Motivation: Start Lifting Yourself Up and Stop Beating Yourself Down

Motivation, non-judgment, authentic life
Listen to the Audio Version of Dr. Bando’s Article.
Often, clients or prospective clients approach me for help with motivation. We all want to live vibrant lives and maybe increase exercise, change the foods we eat, stop eating late at night, make that health care appointment, or countless other important things. Today passes, then tomorrow, then a week goes by, and we realize we haven’t made that change we wanted at all. We can’t seem to find that Motivation, so we get frustrated and feel defeated. Our self-talk becomes harsh: “Ugh, I am so bad at this!” “Why can’t I just do what I’m supposed to?! It should be easy!” “I’m hopeless.” “I’m an idiot!” We give up for the moment and throw in the towel, abandon our goals, and try to accept things as they are, giving up hope that we will ever make that change.

Finally Fed Up?

Maybe we finally decide to get serious. We are disgusted enough with ourselves that we make a strict plan to ensure we adhere to the behaviors we “should” be doing. Then one day passes, then another, then a week, and then here we are: still stuck, still without change.

Perhaps we even make the change for a brief time. Maybe we start eating in a way that makes us feel nourished and energized while helping to reach a target weight. Then, time goes by, and we are sick of being restrictive and “depriving” ourselves, so we give in and “indulge,” feeling stuck in old behaviors, staying unmotivated, and continuing the cycle.

It’s Time to Get Motivated!

MOTIVATION happens when our goals align with our values, then the behaviors we take to move toward our goals link closely to our values, and we reinforce those behaviors. I know from personal experience that the key factors in staying Motivated are reinforcement, which inspires and ignites Motivation, and punishment, which extinguishes Motivation. When we narrow it down to these two simple principles, we begin to realize how straightforward it is to start down a path to lasting change. By reinforcing yourself with simple things like clear goals, being in tune with what is truly important to you, and staying passionate (by focusing on what works and reinforcing the hell out of it), you are guaranteed to break yourself free from that cycle.

Audio Meditation for Motivation:

Listen to Dr. Bando’s Audio Meditation
To stay motivated and moving toward goals that you value, you must build the muscle of Reinforcement. Finding what you are already doing that is working, or taking very small steps forward, and then rewarding those actions creates sustainable motivation for change. Think of it this way: punishment extinguishes motivation and reinforcement creates, ignites, awakens and maintains motivation. Where you have reinforcement, you can create motivation.

Let’s practice building this muscle:

Start with noticing your breathing. You do not have to change or alter your breath. Simply notice that you are inhaling and exhaling. Pay attention to where in your physical body you feel your breath.

Now, for the next three to five breaths, pay attention to where you feel your breath in your physical body and when your mind wanders away or zones out, gently bring your attention back to your breath.

When you notice yourself wander and bring you attention back to your breath, you can think of this as a weight lifting rep, or an exercise to build your ability to put your attention where you want it.

Now, let’s go further. Using this idea of placing the mind where you want it to be in the moment, recall one thing you did in the past day that was effective. Unless you achieved a huge goal in the past day, this exercise requires you to let go of judgments and find where you were effective. Do not dismiss anything for not being “good” enough or “big” enough. If you were tired and you got up on time, that is an accomplishment. If you felt depressed and did not want to get out of bed but you took a shower, perhaps that was effective. It does not matter how big or small you think this action was, take a moment and pick one effective action you engaged in over the past day.

When you have that behavior in mind, reinforce it. You can reinforce this behavior a number of ways: you can reinforce with self-talk, such as, “Good job,” or “I did it,” or “Nice!” Remember, your focus is on what you did well and reinforcing it. If your mind wanders to telling you that it wasn’t good enough, your practice is to gently bring your focus back to what you did well and reinforce it. You may also reinforce your behavior through soothing touch. Maybe if feels soothing to place your hands over your heart center and notice the warmth, or one hand over the other hand, or gently cup your face with both hands. This is touch that feels loving and sweet. Again, when your mind wanders to you or your behavior not being good enough, gently bring your attention back to what you did well and reinforce it.

This is the practice of increasing your motivation in a way that is sustainable and reliable. You can practice this every day – find one thing you did well and practice turning your mind toward noticing what you accomplished and reinforcing it. When your mind goes toward judgments about you or your behavior not measuring up, this is punishment. It will extinguish your motivation and ability to move forward. It’s not wrong, this is just what minds do, they wander, and they come up with judgments. Your task is to calmly notice when this happens and bring your attention back to reinforcing your accomplishment. Practice, practice, practice this and you will notice your motivation grow and your ability to take more steps toward your goals increase.


When Others’ Opinions Get You Down (and What to Do When You Feel Fat)

judging ridicule others' opinions feeling fat
We’ve all been self-conscious about our appearance, and have at one point or another worried about what other people think of us. Whether it’s how we dress, speak, act, or even weigh, that concern can at times be overwhelming. While it’s important to take in others’ opinions (this gives us a reflection of ourselves and how we are perceived), over-valuing what others think or may think, while under-valuing our own ideas can damage our self-respect. If you’d like to spend less time concerned about others’ opinions and more time embodying your own values, I’ve put together a few strategies that will help you in this area.

Tuning In

Tuning in requires focusing on your internal voice and turning up the volume so that it is louder than the opinions around you. When you find yourself in a situation where you feel over-worried about what someone else may think of you, ask yourself, “What, in my deepest values, do I believe about this situation?” You may also ask yourself how you would respond to a friend who was in your shoes. Would you shame and browbeat her or tell her that you understand where she is coming from and she did not do anything to be embarrassed? The strategies of asking how you feel, what you believe and to what standard you would hold someone you care about, gives you valuable feedback about whether you want to correct your behavior or if the problem is not your behavior but worry thoughts and shame entering your mind and body.

Your Values, Thoughts, and Emotions

When you have discovered that you have behaved, dressed, spoken, etc., in line with your values but are still plagued by embarrassment and worries about what others think of you, the first step is DON’T CHANGE YOUR BEHAVIOR. If you change your behavior when your behavior is not the problem, you are sending yourself a confusing message and shame is likely to build.

For example, Marla (pseudonym) found herself concerned that she was not “thin enough” and felt embarrassed about her appearance in certain social situations. As a result of this embarrassment, Marla would tug on her clothes, check herself often in the mirror, avoid being in pictures, and plan her outfit days in advance in response to excruciating worry thoughts. When Marla asked herself about her values, she realized that she would never ever treat a friend the way she was treating herself. She would never judge a friend based on her weight or fit of her clothes and would not want to associate herself with anyone who would judge in this way. Yet, she had been behaving as though she should be ashamed.

Marla’s strategy became clear: Treat her body as perfectly fine and refuse to apologize for how she looks. This means that Marla resisted urges to tug on her clothes, plan the perfect outfit in advance, and even volunteered to be front-and-center in photos. Initially, her self-critical and worry-thoughts increased, and she felt embarrassment wash over her when seeing a full-body picture posted on Facebook. Marla was determined, though, and she persisted.

Over time, her mind and body understood the consistent message that Marla was sending. The message was, “I will not apologize for how my body looks because there is no reason to apologize.” Her self-hating thoughts and worries about what others thought of her began to quiet and feelings of embarrassment lessened over time. Now, when Marla feels a surge of her old urge to apologize for her appearance rear its ugly head, she knows what to do and prioritizes her mental health and self-respect.

As my wise Zen teacher says, “You cannot force yourself to be different. All you can do is practice every day until one day, you become what you have practiced.”

Your Breath and Sensations

If you find it difficult to tune into your values and priorities, start with your breath. Any of my past or present patients will tell you that at least once per therapy session, I will ask them to stop and notice three inhalations and exhalations. This offers an opportunity to notice what the breath is doing in the body. Stop and try it now – place your awareness on your breath for three inhales and exhales. Notice: Where in your physical body does your attention go as you are placing your awareness on your breathing? Your breath is a readily available sensation that can help you start to tune into your body and then your wisdom.

After noticing how your breath feels in your physical body, you can also start to pay attention to sensations. Start to ask yourself questions, such as, “How does my body feel when I am having fun, trusting myself, following what feels right?” Are you relaxed in some areas, tense in others? Do you notice changes in your posture? How about temperature or a feeling of moving energy in various parts of your body? The more you tune into how your body feels, you will begin to get clear messages from your wisdom and be able to sharply access your values and priorities in different situations.

Now What?

The more you practice paying attention to your breath, listening to your body and feelings, identifying your values and behaving as though they matter, the easier it will become. With any new behavior practice, practice and then more practice is needed to help the new habit stick. As my wise Zen teacher says, “You cannot force yourself to be different. All you can do is practice every day until one day, you become what you have practiced.”

Identify a step from this article that you can put into practice today and practice doing this every day until it becomes easy for you. Then, identify and take a next step. If you are a person who has loud self-critical thoughts, it will take a while for them to calm down and for value-driven thoughts to take up your mind space. Give yourself the time you need and devote yourself to one small practice every day.

If you want additional help learning how to truly experience and enjoy your life, contact Dr. Bando today for an online consultation and start shifting from surviving to thriving!


When Everyone Turns to You, and You’d Rather They Didn’t

Everyone occasionally gets assigned to be the Point Person: the one people turn to for making plans, coordinating, and figuring everything out. The people around you may have the impression you are the most knowledgeable, capable, or willing to do the work. They may look up to you or see you as an authority. For whatever reason, you become the Point Person, the hub of responsibility in a situation or group.

Sometimes it can be preferable to be the “Point Person,” but there will be times that you just do not want the responsibility. You may have been told to “just say yes” or “step up to the plate” when you have been put in this position. People may try to cheer you on, thinking you just need encouragement and that leading or organizing will be good for you, or that it’s your duty. Still, you do not want to do it. So, what now?

Your Health

Consider whether it is healthy for you to take on unwanted tasks. The associated stress increase can cause you harm. We all know excessive stress is harmful, but the chronicity of stress that comes from being a “Point Person” can be especially injurious, because there is no apparent time for your body to realize that the situation is over, signaling that it is time to relax.

Over time, continued strain on your body from routine stress may contribute to serious health problems, such as heart disease, high blood pressure, diabetes, and other illnesses, as well as mental disorders like depression or anxiety” – National Institute of Mental Health website

when you're the point person, assigned responsibility, appointed in charge

Your Relationships

Allowing others to decide that you are in charge can be detrimental to your relationships. It is best to talk about what you are comfortable with early before you grow resentful for having endured a situation you felt forced into. This can also prevent tensions that would inevitably arise in the course of you trying to fill that “Point Person” role.

Feeling pushed into a default role of responsibility most likely does not help you put your best foot forward and shine. Your performance as an unwilling “Point Person” may disappoint people that matter to you, or matter to your success at work or other areas of your life.

How to Handle Being Elected Point Person

Once you decide how you feel about being the responsible party, you can then set limits that protect you from absorbing more responsibility than you want. Be clear with yourself about what bothers you, what feels right in your wisdom, and how you would like to interact with the project or situation ahead of you. Then you can set parameters with the people looking to you for guidance.

Setting limits promotes better health and well-being. Some of the benefits of being clear about your boundaries include that you learn more about yourself, you become a more transparent and effective communicator, and you have more time for the things you value.

It can take practice setting boundaries with others. Here are some tips to help you set your boundaries:

  • Do your homework: Ask what others expect of you without assuming.
  • Know yourself and be truthful: Before starting a conversation about your limits, know what you are willing to accept and be honest about it.
  • Negotiate: Be willing to try to find a solution that works for everyone if it exists, don’t accept “solutions” that truly do not work for you.
  • Self-care: Stick with your commitment to take care of yourself.
  • Be assertive: Don’t try to disguise your limits or make them seem like something they aren’t. Be direct and clear.

If you want to learn more about limit setting or other ways to take your health from surviving to thriving, contact Dr. Bando today.


3 Signs You Might Be Struggling with Binge Eating

Whether or not you suffer from an eating disorder, it is typical in our society to experience unhappiness with our body or the way we eat. Unfortunately, we exist in a society that is very appearance-focused, and that really does not allow for diversity in the way we look. This is a cultural norm, but we can work to change this by taking one small action today:

The next time you see someone you have not seen in a while, do not comment on how they look. Refrain from saying anything regarding their appearance and instead, make a comment focusing on how you feel about being with them such as, “It is so good to see you,” or, “It’s nice to get to spend some time with you.”

This simple, easy step gives the message that we are focused on seeing the person in front of us, and not evaluating their appearance.

 

Many of us are familiar with eating disorders, perhaps seeing depictions on television or in movies. Some of us are also personally challenged or have friends or loved ones who struggle with their eating. What you may not realize is that eating problems can include a range of behaviors, outside of the more commonly known Anorexia and Bulimia. One eating behavior is sometimes casually called compulsive overeating or food addiction, but when it reaches a diagnosable level, psychologists label this Binge Eating Disorder.

You may have reached this page through an internet search because you are already worried about your eating patterns, or somebody else’s eating behaviors. You may simply be wondering if your own problems with overeating would qualify as binge eating. Let’s look at three signs that you might be struggling with overeating or even binge eating:

  1. You Eat a Lot of Food in A Short Amount of Time

One of the characteristics of Binge Eating Disorder is that you eat quite a lot of food in a very short amount of time. Up to 10,000 or 20,000 calories may be consumed in just one sitting, compared to an average calorie intake of approximately 1,500 – 3,000 calories a day. Consuming this significant amount of food in one sitting is called binging. People often say that during these times they can “zone out” or lose track of what is happening around them. When binge eating, you often feel guilt and shame afterward. You may or may not engage in compensatory behaviors like self-induced vomiting, food restriction, or excessive exercise. In fact, food restriction can trigger the binge in the first place.

What can you do?

Eat regular meals throughout the day. This means that you eat roughly at the same time each day and do not go longer than about four hours without food. Research confirms that episodes of binge eating typically occur after a period of restriction (not receiving enough nourishment). While this suggested step is not sufficient to treat Binge Eating Disorder, it can be a part of eating disorder treatment and help if you struggle with occasional binge eating. Please note: The suggestions given in this article are not a substitute for treatment from a healthcare professional. Seek help if you are suffering from a serious disordered eating condition.

binge eating disorder, overeating problems California therapist

  1. You Have a Hard Time Stopping Eating

Another characteristic of binge eating is that it is hard to stop eating and there is a feeling of a loss of control. Binging is often called compulsive overeating because you may feel compelled to keep eating and as though you are not able to stop. People also call it food addiction because it can feel very much like an addiction, something you need or depend on, and are unable to reduce. Once you have started binging, it can feel impossible to stop eating despite how full you feel. Those suffering from compulsive eating often keep eating past a feeling of fullness, to a feeling of extreme physical discomfort or even in pain from the amount of food.

What can you do?

Seek help. If you find yourself unable to control your eating behaviors, you most likely could benefit from the support of a healthcare professional who specializes in binge eating. This can be a challenging behavior to change, but with the right help, change is possible. Take the guesswork out and get help from someone who knows how to help you extinguish binge eating behavior.

  1. You Have Other Mental Health Concerns

Overeating and Binge Eating are often associated with other mental health concerns. You may also be struggling with anxiety, depression, shame, guilt, self-doubt, or other troubling emotions. The relationship between these sorts of problems and binge eating can be reciprocal. In other words, one can lead the other and vice-versa. Often, we turn to food for comfort or self-soothing to cope with emotions. Finding relief in food feels helpful in the moment, but it is ultimately a maladaptive coping technique. To resolve this concern, you want to learn alternative, more effective coping skills.

What can you do?

If you are worried about your own eating behaviors, then you may consider going to therapy for Binge Eating. There are many ways a therapist can help you. Research has identified Dialectical Behavior Therapy (DBT) as a helpful approach for Binge Eating Disorder therapy. DBT can help you learn new skills, such as mindfulness and behavioral strategies that will allow you to approach food and eating differently. These skills will also provide healthier, more effective ways of coping with your emotions. Consider contacting a DBT therapist and asking about their approach to Binge Eating Disorder treatment today.

 

 

 


5 Signs You Know a Therapist Could Help You with your Relationships

 

Relationships are one of the most delightful and challenging aspects of life. The closer the relationship, the more our emotional buttons get pushed. When we experience intimacy with others, circumstances often challenge us in ways we are never stretched on our own. This is both difficult and a blessing. By giving us the opportunity to grow and change, relationships can also bring the chance to heal and shift into a whole new way of being. Whether this brings to mind a relationship you have with a friend, family member or significant other, opportunities to transform and flourish are abundant.

 

You may know that you need relationship help, but don’t know where to begin. Sometimes therapy focused on your relationship goals may be just what is required to get unstuck. Here are five specific signs that working with a results-oriented therapist could help you improve your relationships:

 

 1- You Have a Tough Time Communicating Effectively

 

Our communication skills affect the quality of our relationships. Maybe you often feel misunderstood by others. You may communicate in ways that make it difficult for others to understand you, such as by expressing too much emotion or sometimes shutting down. Perhaps your communication breaks down even more during times of stress.

 

Working with a therapist can help you develop new skills and strategies that will help you communicate more effectively. A therapist can teach you skills that will help you better describe, express, and assert your thoughts, wants, and needs, while at the same time, reinforcing the other person and ensuring they continue to like you and want to maintain a close relationship. (This is borrowed from the Dialectical Behavior Therapy (DBT) DEAR skill. If you choose a therapist trained in the DBT model, you will have access to learning all the Interpersonal Effectiveness skills relevant to you and your goals.)

 

relationship help, Therapy for your relationship

 2- You Speak or Act Without Thinking and Hurt Those Your Care About

 

We all have times where we say something without thinking or get ourselves into a sticky situation as the result of acting impulsively. You may even intentionally lash out at those you care about without knowing why. If this happens to you often, it can harm the relationships you want to maintain, and working with a therapist can help.

 

A skilled, results-focused therapist can teach you to line up your behaviors and words with your values. Therapy can help you develop the skills to slow down and behave with intention. Becoming more mindful about your actions and words, and then learning new interpersonal skills and language, can help move you towards your relationship goals.

 

 3- You Have Difficulty Balancing Your Needs with The Needs of Others

 

Sometimes in an effort to maintain relationships, we sacrifice our own needs. You may be so focused on getting your needs met that you fail to compromise, and your relationship breaks down. In any situation, there are three things you need to balance. These include objective goals (what you want out of the specific situation), the maintenance of the relationship, and personal needs or self-respect. (See a qualified DBT therapist to learn more about these interpersonal priorities.)

A therapist can help you better discern your goals in different situations so that you can prioritize how you want to balance them. When your goals for your needs, the relationship and your self-respect are in equilibrium, you are more likely to be happy with the outcomes for yourself and your relationship.

 

 4- You and Your Partner Frequently Disagree and Argue

 

No two people can agree on everything. Everyone comes with their own life histories, personal values, opinions, wants, and needs. Each person also comes to the relationship with their own communication style. If you and your partner frequently disagree that can be okay if you are able to talk through those differences without consistently sacrificing your own or the other’s needs.

 

However, if it seems that your disagreements often lead to arguments, then you may consider counseling for help. In a safe environment, a therapist can help you to gain an understanding for balancing your own and your partner’s (or friend’s or family member’s) needs. A therapist can also help you talk through specific issues and diffuse ongoing conflicts.

 5- Something Big Has Happened for You, Your Partner, Or Your Relationship

 

Life brings ups and downs. When one person in a relationship experiences significant life changes, it can be challenging for the other. Sometimes relationships undergo monumental changes such as a transition from being single to marriage, during a loss (such as miscarriage), or if there has been infidelity or breach in a friendship.

 

Meeting with a therapist can help you and your relationship as you navigate through the changes. Therapists can provide an outlet for support, reflection, and accountability. A therapist can also help you learn how to work through problems and changes with your partner, balancing both of your unique needs and the needs of the relationship.

 

Find a therapist who you feel comfortable interacting with, where you feel safe to disclose information and try new strategies. Therapists well-trained in and practicing Dialectical Behavior Therapy (DBT) help their clients learn mindfulness and interpersonal effectiveness skills to optimize handling conflict in relationships and interacting to bring more fulfillment and closeness.

 

To find out if therapy could be the right fit for you, speak with a therapist who specializes in DBT or helping people navigate their relationships and start shifting from surviving to thriving today!

 

 

 

 

 


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!

 

 


4 Tips for Returning to Therapy

For an audio recording of this post, visit here: Dr. Bando on Soundcloud 

When you make the investment of time, energy and money in therapy, you want to experience progress and change. If you’ve been in therapy before but haven’t achieved the results you want, you may be wondering what you can do to make those changes. Talk therapy can feel helpful, allowing you to have some real ‘aha’ moments and gain insight into the cause of your problems. However, talk or what’s called “supportive” therapy often does not help you change and meet your goal. Often, what is needed is to learn practical, concrete skills that will help you foster lasting change and healing. This can be achieved through treatment with a results-oriented therapist.

If you’re thinking about returning to therapy and want to create more effective change, here’s what to do:

Four things to keep in mind.

1st- Know That Returning to Therapy Takes Readiness and Commitment

If you have decided on returning to therapy, that’s a great sign that usually indicates you have some readiness and commitment to do what is needed to make changes. The most important first step is finding a therapist who aligns with your goals and who you feel comfortable working with. This can help you stay committed and focused.

Many clients prefer a results-oriented therapist who will work with them to make specific changes toward goals, rather than attending therapy indefinitely. The right therapist can help you identify and build upon your goals from the start and keep you motivated to do what is needed for lasting change.

returning to therapy, return to therapy again California online

2nd- Develop A Plan

While the idea of planning your therapy might seem strange, having a goal and a plan in place makes it much more likely you will succeed in making changes. Sometimes people attend therapy to just talk or vent, but to transform your life you need to work systematically to plan and implement change.

The therapist you choose to work with should develop a case formulation within your first few sessions. This formulation offers expert reflections and additional insight on your current situation. A skilled therapist will indicate a thorough understanding of your unique situation and collaborate with you to make sure this formulation is on target. By the third or fourth session, you and your therapist should have treatment goals and a treatment plan that will guide your future sessions, help you better understand what to expect out of therapy and ensure you both keep your eyes on the prize and moving toward your goals.

 3rd- Take What You Learn in Therapy Outside the Session

One benefit of therapy can be receiving support from your therapist and leaving sessions feeling relieved or empowered. Keep in mind, this is not enough. If you are working to make changes, then you must take the work done in therapy with you, outside of the session, and into your day-to-day actions. A therapist focused on getting you the results that you want will probably ask you to do “homework” or to practice new skills throughout the week. It is essential to follow the recommendations of your therapist and do your assigned practices so that you can reap the benefits of therapy and translate them into your daily life. Practice in between sessions is imperative to change. It also arms you with information about what happened when you tried these new skills, and you and your therapist can troubleshoot and hone the skills in your next session. Your practice and feedback are invaluable in helping you and your therapist stay on track with moving toward your goals.

Depending on your therapist’s style and theoretical orientation, they may be able to implement additional ways to help you achieve change. For example, therapists that have been trained in Dialectical Behavior Therapy (DBT) might ask you to complete weekly Diary Cards, so you can plan to try out and practice newly learned skills and then keep track of what happened and have a straightforward way of reporting this in your next session.

4th- Discuss Problems with Your Therapist

 Therapy does not always happen on a linear path without hiccups. At times, problems may arise. Whether you felt misunderstood by your therapist, your homework did not seem to hit the mark, or you are not making the changes you expected as quickly as you wanted, it is important to talk about this honestly with your therapist. This can be an excellent time for you and your therapist to revisit your identified goals, refine your treatment plan, and figure out any adjustments that need to be made. Although it might seem like a challenging conversation, talking with your therapist about what is not working may help you discover some factors that are holding you back or halting change, making this a valuable part of your treatment. Do not underestimate the value of the feedback you give to your therapist. Once your therapist knows your experience, thoughts, and feelings, he or she has the opportunity to respond effectively, make any necessary adjustments, and this ensures you can get the quality care you want and need.

With the right approach, you can make effective and lasting changes when returning to therapy, learning new and valuable skills that lead to a more rewarding and satisfying way of life.

Remember, life is too short to just survive, that’s why I help people thrive. I’m Dr. Amanda Gale-Bando, licensed psychologist. Thank you for reading and best wishes to you in making the lasting changes you want.

 


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.)

Psychotropic medications, taking medicines, psychotherapist

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.

California Online Therapist, holiday stress, relationships

 

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.

 

Peaceful, grounded holiday season, online therapy, counseling

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.

 

 


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Dr. Amanda Gale-Bando

Dr. Amanda Gale-Bando