Editor’s Note: Explore What’s Next continues to grow! As Director I couldn’t be more pleased and proud. In the next few days you will meet the wonderful therapists who make up the Explore What’s Next team. First please meet Nicole. Her recent posts about happiness and mindfulness are quite popular. I can’t wait to hear more from her.
“Life is always moving. Sometimes we fall behind the pace and it can be stressful to catch back up. It’s been my experience that, if you have the right tools, you can get back on track and stay there. But that’s not always easy. Anxiety and depression can be barriers to a happy, healthy life.” ~Nicole Newcomb
As a Mental Health Counselor, LMHC-P, CASAC-T, I specialize in cognitive behavioral and mindfulness therapy. I love working with families, adolescents and young adults who are having trouble navigating life transitions. Individuals may be recovering from the pains in life such as past trauma, family strife and could use some support becoming an independent adult. With a background in substance use counseling I have experience helping people with the recovery process. These days this is not an easy path and can lead to understandable anxieties.
Everyone is recovering from something and could benefit from the support of therapy. As a mental health counselor, I see the prevalence of anxiety and depression and it appears to be ever growing. It can be overwhelming with the increasing pressures of obtaining a college degree, the fast pace of life, the economy and balancing being your own person and figuring out who you want to be for the rest of you life.
With knowledge in Cognitive Behavioral Therapy and Mindfulness Therapy, I can help you to better cope with life stressors, regain your life balance and move ahead with confidence! If you or someone you know could use some guidance and support when it comes to figuring out what’s next for you,
Give me a call at 716.440.5627, find me on Facebook, or email me at firstname.lastname@example.org to schedule your initial consultation!
We have a new look here at Explore What’s Next! For the last six months I’ve worked with SmackSmog to produce a freshened up look to our logo. Developing a new brand representation that I could commit to, be proud of, enjoy showing off and sharing, was deeply important to me. Fortunately, the geniuses at SmackSmog stuck with me until we had a look that filled all my requirements.
My wish was to have a graphic that represented adventure, the challenge of climbing a hill to get to the other side, with colors that invited calm, security and hope. I am thrilled with the results!
And that’s not all that’s new!
Joining therapist Dylan Broggio and me is Nicole Newcomb! Nicole is a Mental Health Counselor who specializes in cognitive behavioral and mindfulness therapy. She loves working with young adults who may be having trouble navigating the transition from original home and family to becoming an independent adult. These days this is not an easy path and can lead to understandable anxieties. Nicole is a terrific counselor so if you or someone you know could use some guidance and support when it comes to figuring out what’s next for you, give her a call!
I am so excited with how Explore What’s Next is growing. It isn’t easy keeping up with everything that entails running a successful psychotherapy practice and having a fulfilling life outside of the office, but I will leave that for another post. For now I wanted to take a moment and just celebrate!!!
Technology is an awesome tool that can enhance psychological services if done by a knowledgable therapist. For many years I’ve enjoyed working with a lot of people from around the world but it’s not for everybody.
Below I provide the basic notes outlined after a popular talk I give to behavioral health professionals interested in the ins and outs of using the modality of telepsychology in their practice.
[Click here for a pdf with hyperlinks to useful articles, information and resources on this subject. Tele-Psychology handout]
Telepsychology is a big fat subject. For the sake of organization and saving a few brain cells, this talk is divided into four parts that overlap here and there:
I. Introduction & History
II. Why do it? With Whom?
III. Ethical & Legal Considerations
IV. How Do You Do It?
Let’s start with a definition of telepsychology: The provision of psychological services given remotely using telecommunications technology.
Email, texting, faxing, telephone and video conferencing all fall in to this category. Here I mainly focus on video for direct service and email/texting for indirect service (scheduling).
Personally, I am not comfortable with the idea of providing therapeutic service in an email conversation or an instant messaging chat. There is too much opportunity for written words to be misread. I prefer telephone and video. This is a personal choice.
Even though I do believe face-to-face is best, tele-sessions can be a good-enough alternative.
Tele-sessions are very enjoyable and effective. People report satisfaction in the quality of counseling they receive via video chat. When it’s done well it can feel as if the client/patient is in the room with you.
There aren’t a lot of reliable studies that I could find but what I did find suggested that for certain situations video sessions can be as effective for long term symptom relief as face-to-face counseling.
Technology is a gift and like any gift can work for us if we have the wisdom to know how to use it, when to use it and when not to. There are incredible positives to being able to help your clients when they cannot come into the office. There are negatives which we will cover here but over all I believe having the ability to use tele-sessions as an added value to your practice and can be rewarding for you and for your clients.Read More...
The statistics on depression are depressing. About 5% of the world’s population suffers from depression at some time. In the US depression is the leading disability for people between 15 and 45 years of age. Chances are good that you or someone close to you has experienced depression first hand. There are so many myths and misconceptions around depression it is refreshing to watch this program, Charlie Rose Brain Series: Depression, where intelligent people explain what depression in all it’s forms looks like, can feel like and how it can be treated.
What I appreciate about this program is that these experts, the people who study depression as well as those who have experienced the worst kind of major depression first hand, all state that psychotherapy alone, or with medication, is a powerful treatment for depression. Too many physicians out there are very quick to treat their depressed patients with Zoloft, Wellbutrin or whatever, and do not bother to make a referral to a good therapist. Offering drugs alone may be depriving their patients of the most effective way to not just get them out of depression but to help them stay out. Depression, like anxiety, can relapse. Good psychotherapy provides people with psychological, emotional and behavioral tools that can be used as needed.
Medication is good. Psychotherapy is good. In combination, for some of the worse, most stubborn depression, they can be the needed one two punch.
Click here to view the program’s video. It is an hour long show well worth your time.
There was such a fuss about Maria Shriver’s commencement speech to the graduates of the University of Southern California’s Annenberg School of Communication, I finally took the time to watch it. And damn it, it was good.
What made it good was what makes most communication good. It was genuine. She spoke with ease and humor, some of it aimed at herself which is always charming when the woman is gorgeous and powerful. And she spoke from a place of passion that made you think that she really believes what she is saying, she really wanted those young people to listen.
What she wanted the kids to hear is not original to her. That doesn’t make the lesson any less valuable to all generations, not just the Annenberg graduates. She pointed out that in this crazy world we live in we could use time to stop, to set aside for ourselves, weary from the chaos of 24/7 connectivity, to pause. She said:
You know, I didn’t invent this stop-everything-and-pause idea.
Jesus fasted for forty days and nights in the desert. Henry David Thoreau went to Walden Pond. Ann Morrow Lindberg went to the sea. Buddha, Gandhi, Mother Teresa — the greatest and wisest have often stopped and withdrawn from active lives to journey within themselves. The wisdom they garnered there and shared with us has impacted the world.
But, hey, don’t worry! I’m not asking you for 40 days and nights! I’m only asking you to stop every so often and turn off your mobile device, put down the Angry Birds and the Words with Friends and take a moment. Stop to look up and look around. Pause and check in with yourself — and spend a moment there.
It wasn’t until after I heard the entire speech that I thought, “She could be describing therapy.”
Good psychotherapy gives you a pause away from the world; a little space and time away from the tsunami of demands coming from all directions from all kinds of people at all hours of the day and night. During the pause of the psychotherapeutic hour, in the hands of a good therapist, we have a chance to step back, even from our own mind and those impossible expectations we place on ourselves. In that pause we give ourselves a precious gift. We learn to nurture ourselves. We learn to heal the hurt places. We re-discover the strength that had abandoned us long ago. We learn to love ourselves again. To love again. That is good therapy.
Here is Maria Shriver’s speech in its entirety:
I read somewhere that properly diagnosing chronic illness can take from two to three years. Many of you wait even longer.
In the meantime, while the doctors scratch their heads, we’re expected to be happy we’re alive. And that’s if they don’t write us off with “It’s psychological.”
It took a year and three doctors before I was diagnosed with scleroderma. Just remembering what I went through during that year-from-hell gets my blood boiling and I was one of the lucky ones.
If you are experiencing symptoms but don’t have a diagnosis yet, here are some tips that I hope will help you get through this trying time a little easier.
Trust yourself. You are not crazy. Physicians have referred many people to me before they had a diagnosis, even doctors who don’t know what else to do for their patients. ALL of them eventually received a medical diagnosis. That’s right. ALL OF THEM.
Maybe I see a skewed sample of the general population but I don’t think so. Medicine is slowly catching up to the experience of hundreds of thousands of people reporting symptoms for which there is no hard, “objective” test. They should be believed. Even the Veterans’ Administration has come to recognize that when a combat veteran says he is suffering from PTSD, he is not faking. We do not want to be sick and it just pours salt in the wound when anyone suggests we are making this stuff up.
Learn who you can confide in and who it’s best not to. Your loved ones may be among those who have doubts, especially if you don’t look sick. They may not understand that there is a huge amount the science side of medicine needs time to deal with or just doesn’t know.
Many chronic illnesses develop slowly and the symptoms overlap. There are few ‘hard, objective’ diagnostic tests that rule-out or rule-in a particular disease. Your family and friends may be frustrated and confused. Before your struggle, they thought doctors knew everything and, like Gregory House, could have you diagnosed and treated within the time it takes to microwave the popcorn. When given a choice of trusting the doctor or trusting you, you might lose out.
For those who are open to it, you can try educating them to this process. To those who aren’t, avoid them like kryptonite. They will suck away your precious energy.
But I’m getting side-tracked. My point is, that even when those around you are questioning the reality of your symptoms, trust yourself first.
If anyone, friend, foe or doctor, tells you any variation of “It’s all in your head,” please, resist the urge to spit in their eye. On the other hand, I’m telling you, getting angry and defensive on your behalf is better than doubting yourself and becoming depressed. Just regulate your anger so that you don’t alienate the very people you need. Do that by being direct, controlled and civil when you say, “That makes me angry.” Then let it go.
When your doctor tells you to go to a psychotherapist, don’t throw the baby out with the bathwater. Some doctors will refer you to a psychologist because they truly believe it would benefit you to talk to a professional who can help you cope with the emotional side of things as they try to figure out what is going on medically. That is great. Take the referral and try it out. A good therapist will totally get what you are going through, the fear and anger, on top of more fear and anger. A good therapist will give you a safe place to sort it all out and practical guidance as to what to do with it all.
On the other hand, many doctors will tell you to see a shrink because they don’t know what else to do with you. It could be your anxiety, depression and anger makes them uncomfortable. Sad but true. Don’t let that devalue the benefit of a good therapist. Take the referral or find your own. You may discover it is actually a relief to talk to a good therapist and there could be other benefits.
Deb wrote to me about her experience after reading my article, Five Rules for Living With Chronic Illness. Before she was diagnosed with neurocardiogenic syncope she was
“in and out of the emergency room for two years and saw scores of “ologists” – cardiologists, neurologists, endocrinologists, internal medicine, you name it. But because I never completely lost consciousness (I could always hear what was going on) the common theory was that my condition was psychosomatic. So I saw a psychologist. He saw one of my spells during one of our sessions and told me “it definitely is NOT psychosomatic, it’s physical.””
It took two more frustrating years before Deb was accurately diagnosed but at least she had validation that her symptoms were real.
Hint to doctors: Listen to Deb, who writes, “
What doctors need to realize is that we, as patients, don’t expect them to know everything. We do expect them to listen and treat us like intelligent, rational people. Maybe some of us are square and don’t fit into the round holes most doctors see everyday; but that doesn’t mean our symptoms aren’t real.”
Finally, as hard as it is, nurture yourself. As a chronic illness patient you will be telling your story to a million people, a million times. You will visit a gaggle of doctors, nurses, lab technicians, receptionists, offices and hospitals. You will fill out reams of forms, give up quarts of blood and pee, be poked and prodded, dress and undress a thousand times. It is exhausting. Stop long enough to replenish yourself body and soul. If you pray, pray. If you meditate, meditate. Laugh! Give yourself a pity party for twenty minutes (no longer),complete with chocolate! If you have just one person, place or thing that eases you back to your peaceful place, be grateful and spend time with them.
Above all, listen to your gut.
Read this article. To Reap Psychotherapy’s Benefits, Get a Good Fit
It has good advice for those in therapy or thinking of engaging a therapist. When people call me to set up an initial session I recommend that they interview me as well. In other words, they are encouraged to ask me questions in the service of helping them determine of I am a “good fit” for them. It’s one of the things I do to help develop what psychotherapists call a “working alliance,” essentially team building.
If we’re not a good fit one or the other of us knows pretty quickly, sometimes even in that first call. And it could be for all kinds of reasons; I may not have the expertise they are looking for, my office location or schedule may be prohibitive, they’d rather see a male therapist… What’s more difficult to identify is when the lack of fit has more to do with that “je ne sais quoi” of personality or approach or style.
A good therapist is one who makes every effort to hone many skills since not any one is going to fit every person who comes to you for help. We carry many tools in our tool kit. A professor in graduate school said, “If you only have a hammer all you see is nails.” Even if we only treated one person, as that person progressed through therapy their needs will change and so must the therapist’s interventions.
So what happens when I don’t have the tool for what my patient needs? Often I go to a colleague for peer supervision. Sometimes I will read on the subject or go to a continuing education workshop. Once in a while the best answer is to suggest a consultation with another professional.
What complicates this decision for the therapist is the concept of counter-transference. We need to be good and sure that we aren’t pushing our patient away simply because we are frustrated, something about them irritates us and that something has more to do with who we are rather than the problem the client brings to us.
This is probably more information than you ever wanted so I’ll stop now. Let me just say that being a good therapist requires quite a bit of juggling, balancing and constant assessment, not only of the patient but of ourselves. To achieve that, our education and training never stops. That’s what makes us professionals.
The therapy hour can go by very quickly. The good work my clients and I do in session carries into the time between visits with “homework” we design together and “bibliotherapy.” There are so many great books out there written by people who are qualified experts in their fields, it’s like having the best and brightest in consultation with us. None are required reading, only really pushy suggestions. Why not take the time to go to a book store with a cafe (whoever invented the bookstore cum cafe idea deserves the Noble Prize!) grab a handful of whatever speaks to you (books, not cookies) sit, sip and browse. Below are just a sampling of favorites.
Cognitive Behavioral Therapy (CBT) is a well-studied talking therapy known to be an effective non-medication treatment for mood problems and low self-esteem. When my clients are struggling with any of these issues I often suggest these books to help them understand the underlying theory that is a big part of how I help them. The more my clients know what I know, the better. In Feeling Good: The New Mood Therapy Dr. David Burns outlines the fundamentals of CBT, what it is and how to apply it to your situation. His style can be on the academic side which many people prefer but it’s not for everyone. He certainly does not talk down to you. Consider his books a reference, not something to necessarily read cover to cover. The Feeling Good Handbook is more hands on with exercises that help illustrate how your particular thoughts can influence how you feel. Some find Dr. Mathew McKay’s workbook Thoughts & Feelings: Taking Control of Your Moods and Your Life an easier read. Your choice of book is purely a personal preference. It’s all good.