We use Exposure and Response Prevention (ERP) techniques, which are based in Cognitive Behavioral Therapy (CBT). While this outcome can be enhanced with the implementation of medications, we have found that many people benefit from therapy alone. Cognitive Behavioral Therapy (CBT) has two components.
It can be hard to understand why people cut themselves on purpose. Cutting is a way some people try to cope with the pain of strong emotions, intense pressure or upsetting relationship problems. They may be dealing with feelings that seem too difficult to bear or bad situations they think can’t change.
I saw a woman in her 60s who told me through tears how she had become pregnant at 15 and did not tell her family until she went into labor at home.
As we all know, some people worry too much. Rather than solving a problem, too much worry becomes the problem. Not only does excessive worry create much personal suffering, but it also affects the people around the worrier. I wonder if a lot of our worrying in life is like this: constant, spontaneous and effortless focus that gets dislodged by distracting external events or our own change of perspective. Now, I think that anyone who does not worry is just living on a different planet; yet, as we know, just worrying about the weather does not make it rain.
After 31 years of working in the field of psychology, I know a few things make a difference in coping with life.
God grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference. Living one day at a time, enjoying one moment at a time, accepting hardships as the pathway to peace, taking, as He did, this sinful world as it is, not as I would have it, trusting that He will make all things right if I surrender to His Will, that I may be reasonably happy in this life and supremely happy with Him forever in the next.
As this year continues, on behalf of the psychologists in the practice, I want to thank you for recommending us to others.
My friend Steve and I talked about him the last time we met for breakfast. The three of us had been college classmates but Steve and Rich were closer in those years. A few years after graduating school, Rich shot himself to death. Neither of us could remember any sign or warning of his despair. He was there in our lives and then gone.
“IS PATH WARM?” is a mnemonic device developed by Lanny Berman, Ph.D. (Executive Director, American Association of Suicidology) to identify acute risk factors for suicide. I share it with you for we all want to be on our toes for those we care about.
I Ideation – directly or indirectly disclosed thinking of ending one’s life.
S Substance Use – misuse of alcohol or drugs.
P Purposeless – finding no meaning or value in living.
A Anxiety – a regular sense of being on edge; sleep problems.
T Trapped – thinking that there is no other solution.
H Hopelessness – and it will always be like this.
W Withdrawal – increased isolation from family, friends, and usual activities.
A Anger – rage at self or others.
R Recklessness – making risky and dangerous choices.
M Mood Change – endless despair or a sudden and unexplained release from it.
In the thirty years I have worked as a psychologist, I have gone to court one time to speak with a judge about detaining someone in a hospital because of imminent danger of suicide. This list captures many of the signs I saw back then.
More information on these suicidal risk factors is available at www.suicidology.org.
On a minor note, I recommend two books to bolster our strength before we get to despair: Endurance by Caroline Alexander and Unbroken by Lauren Hillenbrand. These true stories, one of hardship and the other of wartime cruelty, and are breathtaking descriptions of impossible conditions and human triumph.
I still remember their names to this day: classmates of mine from seventh and eighth grade. I envied their athletic prowess and basketball self-confidence playing on the asphalt behind St. Rita Grammar School. I’ll bet I thought about them and their talent nearly every day and probably wished as often I could be just like them. There have been many times in my life that I have been so caught up as well by an idea (marketing employee assistance programs in 1985) or an event (not getting into DePaul University in fall 1973). This kind of thinking has often struck me as merely and stubbornly obsessive. I came across another explanation recently that I find more compelling and freeing.
Daniel Kahneman, a psychologist at Princeton University, describes this cognitive distortion as a Focusing Illusion, namely “Nothing in life is as important as you think it is while you are thinking about it.” I invite you to recall two or three times in your life where you may have been so lasered in with concentration on something and test out whether it still matters to you today with the same importance.
In treating depression and anxiety issues, I have found this kind of sticky preoccupied thinking present. Using Kahneman’s observation both respects the thinker and dislodges the thought. I have not found successful ways to argue myself or others out of strongly held viewpoints. I think intentionally remembering that whatever we obsess about as “true and forever” will be so until we think about something else.
On a minor note, if you have not heard The Moth storytelling radio show on NPR, I’d recommend it. The show presents true stories told live. I know when I hear it, it gives me something else to think about.
Till the next line…
David
Looking for anxiety help? If you struggle with panic attacks, chronic worry, social phobia, generalized anxiety disorder, phobias or obsessive compulsive disorder, here’s help that’s practical and powerful.
Anxiety disorders are generally very treatable, but people who experience them find them hard to overcome. The reason is that while most people have the ability to recover, anxiety literally tricks them into using methods that make their fears worse rather than better.
This is the most natural thing in the world. People think of chronic anxiety as something that invades their lives, something they have to resist and oppose. However, the worst problems come from our efforts to resist and remove anxiety, rather than from the anxiety itself.
People do not get fooled by this trick entirely on their own. All too often well meaning friends, doctors, and therapists get fooled by it as well, and unwittingly suggest methods to their patients that make the situation worse.
For instance, there’s a well publicized technique called “thought stopping”, in which you snap a rubber band against your wrist when you have an anxious thought, and say “stop!” to yourself. It’s hard for me to understand why professionals still suggest this idea, because it’s very unlikely to be of any help. The more you tell yourself not to think something, the more you’ll think about it.
If you want a quick demonstration right now, take two minutes and don’t think about dancing elephants.
See what I mean? Don’t even think about thought stopping.
When anxiety tricks you, you get fooled into using recovery methods that actually make your fears stronger and more persistent. The more you fight an anxiety disorder, the more it grows. It’s like putting out fires with gasoline.
When your fears and worries and undue anxieties overcome you, give us a call. We can help.
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