Friday, January 3, 2014

Facticity Has a New Location

www.mindfulkc.com

Facticity is now hosted at our Ochester Psychological Services, LLC website:


Please visit us there when you have a chance!

Tuesday, November 12, 2013

Getting Unstuck

One of the trickiest aspects of a psychologist's job is to help motivate clients to do things they are reluctant to do, but may help them feel better.  Common mental health problems like depression and anxiety involve a biased or stereotyped pattern of thinking and behaving which maintains or exacerbates the condition.  These patterns keep people stuck:
  • People who are depressed often resist engaging in healthy activities such as socializing, exercising, and pursuing usual interests.
  • Anxious individuals avoid confronting fears.
  • Individuals who are impulsive, restless, or hypomanic have trouble quieting their minds, pausing before responding and finding balance.
  • When we are angry, we are reluctant to empathize.
  • Perfectionism makes us intolerant of mistakes.
  • Low self-worth makes it hard to practice self-compassion.
  • When we lack confidence, we avoid taking risks .
The treatment for many of these conditions involves prescribing activities that may seem counter-intuitive when a client is stuck in a maladaptive mental state. It is a skillful therapist who can help clients see the value in engaging in the very activities they may be resisting.  In addition, the client must be open to change, because therapists cannot make people do things they don't want to do.

Building motivation for change involves an examination of the pros and cons of maintaining the status quo versus trying something different.  It also involves identifying reasons for change that are preferably personal, internal and positive.  Finally, the therapist helps the client build confidence in the likelihood of success and  that the rewards for change will be worth the effort.

Clients have described the beginning stages of the process as "rolling a boulder up a hill".  At first it takes an enormous amount of energy and commitment.  But, once the crest has been peaked, momentum builds and it becomes easier.

Sometimes individuals are so compromised they do not have the resources to engage independently in the activities that might help them recover.  These individuals may need medications to help them get well enough to use psychotherapy to their advantage.  Some may need more intensive treatment, such as a residential stay, intensive outpatient treatment, or a provider (or therapy collateral) who can meet with them outside of the therapy office and help them implement strategies in their daily lives.

If you or a loved one are feeling stuck, it may be time to consult a psychologist.  You can find mental health professionals in your area through online therapist locators such as those hosted by the American Psychological Association, Psychology Today, Network Therapy and GoodTherapy. If you want to use your health insurance, you call the behavioral health number on the back of your insurance card or visit your insurance company website to get some referral options.

Please also visit my website http://www.kctherapist.com/ for more information and resources regarding a variety of mental health concerns.

Friday, October 18, 2013

How Psychotherapy Helps

Have you ever had somebody listen to you intently and objectively with the sole purpose of understanding you and assisting you in reaching your potential? For most of us, this is a luxury and very rare.

Our loved ones are not very objective and they frequently have their own agendas for us. They give us well-intended, but biased advice. Our friends have busy lives and don't always have the time to give us their undivided attention. In addition, we are often worried about how we might make others feel or how they might feel about us, so we refrain from really opening up to them.

Ideally, a psychologist is an objective and non-judgmental professional who is not involved in your life outside of the therapy session. You shouldn't have to worry about hurting your psychologist's feelings or whether they will like "the real you" or not. You should not have to worry whether your disclosures to your psychologist will directly threaten your job or your relationships. If your psychologist cannot be objective with you with for some reason, they should refer you to someone who can be.

Counseling is confidential (except in some very specific circumstances that you should be informed about before you begin), so you don't have to worry about other people finding out your innermost thoughts and feelings. Your psychologist's sole purpose is to listen to you and understand your point of view so that he or she can help you with your concerns.

Psychotherapy is not necessarily for everyone, but when it is effective, it may help clients:
  • institute change
  • find hope
  • increase self-awareness
  • develop new perspectives
  • identify strengths and resources
  • improve self-esteem
  • feel empowered
  • discover new solutions
  • normalize experiences
  • develop insight
  • adopt a more positive outlook
  • foster acceptance
  • explore options
  • adjust to situations
  • increase objectivity
  • learn new skills
  • create and work toward goals
  • increase motivation
  • challenge fears
Psychotherapy cannot:
  • Make you change or do anything you don't really want to do
  • Change or "fix" other people in your life
  • Give you the answers
  • Make decisions for you or tell you definitively what to do
  • Cure you or "fix you"
  • Take the place of your personal responsibility
Psychotherapy Has Risks

Not everybody benefits from psychotherapy and there are potential risks to making a change. Sometimes psychotherapy leads to changes in you that your significant others , co-workers, or superiors don't appreciate or accept. This can change important relationships and roles. In addition, it can be painful at first to talk about and confront the things that are troubling you. Your distress may actually increase during the early stages of counseling.

Honesty Is the Best Policy

Your psychologist knows only as much as you tell them, so its important to be honest. Despite our extensive training in human behavior, we cannot read minds.

You wouldn't go to the doctor with chest pain and tell them your thumb hurts, right? This would result in a faulty diagnosis, the wrong treatment, and consequently, no improvement or even deterioration.

It is important to be honest with your psychologist, even about things you may feel ashamed of.  Opening up about sensitive subjects with a compassionate and empathetic psychologist often decreases the sense of shame and takes some of the power out of the issues that are plaguing you.

Change Takes Work

In general, psychotherapy helps people help themselves and the more energy you put into your treatment, the more you will get out of it. When your physician gives you a prescription or instructions for getting better, you have to use the medication as directed or follow the instructions in order to experience any improvement. It is the same for psychotherapy. Your counselor can help you generate options, but it is ultimately up to you to follow through with them outside of therapy.

Only You Can Change You

Your psychologist can only help you with the change process and cannot make other people in your life change. Some people come to counseling because other people in their lives are causing problems for them. Your psychologist can help you cope with the situation, but he or she has no power to change people, especially when the people who are contributing to your distress are not involved in your therapy.

It's All in the Relationship

You need to feel comfortable with your psychologist for your therapy to be successful. Psychologists understand that we are not going to be a match for everyone, so we are not offended when a client doesn't click with us. If you are concerned about your relationship with your psychologist, you should try to address this with him or her so changes can be made. Your psychologist should be able to provide you with some referral options if needed.

You can find mental health professionals in your area through online therapist locators such as those hosted by the American Psychological Association, Psychology Today, Network Therapy and GoodTherapy. If you want to use your health insurance, you call the behavioral health number on the back of your insurance card or visit your insurance company website to get some referral options.

Please also visit my website http://www.kctherapist.com/ for more information and resources regarding a variety of mental health concerns.

Saturday, July 27, 2013

Harnessing Your Emotional Superpowers

Do you find yourself riding an emotional roller coaster, catapulted to great heights when good things happen and sunk into the depths when bad things happen?  Do you cry too often and too easily such that its difficult to get your message across and people don't take you seriously? Do you feel inflamed by injustices and turn people off with your intensity regarding hot button issues? Are you overwhelmed by other people's emotions; feeling awkward around those who are anxious, easily drained and hassled by others' problems, devastated by their criticism, or terrified of their anger? Do you fall head over heels into romantic relationships only to be crushed with disappointment when they don't work out?

If so, you may be a highly sensitive person with emotional "superpowers" which you haven't learned to harness.  Emotions are signals that provide information about ourselves, other people and our environments. They can be very useful when managed skillfully, but they can wreak havoc when allowed to run wild.

Emotions are adaptive when they:
motivate behavior in order to respond appropriately to a situation. 
help us make good decisions.
help us remember things we need or want to remember.
warn us of trouble or alert us to new opportunities

Emotions are maladaptive when:
They are too intense
They last too long
We are unable to manage or cope with them.
We react impulsively or destructively based on them.

Emotional sensitivity might be likened to Spiderman's "Spider Sense". Emotionally sensitive people may be much better at receiving emotional signals.  However, the trick is to be able to see these signals for what they really are and respond to them appropriately - just like Peter Parker had to learn what his Spider Sense meant and how to harness it for good.  Learning to harness your emotional superpowers will improve your ability to:
  • control impulses
  • delay gratification
  • self-motivate
  • understand other people's social cues
  • self-soothe in order to cope with life's ups and downs
The first step in learning to harness your emotional superpowers is to pay attention to the signals rather than just responding automatically to them.  When you notice yourself feeling very strongly about something, stop and ask yourself what you are thinking and feeling.  You may not be able to do this in the moment at first, so it can be helpful to make a habit of reviewing your day before you retire for the night.  While you are developing this skill, it can be useful to write down or record your thoughts.  Ask yourself if your thoughts are rational or if they might be biased.  Then practice challenging your biased assumptions and beliefs.

It can also be useful to learn how to relax your body and quiet your mind so that you can respond more appropriately to a situation.  Developing relaxation skills using techniques such as diaphragmatic breathing, visualization or progressive muscle relaxation can help you calm your physiological reactions to the emotions you are feeling.  Practicing meditation can help sharpen your mind so that you can focus better on an adaptive response.

Most people find it easier to manage their emotions when they are living a healthy and balanced life.  This requires taking good care of yourself such as eating right, practicing good sleep hygiene, engaging in daily physical activity (preferably outdoors), and setting aside time for relaxation and socialization.  This also requires avoiding bad habits such as overindulging or driving yourself too hard.

If you suspect you are struggling with unharnessed emotional superpowers, a psychologist might be able to help clarify the problem and assist in transforming superpowers into assets rather than liabilities. You can find mental health professionals in your area through online therapist locators such as those hosted by the American Psychological AssociationPsychology TodayNetwork Therapy and GoodTherapy.

Please also visit my website http://www.kctherapist.com/ for more information and resources regarding a variety of mental health concerns.

Monday, March 11, 2013

Improving Working Memory and Attention

Working memory is the brain function that allows us to hold information in memory long enough to manipulate or perform some function on it in order to solve a problem or come up with a response.  It is considered an "executive function", which is a set of cognitive abilities that allow us to plan, organize, self monitor, initiate and inhibit responses, and shift gears as needed.

We use our working memory everyday for all kinds of tasks.  Pearson's Cogmed website provides a handy chart (see below) of some of the ways we use working memory in all stages of development:

AgeWorking memory is crucial for…Indicators that a working memory needs exercise

Preschool

  • Learning the alphabet
  • Focusing on short instructions such as “Come brush your teeth”
  • Remaining seated to complete independent activities, such as puzzles
  • Seems unwilling or unable to learn alphabet, numbers
  • Can’t focus long enough to grasp and follow instructions
  • Flits from one thing to another

Elementary school

  • Reading and understanding the content (reading comprehension)
  • Mental arithmetic
  • Interacting and responding appropriately in peer activities such as playing on the school ground
  • Reads (decodes) but does not understand or remember material read
  • Problems memorizing math facts
  • Difficulty participating in group activities (e.g. awaiting turn); makes friends but cannot keep them

Middle school

  • Doing homework independently
  • Planning and packing for an activity
  • Solving multi-step math problems, especially word problems
  • Participating in team sports
  • Does not begin or persist with homework without supervision
  • Packs but forgets items essential for activity
  • Reads the problem but can’t break it into understandable parts
  • Problems grasping rules of a game, functioning as a “team player”

High school

  • Getting a driver’s license – and driving safely
  • Understanding social cues, responding to demands of a social situation
  • Writing essays, reports
  • Problems with spatial awareness, reading and following traffic cues
  • Interrupts, talks excessively, doesn’t listen to others
  • Essays and reports are short, sloppy, and disorganized

College

  • Focusing on and following a conversation
  • Making and adhering to work plans, such as studying for an exam successfully
  • Participating in group activities in school and socially
  • Sustaining focus and interest throughout lectures
  • Changes topics suddenly, makes irrelevant comments
  • Procrastinates, then tries to “cram” the night before an exam
  • Doesn’t listen or participate during group activities
  • Falls asleep or “zones out” during lectures

Adults

  • Getting to work on time
  • Meeting deadlines at work
  • Prioritizing multiple activities
  • Handling conflicts within the family
  • Frequently late to work
  • Often underestimates time required for a task
  • Has problems breaking a project into manageable steps
  • Often loses temper with children and spouse

Seniors

  • Actively participate in group discussions
  • Being able to perform what you are planning to do
  • Organizing your materials and activities
  • Managing important financial transactions
  • Forgetfulness
  • Distractability
  • Losing track of the topic in a conversation
  • Misplacing things like glasses, mobile phone, keys etc

As you can see, if an individual has problems with their working memory they may experience significant difficulties across a broad range of tasks and in a variety of situations.  A number of different conditions can be correlated with working memory problems such as:  attention deficits or learning disorders, brain injury, stroke, being over-committed, or even the natural effects of aging.

Fortunately, we are discovering that working memory can be improved.  One way of doing so is using a working memory training program such as Cogmed.  According to Pearson, "Cogmed Working Memory Training is an evidence-based training program developed by leading neuroscientists to improve attention in individuals with weak working memory.  Cogmed is backed by peer-reviewed, controlled research done at leading universities around the world and is proven to lead to significant, real life improvements in 80% of users."



If you are interested in learning more about Cogmed, please visit the Pearson Cogmed website or the YouTube Cogmed Video Channel.  My website provides additional information about ADHD, learning differences and other mental health concerns, http://www.kctherapist.com/.

Thursday, December 6, 2012

The Approach-Avoidance Cycle in Relationships


The Approach-Avoidance Cycle (AAC) - also known as the Pursuer-Distancer Dynamic, Push-Pull Relationship, or Engulfment vs. Abandonment - is a pattern that emerges in relationships where one individual wants more of something (or wants the other person to change in some way) – this is the pursuer - and the other individual resists or withdraws – this is the distancer.  It has been often described as two people “attached by a 10 foot pole”.  When the pursuer moves forward, the distancer is pushed back.  When the distancer withdraws, the pursuer is pulled forward.

While everyone needs a balance of attachment and autonomy in their lives, the ideal formula varies from person to person.  When one person in a relationship wants more attachment and the other wants more autonomy, this is often the perfect storm for an AAC to develop.  At its extremes, the AAC can be quite damaging to a relationship because it becomes a self-perpetuating “war” that is exhausting and builds resentment over time in both individuals.

The AAC can be an overarching pattern in a relationship or it might occur only within certain hot-button issues.  In marriages, these issues often include sex, money or parenting.  For example, one partner might want more frequent sexual intercourse with the other partner or may want them to spend more time with the children, manage the money better, engage in more house work or go out on more dates.  In families or friendships, it can include how much personal contact people engage in or the level of involvement in each other’s personal lives.  For example, how often an adult child visits their parents or the degree to which friends confide in each other.  It is tempting for each person to think they are in the right and the other is wrong, but its really often a matter of personal preference and both people are responsible for their part in perpetuating the pattern.

In the AAC, the pursuer wants more “we” focus and the distancer wants more “I” focus.  The pursuer typically appears to over-function in the relationship and the distancer appears to under-function.  The pursuer’s efforts to get the distancer “on board” feels like manipulation, pressure, control, or smothering to the distancer.  The distancer’s resistance feels like rejection, abandonment or a lack of love/caring to the pursuer.  Each becomes more and more entrenched in their stance and they make increasing assumptions and judgments about the other’s motivations and intentions.  Each tries harder to “win”, thus it becomes a battle with the potential for serious casualties along the way.  Unchecked over time, the damage can become irreversible.

The good news is, if at least one of the partners recognizes and disrupts the pattern early enough, the relationship may be salvageable.  Interrupting the pattern means that the pursuer stops pursuing and/or the distancer stops distancing.  In other words, the pursuer has to decrease the “we” focus and become more “I” focused.  They have to stop expecting the other to change and focus more on what is actually under their control (one’s own thoughts, feelings and behavior).  Or, the distancer has to stop withdrawing/resisting and begin to reach out to the pursuer or make some observable efforts toward change.  Because both individuals are attached by a “10 foot pole”, when one person stops pushing or pulling, often the other will follow suit.   

This is not as simple as it sounds as the behavior can be so ingrained, the individuals involved may have trouble identifying which of their behaviors are pursuing or distancing.  It can also be very difficult to let go of these behaviors when there is a strong fear of abandonment or losing ones autonomy.  In these cases, a psychologist with experience in family or marital therapy can help guide one or both individuals through the process.  Of course there is also a risk that even when the pattern is disrupted, one or both individuals may remain dissatisfied with the relationship due to irreconcilable differences in wants, needs or values.

 If you suspect you are struggling with an AAC in a relationship, it may be helpful to talk to a mental health professional. A good therapist can help you understand the function of your behavior, identify triggers, and maintain your changes. You can find mental health professionals in your area through online therapist locators such as those hosted by the American Psychological Association, Psychology Today, Network Therapy and GoodTherapy.

Please also visit my website http://www.kctherapist.com/ for more information and resources regarding a variety of mental health concerns.

Sunday, April 1, 2012

Walking in Their Shoes: ADHD and Learning Disorders

Have you ever wondered what it is like to have ADHD or a learning disorder like dyslexia, dysgraphia or dyscalculia?

The PBS Misunderstood Minds website offers a number of experiential activities along with a wealth of other useful information and resources.  Try a few of the links below to walk in their shoes for a moment:

1.  Visual Activity: Reading with Distractions "simulates what a child with an attention problem might experience during a classroom reading assignment"

2.   Auditory Activity: Listening to Directions "attempts to illustrate what it might be like for a first-grader with an attention disorder to try to concentrate on a set of oral instructions amidst a cacophony of classroom distractions"

3.  Decoding Activity: Recognizing Phonemes simulates dyslexia by having you try to sound out words without automatic decoding abilities

4.  Memory Activity: Recall and Understanding "simulates the effect that memory and attention problems can have on reading comprehension"

5.  Graphomotor Activity: Tracing Letters "is designed to simulate what a child with a graphomotor writing disability might experience every day"

6.  Composition Activity: Putting Ideas in Sequence "is designed to simulate what a child with a writing disability might experience during a classroom writing assignment"

7.  Arithmetic Activity: Using Basic Facts simulates dyscalculia by having you solve math problems without efficient recall of basic math facts

8.  Spatial Activity: Making 3-D Inferences simulates dyscalculia by impairing your ability to visualize "three-dimensional objects presented on the flat surface of a piece of paper or computer screen"

9.  Sequence Activity: Multistep Problems "is designed to evoke in you the intimidation and frustration a young student with a math disability might feel working out a problem that requires the integration of mathematics skills"

Please visit my website for more information about ADHD, learning differences and other mental health concerns, http://www.kctherapist.com/.