:06<\/a>and negative aspects of a situation dog hair\u00a0 and sometimes i’ve mentioned in other videos\u00a0\u00a0 that around my house it feels like i’m trying\u00a0 to brush my teeth and eat oreos at the same time\u00a0\u00a0 because we have three dogs and four cats and two\u00a0 teenagers and so our house is always needing to\u00a0\u00a001:38:26<\/a>be dusted which drives me crazy i i don’t like\u00a0 dust and and dog hair and everything all around\u00a0\u00a0 but i love my animals more and if i have a\u00a0 completely sterile house that would be beautiful\u00a0\u00a0 but i wouldn’t have my animals and that would\u00a0 break my heart i can’t imagine living without\u00a0\u00a001:38:49<\/a>animals so yeah the dog hair not\u00a0 ideal but the love of my animals\u00a0\u00a0 is much more important feeling vulnerable in\u00a0 a relationship well when you start to care\u00a0\u00a0 about somebody you’re going to often feel more\u00a0 vulnerable and that can be anxiety provoking\u00a0\u00a001:39:10<\/a>but feeling vulnerable and that little bit of\u00a0 anxiety also means that you care about somebody so\u00a0\u00a0 embracing the good with the bad and recognizing\u00a0 you can’t have one without having the other\u00a0\u00a0 or feeling anxiety or distress when\u00a0 doing particular therapy activities\u00a0\u00a001:39:30<\/a>therapy recovery treatment whatever\u00a0 you want to call it often involves debriding at least old wounds opening\u00a0 up old wounds and doing it carefully\u00a0\u00a0 obviously is important but i’ve never worked\u00a0 with somebody in the 20 some odd years that\u00a0\u00a001:39:50<\/a>i’ve been practicing that the entire time\u00a0 we’ve worked together it’s been a cakewalk\u00a0\u00a0 if we did i wouldn’t be\u00a0 doing my job the whole goal\u00a0\u00a0 is to process those issues and those traumas\u00a0 that bring up sadness or fear or even anger\u00a0\u00a001:40:06<\/a>and work through them so yeah it’s uncomfortable\u00a0 to feel some of those feelings sometimes\u00a0\u00a0 but once you process them then you’re able to move\u00a0 forward so you can’t have one without the other and autobiography can be really helpful and you\u00a0 can do autobiographies a lot of different ways\u00a0\u00a001:40:28<\/a>from the adult self assuming\u00a0 you’re working with an adult\u00a0\u00a0 they write their autobiography that’s the way we\u00a0 usually do it i’ve also had people write their\u00a0\u00a0 autobiography from someone else’s perspective\u00a0 if have write your autobiography as if your\u00a0\u00a001:40:44<\/a>mother or your grandmother or your best friend\u00a0 were telling me all about you so it’s writing your\u00a0\u00a0 biography so to speak or they can write their\u00a0 autobiography autobiography from their child\u00a0\u00a0 self perspective and obviously this just goes up\u00a0 through a certain period of time but going back\u00a0\u00a001:41:05<\/a>to maybe when that trauma happened or before\u00a0 that trauma happened having them write their\u00a0\u00a0 autobiography from the perspective of that five or\u00a0 six year old you know what were they seeing what\u00a0\u00a0 were they feeling what were they experiencing and\u00a0 then seeing how that changes as the child grows01:41:27<\/a>you can also engage in letter writing and i use\u00a0 the term letters but in this day and age you can\u00a0\u00a0 write old-fashioned letters by hand you can type\u00a0 them you can do videos or you can even practice\u00a0\u00a0 what we call a gestalt therapy empty chair\u00a0 technique any of these what you’re doing is\u00a0\u00a001:41:46<\/a>you’re getting words and thoughts out of your\u00a0 head and putting them out here you can write\u00a0\u00a0 letters to your future self to your past self\u00a0 or to other people from your past maybe they\u00a0\u00a0 were really important to you or maybe they were\u00a0 really traumatizing to you but you got something\u00a0\u00a001:42:04<\/a>to say to them you can write these letters to any\u00a0 of these people in the voice of your past self so\u00a0\u00a0 maybe the six-year-old that was neglected\u00a0 needs to write a letter to their caregiver\u00a0\u00a0 you can write it in the voice of your present\u00a0 self so as a 26 year old you can write a letter\u00a0\u00a001:42:28<\/a>uh in the voice of your present self telling\u00a0 your past person what happened or telling your\u00a0\u00a0 past self what happened you know you’re in\u00a0 the present writing a letter to your past\u00a0\u00a0 self or writing a letter to your child self\u00a0 or even your future self or you can write\u00a0\u00a001:42:50<\/a>it in the voice of your future self you can\u00a0 imagine yourself as being happy healthy and\u00a0\u00a0 in that rich and meaningful life writing a letter\u00a0 to your present self about the things that you\u00a0\u00a0 learned or the changes that you made so how are\u00a0 you different in your rich and meaningful life\u00a0\u00a001:43:08<\/a>there’s a lot of different permutations of\u00a0 this and i encourage you to get creative journaling kind of similar you can journal by\u00a0 just doing a daily reflection like writing a diary\u00a0\u00a0 you can keep symptom logs some people\u00a0 aren’t into the whole prose thing\u00a0\u00a001:43:29<\/a>you can practice mindful journaling so sitting\u00a0 down in the moment and spending 10 15 minutes\u00a0\u00a0 writing what you’re thinking\u00a0 seeing hearing feeling\u00a0\u00a0 you can journal about a particular feeling\u00a0 happiness so you’re going to write about the\u00a0\u00a001:43:46<\/a>things that make you happy or the things that\u00a0 make you angry you can keep a gratitude journal\u00a0\u00a0 or journal from the perspective of the inner\u00a0 child the manager or the firefighter and these are\u00a0\u00a0 archetypes if you will from internal family\u00a0 systems theory the inner child is the part of\u00a0\u00a001:44:06<\/a>you that may have experienced trauma and is still\u00a0 scared and is still sort of huddling back in the\u00a0\u00a0 corner so that child may come out and journal and\u00a0 talk about what it feels like for them right now\u00a0\u00a0 the manager is the part of you that just tries to\u00a0 get things done and they tend to be less emotional\u00a0\u00a001:44:29<\/a>and more practical and putting one foot in front\u00a0 of the other but they can get frustrated by the\u00a0\u00a0 inner child that is you know fussing and anxious\u00a0 and needy and the firefighter who is the emotion\u00a0\u00a0 response who’s constantly trying to just make\u00a0 it stop hurting and you know throw water on it\u00a0\u00a001:44:51<\/a>or you can write it from the perspective\u00a0 of the firefighter that gets exhausted by\u00a0\u00a0 getting called out all the time you can do\u00a0 journals in text or in video or audio format\u00a0\u00a0 you can change if you’re writing it you can\u00a0 change your writing utensils you can use a\u00a0\u00a001:45:09<\/a>pen or a pencil or a crayon or even\u00a0 charcoal you can make your journals\u00a0\u00a0 verbal where you’re writing words or graphic\u00a0 where you’re scrapbooking or drawing things guided imagery is one of the final\u00a0 techniques we’re going to talk about\u00a0\u00a001:45:32<\/a>but guided imagery can be used for emotional or\u00a0 physical pain people can be helped to envision\u00a0\u00a0 a dial like a knob on the television i guess\u00a0 we don’t have those anymore but you understand\u00a0\u00a0 um on the stove we still have knobs on a lot\u00a0 of stoves where they’re turning it down they\u00a0\u00a001:45:52<\/a>actually turn down the intensity the\u00a0 volume of their emotional or physical pain\u00a0\u00a0 they can envision their emotion or their physical\u00a0 pain as a color and maybe it starts out as red\u00a0\u00a0 and then it turns to blue or it starts out as\u00a0 completely opaque and you just can’t even see\u00a0\u00a001:46:13<\/a>the thing that’s hurting and if it’s\u00a0 your elbow it’s your elbow if it’s an\u00a0\u00a0 emotion maybe it’s your heart it’s red and\u00a0 opaque and you can’t see anything and then\u00a0\u00a0 as the pain goes away it becomes more and\u00a0 more transparent until it goes away completely01:46:31<\/a>nanobots you can tell i watch science fiction but\u00a0 or or your helper t cells or your immune system\u00a0\u00a0 you can envision your body healing itself\u00a0 or sometimes you can envision like if you’re\u00a0\u00a0 having anxiety you can envision a wave coming\u00a0 over you and just whooshing it away sometimes\u00a0\u00a001:46:54<\/a>it can be helpful to be sitting under a fan\u00a0 when you do that but guided imagery can take\u00a0\u00a0 just about any form somebody wants it to take\u00a0 how would you see this getting better and then\u00a0\u00a0 encouraging them helping them actually\u00a0 see it getting better envisioning it\u00a0\u00a001:47:12<\/a>you can use guided imagery for anticipatory\u00a0 anxiety too if somebody has to do a speech\u00a0\u00a0 or they’re anticipating something that’s stressful\u00a0 or they’re anticipating heaven forbid the death\u00a0\u00a0 of a loved one you can help them use guided\u00a0 imagery to envision themselves successfully\u00a0\u00a001:47:31<\/a>navigating that situation it may not be you\u00a0 know all ribbons and roses and butterflies\u00a0\u00a0 but they can start to feel more empowered\u00a0 feel more capable of handling that situation you can use guided imagery for growth you can\u00a0 right before you go to sleep you can envision\u00a0\u00a001:47:52<\/a>what you want to do better or how you want\u00a0 to be tomorrow you can start reprogramming\u00a0\u00a0 your subconscious right before you\u00a0 go to sleep and then when you wake up\u00a0\u00a0 theoretically that has been imp imprinted on your\u00a0 subconscious a little bit now it’s not going to do\u00a0\u00a001:48:10<\/a>things like overnight but they have done\u00a0 a lot of research that has shown that\u00a0\u00a0 meditating or using guided imagery\u00a0 to change your subconscious is most\u00a0\u00a0 effective if done right before sleep and\u00a0 then guided imagery for sleep and the old\u00a0\u00a001:48:30<\/a>counting sheep thing that most of us told our kids\u00a0 to do is an example of guided imagery the person\u00a0\u00a0 is closing their eyes and they’re envisioning\u00a0 they’re seeing this image of sheep jumping over\u00a0\u00a0 a fence and that guided imagery can help them\u00a0 trigger their relaxation response and focus their\u00a0\u00a001:48:50<\/a>attention on a pleasant safe empowering scene\u00a0 instead of going all over the place and thinking\u00a0\u00a0 about the meeting they’ve got tomorrow and what\u00a0 happened today and this that and the other thing and health literacy can’t end something on with\u00a0 cognitive behavioral therapy without talking about\u00a0\u00a001:49:14<\/a>education and cognitions part of cognitive\u00a0 behavioral therapy is helping people understand\u00a0\u00a0 the connection between their mind and their\u00a0 body or their thoughts and their symptoms\u00a0\u00a0 helping them understand the\u00a0 connection between their thoughts\u00a0\u00a001:49:30<\/a>their feelings how they perceive the world\u00a0 and how they react and helping them learn\u00a0\u00a0 and understand the connection between their\u00a0 past experiences and their present reactions it’s also important for a lot of people especially\u00a0 those who encounter trauma early on to understand\u00a0\u00a001:49:52<\/a>to be educated about the impact of cognitive\u00a0 development on their perceptions children think\u00a0\u00a0 differently than adults children tend to think\u00a0 in all or nothing terms and very personally very\u00a0\u00a0 egocentrically so whatever happened the\u00a0 way i perceive it must be the way it is\u00a0\u00a001:50:10<\/a>whatever happened is all my fault and it’s all or\u00a0 nothing so if people’s perceptions when they were\u00a0\u00a0 children were formed that way and formed that way\u00a0 around trauma then in the present they may still\u00a0\u00a0 perceive things in very um extreme terms so we\u00a0 need to help them understand that those schema\u00a0\u00a001:50:35<\/a>that were formed when you were going through that\u00a0 trauma when you were developing were very normal\u00a0\u00a0 because that’s how a nine-year-old that’s how\u00a0 an eight-year-old thinks in the present you have\u00a0\u00a0 different abilities your brain actually changes\u00a0 as you get older so maybe we can re revisit that01:50:58<\/a>cognitive behavioral therapy is not appropriate\u00a0 for everybody but for many trauma survivors it\u00a0\u00a0 can be helpful to have practical tools to better\u00a0 understand address and respond to their thoughts\u00a0\u00a0 feelings and behaviors in context so they don’t\u00a0 feel like these flashbacks and feelings come out\u00a0\u00a001:51:17<\/a>from out of nowhere and they’re powerless against\u00a0 them trauma-informed cognitive behavioral therapy\u00a0\u00a0 always empowers the person to learn about the\u00a0 tool decide whether it’s one that they want to use\u00a0\u00a0 and arrive at their own conclusions when\u00a0 evaluating thoughts beliefs and perceptions
Source : Youtube<\/a><\/div><\/div>","protected":false},"excerpt":{"rendered":"

https:\/\/www.youtube.com\/watch?v=PIPtMcieu4QCEUs are available at AllCEUs.com\/CBT-CEU everybody and welcome to this video\u00a0 on 35 trauma-informed cognitive\u00a0\u00a0 behavioral therapy techniques\u00a0 i’m your host dr donnelly snipes00:00:10as the title implies in this video we’re going to\u00a0 review 35 cognitive behavioral therapy tools that\u00a0\u00a0 can be used to help people feel safer and more\u00a0 empowered now if you’re looking … Continue reading Supercharge Your Therapy Sessions: 35 Essential CBT Tools for Trauma<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":152222,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[192],"tags":[],"class_list":["post-152221","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-transportation"],"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/effectsofanxiety.net\/wp-content\/uploads\/2024\/03\/1709495822-maxresdefault.jpg","_links":{"self":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/152221","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/comments?post=152221"}],"version-history":[{"count":0,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/152221\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media\/152222"}],"wp:attachment":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media?parent=152221"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/categories?post=152221"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/tags?post=152221"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}