Acceptance and Commitment Therapy is defined by a commitment to change while also choosing to accept things the way they are. The idea follows the line of thinking that, “psychological suffering” is caused by our inner language or cognition. When we are inflexible psychologically we lose a healthy connection with the present moment.
Negative self talk is one of the many things that hold us back from enjoying life to it's fullest. Many people don't even realize how hard on themselves they are. When you have it out for yourself you can't win.
If you stop and listen to the chatter in your head, you may realize you are your own worst enemy. If this is true for you then you will want to change your thought habits.
Here are some of the method's you may use against yourself; Name Calling
First I apologize for not writing in my blog for so long. We moved, and other things have held my attention and so I have not been actively writing in here for you. I plan to resume my writing and offer topics of interest. First, on a personal note, I felt compelled to write about my own quest to find a counselor here in Colorado.
Yes, counselors do go to counselors for help with their own personal issues. My personal quest to find a counselor in Colorado has been a challenge.
This is the first in a series on defense mechanisms. We all have them from time to time. However, when they become extreme, we may have very little insight. Our defenses can become highly problematic. Insight gives us freedom of choice; to continue operating under the same set of reactionary belief sets, or to try something different (and hopefully healthier).
Defense mechanisms are the way we prevent ourselves from having insight into our own feelings. We may not like something about our self, our situation, or how it feels, so we defend against it in a variety of ways. In therapy, defense mechanisms are explored, and options for coping in healthier ways are discussed and practiced.
The first defense mechanism I will address is projection. Projection is defined by attributing our own traits to someone else. We don’t want to admit it about ourselves, or we just don’t see it at all, so we blame other’s for our own actions.
A person may label others as “selfish,” for example, when really that individual is very self absorbed. When others inconvenience them, they are quick to label the other as “selfish,” when really they don't want to admit to their own selfish behavior. There are many different ways this happens.
Projection's imagery comes from an old fashioned projector screen in which an image is projected from the screen onto the wall. The real image exists on the projector and not on the wall, however, we see it on the wall. When someone projects their traits onto others they say the other person has the traits they in fact have.
The more pervasive the use of the defense mechanism the lower the insight into oneself. Misattributing one’s thoughts, actions, or feelings onto another person keeps the individual from addressing the real issue within themselves. It is also confusing for those in relationship with them.
In relationships it can feel like nothing gets resolved. Instead it feels things get flipped around. Some individuals may find themselves trying to please the other person by fixing themselves in many different ways. They may feel a great deal of dismay when their efforts (sometimes over the course of many years) rarely get them anywhere. This is called projective identification when the individual identifies with the projection(s) and believes that they have the traits they are told they have (when in fact they do not). In recovery it is important to sort out what is real from what is imagined, and begin to make steps toward clearer communication.
You may have noticed the face of my company has changed. Over the years, one of the main questions I am asked is, “What do you specialize in?” I have been blessed with a wide range of experiences in the field of counseling. I have worked with, adults, adolescents, kids, couples, elderly, and disabled populations. I have also worked in hospital, agency, addictions and in private practice settings taking on just about any problem that comes my way.
I have loved the challenge of working with diversity and with a wide range of people. It definitely keeps my work interesting. I have often considered specializing in women’s issues, but haven’t taken the initiative, until now.
I am thrilled to specialize in women’s issues.
Compassion Fatigue and Burnout
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When Seeking Counseling Should You Use Insurance?
When I was first trained in counseling Managed Care was just starting out. The Professors at my school were adamant against using insurance for clients. They were afraid of confidentiality getting compromised and, as a result, urged students to tell clients to “self-pay” for counseling. This would protect confidentiality, a hallmark of the trade. They gave an example of someone running for public office who was denied the opportunity because they had been diagnosed with Adjustment Disorder in childhood.
However, I have found insurance to be very useful for clients and helps clients who need counseling gain access with a manageable co-pay for sessions. Counseling can add up and is a significant investment in yourself. People tend to minimize the importance of such an investment because it is often difficult to see tangible results without first giving it a try. People are very private about counseling. Unlike seeing a good haircut and asking “who is your hairstylist?,” people don’t usually say, “Wow, your attitude is so much better, who is your therapist?” The word doesn’t get out about good therapy because most of us are very private about it.
Insurances are getting better at recognizing the need for counseling and some plans have good coverage. Other plans have poor coverage for counseling and limited choices in counselors. A diagnosis does have to be made in order to use the insurance. Most therapists try to
Relationships are extremely challenging. Even people who love each other deeply will have challenges communicating sometimes. Here is a list of barriers to help you see what may get in the way. These barriers may be in the pre-conscious states. Realize you may need to reflect further on your thoughts and actions to identify your barriers.
Barriers to Listening (not exhaustive):
Denial- "I am the victim. I am not contributing to this problem."
Entitlement- Making demands on the other, "You ought to treat me the way I expect you to." "I expect you to fulfill my demands of special treatment."
Mistrust- "If I listen to you, you will take advantage of me."
Revenge- "I have every right to punish you because of the way you treated me."
Defensiveness- "I must argue and defend myself."
Barriers to self-expression (not exhaustive):
Conflict Phobia- adhere to the belief that "People with good relationships don't fight. Conflict should be avoided.".
Emotophobia- "I shouldn't feel angry." The belief that anger is an unsafe emotion to have or express possibly due to imbalances in family of origin.
Emotional Perfectionism- "I should always feel happy and loving. I should be in control of my emotions at all times."
Fear of rejection- "If I tell you how I feel, our relationship will fall apart and I will end up alone."
Passive aggression- "I will punish you with silence. I will get back at you indirectly (burn your toast, show up late, forget things important to you)."
The Problem with Matching:
Couples often will start an argument and fall into a trap called "Matching." One will raise his or her voice and the other will match it with an equally strong statement. The other raises his or her voice to defend their cause and the other will also raise their voice. Both are saying a lot and neither is hearing what the other is saying. Each walks away having convinced themselves they are right because they only heard their own side of the argument.
In order to change this vicious cycle each needs to speak more calmly and listen to what their beloved is saying. Listening and hearing your beloved doesn't mean you agree with them it just means you are trying to understand them. If you are both trying to hear the other and let them share their feelings you are more likely to get at the root of the issue. Most couples just want to feel understood.
Once you identify your barriers to self expression and listening it's time to learn how to be a better listener. Dr. David Burns, MD calls his method EAR (copyright 1991/2006).
In communication giving your spouse or friend a sense that you care about them comes through empathy.
1. Disarm- Find some truth in what the other is saying even if you don't completely agree with them.
2. Empathize- Try to see things from their eyes and not your own. Reflect back what you hear they are saying and what you think they are feeling. Give them a chance to clarify.
For example, "I hear you saying that you think the sky is purple and that makes you feel happy." Notice how you don't have to agree with the person to show them you heard them. Refrain from sarcastic tone or rolling you eyes.
3. Inquire- Ask questions to demonstrate interest and to learn more about their perspective.
4. I Feel Statements- Once you have spent the time needed hearing your beloved's thoughts and feelings respond with assertiveness (as opposed to aggressiveness or passivity). If you use "You always" or "You never" statements you will put the other on the defensive and a fight will flair up again.
"I feel _________________ when _________________." Is a good sentence structure to use.
Often couples have a small feeling vocabulary because they are so busy fighting over facts and details. The true emotion behind what has happened gets lost.
Basic feeling words are: angry, sad, hurt, lonely, afraid, uncertain, frustrated, disappointed, upset, confused, happy, glad, good, proud, etc....
5. Stroking- Take time to validate the other persons' feelings. Treat them with respect and even when you feel frustrated or upset. Try to say something positive about the other person. For example, "I appreciate that you helped me out the other day." Or "Thank you for taking time out of what you were doing to help me." or, "I can see that you are working really hard at work, you must be really tired." or even "Thank you for listening to me!"
Make sure you take turns listening and sharing so both of you have been able to address the issue. Healthy Relationships are not one sided.
With these tools you will find that you can resolve your conflicts and learn to understand and appreciate each other.
(Taken in part from David D. Burns Attitudes that Inhibit Intimacy, Therapists Toolkit, 1989/2006).
If you are interested in my seminar Foundations For Marriage. Please contact me at email@example.com if you would like me to present this seminar at your church or local library.
What Questions to Ask:
I am often surprised by the lack of questions asked by new clients. I make it a point to offer a chance to ask me a few questions. Most clients will say they don't have any, and want to know when can we start. To be honest with you, I think that it is really important to ask a few good questions before you start with your therapist, even if they have been recommended to you.
I have often wondered why prospective clients don't ask many questions. Possibly it is difficult to know what to ask. Or maybe there is a sense that the therapist is an authority figure and people feel disinclined to ask pertinent questions. Possibly, there is an assumption that credentials automatically mean you know what you are doing. Here are a few tips on what you might consider asking.
Even if you are not particularly interested in the answer, it is a good idea to ask a few questions upfront. This gives you a sense right away for your therapist. A highly skilled therapist might not be a good match for you personality wise. If this is someone you are going to hire to share your deepest struggles with, then you need to know you might feel comfortable with them before you get started. Clients sometimes have difficulty discontinuing and then starting over with a new therapist once they have started to open up and share their story.
Even if you don't have a clue about psychology or theory it is a good question to ask. A well grounded counselor should be able to answer this question easily and give you a sense of their approach. There is a wide range of theory bases and they vary in how they approach a problem. If you don't feel at ease with hypnosis for example and you start with a Therapist who relies on it in counseling, then you may not be compatible.
If you are looking for a faith based counselor then you may need to know what faith means to that therapist. Does it mean that they went to church a few times growing up or does it mean that they live out their faith daily? A good therapist-client match can be a real dynamic environment for positive growth and change. Clients need to understand that they have a say in the relationship and they should feel free to ask such questions upfront. You are in fact hiring someone to help you with your life. Go ahead and ask.
A very brief summary of some common theory types (These descriptions barely scratch the surface):
DBT (Linehan)- Dialectical Behavioral Therapy is all the rage right now. Insurance companies even reimburse for it (quite frankly a big deal considering their lack of support for mental health). It is based on Eastern Religion practices of mindfulness/meditation practices. If you are desiring to stick to a faith based therapy choose instead a Cognitive Behavioral, Person Centered, or Rational Emotive therapist who has an active faith. Or make sure the DBT therapist has a strong faith and can point you back to faith principles while using DBT workbooks/exercises to improve insight. I personally don't recommend a blending of the two.
Cognitive Therapy (Beck)- Based on the concept that how one thinks is reflected in how one feels and behaves. If you address dysfunctional thought patterns than you modify feelings and behavior. The goal is a "cognitive shift" in which misperceptions are discovered and moved to a more balanced position of function.
Behavioral Therapists (Pavlov, Skinner)- The concept is that behavior needs to be changed first and then cognitions, and feelings will adapt. Concepts of conditioning, social learning, behavior modification are predominant. Understanding is not important.
Person Centered (Rogers)- Based on the concept that when a client is provided with an environment of acceptance a client will work toward "self-actualization" on their own. The therapist provides unconditional positive regard while the client works out their issues of concern.
Rational Emotive (Ellis)- Addresses how our emotions are linked to our behaviors and linked to our thoughts. Finds an Activating Event and analyzes how the thoughts and behaviors are connected to it, and then works to modify the thoughts (irrational beliefs) to modify reactions (Emotional Consequences).
Gestalt (Wolfgang von Goeth and others)- Therapist will engage in dialogue rather than focus client on a goal. Purpose of the dialogue is to increase awareness. Gestalt is understanding of the shape of an entities form. Pictures and symbolism are used to capture the "Gestalt" or shape. Clients are encouraged to do their own decision making. Various therapy models may be used in the context of the therapeutic relationship. Focus on the "here and now" or present awareness of present issues as opposed to lengthy analysis of the past.
Analytical Psychotherapy (Jung)- Focuses on the unconscious psyche and archetypes (i.e. the self, the persona, the shadow). The goal is to become more conscious trough psychotherapy, dream analysis and a process of self knowledge.
EMDR- Eye Movement Desensitization and Reprocessing (Shapiro)- An 8 phase treatment based on information processing therapies. Traumatic memories are paired with a series of eye movements (mimicking REM sleep patterns), and tapping (soothing movements). The pairing has been found to produce diminished trauma symptoms and resolution of the memory. It has been found to be effective for severe trauma including veterans with PTSD. Select a therapist with demonstrated training in the method.
Psychoanalysis (Freud)- emphasis on analysis of the subconscious and dream interpretation. Traditionally this is the one where clients lie on the couch and look away from the therapist while the client speaks. Many of the concepts are still used in current theories but through different means. Dream interpretation, and analysis of the unconscious and conscious states are common components. Transference (the clients projected reaction to the therapist) and counter-transference (the therapists reaction to the client) are used to increase understanding.
Transactional Analysis (Berne)- Addresses three prevalent ego states in within each individual; Parent, Adult, Child. The idea is that we function out of ego states and our response to life will reflect either a Parent, Adult, or Child ego state. Ego states are considered patterns of feelings and experiences as related to behavior. TA therapists use simple vocabulary and set up treatment goals for their client.
Adlerian (Adler)- Individual psychology is interpersonal in recognizing how we interact with others. Emphasis on choices, family history and social interactions. People are studied in the contact of social interactions. The meanings we interpret from life will influence our behavior. Emphasis on meanings and perceptions drawn from life.
Family Systems (Whitaker, Ackerman, Bowen, Minuchin)- Families typically come in with an "identified patient" (symptom bearer). The goal of the family therapist is to modify the family relationships to attain harmony and balance so that the symptomatic behavior is alleviated. The focus is not on the individual but on the system of the family. Concepts of triangulation, double bind, marital schism and enmeshments are addressed.
Side note: I always say you want to make sure you have a sane therapist, not a "psycho" therapist... Har har!
Why choosing a Licensed therapist is important:
After moving to Colorado from Illinois where requirements for private practice are stringent I was shocked to learn that in Colorado you do not even need to have a degree to become an "Unlicensed Psychotherapist." I personally find this appalling because it fails to protect the public from untrained therapists who have not had the training to learn the skills of the trade.
It also fails to protect the counselor from severe pathology. Most clients are high functioning individuals who just want to improve their life. Other clients can be incredibly manipulative and even dangerous. I, myself, have been in life threatening situations.
Please select a therapist who is licensed. This shows that they have dedicated a lot of time and effort to learning how to be effective at helping people. Their skills have been tested and their knowledge base has been established through at least one, if not two, 4 hour examinations on counseling skills. If you want a good therapist but cannot afford a licensed therapist choose a therapist who is working toward licensure. They should have lower fees but are meeting weekly with a licensed therapist to help them with their cases and then are studying to take the examination.
What the letters mean:
LPC- Licensed Professional Counselor
LCPC- Licensed Clinical Professional Counselor
LMFT- Licensed Marriage and Family Therapist
PsyD- Doctor of Psychology
PhD- Doctor of Philosophy (Can be specifically in Psychology)
CADC- Certified Addictions Counselor
What theories do I adhere to?
Well, first and foremost I feel the ultimate therapist is the Holy Spirit, "But the counselor, the Holy Spirit, whom the Father will send in my name, will teach you all things and will remind you of everything I have said to you." John 14:26 He is described often as a counselor. I rely most on Him, and often as clients are sharing their problems I am praying inwardly at the same time asking, "show me how I can help this client." He brings to mind what I need from my training and experience to help clients through their circumstances.
I feel it is unfortunate that some Christians (Authors, Pastors) are opposed to counseling. I assume this is a result of bad experiences from inexperienced therapists, or therapists who rely heavily on secular philosophies rather than faith principles. Again, that is why it is important to interview the therapist you are hiring to help you. Pastors should meet with and interview any therapist they are considering using as a resource for them. A good faith based counselor can really help support pastors who are very busy overseeing ministries.
In my approach, I draw from a range of theoretical methods. My graduate school training taught all of the afore mentioned methods. However, I utilize Cognitive-Behavioral, Rational Emotive, and Person Centered Methods most frequently. If it seems a present behavior is linked to a past experience or event I will spend time there exploring the connection to add insight. I feel insight gives you the freedom to choose how you will proceed rather than just reacting automatically to life as it happens to you.
Dreams can also add insight and are often rich with symbolism that can be looked at to draw from the pre-conscious states. However, I don't spend too much time on dreams because they can also be overemphasized. An occasional peek into dream states can open up a fresh perspective.
An example of dream symbolism, is a frequent dream that I have. When I step out of my comfort zone by accepting a challenge I often dream that I am standing on the edge of a cliff with my back pressed against the outer wall of a house (house offers comfort). I'm usually on a small ledge and considering how I will proceed. This reflects my fear and awareness that I am not in my comfort zone.
I also rely heavily on the concept of forgiveness. What's the point of analyzing past hurts if you don't forgive those who have injured you. Forgiveness releases you from the burden of bitterness and buried rage that finds its outlet in other unhealthy ways that can damage our relationships, "Refrain from anger and turn from wrath; do not fret-it only leads to evil." (Psalm 38:8). The lack of forgiveness brings about more hurt for more people. Forgiveness is not tolerance of abusive or hurtful actions, firm boundaries may be important. It is an acknowledgement that a wrong was done but a decision is made to forgive and let go of bitterness.
I know that was a lot of information but I hope it is useful as you now are armed with a sense of what to ask your prospective therapist.
Best wishes to you in you personal journey toward health,
Current Psychotherapies, 4th Edition by Raymond Corsini and Danny Wedding; F.E. Peacock publishers, Inc. Illinois, copyright 1989.
You may not realize that your diet may be to blame for suffering mood swings. Diet can affect your moods very quickly. Once you learn to follow these principles you will start to feel more emotionally stable throughout the day.
Mood swings can be caused by shifts in blood sugar levels even if you don’t have diabetes. Eating too many simple carbohydrates such as white bread, pasta or white rice can metabolize into sugar and doesn’t really have what your body needs. These simple fillers can be culprits for irritability or mood swings. Allergies or food sensitivities can also be to blame for irritability.
Not getting enough important vitamins, minerals and fatty acids can also affect mood negatively. Do you wonder why you feel so lethargic and moody? Do you wish you could just “snap out of it?” Do you lose your temper sometimes and wish you hadn’t? Check your diet.
Foods that help you to reduce stress:
Turkey- L-Tryptophan is notorious for everyone wanting a long nap after Thanksgiving dinner because of it’s relaxing properties. It also helps your body release serotonin an important brain chemical lacking in people with anxiety or depression. So eat more turkey to increase your serotonin levels and to relax a little. Bananas and dark chocolate also have some Tryptophan as well.
Spinach and green veggies- Has lots of Magnesium in it, which has been known to help combat fatigue and reduce migraines. Fresh spinach is best to avoid cooking out some of the best nutrients with heat. Vegetables are important for your body to function well and have a wide variety of vitamins and minerals needed for energy. Keep your veggie diet diverse and experimental. You might be surprised what you like. I like to add lots of seasonings and herbs to make them flavorful.
Salmon and other fish with omega 3’s- Omega 3 fatty acids are good for you for several reasons. When combating stress, these valuable nutrients help reduce the stress hormones cortisol and adrenaline. This will help your body return to normal after a stressful event. Also, your brain cells rely on fatty acids to maintain optimal functioning.
Sweet Potatoes- Sweet potatoes not only satisfy your craving for carbs they are full of good for you nutrients; beta-carotene, vitamins, and fiber. Their sweet flavor may also satisfy a sweet-tooth (Even the hard-core sweet tooth should try it).
Oranges- The vitamin C in oranges and other similar fruits can stabilize your blood pressure and also lower the stress hormone cortisol. Too much cortisol can lead to weight gain and fatigue. Vitamin C can also strengthen your immune system. Kiwi fruit, red bell peppers and many other fruits and veggies can also provide vitamin C.
Avocados- This delicious food has loads of potassium and healthy fats to help your body. Go ahead and indulge in some yummy guacamole sometimes! I personally like to spread a little bit on my turkey sandwich with a pinch of salt. Yummy.
Nuts- Nuts are usually packed full of nutrients such as vitamin E or B and help your body stay at it’s best. Nuts also contain Omega 3 fatty acids that are important for brain functioning. Small handfuls are best since they do pack a lot of calories.
Whole Grains- Grains offer many beneficial properties but one is to aide in digestion of the foods mentioned above. Fiber helps your body’s digestive system work well.
Protein- If you find that you have had too many simple carbohydrates and your energy and mood starts to tank then quickly eat some protein. Protein is important to give your body the energy it needs.
It is important to eat a balanced diet. I know, I know, you have heard that so many times before that now it just goes in one ear and out the other. If you are having mood troubles it is important to pay attention this time. Ask yourself what you are eating and how much. Have plenty of fresh fruits and veggies around for snacks. Try really hard not to binge snack on simple carbs (anything with refined sugar and white flour). Graham crackers have been a favorite of mine but I started to notice that I became grouchy about a ½ hour after I had indulged. Sometimes I even felt angry. Now if I have clients who tell me they feel angry and don’t know why, I often start with diet.
If you want to make sure you are getting enough good stuff then you may need to supplement your diet. Here are some supplement suggestions:
Vitamin B Complex- There are several B vitamins that are important. A deficiency in B vitamins has been implicated in individuals with depression. Research by Schimelpfening noted that vitamin B1 (thiamine) is a primary vitamin needed to treat depression symptoms. There are 6 B vitamins, so supplementing with a B Complex is a good way to cover your bases.
Calcium- Calcium is an important mineral not just for your bone health. It also helps you to sleep at night, which is also important to function at your best.
Omega 3 Fatty Acids- Fish oil tablets or Flax seed can provide this important fat to help your brain function at it’s best. Some research has shown that a lack of Omega 3’s is to blame for an increase in depression and bipolar disorder. Taking Omega 3’s will help increase the neurotransmitter Serotonin needed to relieve mood disorders.
If you don’t take fish oil because of the unpleasant phenomenon known as “fish burps” then stick with flax seed tablets or ground flax seed. I put mine in yogurt and spaghetti sauce (that way my family gets some too). I have also found fish oil tablets made to dissolve in your intestine so you won’t experience the flavor later. Don’t miss out on the benefits of Omega 3’s in your diet! Even if you don’t have depression it is an important nutrient for your body.
Green Tea- This herb has several beneficial properties. For this article it is important to note that it helps with easing anxiety symptoms. If you need caffeine Green Tea can be a better option than coffee because it is less likely to make you jittery.
Cinnamon- This delicious spice can help your body metabolize sugar. You can take it in pill form or just shake some on your oatmeal or put some in your coffee.
Fruits and Veggies- Believe it or not you can take your veggies in a pill. For those of you who just can’t seem to get your veggies into your diet take them in a pill or powder. A company called Juice+ has these supplements, whole foods or other health food markets have them as well.
So hopefully this helps to improve your mental health and lead to better moods. If we are all in a better mood than this place is a more pleasant place to live. Take better care of yourself and your family and friends will thank you.
Blessings to you, Gretchen