Abstainer or Moderator? Gretchen Rubin explains why it matters to your Happiness

Couples-2During therapy, people often identify behavior changes (stop smoking, be more social, rekindle friendships) as one of their primary goals.  Changing behaviors comes more easily to some than others.  Gretchen Rubin writes in The Happiness Project about how to apply the studies and theories on happiness to your life.  The quiz below provides information on how to make changing behaviors easier for you.

Identifying yourself as a moderator or an abstainer is important for you to make better choices about the easiest way to make positive behavior changes.

 
You’re a moderator if you…
– find that occasional indulgence heightens your pleasure–and strengthens your resolve
– get panicky at the thought of “never” getting or doing something
 
You’re an abstainer if you…
– have trouble stopping something once you’ve started
– aren’t tempted by things that you’ve decided are off-limits
Knowing which strategy works best for you can be a great tool to help you change. There is no right way or wrong way.
Let’s say you want to start walking every morning before work.
If you are a moderator, you may want to use the 80/20 rule.  Ask yourself to adhere to the behavior change 80 percent of the time, but do not try to go “cold turkey”.  Plan to walk 5 or 6 days, but plan to allow yourself 1 or 2 days off each week.
An abstainer would want to plan to walk everyday.
If you are struggling with trying and failing to make a change in your life, try the above quiz, apply the results, and see if you are more successful!

A great tool for a parent/child chat about ADHD

 If you want to chat with a child about ADHD, this is great.


The story ADHD and Me was shared by MrsKirk on Storybird.

Your Happiness

408px-Happy_man_in_a_rainy_dayI have become a big fan of Gretchen Rubin’s book The Happiness Project, and her website. According to Ms Rubin, we become unhappy “when we feel depleted and drained, and when we have no time or energy devoted to the things that give us pleasure.”  Treating ourselves throughout the day with small pleasures is an important way to avoid those feeling of depletion and to prevent becoming unhappy.  

Ms Rubin suggests creating a list of treats and pleasures that have a very low cost in time, energy, or money. Ms Rubin’s readers have shared a fun and varied list of their treats and pleasures.  Some of my favorites are listed here:

Small Treats and Pleasures

taking the pup to the park
dance party in my office
getting a hot chocolate
reading a chapter of my book in bed
Photo courtesy of squacco

Photo courtesy of squacco

looking at a family photo album
taking an extra long shower
stretching or yoga
Belting along to the Dixie Chicks, Patty Loveless or Lyle Lovett while driving
My Nana’s coffee cake
Iced Dunkin’ Donuts coffee with skim milk and sugar
Really good cheese
Doing the NYT Sunday acrostic
Re-reading my favorite children’s books (esp. the “Shoes” and Betsy-Tacy books)
Calling my mom
Walking a different way to work or coming home, especially through a park
Getting into bed when it’s just been made up with crisp fresh sheets
Monkey Bay Sauvignon Blanc
Fresh strawberries, raspberries or peaches when they’re in season.  And tomatoes!
Having breakfast from a wooden tray with a linen napkin on it
A gardenia beside the bed.
Mrs. Meyers’ Honeysuckle hand soap.
washing my hands with Molton Brown hand soap
Make home made soup
Lubricating eye drops – make my eyes feel great!
Planting ferns
Give myself a foot massage
Read a travel guide
Petting a dog I meet in the street
Incense
Lighting a candle
A face mask, especially a minty one
A hot shower
Writing lists
Crafting
Making my own bread, kneading is soothin
Watching foreign movies
Stare at trees stretching to reach the sky
Buy a new color of lipstick
 
I encourage you to make your own list.  Try to work one or two of these into your day.  Enjoy.

Obsessive-Compulsive Disorder in Children.

Obsessive-Compulsive Disorder (OCD) in children can be difficult to diagnose.  Parents often confuse developmentally-appropriate rigid behaviors with OCD behaviors.  The following table (adapted from Freeman and Garcia’s Family based Treatment for Young Children with OCD: Therapist Guide, 2009) may be helpful for parents in differentiating OCD from developmentally appropriate routines.

Photo Courtesy of D. Sharon Pruitt

Photo Courtesy of D. Sharon Pruitt

DEVELOPMENTALLY APPROPRIATE BEHAVIORS
Age 1 to 2:  Strong preference for rigid routines around home rituals.  Very aware and can get upset about imperfections in toys and or clothes.

Age 3 to 5:  Repeat same play activity over and over again.

Age 5 to 6:  Keenly aware of the rules of games and other activities and may get upset if rules are altered or broken.

Age 6 to 11:  Engage in superstitious behavior to prevent bad things from happening and may show increased interest in acquiring a collect of objects.

Age 12+  Become easily absorbed in particular activities enjoyed (e.g., video games) or with particualr people (e.g., pop stars); may also show superstitious behavior in relation to making good things happen.  (e.g., performance in sports).

Weight Loss and Cognitive Behavioral Therapy

I have recently begun working with a few clients who are interested in losing weight.  1024px-Feet_on_scaleThe therapy treatment plan I use is one based on Cognitive Behavioral Therapy (CBT).  CBT was developed by Dr. Aaron T. Beck and is a form of psychotherapy in which the therapist and the client work together as a team to identify and solve problems. CBT helps clients overcome their difficulties by changing their thinking, behavior, and emotional responses.

Dr. Judith Beck (daughter of Dr. Aaron Beck) writes in “An Open Letter to Carnie Wilson: What you need to know to keep the Weight Off” a detailed description of the first step in using CBT to help with weight loss.

Judith Beck’s letter:

Dear Carnie,It’s not surprising that you gained back most of the weight you lost after your first weight loss surgery — so many people do. I’m glad to hear that you’ve now lost 30 pounds following a second lap band procedure. There are, though, a number of important skills you need to learn if you want to keep the weight off for good this time.

I would bet that no one ever taught you essential skills such as: how to motivate yourself to make healthy choices every day, what to do when you experience a craving; how to get yourself to exercise (even when you don’t feel like it), how to get immediately back on track when you make an eating mistake, and how to cope with negative emotions without turning to food.

My guess is that the number on your scale is still going down and so you probably feel quite motivated at the moment. But what will happen once your weight loss plateaus? Your daily weigh-ins on the scale won’t be so thrilling then. And you’ll probably experience more temptations and cravings. Is this what happened last time? Did you begin to have (sabotaging) thoughts like, “I don’t care. I know I’m not supposed to eat this, but I’m going to anyway?” These types of thoughts are common among dieters, especially dieters who struggle with keeping weight off. Fortunately, though, you can start practicing now for the difficult times you’re likely to face.

One important technique I want you to know about is predicting the kinds of sabotaging thoughts you’re likely to have in the future. You probably had these same types of thoughts in the past. Write each one on a card. Then write what you wish you would be able to remember so that you can respond to them effectively, not give in to them, and stick to your new eating plan.

You might have the thought, for example, “It won’t matter if I eat this food that I’m not supposed to eat.” How do you hope you might respond to that thought? Do you think it would be helpful if you told yourself, “No, it absolutely does matter! I’m just fooling myself.  

Thoughts like that have always led me to gain back weight in the past. And every time I give in, I increase the likelihood I’ll give in the next time. It’s so worth it to me to stick to my plan and resist temptation. I’d rather reach my weight loss goals than eat this now.”

This is just one technique from our cognitive behavioral program for weight loss and maintenance. There is a lot to learn, but won’t it be worth it if you can keep the weight off for good this time?

Sincerely,

Judith S. Beck, Ph.D.
Beck Institute for Cognitive Behavior Therapy

I highly recommend her book, The Beck Diet Solution, to anyone who is interested in a new approach to losing weight.

 

Reframe the Way You Look at Your Life

Marc Elliot was born with no large intestine, 4 feet of small intestines, and has Tourette syndrome.  Yet, he has learned to control the symptoms of his disease and have a great life with the classic Cognitive Therapy techniques of Reframing and Challenging Thoughts.

Bucket List

494px-A_metal_bucket

What is on your
Bucket List?

Everyone needs some type of “Bucket List”.  Long term goals and dreams keep us going…….
Here are some different ones I have found by doing a few searches:

From A TRAVEL blogger:

Visit every continent
Go sailing
Snorkel in the Great Barrier Reef
Go skydiving
Live outside North America
Live in Europe
Become fluent in German
Go mountain climbing
Visit Africa
Walk on the Great Wall of China
Visit the pyramids
Get my masters (currently working on it!)
Go paragliding
Ride a camel
Write a travel memoir
Get a book deal
Be an extra in a movie
Star in an asian pepsi commercial
Go into a jungle
Get a tattoo
Learn to surf
Visit Antarctica
Get married
Bike across a country
Have a beach wedding
Smoke hookah in Egypt
Party in Ibiza, Spain
Visit all of the world wonders
Dance in the rain, under the stars
Go skinny dipping
Eat a chocolate covered insect
Meet a member of the royal family
Learn to snowboard
Kiss a soccer player

What’s on your bucket list?

My Psychiatrist says I have Bipolar Disorder. What do I do now?

iStock_000017908199SmallI had two new patients last week who came in for therapy after being diagnosed by their psychiatrist with Bipolar Disorder.  In each case, the patient wanted to spend most of the session expressing his/her relief, sadness, grief, shock, etc. over hearing those words, “you have Bipolar Disorder.”  I often hear, “so this means that I am really crazy.”  Encouraging the patient to learn as much as possible about the disorder is a key part of the therapy at this stage.


The book I most often recommend to patients struggling with a new diagnosis of bipolar disorder (BPD) is Bipolar Disorder Demystified, by Lana R. Castle.  In her opening chapter Ms Castle identifies the following common myths and misconceptions about mental illness.  Patients often find it is helpful to talk about how these myths affect their ability to cope with their BPD.

  1. There is no good reason for the mentally ill to act so crazy.  They just need to learn some self-control.
  2. We all get depressed from time to time.  Positive thinking should be enough to turn things around.
  3. Lots of people think about suicide at times, but don’t actually attempt it.  Those who say they want to kill themselves are just seeking sympathy.
  4. People with mental illness come from bad families.
  5. The mentally ill are immature and self-absorbed.  They just need to grow up and become responsible.
  6. Talking about problems won’t solve them.  It only makes you dwell on them more.  Instead of yammering endlessly in therapy, these people should take action.

Ms. Castle goes on to list 10 more common misconceptions similar to the ones above.  She further points out that the use of the phrase “the mentally ill” reflects the language people often use when making such statements.  She does not (nor do I) condone the use of the phrases “the mentally ill” or ” the bipolar” or “the schizophrenic” .  We both prefer “a person with a mental illness” or “an individual with bipolar disorder” or “my sister who has schizophrenia.”  These phrases help to emphasize the fact that the person and the illness/disorder are separate.  The illness/disorder does not define the person.  The person learns to live with the illness/disorder.

Depression-2

If you have BPD, or love/know someone who does, think carefully about your assumptions and preconceived notions regarding the disorder.  Talk openly about your feelings related to the above myths.  These discussions are key to the process of dealing with BPD.  Some healthy, important steps in  coping with BPD are: 

  1. understanding the disorder – its symptoms, treatments, and possible causes
  2. grieving the impact the disorder has on you life
  3. committing to making adjustments (including medication and therapy) to make your life a long, happy, and productive one.
  4. Recognizing you may have setbacks, along with your major improvements, as you work through this process.

BPD is a difficult condition to deal with; however, the more knowledge and understanding you have of the condition, the better you will be able to manage your life.  I highly recommend Lana Castle’s book, Bipolar Disorder Demystified.

Therapy for Managing Depression, Anger and Aggression

Classic Cognitive-Behavioral Therapy models are based on the assumption that thoughts(cognitive processes) dictate feelings.  Those feelings then dictate behaviors (or actions).

450px-Fire-lite-bg-10Here is a basic example:
A fire alarm goes off in a hotel at night
.

Person A thinks:  some kids pulled the alarm and now I am awake!
Person A feelsanger at the kids andannoyance about being awake.

Person B thinks: there must be a fire, I must get out!
Person B feelsfear of being trapped in the fire, worry about how to escape

Person C thinks: I remember when my friends and I liked to pull the fire alarm.
Person C feelsunderstanding of kids having fun and comfortable to go back to sleep.

You CAN control you thoughts, which leads to the ability to have more positive feelings.

Christy Motta, MA summarizes a Cognitive-Behavioral approach to dealing with aggression below:

In the case of aggression, the individual must change the perceptions and beliefs that contribute to increased anger. In order to do this, the individual must: 1. Cope with arousal. The first step is to identify (observe) what is happening. The individual must become aware of when they are angry and notice the physical sensations and thoughts that accompany it.

2. Replace problem thoughts with thoughts that are helpful in dealing with PROVOCATION. “This could be rough, but I can deal with it” “easy does it” “Live and let live” “Stick to the issues. Don’t take it personally.”

3. Modify problem thoughts to those that are helpful in dealing with CONFRONTATION. “keep my cool, walk away, take a time out” “I don’t need to prove myself” “There’s no point in getting mad”

4. Change appraisals and reflections AFTER A CONFRONTATION.

a. Unresolved: “They don’t have to agree” “let it go” “don’t take it personally”
b. Resolved. Label (Describe) what happened. Praise self.

People frequently need some external limits in order to identify their aggression as a problem and begin actively working on modifying their thoughts. Probation, the risk of losing housing and the risk of losing important valued relationships are common consequences that get people thinking about their aggression.

How to YOU choose your therapist?

women smilingOnce you make the decision to pursue counseling, you must then decide WHICH therapist to call.  Many people ask friends or family members for recommendations, others search the internet, and still others use the old-fashioned yellow pages.  No matter how you choose, that first session is your opportunity to see if you have found a therapist who will meet your needs.

Dr. John Grohol, CEO of PsychCentral, writes 
The four most important attributes of a good therapist are:
1. A good therapist is positive and empathetic.
2. A good therapist is professional, courteous, and respectful.
3. A good therapist recognizes her strengths and limitations.
4. A good therapist is genuine.

As you meet and talk with your therapist the first time, look for these characteristics. Here are some suggestions of questions you could ask as you are determining if your therapist has the four key criteria listed above:

  1. How are you licensed? What are your training credentials? Do you belong to any professional groups?
  2. How would you describe your treatment style? Many different treatment styles exist. Different approaches may be more or less appropriate for you depending on your situation and needs.
  3. What kind of evaluation process do you use to recommend a treatment plan?
  4. What are the measurable criteria you use to assess how well treatment is working? Can you give me a few examples?
  5. Do you use published clinical practice guidelines to guide your treatment planning? How?
  6. What psychotherapeutic approaches and tools do you use?
  7. How do you decide which approach is best for the patient? Do you ever use more than one approach? When?
  8. How will you work with other medical providers, such as psychiatrist, who may also provide care?
  9. How often will we meet?  How long will treatment last?  How do I know when treatment is complete?

Think about how well you will be able to relate to the therapist as she answers these questions.  You want to achieve the best possible match in order to have the greatest chance of meeting your goals.

If you would like to ask me any of the above questions, or learn more about my practice.  Please contact me.