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4 years ago · · Comments Off on How to Find an Effective Therapist? · Sticky

How to Find an Effective Therapist?

What are the most common myths, and what qualities should you look for.

Therapy helps millions of people around the world to cope and to improve the quality of their lives. But finding a good therapist can be tricky. Especially if a person is doing it for the first time.

How can someone tell if the therapist they’ve approached will be effective and help them?

Before describing the qualities of a good therapist, I want to mention few myths, which people still believe about psychologists, therapists, or counselors.

  1. Myth: “My therapist use only orthodox, scientifically approved techniques.” Many people think that if a particular psychological school or technique has been around for a long time, it is definitely effective. But psychotherapy is not an exact science like medicine or math, so when a therapist uses only “science techniques,” it doesn’t mean that they are effective.

2. Myth: “My therapist is a published author. They’ve written many books on psychology or counseling”. Writing books and doing empirical research is essential, but just because someone is an abundant writer doesn’t mean that they can be an efficient therapist.

3. Myth: “My therapist has a doctoral degree, so they should be good”. Of course, degrees and credentials are important, but many counselors and therapists don’t have them, yet they are highly effective. A flashy diploma on the wall is not the best way to select a good therapist.

As I mentioned above, psychotherapy is not an exact science. It is an interpersonal process of building trust, developing client-counselor relationships, and providing a safe space to address very personal problems.

So how to select an effective therapist?

Simple!

Look for some of the following qualities in your potential therapist: 

  • An effective therapist is a knowledgeable, caring, and empathetic person who understands that successful psychotherapy is first and foremost a kind and trusting relationship between client and therapist.
  • An effective therapist is sensitive to their client’s suffering. They listen to understand, show empathy and acceptance.
  • An effective therapist starts by focusing on the client’s personal and cultural needs to decide the best therapeutic approach.
  • An effective therapist is always client-centered. They continuously gather information and feedback from the client to determine if their approach meets the client’s needs. 
  • An effective therapist is culturally and socially aware of their client’s background. They know that there isn’t a “one fits all” solution and are always open to learning from their clients. They realize that the client’s own potential is the driving power behind a successful therapy.

4 years ago · · Comments Off on How to overcome the “I am not good enough” syndrome? · Sticky

How to overcome the “I am not good enough” syndrome?

Self-limiting beliefs can hamper our lives in multiples ways. One of the most common I’ve encountered in my practice is the “I am not good enough.” Added to that, I have my own experience with it. For years, I was struggling, and I could not fully enjoy my achievements because I thought I wasn’t good enough. I was dismissing compliments, saying I “got lucky,” and doubt my choices. This situation put me in a constant hellish circle of work/ try harder, not good enough, anxiety, depression, and all over again. It took me years to get out of it, and here are a few tools that helped me, and they are helping my clients.

  1. Acknowledge your self-doubt.

When you start feeling “I am not good enough,” don’t just ignore the feeling and bury it. Address it, “speak” kindly to yourself, and reject the unrealistic, negative thought.

2. Acknowledge your strengths.

Look at your accomplishments, write them down, and you will see that those weren’t just “lucky breaks.” You’ve worked hard to achieve them. Make a list of all of them and look at it every time you feel low.

3. Find your passions and share them with others.

We tend to downplay the levels of knowledge and experience we have acquired. Find a way to share your passions with others; when you do this, you will constantly remind of your accomplishments.

4. Learn to accept compliments.

People who struggle with “not good enough” limiting belief tend to shrug off a compliment. They tend to minimize their accomplishments. When someone acknowledges your good work, learn to say “thank you” and savor the feeling.  

5. Give yourself permission to slack and fail.

Struggling to be “good enough” can lead to burnout. Give yourself time just to play around, and don’t take yourself too seriously. Practice your hobbies; without an objective to achieve, enjoy the here and now moment.

6. Seek professional help.

If, despite your best efforts, you continue to suffer with “not good enough” syndrome, get professional help. A good therapist can help you overcome it because if left unchecked, feeling like this can lead to anxiety and depression.

4 years ago · · Comments Off on Myths about anxiety · Sticky

Myths about anxiety

Understanding anxiety can be tricky. There are many myths and misconceptions about how it presents itself and how people who suffer from anxiety behave.

Myth #1

You can always tell if someone is having an anxiety attack.

This statement can’t be further from the truth. For people who have suffered and managed anxiety for years, expressive suppression has become the norm. They can look calm and composed on the outside, while their heart is racing, and they feel sick in their stomach. Even if an observer notices the visual symptoms of blushing and sweating, they may not be able to link it to the notion that the other person has an anxiety attack.  

Myth # 2

If someone is feeling anxious in a particular situation, they will feel anxious in a similar situation.

A person’s behavior is not something that happens in a vacuum. There are lots of factors, which affect who somebody will react to a stressful situation. For example, being in a good mood and having a good night’s sleep improve one’s ability to face an anxiety-provoking situation or task.  

Myth # 3

If a person has an anxiety attack, you have to calm them down.

It is upsetting seeing someone having an anxiety or panic attack. Especially if it is a friend or family member, however, the most common “Cool down, relax, all will be ok” response can backfire and make the situation worse:

  1. Because the anxious person may not actually hear them, the mind and body responses to anxiety can dim down our cognitive responses to reason.
  2. If they hear you, they may misinterpret your words as dismissing their suffering.
  3. Practically it is useless advice, as no one can simply relax on command, advice, or suggestion.  

Myth # 4

People who suffer from anxiety are fragile and weak.

On the contrary – people with anxiety are some of the strongest people out there. They get-up day after day to face situations that scare and hurt them. Sometimes they consciously face tasks and situations, which trigger anxiety to learn to overcome them. They face their fears; they seek therapy and follow-through, so they can live the life they want.

Myth # 5

Suffering from anxiety is not a big deal.

Let’s face it, everyone at one time or another had experience anxiety or irrational fear. And because everyone has felt it, they think they know what a person with an anxiety disorder is feeling. They don’t realize that the anxiety alters all enjoyable aspects of their life in a pretty bad way for such a person. They don’t realize the self-judgment, the feeling that you are afraid of fear itself. So, yes, anxiety IS a big deal! But is also treatable, and manageable with a proper therapy. If you or someone you know is suffering from anxiety, seek help and start living your life to the fullest.

4 years ago · · Comments Off on A counselor tips for dealing with the stress of uncertainty

A counselor tips for dealing with the stress of uncertainty

2020 will go in history books as the poster year of uncertainty. The whole world faced challenges, and we weren’t prepared for them. And while some people can deal with uncertainty better than others, in the end, no one can avoid the unexpected. Here are a few simple tips on how psychologists and therapists handle stress and anxiety caused by uncertainty.

Avoid rethinking things you can’t control. Humans are cognitively wired to imagine and revisit the worst-case scenarios. But is the situation you are facing is not under your level of control, the only “benefit” you will get from reviewing it will be an additional stress.

Control what you can. Keep your focus and energy on things you can control, even if it is a simple task like waking up on time or cooking a meal at home. Create a new routine. By bringing structure into daily tasks, your mind finds comfort by recognizing something stable and constant.

Take your own advice. Look at yourself from a different perspective. If a friend was in your situation, how would you advise and comfort them? If they trust your wisdom, why can’t you use it on yourself? And this brings us to the next…

Be kind to yourself. Remind yourself that the situation you are facing is something that you weren’t ready to address. It may take time to get resolved. By trial and error, we all learn by experience, and if you fail at first, don’t be too hard on yourself.

Dedicate time for self-care. Higher levels of stress can cause physical health problems, like headaches, insomnia, and loss of appetite. Make a conscious effort to practice self-care by eating well, exercise, meditate, do yoga. Stress can cause loss of motivation, but keep in mind that sometimes motivation comes after the initial struggle.

Limit your exposure to bad news. It can be a bit tricky, considering we are bombarded with information in every corner of our lives. However, dwelling on negative news doesn’t make us more informed, just more stressed out. Make the conscious decision to change the channel or close the browser tab.

Reflect on past achievements. Self-motivation can be extremely helpful in difficult situations. And what’s better than recalling how you successfully handled challenging and stressful circumstances in the past? Give yourself credit that you survived and learned from your hardship.

Learn new skills. Make an effort to learn something new. It can be anything – studying a new language, learning how to cook, or even getting a new degree. Acquiring new skills will improve your confidence and reduce stress levels.

Ask for help and seek support from people you trust. Constant stress can cause waves of depression and self-isolation. Ensure you reach out to your social support systems like family and friends or look for the professional help from counselors and therapists. A professional can help you develop the best strategies for coping with stress.

4 years ago · · Comments Off on Defense Mechanisms

Defense Mechanisms

Defense mechanisms are a type of behavior, which people use to separate themselves from unpleasant feelings, thoughts, or situations.  Most of the time, those behavioral responses are used unconsciously. Being aware of them can help to choose which one to apply in a particular situation.  

Denial

When a situation or circumstance becomes too much for us to handle, we may refuse to acknowledge it and deny the situation’s existence. By denying the reality of the events we face, we attempt to protect ourselves from having to face with (or take responsibility for) the unpleasant consequences we are experiencing. If we make up stories to justify our responses, actions and behaviors, this is us utilizing denial as a defense mechanism. It’s important to note that while this avoidance strategy might alleviate some short-term pain, in the long run, denial will prevent us from making those positive changes we need to make and will often have other undesired ramifications. As you may imagine, denial is a primitive defense mechanism. No one disregards reality and gets away with it for long!

Repression

There’s a fine line between denial and repression. Where denial involves the (often adamant) refusal to accept a given reality, repression involves our completely forgetting an experience (or, the part we play in an undesired life outcome we experience). With repression, our mind unconsciously decides to bury a memory, thereby preventing painful thoughts from entering our awareness. This is often the case with cases of child abuse or other traumatic events that occur early on in our learning and developmental years. While repression (much like denial), might serve our immediate purposes, (especially for those who witness traumatic experience). If we don’t eventually accept and rationally process the experience, it can have adverse consequences later on down the line.

Acting out

Acting out is performing extreme behavior to express thoughts or feelings we feel incapable of otherwise expressing. Instead of saying, “I’m angry with you right now,” those who act out might instead “kick the cat”, throw an object at someone, or even punch a hole in the wall. Acting out serves as a ‘pressure release’, and often helps those who subscribe to this defense mechanism feel instantly calmer within themselves. For example, children have a temper tantrum when they don’t get what they want from a parent. In the same way, adults get angry and break things or abuse people when they don’t have a more sophisticated strategy for getting the things that they want.

Dissociation

Dissociation is when a person steps out of their perspective and lives life from the standpoint of another to dissociate from the reality of a hurtful memory or life event. Those who dissociate often lose track of time, or themselves and the role they have played in their processes and memories. People who have a history of childhood abuse often subscribe to some form of dissociation. In extreme cases, dissociation can lead to a person believing their perceived reality rather than reality in actuality. People who use dissociation often have a disconnected view of themselves and the part they play in their world. A person who dissociates will often ‘disconnect’ from reality for a time and live in a different reality that’s not cluttered with the feelings or memories that are so unbearable to them. Dissociation is an excellent responsibility avoidance strategy.

Displacement

Have you ever endured a stressful day at work, then come home and take out your frustration on your family or friends? What about a time where you argued with your partner, then got in your car and found your patience being stretched with every other driver on the road? With displacement, we transfer our emotions from the person who is the target of our frustration onto someone else or something else that has nothing to do with our original offence. Displacing our frustrations allows us to avoid confronting the source of our grievances and shift our focus towards another person or situation that is less intimidating to us. While displacement might protect us from losing a job, burning a bridge, or doing some irreparable damage, it won’t help us to manage any negative emotions we’re harboring. Displacement usually ends up hurting something (or someone) who hasn’t even wronged us.

Projection

Imagine yourself in a situation where you feel out of your depth like a fish out of water. You feel both uncomfortable and anxious. You begin to see that others are staring at you in a critical and judgmental way. Even though these people don’t say or do anything that’s objectively negative, the voice of your insecurity becomes so loud and overwhelming that you “project” your anxieties onto them by screaming at them, “What the hell are you staring at!” We all find ourselves in situations where we project our feelings, failures and impulses onto others. One reason we do this is to avoid that particular truth about ourselves which would cause us heartache or suffering. While projection can sometimes positively serve us, when we project feelings of rejection, low-confidence or fear onto others, it can impact us by compounding stress which then prevents us from dealing with the root of our emotions.

Reaction Formation

With the reaction formation defense mechanism, we transcend beyond denial and act
or behave in the opposite way to which we think and feel. Typically, reaction formation is marked by a blatant and very ‘over the top’ display of emotionally led action. Behavior due to reaction formation is often hugely exaggerated, compulsive and inflexible. Reaction formation behaviors don’t vary due to changes in emotion as do natural behaviors. For example, a father who feels guilt at resenting his child may go above and beyond to express showy love to the child under all circumstances. These behaviors based on fake emotions are often easy to spot. Modern Applied Psychologists often observe reaction formation in clients who claim to firmly believe in something and become unreasonably angry if anything gets suggested anyone else which contradicts these firm beliefs.

Regression

Regression is a form of childlike retreat, going back to an earlier stage of development when a person felt safer or where their everyday challenges would be removed by a parent or guardian. In Freud’s view, the stressors of a person’s past development may be used to explain a range of regressive behaviors. Regression leads people back to an earlier stage of maturity as a way of protecting oneself from the need to confront a problem situation. Imagine, for example, arguing with your partner, and instead of using mature communication skills, you stomp off, slam the door and give your partner the cold shoulder. Regression is a defensive and childlike behavior response which often ends up escalating problems beyond what was started with.

Rationalization

Rationalization commonly occurs when we try to explain our unhelpful attitudes and behaviors away. A rationalization is an attempt to justify destructive or unacceptable behavior logically. Rationalizing an event, situation or even a failed relationship might help some individuals to ‘save face’, maintain self-respect or avoid guilt over something thoughtless they have done. In many cases, rationalization is not harmful, but instead, is a state of continuous self-deception, when a person consistently makes excuses for their destructive and selfish behaviors.

Sublimation

Sublimation occurs when we transform our conflicted emotions, unmet wants or needs (our unfulfilled values) into productive outlets. Sublimation is similar to displacement but happens when we manage to displace our feelings into a constructive rather than destructive activity. This could, for example, be musical or artistic by nature. When used to handle a situation you cannot efficiently do anything about, sublimation is a definite form of defense. But when used routinely to avoid addressing an issue that must be resolved to move forward, it can, in many cases, have negative repercussions.

4 years ago · · Comments Off on Can we take control of our emotions?

Can we take control of our emotions?

Emotions are part of what makes us human. In many ways, our emotions give us the biggest insight into who we are, what we believe in, and our core values. But in some cases, our emotions are not very helpful and affect our wellbeing and cause daring life consequences.

No matter how hard we try, we will never be in full control of our emotions and feelings. But understanding the process can give us the upper hand in handling negative outcomes.

Emotions appear suddenly, out of nowhere. We process emotions over time, and they slowly emerge via multiple steps. This process makes it possible to take some level of control over our emotions. It starts with us experience a particular situation, followed by how we assess this specific situation. Our previous experiences, the learned behavior, and socio-cultural environment influence this process and unravel with what we call emotions.

So what’s better? 

Shall we let our emotions run their course or try to take control over them? Well, that’s a very personal decision…

On some level, we all know if a particular emotion is beneficial or destructive. Unfortunately, there isn’t a “one fit’s all” solution. By definition, emotion is something specified by the context of the situation and extremely individual.

So how we decide on what to do?

The simplest way is actually to think about how expressing or acting on this emotion will affect our lives. What long- and short-term consequences may occur from it. In a way, just run a basic “risk assessment” on the possible outcomes. Because when emotions start to obstruct our ability to manage daily tasks when they hamper our relationships and wellbeing in general, then it’s time for a major shift and reevaluation of our cognitive-behavioral mind mapping.

We have to remember that despite being a complex process, an emotion erupts in seconds. Each time of remembering a particular emotion, we reactivated that emotion in our minds. What we may see as prolog sadness or anger is our brain discharging one emotion after another.  

According to the Process Model by Prof. James Gross (2015), emotions are generated over four different stages:

  • Situation: a person is faced with a situation (real or fictional) that has some emotional significance to them
  • Attention: person attend to the situation
  • Appraisal: person assess the situation based on their personality and their objectives
  • Response: a person generates a response based on their experience, behavior, and psychology in line with how they have apprised the situation.

But there is a piece of good news, based on the Process Model; there are few ways to regulate our emotions. McRae and Gross developed these helpful strategies.Avoidance, aka situation selection – by not engaging in emotionally relevant situations (example: deciding not to interact with a person who has hurt you in the past)

  1. Direct request, aka situation modification – by influencing the situation directly (example: asking a person to refrain from using specific phrases or exhibiting particular behavior, which affects you)
  2. Distraction, aka attention deployment – by directing the attention towards less emotional aspects of the situation (example: starting to feel anxiety during a social gathering, you can look/ read something on your phone for few minutes till the emotion passes)
  3. Cognitive reappraisal, aka cognitive change – by reevaluating the situation (example: a person you have texted not responding, not because they don’t like you, but because they may be busy).
  4. Acceptance, another type of cognitive change – by accepting the situation, but not judging prematurely to the outcome (example: my partner breaks up with me, but that doesn’t mean I will spend my life alone).
  5. Expressive suppression, aka response modulation by suppressing your reaction to a certain emotion (example: you feel anxiety, but control your facial expressions so that no one will notice).
  6. Psychological interventions, another type of response modification by doing or thinking something which carries positive charger in our minds (example: when feeling anxiety raises, take a few deep breaths to calm down).

There isn’t one best way to take control and regulate our emotions. Different situations and different personalities call for different solutions. Once we start paying attention to our emotions, we can build a mental “database” on how to regulate them.

As Jane Elliott says, anything that is learned can be unlearned and vice versa, so with practice, self-awareness, and of course a will to change, we can, if not control, at least manage our emotions in a way, which will let us have a happier life. Our emotions shape who we are and how the world and other people feel around us.

So, who do you want to be?

Refrences.: 

Gross, J. J. (2015). The extended process model of emotion regulation: Elaborations, applications, and future directions. Psychological Inquiry

McRae, K., & Gross, J. J. (2020). Emotion regulation.

4 years ago · · Comments Off on When Therapists Make Mistakes

When Therapists Make Mistakes

By Dr. K. Kolmes

We don’t often talk about therapeutic blunders, although they happen all the time. There are so many ways for therapists to fail clients. There is probably the most common: a mismatch of styles, or a therapist who is not really helping her client. Then there are those moments when perhaps we fail our clients by not responding in the moment in the way the client might desire. Maybe we sometimes challenge when we should nurture. Or we nurture when we should challenge. Or we may do any number of subtle things, perhaps below the threshold of consciousness, not even fully acknowledged by our clients, but which create distance, disappointment, or detachment. Some examples of this are the stifling of yawns, spacing out for a moment, or failing to remember an important name or detail and the client feels we are not really fully present or engaged with them. This lack of connection may trigger feelings of disappointment, loss, or abandonment. For clients with relational traumas, events such as vacations, emergencies, or even adjustments in session times may also cause feelings of loss and abandonment.

Recently, I was having one of those weeks. The details aren’t important, but I’ll acknowledge that I had taken on a few too many things. Top it off with having a few people needing to meet at different times. Add to that one way I manage client confidentiality: putting client names into my hard calendar (which I do not carry about with me) and then transcribing the sessions later to my iPhone calendar simply as “client,” to preserve confidentiality in the event that my phone is lost or stolen.

The result?

I mistakenly transposed a client session time from my hard calendar to an hour later in my phone. And, yes, I missed the client appointment. A client arrived at my office, waited in the waiting room, perhaps knocked on my door, wondering about my whereabouts, and I wasn’t there. The mistake was realized within the hour and I phoned her and we spoke.

But still. I was confused and felt bad that it had happened.

After eleven years of becoming accustomed to some clients not showing up, some clients canceling last minute…this was new. Never before had I been the one to miss the session.

Therapy is about being present. Being witness to your client’s emotional life, and literally, being awake and engaged for fifty minutes at a time, taking in all that your client shares and responding based upon your knowledge of the history of this person. What then, do you do when you fail to be present in the most obvious of ways? By actually not showing up?

This event brought me back to 1992:

A year into therapy with my therapist, I show up at her office, which also happens to be her home. As I pull my car into her long gravel driveway, deep into the woods of Pittsboro, NC, I notice that her car isn’t there. Hmm.

Maybe her car is being serviced?

The front door of her home is unlocked, as usual and I open the door and let myself into her office and sit down on her couch to wait. Her orange tabby cat pokes his nose into the office and then rubs his body against the doorframe as he sways back into the recesses of the house.

I wait for about ten minutes, but I think I knew she wasn’t there from the instant I’d arrived. Still, it slowly dawns on me that she’s not just running late…but she probably isn’t coming to our session at all. This is….different.

I stand and walk into the hallway and hover there, weighing the threshold between her therapy office and the rest of her home..the edge where her work life ends and her real life begins. I look for the first time into her living room…forbidden territory which I’ve never had a real glimpse of before. I scan the room, taking in all I can from my vantage point in the doorway, looking at signs of her lived life: a blanket on the sofa, books and magazines on the table, pictures on the walls, a coffee cup on a side table. I call out her name. Nothing. Nobody home. I note the desire to walk further into her home and poke around. This seems such a unique opportunity to learn more about her, but the thought of being discovered wandering around her home is a strong deterrent. I slowly leave her house, get back into my car, and drive home.

When I get home, I call and leave a message: “It’s Keely. I think you forgot our appointment today.” She calls back later that day to apologize and I joke on the phone,”Well, I was going to discuss my abandonment issues with you today, but you didn’t show up.” I appreciate how it feels completely okay for me to make this joke because she has been there for me, week after week, for over a year. It is clearly a joke, and her missed appointment this day is a clear aberration. I know she will laugh at my joke. And she does. And that feels good. I know she knows it’s not a big deal to me, and that she is forgiven.

I can’t even remember if we spent any more time of it other than a brief acknowledgment at the beginning of the next session.

Back to 2009:

But here I am, 17 years later, a therapist myself, who is earlier into treatment with some clients who do not yet know or trust that I will be there for them. When we make mistakes as therapists, how do we convey both our regret, and the reassurance that this is not typical. And, more importantly, despite the fact that (hopefully) mistakes of this nature are atypical how do we position ourselves to be fully available for the range of our client’s feelings, whether they be rage, despair, sadness, or blame over the fact that we have let them down? Some clients may shrug off a mistake as no big deal, but for others it can be a very big deal. We cannot let our own desires for forgiveness and understanding get in the way of our first job to our clients which is to be present for their feelings.

Many of our clients have long histories that involve being let down by others. When a therapist fails the client in any way, this often ripples on the theme of being let down by others. It can be important to show up and be present for the processing of how this affects our client. Patients can also use their own responses to therapist errors to explore past failures by others in their own lives. When a therapist hides or denies her mistake, she not only risks avoiding an opportunity to move the therapy forward, but also creates a second breach by showing she cannot be trusted to model appropriate responsibility or, even, the ability to enact human error.

This brings me to my other point: the awareness that for some of my clients, a big piece of the work is about perfectionism and self-forgiveness. How do we allow ourselves, as therapists, to be both present for our clients, and, at the same time, models of real human beings who are imperfect? Is my self-flagellation a lesson I want to share with my client? Or would it better benefit her for me to be self-forgiving? Where does one find the balance, and how much of this can we convey to our client? How do we create appropriate space to talk about mistakes without spending too much time on them? Do we make it clear that the client can return to it, if we move on and she later finds it’s still nagging at her? Difficult questions and likely the right response depends upon each particular client.

Another factor for consideration: my office policy explains that I charge my full fee if a client does not adhere to my 24-hour cancellation policy. I do not feel it bodes well for the therapeutic relationships if we convey the belief that we value our own time more highly than those of our clients. This can be an interesting conversation to have with a client. What would she think is fair in the event of a therapist missing the session? A free session? A half-fee session? An extra fifteen minutes at the end of one session? A free pass for a same-day cancellation in the future without the penalty of full-fee? What is appropriate for a therapist to offer and what veers again into the zone of being too repentant? This exchange can be a rich opportunity for exploration with clients who wish to engage in it. Again, this can also bring up deeper issues related to fairness and resolution connected to other issues in our client’s lives.

In the end, an important lesson for me as a therapist was that sometimes unintended things happen. We may strive for consistency and perfection, but we are all imperfect. We hope that over time that our consistency and responsibility will become apparent to our clients. But one goal of therapy is to reach a safe attachment in which one can weather disappointments and unintentional blunders without either party (especially the client) having to experience the threat of losing the relationship. Mistakes do happen and sometimes it’s just as important for us as therapists to remember this as it is for our clients. And, as in all relationships ― not just the therapeutic ones ― it’s often not about whether mistakes occur, but how they are acknowledged and repaired that really counts.

4 years ago · · Comments Off on On the Difference Between Therapy and Giving Advice

On the Difference Between Therapy and Giving Advice

By Dr. K. Kolmes

“But what should I do?”

It doesn’t happen often, but once in awhile, I will meet with a client who asks me some variation of the above. The thing that is most challenging (to me) about clients who directly ask what they should do is that they are usually those who are experiencing the most pain and confusion. It makes sense that people who are struggling, hurting, or experiencing despair would want someone to tell them what to do to make it stop. And, often, I would like to help them make it stop too, so there is a strong pull to give an answer.

But giving advice is not psychotherapy. Therapy is a place to explore your feelings and learn about yourself. It’s a place of self-discovery. It’s a place to find out how you have become tangled up and a place to learn how to untangle yourself. It’s a place to gain a better understanding of your inner world and your relationships. This process is what people come into therapy to learn. It’s what mental health professionals go to school to learn how to provide. Sometimes it takes time and reflection to see the patterns and it isn’t a quick fix, as much as both therapist and client sometimes wish it were. Sometimes just acknowledging and sitting with that pain, confusion, and wish for an immediate answer is the best thing we can do.

This does not mean that I withhold information from clients when I think it might be helpful. If I notice a theme or have some concern that a client may not be acting in their best interest, I speak up. It also doesn’t mean that I am non-directive. There are times when I get very directive with clients. I integrate cognitive-behavioral interventions in my work and I tend to use them when people need symptomatic relief or when people are trying to break habits. At the most extreme that can happen when someone is in danger and I need to get them into the hospital or go over a safety plan with them. In these cases, we may make a list of people to call and things to do when they are feeling actively suicidal.

Less extreme versions of my being directive may include encouraging a client to make an appointment with a psychiatrist. Or I may develop a plan for a client to do breathing or relaxation exercises when she or he is anxious or call a friend to go to the gym when depressed. With my couples, I often prescribe “homework,” which includes communication exercises or plans to notice positive aspects of one another or the relationship. In my dissertation support group, I will sometimes make suggestions to counteract procrastination.

But these are specific treatment approaches to specific problems and not the same thing as telling a client what to do with major life decisions. If you want a therapist to tell you what to do, as opposed to helping you figure out what is right for you, it could be worth thinking twice about what you’re seeking. Some people want others to tell them what to do because it means not having to take responsibility if things don’t work out. Friends and counselors can give you advice. But if what you are looking for is just someone to give advice or tell you the things that have worked for them, it may not be psychotherapy that you’re looking for. Conversely, if you are going to therapy and you find that your therapist fills the time with advice, suggestions, or anecdotes about their life, it could indicate that they have some discomfort with allowing the therapeutic process to unfold. Be aware that you can find someone else who creates the space for your process of becoming conscious and finding the answers that are right for you.

4 years ago · · Comments Off on Daniel Kahneman Cognitive Biases

Daniel Kahneman Cognitive Biases

Cognitive biases describe the irrational errors in human decision making. Our brain absorbs enormous amounts of information every day. Some of this information we consciously think about, but as the conscious part of the brain can only be focus on one thing at a time, our brain is looking for shortcuts to help us make decisions. These mental unconscious shortcuts are called heuristics. Unfortunately, these heuristics often fail to produce a correct judgment, and the result is cognitive biases. Knowing what the most common types of cognitive biases are, can help us to make a correct judgment when it comes of taking a decision or creating and voicing an opinion.  

Fact and Information Bias (Qualifications/Competency)

Information bias is when people get caught in the need to seek and validate information which doesn’t lead to effective or affirmative action. There’s a big difference between being an innovator and imitators: there are people who will gather ideas just to talk about them, whilst there are others who will gather ideas and then apply them into meaningful action.

The Placebo Effect (The Secret & Manifestations)

This bias is one which inadvertently brings about the effects we predicted would happen i.e. a self-fulfilling prophecy. As we know, the placebo effect stems from scientific experiments where patients were given a fake drug which they told would cure them and found that the positive mindset of believing they were receiving an effective drug alleviated many patient’s symptoms. The problem is that this can happen both ways, depending on the negativity or positivity of our mindset: when we are biased towards our inefficiency, we’ll fail because we won’t try to disprove ourselves.  We cannot expect things to happen to us in life just because we think good things and, in the same way, we shouldn’t expect only bad things to come about because we think it so. We cannot manifest a reality: we can only make a reality.

Outcome Bias (Judge, Jury & Executioner)

This is when people judge the soundness if a decision by its outcome rather than the process as to how the decision came about. An example of this would be for our relationships with others: we judge people for what they do and how they act without considering what they may have gone through which caused them to be the way that they are (and, therefore, have an ability to change).

Pro-innovation Bias (Greatness bound by Dependency)

Being innovative is fantastic, but innovation can only take people so far. The problem that occurs with innovation bias is when proponents of an innovation overvalue its usefulness and undervalue its limitations. This shows itself in our relationships when being part of an initiative becomes more important than the initiative itself: people join movements, community groups or even political parties, but become bogged down and distracted with their status within the group rather than focus on what the group is supposed to accomplish and the reason why it was established in the first place.

Stereotyping & Generalizing (All Intentions are Good)

Stereotyping is when a person lays expectation for a person (or group of people) to have certain qualities, thoughts and behaviors without knowing anything about them personally. Whilst stereotyping arguably has a psychological advantage for its use to categorize strangers as safe or dangerous, the cultural divisions and sociopolitical climate has blurred this line thanks to skewed media portrayals and sociocultural conditioning of who “looks good” and who “looks bad”.  As adults, we cannot allow ourselves to accept socially indoctrinated or experienced concepts of what people are and who they will be based on a category they may fit on a surface level.

Sensory Anchoring Bias (Memory Reliance)

Whenever someone makes a decision, they will instinctively “anchor” down onto a detail or value about that thing. This first detail people anchor down onto becomes the bias adjust themselves to within their circumstances. This is why the phrase “you never make a second first impression” exists: people will anchor onto the first piece of information you reveal about yourself.  The same goes for other people: when we’re young and impressionable, we will pick up the biases our parents hold because we, instinctually, want to survive and therefore want to appease and agree with our primary caregivers. We will pick up on little things like their disgust of certain habits, foods, dislike of certain people and animals, styles and even shops! Sensory anchoring also affects our memory. Our sensory anchoring bias is responsible for some of our distorted memories when it comes to relationships, events and our self-perception.   Important questions to ask ourselves when it comes to challenging our biases include: How do I know this is bad? Where did this idea come from? Who taught me this was good/bad? How authentic is this thought to me?

Availability Heuristic (Self-Justification)

Also known as a mental short-cut, Availability Heuristics is when we rely on information which comes quickly to us and estimates the value of our own experience more than others. When we try to make a decision, a number of related events or statistics may jump to the forefront of our mind, which results in us putting more statistical weight and value in their probability. This is because, when we are in situations which are somewhat dangerous or anxiety inducing, our brain needs to make a quick decision. This, obviously, also affects our relations with other people because the examples you have to hand may conflict with someone else’s: this is why we become closed-minded to counterarguments, conflicting evidence or conflicting anecdotal evidence in debates and discussions.

The Bandwagon Effect (If you go, I’ll go)

Have you ever been asked “and if all your friends jumped off a cliff, would you do it too?” This phrase is connected with the bandwagon effect, a psychological phenomenon which causes people to do something just because everyone else is doing it, even if it conflicts with their personal values. Herd mentality is responsible for waves in politics, fashion trends, music hits, technological development, and shifts in social acceptance and culture. We become so stimulated by what other people do and invest time into that we adopt their behaviors, attitudes and interests. The problem arises when we surround ourselves with people who aren’t living worthy and fulfilling lives: people who engage in unhealthy or dangerous habits, have little to no aspiration, are unkind and judgmental, etc. We are the sum of the five core people we surround ourselves with: so we should make a conscious effort to surround ourselves with empowered, passionate, energetic, kind and like-minded people who are striving for something greater than themselves.

Personal Blind-spot Bias (I’m ok, you’re not ok)

Most of us know what we don’t like in other people and things: being judgmental is easy. The trouble is, very few of us are able to turn the critical eye in on ourselves where necessary. Of course, there will be many of you reading this who are incredibly self-critical people who claim to know all their flaws – but the reality is, self-critical people also have blind spots. In fact, overly self-critical people tend to be critical in the wrong areas, because their criticism stems mainly out of self-shame rather than honest critique with an empowered intention to change. Our blind spots develop out of our desire to see ourselves more positively – something which most self-critical people crave the opportunity to do. After spending a lifetime of criticizing ourselves, what could be more perfect than taking fifteen minutes to critique someone else whilst turning a blind eye to all our own (probably very similar) flaws? However, personal blind spots not only occur more frequently in people who don’t think they’re biased but also amongst people who are the least receptive to criticism and advice.

Confirmation Bias (I determine what’s right and wrong)

We are all inclined to accept ideas which validate our beliefs more than those which challenge them, regardless of whether or not our beliefs are positive or negative. Confirmation bias serves to show us that we rarely look at ourselves and circumstances objectively: if we have incredibly low self-esteem, we seek out words in conversations which we believe implies insult or criticism; if we’re struggling with our health but don’t want to challenge it now, we seek out people who don’t tell us to lose weight; and if we agree with one political party, we only surround ourselves with others who align with us politically, refusing to converse with those who challenge or question our stances.

4 years ago · · Comments Off on Types of Cognitive Distortions

Types of Cognitive Distortions

Deletions and Mental Filtering

You most likely agree on the fact that it is very easy to remember our credits and even easier to forget about debts. Our minds are very good at avoiding the useless pains that are caused by uneasy thought. However, deletions happen for different reasons – when it is necessary
to concentrate our energy on a particular task, we delete every extra perception to help us focus on what we consider most crucial. Even during non-critical moments of our lives, we delete about 80% of the data that reaches our brain. When an individual is anxious, they commonly develop ‘tunnel vision’ where they focus solely on the negative aspects of situations and delete any positive aspects. Sometimes the whole picture can be colored by a single negative detail. For example: Focusing on the one person who doesn’t like you rather than the other twenty who do. A mental filter is when we are presented with a collection of ideas or experiences in close concession, and our minds filter all these experiences together through one funnel to come up with one conclusion. This cognitive distortion plays part largely when it comes to negative experiences, which magnify the negative aspects of past experience and then ultimately trigger an automatic response for future events.

Polarized Thinking (Black or White thinking)

Black-or-white thinking is extreme thinking that often leads to intense emotions and behaviors. When things are either ‘black-or-white.’ We’re either perfect, or we’re a complete failure — and there’s no middle ground. When we place people or situations in ‘either/or’ categories, where there are no shades of grey. This doesn’t allow for the complexity of most individuals and situations. Black-and-white thinking does not acknowledge that there are usually several shades of grey that exist between black and white. In seeing only two possible sides or outcomes to something, a person ignores the middle — which is most often the more reasonable ground.

Overgeneralizing and Categorizing

Based on one instance in the past or present, you assume that in the future all others will follow a similar pattern. A sense of helplessness often accompanies such overgeneralizations. “Nothing ever goes right for me”, and then feel even worse. Put things into perspective. How true is it that ‘nothing ever goes right for you?’

Jumping to Conclusions and Mind Reading

A person who ‘jumps to conclusions’ will often make a negative interpretation or prediction even when there is no real evidence supporting their conclusion. This sort of thinking is often based on what we think other people feel towards us. It can show up as “mind reading” (assuming the thoughts and intentions of others) or also as “fortune-telling” (anticipating the worse and accepting it as fact).

Catastrophizing

Magnification is taking a fairly minor negative event and blowing it completely out of proportion — imagining all sorts of disasters resulting from the one small event.
You can nip catastrophic thinking in the bud by acknowledging it for what it is – it’s simply just “thoughts.” If you find yourself thinking about the worst-case scenario, consider the following: Take your objective stance and put things in perspective. Consider fewer terrifying explanations. Weigh up the evidence that you have (the facts). Do you have enough information to reach the conclusion that she wants to leave you? Focus on what you could do to cope with the situation and the people or resources that can help you. No matter what catastrophic assumption you’ve reached in your mind, it’s unlikely that the world is going to end even if your assumption does come to fruition. And in which case, if the worst- case scenario did happen – you’re most likely capable of surviving and growing stronger as an individual through it all – human beings can be very resilient.

Personalization (Self-centeredness)

When you believe that everything others say or do is some sort of direct, personal reaction to you. Also, when you compare yourself to other people and try to determine who is smarter, better looking, etc. If you think in this way, you may see yourself as responsible for some unhealthy external event that you were not actually responsible for at all.

Self-victimization (Learned Helplessness)

We’ve all known someone who regularly feels sorry for themselves. Heck, even we fall victim of this mindset once in a while. Self-victimization is when a person reflects on their past trauma, experiences and circumstances (or even their present) and overindulges themselves in self-pity and sympathy. They become so immersed in their negative thoughts and experiences that they begin to live in them permanently. What we focus on in life, we feel. Emotions aren’t illnesses: they’re the results of particular thoughts, and thoughts don’t need curing – they need managing and changing. People with learned helplessness believe they cannot change or that they should be treated a certain way and handled a certain way because they learned from their experiences, peers and family that they are a victim.

The Fallacy of Fairness

This is when people become consumed with the concept that certain things in life “aren’t fair”: it’s not fair they weren’t born into a rich family, it’s not fair they’re not taller, it’s not fair that other person got a promotion and not them, it’s not fair that they have depression whilst other people have happy lives, etc. This attitude translates, quite plainly, into someone saying: “the world is not giving me what I want when I want it in the way that I want it when it should be”. Life is never fair: everyone has their moments of struggle, some more than others. There are good people who suffer their whole lives whilst there are bad people who never suffer at all. However, fairness is nothing more about perception and comparison: it’s how we view the world rather than the way the world is.

Blaming and Irresponsibility

People find it relieving and liberating to blame other people for the way their life is the way
it is: it’s X’s fault they have self-esteem issues, it’s Y’s fault they feel depressed, it’s Z’s fault things didn’t go to plan. Whilst it may be satisfying to place blame, blaming others doesn’t alleviate or solve the problems you’re dealing with: only you can fix how you feel about a situation, and only you can get yourself through a situation. When we take more responsibility for the role we play in our own lives (for our actions, thoughts, behaviors, beliefs), the more empowered we are to change.

Heavens’ Reward Fallacy

This is where people live in a world of idealism in which they believe martyrdom is a worthy role to play in life. Serving the greater good can be often time be a distortion in our minds of a justification for doing things we want to do and endorsing things we want to believe in. No one is serving the greater good in these scenarios: they’re just using the greater good as an excuse and justification for their actions and behaviors.

Confusing Feelings with Facts

Some people can become so distorted in their thinking that they end up defining themselves by how they feel: if they define themselves as depressed, they’ll act depressed and if they define themselves as anxious, they’ll act on the edge and anxious. Note, self-defining is different from expressing to someone you’re feeling on a certain day or through a certain period of time. Feelings are not facts: no one should ever feel the need to define themselves to emotion because they are so much more than that emotion. The danger of defining oneself by an emotion such as depression, we’re psychologically more inclined to feel secure and comfortable being that way (as we assign our self-esteem and identity to it), meaning it’s much harder to help someone out of this emotion and through recovery, as they’ll feel like they are losing a part of themselves.

Mistaking Believes for What’s True

Just because someone believes in something doesn’t always mean it’s true. Whilst there are some examples of grounded, scientific evidence supporting many things which were once theories (i.e. beliefs such as evolution), most beliefs are nothing more than beliefs. However, because people put so much personal identity into their beliefs, they distort their beliefs into facts and feel challenged and personally offended by those who challenge or disprove them. Just because you believe something is wrong doesn’t mean it is, just because you believe in a god doesn’t mean there is one and just because you don’t believe in a god doesn’t mean there isn’t one. People, unfortunately, justify many actions with their beliefs: their beliefs permit them to be prejudiced against groups of people, behave certain ways and do certain things.

Labelling

When we ‘label’ ourselves based on our behavior in specific situations. We define ourselves by one specific behavior (usually a negative behavior) and fail to consider other positive characteristics and actions. For example: “I’m always anxious” even though this is not always the case, or ‘I’m not good enough’ because you failed at something, even though there are many other things that you’re good at.

Mystical Guesswork

We are only ever one thought and decision away from transforming everything about how you’re experiencing life. However, we are most times our greatest enemy by telling ourselves through mystical guesswork that we won’t be good enough, that we can’t do something, that we won’t like something, that we’ll end up feeling this way if we do X, etc. We can’t mystically guess our futures and how we (or other people and situations) will be or feel in the future.

Ridged Rule Keeping

When you have a list of rules about how you and other people should behave. Those who break the rules make us angry, and if you break the rules, you feel guilty as a result. People often believe they are trying to motivate themselves with should and shouldn’t, almost as if they must be punished before they can do anything. Such statements provide insight into the standards you tend to uphold and the things you expect of others and yourself. These standards can at times be helpful. However, they can also create unrealistic expectations that you or other people will find it difficult to live up to. The inflexibility of the demands that you place on yourself, others, and the world around you, often means you do not adapt to reality as well as you could. You believe that you “must” have the approval of your friends and associates. This causes you to feel anxious in various social situations and drives you to try and gain everyone’s approval. Adopting flexible preferences about yourself, others, and the world, in general, is a healthy alternative to inflexible and rigid rule-keeping. Rather than making demands on yourself and others, instead, pay attention to language. Replace words like “must,” “should” and “need”, with “prefer”’ “want” and “wish”. Limit approval seeking. Would you have a satisfying life even if you didn’t get the approval of everyone, you’re seeking it from?

Emotional Reasoning

Often if we depend heavily on our feelings as a guide, this leads us away from the path of reality. Start paying attention to your thoughts. Watch out for thoughts like “I’m feeling apprehensive, something must be wrong” and recognize that feelings are often not the best way to measure reality, especially if you’re not in the best emotional state at the moment. Consider how you would view the situation if you were feeling calmer. Check to see if there is any concrete evidence that supports your interpretation of your feelings. Is there really any evidence that suggests something bad is about to happen?

Minimalization

In the opposite way to magnification, which is taking a fairly minor negative event and blowing it completely out of proportion, minimizing is when we play down our own positive attributes. A person who assigns multiple negative labels to themselves tends to promote these definitions before anything positive. Minimization makes us susceptible to being abused, mistreated and taken advantage of as these behaviors against us correlate with how we define and describe ourselves. We devalue ourselves proportionately to how we pedestal and idolize others to the detriment of our self-esteem and confidence, all in the pursuit of humility. It’s easy for many people who have never suffered from low self-esteem to regard those who inappropriately shrink the magnitude of their self-worth with detrimental self-talk as attention-seeking or fishing for compliments; but it is the job of a life coach to be able to identify the difference between those seeking compliments vs. those who truly believe what they are saying. To a conscientious, empathetic and congruent person, low self-esteem can be seen as clear as the light of day; the challenge therefore as a life coach is to give the client the permission to keep employing the same minimizing and magnifying techniques, but reverse the application, and to not feel guilty, arrogant or ashamed of doing so.  Our perception of reality is rarely reality, and cognitive distortions occur when the brain creates faulty connections and, effectively, lies to you. Everyone who reads psychology will be familiar with the phrase, “correlation does not equal causation”, and this is where such a statement applies. It’s commonplace to make connections where there is none when interpreting life as most people assume that because two variables are correlated, one causes leads to the other. Cognitive distortions are irrational thoughts and beliefs we unconsciously reinforce over time through mental, or oral, repetition, and are effective at provoking or exacerbating symptoms of depression if propagated over a long period of time. Minimization is a defense mechanism employed to help the individual through adversity, but its power to generate distorted thinking causes more damage in the long term. Starting a daily journal in which you take note of only the positive experiences you’ve had in your day (no matter how minor they are), practicing gratitude, and focusing on building a foundation for self-worth and internal validation will allow you to cease minimalizing your worth and self. Whereas taking a step back from reality, practicing objective questioning and emotional responsibility allows for an empowered and measured reaction to maximization.

Disqualifying the Positive

Disqualifying the positive is about processing information in a biased way. Disqualifying the positive is a mental process that changes a positive event into a neutral or negative event in your mind. Instead of feeling pleased with yourself, you feel quite disappointed.