Blogging on Good Therapy

By Judith Barr, MA, LMHC

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

People don’t generally want to look at how politics and psychology are joined. But if we don’t, we will miss the seam that allows us to utilize what is happening in our world for the deepest healing and transformation possible!

When something brings up intense, deep, raw feelings for you . . .
It means something in your past has been triggered.
It means something within you has been evoked.
It is becoming more commonly known in our world that this is true in our personal lives and our professional lives.

For example . . . (more…)

The GoodTherapy.org Team is very pleased to announce that the National Board of Certified Counselors (NBCC) has awarded GoodTherapy.org with Approved Continuing Education Provider Status. This status is a high compliment to the GT Continuing Education Team who over the last year has produced nearly a dozen excellent events. Thanks to Whitney Whitman, MS, our new Continuing Education Provider, for all of her work scheduling some excellent events for the 2008 and 2009 calendar. We look forward to announcing our upcoming events. Click on the following link for more information on our live teleconferences for therapists

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

Researchers at Brown University in Rhode Island are reporting that children as young as four can meet criteria for obsessive compulsive disorder (OCD). This condition, associated with anxiety, has been studied in older children and adolescents, but this new study was the largest ever study of OCD in preschool age.

“OCD, if left untreated, can significantly disrupt a child’s growth and development and can worsen as the child gets older,” said Abbe Garcia, PhD, director of the Bradley Hasbro Children’s Research Center (BHCRC) Pediatric Anxiety Research Clinic at Brown, and chief author of the new study. “[E]arly diagnosis and intervention are critical to reducing the severity of symptoms and improving quality of life.” (more…)

By Jeanine Austin, Ph.D.

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

Part of my job as the Department Head of Social Services when I worked for a skilled nursing facility was to have regular client contact. One morning, I stopped by to see how Mr. and Mrs. Carol (not their real names) were doing. As soon as I stepped in the room I felt I was entering into a combat zone. The couple was sparring loudly about which television program they were going to watch: People’s Court or Sally Jesse Raphael. Not five seconds into the debate, in horror I watched a cup of hot tea, launched by Mr. Carol, fly past my head only to narrowly miss Mrs. Carol, his bride of more than 60 years. Not to be outdone, Mrs. Carol chucked her full tray of gooey hospital food towards Mr. Carol. For someone in her final days of a terminal illness, she surprisingly mustered enough strength to create a giant mess with food landing on the ceiling, windows and walls. Indignant and incensed, I looked at my 90-something year old patients and exclaimed with all the authority a 23 year old might command and said, “You two should be ashamed of yourselves!”

Back in my office, I reviewed the couple’s intake and psychosocial assessments. Their marital history was unremarkable and by all accounts it was a happy liaison. What was up with these two crazy characters? Then it hit me. They didn’t know how to say goodbye to each other. Of course, it is much easier to contemplate leaving someone who is on your last nerve than someone whom you feel a warm fuzzy connection with. I was able to bring this up later with Mr. and Mrs. Carol and they both acknowledged that their bickering the last few weeks had to do with their fears of losing each other. (more…)

by Noah Rubinstein, LMFT
Executive Director GoodTherapy.org

The phrase “good therapy” encourages a misconception: the idea that there is such a thing as pure good therapy, a process exempt of any problems or issues. In the same way that a good marriage is not one without problems, but rather one that works through problems – so is good therapy. No therapist is perfect and no therapy can be provided perfectly, no matter how ideal a therapy may be in theory. Even those of us who do the best we can to be conscious of our inner world and attuned to the therapeutic process have aspects we are unaware of, pieces of ourselves unhealed, and mistakes we make. Good therapy is the sum of all the experiences, internal and external, occurring as a result of the imperfect psychotherapy process; and it leads toward self-awareness, growth, and the release of extreme feelings, energies, and beliefs. And what a blessing it is that even the best therapy can be lined with areas of unawareness, mistakes, challenges to the therapeutic relationship, and yet still turn out good…like a marriage. Perhaps we even need a little bad therapy mixed in with all the good? As paradoxical as that sounds, think of the beautiful repairs you and your life partner may have made, the important problems you’ve worked out with friends, and perhaps the repairs you’ve made in therapy with the people you work with. A solid repair improves the connection and deepens the trust. So, cheers to road bumps in therapy, within all relationships, and within ourselves! Read More about ‘Good Therapy, Bad Therapy, & Everything in Between.’

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

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

If you thought telephone therapy was going too far from the human touch, wait until you read this: Astronauts will receive computerized therapy during space flights under a new NASA project, called the Virtual Space Station, which gets underway next month with some terrestrial-bound clinical trials on civilians in Boston.

The cost of the program is just under two-million dollars.

Space flight can also be stressful, isolating and depressing. The job is dangerous and comes with tremendous pressure. Colleagues may spend days, weeks, or even months living in extremely close quarters without a break, and are separated from friends and family for extended periods. And the normal comforts and coping skills of home – a delicious meal, a walk in the sunshine, a long bath, or a night on the town, are unavailable.

The new project is sponsored by the National Space Biomedical Research Institute, and will provide a recorded video therapist to provide the popular therapy called “problem-solving treatment,” helping astronauts identify depression, its causes, and possible solutions they can implement while in space flight, before symptoms grow too intense and interfere with their mission. Then astronauts can type in a description of their problems and feelings and the video therapist responds. Astronauts can also practice conflict resolution with role-playing, and will have access to virtual psychology text books.

Twenty-nine current and former astronauts have been consulted for the project, but it has great potential for many populations, such as scientists or soldiers at remote outposts, or anyone who has physical or emotional difficulty getting to appointments in person.

The program comes in response partly to past experiences. In 1985, a mission on Russia’s Salyut 7 space had to aborted when the commander become depressed and lethargic. Three years earlier, another Salyut mission was almost abandoned due to conflicts between two astronauts.

Click here to contact Daniel and/or see his GoodTherapy.org Profile ©Copyright 2008 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
Therapist Seattle

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

A new study in the Journal Human Reproduction reports that depression is a measurable risk factor for pregnant women and their infants, leading to higher rates of premature birth. “Depression during pregnancy has been understudied, under- recognized and frequently ignored,” Dr. De-Kun Li, who authored the study, told Bloomberg News. “Now, we have the strong evidence that I hope will raise the alarm.”

Previous research indicates that as many as a fifth of pregnant women will experience depression, with about 1 out of 15 pregnant women having severe symptoms like anhedonia, sleep disturbance, and suicidality. In this new study by Kaiser Permanente, of 791 San Francisco Kaiser members 10 weeks pregnant, 41% had either significant or severe depression symptoms, and women with symptoms of severe depression had twice the risk of early delivery in the new study. Women with less severe depression had a 60 percent higher risk of giving birth prematurely, defined as delivery before 37 weeks. (more…)

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

The suicide rate in the United States is increasing for the first time in a decade, according to a new study at Johns Hopkins that relies on CDC data. The study was remarkable not just for this reversal in trend, but for a demographic surprise: The rate of suicide is increasing fastest among middle-aged white women.

The researchers found that from 1999 to 2005, the overall suicide rate in the United States rose 0.7 percent. However, among middle-aged white women, the annual increase was 3.9 percent; among middle-aged white men it was 2.7 percent.

The study did contain some good news: suicides have declined among the elderly, possibly due to more attention to suicide risk in older adults, resulting in successful interventions with depressed individuals, including mental health services and social supports.

The suicide rate also declined for black Americans and remained stable for Asians and Native Americans.

Among women, “this 40-to-64 age group has been neglected,” said Susan P. Baker, public health professor and lead researcher on the study. “The death rates were higher in elderly white males, and there has been a lot of attention to teenagers and young adults.”

The most frequent method of suicide was using a firearm, although the rate of suicide by this method declined. Suicide by hanging and suffocation rose significantly, accounting for 22 percent of all suicides by 2005. Among men, hanging/suffocation rates increased 6.3 percent annually; among women, the yearly rise was 2.3 percent. Poisoning accounted for 18 percent of suicides, the study found.

The report was published online Oct. 21 in the American Journal of Preventive Medicine.

Click here to contact Daniel and/or see his GoodTherapy.org Profile ©Copyright 2008 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
Therapist Seattle

By Arthur Becker-Weidman, Ph.D.

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

Attachment is fundamental to healthy development, normal personality, and the capacity to form healthy and authentic emotional relationships. How can you determine whether your child has attachment issues that require attention? What is normal behavior, and what are the signs of attachment issues? If you’ve adopted an infant, when will you see attachment problems develop? These and other related questions are often at the forefront of adoptive parents’ minds. In this article I will help you understand what to look for and how to identify concerns. (more…)

By Jeanine Austin, Ph.D.

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

Years ago, I was working late at my office in social services when two young prostitutes who had just been released from jail knocked on the front door of the building. They were in need or food and clothing. Despite their inquiry, they were somewhat sarcastic and rude. My intuitive feeling was that neither of them was long for this world. They both appeared to be drug addicted and seriously ill.

I got them some both something to eat and then I took them into the storage room to look for some clothes. They both began to choose the clothing they wanted. One of the young women had red hair and when she tried on a blue blouse her blue eyes shone. I told her how pretty she looked in the blouse. Her demeanor instantly changed and I think I knew why. In that moment, I acknowledged her not as a drug addicted prostitute, someone to be thrown away, but as a dignified human being. That lesson has stayed with me throughout the years. (more…)

By Lisa Brookes Kift, MFT

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

From the time we are born, relationships are one of the most important things to all of us. Our behavior has the power to either bring people closer to us - or push them away. Consider for a moment the people in your life; your family, friends and intimate partnerships. What is the quality of relationship you have with them?

Are there people in your life who are behaving in a way towards you that causes distress, sadness, confusion or anger? Is there not a shred of evidence to support the possibility that they take responsibility for this and/or willing to make changes for the sake of the relationship? Ask yourself whether this works for you. (more…)

Dear Members and Visitors to GoodTherapy.org,

Today the GoodTherapy.org Team and many GT members enjoyed the second event in our Fall Teleconference Series: ‘Emotional Intelligence in Relationships: Advanced Strategies for Teaching your Clients to Rewire Outmoded Emotional Habits’ presented by Brent Atkinson, Ph.D. A great big thank you to Brent for presenting his fascinating work with couples and sharing his wisdom about applying emotional intelligence and findings from neuroscience to therapy with couples. (more…)

Written by Jeanette Raymond, Ph.D.

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

If you are considering entering into psychotherapy chances are it is because of a strong sense of unease within yourself. There is a powerful urge to get rid of that discomfort no matter how it is manifest. It may be anger, jealousy, guilt, feeling constantly wounded, fear of losing an important relationship, or a sense of frustration/dissatisfaction with the way  life is. Often there is a need to feel in control of your life, or a desire to discover if you are lovable no matter how bad you think you are. Sometimes there is a massive fear of change and needing a place where the world can stop for a while. Whatever the initial reason for seeking psychotherapy the basis for the work will mean exploring the relationship you have with yourself. The process can be long and arduous and it takes courage and forbearance. It requires allowing yourself to pass through many stages of self-discovery while you get relief from your discomfort. (more…)

By Barbi Pecenco Kolski, Marriage & Family Therapist Intern

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

People often come into therapy talking about what bad people they are and go on to describe the “horrible” things they have done. Their language is often extremely pathologizing and they feel they deserve to beat themselves up. They are filled with shame, believing that their behavior shows what a bad person they are.

A good therapist will listen in a nonjudgmental way and help the person to see that a person is not their behavior. We are so much more than our behavior. I also like to explain to clients the difference between “healthy guilt”, “neurotic guilt” and “shame”. When we experience healthy guilt, we are essentially saying, “Ok, I messed up. I violated a value that I have that says….blacking out, cheating on my boyfriend, lying to my parents, you fill in the blank…is wrong. I am not happy with this behavior, so I need to take some steps to self-correct.” (more…)

Dear Members and Visitors to GoodTherapy.org,

Today the GoodTherapy.org Team and many GT members enjoyed the first event in our Fall Teleconference Series: ‘Walking The Healing Walk with Power’ presented by Judith Barr, LMHC. Big “thank yous” to Judith for presenting to GoodTherapy.org members her very important work on healing the abuse of power in our world. It was a unique and supportive gathering that gave participants room to reflect, explore, and share with each other how each of us has been impacted by the recent political and economic events. (more…)

Written by Julie Simons, LCSW

“So what do you do for a living?”

The inevitable question asked at any social gathering. Though typically an innocuous question, I find myself dreading it. This is probably due to the flash of fear I often see upon the word, “Psychotherapist.” Sometimes, people are even bold enough to ask, “So are you analyzing me right now?” Unfortunately, this is reflective of one of the many myths that continue to persist around this profession. So I’ve taken on the task of blasting some of those myths and hoping to provide a clearer understanding of what this therapy business is all about. (more…)

Written by John C. Rhead, Ph.D.

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

DEFINITION OF PSYCHOTHERAPY

For the purposes of this essay, I will use the term “psychotherapy” to refer to a particular type of interpersonal process intended to facilitate conscious awareness of that which had previously been unconscious.  It is not meant to include the direct attempt to modify behavior, whether overt as action or covert as thoughts and feelings, through medication or manipulation of the external consequences of behavior.  Similarly, it does not include counseling, coaching, advising, or teaching as its primary goal. (more…)

Therapy for Abortion - Update to Common Therapy Issues

This relatively new area of therapy is emerging as an important part of the process for many women who choose to terminate their pregnancy.

The political controversy over abortion may make the process more confusing or upsetting for some. But even leaving politics aside, research indicates that having an abortion is a very difficult decision for the vast majority of women and that the aftermath is likely to lead to at least some emotional and psychological challenges, whether they are minor and short-lived, or more intense and long-lasting. Having second thoughts, guilt, internal conflict, grief, or other challenging emotions and thoughts is somewhat typical, and the nonjudgmental, compassionate ear of a good clinician can be very helpful in working through these thoughts and feelings.

Men whose partners have an abortion may also experience internal conflict or unpleasant feelings, and should not hesitate to talk about this in therapy. Couples work may be particularly helpful – if also especially challenging at times – when an abortion has occurred in the relationship.

Read More here: therapy for abortion

A GoodTherapy.org Featured Column written by Mary Ellen Barnes, Ph.D. & Ed Wilson, Ph.D., MAC

Click here to contact Mary Ellen and/or see her Profile
Click here to contact Ed and/or see his Profile

Over the past decade research has found that for many women the onset of alcohol abuse coincides with changes in hormone levels – changes that many women are unaware of in the early stages. When this is combined with other stresses in their lives - job changes, health concerns, children leaving home - women can find themselves abusing alcohol for the first time in their lives.

In our teens, 20s and 30s, our ovaries and adrenal glands produce a form of estrogen called estrodiol. Later, during our mid to late 40s and early 50s, our ovaries begin producing less estrogen, leaving more of the work to our adrenal glands. As the adrenal glands take over the job, estrogen drops, spikes and drops again—rather erratically. At this point, many women report that they start to get forgetful and experience “foggy thinking” and moodiness. That’s because our brains work better when estrogen levels are steady. These are the first signs of menopause and, sometimes, the beginning of escalating alcohol consumption as a means of easing various unfamiliar discomforts. (more…)

Anxiety - Update to Common Therapy Issues

Anxiety is one of the most common reasons people seek therapy. Some level of anxiety is normal in human beings; excessive anxiety can interfere with relationships, sleeping and eating patterns, work and school, and all areas of life.

The Basics: Anxiety is defined as nervousness and an inability to relax. In the Body, people with anxiety may experience psychomotor agitation, pacing, shaking, trembling, quivering, sweaty palms, racing heartbeat, insomnia, tension, headaches, nausea, and difficulty breathing. A panic attack occurs when these somatic symptoms are severe and acute, sometimes mimicking the symptoms of a heart attack (though there is no record of panic attacks leading to actual coronary arrest). Read More here: Therapy for Anxiety

Depression - Update to Common Therapy Issues

Depression is a state that affects mind, emotion and body, creating a dysphoric mood, lethargy or anxiety in the body, and thoughts of hopelessness, helplessness and, in a significant number of cases, suicidal ideation. Depression should not be confused with normal grief in the aftermath of a major loss, although extended grief may lead to true depression. Depression that is mild and chronic, with fewer symptoms, is known as dysthymia. Depression may present differently based on age or cultural factors. Adolescents tend to show an irritable and agitated depression; older adults may or may not be irritable; certain cultural groups may mask their feeling to varying degrees; women are known to be more likely to admit to depression than men. Depression is one of the most common reasons people seek therapy. Read More here: therapy for depression

By Jennifer Lehr, MA, MFT

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

How many times have we begun a relationship, full of hope, only to have it crash and burn, or one party flee?

Many of us have relational injuries from the past. This often manifests as a “fear of intimacy.” Beneath this phrase, lurks not feeling safe in relationships. Our fathers may have had tempers, or our mothers may have been intrusive. A past partner may have been abusive, or perhaps their neediness or jealousy was a burden. A multitude of possibilities exist. Whatever the case, we found that relating to another could be costly. We learned to defend ourselves, to shut down, cover up, disappear, attack, or protect ourselves in some other way. We learned to not be too vulnerable, to only let the other in so far, or to run if we got scared. We learned to make ourselves safe by controlling the depth of the relationship in a variety of ways. (more…)

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

A review of 23 studies that looked at the results of long-term, psychodynamic talk therapy concluded that such therapy improved the symptoms of chronic mental problems, including anxiety and borderline personality disorder, better than some shorter-term therapies.

The studies included a total of 1,053 clients undergoing weekly, twice weekly, or three times weekly session for at least a year and often much longer. Most of the clients had 50 or more sessions, and all were followed closely by researchers in the original studies.

The authors, writing in the October 1 issue of The Journal of the American Medical Association, recommended that researchers focus more on psychodynamic therapy, noting that the managed care system has been loathe to pay for such treatment, citing other studies that seemed to show the superiority of cognitive behavioral, short term therapy. (more…)

By Jim Hutt, Ph.D., MFT

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Yelling at Children

This is a topic that has meaning for everyone. All of us have raised our voices, probably more than once. No, I did not come from a home of screaming parents or siblings. However, I do see many families and couples who yell a lot at each other, and the short and long-term consequences of regular yelling/screaming are not pretty. Those of you who experience yelling know what I’m talking about.

Let’s start with the impact of yelling at children:

First, it teaches them how to yell, when to yell, and that yelling is an effective response to emotionally charged situations. By extension, it teaches them an ineffective way to process anger, as anger is usually associated with yelling.

Second, yelling scares most children—the younger the child, often the more fear they feel. In a state of fear it is next to impossible for a child to think about their mistake or misbehavior. If a child cannot think about their mistake, a child cannot learn from their mistake. (more…)

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

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

“You can outdistance that which is running after you, but you cannot outdistance that which is running inside you.” -African Proverb

My soul thirsted for down time, as if it was parched for the very fundamental nature of itself. Two weeks off from all that was my daily life and practice. Read. Write. Rest. Heal. Yet, as my soul and body thirsted for it, my ego struggled with the decision. My mind knew that I needed the time away to recover from a medical procedure. Not a big deal; it knew all of the valid reasons for it. I couldn’t imagine that my ego would argue with me. But, it did. And it yelled loudly.

The Hurricane

When is the last time that you focused on really, truly, not “doing” anything? My ego wanted me to stay busy, do usual activities, drive forward, and, ultimately, keep things the same. It was becoming agitated by the very stillness that the absence of those activities would create. Yet, my soul knew that the calmness was exactly what was necessary. And, by wanting to keep things the same, my ego wanted to distract me from whatever it was that I could not outdistance. Oscar Wilde once said, “Nothing is so aggravating than calmness.” For the first few days of my down time, I agreed with him. (more…)

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

New research indicates that women are generally better at expressing emotions and articulating their presenting their problems in therapy. A new study of 18 men and 18 women, carried out by the University of Montreal department of Psychology, used the “Grille de l’Élaboration Verbale des Affects” (GEVA, or verbal elaboration chart) to measure verbal communication and emotional expression. It found that women (and French-speaking Canadians) were more apt to use metaphors, identify childhood traumas as causes of their emotional problems, and verbalize rather than act out anger.

Serge Lecour, the study’s author, also sees the GEVA as a potential tool for predicting the presence of personality constellations, success in therapy, and potential for aggression. The GEVA scale has five levels and it factors in four distinct ways of expressing emotion: somatization, motivity, imagery and verbalization.

For example, someone who is aggressive will be a “Motor 1” while a “Verbal 5” will rationally examine his or her emotions and potentially connect them to childhood experiences, and a ‘Psychsomatic 1,” is likely to have a panic attack, while “imagery” users are able to think abstractly and metaphorically (“I saw blue, I saw red”).

Researchers have long observed differences in how men and women verbalize differently, but according to Lecours, these findings are different. (more…)