A GoodTherapy.org News Update

href=http://well.blogs.nytimes.com/2009/03/13/the-12-most-annoying-habits-of-therapists/?hp”>The New York Times has put together a list of the top twelve annoyances endured by therapy clients, and in addition to harmless mistakes or one-time slip-ups, there are some upsetting trends.

A fairly common and sometimes unavoidable issue reported by clients is the problem of therapists showing up late. Whether by a few minutes or a few hours, the message seems to ring out that the client is not important or worthy of time or attention — not a nice message to send. Eating and yawning or even sleeping in front of clients also made it on the list; one reader reported that their therapist took the initiative to use their session time — around noon — to have their lunch. Being self-centered or focusing on the minute details of their own life is one therapist behavior that appeared anathema to client preference. Distractions including ringing phones, computer use, and in-office pets ranked high on the list of grievances as well. Making it hard for clients to make contact via phone or email was reported as a major problem, as was discussing the therapist’s personal racial, sexual, and religious preferences; music and lifestyle choices also made the list, though these seem to become an issue only when they are the focus of a session’s precious time.

Clock watching and excessive note taking seem like fairly obvious no-nos, and uncomfortable hugging or touching was noted as a problem. One reader mentioned that her therapist, seemingly very concerned with whether the patient cared for her, would frequently ask for an opinion and give small gifts to the client. A final item well worthy of its place on the list is flamboyant displays of wealth or of flesh — behavior not suited to the therapist’s office.

© Copyright 2009 by http://www.GoodTherapy.org Therapist Portland Bureau - All Rights Reserved.

By Lois V. Nightingale, Ph.D.

Click here to contact Lois and/or see her GoodTherapy.org Profile

Often when we think of forgiveness we think of letting someone, “getting away” with something or, “getting off scott-free”. Forgiveness is not about ignoring the fact we were hurt. It is not about setting yourself up to get hurt again. Forgiveness is not reconciliation or changing your mind about what is best for you. Forgiveness is not even something we do to enhance the life of another. It is, in one sense, a very selfish act.

A wise man once said, “Resentment is a poison one takes hoping to harm another.”

If we really look at what the lack of forgiveness does to us, we notice the emotional internal pain we inflict on ourselves. Long-held resentment can lead to physical symptoms as well; muscle tension, migraines, high blood pressure, poor concentration, sleep and appetite disturbances, and a suppressed immune system, to name a few.

Another important reason to learn to forgive is as a model for children. Children do as we do, not as we say. If you can’t forgive for yourself and your own serenity, then forgiving as a life-lesson for your children may be the reason you need. When children see us do things that are extremely difficult, it makes an impression. Children then believe that they also are able to overcome difficult emotional situations and find the best possible solution for their own peace of mind. Most of the movies and games children are exposed to glorify retaliation and holding grudges. Your real-life modeling can have a great impact on their own ability to forgive and not carry insults and betrayals throughout life.
Forgiving is not endorsing what the offender did, or pretending that consequences aren’t deserved. But in forgiving we place the quality and serenity of our own life above what may be warranted for another. It is difficult to put down resentment. It is not in our nature to accept when things are not “fair”. Sometimes we fear we will be placing ourselves in vulnerability again if we forgive and try to forget. Read the rest of this entry

A GoodTherapy.org News Update Presented by Jolyn Wells-Moran, PhD, MSW

Imagine that a friend is having a heated verbal argument with his wife. You’re watching from the couch. He turns to you and asks for your input. You hesitate, and then say you really don’t want to be involved. It doesn’t seem to you that there’s any solution that would be acceptable to both people or that is otherwise possible. Friend and spouse then tell you they really want your input, so you think for a moment and suggest they look instead for alternative strategies to resolve the matter. The couple then comes up with a few different ways of resolving the issue. Ah, you think, that was a good idea. You throw in a few more possible strategies. They nod in agreement and proceed to use several of the approaches. Yes, you think, now we’re getting somewhere — but wait a minute, their voices are rising. They’re using all of their own strategies and yours too, but look angrier than ever!

What happened?

Well, according to researchers at Arizona State University (ASU) – and counter to what we might consider the common logic of using many strategies for conflict resolution — people in conflict may actually become angrier and more frustrated the more strategies they use. A new ASU study suggests that limiting strategies is less likely to result in escalating anger, when the conflict seems unresolvable, even though we may believe that to be unhelpful rigidity.

This shouldn’t be confused with the idea that we should limit our options for solutions. No one is advising that. It also doesn’t mean we shouldn’t try various strategies when it seems like a resolution is possible.

Instead, if there doesn’t seem to be a solution that would be acceptable to both parties engaged in an argument after they’ve used one or two strategies already, it might well be best to let the argument go. According to Danielle Roubinov, an ASU doctoral student in clinical psychology, “Although being flexible in how you respond to different situations may be beneficial, continuously trying different ways to work out the same situation may lead to greater anger, frustration, and an unhealthier biological response.” Read the rest of this entry

A GoodTherapy.org Featured Column written by Judith Barr, MA, LMHC

Click here to contact Judith and/or see her GoodTherapy.org Profile

This Must Be Healed!… Recently, I learned from a friend, that his company was taken over from the inside. This was political. It may have happened in a company, but it could have happened in an educational institution, a religious institution, or in a government. My friend shared with me that his company was taken over from the inside, that people who had been in the company, partners in the company even, for 30 years, were let go . . . all that mattered was money. That the values of the company collapsed . . . all that mattered was money. That the humanitarian efforts the company had so embraced previously were tossed aside . . . all that mattered was money. That the people who had devoted themselves to the company were thrown out . . . all that mattered was money. That the people who remained only mattered in relation to how much money they could bring in . . . all that mattered was money.

At the root, people’s relationships with money and feelings about money preceded the current market turmoil by a long, long time. Those feelings - whether they appear as anxiety, fear, anger, greed, power, helplessness - will be here long after the chaos of our economy right now is calmed down. In fact, the feelings at the root of our relationships with money exist all the time. They are not going to go away, certainly not as a result of things we do on the practical level in the outer world - not by selling our assets, getting another job, destroying the company to which people have been committed for decades, making nothing matter but money! Read the rest of this entry

A GoodTherapy.org News Update Presented by Daniel Brezenoff, LCSW

Research by psychiatrists at Columbia College of Physicians and Surgeons suggests a link between thinning of the cerebral cortex and a family history of depression. Whether the physical difference in the brain is genetic, or is rather a result of environmental factors associated with familial depression, is not yet clear.

What is clear is that brain imaging is providing more evidence that depression affects the brain, is affected and the brain, or both; individuals aged 6 – 54 years who were identified as “high-risk” for depression had an average of 28% less thickness in the right cerebral hemisphere than people identified as low-risk in this study.

Brain imaging may also help screen for individuals at risk of depression, and help understand their needs; the right cortex is associated with reasoning, planning, mood, and reading social and emotional cues – all areas that would be affected by and contribute to a depression.

The study, to be published in Proceedings of the National Academy of Sciences, was primarily the work of by Dr. Myrna Weissman and Dr. Bradley S. Peterson. “You’re seeing it two generations later, and you’re seeing it in both children and adults,” said Dr. Peterson, “and it’s present even if those offspring themselves have not…become ill.”

©Copyright 2009 by GoodTherapy.org - All Rights Reserved. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Daniel and/or see his GoodTherapy.org Profile

A GoodTherapy.org Featured Column written by Dennis Thoennes, Ph.D., ABPP

Click here to contact Dennis and/or see his GoodTherapy.org Profile

The song says, “Sorry seems to be the hardest word.” Well… that depends. There is a bounty of research that tells us about the impact of trauma such as mugging, rape, burglary, war, genocide etc. No doubt such activities inflict pain and leave scars. What is too often missed are the scars that are not there. That might well be because this scar is the imprint of neglect.

Alan Schore Ph.D. has done a masterful job of educating us about the neuropsychobiological effects of interpersonal relationships including the dyadic regulation of affect. Right there on the screen, evident for anyone looking is (or could be) an FMRI (functional magnetic resonance image) that shows us a person’s brain. We can see differences between the prefrontal orbital cortex of a person raised with a healthy degree and manner of attunement and one who had less than that. This is evident in many of the children found in Romanian orphanages or those here in the US. One such orphanage was depicted in the movie Cider House Rules.

There is a long and storied history of the tough, silent guy, the “John Wayne” type. The difference though, between that silent type and the adult we might see in our office, the adult who grew up neglected and unattuned to, is that the former is more likely to care about other people, society and relationships. The adult who was profoundly neglected as a child is more likely to display a generalized indifference, disconnection from others and a diffuse visceral reaction and feeling unrelated to others and thus feel, think and behave like a stranger in a strange land. This has many of the hallmarks of depression: anhedonia, isolation, poor self care, and lack of future plans and ambitions. We might see these symptoms.

To some therapists this person may appear to be in need of social skills training or direction and encouragement to get involved in life activities such as gardening, exercise or a drumming circle, or an antidepressant. The benefits of these treatments are most likely to be short lived or prove insufficient. The lyrics in Elton John’s song ask these questions “What have I got to do to make you love me? What have I got to do to make you care?” Read the rest of this entry

by Noah Rubinstein, LMFT
Executive Director GoodTherapy.org

There are countless challenges that therapists and counselors inevitably face during the course of their professional careers. Ranging from the small and passing to the immensely difficult, these challenges help to shape not only the experience of the professional, but can shape the profession itself, as well. Jim Cates of Topeka, Indiana, is one mental health professional with a challenge that truly reveals the ability of psychotherapy to transcend traditional use and setting.

As Alix Spiegel of National Public Radio related this week, Cates has found that the majority of his clients are those belonging to the local Amish community. A group known for its reliably manual labor and farming, along with seemingly strict or outdated lifestyle mandates, the Amish would seem at the outset to be an unusual subject for psychotherapy. But Cates’ practice has been useful in treating Amish teenagers, many of whom are assigned to Cates after running into trouble with the law for drinking or other related misdemeanors. The Amish rite of passage known as Rumspringa allows teens approaching adulthood to break free of their traditional constraints and experience life as a “regular” American teenager. Often, the teens find that a return to their familiar Amish customs is a positive choice, but some find themselves caught up in the excitement and intrigue of alcohol, drugs, and other potentially harmful things. Read the rest of this entry

By Jennifer Lehr, MA, MFT

Click here to contact Jennifer and/or see her GoodTherapy.org Profile

Sue and her husband Dave were talking in the morning before leaving for work. Dave mentioned that he had made dinner plans with a friend later that week. Sue immediately bristled. “You never make plans with me, everyone else is always first”, she hissed. Dave sighed. “Here we go again,” he thought to himself. He tried to reason with his wife, but she was already upset and angry. Dave got quiet and pulled back rather than get into a fight. Sue got angrier as she felt more and more abandoned. Dave said that he had to go and left for work. Later that evening when they were both home, there was a chill in the air. Neither of them brought up the morning’s fight. Eventually things went back to normal again, and although the dinner with the friend came and went, this dynamic between them would come up over and over again, causing distrust, resentment and fear, and over time eroding the bond between them.

Victim hood is a self-concept, a way of seeing ourselves. It is not the same as being a victim of real circumstances such as a natural disaster or a crime. We all know people who are emotional victims. Emotional victims look at the world through a lens of past injustices without seeing the link in all of the situations: themselves. Read the rest of this entry

By Anne Ream ATR-BC, LPC

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Many people confuse the feelings involved in attraction or relationship addiction with the feelings involved in love. Attraction is the first part of growing toward a love relationship. I use the phrase “growing toward love” because the idea that any one “falls in love” is a fallacy. Although attraction is an important part of a relationship, it is just the beginning and cannot carry a relationship for a long time. We all change with time. Part of attraction is the adrenaline rush many confuse with love. That adrenaline rush can be addictive. A lasting relationship cannot be based on physical attraction or addiction to an adrenaline rush.

Our highly commercialized, capitalistic society has romanticized attraction to an extreme. When we believe the messages in “their” music, tv shows, movies and more, “their” income increases. “They” are opportunistically trying to make money, whereas many (naively, sadly), believe “them.” Yes, we know that, but are we always conscious of how much we believe their psychological sales pitches and how deeply it affects us? Self awareness grows with practice.

Relationship addiction can easily be confused with love. A person can be addicted to another without knowing it. A persons lack of self-awareness and self-understanding often results in denial their thoughts, feeling and behaviors. This can be misleading and confusing for the recipient of the addictive relationship behaviors. A few warning signs include; Read the rest of this entry

by Noah Rubinstein, LMFT
Executive Director GoodTherapy.org

In modern society, where academia is an integral aspect of professional fields, and a constantly growing body of bright minds and researchers, it is unsurprising that a veritable sea of academic journals are published each month, quarter, or year. Rounding up the prominent studies and touching upon extant wisdom worth revisiting, these journals create the basis for understanding and cooperation within professional communities. In the field of psychology, an impressive number of journals focus on everything from adolescent development to Alzheimer’s. Yet when it comes to schizophrenia, the selection is limited to journals that grapple with what little we understand about the condition and its etiology.

The entrance for Psychosis, then, couldn’t be more timely. The journal, which will focus on “psychological, social, and integrative approaches” to the treatment of schizophrenia and related disorders, is being published in the United Kingdom. The first issue, recently released, features a review of the scarce yet valuable studies performed to ascertain the effectiveness of psycho-social support, rather than anti-psychotic medications, on patients diagnosed with schizophrenia. Read the rest of this entry

A GoodTherapy.org News Update Presented by Jolyn Wells-Moran, PhD, MSW

In a new research study, participants who had all experienced either the train attack in Madrid or the 9/11 attacks in New York City who used more words that described their thoughts, emotions and the causes of the attacks, and more positive words, recovered better from their shock than other participants. The researchers say that the Spaniards and the Americans who experienced those terrorist attacks underwent similar psychological processes in recovery. The study points to the therapeutic value of expressive writing as a beneficial tool for recovery from shock from about eight weeks following a traumatic event and, perhaps, for an unknown period forward from eight weeks.

The study looked at pronouns used, and emotions, thinking and social interactions expressed, in the writings. Three hundred and twenty-five participants were from the US and 333 were from Spain. Some differences were noted in the use of pronouns and social interactions between writings from the two countries, although feelings about the events were quite similar. For example, the use of “we” and greater attention to the social milieu were apparent in writings of participants from the more collectivist culture of Spain. Participants from the more individualistic culture of the US tended to use “I” language more frequently, an indicator of greater concern about what they had personally experienced. Yet, the importance to better recovery of sharing the experience with others appeared to be the same for both groups. The cognitive processes and phases for overcoming shock seemed very similar. Depression and major depression were about the same between the two study groups too, and at expected rates after such events. Read the rest of this entry

A GoodTherapy.org Featured Column written by Sarah Jenkins, MC, LPC

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As a young child growing up in the hills of North Wales, Great Britain, my imagination assured me that the small, brown, dark circles dotted across the fields were truly doorways into other worlds. Skipping in circles, dancing to the harmony of the breeze caressing the trees, I was certain that, at any minute, I would be whisked away into the worlds in between this one, and the next. And, in between those worlds, I could find mystery and magic.

I held onto my belief in the world of fairies until I was about seven-years-old. My neighbor, innocently enough, burst my bubble of fantasy when he innocently told me that fairies weren’t real. Fairy rings didn’t exist. Though the Celtic folklore surrounding the land of fairies was generations old, the dark rings were, in fact, a unique moss that grew in circles amongst the green hills of Wales. I was crushed. The land in between worlds, the place that I believed I could travel to, became a cherished reminiscence. I grew up, and thought my imagination would forget about it. Read the rest of this entry

A GoodTherapy.org News Update Presented by Daniel Brezenoff, LCSW

A new study could alter the way educators, parents, and mental health professionals understand and treat Attention-Deficit/Hyperactivity Disorder (ADHD). Researchers in the University of Florida system have discovered that the incessant, undirected movements of “hyper” 8-12 year old boys seem to actually help them to retain concentration and short-term memory better than if they are prevented from moving around.

In other words, when hyper-Johnny can’t sit still, he’s only doing what he needs to do in order to learn, and forcing him to stop may only decrease his retention, while increasing his frustration – and the frustration of adults who expect him to learn in the same way as other children.

“When they are doing homework, let them fidget, stand up or chew gum,” study leader Mark Rapport of the University of Central Florida said in a statement. “We’ve known for years that children with ADHD are more active than their peers. What we haven’t known is why. They use movement to keep themselves alert. They have a hard time sitting still unless they’re in a highly stimulating environment where they don’t need to use much working memory.” Read the rest of this entry

By Tom Badzey, M.A., MFTI

Click here to contact Tom and/or see his GoodTherapy.org Profile

As a therapist who offers counseling for teens and their families, I’ve become aware of some of the biggest issues facing young people today. While depression and anxiety remain two of the major reasons why parents seek my help, often these are not the first issues that drive them to consult a therapist about their child. Usually, it’s one of the “Big 3” teen issues of our day – Sex, Drugs and Body Image issues (which includes eating disorders and steroid use).

Understanding the Adolescent Brain
Adolescence seems to be a time when these 3 issues surface more commonly than at other ages. That is not by accident. From what we now know about the developing brain - and what we are continuing to discover – dramatic changes occur during adolescence. These changes include forming a sense of identity, acquiring the ability to think critically, testing judgments about risk and reward, conceptualizing the world in abstract ways and forming lasting social relationships, among others.

These are all critical skills that will prepare young people to become independent and autonomous adult individuals. However, these changes – and the rapid, sometimes “herky, jerky” pace at which they happen – also leave many teens vulnerable to the lure of unhealthy sexual activity, dangerous abuse of alcohol and other drugs, frightening problems with food and eating, as well as the use of steroids and other “body enhancers.”

Often, teens are expected (by both adults and their peers) to be able to handle life’s unpredictable events as an adult would, even though they have yet to fully master the skills necessary to do so. Therefore, when stressful, traumatic or depressing events occur – sometimes exacerbated by high performance expectations in school or athletics, physical or sexual abuse, loss of a loved one, problems with romantic relationships, etc. – teens often find the attraction of sex, drugs, steroids and other behaviors too good to ignore. Read the rest of this entry

A GoodTherapy.org News Update

While there is no “typical” psychotherapy patient or lifestyle that automatically suggests a need for psychotherapy, there are certainly some fields of work and walks of life which, being subject to especially high or enduring levels of stress, commonly benefit from a positive counselor relationship. One such profession is that of the clergy. While often seen as a stigma, the ability of clergy members to approach and seek growth from psychotherapists is an emerging trend that highlights a growing global appreciation for the potential and power of psychotherapy.

Many ministers and leaders of faith-based communities experience large amounts of stress due to their administrative duties, as well as the pressures of serving as a very public and scrutinizable figure. Long hours and a sense of great responsibility combined with a tendency to work around a fair amount of human suffering — whether as part of a hospital visitation program or simply accepting prayer requests or visits from troubled congregants — add to the psychological load endured by such people. Read the rest of this entry

© Copyright 2009 by http://www.GoodTherapy.org Therapist Austin Bureau - All Rights Reserved.

A GoodTherapy.org News Update Presented by Jolyn Wells-Moran, PhD, MSW

What do antidepressants and psychotherapy have to do with irritable bowel syndrome (IBS)? According to an article from Reuters Health Information, published on Medscape Today, they should be included as important options by sources concerned with IBS. Antidepressants and psychological therapies both appeared to help about one in four patients.

This held true even if the person was already taking an antidepressant for depression without any apparent effect on depressive symptoms. Earlier studies were inconclusive about antidepressants and psychotherapy for IBS. Lead researcher, Dr. Alex C. Ford, from McMaster University Medical Center, Hamilton, Ontario, Canada told Reuters that, “The take-home message for clinicians…should be to consider using antidepressants for people who fail first-line therapy, and psychological therapies for those with resistant symptoms (i.e., failed more than one therapy).”

In the study, published in the gastroenterology journal Gut, selective serotonin re-uptake inhibitors (SSRIs) and tri-cyclic antidepressants both appeared to work, but cognitive-behavioral therapy (CBT) seemed to work best of the psychotherapies. Antidepressants alone may have a slightly higher rate of effectiveness since some errors were found in the studies measuring psychotherapy effectiveness, according to the study, but the researchers point out that the data suggests a similar outcome with psychotherapy. Read the rest of this entry

By Jason Wasser, LMFT

Click here to contact Jason and/or see his GoodTherapy.org Profile

One morning I was visiting a school to do a clinical observation for a student when my mouth dropped. What I saw before me seemed like nothing out of the ordinary for the students and teacher but there it was at 8:30 a.m. as clear as can be. A child was sitting at his desk, eating a pastrami sandwhich, chips and drinking a can of soda. When I asked the teacher what the school snack policy was, I was told there was none.

So the question I asked myself is who is really to blame for this problem? Is it our school system for having unclear snack policies or is it the parent’s fault for not feeding the child a substantial breakfast and sending the child to school without a more balanced meal?

When determining a clinical diagnosis in regards to a child’s behavior, one of the very first questions I would ask is “ what do they eat?” The amount of times the response from the teacher or parents was “ what does that have to do with how he/she is misbehaving” shows how much we all need to learn about how our diet truly can have an effect on our behaviors. Did you know that good nutrition and other important health habits are best established in childhood? If not, here are some facts to look over carefully. Read the rest of this entry

A GoodTherapy.org News Update Presented by Jolyn Wells-Moran, PhD, MSW

Here’s the deal. If you have depression in your biological family, you should be aware that the use of alcohol can activate major depression. On the other hand, if you have no depression heredity, abusing alcohol can still lead to an episode of depression. You might wonder why this is news, but it has never been clear which comes first, the alcohol or the depression. Science has been puzzling for decades over whether the use or abuse of alcohol is an attempt at self-medicating for depression or whether depression may, at times, be caused by alcohol abuse. It appears that the answer is a bit confusing, but read carefully. Unlike the answer to the chicken and egg question, a new study published on March 7 appears to show that depression genes exposed to alcohol can flip the switch to major depression. Read the rest of this entry

A GoodTherapy.org News Update

When it comes to abuse, many people conceptualize physically violent encounters or the sort of horrific and rare events wrapped around media-crazy murder cases. But mental health professionals are likely more aware of how many different forms abuse can take. From subtle occurrences to overt instances, abuse is a part of life for many modern people, and studies of people of all ages and life situations suggest that a great deal of them aren’t cognizant of the problem. Read the rest of this entry

© Copyright 2009 by http://www.GoodTherapy.org Therapist Minneapolis Bureau - All Rights Reserved.

A GoodTherapy.org News Update

Whether they saw the machine for themselves or only heard about it through professional gossip or industry papers, many mental health care providers came into some sort of contact with “Eliza,” a robot created in the 1960’s that posed as a viable psychotherapist. The robot made use of the Rogerian method, accepting data typed-in by the patient and returning it after a bit of processing as a set of provocative questions. It might have been interesting, or simply funny, to some professionals, while to others it may have seemed an irreverent oversimplification of the science of psychology and modern therapy practices.

Those who weren’t avid Eliza fans might cringe at the idea of Eliza 2.0, but not to worry. The re-vamped model has been produced by a team at the New York City College of Technology, of the City University of New York, not for its potential to replace a trained human therapist, but as a piece of entertainment incorporating current trends in technology. Adventuresome reporter Steve Kolowich of the Chronicle of Higher Education took a seat with Eliza to discover whether the machine was good for an insight — or just good for a laugh. Excerpted from his transcript of the conversation:

“Eliza R.: What is the first thing that comes to your mind in this session?
Me: What will I learn about you?
Eliza R.: Perhaps in your fantasies we learn about each other.
Me: Excuse me?
Eliza R.: I’m not sure I understand you fully.
Me: That makes two of us.
Eliza R.: Please go on with whatever it is you are inadequately expressing.
Me: Well … I am writing an article about you, so I want to learn what you are all about.
Eliza R.: Is it because you are writing an article about me that you came to me?
Me: Yes.
Eliza R.: You seem to be quite positively positive.
Me: I suppose I do.
Eliza R.: Really, how is that possible?
Me: I cannot say. “

© Copyright 2009 by http://www.GoodTherapy.org Therapist Schaumburg Bureau - All Rights Reserved.