5 Thoughts to Help Cope with Anxiety in The Moment

Anxiety can feel overwhelming, often involving unpleasant physical sensations accompanied by rumination that just won’t stop. Anxiety can creep up and spoil an otherwise pleasant moment. The very best thing you can do to cope with anxiety when it rises is welcome it in! It’s entirely counter-intuitive to do so, yet it works. In fact, it is the most effective treatment for anxiety.

When you try to avoid feeling anxious, push it away, or try to distract from it, you are feeding the monster and anxiety will continue to grow. If you attempt to escape anxiety, you are learning that anxiety is something dangerous to be feared, which in turn increases your experience of anxiety. When this happens repeatedly, you become more and more anxious. When you not just face anxiety, but welcome the experience in, you will learn that anxiety is not to be feared, you can cope with whatever comes your way, and then, and only then, will anxiety subside and become tolerable.

Use these to encourage yourself to cope with anxiety in-the-moment.

 

 1. “This is a moment of suffering”

Acknowledging that you are in a painful moment is a first step toward tolerating it. Taking a mindful approach by simply labeling that “this is a moment of suffering,” can help you notice and attend to what is happening. When you mindfully label this experience, it can give you some space to decide how to respond. Instead of being caught in the hurricane of anxiety, you can take an internal step back, put words on your experience, and have a moment to get a little perspective to cope with anxiety. Acknowledging when you are in a moment of suffering is also a first step in the practice of mindful self-compassion, a therapy developed to alleviate human suffering.

 2. “I can do it”

Anxiety and fear can make you freeze up, holding you back from some task you need to do or a goal you want to go after. Remind yourself you can do it (after all, you made it this far). Sure, it may not turn out perfect or exactly as you want. However, when you commit to trying, there is hope that it can work out. When you try, you also get a chance to learn. Saying to yourself, “I can do it,” reminds you that even if you are feeling so anxious that you are sweating and shaking, you can still continue to put one foot in front of the other, gently moving toward your goals. Anxiety and fear may come along for the ride, and they don’t have to stop you from getting to where you want to be.

5 Ways to Cope with Anxiety in the Moment

 3. “I can get through this”

Maybe you have tried something new, and it’s not working out. You may feel like your world has crashed down and thoughts like “I can’t cope with this” and “I can’t get through this difficult situation” may cross your mind. Anxiety is a common trigger for the belief that we cannot cope or we can’t make it through. Remind yourself you can get through this. Chances are, you have already faced challenges in your life. Each time, you managed to make it through and learn from the situation – you may have even ended up with a better outcome. Draw upon this inner reflection on strength and resilience to get through this situation too.

 4. “I am here now”

One of the biggest causes of anxiety is the tendency to live in the past and the future, rather than the present. Sometimes, you may dwell on the past with regrets. You may worry about the future and what could be. This adds to anxiety by keeping your mind spinning in many different directions and adding the pain of the past and possible pain of the future to an already difficult moment. Use gentle reminders to pull yourself into the present. You can also support a present-focused mindset with mindfulness techniques, such as slow, deep breathing or noticing and labeling your surroundings, such as describing the shape and color of objects in your environment.

 5. “I am okay”

Fear is a hard-wired response that you have developed through many years of evolution. Fear tells you a threat is near, and you must take action. However, fear does not always fit the facts. Anxiety is fear run amok and the fear of possible threats. When you feel anxiety, check things out. Look at your emotions and the facts of the situation. Evaluate whether that anxiety is well-founded or a false alarm. Sometimes your anxiety is well-founded, and you should react. Most of the time, anxiety is your mind working in overdrive and there is no real life-or-death threat in your path. In those cases, remind yourself that your brain is trying to keep you safe, but you are okay. It helps to notice the fear so you can cope with anxiety and understand that it is the experience of it and, you are okay.

If you struggle with persistent anxiety, you might benefit from the help of a therapist. Mental health providers who use Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT) can help you recognize and challenge your thoughts, tackle anxiety, and provide one-on-one solutions empowering you to manage and cope with anxiety. If needed, contact a qualified therapist to help and start shifting from surviving to thriving today!

 

 


What Happens When You Stop Depressant or Anxiety Medications?

Anti-depressant and anti-anxiety medications work to alter your brain chemistry and support a more balanced mood state. Since psychotropic medication changes your brain chemistry and may also come with side effects, deciding to take medication should not to be made lightly.  It’s helpful to understand how the medication you are prescribed works and what to expect when discontinuing it before deciding to stop. It’s always advised to be under the supervision of a doctor who can ensure your safety and help minimize any side effects before discontinuing psychotropic meds.

(Please skip to the last section of this article if you would like to consider alternatives to psychotropic medication and discuss your options with your prescribing doctor and other healthcare professionals.)

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Why Take Psychotropic Medications?

If you are struggling with depression or anxiety in a way that is significantly affecting your life, your doctor may recommend anti-depressant or anti-anxiety medications. Medications are also sometimes prescribed to alleviate symptoms, making therapy more helpful and useful. When feeling burdened by emotional overwhelm, at times it can be impossible to participate in your therapy in a way that promotes the change you need or motivate yourself to follow up on homework in-between sessions. When this is the case, your doctor may recommend psychotropic medication to help you engage in therapy in the way that you need to give you some relief from the symptoms you are experiencing.

Current-day research supports the use of both psychotropic medication and Cognitive Behavior Therapy (CBT) to treat diagnoses associated with depression. Medication may help you be fully involved and benefit from therapy. CBT will help you make the chemical changes in your brain for the long-term so that if you decide to taper off your medication at some point, you can maintain the brain changes you have worked to achieve in therapy.

In other cases, psychotropic medications may be prescribed to address chronic forms of depression and anxiety. Some people suffer from depression and/or anxiety for years. Despite trying many approaches, they struggle with symptoms on a daily basis. In these cases, medication may be a helpful option. Some people choose to maintain their medication regimen for a lifetime because when the medication is withdrawn, symptoms quickly return. Sometimes, even when engaging in all the behaviors necessary to support your health, the chemical components of the disorder you suffer from are just too strong, and medication is an essential part of your health routine. Each person is unique, as are the type, dosage and length of time prescribed medication works best.

It is very important to note that psychotropic medications may be contraindicated for some anxiety disorders and interfere with treatment and prognosis. Evidence-based treatments for anxiety require that you are able to experience the anxiety to its fullest extent in therapy in order for the treatment to be effective. If you are taking medication to decrease your experience of anxiety, in some case, this may interfere with your therapy. Talk to your treatment provider so that you can collaborate about the most effective treatment for you.

 

How Do Psychotropic Medications Work?

Different anti-depressant and anti-anxiety medication work in distinctive ways. Some medications stimulate the brain to produce more neurotransmitters (chemicals in the brain that regulate mood and other processes). Some help the brain by blocking the effects of neurotransmitters. Others, affect the brain by encouraging it to hold onto extra neurotransmitters. Because it takes some time for these medications to affect and balance the neurotransmitters in the brain, anti-depressant and anti-anxiety medications need to be taken for a minimum period of time before results are noticed. Your prescribing doctor can advise you the time needed to experience the affects from your medication.

 

Why Stop Taking Psychotropic Medications?

People often decide to stop using their medications once they start to feel better. This can be a mistake. It is important to carefully consider this decision and preferably, discuss your desire to discontinue medication with your healthcare professional. Often, it’s wise to wait a while after feeling better before discontinuing your prescription. When people quit taking their medication too soon, symptoms can return and sometimes the medication does not have the same effect or potency on mood symptoms the next time around. It is often preferable to wait until you have made changes in your health behaviors and maintained them for long enough where they have become habits. Once you have made the changes needed to support your sustained mental health, you’ll want to make sure they are engrained and part of your life so that you will continue to be supported in this way after your medication has stopped. Other times, people may find the medication they are taking no longer works and they may need to stop one type of medication to start another. Additionally, people may need to discontinue using their medication due to some other health concern (possible side effects, drug interactions, or in cases of pregnancy).

 

What Happens When You Stop Anti-Depressant or Anti-Anxiety Medications?

If you are taking an anti-depressant medication and suddenly stop, it can cause unpleasant symptoms including nausea, vomiting, headaches, dizziness, nightmares, and paresthesia (unpleasant sensations in the skin). If you are taking an anti-anxiety medication (or anxiolytic) and suddenly stop, symptoms could include nausea, vomiting, seizures, sweating, weight loss, heart palpitations, migraines, muscle pain, insomnia, and even suicidal thoughts. Specific side effects are unique to the medication and the person who is taking it. In either case, you may experience a rebound of psychological symptoms.

Because suddenly stopping anti-depressant or anxiety medication can cause unpleasant side effects, it is very important to consult with a doctor before you stop taking prescribed medications. A doctor can help to assess whether this is the right choice. They will also help you slowly reduce your dosage so that you are weaned off the medication safely, which helps to prevent uncomfortable side effects.

When you start or stop medications, it can be helpful to also seek the services of a qualified therapist who can help you address thoughts, feelings and emotions that may be affecting your mental health. A Dialectical Behavior Therapist (DBT) can provide specific education and skills to help you naturally cope with life’s ups and downs, without medication in some cases. A frequently used DBT slogan is, “Skills over pills.” This means that with learning and practice of DBT skills, often people can reduce or eliminate medication and lean on the DBT strategies they have learned to help them function effectively. The most important thing is to work together with your doctor and therapist to find the healthiest and most effective treatment solution for you.

 

Alternatives to Psychotropic Medications

Taking any type of prescribed medication is a personal choice. While doctors can advise you and make recommendations, ultimately, the decision whether to take psychotropic medication is up to you. Many times, making lifestyle changes can significantly impact your mood and decrease the need for prescription use. However, making these changes can be difficult and requires work. Only you and your wisdom can decide whether you are in a position and have access to the support needed to make these changes, or if now is not the time and medication is a worthwhile option.

If you are interested in making changes to your health behaviors to support a more balanced and stable mood, consider consulting with a Health Psychologist, such as Dr Bando. Health Psychologists are trained to understand all the factors maintaining the ineffective behaviors you are engaging in and help you directly target and change those behaviors to better support you. A good therapist can take out the guesswork and help you move toward your health goals with ease and precision.

Whatever your choice, please consult your wisdom and be gentle with yourself. In a time of difficulty (like experiencing depression or anxiety), increased self-compassion is needed.

Take action today and start shifting from surviving to THRIVING!


Feeling Over-“stuffed”: 2 of 4

How to Focus on What Matters During the Holidays (and Keep Yourself Feeling Merry).

Part 2 of 4 of the Holiday Stress Survival Guide

 

The holiday season is here, and along with this time of year comes a lot of “stuff”! Yes, “stuff” can come in the form of things, objects, presents, toys, etc., but there is also a lot of emotional “stuff” that gets stirred up this time of year. If you are feeling over-“stuffed” and want to loosen the button on your emotional pants, read on for ways to cope. Part 2 of this four-part Holiday Stress Survival Guide focuses on relationships.

 

RELATIONSHIPS DURING THE HOLIDAYS

The holidays are a time when relationships come front and center. We often spend more time than usual with family members or those who are like family. We can find ourselves in a cocktail of a lot of face-time with people with whom we have a lot of history, and high stress, all while feeling rundown during these cold months and at the height of cold-and-flu season. Maybe not a mixture we would like to order often, but during the holidays, this is what we have on our plate.

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SKILLS FOR INTERPERSONAL CONFLICTS

Dialectical Behavior Therapy (DBT) is a well-researched therapy offering lots of skills that you can put into practice in real-time to get true results. There is a whole module in DBT focusing on Interpersonal Effectiveness. Here are some quick tips for applying some of my favorite Interpersonal DBT Skills to ward off (or decrease the likelihood of) interpersonal conflicts during the holiday season.

 

Be skillful, and ask for what you want, DEAR. DEAR is an acronym used in DBT that gives us a template for what to say when we would like to ask for something we want. It goes like this:

 

D – Describe just the facts, without judgment. This orients the person to what you would like to discuss.

Example: I’d like to talk about who is making each dish for Christmas dinner this year.

E – Express how you feel about the situation. Explicitly tell the other person how you feel. They may not know if you don’t say the words!

Example: Nobody has committed to bringing a dish yet, and since I am hosting, I’m feeling overwhelmed.

A – Assert what you want. Say precisely what you are asking. Don’t leave it up to guesswork. Be specific, direct and clear.

Example: I would love if you could tell me two dishes you will bring and let me know by this Friday.

R – Reinforce the person in advance for giving you what you want. Here, you are answering the question, “What do they get out of giving me what I am asking for?”

Example: If you tell me by Friday, you can choose whatever is your favorite to bring, and I will be much less stressed the next time we talk! (Don’t be afraid to use a little humor and an easy manner to loosen up the conversation.)

Practice writing out your DEAR ahead of time and then rehearse a few times before you deliver it. The beauty of this skill is that only four little sentences are needed to ask for what you want in a direct and assertive way. You can also use this skill to refuse a request, like a dinner invitation. Use the same steps but instead of “Asserting” a question, say “no” to the request. Try it!

 

VALIDATE (yourself and others)

Validation may be the most powerful interpersonal skill. Use it wisely! When used effectively, validation opens the doors of communication and closeness. Make sure that is what you want and you’re ready. I have seen validation break down walls that have taken years to build. It may be the most potent tool to affect change.

 

People often misinterpret what “validation” means. Validation is not a compliment, agreement, or approval. Telling someone you like something about them or think they are “right” is not validation. Validation is exhibiting that the other person (or yourself) makes sense. We display validation in many ways: paying attention, nodding, asking questions to clarify, making statements such as, “I understand why you feel that way,” or, “That makes sense.” In other words, validation is treating someone as though they make sense whether or not you agree with them or like what they are saying.

 

Validation of either ourselves or others is a mighty technique in diffusing conflicts. Once any of us feel understood and like we matter, we calm down and are less defensive. If you’re interested, check out my quick steps and worksheet for practicing self-validation. You can use the same steps on someone else.

 

Happy Holidays! Please remember, life is too short just to survive. Use these practices to help you THRIVE!

Read the whole series

Feeling Over-”stuffed” Part 1: Holiday Stress

Feeling Over-”stuffed” Part 2: Navigating Relationships

Feeling Over-”stuffed” Part 3: Loneliness

Feeling Over-”stuffed” Part 4: Overeating

 

If you use any of the practices suggested, please feel free to share your experiences and send your comments to contact@drbando.com. While Dr. Bando will not answer personally, your comments and feedback help inform future posts.


Feeling Over-“stuffed”: 1 of 4

How to Focus on What Matters During the Holidays (and Keep Yourself Feeling Merry).

 

The holiday season is marketed as being the “most wonderful time” of the year. For many of us, this is not always the case. Our to-do lists get longer: we have gifts to buy, trips to book, decorations to hang, cards to send, and on it goes. Many of us deal with stressful family dynamics that also like to come along for the sleigh ride.

 

All this busy-ness during the holidays can divert us from getting to the heart of what really matters. Everyone may have a slightly different idea about what they value most, but all of us typically want some sense of inner peace, satisfaction, happiness, and connection with those we love. Read on for Part 1 of my four-part Holiday Stress Survival Guide; it contains helpful tips to stop “stuff”ing yourself with all the things the holidays bring – gifts, lists, endless tasks, and yes, food – and ease through the season with a strong connection to whatever is deeply important to you.

 

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UNREALISTIC HOLIDAY EXPECTATIONS

Holiday movies often set the stage for unrealistic standards. With a funny or heartwarming story centered around family, they sell us the message of a season with fantastic holiday décor, impeccably wrapped gifts, chef-quality meals that magically appear, and relationship snafus ending in a hearty laugh and a hug. This all happens with full hair and makeup, flawlessly styled outfits, and no lint or wrinkles in sight. The media (and retail shops) create pressure to make the holidays shine with the perfect gifts.

 

Social media can also create pressure. Have you ever been at an event that was chaotic and not-so-fun, only to discover a friend post a picture of that same event looking charming and lovely? You wonder what happened to the screaming, running children, dog pee in the middle of the room, turkey that fell on the floor and all the grumbling guests.

 

The point here is that pictures and videos, whether they are professionally laid out ads who employ a full-time staff to capture one perfect-looking moment or a friend’s Facebook post, are typically not representative of how the in-person moment honestly feels. People are putting their best foot forward, and we don’t see the behind-the-scenes struggles. Have you heard that old saying, “Don’t compare your insides to others’ outsides?” You will almost always come up short.

So, what do we do?

Take control and set your own expectations!

 

STEP 1: DEFINE YOUR OWN VALUES

As always, take a deep breath (or three), and center yourself. Acknowledge that you have access to your wisdom and call on it to come forth and take over for a moment. Now, define a couple of values that you would like to take through the holiday season and jot them down or save them somewhere. Some ideas are below. Pick a few or come up with your own. Make sure to select value-words that resonate with you right now. Do not choose any words that come with the idea that you “should” value them. Only pick the values that sing to you in this moment.

 

ACCEPTANCE — ADVENTURE — BEAUTY — CARING — COMFORT — COMPASSION — CONTRIBUTION — COOPERATION — CREATIVITY — ECOLOGY — FAITHFULNESS — FLEXIBILITY — FORGIVENESS — FUN — GENEROSITY — GENUINENESS — GROWTH — HEALTH — HUMOR — INTIMACY — LOVING — MINDFULNESS — MODERATION — OPENNESS — PASSION — PLEASURE — PURPOSE — ROMANCE — SELF-ACCEPTANCE — SELF-COMPASSION — SIMPLICITY — SPIRITUALITY — TOLERANCE — TRADITION

 

STEP 2: PRIORITIZE

If you chose a bunch of values, take a moment to pick just one or two that stand out most to you. Check in with yourself and make sure it feels right – that if this value carries you through the holiday season, you will feel pride in your actions and as though you are living in your integrity.

Make the holidays easy, telehealth online therapy California

STEP 3: MAKE IT EASY

Nobody needs extra work during the busy holiday stress season. Instead of setting hard-to-reach goals about behaving in particular ways according to your values, let up a bit and create something gentler that will permeate and be effective.

 

I suggest putting the couple words you chose in the places that you will see them often. Some ideas: post-its on your computer screen, your bathroom mirror, in the car; notes with reminder bells on your calendar; a love note to yourself with these words placed in your packed lunch or on your nightstand to read just before bed and upon waking. You get the idea – put these meaningful values places that you will see them often. When you see them, you can just walk on by, and let them sneak in through your periphery. Sometimes, when you have the minute to spare, you can use the words as a reminder to take a breath (or three) and focus on your desire to bring these qualities into your life.

 

STEP 4: DON’T FORGET SELF-COMPASSION!

Want to turn it up a notch and ensure these values powerfully appear in your life? Offer them to yourself! Try a short, little practice daily, and you may be amazed at what starts to happen. Find a ritual that you engage in every day: brushing your teeth, making coffee or tea, putting on your shoes. Tie this ritual to the value-words you have chosen and offer these values to yourself. For example, if you selected the values of “comfort” and “health,” while brushing your teeth (or whatever activity you choose) say to yourself, “May I receive comfort. May I receive health.” Repeat the statements over and over again. Do it again the next day and the next. It does not matter whether you feel their impact or reject them totally. Keep saying the statements over and over. Let the statements do the work and seep in on their own time.

 

Happy Holidays! Please remember, life is too short just to survive. Use these practices to help you THRIVE!

 

Read the whole series

Feeling Over-”stuffed” Part 1: Holiday Stress

Feeling Over-”stuffed” Part 2: Navigating Relationships

Feeling Over-”stuffed” Part 3: Loneliness

Feeling Over-”stuffed” Part 4: Overeating

 

If you do partake in any of the holiday stress relieving practices suggested, please feel free to share your experiences and send your comments to contact@drbando.com. While Dr. Bando will not answer personally, your comments and feedback help inform future posts.

 

 


Where Does Anxiety Come From?

We’ve all experienced stress, worry, and anxiety from time to time. For some of us, or at certain times in life, it occurs frequently and can feel overwhelming. At its worst, anxiousness can even impair daily functioning. A lot of factors work together to cause the experience that we call anxiety. Let’s take a look at some specific ways that it develops:

From Chronic Stress Conditions 

Most of us equate stress with anxiousness, and oftentimes, these two do go together. However, when we talk about anxiety as opposed to a passing stressor (a stressful life event that comes and goes rather quickly), there is a lot more to it than just feeling stressed. Some people grow up or live in incredibly stressful environments (e.g., low-income households, experiences of neglect and abuse), and these long-term stressful conditions can make people more vulnerable to anxiety, and in some cases, weaken their ability to handle stress. If your system is already taxed by dealing with chronic, daily stress, your ability to manage more stressors thrown your way will very likely be compromised. A buildup of chronic stressful situations that do not go away quickly can lead to an experience of anxiety.

From Reinforcement

Have you ever heard someone say, “You don’t need to worry,” and you want to answer with, “I do need to worry!”? When we are experiencing anxiety, we often believe it’s helpful, because it gets reinforced. When we feel anxious about something and spend time ruminating and worrying, often everything turns out just fine. We can then believe that anxiety helped achieve the desired outcome. There is an old quote by an unknown author that goes, “Worrying works! 90% of the things I worry about never happen.” We continue to feel anxious and sometimes become almost fearful that if we are not anxious, things will not work out. Most of the time, this isn’t even a process we choose. The cycle gets reinforced, and the brain keeps it going without our intent. Reinforcement is brain food; when a behavior is reinforced, it is likely to occur again.

 

Anxiety, anxious, anxiousness, worry

 

From Avoidance

One function of anxiety is that it helps us to avoid other issues. This can be the most puzzling reason for anxiety. Most of us hate the experience of anxiety, and at first glance, it does not make sense that we would use anxiety to avoid anything. Rather, we want to avoid anxiety! Think of it like this: Anxiety gives our mind something to chew on. We may not like it, and it may not feel pleasant, but it occupies us, nonetheless.

Anxiety tells us that something is wrong and we need to fixate on it, wring our hands, figure it out, look up facts, check out others’ opinions, etc., and it keeps us very busy. Sometimes it keeps us so busy that we can’t focus on much else. If we are having an uncomfortable emotional experience or find ourselves in a painful situation that cannot be solved (e.g. a job we cannot quit, the death of a loved one), sometimes we are so overwhelmed that anxiety jumps in to try to give relief. We may prefer (on some level) the experience of spending our time figuring out an unfixable problem than sitting with the feeling of grief or helplessness.

 From Other Emotions

Another function of anxiety is its ability to hide other, more difficult emotions, because it is a secondary emotion. Anxiousness (or any secondary emotion) happens when the primary emotion is not sufficiently experienced and processed. In other words, your anxiety serves as an avoidance (see above for more explanation on this). When we experience it, we don’t feel the underlying emotion. Our way out of anxiety is to feel this primary emotion. When we resolve a primary emotion, the secondary emotion regulates.

 From Itself

One of the most unpleasant aspects of anxiousness is that once we are aware of it, we can start to feel anxious about our anxiousness. The more we work to avoid it, ignore it, fight it, or self-criticize it, the more space it takes up in our mind. We end up feeling anxious about having anxiety and sometimes anxious about the rare times we do not feel anxiety. We may also experience additional concern about others noticing or criticizing our anxiousness.

If you struggle with anxiety, consider seeking therapy. Therapy can help you safely address and resolve unrelenting anxiousness. A therapist who practices Dialectical Behavior Therapy (DBT) is a good choice. DBT can help you build skills to address any vulnerabilities you have, to identify and cope with primary emotions, and to make more effective choices than avoidance. They can also teach the skill of Radical Acceptance, which is learning how to accept things that cannot be changed, rather than adding to your suffering by fighting it or feeling more anxious. If you could benefit from these skills, contact a qualified therapist and start shifting from surviving to thriving today!


How To Get The Most Out Of Your Therapy Session

If you are seeking a therapy session, it is likely because you want something in your life to change and you would like expert support and guidance through the process. You want a skilled professional to help take out the guesswork and help get you to your goals.

In the past, this has meant that on top of the stress or problem(s) for which you are seeking help, you must find the time, during business hours, to leave your home or office and make it to a weekly therapy session. Packed schedules, work requirements, and congested commutes present valid obstacles to taking over an hour out of your day every week to drive to your therapist’s office. Not to mention the trouble if the expert you’d like help from lives far away from you. In today’s busy world, many people are turning to TeleHealth or TeleTherapy sessions. These video therapy sessions use HIPAA-secure formats that function similar to Skype or Facetime to make therapy more accessible.

Whatever format you select for your therapy session, your success depends largely upon the work you put in, not just on the effort of the therapist. When attending therapy, your active participation in the process will help you to get the most out of your therapy appointments and ultimately, achieve the results you want.

Treat Therapy As A Collaborative Process

We often view therapists as the expert in the room. Therapists do bring a great deal of knowledge about psychology and new ideas for how to help you. However, you are also an expert in the room. You know best about your history, what you have tried in the past, and what is happening in your present.

A therapy session will be most successful if you work collaboratively and come prepared with what you want to work on in each session. Then, work with your therapist to set goals, explore information, make discoveries, and learn how to apply new skills to your life. Ultimately, you decide what to take away from the therapy session.

 

Make therapy work for you, Get the most of therapy, California therapist

 

Apply What You Learn Outside Of Session

As you and your therapist work together, you will understand yourself better and identify new, more effective ways of behaving. It is essential to apply these new skills outside of session. Whenever possible, ask for homework and then do it. If it is too challenging (usually this is the case when you find yourself not doing the homework), ask your therapist for help. It is your therapist’s job to help you generalize the skills that you learn in the therapy office to making real-time changes in your life. This means the therapist must use their expertise to assign homework in a way that not only challenges you but also is likely that you will engage with and complete the practice(s) they’ve suggested.

Remember to communicate with your therapist about any barriers you face putting the new skills into action. Trying a new skill once and never again will not help you get to that point of lasting change. Every new skill takes practice to become a new habit, and you are paying with your time and money to get help. Use it to your advantage!

Talk To Your Therapist About Your Therapy

When people go to therapy, it is often because they want to address some concern or problem in their life. You may be focused on discussing that problem and finding solutions, which makes sense. In addition, therapy works best when you also talk to your therapist about your therapy.

This means you can reflect on what is working and share those thoughts with your therapist. If you like a new skill, let your provider know. If you are unhappy about something, talk to your therapist about it and see how the two of you can navigate this situation. Giving your therapist this feedback allows them to respond by adjusting their interventions to be more appealing to you or more relevant to your treatment goals.

Find Therapy That Fits Your Lifestyle

Nowadays, most people don’t want to travel to get to therapy appointments or lie on a couch in the room with a therapist. And you don’t have to do these things to get results. With TeleHealth therapy, you can benefit from the skilled, focused attention of a therapist when and where you need it. Even within the comfort of your home, you can access professional therapy with TeleTherapy services via video calls. Making therapy easier to access means you are more likely to stay engaged and on track with your goals.

Once you have started therapy, use these tips to get the most out of your sessions, get the results you want, and start shifting from surviving to THRIVING.


What is DBT and How Can It Help Me?

Seeking help and going to therapy can be stressful. Choosing the right approach can ensure you get the care you need to make the changes you want. In this article, I’m going to give you introduction to Dialectical Behavior Therapy (DBT), a treatment that may be helpful if you want more balance in your emotional life. DBT has become a popular technique used to help individuals cope with the stressful challenges life throws their way, and the intense emotions that can follow. The scientific research for this treatment is strong. Individuals often report huge, impactful, positive life change as a result of DBT. DBT focuses on helping people change their reactions and behaviors to create more resilience in life. Understanding what Dialectical Behavior Therapy is and how it works can help you decide if it is the right approach for you.

What Is Dialectical Behavior Therapy?

Dialectical Behavior Therapy is a form of Cognitive Behavioral Therapy (CBT) that was initially developed for people suffering from chronic suicidal thoughts and behaviors, and those diagnosed with Borderline Personality Disorder. However, implementing DBT revealed that it is helpful for people in a range of situations having difficulties managing emotions, and can help to reduce anxiety and improve coping mechanisms under stressful circumstances. DBT teaches you coping techniques and strategies to deal with difficult emotions without being caught up and swept away in them.

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What Does Dialectical Behavior Therapy Involve?

DBT is best administered by an experienced therapist, with a history of training and supervision in DBT by experts in the field. Full program DBT involves weekly individual therapy in addition to attending a weekly DBT Skills Group. Treatment length varies by person and treatment goals.

DBT includes –

  • Collaboration – working with a skilled therapist can help you identify what you want out of life and obstacles getting in your way. Bringing awareness to both your goals and challenges in a specific, systemized way is a key step toward making the changes you want.
  • Learning skills – one of the most important aspects of DBT is learning specific skills to incorporate into your everyday routine for growth, happiness, and fulfillment.
  • Practice – DBT is a behavioral therapy. This means that new behaviors must be practiced for change to occur. Practice, practice, practice, and then some more practice, is a common mantra in DBT.

The Four Modules Of DBT Skills

The four areas of skills learned in DBT are designed to help you better understand your thoughts and feelings, and change your behaviors to better achieve and support the life that you want. These modules include:

  1. Mindfulness
  2. Distress Tolerance
  3. Interpersonal Effectiveness
  4. Emotional Regulation

Who Can Benefit From DBT?

DBT has been shown to be successful in a number of different areas and for those suffering a range of issues including:

  • Relationship problems
  • Low self-esteem or shame
  • Weight management
  • Eating disorders
  • Anxiety
  • Depression
  • Borderline Personality Disorder

DBT can also be used in many other situations, even where a specific diagnosis may not be defined. Under the guidance of an experienced and well-trained DBT therapist, you can learn life-changing skills to make a profound impact on your well-being.

DBT is an inspiring treatment method that can help change your life for the better. Talking with a DBT therapist can help you determine whether DBT is the right therapy approach for you. Contact me today if you may be interested in finding out more about DBT and shifting your life from surviving to thriving!


4 New Perspectives To Free You From The Guilt And Shame Drain

Guilt and shame can hold you back from the happiness and freedom you desire, draining your energy and burning you out. Sometimes it can feel like shame is eating away at you from the inside, and you can’t even bear to face family and friends.

Fortunately, there are steps you can take to be free from the guilt and shame drain, starting today. Working one on one with a skilled Dialectical Behavior Therapist is a key way to begin letting go of these painful emotions to live a happier, more fulfilling life. As a part of DBT, you will learn specific techniques to shift your perspectives and see things in new light.

  1. Recognizing Guilt and Shame is the First Step

If you recognize your feelings and are able to label them as guilt or shame, you’ve already begun the journey to cope skillfully with these emotions. Just bringing attention and mindfulness to when you are feeling guilt or shame is a powerful step. When you realize that guilt or shame is what you are feeling, gently label and make a note of it internally, without trying to change or modify it. This act of mindfulness and recognition of emotions works into the further stages of DBT where you can learn to welcome pain and skillfully cope with it, rather than pushing it away, which often increases emotional distress.

  1. Your View May Not Be What Others See

One of the tricks that guilt and shame play on your mind is creating thoughts that things are all your fault or that everyone is blaming you. One of the first steps DBT teaches is to recognize and unglue from your thoughts. This step involves working with a DBT therapist to carefully review how you may be automatically coming to conclusions about situations and staying stuck in a rut. When you are feeling guilt and shame, take a closer look at your thoughts and interpretation of the situation that brought up these painful feelings. Recognizing these biases in interpretation is a first step to using DBT to tap into your wisdom and let go of worry thoughts.

  1. Take A Short Break From Your Feelings

When you are feeling guilt and shame, it can be easy to get stuck in a cycle of self-blame and anger. It is important to give yourself permission to give yourself a break from what can be an endless cycle. Do this intentionally, not to avoid the problem-solving process, rather, just to give yourself a break so you can come back to solve the problem at a different time. Take time off to do an activity you enjoy, to help others, or to just do or think about something else for a while. Taking a break from the intensity of emotions can give you the chance to refresh and gain a new perspective on the situation.

  1. Remember That Emotions Are Temporary

Always remember that “this too shall pass” and nothing lasts forever. Mind states and emotions – no matter how powerful – are  temporary and we can ride them out. (If emotions feel never-ending and do not feel temporary to you, a DBT therapist can help with that!) This doesn’t mean you should avoid problem-solving when necessary. Still, you may not need to treat every thought and emotion as though it is very serious and must be solved immediately. Training the mind is a process. The mind is always changing, and we can learn to let thoughts and emotions come and go gracefully.

An experienced DBT therapist can equip you with essential skills and techniques so you can learn to be free from the guilt and shame drain. Contact me today to work with me on creating a happier and more fulfilling life.


HOW TO FIND A RESULTS-ORIENTED THERAPIST

Maybe you have never been in therapy. Perhaps you have been in therapy, and it hasn’t gotten you the results you’d hoped.  This time, you want to try something a little bit different. You may even have a particular goal(s) and know what it is that you want to change. Now come the questions, “How do I get the results I want?” and, “Who is the best person to help me?” Despite the consumer-savvy world we live in, there is little information on how to find a therapist, let alone how to find a therapist who will truly help you achieve real results and change your life in the way that you want.

Here, you will find a five-step process to help you find a therapist who will help you achieve the goals you want to reach. Stop wasting time, money and effort with treatment that doesn’t work. Set yourself on the path to success today!

 

  1. Get COMFORTABLE. – Going to therapy can be a hard process, requiring courage to step outside of your comfort zone and ask for help. At times, therapy asks you to be quite vulnerable, talking with another person about your deepest, most private experiences. Treatment often requires you to be super uncomfortable, and even want to temporarily squirm out of your skin or run for the door. After all, you are in therapy to get help with areas that are likely challenging and possibly, quite painful. To venture to feel this awkward and uneasy, you must first be comfortable! It is so important that you are at ease in the presence of your new therapist and feel understood and not at all judged. In other words, think about whether this is a person to whom you would want to open up.
    • Ask for a PHONE CONSULTATION to get a feel for the therapist. Most therapists will agree to talk to you for a free, 10-15 minute phone consultation. During this meeting, you can give the therapist an idea of what you want help with and hear his or her response. It is important to ask questions and leave time for the therapist to talk so that you can start to assess your feel for this clinician’s competency and ability to help you. Trust your instincts. The therapist should give you a choice (or you can ask) whether you want to schedule an in-person appointment right then and there, want time to think about it, or do not believe that this therapist is a good fit for you.
    • MEET IN PERSON with the idea that you are still evaluating whether this professional is a good fit for your needs. During the first session, the therapist will likely ask you questions about why you are seeking therapy and many other detailed questions about yourself and your treatment goals. The more open you are will help you to experience how the clinician responds to you and gives you the opportunity to evaluate your comfort level with this person. Their response will provide valuable information about whether you would like to proceed or seek another’s help instead.

 

  1. Ask for a CASE FORMULATION. – A results-oriented therapist will be able to discuss their conceptualization of your problem(s) and what is currently missing for you to reach your goals. Likely, this won’t be obvious information that you already know. Rather, it should add more information to your understanding of your stuck point(s) and show you that this person has the education and experience to understand your particular problem area(s) expertly. Think of the analogy of visiting a medical doctor (M.D.). You may report your symptoms (e.g., poor digestion, feeling light-headed) and the doctor will not simply repeat your symptoms back to you: “You have poor digestion and feel light headed. That must be hard.” They will tell you, based on their evaluation (e.g., examining your vitals, blood tests), what is wrong (e.g., “You have high blood sugar.” “Your thyroid is malfunctioning.”). You can expect this same kind of expert information regarding your psychological and emotional health as well. A results-oriented mental health professional will not only repeat your complaints back to you; they will add information to fully conceptualize what is contributing to the problem and why you need help in solving it. For example, you may report repeated over-eating and sudden emotional outbursts. The results-oriented clinician may suggest after their assessment (e.g., conversation with you, standardized questionnaires), they believe these problems come from deficits in understanding how to change behaviors and regulate emotions successfully.1 The results-oriented therapist will explain this to you in detail and discuss precisely how this affects you. This explanation will be in language you understand, and the conceptualization should make sense to you. If you think the therapist is off-base, does not accurately comprehend your problem, or cannot communicate in a way that you understand and agree with, openly discuss this with him or her. If you still cannot come to an agreement, it may be time to interview another therapist for your treatment needs.

 

  1. Ask for a TREATMENT PLAN, including TREATMENT GOALS, prognosis, and length of therapy. – Just as your general medical practitioner will give you an idea of your treatment options, likely results, rate of recovery, and time needed to achieve these results, you can also expect this from a results-oriented therapist. For example, a clinician may tell you that in the first three sessions2, the two of you will collaborate to reach a case formulation. At that point (by the third session) the therapist will make a treatment recommendation. They will talk with you in detail about how the treatment he/she is recommending addresses your particular problem(s), will help you reach your goals, and the time you should expect to devote to attain this outcome, including frequency and length of sessions, and expected length of time in therapy. Alternatively, at the third session, the therapist may refer you to another professional with the expertise to help you meet your goals if you and the clinician have determined that is what is needed. Again, think of the M.D. If blood tests reveal you have a thyroid problem that is relatively simple and straightforward, the doctor may express this to you and lay out a treatment plan. If, however, the problem seems more complicated, the M.D. may then refer you to an endocrinologist or another specialist to help you achieve your health goals. Defining treatment goals in therapy is important because these goals will help you know if you are making progress and whether the therapy is working.

 

  1. Understand how you and your therapist will MONITOR TREATMENT PROGRESS and ask for HOMEWORK. – How will you know whether you are moving toward your treatment goals and making progress? This is a question a results-oriented therapist will be able to answer with clarity.
  • Together, you and your therapist may choose to use standardized measures of symptoms or progress and chart them on a graph, making sure your symptoms are decreasing, and skills needed are increasing. You may also choose to track behavioral markers, such as how often per week you are engaging in a particular behavior or have the urge to do so. Successful treatment would show a decrease in those behaviors (and possibly urges) the therapist has agreed to help you decrease (e.g., over-eating). You will also see an increase in the behaviors moving you toward your treatment goals (e.g., taking three breaths before a meal, stopping eating your meal when you experience a feeling of satiation regardless of the quantity of food left). Your therapist may ask you to chart each time you have the urge to or actually engage in these behaviors in between sessions to track your progress.
  • PRACTICE, PRACTICE, PRACTICE, and then, you guessed it, more PRACTICE is needed to make changes and reach your goals. Homework will always be present in results-oriented therapy. Homework doesn’t mean that you will be sent off to write a 5-page paper about what you learned. Rather, therapy homework is a way for you to put into practice what you are learning in therapy. Typically, therapy sessions last about 50 minutes once per week. What about the other six days of the week and 24 hours each day? 50 minutes is not going to change your life in the way that you want. A results oriented therapist will send you home with something to practice (e.g., filling out a worksheet about a skill you learned at your session, practice saying “no” and noticing in detail the thoughts that come into your head or sensations in your body). If you want results, you must practice. Change does not happen in our thinking. Change happens when we do things differently over and over and over again. If you want results, ask for homework!

 

  1. CONTINUE TO EVALUATE, on an on-going basis, whether your treatment is helping you move toward your goals and achieve the results you want. A results-oriented therapist will regularly review treatment progress with you using the techniques described in Step 4. Therapy is not meant to be life-long. Remember, you are hiring a professional to help you reach specifically-defined treatment goals. At some point, if therapy is working (as you are carefully monitoring), you will have achieved those goals and will either want to develop new treatment goals or decrease the frequency of your contact with this clinician or terminate your treatment.

 

Therapy can be an enriching, life-changing experience if you choose an effective treatment. Use the five steps above to help you get the help you need and deserve, and start shifting from surviving to thriving today!

 

NOTES

 

  1. This is provided as an example only and does not imply that all causes of over-eating or emotional lability come from the same source. These statements are meant to clarify the topics addressed in this article, not to assess or diagnose.

 

  1. Not all clinicians assess within one to three sessions. This is meant as an example only. Please check with the therapist you plan to see about their individual policy and of course, ensure that it makes sense and is reasonable to you.

Frequently Asked Questions:

  • What is the difference between a Ph.D., Psy.D., LMFT, LCSW, MFTi, etc., and will it affect the quality of my treatment?

A Ph.D. and Psy.D. both have doctorate degrees in psychology. LMFTs and LCSWs have a  master’s degree. A Psychological Assistant (someone with a doctorate who is not yet licensed) and MFTi (Marriage and Family Therapist intern) indicate this person is still in training and under supervision before they can become licensed. While the degree itself may show different types of training and specialties, what is usually more informative is how the therapist works with their clients. I have results-oriented colleagues with LMFT and LCSW licenses who work similarly to myself and other contemporaries who have doctorate-level training. I also have met professionals with doctorates who are not results-oriented and do more of a supportive-type therapy. In my opinion, if you follow the five steps laid out in this article, you will significantly increase the likelihood that you will work with a therapist who will help get the results you want, regardless of their type of license. Trainees can also be good options. I personally would choose to work with a Psychological Assistant or MFTi if they met all of my requirements in the 5-steps to finding a results-oriented therapist. The quality of work a therapist demonstrates to me is more important than where they are in their education and whether they have a master’s or doctorate degree. One caveat: if your problem is quite complicated and you have been to several clinicians before who haven’t helped, you may need a skilled and seasoned eye and choose a therapist who has some years of experience under his/her belt.

 

  • Should I look for a therapist with a particular theoretical orientation?

Some of my results-oriented colleagues may argue that it is imperative to receive treatment from someone doing “evidence-based therapy,” such as cognitive-behavior therapy (CBT). I like to be careful about making this generalization. There are certainly CBT practitioners who are results-oriented, and there are those who are not. Because someone professes to work under a particular modality is not an assurance that they do. More relevant is whether the therapist helps you develop treatment goals, assigns homework, monitors your progress, etc. I am less inclined to be concerned about the modality and more interested that the therapist can give you evidence that their treatment recommendation(s) works (has been researched to be effective) and the way the therapist is applying the treatment to your problem makes logical sense to you.

 

  • What if my therapist tells me that being uncomfortable with him/her or wanting to leave therapy is as a result of my problem(s) and I should not act on this?

This answer is not a straightforward “stay” or “leave.” Rather, it is a more nuanced answer: Use your WISDOM. On the one hand, if this is a new therapist, it is important to be comfortable and feel at ease in his or her presence right away. (See Step 1.) You will already be challenging yourself to grow in various ways throughout your treatment; no need to do this with the relationship with your therapist. I have talked to countless people who have stayed with a therapist they didn’t like or felt uneasy around because they assumed they (the client) were at fault and there was something wrong with them that they felt this way. I previously had a personal experience visiting a therapist with whom I was uncomfortable. I told her so, and she stated that she thought this meant I had significant problems with intimacy and needed to sit physically closer to her than I was comfortable with and work through the problems in my relationship with her. At that moment, I felt ashamed and unsure of myself. After leaving the session, and discussing it with a loved one, I determined that the only relationship in my life that I was having a significant problem with and wanted to get out of was the one with my therapist. I left, found a new therapist who I was immediately comfortable with, and therapy was successful. I have heard some version of this story from many clients about their past therapy, and often, once they remove themselves from that clinician, they find much success moving toward their goals with much more ease. On the other hand, it could be useful to ask yourself if your therapist has a point. Does this reaction toward your therapist happen in many other relationships? After visiting a few therapists, do you feel this same way about each of them? If so, you may want to consider whether this is something you want to target (work on) in therapy and may decide to stick with this therapist. You may want to consult with a trusted loved one and get some help tuning into your WISDOM to make this decision. Also, remember Step 5 and to continuously evaluate whether this treatment is helping you.


© 2017 Amanda Gale Bando Phd · Designed and Developed by D-Kode Technology

Dr. Amanda Gale-Bando

Dr. Amanda Gale-Bando