Thursday, 2 May 2019

How an Innovative Therapy Technique Made Me Feel like a Superhero When I Was at My Worst

“Take another deep breath, hold it, and let yourself feel like you’re drifting and floating.”

The voice overtook me as I felt my body slip into that weightless feeling between consciousness and sleep. It was as if someone wrapped my body in memory foam and filled every corner of my mind with white noise.

“My jaw is slack.”

“My shoulders are relaxed.”

“My neck is loose.”

These were some of the phrases that I was told to repeat to myself in a recording made by my therapist and given to me during our first session together. Each one focused on a different body part, meant to make me feel warm, heavy, and unconstrained. This was the beginning of my biofeedback training.

Just Relax

I chose my therapist because he’s an expert in biofeedback, a psychology technique where a patient learns to control their body’s functions, like heart rate or palm sweating. Biofeedback was first introduced in 1969 as the crossroads of traditional whitecoat psychologists and those interested in a higher consciousness.

Before I could reach a higher consciousness though, I had to master just being relaxed.

A few weeks prior to my first appointment with him, I was trapped in a horror movie in my own mind. I couldn’t shake this one single thought that replayed itself incessantly for a week straight: that of the top knuckle on my right ring finger snapping backwards and breaking.

It’s a disturbing thought on its own to anyone who prefers their fingers in tact, but imagine it popping into your mind over and over — and over and over — until you want to check yourself into a psych ward. I was consumed. I could barely talk or sleep or work without wanting to slam my head against a wall. I was desperate for any advice, so when my dad recommended biofeedback, I made an appointment immediately.

The technique he employed in the recording is called autogenic relaxation. Through the self-induced relaxation akin to hypnosis, my doctor coaches his patients to cure themselves of ailments like depression, migraines, irritable bowel syndrome, high blood pressure and anxiety — my personal woe. Learning to relax your body was just the first part, though.

Anxiety by the Numbers

At my next appointment with my therapist, he hooked me up to a slew of sensors as I reclined in his plush leather chair. Three cold metal circles stuck to my forehead measured my muscle tension in millivolts, a small wire taped to my pointer finger took my skin temperature, and two more sensors on other fingers measured my sweat production. Once I was connected, the doctor quizzed me.

“Alright, count backwards from 1,000 by 3s. If you mess up, you have to start over. If you don’t get to 940 in 30 seconds, you have to start over. Ready, go.”

I’m sure my measurements immediately spiked. I’m terrible at math and to add a time pressure to them was beyond stressful. But I got through it. He did it again, but with higher stakes.

“Okay, now you’re going to count backwards from 1,000 by 6s and you have to get to 860 in 30 seconds. Ready, go.”

To prepare for my biofeedback training, my therapist was simulating an anxiety-inducing situation to see what my normal and stressful levels were.

During the following appointment, he again hooked me up to the muscle tension sensors, but this time instead of stressing me out, he walked me through the autogenic relaxation phrases from the recording. But this time, the machine I was hooked up to was now emitting a pulsing sound that correlated with my muscle tension level. The more tense I was, the faster the pulses.

As his voice coached me through the phrases, and then in the next appointments as I walked myself through them, I learned to listen to the pulsing and to my body to see what slowed the tempo. My muscle tension level started at around 4.0 millivolts and he told me some of his patients start out at as high as 10 millivolts. Each appointment, he set the threshold lower and lower on the scale and once I reached it, the pulsing turned off. Each appointment, I was learning to bring myself to a more relaxed state than the time before.

By focusing on the pulsing, I experimented with what autogenic relaxation phrases worked best for me, what my ideal relaxed breath is like, and even how to position my head and arms for optimal relaxation.

Put to the Test

I’ve struggled with anxiety for as long as I can remember.

As I walked into the doctor’s office during my fourth session, I laid eyes on someone from my past who brings me a great amount of anxiety. My heart rate spiked and my chest tightened. Suddenly, breathing became a difficult task. I immediately turned on my heels and hid in my car until the person left, but the anxiety followed me into my appointment. My newfound relaxation technique was about to be tested.

As I cleared my mind during the biofeedback training, I was able to turn the pulsing off, meaning I brought my muscle tension down to the threshold set by the doctor, but the second the stressful person popped back into my mind, the pulsing turned back on. Over and over I emptied my mind and filled it with the autogenic relaxation phrases and turned the pulsing off, but, again, it’d spike back up once I thought of the person.

Running into my past turned out to be a blessing in disguise; I was learning to control the stressful thoughts and ensuing physiological response with just my mind. It was hard work, but I knew it would be a skill I could turn to my whole life. If I could control my heart racing, maybe it’d be easier to quiet my disturbing thoughts.

In the sessions that followed, I learned to relax myself instantaneously and in any situation without the autogenic phrases, getting my muscle tension level from the original 4.0 down to just 1.7. I’m now able to take a deep breath, let it out, hold it, and find that perfect state of relaxation — like magic.

Biofeedback empowered me during a time when I felt shaken down to my core. I walked away from each appointment feeling like I have a superpower and for the first time in years, I feel like I can finally control the anxiety that seems to rule my life.



from World of Psychology https://psychcentral.com/blog/how-an-innovative-therapy-technique-made-me-feel-like-a-superhero-when-i-was-at-my-worst/

Does ’13 Reasons Why’ Increase Suicide Rates?

Anxiety Management: It’s All Downhill from Here

Les relâches is a winter break that every Swiss public-school system takes in February, though the actual dates vary from canton (state) to canton. In French, “la relâche” means “rest,” but as this week usually involves skiing in Switzerland, it is the least restful week of my year! Personally, I call it anxiety management week. It is the one week every year that this psychotherapist becomes her own private client. I set a goal each time to try to keep up with my family on the trails for at least a couple of hours during the week. Sometimes I succeed, but, mostly, I just keep trying.

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During ski week, my empathy skyrockets for past and current clients who combat anxiety on a daily and sometimes hourly basis. I join their ranks in that need for anxiety management anytime my personal context intersects with a few notable laws of physics that involve speed and momentum. I employ copious doses of the cognitive, behavioral, and affect regulation strategies I often prescribe to the people I work with. These strategies become my lifelines on those steep mountains, which are crowded with other skiers who could literally carve laps around my effort-filled descents. My five-and-a-half-year-old daughter and my eight-year-old son are two of them.

I recognize that real danger is inherent in practicing a sport in which momentum is needed to perform accurately, and where the physical environment often includes steep, rock-and-tree-filled obstacles, much less the human-made ones. Learning to ski involves mitigating the risks of navigating changing terrain and conditions, avoiding falls and collisions with stable objects or other skiers, and maintaining one’s personal equilibrium within the bounds of one’s own ability and limits, all while attempting not to become the obstacle in other skiers’ paths! (From this angle, it actually sounds a lot like practicing therapy!)

This constant processing of rapidly evolving environmental data can frankly be quite physically and mentally exhausting! However, the rewards of learning to synchronize with oneself, with nature, and with others can also be quite rewarding, sometimes comical, and usually humbling.

My daughter and I had the makings of a beautiful mother-daughter moment together one afternoon on a blue trail when she decided to ski beside me, about three feet away. She excitedly exclaimed, “Mommy, you’re going fast now!” Her broad smile showed me that she meant this as a compliment and was proud of the progress I had made through the daily lessons I had been taking during the week. Several thoughts traversed my mind in rapid succession as I processed her spontaneous and heartfelt gesture and as my anxiety welled:

“Why are you looking at me and not straight ahead where you are going?”
“How on Earth do you ski without looking where you are going?!”
“How do you manage to get so close to others and not veer into their path?”
“Oh Heavens, you are close!”

As much as I was in awe of her ability to remain calm, cool, collected, and courageous in her posture (as we were speeding downhill, nonetheless), I began to have palpable concerns for her safety in skiing so close to me. Instead of relishing that beautiful mother-daughter moment she created, my thoughts raced, my anxiety overflowed, and I awkwardly blurted out, “Honey, please ski a little further away (so that if I crash and burn with the newfound awareness your astute speed observation evokes, I won’t be able to take you down with me)! I need a little more room to turn here.” She shrugged, then proceeded full speed down the mountain, making perfect “S” turns with her skis in parallel, catching up easily with her brother and father below.

My speed on skis, and my ability to go with the flow of it (instead of fighting it), is usually a great source of vexation for me and my family. My “pilates” approach to finishing a trail involves turning with intention, methodically repeating to myself, “Up... turn... down,” and mechanically pacing my breath to the piston-like movements I consciously will my knees to make. My family is greatly annoyed about the mid-trail wait times this entails for them, especially when we agree to stay together.

When in difficulty, staying together comprises part of the rules and common-courtesy practices that skiers adhere to for safety, along with signaling dangers to others and calling for or providing help. For the most part, I have been on the receiving end of those practices. But, with a few more ski weeks and the mental and emotional strategies I employ to stave off full-blown panic attacks, I may someday be able to help others as they have helped me on the trails. Until then, skiing with anxiety will continue to be downhill all the way.

Helping clients manage their anxiety through a caring counseling relationship allows them to see that they, too, can benefit from employing strategies discussed in session on their own slippery slopes. We can help them to categorize situations like ski trails to understand how steep the slope (and the learning curve) feels for them: blue for low anxiety, red for mounting anxiety, or black for high anxiety. We can accompany them in using their available and developing resources to recognize the thoughts that make their slopes feel dangerous to them and to process how their body captures, holds, and releases their anxiety, much like skiers must do to evaluate how their skis react to shifting environmental conditions throughout the day. We can urge them to consider how their anxiety affects them and their loved ones, and to call upon those loved ones for support when needed. With time and practice, they will hopefully learn to navigate those more difficult trails with greater agility, crossing their own finish lines in their own time and on their own two skis.

from http://www.psychotherapy.net/blog/title/anxiety-management-it-s-all-downhill-from-here

Podcast: What’s it Like to Work in a Psych Hospital?

It’s a sad fact that many people still think a psych hospital is like what they saw in One Flew Over the Cuckoo’s Nest. But modern psychiatric care is nothing like that. This week’s guest worked for years in a psychiatric emergency facility and joins us to share his thoughts about the experiences he had while employed there.

 

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About Our Guest

Gabe Nathan is an author, editor, actor, playwright, director and a lover of commas. He has worked as an Allied Therapist and Developmental Specialist at Montgomery County Emergency Service, Inc., a non-profit crisis psychiatric hospital. While there, he created innovative programs such as a psychiatric visiting nurse program, a suicide prevention collaboration with a regional public transportation authority, and an Inpatient Concert Series that brought professional performing artists to entertain the patients and enrich their inpatient experience. Gabe serves on the Board of Directors of Prevent Suicide PA and the Thornton Wilder Society.

Gabe spreads a message of suicide prevention and awareness with his 1963 Volkswagen Beetle Herbie the Love Bug tribute car. The car, a participant in Prevent Suicide PA’s innovative “Drive Out Suicide” awareness campaign, bears the number for the National Suicide Prevention Lifeline (1-800-273-TALK) on its rear window, and Gabe talks about suicide prevention and mental health wherever he and Herbie travel together. Gabe lives in a suburb of Philadelphia with his wife, twins, Herbie, a basset hound named Tennessee and a long-haired German Shepherd named Sadie.

 

WORKING IN A PSYCH HOSPITAL SHOW TRANSCRIPT

Editor’s NotePlease be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Narrator 1: Welcome to the Psych Central show, where each episode presents an in-depth look at issues from the field of psychology and mental health –  with host Gabe Howard and co-host Vincent M. Wales.

Gabe Howard: Hello everyone and welcome to this week’s episode of the Psych Central Show podcast. My name is Gabe Howard and I’m here with my fellow host Vincent M. Wales. And today we have a very, I’m going to go with unique, guest not because he himself is unique, although he’s a rather cool guy, but because his experience is unique to mental health shows. Let me give a little background. Early in the early days of the Psych Central show Vin and I used to do Gabe and Vin only shows. Remember those, Vin, way back when?

Vincent M. Wales: Oh, yeah.

Gabe Howard: And one of the first episodes we did was Vin interviewing me about my experience in a psychiatric hospital. I was in the psych ward of the hospital as a patient and how I felt about it. And then a year or so later with the launch of A Bipolar, a Schizophrenic, and a Podcast, me and Michelle Hammer, who lives with schizophrenia, we both talked about our experiences inpatient. And we got a lot of feedback from a lot of people that said, “Yeah. It was traumatizing being a patient locked away. Everybody was mean to us, and it was just an awful experience.” And Michelle and I said, “Yeah, yeah, it was terrible. We didn’t like any of it.” And then I was talking to my friend Gabe, who I will introduce here in a minute, and he said, “You know, it’s very one sided. You know people who work there, they have an opinion.” And the exact phrase that he used was “psychiatric hospitals are traumatizing for everybody.” There’s nobody that really escapes the trauma of these places they’re just scary places for everyone. And that really is worth investigating more. So without further ado, Gabe Nathan, welcome to the show.

Gabriel Nathan: Hi. Thanks for having me.

Vincent M. Wales: Thank you for being here.

Gabe Howard: Now first, in interest of full disclosure, you currently do not work for a psychiatric hospital, but you worked there for a number of years.

Gabriel Nathan: Yes, I worked in an inpatient crisis psychiatric hospital for five years.

Gabe Howard: And inpatient is people who are admitted there, sometimes voluntarily, sometimes against their will. It’s the locked door, they have to be probated to leave, they sleep there.

Gabriel Nathan: Yeah, there are many locked doors at our facility. It’s a freestanding independent locked crisis psychiatric hospital and the majority of our patients were involuntary, but there were a mix of voluntary and involuntary patients. If you were brought there on an involuntary hold, in Pennsylvania where I worked, it’s called a 302. You are there for up to one hundred and twenty hours. You have a hearing in front of the mental health review officer. Sometimes there are people who testify about your behavior. The treating psychiatrist testifies, you can testify. You have a public defender. If the mental health review officer believes you need more time then add more time. That’s how it goes.

Gabe Howard: And when people think of psychiatric hospitals and psychiatric wards, this fits, right?

Gabriel Nathan: I mean yeah. I can I can give you like a general feel of the facility where I work. You know, it had institutional furniture. You know, the stain resistant industrial vinyl. Very very heavy chairs, because you know sometimes people get angry and like to throw chairs. So we try to mitigate that with you know heavy furniture.

Vincent M. Wales: And you’ve got the ligature free everything.

Gabriel Nathan: Yeah everything is reviewed. So we have what’s called environmental rounds where staff members patrol the hallways and actually look for things. Could this be potentially be a ligature point? Could this be used to harm someone? We had sometimes wicker furniture that people would pick off the pieces of wicker and use that to cut themselves. So, you know, you had to be looking for everything. The art that was on the walls is covered in Plexiglas that is screwed to the wall. Like the frame is screwed to the wall because we have patients rip the artwork off the wall and try to break the Plexiglas to hurt themselves. If you were writing you’d have these little bendy pens that were nearly impossible for you to hurt yourself with and little tiny little golf pencils. So the entire environment is regularly scrutinized and the quote “therapeutic milieu” which is the term that’s used to describe the patient environment, is all designed to keep people safe from themselves or others.

Vincent M. Wales: I have a couple specific questions since I work in the hospital end of things myself here. Did your hospital have a psychiatric E.R.?

Gabriel Nathan: Okay, so this was a psychiatric emergency facility. So we would have cops roll up at 3:00 a.m. with the ambulances. We in fact have one of the only dedicated psychiatric ambulances, it’s based out of our hospital. So when a warrant is issued, it’s an EMT is along with the police serving that warrant so that it’s not the police showing up to the house. It’s not the person being handcuffed and thrown in the back of a patrol car like a criminal, right? It’s more trauma aware. Not to say that it’s not traumatizing to be dragged out of your house at 3:00 a.m., whether it’s by EMT’s or whomever, but it looks a little better to the neighbors.

Vincent M. Wales: Sure. So Gabe what was your position there? What was your job?

Gabriel Nathan: When I was hired in 2010, I was a hybrid of psych tech. So which is really like your lowest rung. Sometimes they’re called psychiatric aides. They’re really the backbone of any psychiatric hospital. They’re doing rounds, they’re checking the bathroom to make sure people are not doing inappropriate things in there, or harming themselves, and they’re checking every single room, they are monitoring the hallways. They’re everywhere, and there’s usually, you know, eight to 10 on duty per shift. So I did that a couple of days a week and then a couple days a week I was what’s called an allied therapist. Basically my job as an allied therapist was to facilitate a wide range of psycho educational and recreational groups for the patients. So at eleven o’clock I could be running coping with anxiety at one o’clock I could be running creative writing or current events and then doing a lot of documentation and conducting like one on one interviews with patients, just to see how they were doing that day. So that was what I did for three years and then I moved up to development and programming.  I did that for two years.

Vincent M. Wales: Okay, and one last hospital question. How large was it? How many beds did you have?

Gabriel Nathan: At the time I was working there, we had a 73 bed capacity.

Gabe Howard: So let’s talk about differences between patients and staff. So one of the things that you just talked about is all of these things are done to keep patients safe. What was the word that you used? Therapeutic value?

Gabriel Nathan: Therapeutic milieu

Gabe Howard: Milieu? OK, so milieu.

Gabriel Nathan: Yeah yeah.

Gabe Howard: Speaking purely as a patient, you’re constantly staring at people and trying to see if they’re up to anything, and it appears very infantilizing and you’re talking down to us and you’re constantly treating us like we’re not adults. That’s very much what I felt when I was there. How do you feel about that? Not like why is it done. I think we all understand why it’s done. But how did you, Gabriel Nathan, feel sort of, I’m trying not to say baby sitting adults, but in a way you’re responsible for keeping adults safe who don’t appreciate it. How did that make you feel?

Gabriel Nathan: Sure. We’re responsible for keeping people safe who have demonstrated that they do not possess that ability.

Gabe Howard: Yes, agreed.

Gabriel Nathan: So, unfortunately it’s an unwanted reality. And we were often being confronted with people saying, “F you! You’ve got no right to to be watching over me,” and you know whatever, when they just tried to throw themselves in front of a bus. So there was often a disconnect there. And I tell people the most commonly uttered phrase in the hospital is, “I don’t belong here.”

Vincent M. Wales: OK. Yeah.

Gabriel Nathan: And that was said by a great number of people. It was said by very wealthy well-to-do individuals who I guess were saying it because they didn’t belong with, you know, kind of the impoverished psychotic individual who was wearing newspaper underwear, right? They felt this kind of righteous indignation of I don’t belong here. But it was said by everyone regardless of their socioeconomic status or whether or not they used illicit substances or what. Nobody belonged there. Even when we were at capacity, no one belonged there.

Vincent M. Wales: Yeah, you have no reason to exist.

Gabriel Nathan: Exactly right. So how did Gabriel Nathan feel in that position? I think uncomfortable is the word. I felt uncomfortable for quite a few reasons. First of all ,I did not have a lot of psychiatric training when I was initially hired for this job and I felt uncomfortable about that where I was feeling like I was a fish out of water.

Gabe Howard: Ok that makes sense.

Gabriel Nathan: So I felt uncomfortable that way. I felt uncomfortable you know being somewhat of relatively slight build, being put in a position where the alarm would go off and, you know, if you’re the first one who’s arriving at whatever emergency it is, like you’ve got to deal with it. And you don’t have a lot of tools at your disposal to deal with issues in an inpatient psychiatric hospital. And so I felt kind of outmuscled and that got uncomfortable several times. And I also felt uncomfortable because the whole environment is . . .  it’s bizarre. You really feel like you’re in a bizarro world. You’re with individuals, some of whom are psychotic, some of whom are reality based, some of whom are suicidal, some who have severe depression and anxiety or inability to care for themselves. It is a huge mix of individuals because of the makeup of our hospital. It wasn’t divided into separate units like this is the bipolar unit and this is the schizophrenia unit.

Vincent M. Wales: Right, right.

Gabriel Nathan: And it was just everyone together, so facilitating a let’s say creative writing group when you have individuals who are psychotic and actively responding to internal stimuli and people who are reality based. It was very very difficult and very frustrating at times. And I want to address the point too about it feels like everyone’s watching us. It feels that way for staff too. Don’t forget that we’re on camera also. When you get called up to H.R. You’re feeling it, okay?

Vincent M. Wales: It’s like being called in to the principal’s office.

Gabriel Nathan: Well it’s like being called to the principal’s office, But the stakes are so high. Because unfortunately at the hospital you are going hands on with people. A woman comes out of her room stark naked and there’s three male employees around. You have to manage that situation and that gets very problematic. So we are being watched as well as employees. And I used to run one of the groups. I would run is was called, it was called a safety group and we would talk about the hospital. I would talk very frankly. I would let them know, yeah, you are on camera 24 hours a day. The only places we don’t have cameras are your bedrooms and the bathroom. But other than that you’re being watched all the time so it’s not paranoia. Like I was very frank about it, but I also emphasized we are too. And that is for your safety as well. You’ve got to watch everyone.

Gabe Howard: We’re going to step away for a moment to hear from our sponsor. We’ll be right back.

Narrator 2: This episode is sponsored by BetterHelp.com, secure, convenient and affordable online counselling. All counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face-to-face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counselling is right for you. BetterHelp.com/PsychCentral.

Vincent M. Wales: Welcome back everyone we’re here with Gabriel Nathan talking about what it’s like to work in a psychiatric hospital.

Gabe Howard: Gabriel, when you worked there, did you feel personally scared? Were you ever afraid? I mean you talked about being nervous or being you know worried about HR or feeling watched. But did you ever fear for your own physical self or emotional self while an employee there?

Gabriel Nathan: Yes. You know the first time I ever got punched in the face was at the hospital, that was like a unique experience. And you actually do see stars. I did, like the bursts of light that’s how it is and I was like wow I thought that was just a cartoon. That’s real. I got attacked during what’s called, we call it an “elopement attempt.” I was the only one there and that really sucked and that was a turning point in my time there.

Vincent M. Wales: What happened exactly?

Gabriel Nathan: I will tell the story exactly as I can tell it. It was September 17th, 2012, and you don’t you just don’t forget this stuff. It was a Monday morning and I worked every other weekend when I was on the unit and this was my weekend off. So it’s coming in on Monday fresh. You didn’t know the patients who had been admitted over the weekend, morning report had not happened yet. So I didn’t get the skinny on who was who and I was preparing the paperwork for the allied therapy department. It was a lot of paperwork from the weekend that I just have to get together and put in every patient’s chart and everything. You have to make photocopies. So the photocopies are used for Morning Report and the originals are put in the charts. So the copier in the chart room was broken. It was always broken. It was a pain in the ass. So I had to take all the originals and go out to the crisis lobby. They had a photocopier. So I go out of the chart room and there was a young man in his early 20s, white guy, T-shirt, shorts standing by the door to the crisis lobby and there’s a red and white lines you know square by the door to signal like stand outside of this box like you’re not allowed to stand inside the box. And he was standing inside the box and I was like. “Oh great. You know, first thing in the morning I’m going to have to tell this guy you can’t stand by the door. It’s going to be a confrontation.” But as I was walking towards him he moved outside of the box, but still like near the door. But I was like Oh OK. He did the right thing. I don’t have to say anything to him. I nodded my head and I said good morning. He looked at me and I put my key in the door and I opened the door and I felt him right behind me and I turned around and had my keys in my hand and the papers and I said, “No.” And he said, “Let me in there,” and he shoved against the door and I was shoving back trying to close the door on him and I was standing on a mat like that wipe your feet. I’m on the mat with it sliding back on the floor. And I was like I’m going to lose it. He shoved his way through and he bear hugged me and pushed me up against the wall. And I’m thinking, just stay on your feet. All you have to do is stay on your feet and in 20 seconds there’s gonna be 10 guys in here, right? So I’m wrestling with him and I had a hoodie on. Which if you ever work in a psychiatric hospital don’t wear a hoodie.

Vincent M. Wales: OK.

Gabe Howard: OK.

Gabriel Nathan: And I never ever did. This was the very day. So I had this stupid hoodie on he reaches over the back of me and pulls the hoodie over my head. So now I can’t see anything. I hear screaming and someone hits the psych alarm and I can hear the bell. And then the next thing I know I’m on the floor and I can feel on top of me and I’m like, “Oh great. They took him to the floor and we’re all on the floor together and they’re going to pull him off me and it’s all gonna be over.” Well, what I didn’t realize until I watched the video was when he had pulled my hoodie over me and someone activated the alarm, it was actually a patient who hit the alarm. He immediately got off me when the other staff came in and staff took me to the floor, not him. And he faded back and was just watching with the other patients and a nurse came in with a trilogy, which is a needle with Haldol, Benadryl, and Ativan to give to me. And I was face down on the floor with my head covered with the hoodie, and she looked at me and said, “Oh my God! He’s got a belt on. Why does he have a belt on? How am I going to give him the needle?” Because obviously when you come into a psych hospital, they take your belt.

Gabe Howard: Right.

Gabriel Nathan: So the guy who’s on top of me pulled my hoodie up and he said, “Gabe?” And I was on the floor staring at one of my colleagues and he said, “What is going on?” And I said young guy, white T-shirt, gray shorts. And they found the guy and put him in restraints and gave him the trilogy. That’s how that incident went down and that sucked. And after they brought me up and after I had explained what happened, all my co-workers are standing around and they’re trying to comfort me or whatever. And you just see me I take my glasses off and I throw them against the wall as hard as I can. And I took that stupid hoodie off and I throw it against the wall. And I was just so incensed that I didn’t get saved. Like it didn’t go down the way it was supposed to. You know?

Vincent M. Wales: Right, yeah.

Gabriel Nathan: Not the way I had been there for colleagues, it didn’t pan out for me. I want to make it very clear there are colleagues who have been hurt way, way worse. You know I went and ran a group the next hour, and I should not have, but I did. We’ve had people who’ve had their shoulders broken, who’ve had concussions, who’ve had their jaws busted. I mean all kinds of stuff. So I don’t want this to be like, “Oh my God!” You know, it happens to a lot of people. A lot of people. So the short answer to your question is yes, I have been scared. And I had been preparing for something like that to happen since the day I started working there.

Gabe Howard: Yeah I think that anybody can understand why being attacked at work is traumatizing. And I think that there’s a lot of us who can really relate to the idea that you thought you were safe. You thought that there was all of these protocols that would keep you safe and they failed you.

Gabriel Nathan: I never, I never thought I was safe really.

Gabe Howard: Okay. So the whole time you were there, you just didn’t feel safe at work. But you did this work for how long?

Gabriel Nathan: I was on the unit every day for three years.

Gabe Howard: And then after three years you went to work and didn’t feel safe. And as you know people like me, people like Michelle Hammer, people that we interview on other shows, we’re there three four or five days and we don’t feel safe and we carry a lot of whether you call it anger whether you call it misunderstanding trauma whatever toward the hospital and staff. I am listening to what you say and I’m thinking My God I would never want to work there but there’s still that part of me that’s just like you were still mean to me.

Gabriel Nathan: But there should be. There should be that part of you and I don’t begrudge that anger at all. Not at all. And I would never pretend to say I understand it because I don’t. Look, I’m a mental health consumer. I go to therapy. but that’s not the same thing. And I would never pretend that being an employee who has keys that jingle jangle at 3:00 o’clock and I’m out of here is the same thing. But what I will tell you is that I was traumatized long before the assault. I mean I was. I had to take, I took a patient down my first hour on the unit. The first hour I was sitting ,I was sitting on the acute unit with my trainer. You have a trainer or preceptor for I don’t know what it is two weeks maybe. You’re his shadow, you know for every hour you’re on the unit. The first hour I’m sitting there with him. And just like what happened to me, a staff member put his key in the door to go out and a patient followed him and cold cocked him. Hit him right in the back of the head. Immediately, my trainer and I jumped up I had to the midsection he had the top. Took the patient to the ground. He was a Hispanic young man. Waited until three or four more other staff members got there. Picked him up, put him on a bed, putting him in restraints. That’s traumatizing for everybody in the room.

Vincent M. Wales: I can imagine.

Gabriel Nathan: Everyone. So that to me even with the words coming out of my mouth and I know it’s true it sounds disingenuous because you’re like How dare you? Staff members say that you’re traumatized? You’re not the one being put in full leathers. You’re not the one being, you know, exposed in this way. No, but you’re perpetrating an act that is it seems so draconian it seems like very 12th century. To be restraining somebody to a bed, it seems very vulgar and very violent and it is. It’s an act of violence. So what you’re whether you’re on the receiving end of that or the perpetrating act, that’s traumatizing.

Gabe Howard: I think that there’s a lot of analogies that would probably fit this situation and I hate that the one that keeps coming to mind has to do with infants. Since we’re talking about feeling infantilized as a patient, but it just sort of reminds me of a parent taking their 2 year old to the doctor to get a shot and the 2 year old understands that this is going to hurt and the parent understands that it’s going to hurt and the doctor understand it’s going to hurt. But there’s that little bit of disconnect from the 2 year old. It’s like why are you allowing this to happen, Mom? Why why won’t you take me out of here, Dad? And the parent is always holding the child down while you know that the treatment is being given, the vaccination or whatever it is. And how can you not be affected by that? You just held your kid down when your kid asked you not to do it. Does that resonate with you? I mean from my perspective, when I was there, you all looked like you were enjoying yourselves, which I now know is ridiculous. Nobody enjoys themselves there. But at the time it felt like that. Where’s the bridge for that? Obviously like you said, we can’t sit people down and say listen it’s going to look like the staff is having a good time because they may whistle or they get to go home or they’re going to laugh or tell a joke but really we’re all traumatized too. Because that doesn’t really make a patient feel safe either.

Gabriel Nathan: Right.

Gabe Howard: What’s the goal here? Everybody’s miserable.

Gabriel Nathan: Well here’s the thing, everybody isn’t miserable. So the patients aren’t miserable 24 hours a day. Like you will go, you will hear patients laughing and joking with each other and having a good time in the activities room or watching a movie. Let’s not sell each other a bill of goods on either end, that like it’s a completely horrendous experience for the patient. It’s not.

Gabe Howard: That’s true. I got better I got better. It saved my life.

Gabriel Nathan: The staff isn’t miserable 24 hours a day either. We like each other, we love each other. There is an incredible bond that happens with employees who are kind of in a first responder environment. And within the confines of a closed psychiatric hospital, you are the first responders. So you know, you are the ones running down the hall when there’s an emergency. You are the ones leaning on each other. We’re hugging in the chart room, we’re crying with each other. We get mad and yell at each other. It sounds so cliche, but it is very much like a family. We’re not walking around 24 hours a day crying about how horrible it is. We’re just not. Because first of all, we wouldn’t be able to function. We would not be able to do our job if that’s how we acted.

Gabe Howard: That’s true.

Gabriel Nathan: It’s totally ineffective for the patients and for each other.

Gabe Howard: No.

Gabriel Nathan: We depended on each other for support and to be able to get through hard incidents and a lot of that was done through humor and very very black humor, as I think you’ll find in all hospital environments and first responder environments. The gallows humor, it gets you through. So yeah, I think people are traumatized. But you deal with that in lots of different ways. You know, whether it’s through humor, whether it’s through a variety of coping mechanisms. Some of them are healthy, some of them are not.

Gabe Howard: I understand what you’re saying. I really really do. That’s really beautiful. Gabe, thank you for being so open and so honest with all of your stories. We really appreciate it. So I know that you no longer work at the psychiatric hospital and you went on to another job, but it still involves a lot of mental health advocacy and empowering people through telling their stories and making movies. Can you talk about the job that you have now and tell people where to find that site?

Gabriel Nathan: While I no longer work there, I am still back there every other month or so. It seems like there’s always some kind of reason where I’m back there, and that’s nice actually. It’s kind of nice not to have the cord and completely separate. But where I work now it is still involved in mental health. It’s just not the trenches anymore. I’m the editor in chief of a mental health publication called OC87 Recovery Diaries. We’re at OC87RecoveryDiaries.org. We’re on Facebook, Twitter, Instagram, all over the place. And we publish mental health personal essays and do original mental health documentary films. We have a new essay every week and a new film every month that just really highlighting stories of mental health empowerment and change.

Gabe Howard: I want to blow your horn a little bit, Gabe. Because you know sometimes people hear you know we’re a web site and we make little movies every month. These aren’t little movies, these are very high end well thought out. They’re incredible mini documentaries about various people and things and they’re really quite amazing.

Gabriel Nathan: Well I love what we do and I love how we do it and the production company that we work with for the films calls it giving mental health stories the red carpet treatment. It gives to them to give mental health storytellers the respect and dignity of having a professional editor and laying their story out correctly. And same thing with the films. If we’re going to profile you, we’re gonna do it right.

Gabe Howard: Well excellent. Thank you so much everybody. Check that out over at Oc87RecoveryDiaries.org. Thank you again.

Vincent M. Wales: It was great having you.

Gabriel Nathan: Thanks. Thank you, Vince.

Gabe Howard: Thank you for putting up with both of us and thank you everyone for tuning in. And remember you can get one week of free, convenient, affordable, private online counselling anytime anywhere by visiting BetterHelp.com/PsychCentral. We’ll see everybody next week.

Narrator 1: Thank you for listening to the Psych Central Show. Please rate, review, and subscribe on iTunes or wherever you found this podcast. We encourage you to share our show on social media and with friends and family. Previous episodes can be found at PsychCentral.com/show. PsychCentral.com is the internet’s oldest and largest independent mental health website. Psych Central is overseen by Dr. John Grohol, a mental health expert and one of the pioneering leaders in online mental health. Our host, Gabe Howard, is an award-winning writer and speaker who travels nationally. You can find more information on Gabe at GabeHoward.com. Our co-host, Vincent M. Wales, is a trained suicide prevention crisis counselor and author of several award-winning speculative fiction novels. You can learn more about Vincent at VincentMWales.com. If you have feedback about the show, please email talkback@psychcentral.com.

About The Psych Central Show Podcast Hosts

Gabe Howard is an award-winning writer and speaker who lives with bipolar and anxiety disorders. He is also one of the co-hosts of the popular show, A Bipolar, a Schizophrenic, and a Podcast. As a speaker, he travels nationally and is available to make your event stand out. To work with Gabe, please visit his website, gabehoward.com.

 

 

Vincent M. Wales is a former suicide prevention counselor who lives with persistent depressive disorder. He is also the author of several award-winning novels and creator of the costumed hero, Dynamistress. Visit his websites at www.vincentmwales.com and www.dynamistress.com.

 

 

 



from World of Psychology https://psychcentral.com/blog/podcast-whats-it-like-to-work-in-a-psych-hospital/

Wednesday, 1 May 2019

Which Came First: Smiling or Happiness?

Intentionally smiling can be part of your spiritual practice.

I recently played a word association game with my eight-year-old granddaughter, Kya. I said “peanut butter,” she said “jelly.” I said “dog,” she said “cat.” I said “smile,” she said “happy.” After this game, I reflected on the association we often make between smiling and happiness. As Kya’s response indicated, when we see someone smiling, we tend to assume they’re happy. Being happy, we think, comes first: People feel happy and then they smile. But can it work the other way around: people smile and then they’re happy? Both scientific evidence and personal experience support this idea.

Science tells us that a smile has the power to not only impact you but also the people around you in positive ways. One study used MRI technology to investigate ways in which facial actions can initiate particular emotions. When people are asked to use the muscles in their face to show such emotions as fear, anger, disgust, sadness, and happiness, they actually experience elements of the corresponding emotion. This is due to the fact that the muscles in your face let your brain know that you’re smiling. Your brain then generates the chemicals that make you feel happy.

Perhaps you don’t need research to tell you that smiling can make you feel happy. Perhaps you’ve experienced it personally. I know I have. I first learned about the power of the smile during a meditation retreat several years ago. At one point during the retreat, we were invited to silently think of certain mantras during our in and out breaths. The mantras consisted of four sets of words: “in-out, slow-deep, smile-relax, present moment-beautiful moment.”

I readily accepted the relevance of the other three sets, but “smile-relax” seemed somewhat out of place. I was looking for depth through a meditation practice, not enjoyment and relaxation. After following the directions, however, I soon discovered deeper meanings to the smile-relax mantra. I discovered, too, that just thinking about this mantra brought a smile to my face. And with that smile, I felt a sense of happiness.

I’ve since adopted smiling as a spiritual practice for responding to frustration, pain, and discomfort.

While this practice helps me appreciate the power of smiling for diffusing stress and promoting happiness, it’s also taught me something about the deeper meaning of the ups and downs of life. Feeling happy when things go our way is easy, but smiling when things get tough can be a challenge. Doing so, however, helps me move beyond the labeling of events as good or bad to a spiritual reality that enriches my experience of life.

I’ve discovered the power of the smile in some surprising ways. Yesterday, my first reaction to cutting my finger was to focus on the pain and inconvenience this caused me. But even before reaching for a bandage, I remembered to smile. My focus switched immediately to healing versus pain. Yes, the pain and inconvenience were still there, but I was more attuned to the healing that I would soon experience than the short-lived pain of a simple cut on my finger. Another surprising place where I experienced the power of the smile was in my yoga practice. There are days when maintaining my balance during the tree poise proves to be challenging. Smiling during this poise, however, helps me stay balanced for a longer time and with less energy. I assume smiling relieves tension, and that relaxed muscles are easier to control than tensed muscles.

I’ve read that “it’s in your blood” to smile and that the act of smiling promotes healthier functioning of our immune system. Researchers examining this phenomenon tell us that a daily dose of smiling can promote our physical well-being.

But the power of the smile is more than a personal thing. It can extend to people around you, as well. We might think of this as the ripple effect.

Try this. Walk into a room and greet people with a smile. Then watch what happens. Typically, other people in the room will return your greeting with a smile on their face. You smile, they smile, and everyone feels a touch of happiness.

But is a smile appropriate in today’s troubled world? This question stops me in my tracks. I wonder, “Is it OK to be happy in a world filled with greed, environmental destruction, and other forms of violence?”

I then recall Mary Oliver’s words: “Happiness, if done right, is a kind of holiness.” Yes, it’s OK to smile — even necessary to do so. Just as smiling helps me stay physically balanced during my yoga practice, so smiling during times of anxiety helps me stay emotionally and spiritually balanced. And I believe this, too, has a ripple effect.

Happiness, if done right, isn’t selfish. While smiling can generate individual happiness, it also spreads joy to others and, interestingly, broadcasts a cooperative disposition. What could be more effective in healing social wounds than cooperation? With this in mind, I’ve come to appreciate smiling as one of the most nonviolent forms of communication.

Smiling, alone, will not save the world. It can, however, make the world a more pleasant and peaceful place to live.

This post courtesy of Spirituality & Health.



from World of Psychology https://psychcentral.com/blog/which-came-first-smiling-or-happiness/

How to Get Started Doing That Thing You Really Don’t Want to Do (But Have to!)

You need to fill out paperwork. You need to clean out the garage. You need to pay the bills. You need to start a really challenging project that you’ve been putting off for months. You need to do some other dreaded task that you really don’t want to do but must be done.

And yet, instead of tackling that task, you’re scrolling social media, looking at photos of strangers or people you didn’t like in high school. You’re watching cute videos of cats (or dogs). You’re texting memes back and forth to your friends.

It’s so bad that you’re actually cleaning the kitchen, or scrubbing the toilet, or washing the dishes.

Yes, it’s that bad.

It’s easy to put off tasks we don’t want to do. After all, it feels good. Literally. That is, “our brains deliver a dose of feel-good chemicals when we choose something fun over something we should be doing,” said Maura Nevel Thomas, a speaker, trainer, and author on individual and corporate productivity and work-life balance. Which, of course, today is easier to do than ever before thanks to technology. After all, distractions are—again literally—at our fingertips. You can’t get any more convenient than that.

We also tend to procrastinate on big tasks that have vague action plans, Thomas said. “We keep putting them off, because we don’t know where or how to begin tackling them.”

But even though it’s tough to complete certain tasks, and it feels like the universe is conspiring against us, we can absolutely accomplish the most frustrating, boring, mundane, or daunting things.

The key is to begin. As such, below, you’ll find a list of tools and tricks to help you spark your start.

Avoid using vague verbs. “When we phrase tasks with ‘vague’ verbs, they sound too big and too difficult,” said Thomas, author of the forthcoming book Attention Management: Breaking the Time Management Myth for Unrivaled Productivity (September 2019). Which makes it all-too easy for us to push these tasks aside and pretend they don’t exist.

Thomas calls vague verbs “speed bumps,” and shared these examples: Instead of writing “organize the meeting,” write “email the staff about the meeting.” Instead of “create the budget,” write “enter receipts into spreadsheet.” Instead of “research competitors,” write “Google business coaches in Chicago.”

Set a timer for 7 minutes. Thomas suggested shutting out all distractions and giving the dreaded task your full focus for those 7 minutes. She noted that this trick takes advantage of an idea from physics called “activation energy”: “The idea is basically that once you’ve started, you’re more likely to keep going.”

And even if you don’t keep going, 7 minutes of concentrated work is still work, which means you’ll be much further along than before you started. And you just might be surprised at how much you can accomplish in that time.

Do it first thing in your day. “It sounds counterintuitive, but do the most annoying task first, the thing you’re seriously dreading,” said Julia Dellitt, author of the book Get Your Life Together(ish). Make it non-negotiable. This way there’s no time to waver. And you’ll feel amazing after it’s done, and can focus on enjoying the rest of your day.

Set strict deadlines. For Emily Price, author of Productivity Hacks, one of the toughest tasks to do is writing a longer feature story that doesn’t have a specific deadline. “I’m great at getting even the largest projects done before a deadline, but whenever there isn’t one I tend to go into procrastination mode,” she said.

Price suggested setting a deadline for tasks that don’t have one—and telling that deadline to a coworker, your boss, or someone else who can keep you accountable.

“Saying you’ll get a project done ‘this week’ might end up meaning you’re plugging away on it late Friday afternoon. Instead, tell your boss you’ll get it in on Thursday. That forces you to buckle down and actually get the work done.”

Use regular rewards. The key here is regular. “According to psychologist Alexander Rozental, promising yourself a big reward at the end of a project isn’t likely to motivate you if you’ve been procrastinating on getting started,” Thomas said.

However, rewarding yourself as you progress through a task or goal, or complete quick tasks is highly effective. For instance, you might take a 20-minute walk after writing the first draft of your article. You might eat at your favorite lunch spot after submitting a brief report. You might buy yourself a freshly baked bagel and cup of coffee after spending the morning paying the bills or filling out preschool paperwork.

Blast through a bunch of dreaded tasks. Make a list of all the irritating, excruciatingly boring things you need to do. “Then, divide the list of tasks into two categories—what will take a couple minutes, or what needs more time devoted to it,” Dellitt said. “From there, set a timer for 15 minutes and do as many of the smaller tasks as possible until the timer goes off.”

This helps Dellitt create some momentum, and it sparks an important realization: Many of the tasks looming on her to-do list (and lingering inside her mind) don’t actually take that long if she just concentrates on completing them. 

Set an “implementation strategy.” According to Thomas, “When you set an implementation intention, you commit to engaging in your desired behavior whenever you receive a certain cue,” such as: “When my alarm clock goes off, I’ll do a quick guided meditation to start the day.”

This kind of tool is especially effective because it doesn’t require relying on willpower, “which may get depleted with every decision you make,” Thomas said.

Other examples are: “When I get to work at 9 a.m., I’ll spend 20 minutes Googling a research study for my article on depression.” “When I sit down on the bus tomorrow morning, on my way to work, I’ll call the doctor to make an appointment.”

Create weekly systems with small daily actions. “Instead of spending your entire day working on something from start to finish, find ways to break it up into smaller bites that you can handle scattered throughout your day or week,” Price said. For instance, when Price is working on a larger story, she transcribes an interview in the morning. Next she works on something else. Then in the afternoon she returns to the project, and focuses on the actual writing.

Price does something similar with cleaning. On Mondays, she cleans the bathroom. On Tuesdays, she cleans the kitchen. “It doesn’t really matter how things are divided, the key is breaking it up into small enough pieces that I’m able to actually accomplish what I set out to do,” she said.

If your dreaded tasks are ones that need to be regularly done, separate them into chunks, and create systems. Make doing them automatic and easy, and make your environment work for you, so you don’t even give yourself the chance to back out.

Find a way to make it fun—or less awful. Put on your favorite music. Work at your favorite café, library, or park. Ask a friend to join you. This can be a time for them to tackle their dreaded tasks, too. You can even make it into a weekly ritual, and go out for dinner after you’re both done.

Doing tasks we don’t want to do is hard. It’s especially hard when we have so many other things going on in our lives, and distractions are aplenty. It becomes all-too easy, and natural, and automatic to put those annoying or daunting tasks off. However, when we’re strategic about these types of tasks, we can actually complete them.

Plus, keep in mind that the longer we put a task off, the more intimidating and overwhelming it becomes. Because that’s what avoidance does: It creates and magnifies our anxiety.  So remind yourself that this is just a task. Sure, it’s annoying. Sure, it’s boring. Sure, it feels really difficult. But maybe you’re also building it up in your mind. Maybe you’re also giving it too much power. Maybe it’s all bark, and no bite.

And remind yourself that you’ve handled lots of stuff tough before. Remind yourself that all you have to do is start. You’ve got this.



from World of Psychology https://psychcentral.com/blog/how-to-get-started-doing-that-thing-you-really-dont-want-to-do-but-have-to/

Parenting Beyond Behavior Management: Five Fundamentals Supporting Developmentally Sound Parenting

Each day more information becomes available in all areas of living, and with a few clicks we can immerse ourselves up to the chin in ideas and opinions. “Parenting” is such a topic and a Google search offers 294 million results. Refine the search with one word, “effective,” and we are down to 179 million results. No wonder most seekers don’t make it beyond the first few pages.

Further, most parenting advice centers on behavior — specifically misbehavior, with the overarching tone of management. Yet developmentally, mental models of self, relationships, and how the world works are being formed implicitly in the child’s mind before they can effectively self-regulate and long before they can “use their words.”

Advice, strategies, and programs that approach parenting simply as a set of skills and things done to a child miss the key aspects of development, attachment, and the complexity of mind. In other words, as parents we are responsible for providing the environment for a child’s developing mind until they are fully independent. This is the essence of parenting of which discipline is only a part.  

Modeling and teaching are key aspects of the parenting process, but there is something deeper, a relational aspect that is often missing in the behavioral-centered approach: in the parent-child relationship we are consistently conveying who we are and who we believe the child to be. We are continually creating impressions in a child’s mind in the dance of responsiveness and attunement. Psychiatrist Daniel Siegel proposes that a mind is “an embodied and relational process that regulates the flow of energy and information.” And we, as parents, are a part of that energy and information flowing in a child’s mind.

As a child’s mind develops there are fundamentals that go deeper than outward behaviors to the core of being human and being dependent. These processes are within the child and within the parent-child relationship, wired for the potential that must receive attention with intention. Neurons that fire together wire together to form more complex connections — and the elemental source of this connectivity is the quality of the parent-child relationship.

Here are 5 fundamental, hard-wired processes supporting developmentally sound parenting:

Wired for relationships: Children innately seek interaction and connection with caregivers. The quality of a child’s most intimate relationship, the attachment with a primary caregiver, is predictive of vital aspects of development throughout childhood and into adulthood. Secure attachment predicts higher levels of self-agency, emotional regulation, self-esteem, as well as the ability to form friendships.

We are wired for integration with others in social networks and the need of belonginess is paramount to a child’s sense of self. Responsiveness within the relationship and demandingness in the form of structure and limit-setting provide a secure home base, and the predictability and mental space to explore. Children need these conditions to thrive.

Wired for Meaning: Behavior is the tip of the iceberg as underneath the actions and choices of parents and children, a set of developmental principles informs and governs the consequences that follow. Meaning is the driving force of action and as Psychologist Jonathan Haidt states, “Reason and emotion must both work together to create intelligent behavior, but emotion… does most of the work.” Emotion is intimately tied to values and sets meaning in motion, for our choices reflect our values.

When we say “no” to a child we are setting a limit based on what we deem important. When we are responsive to a child, we are saying, “yes” and “you matter.” When we engage and make amends for our mistakes we are acting from respect and responsibility. When we lead children to choices, we are honoring the basic need of autonomy. The authoritarian demand of “Because I said so…” misses the learning and meaning of going deeper to the principle, a step that can foster self-discipline down the road.  

Wired for Roles: As social beings we possess the innate capacity for role-taking and learning from role-models. Not only are children forming mental models of self, but our actions as parents model roles of leading, relationships with significant others, and citizenship to name a few.  Models go beyond words as children absorb the communication of the emotional and nonverbal world, and we see the priming for role-taking in their imaginative play.

As a parent, an important task is to make sense of your own upbringing so that unresolved conflicts do not intrude on the quality of the relationship between you and your child. Importantly, the strongest predictor of infant attachment is parental state of mind with regard to attachment. Making sense of your experience in the role of child matters greatly. A coherent personal narrative—meaning you have made sense of your experiences of being parented— is a strong predictor of parenting behavior.

Wired to learn: Children are primed for learning and the window of language is wide open in early development. Importantly children learn better when they know what to do. Clarity of expectations, and consistent feedback and consequences are great teachers. Punishment or telling children what not to do are not nearly as effective. In fact, studies have shown that punishment without teaching can reinforce the very behaviors you are trying to stop.

Children can’t think like adults nor are they “little adults.” A two-year-old is much different than a four-year-old or a seven-year-old or an adolescent. While children are wired to learn, age and developmental stage matters in our parenting approach.

Wired for Uniqueness: Temperament, developing personality, interests, and individual aptitudes are all expressions of differentiation and as unique as a child’s fingerprint. The parent-child relationship is the foundation of parenting for this very reason. One size does not fit all as fairness in parenting is treating each child differently based on the principles of development. One child may be more outgoing and another more introverted yet each child needs connection— but in a different manner. Understanding the uniqueness of each child can only happen within the relationship. And when attunement and trust prevail, the quality of the parent-child connection provides the conditions for well-being.

In summary, Children misbehave for many reasons. Their job is to explore and learn which inevitably leads to situations when things just don’t work. You can’t know limits unless you find out where they are, and sometimes children bump or crash into them. And we as individuals can only give what we have received. To consider behaviors only at the source of conflict, is to miss a myriad of developmental opportunities in the parent-child relationship.  Keep these five developmental processes in mind through each stage of your child’s life.

Resources

Dozier, M., & Bernard, K. (2004). The impact of attachment-based interventions on the quality of attachment among infants and young children. Encyclopedia on Early Childhood Development. Montreal: QC.

Haidt, J. (2006). The Happiness Hypothesis. Basic Books.

Siegel, D.J. (2015). The Developing Mind, Second Edition: How Relationships and the Brain Interact to Shape Who We Are. Guilford Publications.



from World of Psychology https://psychcentral.com/blog/parenting-beyond-behavior-management-five-fundamentals-supporting-developmentally-sound-parenting/

Tuesday, 30 April 2019

Bipolar Professor

It’s hard working as a college professor with bipolar disorder. I suppose it’s hard working anywhere with bipolar disorder, but my particular vocation is teaching 18-year-olds how to write at a local university. I’ve had bipolar illness for almost 30 years now; I was diagnosed in 1991. I’m 56. I’ve been at my university for about as long as I’ve been bipolar.

Why is it so hard to be a bipolar teacher in the higher education system? 

The main reason is the stigma of the disease. As you probably know, even in 2019, there is horrible stigma about bipolar illness. There is sympathy for anxiety/depression and now for PTSD, but for bipolar, there is still relentless stigma.

If I tell someone I’m bipolar, they look at me as if I have a hidden tail tucked into my pants. This is why I don’t talk about my illness as a rule. Academics are often not as accepting as they make themselves out to be. The university is a place to freely exchange ideas about things, but not about your bipolar illness. In the age of disability awareness, no one is talking about this issue.

Then, there is the basic stress that comes with living with the illness.  This is one disease where medication is absolutely necessary. If I forget to take my meds, I have a bad day. Sometimes, the meds don’t do their job. I may find myself sinking into depression or rising into hypomania. Because of my illness, I live with more unpredictability than the average person. This is stress-inducing, and we all know extra stress makes things harder.

Loneliness. This is a lonely illness. I literally know no one who lives with this issue at my university. At school, I walk around with the knowledge of my mental health problem and I never talk about it.  The LGBTQ folks have each other. Many of them are out of the closet. I would love to be completely out so that I could be myself. Bipolar illness doesn’t define me, but it’s a big part of who I am.  

What can I do about this difficulty I face every day?

Come out of the closet with my teaching peers. Begin talking about my disability openly. (I should tell you that I am “out” as a bipolar person in my writing, but since I use my maiden name as my pen name, no one recognizes me. This is illustrative of my ambivalent nature about this issue.)

Come out of the closet with the students and start a club for people with mental health issues. (Would I want to be part of a club that would accept me as a member?) I’ve thought about doing this for years, but I’ve doubted my ability to lead this type of organization because I don’t have any psychological credentials; I think I’d be better at running a club if I were some sort of counselor or psychologist. This is what has held me back from taking on this enterprise. 

Nothing. Go on living the way I’ve been living for 30 years.

So at the university, where you can be whatever you want to be, it’s hard to be bipolar.

My brain is different; it’s what manifests this illness, but it’s also what makes me creative and drives my writing. 

You might be thinking it’s here she’s going to say that if given the choice, she’d remain bipolar if a cure for it were developed.

Well, surprise, if there were a cure for bipolar, I’d take it. This is not a picnic, and I’d get myself out of my life situation if I could. 

Not surprisingly, there is no national mental health coming out day.  There is a day to observe mental health; this occurs on October 10 of every year, but this day is simply to “raise awareness” of mental health issues. This is very different than a day of coming out. (It should be noted that LGBTQ coming out day is October 11.)

I propose (as a few might have done before me) that we create a day for coming out with a mental health issue, a day when all the bipolar folks and schizophrenic people and depressives and the anxiety-ridden and individuals with OCD and all the people with personality disorders and PTSD can simply say “I am the way I am.”

If this happened, things might get better for everybody.  

No one knows when and if they will develop a mental illness.

It could happen to anybody.



from World of Psychology https://psychcentral.com/blog/bipolar-professor/

Art Therapy: 7 Ways to Draw Your Stress Out

As an art therapist for over four decades, I’ve been able to give my clients simple yet enjoyable tools for dealing with stress. Whether the stress was related to a chronic or life-threatening illness, divorce or separation, job security, or any number life crises, scribbling and drawing have proven to be powerful ways to release pent up emotions, worries, and self-judgment.

In order to embark on the adventure of stress release through scribbling and drawing, a few simple art materials are required.

  • Unlined paper – 8-1/2 x 11 inches or larger
  • Old magazines or newspapers
  • Crayons – 12 colors or more
  • Felt markers – wide tip for drawing (optional – fine tip felt markers)
  • Your favorite recorded music
  1. Scribbling: Warm Ups

If you are like most of my clients and students, your first reaction to the idea of drawing may be, “I can’t draw” or “I have no artistic talent.” Or you may be thinking, “I’m not an artist, I just do quilting.” The point is that the vast majority of people get nervous when I ask them to draw. Their inner art critic immediately shouts them down as being uncreative. That’s why I start with warm ups, recommending that they scribble on old newspapers or magazines to get past the fear of making mistakes or drawing something that is ugly.

We are not making art with a capital A here. Rather, we are allowing the stress we carry in our bodies to literally flow out onto paper using simple drawing tools. So, try it now. Imagine a stressful situation in your life. If you can’t think of one, recall the most recent stress you experienced. With a crayon or wide tip felt marker, use any color to scribble out the feelings associated with the stressful situation you pictured in your mind. Imagine being in kindergarten again and scribble to your heart’s content using whatever colors appeal to you.

  1. Dancing on Paper

We all know that music is a stress reducer. Scribbling to music takes it a step further.

Put on some music that you enjoy. Using a crayon or wide tip marker in the color of your choice, draw to this music as if you were “dancing on paper.” Start by drawing with your dominant hand (the one you normally write with). Draw for a few minutes and then, with another crayon or maker, include your non-dominant hand (the one you do not normally write with). You’ll be scribbling with both hands, creating a duet on paper.

Don’t try to make pictures of anything. Instead, think of this as leaving marks on paper the way ice skaters leave tracks on the ice. These marks are the tracks of your stress literally being shed onto the paper.

  1. Drawing Feelings Out

We all carry unexpressed emotions in our bodies and we even express it with phrases like “butterflies in my stomach” or “a pain in the neck.” We also use colors when talking about strong feelings: “red with rage,” “green with envy,” or “feeling blue.”

The next time you become aware of strong emotions being bottled up inside your body, dump them out on paper with crayons by scribbling. Choose colors that express the emotions you are releasing. There is no right or wrong color for any emotion, only the color that feels right to you. After a while, switch hands and draw with your non-dominant hand.

  1. Moving from Tension to Relaxation

One way to relax is to accentuate the experience of tension by tensing up the body as much as possible and then allowing yourself to relax and loosen up with an outbreath. This experience can be extended through scribbling two contrasting images. Image one, drawn with the dominant hand, is “what tension looks like.” Use whatever color you associate with tension. On a second page, draw with the non-dominant hand “what relaxation looks like.” Select a color that feels relaxing to you.

  1. Slowing Down

In our fast paced world with pressures to meet deadlines and achieve instant gratification, slowing down is a great way to release tension. Using a crayon or wide tip marker in the color of your choice, try drawing as slowly as you can using the non-dominant hand. Making continuous circular loops on the paper can help you relax while you draw more and more slowly. If relaxing music helps you slow down, accompany your drawing with the music of your choice.

  1. Turning Stress into Inner Peace

Much of our stress is caused by negative images and expectations in our own minds. We practice “negative affirmations” every time we worry about painful or uncomfortable situations in our lives. On the other hand, we can use drawing to create a positive image, a relaxed mind and body, and inner peace.

With your dominant hand draw a picture of a stressful situation in your life. This can be simple stick figures or even abstract lines and shapes.

Now, imagine in your mind what the stressful situation you drew would look like if it were resolved to your satisfaction. With your non-dominant hand draw a picture of how that looks.

  1. Creating Your Safe Place

Imagining a place that is safe and comfortable can help to calm ourselves down when we are feeling anxious and stressed out. A safe place can be a location you’ve actually experienced, or it can be one you make up in your imagination. This can be drawn with the dominant or non-dominant hand using crayons and/or makers. It can be a simple portrayal of a place in nature, a cozy room, or any other place that has personal meaning for you.

If your inner art critic starts bullying you about your drawing skills, just tell it to take a coffee break. Remember, we’re not making art with a capital A here.

Allow yourself to play with colors, shapes, and lines on the page. Who knows, you might even find an inner artist that is longing to come out.



from World of Psychology https://psychcentral.com/blog/art-therapy-7-ways-to-draw-your-stress-out/

Talkspace: The New Therapy Room

I am always on the lookout for new opportunities and exciting options through which to share my mission of promoting positive mental health. I have been a psychotherapist for over 31 years. Working with adolescents has taught me many things, foremost among which is to expect the unexpected and be open to whatever is happening in the digital world. And it’s not like I’m a dinosaur who’s ignored trends in the digital world, but when did texting become the new form of talking, and can it possibly be an effective form of communication? For therapists?

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Along came Talkspace (TS), a highly sophisticated digital therapy platform which provides for communication with clients through audio and/or video messaging and live video sessions. I thought it was an opportunity, but even more so, a resource, I could not ignore. The “on-boarding” process, as it is called, required a significant commitment including providing my professional credentials, proof of liability insurance and completion of their comprehensive Talkspace University+ training, so that I could understand and effectively use their digital platform. Yes, it is HIPAA compliant.

Clients provide informed consent along with emergency contact information. One hopes to never have to use the emergency contacts, yet it is reassuring to have them readily available, if needed. Talkspace handles all financial transactions, including insurance, private pay and EAP (employee assistance program) fees. Clients are paired with therapists or can choose their own clinician. They complete a general application outlining their presenting problem(s) which triggers an assessment designed to establish a baseline of the frequency and or intensity of the presenting problem(s). Once client and therapist are paired, the therapeutic relationship begins. Rapport building beings and expectations related to frequency and mode of communication are agreed upon. For me, it involves five twice-daily visits to my “room” each week. The client has 24/7 access to their “client room” which is where we maintain contact. The relationship can form surprisingly quickly compared to some of the typical live sessions I have had in my on-ground or in-school clinical work.

Has it been significantly different for me from the traditional face-to-face therapy that I have practiced for so long? Yes and no! The convenience for myself and my clients is incredible. If you have an iPhone or iPad with a wireless connection, you can provide psychotherapy through the Talkspace platform. Italy, here I come! Yes, that does make it sound easy, however just as I have in my on-ground office, it has been important to trust in and use the experience I have accumulated to read through the message in the messages. Do I miss the nonverbal cues? Well, yes! This introduces the challenge of asking additional questions that I might not otherwise ask in my face-to-face work. For example, “What are your feelings about this? How are you processing all of this?” Yes, you ask these questions in face-to-face therapy, however it is typically more in the flow while you are reading the client’s nonverbal cues that insight into their feelings is acquired.

Most of us do not audiotape/review our sessions, we use notes and memory, right? Think about what YOU use to recollect your session. The nature of this digital therapeutic communication is very similar to in-person communication, but the entire exchange is right there on the screen. Client and therapist can read re-read the entire communication. This has allowed me to use the CBT model with greater impact. I encourage my TS clients to reread and review some of our previous messages to reinforce interventions, sometimes cutting and pasting in order to highlight and reinforce a concept. Here is an example of part of an interchange I had with a client:

Client: “I value my friends a lot and I genuinely do whatever I can to make them feel as good as I can get them to be.”

Me: “I am wondering if you can apply that thought/ideal to yourself. I value me a lot and genuinely do whatever I can to make me feel as good as I can for myself. How would that statement/thought feel? Try it on.”

Of course, I asked my client permission to use this. Within my message to ask permission, I once again copied and pasted the previous message for the client—an effective way of reinforcing and restructuring some of the negative thinking that occurs for her. One of the advantages of this platform is the ability to go back with accuracy to reinforce while highlighting the possibility of change. Additionally, I like the use of visuals in therapy such as the CBT triangle (thought, behavior, emotion), but as yet, it has been a challenge to bring these into the Talkspace room. I’ll get there.

The one constant in life, and no less in my evolving professional role, is change. Talkspace has challenged my preconceived ideas about digital therapy and enabled me to bring my clinical skills into the digital sphere. I welcome the research and data to support this work. I recently asked one of my digital international clients to articulate their experience with me on Talkspace. She said, “I don’t know if this could be of any use, but face-to-face therapy here in Saudi Arabia is really limited…I was faced with ignorance and people didn’t know how to handle me.” She continued, “With Talkspace, I truly felt heard and comforted in ways I couldn’t in face-to-face therapy. I’m sure professionals here are extremely good at what they do, but I was blessed to have you as my therapist and like I’m taking a huge step into bettering myself.”

Face-to-face and digital therapy both include rapport building, the establishment of baseline through careful assessment, the development of treatment goals, the creation and implementation of interventions and assessment of treatment outcome. Talkspace has brought me and my therapy room to clients who I, more than likely, would never have had the opportunity to work with. The clinical effectiveness, affordability and accessibility of Talkspace have worked for both me and my clients, allowing me to continue my mission to promote positive mental health. Therapy is not about a room, it is about creating a space for connection and healing. Welcome to the new therapy room. 

from http://www.psychotherapy.net/blog/title/talkspace-the-new-therapy-room

Best of Our Blogs: April 30, 2019

I swing back and forth in my belief about whether this is a stressful time to be alive in the world. With the environment at risk, political instability, and violent crimes, there are legitimate reasons to feel this way. And yet, there are amazing things happening too.

One has been all the accessible information on current health research. For example, I’ve been listening to the Brain Change Summit by Sounds True. In the last few days, I’ve learned the newest information on things like preventing Alzheimer’s, what tools can build resilience and how the environment, mindfulness and meditation can make a difference in mental health. The presentations are led by experts in the field who give us hope that there are new and research supported treatments for those suffering.

If you don’t have a chance to listen before the free access ends on May 2nd, you’ll also find hope in our top posts this week. You’ll feel liberated by reading how one woman freed herself and her wardrobe from her narcissistic mother, tools to recover from abandonment and finally have proof that you’ve been emotionally neglected and grew up in a dysfunctional family.

Yes there are a lot of reasons why it’s difficult today, but I’m grateful there are sites like ours and Sounds True that can provide free information, education and research to everyone around the world.

20 Things People With Childhood Emotional Neglect Often Say
(Childhood Emotional Neglect) – If you catch yourself saying things like, “I can handle it,” you might need to get yourself on the CEN recovery path.

25 Characteristics of Narcissistic Parents and Dysfunctional Families (Part 1)
(Psychology of Self) – If your parents were untrustworthy and exhibited other behaviors listed in this post, chances are you grew up in a dysfunctional family.

Recovery from Abandonment
(The Recovery Expert) – These nine tools can help you heal from abandonment.

What is Emotional Abuse?
(The Exhausted Woman) – Victims of emotional abuse often experience these emotions.

Body Shaming and Slut Shaming: When Narcissists Control Our Wardrobe
(Narcissism Meets Normalcy) – All through your life you were shamed and controlled. Now is the time to break free from your narcissistic mother and wear what you want.



from World of Psychology https://psychcentral.com/blog/best-of-our-blogs-april-30-2019/