Thursday, August 30, 2012

Exercise to Reduce Depression, and Anxiety

Mental Health Providers Should Prescribe Exercise More Often for Depression, Anxiety, Research Suggests

ScienceDaily (Apr. 6, 2010) — Exercise is a magic drug for many people with depression and anxiety disorders, and it should be more widely prescribed by mental health care providers, according to researchers who analyzed the results of numerous published studies

"Exercise has been shown to have tremendous benefits for mental health," says Jasper Smits, director of the Anxiety Research and Treatment Program at Southern Methodist University in Dallas. "The more therapists who are trained in exercise therapy, the better off patients will be."
Smits and Michael Otto, psychology professor at Boston University, based their finding on an analysis of dozens of population-based studies, clinical studies and meta-analytic reviews related to exercise and mental health, including the authors' meta-analysis of exercise interventions for mental health and studies on reducing anxiety sensitivity with exercise. The researchers' review demonstrated the efficacy of exercise programs in reducing depression and anxiety.

The traditional treatments of cognitive behavioral therapy and pharmacotherapy don't reach everyone who needs them, says Smits, an associate professor of psychology.

"Exercise can fill the gap for people who can't receive traditional therapies because of cost or lack of access, or who don't want to because of the perceived social stigma associated with these treatments," he says. "Exercise also can supplement traditional treatments, helping patients become more focused and engaged."

The researchers presented their findings March 6 in Baltimore at the annual conference of the Anxiety Disorder Association of America. Their workshop was based on their therapist guide "Exercise for Mood and Anxiety Disorders," with accompanying patient workbook (Oxford University Press, September 2009). For links to more information see .

"Individuals who exercise report fewer symptoms of anxiety and depression, and lower levels of stress and anger," Smits says. "Exercise appears to affect, like an antidepressant, particular neurotransmitter systems in the brain, and it helps patients with depression re-establish positive behaviors. For patients with anxiety disorders, exercise reduces their fears of fear and related bodily sensations such as a racing heart and rapid breathing."

After patients have passed a health assessment, Smits says, they should work up to the public health dose, which is 150 minutes a week of moderate-intensity activity or 75 minutes a week of vigorous-intensity activity. At a time when 40 percent of Americans are sedentary, he says, mental health care providers can serve as their patients' exercise guides and motivators.

"Rather than emphasize the long-term health benefits of an exercise program -- which can be difficult to sustain -- we urge providers to focus with their patients on the immediate benefits," he says. "After just 25 minutes, your mood improves, you are less stressed, you have more energy -- and you'll be motivated to exercise again tomorrow. A bad mood is no longer a barrier to exercise; it is the very reason to exercise."
Smits says health care providers who prescribe exercise also must give their patients the tools they need to succeed, such as the daily schedules, problem-solving strategies and goal-setting featured in his guide for therapists.

"Therapists can help their patients take specific, achievable steps," he says. "This isn't about working out five times a week for the next year. It's about exercising for 20 or 30 minutes and feeling better today."

Sunday, August 26, 2012

How to Give Effective Advice

There are many compassionate people in the world who see others struggling. Often the gut instinct is to give people advice to help "solve" their problems. The problem with that is unsolicited advice is often very dangerous for relationships.

The first time you give uninvited advice you will most likely be ignored. 
The second time you give uninvited advice the person is likely to be annoyed. 
The third time you give uninvited advice the person is likely to push you out of their life. 

When people give too much advice they lose the privilege to speak into that person's life. This can happen between parents and adult children, friends or any other relationship. 

The good news is saying nothing at all often results in people inviting you to give advice. If you meet people with love and compassion, and a good listening ear they are likely to open up and seek advice. At that point they just gave you permission to speak into their lives. Then the advice you give has a much more powerful effect on their life and the relationship is not harmed. 

The biggest point to understand is that a person must feel loved, accepted, and listened to before you give any advice. 

During the listening period you do not have to condone or encourage problem behavior but it is not time to tell them how to change it. If you want them to hear you, you must listen first. 

For more on listening skills read my article on how to be a good listener.

Friday, August 24, 2012

Thinking Patterns that Cause Problems

Cognitive Distortions (dangerous ways of thinking)

Aaron Beck first proposed the theory behind cognitive distortions and David Burns was responsible for popularizing it with common names and examples for the distortions.
1. Filtering.
We take the negative details and magnify them while filtering out all positive aspects of a situation. For instance, a person may pick out a single, unpleasant detail and dwell on it exclusively so that their vision of reality becomes darkened or distorted.
2. Polarized Thinking (or “Black and White” Thinking).
In polarized thinking, things are either “black-or-white.” We have to be perfect or we’re a failure — there is no middle ground. You place people or situations in “either/or” categories, with no shades of gray or allowing for the complexity of most people and situations. If your performance falls short of perfect, you see yourself as a total failure.
3. Overgeneralization.
In this cognitive distortion, we come to a general conclusion based on a single incident or a single piece of evidence. If something bad happens only once, we expect it to happen over and over again. A person may see a single, unpleasant event as part of a never-ending pattern of defeat.
4. Jumping to Conclusions.
Without individuals saying so, we know what they are feeling and why they act the way they do. In particular, we are able to determine how people are feeling toward us.
For example, a person may conclude that someone is reacting negatively toward them but doesn’t actually bother to find out if they are correct. Another example is a person may anticipate that things will turn out badly, and will feel convinced that their prediction is already an established fact.
5. Catastrophizing.
We expect disaster to strike, no matter what. This is also referred to as “magnifying or minimizing.” We hear about a problem and use what ifquestions (e.g., “What if tragedy strikes?” “What if it happens to me?”).
For example, a person might exaggerate the importance of insignificant events (such as their mistake, or someone else’s achievement). Or they may inappropriately shrink the magnitude of significant events until they appear tiny (for example, a person’s own desirable qualities or someone else’s imperfections).
6. Personalization. 
Personalization is a distortion where a person believes that everything others do or say is some kind of direct, personal reaction to the person. We also compare ourselves to others trying to determine who is smarter, better looking, etc.
A person engaging in personalization may also see themselves as the cause of some unhealthy external event that they were not responsible for. For example, “We were late to the dinner party and caused the hostess to overcook the meal. If I had only pushed my husband to leave on time, this wouldn’t have happened.”
7. Control Fallacies.
If we feel externally controlled, we see ourselves as helpless a victim of fate. For example, “I can’t help it if the quality of the work is poor, my boss demanded I work overtime on it.” The fallacy of internal control has us assuming responsibility for the pain and happiness of everyone around us. For example, “Why aren’t you happy? Is it because of something I did?”
8. Fallacy of Fairness.
We feel resentful because we think we know what is fair, but other people won’t agree with us. As our parents tell us, “Life is always fair,” and people who go through life applying a measuring ruler against every situation judging its “fairness” will often feel badly and negative because of it.
9. Blaming.
We hold other people responsible for our pain, or take the other track and blame ourselves for every problem. For example, “Stop making me feel bad about myself!” Nobody can “make” us feel any particular way — only we have control over our own emotions and emotional reactions.
10. Shoulds.
We have a list of ironclad rules about how others and we should behave. People who break the rules make us angry, and we feel guilty when we violate these rules. A person may often believe they are trying to motivate themselves with shoulds and shouldn’ts, as if they have to be punished before they can do anything.
For example, “I really should exercise. I shouldn’t be so lazy.” Mustsand oughts are also offenders. The emotional consequence is guilt. When a person directs should statements toward others, they often feel anger, frustration and resentment.
11. Emotional Reasoning.
We believe that what we feel must be true automatically. If we feel stupid and boring, then we must be stupid and boring. You assume that your unhealthy emotions reflect he way things really are — “I feel it, therefore it must be true.”
12. Fallacy of Change.
We expect that other people will change to suit us if we just pressure or cajole them enough. We need to change people because our hopes for happiness seem to depend entirely on them.
13. Global Labeling.
We generalize one or two qualities into a negative global judgment. These are extreme forms of generalizing, and are also referred to as “labeling” and “mislabeling.” Instead of describing an error in context of a specific situation, a person will attach an unhealthy label to themselves.
For example, they may say, “I’m a loser” in a situation where they failed at a specific task. When someone else’s behavior rubs a person the wrong way, they may attach an unhealthy label to him, such as “He’s a real jerk.” Mislabeling involves describing an event with language that is highly colored and emotionally loaded. For example, instead of saying someone drops her children off at daycare every day, a person who is mislabeling might say that “she abandons her children to strangers.”
14. Always Being Right.
We are continually on trial to prove that our opinions and actions are correct. Being wrong is unthinkable and we will go to any length to demonstrate our rightness. For example, “I don’t care how badly arguing with me makes you feel, I’m going to win this argument no matter what because I’m right.” Being right often is more important than the feelings of others around a person who engages in this cognitive distortion, even loved ones.
15. Heaven’s Reward Fallacy.
We expect our sacrifice and self-denial to pay off, as if someone is keeping score. We feel bitter when the reward doesn’t come.

Sunday, August 19, 2012

Safety Plan For Suicidal or At-Risk People

There are times people people we love are in an "at-risk" place and we are concerned about their safety. If you or someone you love is at that place they should absolutely be seeing a counselor, but something you can do with them is fill out a safety plan to be proactive about their mental health. By being proactive about our mental health you can prevent a crisis. 

Sunday, August 12, 2012

Never Give Up

I have had many clients tell me their vices are too strong for them. They report having no hope of recovery. Please listen to me and listen carefully. 
You are never too far gone. You have never made too many mistakes. Your life can always get better. There are many things that are hard to change but if you are determined to find a solution it is there. 
If you are not sure where to start, please read my article on 7 steps to change a habit for "how to" steps to move forward.
Often times lack of hope is what prevents people from moving forward. Hope is a powerful way to change behavior. People do drastic things on hope alone but without it people can loose their will to live. 
If hope is something you struggle to find, look for a person with this core value that can encourage you and remind you how strong you really are. We are as strong as we decide to be. 

Thursday, August 9, 2012

Divorcing Your Parents by Dr. Schwartz

Should I Divorce My Parents or Forgive Them?

Allan Schwartz, LCSW, Ph.D. Updated: Aug 7th 2012

Should I Divorce My Parents or Forgive Them?My colleagues Rick Hanson and Elisha Goldstein have written sensitive and eloquent articles about the power of forgiveness. In my estimation, one of the major themes in both essays is the importance of forgiveness of oneself because anger and hate eat away at the very fabric of ourselves and our lives. No one can argue with them about the truth of these messages. Therefore, is it wrong if an adult chooses to "divorce" or sever all relationships with their parent? This is a question that is rare but it does come up for those suffering from continuing emotional abuse at the hands of one or both parents.

At the outset of this article, it's important to emphasize the fact that, taking the radical step of no longer speaking to a parent, should not be done out of revenge or hate. It's also important to state that adult children can be just as abusive and unreasoning as some parents. There are no perfect people. So, why would someone sever all ties with a parent? Relationships between adult children and parents are emotionally powerful. On the surface, it seems impossible that anyone would refuse to relate to mom and dad.

It is a well established fact that physical and emotional abuse of children is extremely damaging can lead to life-long depression, low self-esteem and troubled relationships. However, it is commonly thought that all forms of abuse must end once children have reached adulthood. In most cases this may be true. Yet, there are circumstances in which parents continue to mete out emotional abuse even though their sons and daughters are adult. A constant barrage of criticisms, disapproval, rejection, hostility and parental disregard continue to be harmful. I have come across several cases in which this type of thing happened. For example, it is painful for a daughter to call her mother and hear her disappointment when mom answers the phone. In one case, her father reported that he was well aware of the way mom was behaving. The borderline or narcissistic mother's problems are such that all problems center around her. This destructive dynamic is also directed at sons. Of course, there is also the narcissistic type of father who is equally aloof, cold, critical and rejecting. Let me add that there are adult children who can be the same way.

In my experience, it has been rare for an adult child to consider cutting off all ties with a parent. Generally, what happens is that the adult child distances himself from the parent, maintaining ties with conversations and visits that are few and far between. In even more rare cases, an adult child will end all contact in circumstances where there is too much ongoing abuse to continue to have a relationship.

In these very rare cases of "parental divorce," all attempts at discussion, even with a therapist, have failed. Ultimately, the adult child is left to feel that there is no other way. In my experience and in those cases I have read about, people felt relieved at no longer having to cope with such a parent.

To repeat what was said before, this step is taken not out of revenge but out of genuine self-preservation. In fact, it's important to be forgiving so that the adult child does not feel filled up with venomous hate. It is also important to forgive oneself because it is all to common for victims of abuse to blame themselves.

By the way, there are also parents who cut all ties with children.

Sunday, August 5, 2012

Questions to Know About Your Spouse

My brother used to tell me whether or not girls he was dating passed the "porch test". The "porch test" consisted of whether or not he thought they as a couple could hold a conversation after everything was stripped away, and they were in the 80's sitting on their porch, watching the world go by. I think my brother was on to something. He wanted to be with some one that he could talk to and know.

In Val Farmer's book, To Have and To Hold, he lists a series of questions to know about your significant other. Part of what makes marriage enjoyable is if you are living life together. Marriage can be an absolute blast if you are married to your friend. Knowing that when someone annoys you , you can come home and tell your spouse about it, and they will encourage you. Knowing that if you are depressed, all you have to do is ask and they will hold you until you fall asleep. Seven years into my marriage and there still are many nights where my husband and I will stay up late talking about our dreams and hopes for the future. I cherish these moments. If you are dating seriously or married make it a point to know the questions below about your partner at any point in time. Knowing these things about your partner on an ongoing basis is part of how you will continue to feel connected.

1. Who is my partner's favorite people?
2. What stress is my partner currently facing?
3. Who has irritated my partner lately?
4. What are my partner's life dreams?
5. What are my partner's religious beliefs?
6. What is my partner's basic view on life?
7. Who are the relatives my partner likes the least and most?
8. What are my partner's current aspirations or goals?
9. What would my partner do if they won the lottery?

Thursday, August 2, 2012

What's Up With Liars?

The Common Liar
People lie all the time in every day life, but most of us would like to think we can trust the bulk of what people say. Some times people lie to protect someone's feelings, or because of a fear of what consequences the truth might hold. Insecurity can often cause lying. If a person isn't secure enough in themselves they might make up what they think you want to hear about them. This type of person might make up an interest or pretend to share yours. Over all the people in this category are generally healthy people that just lie once in a while.

The Habitual Liar
The person in this category lies all the time about almost everything. The truth makes them uncomfortable, but lying is just right. Typically people in this category starting lying in their childhood. For some of these people it may have been to prevent verbal or physical abuse. Lying served a specific purpose in their life and they carried it into adulthood. For this type of person stopping lying would be very difficult because their instincts would tell them it is not safe to tell the truth.

The Sociopath
A sociopath is a separate category. People in this category lie for a specific purpose and are often very good at it. A sociopath will have no regard for who they hurt or any law they break. Sociopaths can be very charming and can hide their deviant nature. Their lies are typically more thought out. A sociopath is very skilled at manipulation and lying is a frequently used tool to achieve their selfish goals.

Take a quick survey and see how your lying compares with others - 

New CEU now ready!!

  Objectives:  Participants will gain an understanding of common comorbid diagnoses associated with Autism (ADHD, Depression, and ODD).  Par...