#my only experience with therapy was cbt and it was really beneficial for the first maybe half year

[aromacaque]

i feel like, while it can be beneficial, i have gripes with cbt but i cannot articulate it into words

[techmomma]

I made big progress with my trauma recovery the other day! I’m really proud of doing a very hard thing, and honestly doing so made me feel so much better.

Said growth involves realizing some unfun things, so y’know, look out for that under the read more, even if I consider this a hopeful, uplifting realization by the end. Christ this is long, have fun reading this word wall.

So I essentially lived in a bitter divorce household. Y’know, when the two parents have an awful, agonizing divorce that pits the kids’ loyalties against each parent and each other and themselves.

I grew up in that. Except they never actually divorced. Or separated. Not till after I’d moved out, anyway. So 20+ years of living in a household where my parents flip-flopped between “trying to make it work” and “screaming at each other and bitterly trying to corral their kids in this us-vs-them, me vs your other parent toxic tug of war.”

Why didn’t they divorce? Codependency and religious pressure because both were previous divorcees, one was an excommunicated catholic because of this, and the other was a narcissist who couldn’t admit defeat and made a promise to god to make it work for fear of the shame that would come from failing again! What a winning pair! Who definitely did not mutually cheat on one another and then act scandalized and eternally vindictive about this.

Anyway, what this meant for Steph’s psyche was every day was an eternal battleground of loyalty tests. Any disagreement was disloyalty. Saying the wrong thing could be taken as disloyalty. Yet, y’know. You don’t want to be disloyal to the other parent that you love. You don’t wanna throw them under the bus. You just wanna say what you saw happened.

Which meant every answer became this tightrope of not only validating and appeasing one parent’s ego, but also finding the diplomatic thing to say so as not to implicate the other parent, or get that parent in trouble, or appear disloyal because that too could come around to bite you in the ass. Sometimes we agreed with what one parent was saying, but taking issue with a small part or one aspect? This was seen as fully disagreeing and being disloyal.

You can imagine the pressure this put on an already socially-awkward kid, ages 4-20, to find the exact correct thing to say. It rarely worked out.

But I figured out a clever loophole early on: if I shut down, if I didn’t make a peep, if I said not one word—sure. That parent would be mad at me for not responding. They’d be made I wasn’t saying anything. They might yell louder, or guilt me, or threaten me with some form of humiliation.

But not saying anything was so, so much better than any alternative. Never once did speaking up end well.

If you know about pavlovian training, you can probably quickly see the conditioning that was set in. Parent would state an opinion, about anything. Give validation. Parent looks for validation about shitty feelings about other people? Don’t say a peep, let parent be mad, and eventually they’ll either get so frustrated they give up, or they say their piece and get whatever was on their chest off of it. Either way, they leave me alone. Maybe after three hours of screaming at me, but three hours could turn into six if I made them more mad by disagreeing or seeming disloyal.

And for the record, when I talk about loyalty, I’m not saying they were asking about actual loyalty. They wanted me to agree with their opinions. They wanted me to be on their side, their ally, no matter what the other parent said. It was all or nothing. “You’re with me or against me.”

Made all the more complicated that sometimes, if you seemed disloyal to the other parent, the supposed “enemy” in the situation, the first parent might berate you for that too. “How could you talk about your mother/father that way? How could you say those things?” Despite having been saying worse things minutes before.

They were volatile. The smallest, stupidest things could become full-blown arguments that could last for hours, at the top of their lungs. After which they might turn that to us, the kids, to get out whatever was left in their system I guess. Small questions, statements, became tests. Answer wrong, and there would be hell to pay. The most innocuous things could become loyalty tests. But most of all, the most discerning tests came when they were complaining about the other. When Dad complained about Mom, and when Mom complained about Dad. “Agree with me,” they said between lines, “Are you on my side? Aren’t they terrible?”

I just wanted to love both of my parents. I never wanted to choose.

My epiphany came when I realized that when others seek comfort from me, when looking for validation during shitty events or people being mean to them—y’know, normal things people do with friends—I was having emotional flashbacks. I was being triggered into a state of trauma, my brain receding to that familiar shutdown state. Terrified that whatever I say to comfort them, whatever I say to help them feel better, would be taken as a loyalty test. To voice even slight disagreement could be disloyalty.

My friends had never tested me. But my brain was reacting so firmly and my body so wholly that I had no idea. I try to be aware of my emotional states and how my body reacts but this shutdown response has just been so normal for so long, and such a large bodily feeling, that I never noticed what it was. And it wasn’t until watching a video about this type of situation, feeling like you have to validate someone not necessarily from a place of concern but of fear, that I realized what was happened.

I realized how deep the rabbit hole went. This has been happening for decades. At work, when coworkers would complain or even just chat normally about other coworkers, my brain was shutting down out of fear that my loyalty was being tested, I was being scrutinized for disagreement. When customers talked about my coworkers, my brain was shutting down, terrified to say the wrong thing and either disagree with said customer or throw my coworker under the bus. I shut down when friends talk about other friends, when people talk about other people and maybe I agree, but there’s an aspect or idea in the situation that I don’t agree with, or maybe I’m just seeing things differently from an outside perspective.

But every time, I was terrified. I was so scared that my brain returned to trauma, returned to that shutdown state from childhood (and some adulthood), because shutting down, previously, had always yielded the better result. Staying quiet, keeping my head empty and my thoughts blank, kept me safe for twenty years.

And now I can’t hear other people talking in a room without returning to that same shutdown state, for fear that they are arguing and I will be forced to choose between people. To love one friend more than another. Forced to pick a side, forced to soothe their emotions because if I don’t, things will be so many times worse. Heaven forbid they have disagreeing opinions, even if they’re calmly sorting them out, communicating in a healthy way. God help me if they’re actually arguing. I can’t think, I can’t even speak sometimes, voice pulled tight like I’m being strangled; I can’t even squeak out a sound. It hurts too much. It hurts so much.

Sometimes I can hear people through my earbuds or headphones and all I can do is lay on my bed and plug my ears with my fingers as tight as possible and try to hum a song, try to force a mantra to drown out the sound as I desperately try to soothe myself with some kind of stim, even if it’s just rocking side to side on the bed.

I knew I had problems with listening to people disagreeing. But I realized the other day how deep the rabbit hole goes. How often, daily sometimes, I’ve been having emotional flashbacks. How thoroughly this has been effecting my life, my relationships, my sanity.

It’s been so exhausting. Realizing how many things connect back to this central issue of toxic loyalty that I grew up with, how thoroughly engrained this trauma is in my life. Realizing I’ve been having emotional flashbacks almost every day, for decades.

I’m so tired.

But I’m really glad I did. It’s putting a name to the beast. I am finally getting to the heart of an issue that was so much larger than I originally thought but in turn, there is so much potential to truly grow and heal. If I know the beast, then I can know how to face it. I can know how to use CBT therapy for this, how to weaken it to progress. And I’m really glad for it.

I also did something very hard: directly forcing myself to face it, and told my roommates about this deep-set fear. I realized that I don’t often just talk about how I’m feeling, I usually do so in the context of like having an issue or a problem that we need to talk out or talk through. I don’t usually just say, “I’m really really scared of this thing.”

I told my roommates this realization and like the wonderful, amazing friends they are, they understood. It’s an internal problem for me, something just for me to work on. It’s my issue. But now... they know that if I go quiet when discussing other people, or leave the room when disagreements are happening, I’m not just trying to blow them off or or be wishy-washy. I imagine there have been many times in the past when a friend has come in need of support and my answer came across weird or like I was trying to change the subject and it was awkward and not what they were hoping for.

Now they know that my response might be weird because I’m having a flashback. I’m scared, my brain is shutting down and I can’t think.

And that’s okay. It’s okay to be scared in front of my friends. It’s okay to experience that trauma in front of them. I don’t have to try to pretend I’m okay or try to push through the fear when I really, really can’t. It’s okay to need a subject change or even to just listen quietly if I don’t necessarily want my friend to stop venting, I just may not be able to answer in a beneficial way. I may be shutting down and sometimes all I can do is wait it out. And that’s okay.

I don’t have to validate other people because I’m scared. Because I think I’m being tested.

I felt better not just because talking about these things helps but also because a weight was lifted. One of my main triggers is feeling like I have to respond and have to respond correctly Or Else. But now that they know, that weight is off of my shoulders. I can be afraid and not able to respond and they understand why now. I don’t have to try to keep up that lie or try to put on a face or try to push through it.

I can be scared. And letting yourself be scared is the first step to healing from it. I don’t have to pretend to not be scared anymore.

I always know I’ve hit the hammer on the head when it comes to my emotional issues because I start crying and even just typing this out made me weepy, haha. It’s a good weepy though. I made a big step, and I’m really proud of myself. My instinct was to take this and agonize quietly over it myself, find my own solution on my own and deal with it on my own. But I didn’t. I reached out, and it was scary and hard and it hurt and now I’m so, so much better off for it, and now I can really start healing. I can change this.

God I’m so tired tho. Holy shit.

[sparklyandchic]

🦋 MINI MIND MAKEOVER 🦋

okay i started the idea for this mini little mind makeover when i broke up with my boyfriend in like january. instead of being sad or angry, i wanted to be grateful for this time and take it as an opportunity to make life better for myself. then quarantine happened, so some of these are related to things i’ve learned since that started. either way, these aren’t all concrete things to do for your mind; some of them are just ways of thinking or pep talks. but if you can find one little piece of information or thought that makes you a little bit happier for a moment, that’s all i can hope for!

5-htp: okay first off- please ALWAYS consult your psychiatrist or medical professional before taking a supplement! taking 5-htp with, for example, serotonin-increasing medications can lead to a fatal illness called serotonin syndrome. personally, i started taking it because i had been on 10 mg prozac for a few months. it definitely dulled a lot of my anxiety and had a lot of positive aspects to it, but it dulled them almost too much to the point where i felt apathetic and detached from myself and the situations i was in. i was in a very unhealthy relationship and felt like i needed my mental clarity and “overthinking” processes back in order to identify what i was feeling and how to deal with it. i felt a lot more “sensitive” after coming off it, which was actually really welcome for me at first, but then it sort of dropped off into withdrawals. i was having constant panic attacks and crying very often. after a while, i was debating going back on prozac, but remembered i had taken 5-htp before. 5-htp is an amino acid that is a direct precursor to serotonin being produced in the brain. when u eat turkey, tryptophan is converted into 5-htp which leads to your brain producing serotonin, thus why you feel calm and happy afterwards. after taking 5-htp for just a few days, ranging between 200-300 mg per day (again, do your research, ask your doctor, and start small) i stopped crying constantly and really felt this sense of calmness and wellbeing but without the detachment and apathy i felt with prozac. i could still think clearly but didn’t feel overly sensitive to every emotion which arose. personally, it is really a lifesaver and really does make a noticeable difference.

cognitive behavioral therapy: ive tried therapy a million times. well okay, like 5 or 6 different therapists. at its worst, therapists told me i needed to use my sexual power as a woman in order to get what i wanted from men, told me i’m bad at socializing and should do group therapy, said my mom shouldn’t have encouraged me to “be myself” when i was younger because it made me less likeable than if i had conformed to normal societal standards of dressing. i had gone to “therapists” who claimed to be trained in CBT, but when i told them about my experiences with dissociation, the only feedback i got was to “take more baths.” while going through a few unpleasant experiences in my personal life, i decided i should try CBT once more, but like the real kind. i found an ivy-league educated licensed psychologist (NOT a “licensed clinical social worker” who doesn’t even have a psychology degree!!) who SPECIALIZED specifically in cognitive behavioral therapy. just after the first session, i was so elated with my experience. as opposed to just telling me that i needed to be more normal or more kind or a better person, she tried to identify WHAT was making me feel that way about myself in the first place. she pointed out the positive things i do and reassured me i was kind, good, and deserving of good things. she pointed out many aspects of my situation that would have taken me days or weeks to come to on my own. i’ve realized my hubris isn’t that i’m not socially acceptable or not perfect enough, but its just that i tend to THINK that i am these things despite having no evidence of it. so, over time with therapy, my positive self image about who i am as a person has grown and strengthened and i dont just randomly feel like a bad human being anymore lol. moral of the story, if you wanna do therapy but it keeps sucking, dont give up. go to a legit psychologist, find someone who specializes in the type of therapy you’re seeking, and also be vocal during your sessions. stand up to your psychologist when they continually push a narrative onto you, and explain why you don’t agree with it. sometimes it’s their job to try different narratives to see what fits, and if you just passively let them say what they want to, you’ll never find the truth of your experience! it’s a communal effort! therapy isn’t usually a magic cure-all where one session fixes everything that goes awry in your brain. but if you find someone who knows what they’re doing they can in fact really help your thought processes become less twisted up and more clear and healthy.

meditation and mindfulness: a few weeks ago i felt anxious and overly driven to get things done to the point where i spiraled into a space of guilt or a panic attack over not getting enough things done. meditation can be so so helpful here. it’s better to spend an hour sitting and doing nothing, but doing it peacefully and then calmly moving on to doing something else, than to spend 5 hours stressing yourself over every single thing you need to get done and how much time you’re wasting. the things that need to get done will get done. another thing that i’ve realized and say to myself a lot is: “focus not on doing all things perfectly, but on doing the small things well.” by this i mean, stop thinking about the 20 things you need to get done and how it all needs to be perfect, but instead take your time with the task that presents itself as most beneficial right now and focus on enjoying it and giving your whole self to the process. for example, stop thinking about how you need to clean your room, your closet, donate clothes, take a shower, take out the trash, read, workout, etc. think to yourself; “which task would bring me the most joy right now?” if the answer is taking a shower, then take that damn shower. bring your speaker into the bathroom, scrub every inch of your scalp with shampoo, scrub your feet and behind your ears and your neck with body wash, brush the conditioner through your hair fully. you may end your shower with 19 other things to do, but god damn if you can’t enjoy a single one of them and be present for it, what’s the fucking point! go light a candle and bask in its glow, go make your bed and huddle up in your neatly arranged covers, go take a long bath or a thorough shower, and be proud of and content with that today. 

relationships, with others and yourself: okay, if you missed the memo, my ex-boyfriend sucked. like genuinely was a bad person. he was a drug dealer, so that’s red flag number 1 (which i ignored of course), he hadn’t graduated high school (he was 18, i was 20, he was supposed to graduate the last semester but refused to do the work and ignored me and his mother when encouraged to do it, which is uhh definitely red flag number 2 which i also ignored), he habitually did not show up for dates on time or lied about what he was going to do or what he did (literally everything he did was a red flag and i rlly ignored all of it). the worst part was how he responded when i worked up the courage to speak to him about it. if we had agreed upon a time for our date but he showed up literally 8 hours late, he would blame it on me because i “could have called” him, or that i was “demanding too much of” him, or that i “should have said something earlier so now [i was] just dragging it out because it already happened.” basically, whatever narrative he pushed at me, i eventually gave into. i’ve dealt with gaslighting in a relationship before and a part of me knew what was happening to me, but a part of me also kept having hope for him, kept empathizing with him, kept wanting to believe in him. after a bit too much time, i finally realized you have to trust yourself, empathize with yourself, and believing in yourself over anyone else. at first i felt bad for him not being able to graduate because i had my own struggles with high school and getting work done. i thought he may have issues but he deserves someone to be there for him because i wanted someone to be there for me. despite the pain and stress he was causing me, i sat around crying over him because i cared about him and tend to over-empathize with people close to me, whether they deserve it or not. my therapist told me something that at first i did not understand, but over time came to grasp in its entirety: “some people do not deserve your love or kindness.” after our first session, my homework was to “consider when you are being kind and when you are being taken advantage of.” this made me realize that what feels like your instinctual nature to be nice to others, can in fact be a self-sabotaging unfair action, depending on the other person’s response. i might be dishing out a lot right now, but bear with me. think of it this way: you regard an action as a “kind action”. you might think “kind actions” include: forgiving someone for large mistakes, putting someone’s needs over yours, sparing them some change when they ask for it, listening to the problems they are dealing with every day. BUT when their actions include not forgiving you for minor mistakes, not giving a sh*t about your needs or considering them, not caring how much money they take from you and how much money you need to have around, or habitually glossing over your problems because it doesn’t benefit them to care, THEN those actions you performed are NOT “KIND ACTIONS” anymore. the act of continuing to give them leeway is now the act of being taken advantage of. the act of giving them money is now the act of being taken advantage of. the act of buying into their story at the expense of your sanity, is now the act of being taken advantage. basically, all i’m saying is START PUTTING YOURSELF FIRST AND TRUSTING YOURSELF WHEN YOU FEEL SOMEONE DOESN’T HAVE YOUR BEST INTERESTS IN MIND. 

ending thoughts: i know quarantine is difficult right now. the desire to grow contrasted with the inability to move. maybe try and follow that old 2008~ quote; “bloom where you are planted”. you might not be able to reach the goals you thought you would during this time. you might not be able to run a marathon or make a bunch of new friends or wake up at 6 AM to workout or redo your bedroom or get a rhinoplasty or join a gym or get an internship. working towards productivity might be unrealistic right now. but you can work everyday towards becoming the woman you want to be, mentally. you can work on learning to be content, learning to make the best with what you have, learning to appreciate the little things, learning to slow down. these are all qualities that i for one want to have just as much as i want to be attractive or successful. if you can’t enjoy success, what’s the fucking point! life is on pause right now, take this moment as a gift and consider your internal world and what parts of your mind need a makeover. there are horrible things happening in the world right now, do what you can to help, but if you’re safe and healthy then be grateful for the things you can learn from this difficult time. take it slow, but keep moving forward! 

[therapy101]

What can therapy do in the face of climate change & fascism?

I’ve received several requests to comment on how worry about existential and sociocultural threats impact therapy and therapeutic approach. A couple of people have linked me this post as an example.

The question is: what can therapy do about real, objective threats to the individual therapy client and the world? For example, the linked post mentions climate change and the rise of fascism. Can therapy do anything? Is therapy only for minor problems, or issues that the client is ‘blowing out of proportion,’ so to speak?

I have a few points to make, so this may be a long post.

First, I want to acknowledge clearly that the earliest conceptions of psychotherapy- yes, like Freud –were built for rich people, and mostly those without acute or chronic threats to their wellbeing (I say “mostly,” because Freud and his colleagues saw a lot of women, who were still rich, but often lacked power due to their social status). Because of the target population for therapy in those days, therapy was not necessarily made to recognize or help with tangible, sociocultural threats that negatively impact mental health, like poverty or bigotry. That might be partially why psychodynamic psychotherapy is largely not evidence-based: it doesn’t target tangible outcomes, like symptom severity or functioning. So we would not expect those types of therapies to be helpful for people facing these sociocultural threats to their wellbeing.

I think the post linked, though, is mostly hinting at a cognitive behavioral therapy (CBT) approach (“are you sure that’s rational?”), so let’s talk about CBT and tangible sociocultural threats. It’s important to remember that a thing can be real, AND a person’s thoughts/beliefs about that thing can be distorted. Examining thoughts, and how they connect to feelings and behavior, can be helpful in many situations, not just when a person is completely misinterpreting/misunderstanding a situation. So for example, in that example post, there are two beliefs that are worthy of examining in a CBT context: 1) the belief that if you might not live to be 60, your life is pointless; and 2) the belief that there is nothing you can do to prevent the threats that might limit your lifespan.

That first belief (if you might not live to be 60, your life is pointless) really caught my eye because it’s so clearly in need of some Socratic questioning. Like: which lives are worthwhile? Is lifespan the main determining factor? How long do you need to live for your life to have a point? If you die the day after your 60th birthday, was your life worth more than if you die the day before your 60th birthday? If dying before age 60 renders your life pointless, was MLK’s life pointless? Joan of Arc? Jesus? (Insert your own examples of historical figures who died before age 60 here). If you knew you were going to die the night before your 60th birthday, would you just give up now because the years you do have left are pointless?

Or: if you knew you would die before age 60, how would you want to use the time you do have? How could you use it in the most meaningful, most worthwhile way?

That second belief is all about powerlessness, a common theme in CBT. For many people, one of their core beliefs is about lack of power or lack of worth. Core beliefs impact the decisions people make throughout their lives, the emotions they feel on a day to day basis, and their ongoing thoughts. Beliefs about powerlessness are also called defeatist attitudes, because when people believe “I am powerless,” or “There is nothing I can do to help myself/the world,” they act that way. They don’t try to change things or to help. It’s a self-fulfilling prophecy- if I believe I can’t make an impact, I don’t try to make an impact, and therefore I don’t make an impact, proving to myself that I am in fact powerless.

Look: there are real, tangible threats in the world today, including climate change and fascism. That being true does not mean that all associated beliefs a person might have about the world or the future is also true. Steven Pinker, an experimental psychologist at Harvard, would say that overall, the world is better today than in the past. He would mention that lifespan is increasing, female education and literacy rates are increasing, and crime is decreasing worldwide. He would mention that the hole in the ozone layer has mostly mended. With more fact gathering, I think we would find more evidence that is more optimistic than that post- for example, the record number of women elected to the House of Representatives last year, or the (small) reduction in CO2 use in the US. I’m not saying that existential and sociocultural threats aren’t real, or that being worried and anxious and sad about them is wrong. I’m saying that any black and white belief about the world is almost always wrong (I say “almost” because if I didn’t, I’d be engaging in black and while thinking!). And that when we engage in black and white thinking, it often leads to us ignoring other, more nuanced information that might help us make better or more helpful decisions. If someone thinks, “things are terrible and there is nothing I can do,” they won’t do anything. But if someone thinks, “things are terrible, but I can vote/donate/volunteer/run for office/protest/etc,” they might do something that makes a difference (and might feel more hopeful and have a sense of purpose, both of which can really help with mental health). So considering whether your beliefs are fact-based, and then, whether they are helpful, is a really important therapeutic strategy.

But let’s also think beyond CBT. Sometimes people’s beliefs are totally rationale and there is no need to examine evidence. (Alternatively, sometimes people’s beliefs are not rationale but it won’t be helpful to examine the evidence.) Grief  and loss is often a good example of this. Trauma can also often fit into this (although not always, which is why nearly all evidence-based trauma therapies include examining thoughts).

When that’s the case, other approaches, like Acceptance and Commitment Therapy (ACT), can be really helpful. I think sometimes people think of evidence-based therapies or manualized therapies as being totally divorced from existential or meaning-focused questioning. CBT can actually do a great job of integrating those sorts of things too- like above, you can totally use CBT to delve into a question like, ‘what makes a life worth living?’ But ACT is developed with a specific orientation towards value-based living. The question the ACT might help someone answer is, ‘what are my values and how can I live my life in accordance with those values?’ The idea is that people experience less distress and feel more fulfilled when their actions are congruent with their values. That approach might lead the client from that post into a direction like: how can I use my values to integrate more meaning into my life, so that I don’t feel like my life is pointless?

Another thing that ACT does that can be hugely beneficial is to help people accept thoughts and create distance from them, instead of feeling so attached to thoughts. The central (VERY simplified) concept in ACT is that we as humans tend to see thoughts are core aspects of ourselves- innately meaningful and emblematic of our identities and truths, but that this is not actually true, and over-attachment to thoughts can be distressing and ultimately harmful. So creating that distance, and seeing a thought as just a thought, can help people feel less trapped in those thoughts and more able to take value-based action. In this case that might be having thoughts about life being pointless, or the rise of fascism being unstoppable and personally or universally fatal, and continuing to move forward and engage in meaningful action. So while in CBT, we often want to change unhelpful thoughts, in ACT we want to leave them as they are, but be less attached to them and less motivated to action by them.

There are other approaches that I haven’t touched on, but I’m realizing how hugely long this post is.

So my point is: therapy is not just for minor issues or irrational thinking. Therapy can help a person tackle existential questions, tangible sociocultural threats, and other big, real issues. Is it perfect at this? No. Is therapy able to stop climate change or turn the political tide? No. Can therapy always fix individual level experiences of sociocultural threats, like poverty or bigotry? No. 

But: can therapy help people navigate overwhelming, difficult, tragic, traumatizing experiences? Yes. Can therapy help people feel more empowered to take the actions that are available to them within that sociocultural context? Yes. Can therapy help people feel less distressed and more able to pursue the life they want? Yes. Can therapy sometimes even help people change or fix those individual experiences of sociocultural threats? Yes, particularly when we’re talking about things like getting housing, disability payments, and other community supports and access.

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[secretbloggerme]

An Addicts Reality

I would like to take a little time to discuss addictions. The reason I chose this topic is because I can relate. Hello, my name is Kassandra and I was once an addict. My drug of choice was Crystal Meth. I grew up with an addict, always considered one of the “guys”, so I was around a lot at an early age. My first hit was given to me by my father at the age of 14. Prior to that, I was sent to score for him as well as a couple others in the family at the age of 12. My first beer was given to me at the age of 9. So, as you can see, it was not a choice I made on my own. I was raised in a different lifestyle, until my mother finally was able to leave and escape the abuse. There are a few things I would like for people to understand. First of many is about rehabilitation centers that are there to assist those who cannot get cleaned on their own. In addition, I would also like to touch basis on the importance of family. Also, I would also like mention the counseling that is also provided for situations like this. People can be so judgmental of addicts they see or come across, rather than trying to understand the circumstances. 

Rehabilitation centers aren’t all what they seem to be. I cannot speak for others, but I am speaking from my experience. The most frightening of all when entering is being able to get through all the pain that comes along with it emotionally, physically, as well as mentally. My worst pain I had to endure was the body aches, the cold sweats, and not being able to drop a bowl movement for 1 week and a half. Also, I was not eating for approximately 8 months, besides alcohol and the drug of choice. To having to endure all the emotions at once with all the past trauma that I will not speak of. Not only emotionally, but to mentally be able to be stabled enough to deal and confront my issues was also something that I struggled with until this day because I was taught by my father emotions were a sign of weakness; currently, I have a challenging time with my girlfriend speaking of what I feel; yet I can write it down, which is not the greatest, yet it is an effort. Finally, my biggest issue I had was being able to keep my sobriety. Not many know that the most drugs you can get or that are the fastest to find is in rehab itself. That is how after almost making it a month, I relapsed; because another member had it in hand and offered it to me and many others. As an editorial staff states, ( Hardy was ordered to go to rehab by the court after a string of run-ins with the law. We’re told the staff at the rehab got suspicious of Hardy’s behavior on Friday and gave him a breathalyzer test on the spot... which he failed). So, it is not exactly the most resourceful-but in all reality what is?

In addition, I would like to discuss the importance of family. Not many realize that deserting someone that is struggling with addictions, in my opinion, really shows the fear of being unloved is becoming a reality. For instance, Kristina Murray, an author, who writes about the importance of family roles in sobriety also states;” Despite seeing a loved one struggle, family members can and ideally do play a major role in the treatment process.” When I was going through my tough time, the words I got from my mother was and I quote, “ I will not have a drug addict as a daughter” and from there I was on my own. Not ever trying to understand as to why or even bother to ask how it happened, but in our family, we never speak emotionally so to grow up with no affection also was not beneficial. When I was on my own is when I had met my ex-wife, who was the one who reached out to my mother, who then decided to assist me.So, if it wasn’t for my ex-wife, my mother would have never known much about what i have been through. I do also understand that you cannot help someone who is not willing to help themselves. I also tried to talk to my father about becoming sober, but it has not happened until this day. Even if he is not ready to become sober, I will never stop being there, even if it’s to buy him food, clothes, shoes, blankets etc. Family support goes a long way to show affection, to be able to have that one-on-one talk because you get them to think beyond the front they try to impose. Tough love does not work for everybody, but I can admit, it gave me some thick skin. I have also met women who were not working for the greatest job in the world, as well as men who even served this country, and being able to hear and listen to their stories also was an eye opener for me, it made me that much more of a genuine person.

Also, I would also like to mention the counseling that is provided for situations like this. I can agree this can help some people; as for me, it was not much helpful. Take into consideration, I have done counseling most of my entire life, it just reminds me of my past trauma, but at the same time, I finally was okay with it. Meaning what i went through, I see it as normal every woman goes through it; but for my counselors they see me as crazy, and not a normal person, because I am content with my trauma. They have all told me the same thing you will never forget but you will learn to let go. Since I have let go, I think it is normal they assume I am not mentally stable. I believe I am stabled and I have let go, but with the outcome of my traumas my anger built, my mindset changed, my personality has been destroyed, and now I am serious, observant, and my trust is broken. I keep myself away from family because they do not like how I have become. They do not understand I am in this situation because I have protected them since I was young. So out of all the counseling I have done, all it has done to me is remind me of all the pain I have been through and had me continue to be so closed in from everything, as well as everyone even to be able to move forward. I will have to go back to counseling once again just to be able to transfer my medication from Arizona to California. Counseling really in my opinion is not the best source because all I am doing is re-living my traumas which is not the best way to live your life. But again, what can one do, when the medication keeps your mind at ease and it makes you live as normal as it can get for you? Therefore, I do my best to avoid counseling for the reason being the whole reason for my addiction was to cover my emotions, hide away a pain that is unforgettable, and to be able to continue and move forward with my life. As Kate Anderson, B Sc. author of tech-based delivery of CBT shows promise for alcohol use treatment states, “ Cognitive behavioral therapy (CBT) focuses on challenging unhelpful thoughts and behaviors, and is proven treatment for alcohol disorder.” Not only is counseling like an alarm clock but a goos percentage of the counselors have also once been an addict. I have worked in a prison facilities where we have had counselors compromised by these inmates and have brought drugs into the facility for them. So how is one to know that your counselor is trustworthy of hearing your most silent pain? There is a saying “ once an addict always an addict” with the reason being that it is a lifelong battle and you can relapse at any given moment. 

In all reality, people that have not been through addiction should not be so judgmental. It does matter if you have seen a loved one, a friend, ex co-worker through addiction; you will never be able to understand it unless you have been through it yourself. I have had many people around me speak ill of them and degrade them that enough is enough. All this talk about removing the homeless is in my opinion ignorant. I have fed the less fortunate, I have met amazing people when I went to feed the homeless. Yes, addiction is a disease as well as STDS, HIV, and AIDS, but do people stop having sexual relationships? Now that I am also in this position of going place to place or even motels I can minus the addiction, I am still grateful enough to push forward and to continue my sobriety, because it is one of the hardest things to overcome in a city full of it. The day I began working in Corrections I made a vow to myself to be honest. So, May 9th of 2016, during mt academy, I had spoken to my Sergeant and advised her I  that I have only been clean for 2 months and if I ever doubt myself in turning anything in is the day I will quite because a job is not worth losing my sobriety and she respected that. So, the next time you think to yourself about rehabilitation centers, or family,as well as counseling, understand that it is not always best for everyone.It is easier said then done hearing it from someone who knows nothing about it or even lived it. So instead of judging them, why not assist them with food clothing, or even see how there day is going?

Written by: Myself 

Based on real life experiences 

[curatedjournal-blog]

World Mental Health Day - Some thoughts for students

So, likelihood is you’ve seen these before or they don’t matter/apply to you BUT in the off chance that you may need to hear it today, tomorrow, yesterday or 5 years from now let me tell you a few things about self-care and dealing with ill mental health not just as a student but as a human being.

DISCLAIMER/WARNING: I have been on and off depression and anxiety meds for the past 5+ years, have been through counselling, CBT, you name it. Also, some of this may be TRIGGERING so please be kind to yourself and stop/don’t start reading it if it feels wrong or painful. Also, these are as much for me as they are for others so there’s that...

1. YOU ARE NOT ALONE. Sadly, all around the world, ill mental health is misunderstood, mocked and disregarded by many. Sometimes you may not be able to find support in your family or friends. Often not because they don’t want to support you but because they don’t understand what you are going through. However, there are multitudes of online and offline communities that can help for free and with no strings attached (I don’t want to recommend any service in particular for personal reasons but Google

can be a great friend in these cases. Also, your school/uni often has free psychological support for students).

2. Stress and anxiety are more common among students than you think. The pressure can be awful and it comes from all sides - family, money, professors, yourself. It sucks. Which is why you NEED to...

3. TAKE CARE OF YOURSELF. Dude, self-care is everywhere these days. In a way, it almost lost it’s meaning! What is it really? Going on a shopping spree? Having a spa day? Exercising? Eating your favourite snack? Watching an episode of your fave show? All of the above? Well...

4. ONE SIZE DOESN’T FIT ALL. For me self-care is not binge watching Netflix as a way to avoid my to-dos, not letting shit accumulate, staying moderately on top of things and not kicking myself in the ass if I don’t. It’s also practicing kundalini yoga as OFTEN as I REMEMBER, journalling WHEN I feel like it, engaging in a hobby for 5 MINS to take my head of things, cooking a healthy meal IF I have time, etc.

5. SELF-CARE DOESN’T HAVE TO COST MONEY. Students are broke, we ain’t got no money (or time) for expensive massages and weekend yoga retreats. There’s so many free stuff that DOES NOT REQUIRE A SUBSCRIPTION which you can engage in to help you relax. Find a free exhibition to visit on a weekend, go to the local library and read a couple of soothing poems, go for a walk in the park (I’m a big believer in FOREST THERAPY). Also, if that’s your thing, youtube has LOTS of free self-care content: yoga classes, guided meditations, tips, soothing music...

6. If you’re STUCK IN A RUT, motivation doesn’t come, you can’t face leaving your bed because you fear something awful will happen well, I’m sorry but I’ll give you some tough love... Motivation won’t come. You have to do the thing even if you don’t feel

like it or are scared to do it. Likelihood is it’s not that big of a deal once you get started so... Take the first step (also, look into BEHAVIOURAL ACTIVATION a tried and true CBT technique).

7. EAT ONE FROG A DAY. You know that awful, anxiety inducing shit task you’ve been post-poning for ages that lingers in the back of your mind, eating at you and your sanity, neuron by neuron? Just get it over with. It won’t get any easier to do so may as well do it now and at least you can tick one off.

8. Frogs come in every size and SMALL WINS ARE IMPORTANT. Maybe your frog is making your bed in the morning or getting up before 7am or doing the dishes. Small victories accumulate and will make you feel accomplished step by step, no matter how small that step is. This can REALLY IMPROVE YOUR MOOD. Also, small frogs can easily become major frogs the more you put them off.

9. If it applies to you, TAKE YOUR MEDS and REMEMBER YOUR REPEAT PRESCRIPTIONS. Many times have I forgotten to take mine or reorder them to then feel like shit and completely useless for a week. What works for me may not work for you but here are my tips anyway - keep a water bottle and your meds by your bed next to your alarm clock/phone so you take them first thing when you wake up. Keep some extra meds in your bag so that IF you forget to take them then you have them with you and can easily get on top of it as soon as you realise.

10. KEEP HYDRATED. Honestly, I get majorly moody if I haven’t been drinking enough and it’s good for you eiter way so, do it!

11. BE ACCOUNTABLE. Find a buddy to help you keep in check (if you don’t have regular medical appointments or therapy sessions). Someone who you can talk to about how things are going or share experiences. Hey, I’m here if you’re desperate for a bud!

12. TRY TO DEVELOP AND KEEP A ROUTINE. Developing new habits takes a lot of effort and time. So it’s gonna be hard and you’ll feel like you want to give up and just hide under your covers (again, I speak from experience). Try and visualise what you’d like your daily routine to be - write it down, monitor it daily and if you fail try again...

13. TOMORROW IS A NEW DAY and a new chance to do things better. Try again and again until you succeed. And don’t beat yourself up everytime things don’t go exactly the way you want them to...

14. FOCUS ON POSITIVES. Remember those small wins? Write them down at the end of the day (or simply go over them in your mind). Keep a gratitude journal - as cliche as it sounds, remembering the good things at the end of a shit day will help you go to bed on a good note. I once heard of a lady who kept a journal where she only wrote positive things - all the negative crap she left out - I think that’s a great idea and something I am eager to try.

15. DECLUTTER FOR 5 MINS EACH DAY. A clean space makes for a clean mind. I always feel more anxious and moody if my space is messy.

16. EMBRACING MINIMALISM CAN HELP. Having lots of things doesn’t equal happiness or peace of mind. Lots of things create clutter and chaos and, in my case, mind clutter and anxiety.... which is why I’m currently actively trying to be more conscious about my possessions and purchases.

17. LEARN TO SAY NO. A lot of students in this community are perfectionists, overachieving, ambitious young people. It’s very easy to be seduced by cool opportunities, collabs, requests, invitations... Think twice before saying yes - can you realistically do what you are agreeing to? Will it contribute to your anxiety? Will it truly be beneficial for you? Be a bit selfish if you have to. It’s okay to focus on your wellbeing.

18. DON’T LET IMPOSTER SYNDROME TAKE THE REIGNS. We’ve all been there: I don’t deserve this, I’m not good enough, everyone else is smarter, I CAN’T DO THIS. Yes you can! Tell that voice to shut up. Say it in front of the mirror everyday: I AM ENOUGH AND I CAN DO THIS.

19. BREAK THINGS DOWN. Instead of writing on your to do list “clean bedroom”, break it down into as small tasks as possible: “pick up clothes from floor”, “change bedding”, “organise books”, “dust surfaces”, “vacuum”, etc.

20. ASK FOR HELP. I end it as I begun it. When it gets too hard, reach out. Whether it’s a close friend or an anonymous support line you don’t have to go through it alone. AND MORE IMPORTANTLY, YOUR LIFE MATTERS.

YOU ARE UNIQUE AND AMAZING AND YOU HAVE SO MUCH TO OFFER.

[mental-health-advice]

I’ve had depression episodes for 11 years now, they go away eventually but not before I’ve failed everything because I spend my days using all my energy on exercising and making healthy food and I’m in so much pain and sadness that I’m distracted and unfocused and every little bit of outside world knocks my train of thought. Nothing has helped prevent or treat depression episodes, I’ve come a long way with panic disorder but depression comes back time and again and I don’t know what to do. (66)

Hey lovely,

I’m sorry to hear that this has been going on for such a long time already! I can imagine it really brings down your spirits when you keep getting knocked down by those depressive episodes over and over again. It’s so great that you’ve come such a long way with your panic disorder already though! I’m so proud of you!! 

I hope you don’t mind me asking this, but what have you tried so far regarding preventing and treating depressive episodes? I’m asking because I have a couple suggestions but I don’t want to bring something up when you’ve tried it already. I will still write my suggestions in this answer (as you’ve waited long enough) but I apologise if you’ve tried those and it didn’t work out. I definitely do hope at least some of my suggestions will be things you haven’t tried yet and that something will work for you! 

First of all, there’s the option of medication. Even if you’ve tried medication before and it didn’t work, that doesn’t mean that no medication at all will work! There are different groups of medications, each group working a little differently. Than within those groups there also are a few different medications you could try. Even though they tend to work in the same way, it’s possible that one medication on group A doesn’t work for you and another medication in group A does. You won’t really be able to know whether something works unless you’ve given it a try. Everyone has different experiences with meds, and every person reacts differently to them. So it really is a process of trial and error. Once you’ve found a medication that seems to work, you can work with your psychiatrist until you find the right dosage. It’s also possible to work up towards a couple of medications together. Note that this should all be done only under the supervision of a psychiatrist and to only take (or stop taking) medications that are prescribed by them. Another important factor is what to do when your depressive episode goes away. At those times it’s tempting to wean off your medication, but that might mean that another depressive episode will present itself in time and we want to prevent that from happening! So instead, it might be better to continue to stay on the medication so that such episodes might be prevented. This is also something to discuss with a psychiatrist though.

Then there is therapy, which you might have tried already as well. However, there are many different forms of therapy, each one helping in a different way. I’ve been in therapy for the past nine years now and there have been a lot of times where I felt it just wasn’t helping. I usually then came to the conclusion that it was hopeless anyway and that I’d always be struggling as much. But I now realise that the therapy I was receiving simply wasn’t the kind of therapy that could help me. Another factor was that I wasn’t always ready for such therapy. I did a training for emotion regulation years ago and while I learned a lot from it rationally, I couldn’t use the skills to better regulate my emotions. Instead I kept falling back on my destructive behaviours. But I’m currently working a lot on not using those destructive behaviours and now I am actually trying to use the skills I learned in that training. Basically there are two things to ask yourself; 1) Have I tried every different form of therapy? and 2) When I tried a form of therapy, was I ready to actually give my everything and work really hard? If the answer to the second question is no, then it could be beneficial to try out that form of therapy another time.Often when starting therapy, it’s counselling or ‘regular talking therapy’ where you talk about anything that’s bothering you. Another common therapy is CBT (Cognitive Behavioural Therapy) where you work on challenging your thoughts and coming up with more rational ones, trying to listen more to those than to your negative thoughts. But there’s also DBT (Dialectical Behavioural Therapy) where you learn a lot of skills that can help with different issues, such as emotion regulation, mindfulness, interpersonal relations and distress tolerance. There’s MBT (Mindfulness Based Therapy) where you learn to become more mindful and not act as much on your impulses. There’s schema therapy, which is based on the idea that we all have different modi, each modus representing something. All your actions and thoughts and feelings come from a certain modus and the key is to gain insight in which modus causes what and then learning how to use other modi to act, think and feel differently. I’ve done bits of this with my therapist and I personally found it really helpful! These are all forms of talking therapy, but there’s also EMDR (Eye Movement Desensitisation and Reprocessing, a form of trauma therapy that helps to reduce the emotions that certain memories can bring up), art therapy, psychomotor therapy, equine therapy, hypnotherapy, etc. You can also read more about different forms of therapy on our page on getting help.

Aside from trying out other forms of therapy, it’s also possible that you need a more intense form. For example, schema therapy might help you a little when you have weekly individual sessions but it’s not quite enough. Then it could be a good option to do an intensive outpatient program (IOP) where you have a (couple) day(s) of following therapy (usually in group as well as an individual session occasionally) or get into residential treatment where you stay the whole week in a clinical setting (sometimes with weekends home) following therapy every day as well as having other sessions where you focus on other factors (for example a group where you work on building up your life for when you get out of residential so that you don’t fall in a black hole when you do). 

I hope that you can do something with these suggestions! Unrelated to all this, it’s always important to have a solid support network that you can fall back on when needed. Do you have such a support network? If not, it might be good to look into how you can build this up. Is there a friend, family member, or other trusted adult that you could reach out to? You don’t have to do this all by yourself! I’d also strongly recommend you to talk through your different options ( / the suggestions I gave) with someone. It can get a lot when you have to think it through all in your head and talking it through with someone can help clarify it and give you an idea of what a good step to take is. I hope this helped though!

Sometimes what seems impossible, is just hard.Love Pauline

[vulnera3sanentur-blog]

The Very Best 10 of How to find Psychologist

Should you be in the process of choosing a psychologist, how should you begin causeing this to be choice?

psychologist prague

Choosing the best psychologist may be a overwhelming project particularly in Quebec and then there are over 7500 registered psychologists. Moreover, Quebec provides a disproportionate number of psychologists when compared with other provinces making your pursuit even more tough (practically 50Per cent of all the psychologists in Canada are authorized in Quebec).

What in the event you consider when searching for a psychologist? What tactic is it advisable to consider? Is the particular education and software critical? These are very important issues to take into consideration when looking for a reliable specialized that may help you. Luckily, listed below are a set of guidelines will assist you in making your choice. Here are the very best 10 aspects you must look for and give some thought to determined by my skilled view and what my consumers have stated have already been the most crucial components on their behalf.

1. Be sure the professional you are looking for is a accredited psychologist. You may have encounter conditions for example 'therapist' or 'psychotherapist' and instantly imagine they are a psychologist. Nonetheless, this is simply not essentially the way it is. On the whole, anybody in Quebec, even people that have no experience in psychological overall health, can call their selves a therapist or psychotherapist, and claim to training psychotherapy. Nonetheless, with current adjustments in the law, psychotherapy are only able to be practiced by the particular person authorized with l'Ordre des psychologues du Quebec (OPQ) or the Higher education des medecins du Quebec.

2. Ensure that they have a degree in Clinical Mindset. Psychologists are educated to tackle troubles utilizing clinically-validated therapy methodologies. Even though industry experts with some other qualifications might be valuable, you may never want a person to just guide or advise you by supplying commonly used assistance when you really need help with an recognizable mental dilemma that may be impacting your lifetime.

3. Reliability. Request additional references. Will they are employed in personal apply only or maybe in a medical facility configurations likewise? Psychologists who function in nursing homes tend to be powerful, instruct learners that will grow to be potential future psychologists and therefore are in linked to dealing with essential analysis concerns that could move forward the realm of mindset. Will they be looked for with the media because of their skills? Will they be interviewed for judgment about critical problems? If an specialist is preferred, it will always be a sign they are possibly an experienced and trustworthy professional.

4. Make sure to decide on a psychologist having a PhD or doctorate. In the past, simply a Master's college degree was needed to process being a psychologist in Quebec. Having said that, recently there were changes on the laws which require a PhD. Obtaining a doctorate in Medical Psychology usually requires at the very least 5 extra numerous years of teaching, experience and monitored apply with a licensed psychologist, while a Master's diploma can be completed inside of one full year. This is not to state that someone which has a Master's education is probably not an effective in shape for you. Nevertheless, because your emotional wellness is very important for you, you almost certainly wish to opt for anyone who has received more comprehensive monitored training.

5. What tactic ought i use? In seeking support for any issues that are interfering with your way of life, you would like to optimize your enhancements with remedy that works well in the quickest time feasible. Although there is overlap with various kinds of therapies, Process Pushes from both the Canadian and American Psychological Associations have validated that Intellectual Actions Therapies, or CBT for short, has received the most technological help and support. In my opinion, go along with the strategy that scientific research indicates functions.

6. When a psychologist promises to use CBT they must be analyzing improvement. A crucial element of CBT is measuring treatment method effects with consistent and targets questionnaires to evaluate cure efficiency. Research has shown us that tracking this kind of improvements increases success in therapies. Numerous psychologists will say they exercise CBT, so how will you start verifying their claim that they normally use CBT? Ways to test out for your psychologist's fidelity to CBT is to find out should they will measure results with you. Just question them what questionnaires they will likely use to track the gains you achieve. If they cannot recognize any list of questions, you need to question whether they really do practice CBT.

7. Look at to be certain anyone is usually a listed psychologist according to the OPQ by referring with.The OPQ was proven with the Government of Quebec in order to protect everyone when seeking mental solutions. By way of a rigorous evaluation method, the OPQ ensures that a person has got the necessary accreditations and practical experience to be a registered professional medical psychologist. In case you are in another province or express, always get hold of your nearby professional order that permits psychologists in your town.

8. Does a person profit your phone calls promptly? Getting in a situation that you are asking for help, a brief come back call is a superb signal with the responsibility with the specialized. Would you feel should you be seeking aid and you also only receive a get in touch with back days or weeks down the road? Can this make you feel like the individual can be trustworthy? When somebody foliage us a information, I place their call up very seriously, even when it is just for details or perhaps a request for solutions. I return their call up within just 24hrs. I think, this needs to be the norm in a being able to help career and is also the common that my clientele have appreciated.

9. Level of comfort. In talking with a psychologist initially, assess your feelings. Are you at ease with them? Is the person well mannered? Would they listen to you and respond to questions? Be sure to think about you gut instinct immediately after the first exposure to anybody.

10. The alliance between you and your psychologist is a essential element. Research has shown the extremely helpful alliance is the perfect predictor of success in therapy. A restorative alliance is called a relationship when the psychologist is true, warm and also has empathy. Following your first achieving, how do you sense? Were you at ease with them? If your psychologist complies with these a few standards depending on you, you almost certainly have a very good match.

To conclude, choosing the right psychologist is essential element in recovering from the challenges that you are facing. I hope you will find these Leading 10 rules beneficial while searching!

[little-blacky-blog]

The Very Best 10 of Where to find a Psychologist

For anyone who is in the process of deciding on a psychologist, how should you go about making this decision?

psychologist prague

Finding the right psychologist may be a difficult undertaking specifically in Quebec where there have ended 7500 registered psychologists. Furthermore, Quebec has a disproportionate variety of psychologists in comparison to other provinces creating your research much more complicated (pretty much 50Per cent of most psychologists in Canada are authorized in Quebec).

What should you consider when searching for a psychologist? What strategy is it advisable to think about? Is the particular education and system critical? These are typically very important queries to consider when looking for a dependable skilled that may help you. Luckily, the following are a couple of recommendations you can use to help you make your option. Allow me to share the highest 10 elements you need to look for and think about based on my specialist thoughts and opinions and what my customers have explained are the most crucial variables for the kids.1. Make sure the professional you are considering is really a licensed psychologist. Maybe you have run into terms and conditions such as 'therapist' or 'psychotherapist' and automatically feel they may be a psychologist. Nonetheless, this is not actually the situation. Generally, any person in Quebec, even people with no experience in mental wellness, can get in touch with them selves a counselor or psychotherapist, and state they practice psychotherapy. Nonetheless, with the latest adjustments in legislation, psychotherapy is only able to be practiced by a individual recorded with l'Ordre des psychologues du Quebec (OPQ) or the Higher education des medecins du Quebec.2. Make sure these people have a level in Professional medical Psychology. Psychologists are educated to address issues utilizing medically-validated cure standards. Even though specialists along with other degrees could be helpful, you almost certainly tend not to want someone to just manual or counsel you through providing general advice when you really need help with an recognizable emotional difficulty which is impacting on your lifetime.3. Credibility. Demand further references. Can they operate in exclusive training only or possibly in a medical center configurations as well? Psychologists who are employed in medical centers tend to be vibrant, instruct students who can grow to be potential future psychologists and are also in involved with dealing with crucial study inquiries that will improve the realm of mindset. Is it sought-after through the press for their skills? Will they be interviewed for their thoughts and opinions about crucial troubles? If the expert is popular, it is almost always a signal these are probably a knowledgeable and dependable specialist.4. Make sure you decide on a psychologist having a PhD or doctorate. Previously, just a Master's degree was necessary to apply as being a psychologist in Quebec. Nevertheless, just recently we have seen improvements on the regulation which need a PhD. Finding a doctorate in Specialized medical Mindset normally consists of at the least 5 various extra many years of coaching, expertise and supervised practice by the licensed psychologist, whilst a Master's education might be carried out within one full year. This is not to say that someone with a Master's diploma may not be an effective match to suit your needs. Even so, since your subconscious health is important to you personally, you most likely desire to opt for somebody who has got far more comprehensive monitored instruction.5. What tactic ought i use? In seeking aid for the things that are disturbing your lifestyle, you need to increase your improvements with therapies that operates within the quickest time probable. While there is overlap with many types of therapy, Process Makes from your Canadian and Us Subconscious Associations have validated that Intellectual Conduct Treatment method, or CBT for brief, has brought essentially the most technological help and support. For me, select the strategy that scientific discipline has revealed will work.6. If your psychologist states to use CBT they should be examining development. An important element of CBT is measuring remedy benefits with consistent and aims questionnaires to observe cure effectiveness. Research has revealed us that keeping track of this sort of adjustments raises accomplishment in treatment. Numerous psychologists will say they exercise CBT, so how will you go about making sure their say that they will use CBT? An effective way to test out for a psychologist's fidelity to CBT is to find out should they will determine results to you. Simply just inquire further what questionnaires they will likely use to track the results you accomplish. Should they could not establish any set of questions, it is best to problem whether they do practice CBT.7. Verify to ensure the individual is really a listed psychologist according to the OPQ by talking to.The OPQ was proven by the Authorities of Quebec in order to safeguard consumers when seeking out mental services. Using a extensive assessment method, the OPQ means that somebody offers the important expertise and experience to become licensed specialized medical psychologist. In case you are in one more province or condition, make sure to speak to your community specialist obtain that permits psychologists in your neighborhood.8. Does the individual returning your messages or calls instantly? Simply being in a situation that you are seeking support, an easy returning telephone call is an effective sign of the dedication from the skilled. How would you truly feel for anyone who is requesting help and you only obtain a contact rear days or even weeks in the future? Performs this have you feeling much like the person could be trustworthy? When an individual makes me a meaning, I place their call really, even after it is simply for information and facts or maybe a request for information. I returning their phone inside of 24hrs. In my view, this ought to be the standard in a assisting occupation and is also the regular that my clients have loved.9. Level of comfort. In talking to a psychologist the first time, determine your feelings. Do you find yourself at ease with them? Would be the particular person considerate? Can they listen to you and also respond to questions? Always think about you gut intuition immediately after the first contact with anyone.10. The alliance involving you and your psychologist is a important factor. Research shows how the beneficial alliance is the greatest forecaster of results in therapies. A therapeutic alliance is known as a relationship in which the psychologist is genuine, hot and possesses sympathy. Right after your first conference, how does one truly feel? Were actually you more comfortable with them? When the psychologist meets these about three key elements depending on you, you may have a very good in shape.To conclude, deciding on the best psychologist is essential aspect in recovering from the difficulties you happen to be facing. I really hope you will see these Top 10 regulations practical in your search!

[adaptform]

Not so much Lost in the System but…

Mid-November 2015 I hesitantly pick up my phone and text a friend asking if it’s ok to ring. A positive reply is received. I pause…  With a growing sense of dread I press to ring and slowly lift my phone to my ear. The dull trills seem to last a lifetime as I wait for an answer. This phone-call signalled to my friend that things were not as they should be; a deteriorating state of mental health which had seemingly come from nowhere. Incoherent explanations of my thoughts were naturally met with confusion and I wouldn’t even talk in detail about what was happening because I was so scared of what would be thought of me, what others would then say about me. A feeling that has not left me.  

December 2015 I go to a GP. The system where I live in theory is meant to make it easy for someone to get an appointment by offering times at different surgeries if one venue is fully booked. It does not make it easier… after numerous phone-calls on the mornings of numerous days I finally get to see someone. I take time out of work secretly to drive about 30 mins to the GP. It’s busy and uncomfortably warm which does not calm my growing anxiety. They are running about 40 mins late. All I can think is that I should be back before the next hour strikes to finish the work I had left to be here. As this deadline passes more worry, more heat, and I’m surrounded by sick old people. My name gets called. I am rushed into a room. I am rushed to speak. I do not know how I am meant to speak about this at all let alone quickly. However with previous experience of mental health difficulties at least I have a starting point unlike some people in similar positions. I am given some leaflets… I am told there are some groups that offer support but also after hearing what I have said the GP says words to the effect of “but it doesn’t sound like a group environment will be beneficial to you”. End of appointment. All I want is to speak to someone one to one but after this I feel totally discouraged from speaking to anyone at all. I’ve spent so long waiting that I rush home to try and finish work. I make my excuses about why I haven’t been able to.

March-ish 2016 I am encouraged to go back to a GP. I go to a different practice and see a wonderful nurse who not only listened to me but directed me to clarify what exactly it is I am feeling, as best as I could. She gives me some leaflets. Then tells me I have to go to the surgery I had previously visited to see a mental health link worker. At this point all I can think is that I hope it is not the same person as I saw previously…

I go back to the one place I don’t want to be… I see the mental health link worker (who is thankfully not the person who had no time for me). They essentially repeat everything the nurse had said, also admitting the mental health services in this part of the country are not adequate, not meeting the demand of the service and that waiting is inevitable. She then tells me the main point of entry is the Suffolk Wellbeing service which adopts a self-referral process. This is the first time I hear the words “self-referral”. Why didn’t anyone else tell me this before??? Months wasted… If I had known then I wouldn’t have had to even go to a GP… frustrated and feeling pretty f***ing worthless I head home. The next day I refer myself to Suffolk Wellbeing…

At this stage about 2 people know I have referred myself.

I wait for a fortnight for a letter to come through the post. I then wait for a phone-call about having a phone assessment to help decide what kind of support I could get from the service. A phone assessment is booked. I wait about a month for this to happen.

I have a phone assessment. I still do not feel confident in finding the words to coherently speak about how I feel. It’s a clunky call, me speaking myself into circles while questions try to clarify my standing. The phone-call turned out to be a relevancy test. Assessing whether it is appropriate for me to use the service. Although asked about what support I think I need – someone to speak to, I just want someone to talk to! – everyone is made to go through a series of lectures referring to mental health. I am told about a series of lectures under the title of ‘Stress Control’. Even those words are generalised. I am told in order to access any further support I must attend these. I am then told the next set of lectures is in September 2016. If my situation deteriorates in this gap i am encouraged to contact my GP. And I think we can all agree that I won’t be doing that.

Typically I miss the first lecture as I was abroad. I attend the rest. For each lecture you are asked to fill out a questionnaire to assess your levels of anxiety and depression. It was late last year that I found out these were written by drugs companies, which explains why all the words used in the questionnaire are all so doom and gloom. They are geared up to signal that someone needs drugs not that they need support. There is a massive difference. Why this is an accepted method in understanding someone’s mental health in this capacity I fail to understand.

The lectures themselves have an audience of about 30 people so the content is diluted… heavily diluted. They mention processes and plans to figure out your vicious cycle and to rationalise your thoughts which is all fine. Fine if you don’t have a job or any sort of commitment so you could actually spend time doing it at the moment of anxiety or depressive moods. They of course also encourage making time in an evening or weekend to figure out thought processes. Each week little handbooks for each topic are given out to refer back to every generalised thing that is said at the lectures. I go through all the handbooks. I still have them and will again revisit. Mainly because what else am I meant to do?

(Side note: Lectures, in terms of someone’s interest in the topic is affected by the person leading the lecture, the person speaking at the front of the room. I suggest they review some of those speakers.)

At the end of the last lecture we are all told what happens next. We will receive a letter through the post. It will either state that judging from your questionnaires that it is not believed you require further support OR it invites you to request a review assessment.

I wait a couple of weeks for my letter.

It invites me to review if I so wish. Yeah I think I’ll do that. It take multiple attempts across a few days to get through to the service on the phone. Saturated is the word that comes to mind. And a review phone assessment is booked.

I wait for a letter to confirm.

November 2016 my phone assessment arrives and I again attempt to explain what it is I am feeling. The person on the phone tells me I have explained myself very well and really tries to give me the support she knows I need. She suggests a couple of options and then asks me to hold the line… she comes back with the option of seeing someone face to face for a CBT assessment. The seeing someone in a one on one situation was what I knew I needed from the beginning… I am told there will be a wait. Realistically I will be waiting until Feb 2017… My feelings of content after being listened to and feeling as if the person on the end of the phone went out of her way to help me was met with disillusionment. I know it is not their fault that I have to wait. They don’t have that sort of control over how the service they provide is implemented. They can only use the resources they have to provide the best possible support for the increasing influx of people with mental ill health. But reading this you can imagine how my frustration over all these gaps has by now turned into a reluctant acceptance and well I feel pretty bummed out…

Surprisingly come January I receive a letter in the post with an appointment date on in. It’s for that very same month!

I recently attended this session, one-to-one, face-to-face and because of it was able to talk openly about what I consider to be the problem, where I think it stems from and what I think will help. You can’t have that kind of interaction with someone over the phone or during a lecture. Because this system really enjoys circles the support which is then offered to me, as after all this was just another point of contact to direct me to another area of support, is group CBT. I have by this point already expressed my fear of group support, that I will not be able to address the things I need to with others there but after discussing all the options this was still the support thought to be most beneficial to me at this time. Upon leaving I feel a mixture of relief and well I just want to give up.

I am currently waiting for someone to tell me when this group CBT will begin.

I’ve been referred to Suffolk Wellbeing since March 2016. My first GP visit concerning this which I would still count as part of “the system” December 2015… It has been over a year since I sought professional help. I don’t exactly feel positive about the time I have been working through this process. You must agree this is not acceptable. Perhaps needless to say I do not have the money to pay for talking therapy or other types of support. I live in a village in Suffolk and in terms of professional help I am not even close to feeling like I am supported.

To reiterate Suffolk Wellbeing are not completely at fault here. There is a bigger issue to hand including the general awareness of what mental health is and the conditions referring to it as a result of mental ill health. There is no one model that will ensure that this experience is not replicated many times over. It is not something that can be rolled out nationally, it must be tailored at least regionally and again to the individuals using the service. The resource in this region is poor. I have had mental health first aid training to help others (yeah… I know right… others…) for both adults and young people, both tutors of those courses explained the state of mental health support structures in this country as poor. Theresa May in her grand Charity Commission speech focused on mental health. Her words were welcome but a significant number of mental health charities have voiced their concerns over the plans and unfortunately as is usually the case money has a lot to do with this. On the subject of charities it would be ignorant of me not to mention the growing number of organisations that exist to advise and help those with mental health issues. Time to Change, Mind, Young Minds, Blurt Foundation to name a few. And for a more creative take on it The Sad Ghost Club are a personal favourite. They make zines and other crafty bits all centred around mental health with the money they make from sales going towards workshops with young people to express their mental health creatively. There is a growing amount of online resources available.

I 100% do not want to discourage anyone from using the kind of service that I am still using especially if you are struggling with your mental health. These are the kinds of services that should be a go to and should address your needs genuinely and in a timely manner. I write about my experiences not to unjustly criticise but because more awareness is needed of both mental health conditions and the support structures that are in place.

As a final note try as hard as can to not fall silent. I have not included in the above the ongoing support I get from friends who I hope know how thankful I am for them being in my life. It has been difficult trying to explain my thoughts to those who have had no experience of anxiety and depression but if I didn’t say anything at all then my situation would deteriorate further. I am just sorry that they have equally had to spend this amount of time living alongside this.

[lalka-laski]

1 How often are you optimistic? I’m getting better at it. But my anxiety always has me leaning towards the worst case scenario.  2 Would you say your thoughts are generally rational and logical or irrational and illogical? See above about my anxiety^ Irrational is my middle name! But again, I’m getting better at it. I’ve done some intense personal work lately that helps me to challenge and reverse my negative thoughts.  3 Tell an interesting fact about your favorite country? I’m not so sure I have a favorite country 4 Are you wearing anything of any sentimental value? Describe? My claddagh ring from my mom and my promise ring from Glenn. 5 Are you the type to pay attention to detail? I fixate on the unassuming & unimportant details. So I might overlook something super obvious but zero in on something small and unnecessary. Another feature of my anxiety, I think. 

6 To you, what is especially distracting? E v e r y t h i n g.  7 What are some things that are important in your life right now? As I said before, the personal development I’ve been doing lately has proved incredibly beneficial and I only see it improving my life more and more. Most of the techniques I’m utilizing are CBT methods & I can’t believe I’ve never used this type of therapy before.  8 When was the last time you did some major cleaning? A couple weeks ago. I’m pretty neat & I’m a “clean as I go” person, so I never have to do one big major clean-up. Except after a depressive episode.  9 Have you ever thrown anything away, and regretted it later? Countless things.  1o Are you the type to regret things, or live and learn? I never seem to learn from my mistakes 11 How often do you feel like you need time to yourself? Quite often.  12 Do you like being around other people? Why is this? Friends & certain family members, of course. But the general public? Hard pass.  13 Do you feel like anyone “gets” you? Who? I think I’m a pretty transparent person so honestly, most people probably get me.

14 What would you be most likely to do with a friend, today? Well, Glenn & I are gonna go on a nice nature trail walk and then get some ice cream!  15 When are you most likely to be crabby? Anytime I’m woken up abruptly. This happens most often between 11-12:30 every night when my upstairs neighbors for some reason go on a stampede. It happens like clockwork and nothing enrages me more. It’s taken everything in me not to go beating down there door but one of these days...  16 How about upbeat and cheerful? I’m most upbeat when I feel relieved and anxiety-free. So usually the aftermath of an anxiety-inducing situation, when I’m reached a resolution, I’m BEAMING. That’s when I feel the best.  17 Who challenges you the most? In what way? Glenn is a strong contender for that. He notices features of myself that I try to hide or avoid & forces them into the light. This is a great thing for my personal growth but it can get uncomfortable. I’ve actually told him before that I can understand why a lot of his past relationships didn’t work out. People don’t want to confront the negative parts of themselves. (To be clear: he also COMPLETELY celebrates my positive traits & brings them to the surface. My point is that he recognizes me and understands me fully: the good, the bad, & everything in between. There is no hiding from him).  18 Who seems to hold you back? In what way? Myself, absolutely. I get too wrapped up in my own head, my own fantasies, my own absurd expectations & delusions.  19 What was the last opportunity that you passed up, and why? All that comes to mind was my coworker asking me to go for a drink after work yesterday. Part of me wanted to go, but an even bigger part of me desperately wanted to go home & take a long shower. Which I did. & it was glorious.  2o Would you rather have a quiet day at home, or be on the go? If I’m on the go doing fun things then I’d choose that option right now. I’ve had PLENTY of quiet days at home these past few months.  21 Do you think you made a good impression on the last person you met? The last person I met was probably a patient & I’m gonna say “yes.” I’m very friendly & cordial at work... patients seem to like me. 22 How do you feel about people who neglect their pets? Don’t have a fucking pet if you won’t properly care for it. Simple. People who neglect their pets are scum. 23 Should there be an application process for having children? In a perfect world, yes. But there’s no moral or practical way to do that & you certainly can’t stop people from getting pregnant. 

24 Are you able to ask for help when you need it? I’m very good at that, actually. I know that life is a team effort & I rely on others for plenty of things.  25 How intense is your anger? Have you ever hurt anyone|yourself? I get irritable and crabby but I’d hardly ever describe myself as “angry.” And I’ve certainly never hurt myself or anyone else as a result of those feelings.  26 What is something red that you like to eat? Baby Bel Cheese. Well, the packaging is red. I have no idea why that’s the first food that came to mind? I couldn’t have said fucking strawberries or apples or something normal?  27 Do you ever have trouble getting lighters to work? Very often, especially now because I don’t have my acrylic nails.  28. If someone drinks, would that lower your opinion of that person? I’m a frequent drinker so uh, no. Definitely not.  29 What if they did drugs? It’s never ever my place to judge 3o Do you know anyone who is abusive? Are you abusive? Um...can we like, not...? 32 If your best friend wanted to cheat on his/her partner, you would say? It’s never the answer. I’d advise him/her to break up with their partner & let them down gently if they really were interested in seeing other people.  33 Who do you know that gives very sound advice? My friends, my sisters, Glenn. And my therapist but that kinda goes without saying. 

34 What do you think makes a person weak? Dishonesty, abusing power, refusal to admit wrongdoing, refusal to admit/discuss emotions, the list goes on.  35 What makes a person strong? For the sake of the argument I’m just gonna say the exact opposite of everything I listed above  37 Name one thing that you think defines you as a person? Sensitivity  38 Who do you go to when you need comfort? Glenn, my friends, my parents, the angels I pray to 39 Is there anyone|thing with whom|which you like to cuddle? Actually not at the moment. I mean I *should* say Glenn but I’m not in a very cuddly mood right now. I’m too energized! 4o Do nightmares still bother you? Occasionally. But I don’t have the traditional type of nightmares. No monsters or ghosts or near-death experiences. My bad dreams are manifestations of my biggest insecurities & anxieties.  41 At what age did you start to feel like a teen, and not a kid anymore? 15 or 16 maybe? I felt like a bit of a late bloomer as compared to my friends.  42 Are you or were you in a hurry to grow up? Never. I’m still not. 43 What is a fear you have about living on your own? As much as I love living with Glenn, I enjoyed living on my own so much. And my apartment complex is in a safe area so I never felt uncomfortable or scared being alone. It has good vibes to it.  44 Do you have any survey-maker recommendations? If yes, who? Ha, no. I get majority of my surveys from the same girl’s Tumblr but she’s not the one who makes them. 45 Who was the last person to completely fascinate you? The author of the workbook I’m currently reading/doing... does he count?

[magical-bellybutton]

Below are some of my thoughts about Steven Universe Future that I have has thus far. If you enjoy reading long essays, this may interest you, or you may continue to scroll on. I am not bothered either way; I just wanted to write down what I was thinking and share it with others. 

This homeschool gem thing that Steven is doing is basically providing an opportunity to provide therapy and rehabilitation for all these gems. I don’t think it’s fair to simply dismiss this as Steven simply having a Savior complex (if that’s the case, using that same train of thought, perhaps doctors and psychologists and therapists should just stop doing their jobs because wanting to help people with the skills and resources they have is being a savior I guess [or maybe it’s just realizing one has some appropriate skills, experiences, and resources that would benefit other's well-being if shared...]). Personally, I think that little homeschool is a metaphor for therapy treatment (particularly talk and behavior therapy/counseling [such as CBT] aimed at underserved or traumatized populations perhaps) and the gems helping out at little homeschool are supposed to represent those volunteers and semi and professionals who are helping provide services to those who may need it. Steven, I believe, is how a new counselor/coordinator feels when they first start helping people, and I think there are several examples that serve to support this theory of little homeschool being a loosely veiled metaphor for therapy.

First, let us examine Steven in these episodes thus far. Steven, someone who has experienced a lot of things (some horribly traumatic-like the whole pink diamond/rose quartz arc- and some really lovely things-like having a supportive father and supportive gems like Pearl, Amethyst, and Garnet to help raise him and work things out along the way). Steven has a lot of authority being half diamond, and he chooses to use his authority to dismantle the rigid social caste system, end imperialism, and no longer exploit gems. He essentially relieves them of their duties they were born to do and encourages them to fulfill their lives in whatever way they want, provided that way is healthy and does not provide harm to others. However, after observing how hard this was for gems like Peridot and Lapis to do without some additional help from other gems who knew what it was like to adapt to life on earth and create a fulfilling life, Steven decides to pool the resources he has (an empty barn outside of town and gem friends with lots of experience working with other gems and helping them eventually healthy adjust to life outside a rigid social hierarchy) to help cooperatively create and run an opportunity for gems to navigate this new, unfamiliar life without strict outlined rules on what they should do and who they should be. Steven has a lot of ambition and has a horrible work-life balance as well as deep-seated trauma that he desperately needs help working through himself (some people working in the field of providing psychological have this, especially when they first start out). You can tell he means well, and I don’t think we should be quick to judge him without acknowledging that for every mistake he almost always learns from it by the end of the episode. This leads me to my next example, which is about one instance that Steven made a mistake and learned from it- Jasper.

Looking at Jasper, there are a number of things that jump out immediately as quite concerning from a physiological standpoint. For one, Jasper is refusing to live differently in this new society that has new roles and new rules. Jasper reacted to this huge change by isolating on the fringe of society. They are quick to violence when confronted and chooses isolation over change. One might see Steven asking Jasper if they want to join the homeschool thing as trying to force them to change when change is unneeded and interpret that as disrespecting Jasper’s wishes. However, self-imposed isolation and refusal to change isn’t a healthy long-term coping mechanism for anybody. While one may need time alone to process things, long term isolation is not a healthy coping mechanism, and neither is a fixed mindset. Self-imposed isolation is often a symptom of depression (or similar mental health disorders). Being around people is beneficial for people’s mental well-being (this is a fact and not up for debate-this is proven time and time again in various psychological studies and theories). Interacting with others helps can help people feel accepted, loved, and can help create a positive self-image. In addition, talking to others and being around others can help one work through what’s on their mind- one can verbalize what they’re feeling, they can sympathize with others who feel the same way which helps them realize that they are not alone in their struggle. It is alright for Jasper to need some time away from people, but long term-isolation is not healthy, especially accompanied by rumination and violence. Steven recognizes this and that’s perhaps one reason he asks Jasper seemingly again and again to give Little Homeschool a chance- like a friend trying to convince their friend that therapy can be helpful if they give it a try. It’s not so much that Steven is trying to change people who don’t need changing. Jasper does indeed need to change- they are living in a way that is not sustainable and it is not healthy for them (especially after everything Jasper has experienced - corruption and the end of gem society as they knew. That is a lot for anyone to handle and wrap their head around by themselves.) The way that Steven ultimately ends up approaching Jasper (ie engaging in battle) is not the healthiest way to do it (far from it). However, it is clear that Steven himself still has a lot to learn, especially in his technique for approaching others, and he is also attempting to meet Jasper on terms they are familiar with (using violence and proving physical strength). It also shows us that one needs to want to change in order to start to change and accept help and start practicing healthier habits, not have the change forced upon them at the wrong time when they are not ready for it. Jasper is not ready to change nor wants, and perhaps that is why they are not ready or willing to join the other gems at little homeschool. I think this fits well into the therapy metaphor, as this also applies to real people, not just gems- people need to come to want to become healthier and bring their own motivation to truly improve. It is not wrong to want to help others, but it has to be on the person’s own free-will to be the most effective.  I think one such example of someone that chooses to improve comes in the form of the Lapi.

Lapis Lazuli has a long and traumatic past-trapped in a mirror without a way to communicate for thousands of years, then thrown into an unhealthy fusion with a violent gem for months, then realizing their original purpose for creation is no longer needed, and they have to forge a new life on Earth. Lapis has been through a lot, and she has come so far. I think Lapis is a wonderful example to what happens when one is surrounded by those who support them, love them unconditionally, and help them in their journey to a healthier life. I think this can especially be seen in the episode where Lapis encounters the other two Lazulis who are terraforming the planet and destroying things. Lapis sees a lot of her old self in them, and she tries her best to use her experience to help the other two Lazulis realize that their destructive habits are not only harming others (the environment and other life forms in the way of their carnage) but are also harming themselves. Steven and Lapis do their best at first to simply show the other two Lazulis the positive and healthy alternatives that exist so the Lazulis can still channel their power and expression but in safer, sustainable, and more fulfilling ways. However, when the other two Lazulis begin to show aggression and harsh words towards Lapis, going so far to personally attack her physically and verbally, Lapis momentarily reverts back to using destruction to show power (this is similar to what happens when Steven fights Jasper as well- trying to use brute force to convince others to change). However, Lapis then realizes the same thing that Steven comes to realize- one must want to change in order to accept help from others. This is confirmed in the last moments of the episode when the freckled Lazuli willingly shows up to the little homeschool to seek some guidance. In the end, it was not the brute power that reached her, but instead the two showing her that they would be there for her when she was ready and seeking help. It is also shown in this that it isn’t just one person that can change someone’s outlook, but is rather a result of the combined efforts of multiple people whose strengths and weaknesses help balance each others out. Another great example of this can be seen in the episode with Amethyst and Steven.

Amethyst and Steven both work for the homeschool, however, they take care of different sectors where their strengths lie. Steven is pretty good at overall coordination and planning whereas Amethyst really excels at working with individuals. Amethyst starts a program to place gems into jobs in the community where they will thrive and gain positive experience working with others while doing something they enjoy. Steven is incredibly pleased to hear this but worries that the roles were chosen superficially due to what their original roles were on homeworld, not based on what they want to do now. This is a valid concern, however, by the end of the episode, it is made clear that what at surface seemed superficial to Steven was actually a result of lots of listening to other’s individual needs. This demonstrates the strengths and weaknesses of Steven quite well- he seems to excel at viewing things from a distance, being orderly and being in charge of many (showing this in tasks such as such as coordinating schedules, gathering resources, talking diplomatically to leaders, leading, etc.) while he struggles with detailed matters sometimes, such as really listening to others (this could be a result of him being very introspective and not perhaps not listening to others as much as he could/should, but that is up for debate I suppose). Amethyst is the exact opposite, as she is loose and very intune with other people’s feelings, and she is able to listen to others and find what works for them specifically. Steven and Amethyst both thrive with different sectors with different jobs and balance out each other, and I think this episode really shows that people with the same goals (in this case, helping gems find a new purpose and overcoming trauma) can help in different ways using their strengths.  

I hope that the show continues to explore how other gems are helping other gems grow and overcome trauma (like how Pearl helped Volleyball Pearl) as well as exploring how Steven will come to terms with his own trauma and strike a healthier balance between life and work. I am excited to see what is left to come :D

Anyways, here’s the tl:dr- Little Homeschool is basically provides therapy for gems and we need to realize that, while Steven is far from perfect and has a lot to learn and perfect, he really is trying his best to provide the opportunity for gems to overcome any trauma they may have from being corrupted, from being part of the gem war, and/or experience they end of society where they had defined roles with defined jobs and purposes as well as providing a safe place for gems to try out new things and find a new sense of purpose for their own life of their own choosing.

[detoxnorco-blog]

pasadena rehabilitation

As with most things in life, depression treatment and its effectiveness, actually depends upon the individual.

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Having Said that, it's widely regarded in the health care sector that the best remedy for depression includes psychological therapy AND medication.

Whatever the reason behind depression, both psychological treatments and drugs help to ease the principal symptoms.

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It Is better if a person who has depression works together with their physician or mental health professional, to obtain the treatment that's ideal for them.

Some people respond well to psychological therapies, while others respond better to drugs.

While Some people might just require psychological, "speaking" treatment, others (me included!) , require BOTH psychological therapy and medication.

A word of warning: I'm not Saying that each and every person that has depression should take medication. For now what I want to share with you, are my experiences with depression medication, I have utilized to deal with my depression.

Before We get into the efficacy of depression medication, I believe that it would be beneficial to outline precisely what medications are utilized to treat depression.

Medications Used in the Treatment of Depression

The most common drugs to treat somebody with depression are anti-depressants.

So what exactly are anti-depressants?

They're medications that are intended to reduce or alleviate the effects of depression.

Kinds Of Anti-depressants

There are lots of kinds of anti-depressants available. Every type, class or family has its own way of helping depression.

Within The classes, each medication is a little different. There are side-effects and warnings common to every category of antidepressants, and lots of the individual drugs have added side-effects or warnings also.

Let us take a closer look at each household of anti-depressants, beginning with the one most of us have heard about.

SSRI  These medicines work by preventing the neurotransmitter serotonin from being reabsorbed from the nerve cell that released it, thereby forcing the serotonin to keep actively functioning.

Sertraline - this is what I take to control my depression.

Both of these terms are basically synonymous.

SNRI Stands for serotonin norepinephrine reuptake inhibitor, while SSNRI stands for selective serotonin norepinephrine reuptake inhibitor, but there really isn't any considerable difference.

The two duloxetine and venlafaxine are SNRI's.  I had been on a venlafaxine for 3 years until it appeared to stop working for me.

There Are different classes or household of anti-depressants, but the above 2 are what I've used, and I do not want this guide to be too technical!

Unfortunately, If it comes to anti-depressants, 1 size doesn't fit all! It's only through trial and error by trying the anti-depressants your physician or psychiatrist prescribes, until you find one that is right for you.

Also, It's trial and error with the dose amount. Each time I was put on an antidepressant, my psychiatrist began with a very low dosage and increased it as need be over time.

Medications, there are potential side-effects. I was blessed with both venlafaxine and sertraline in that the sole side-effects I had with every anti-depressant was a headache and mild nausea.

These side-effects only lasted a couple of days, so it was a small price to pay for the enormous positive advantage that they gave me.

It Is important to notice, that a physician or psychiatrist should monitor someone's anti-depressant medication to find out if it's still working and if the dose is right.

Anti-depressant drugs help reduce the signs of depression.

Feeling extremely sad for no specific reason.   Sleeping too much or too small.      So anti-depressant drugs work by helping the brain to restore its usual chemical balance and thus decrease symptoms.

I frequently get asked the question, "How long does it take for them to function?"

For Me personally, it took two to three weeks to the anti-depressants to work. But my research indicates that it may take up to six weeks following the first dose of medicine before it's an anti-depressant effect.

For some People it can take up to eight weeks or a bit longer until they begin to feel better, and the maximum benefit is felt after six months.

Anti-depressant Medication is generally quite effective. Around 70 percent of individuals with major depression begin to feel better using the first sort of anti-depressant they're prescribed.

 Despite the fact that I had been using "taking treatment", there wasn't much progress in my depression symptoms. My "break-through" with my melancholy only happened once I started taking anti-depressants.

Psychological Remedies used by psychologists and psychiatrists are extremely effective in helping a man to deal with and even recover from depression.

I Would go so far as to state that my emotional treatment was instrumental in treating my depression to the extent that I now live a very happy and joyous life.

Which are Psychological Treatments?

Among the very best psychological treatments is Cognitive Behaviour Therapy (CBT). CBT teaches people to think logically about common issues, helping a person to change their thought patterns and how they react to certain conditions. I love to think of CBT as "My thoughts affect my feelings."

When people are depressed, they might think negatively about:

Themselves e.g. "I am a failure." The planet e.g. "The world is a cruel and scarey location." Their future e.g. "I have nothing to live for and my life will not get any better."

Negative thinking interferes with healing and makes the Person more vulnerable to depression later on. It's important to recognise unhelpful thoughts and replace them with more rational and realistic ideas.

This is why I find CBT so strong as it provides me with all the tools I want to challenge my negative thoughts.

IPT Is used when a person with depression is easily upset by other people's opinions.  They might feel criticised when no criticism was intended.  So what IPT does, is it helps people find various ways to get along with other people.

And then there's Family Therapy.

Family Treatment helps relatives and close friends learn about depression and recognise that it's a real medical illness which can be treated.

Family And close friends of a miserable person have to know more about the illness due to their understanding and support is quite important.

A Person who's depressed may need the support of an anti-depressant to deal with their depression, and should consult with their physician. The sooner that depression is treated, the greater the possibility of a faster recovery.

If the first anti-depressant that a person attempts doesn't Work, they shouldn't get discouraged since they may try another one, which can really make a difference in assisting them with their melancholy.

Once someone begins taking an antidepressant, their disposition ought to be monitored closely by a physician or psychiatrist.

In Addition to anti-depressants, I highly recommend that someone that has depression, visit a psychologists or a psychologist for CBT.

This 2 Pronged approach has worked really well for me for the last twenty years and I will continue with both the anti-depressants and CBT to make sure that I maintain the terrific quality of life that I have now.

Depression Treatment is available to enable someone that has depression.  Depression isn't the whole of you, it's merely are a part of you, that may be treated.

Libby Kalis resides in Brisbane, Australia and has lived with Depression for more than 20 years. During this time she has obtained a wealth

[menssoberliving-blog]

bipolar signs in men

As with most things in life, depression treatment and its effectiveness, actually depends upon the individual.

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Having Said that, it's widely regarded in the health care sector that the best remedy for depression includes psychological therapy AND medication.

Whatever the reason behind depression, both psychological treatments and drugs help to ease the principal symptoms.

It Is better if a person who has depression works together with their physician or mental health professional, to obtain the treatment that's ideal for them.

Some people respond well to psychological therapies, while others respond better to drugs.

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While Some people might just require psychological, "speaking" treatment, others (me included!) , require BOTH psychological therapy and medication.

A word of warning: I'm not Saying that each and every person that has depression should take medication. For now what I want to share with you, are my experiences with depression medication, I have utilized to deal with my depression.

Before We get into the efficacy of depression medication, I believe that it would be beneficial to outline precisely what medications are utilized to treat depression.

Medications Used in the Treatment of Depression

The most common drugs to treat somebody with depression are anti-depressants.

So what exactly are anti-depressants?

They're medications that are intended to reduce or alleviate the effects of depression.

Kinds Of Anti-depressants

There are lots of kinds of anti-depressants available. Every type, class or family has its own way of helping depression.

Within The classes, each medication is a little different. There are side-effects and warnings common to every category of antidepressants, and lots of the individual drugs have added side-effects or warnings also.

Let us take a closer look at each household of anti-depressants, beginning with the one most of us have heard about.

SSRI  These medicines work by preventing the neurotransmitter serotonin from being reabsorbed from the nerve cell that released it, thereby forcing the serotonin to keep actively functioning.

Sertraline - this is what I take to control my depression.

Both of these terms are basically synonymous.

SNRI Stands for serotonin norepinephrine reuptake inhibitor, while SSNRI stands for selective serotonin norepinephrine reuptake inhibitor, but there really isn't any considerable difference.

The two duloxetine and venlafaxine are SNRI's.  I had been on a venlafaxine for 3 years until it appeared to stop working for me.

There Are different classes or household of anti-depressants, but the above 2 are what I've used, and I do not want this guide to be too technical!

Unfortunately, If it comes to anti-depressants, 1 size doesn't fit all! It's only through trial and error by trying the anti-depressants your physician or psychiatrist prescribes, until you find one that is right for you.

Also, It's trial and error with the dose amount. Each time I was put on an antidepressant, my psychiatrist began with a very low dosage and increased it as need be over time.

Medications, there are potential side-effects. I was blessed with both venlafaxine and sertraline in that the sole side-effects I had with every anti-depressant was a headache and mild nausea.

These side-effects only lasted a couple of days, so it was a small price to pay for the enormous positive advantage that they gave me.

It Is important to notice, that a physician or psychiatrist should monitor someone's anti-depressant medication to find out if it's still working and if the dose is right.

Anti-depressant drugs help reduce the signs of depression.

Feeling extremely sad for no specific reason.   Sleeping too much or too small.      So anti-depressant drugs work by helping the brain to restore its usual chemical balance and thus decrease symptoms.

I frequently get asked the question, "How long does it take for them to function?"

For Me personally, it took two to three weeks to the anti-depressants to work. But my research indicates that it may take up to six weeks following the first dose of medicine before it's an anti-depressant effect.

For some People it can take up to eight weeks or a bit longer until they begin to feel better, and the maximum benefit is felt after six months.

Anti-depressant Medication is generally quite effective. Around 70 percent of individuals with major depression begin to feel better using the first sort of anti-depressant they're prescribed.

 Despite the fact that I had been using "taking treatment", there wasn't much progress in my depression symptoms. My "break-through" with my melancholy only happened once I started taking anti-depressants.

Psychological Remedies used by psychologists and psychiatrists are extremely effective in helping a man to deal with and even recover from depression.

I Would go so far as to state that my emotional treatment was instrumental in treating my depression to the extent that I now live a very happy and joyous life.

Which are Psychological Treatments?

Among the very best psychological treatments is Cognitive Behaviour Therapy (CBT). CBT teaches people to think logically about common issues, helping a person to change their thought patterns and how they react to certain conditions. I love to think of CBT as "My thoughts affect my feelings."

When people are depressed, they might think negatively about:

Themselves e.g. "I am a failure." The planet e.g. "The world is a cruel and scarey location." Their future e.g. "I have nothing to live for and my life will not get any better."

Negative thinking interferes with healing and makes the Person more vulnerable to depression later on. It's important to recognise unhelpful thoughts and replace them with more rational and realistic ideas.

This is why I find CBT so strong as it provides me with all the tools I want to challenge my negative thoughts.

IPT Is used when a person with depression is easily upset by other people's opinions.  They might feel criticised when no criticism was intended.  So what IPT does, is it helps people find various ways to get along with other people.

And then there's Family Therapy.

Family Treatment helps relatives and close friends learn about depression and recognise that it's a real medical illness which can be treated.

Family And close friends of a miserable person have to know more about the illness due to their understanding and support is quite important.

A Person who's depressed may need the support of an anti-depressant to deal with their depression, and should consult with their physician. The sooner that depression is treated, the greater the possibility of a faster recovery.

If the first anti-depressant that a person attempts doesn't Work, they shouldn't get discouraged since they may try another one, which can really make a difference in assisting them with their melancholy.

Once someone begins taking an antidepressant, their disposition ought to be monitored closely by a physician or psychiatrist.

In Addition to anti-depressants, I highly recommend that someone that has depression, visit a psychologists or a psychologist for CBT.

This 2 Pronged approach has worked really well for me for the last twenty years and I will continue with both the anti-depressants and CBT to make sure that I maintain the terrific quality of life that I have now.

Depression Treatment is available to enable someone that has depression.  Depression isn't the whole of you, it's merely are a part of you, that may be treated.

Libby Kalis resides in Brisbane, Australia and has lived with Depression for more than 20 years. During this time she has obtained a wealth

[douglasbergerpsychiatristto-blog]

Tests, testing, and tested – we need to critically evaluate the meaning of tests in psychiatry

Douglas M. Berger Meguro Counseling Center, Tokyo, Japan

A recent article entitled, “Perils of Newborn Screening”[1] led me to think of how we in psychiatry and our patients also have some perilous ideas about screening and testing. The article describes testing initiated in 2006 in New York State for Krabbe disease of the nervous system. Krabbe disease is a rare inherited disorder where lack of the enzyme galactocerebrosidase causes the myelin coating on the nerves to break down. Mental and motor development are affected, and muscle weakness, deafness, and blindness may occur.[2]

Out of the total one-million babies tested, 24 tested positive and out of 24, 4 developed symptoms. One family refused treatment and subsequently the child died; another child died from complications of the treatment; another’s illness is progressing despite treatment, and one baby who had been treated successfully has recently lost his ability to walk. Parents of babies who test positive, are described to be in a constant state of worry, some pursue risky tests, and the emotional trauma (not to mention the cost) incurred is likely to outweigh the benefits.

This example illustrates how one kind of test may have pros and cons. The pros and cons of ‘testing’ can also be seen in one’s daily practice of psychiatry. The following are personal experiences of my practice in Tokyo.

CLINICAL EXAMPLES

“My 8-year-old child is depressed, should they have psychological (psych) testing to determine if antidepressants are warranted?” A woman I have been treating for a few years for major depression told me about her 8-year-old son who is irritable, has been crying more, and has written some notes contemplating suicide. She first brought her son to a large local counseling center where they recommended in-person counseling with their staff psychologist, school observations, and psych testing (costing about $4,500), and told the mother that they could not recommend starting antidepressants until the psych testing was complete. The son could not finish the testing because he was unable to maintain concentration.

The mother eventually decided she couldn’t wait anymore and asked me to evaluate the child who clearly looked depressed. I explained that if the psych testing assessed the son having a depression, this affirms the obvious. If the psych testing assessed the son without a depression, we are still left with a depressed-looking child who is writing suicide notes, and with an anti-depressant responsive depression in his mother. Neither family dynamics nor school issues could explain the child’s depression.

We agreed that there was no logic for psych testing in terms of, ‘to treat’ or ‘not to treat’; and in tandem to a medical work-up for depression, we initiated 2.5 mg of escitalopram a day with a good response. Scales and tests for depression may indeed provide some helpful information; however, predictive value, sensitivity, and specificity are still far from perfect,[3] and the National Institute of Mental Health (NIMH) guidance only mentions medical examination and history of symptoms in the evaluation of depression.[4]

While no test can fully prove a psychiatric diagnosis, we understood that the medication can be construed to be both a treatment as well as a kind of diagnostic test, i.e., improvement on administration, and relapse on discontinuation would support the diagnosis of a major depression.

In addition, while the son was ill with depression, the other aspects of psych testing, i.e., personality or intellectual testing, would not properly reflect these areas of functioning. It would be like asking a person with pneumonia to run around a track, time them, and then make an interpretation of this person’s ability to run (not to mention the cost saving of the psych testing).

The next peril is the way the school authorities may use the results of his psychological testing, which may have a negative impact on the child’s education in the future. I opined that the school only needed to know that the son would get help, but did not need to know the diagnostic or treatment details.

“My 4-year-old has been tested and diagnosed with Asperger’s Disorder, can you counsel him?” This has been a more frequent inquiry in recent years. Some parents or adult patients almost seem to be proud to have this diagnosis, thinking that it portends high intelligence, but it may actually be a way to avoid a more uncomfortable mental illness diagnosis. Most of these parents do not realize that there is no test to prove that someone has Asperger’s, (the criteria for Asperger’s includes: Marked impairment in social relations, often with stereotyped motor movements, and a vast knowledge of some topic of esoteric or impractical value),[5] and that the incidence of Asperger’s is thought to be extremely low (about three in 10,000)[6] when compared with other disorders whose symptoms overlap with Asperger’s (i.e., attention deficit disorder/ attention deficit hyperactivity disorder (ADD/ADHD), which may affect up to 10% of children.[7]) Few of the patients who come in with a supposed diagnosis of Asperger’s actually fulfill the criteria for Asperger’s.

On examination, most of these children have symptoms suggesting ADD or ADHD; some have depression or anxiety, and others a shyness or awkwardness that may be normal or may evolve into social anxiety disorder later in life. On rare occasion some do look like high-functioning autistic children, although it seems parsimonious and logical to assume that these children have the far more common diagnosis rather than a rare diagnosis if the symptoms overlap significantly.

The peril here is when the parents or an adult patient does not accept having a diagnosis or treatment other than that for Asperger’s. If a child also seems to have a comorbid ADD or ADHD, it needs to be treated first; to ascertain what Asperger’s symptoms may be left. Otherwise, it would be like making a diagnosis of asthma in a child with pneumonia (i.e., it is impossible to see if Asperger’s is there while the person is clearly impaired with ADD or ADHD).

In addition, once a child gets a diagnosis in their educational record, it tends to have a life of its own as definitive, and neither parents, educators, nor even psychologists or psychiatrists, endeavor to change the record.

“Cognitive behavioral therapy has been tested and proven to be effective for depression; can you give it to me?”

This is another situation where the use of the word ‘tested’ comes in and is an inquiry that can be a challenge for the psychiatrist to handle when the patient has vegetative symptoms, a strong family history, and a chronic course of depression because these patients usually require antidepressant medication in addition to any therapy.

Cognitive behavioral therapy (CBT) aims at repairing negative thoughts that are thought to cause depression.[8] Clinically, it is easy to observe; however, that negative cognitions improve when depressed mood improves, be it with antidepressants or the natural cycling course out of depression.[9] This is analogous to delusions improving, when one is given an antipsychotic, so that negative thoughts are more likely the result of depression rather than the cause, just like a runny nose and a cough are the result of a cold. If negative thoughts were the cause of depression, then this would be the only Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I condition where the symptoms are also construed to be the cause.

However, it can often be seen that CBT may help persons with depression function better. Degree of depression is usually evaluated by a rating scale that assesses both neuro-vegetative symptoms as well as misery (i.e., cognitive symptoms such as despair and helplessness). Giving persons hope and support can alleviate some of the misery symptoms decreasing depression scores. Allowing some time to pass where the persons improve by themselves or cycle out of depression can also decrease scores. In either case, the person functions better and their depression scores decrease over time. Even a few points lower on a depression test can result in a call of a “statistically significant difference” compared to a supportive therapy control group, but that does not mean the illness is really treated. For example, I broke my arm by falling on the ice. I had real pain and also misery because I couldn’t do things I normally liked to do. When my orthopedist told me, “I see many fractures like this, you will be fine in a few months,” all my misery disappeared, but the fracture did not change. Patients in misery can respond well to an authority figure which gives them hope.

A more important problem with using the word ‘tested’ is that it is not easy to study psychotherapy as a modality of treatment because the studies cannot be double blinded like a drug study that has a placebo arm—an extremely crucial point. A study on bias in treatment outcome studies concluded that the results of unblinded randomized clinical trials (RCTs) tended to be biased toward beneficial effects if the RCTs’ outcomes were subjective (as they are in psychotherapy studies) contrary to being objective.[10]

Patients and even professionals assume that the words “randomized and controlled” mean that the studies looking at a therapeutic modality are fully evidence based, even if they are not double blind. They may be single blinded, i.e., the rater may not know the treatment the patient received, but the patient themselves cannot be blinded to the type of therapy, thus potentially biasing the results. Depression studies notoriously have large random errors due to the wide variety of subjects many of which have mild forms of low mood, investigator and patient preference and economic incentive, or non perfect rating instruments, etc. Bias can lead to a result very far from the true value.[11]

A recent meta analysis[12] examined how effective CBT is when placebo control and blindedness are factored in. Pooled data from published trials of CBT in schizophrenia, major depression, and bipolar disorder that used controls for non-specific effects of intervention were analyzed. This study concluded that CBT is no better than non-specific control interventions in the treatment of schizophrenia and does not reduce relapse rates, treatment effects are small in treatment studies of major depression, and it is not an effective treatment strategy for prevention of relapse in bipolar disorder.

This does not mean that CBT has no value, it only means that we need to consider CBT as an adjunctive modality to help functional impairment and suffering vs. an illness course-changing intervention. It is imperative that our field does not allow studies that are unblinded to be called “evidence based tests.” They need to be in a different category, i.e., “uncontrolled clinical data”, or “clinical impressions” (of CBT practitioners and/or their patients).

CONCLUSION

To the lay-person, the word “test” implies some absolute truth. The value of a test or a diagnosis given by an authority is very hard to evaluate by the average lay-person, and when it comes to testing of a therapeutic intervention, even most mental health professionals do not understand why it is crucial to control bias by double-blinding in a clinical trial of an intervention, whether psychotherapy or drug. The words “controlled” or “randomized” seem to carry more weight than they are worth if there is no placebo or double blind to back them up. We must also not avoid a critical discussion of the economic incentive to do a test or to “prove” the evidence base of a certain therapy.

{Ed.: Dr. Berger is in private practice in Japan and consultant on pharmaceutical clinical trials. Web page is at: www. japanpsychiatrist. com. This article is intended as a personal opinion piece and not a scientific analysis.}

REFERENCES

1. Bleicher A. Perils of newborn screening: Doctors may be testing infants for too many diseases. Sci Am 2012;307:16-7.

2. Pastores GM. Krabbe disease: An overview. Int J Clin Pharmacol Ther 2009;47(Suppl 1):S75-81.

3. Rivera CL, Bernal G, Rossello J. The Children’s Depression Inventory (CDI) and The Beck Depression Inventory (BDI): Their validity as screening measures for major depression in a group of Puerto Rican adolescents. Int J Clin Health Psychol 2005;5:485-98.

4. Available from: http://www.nimh.nih.gov/health/publications/men-anddepression/diagnostic-evaluation-and-treatment.shtml. [Last Accessed on 2013 Mar 30].

5. F84. Pervasive developmental disorder. International Statistical &ODVVL¿FDWLRQRI’LVHDVHVDQG5HODWHG+HDOWK3UREOHPVth (ICD-10) ed. World Health Organization (2006).

6. Fombonne E. Epidemiological surveys of pervasive developmental disorders. In: Volkmar FR, editor. Autism and Pervasive Developmental Disorders. 2nd ed. Cambridge: Cambridge University Press; 2007. p. 33-68.

7. Centers for Disease Control and Prevention. Summary Health Statistics for U.S. Children. National Health Interview Survey, 2002. March 2004, Series 10, No. 221.

8. Burns, David. Feeling Good, The New Mood Therapy. Avon Books; 1980.

9. Fava M, Davidson K, Alpert JE, Nierenberg AA, Worthington J, O’Sullivan R, et al. Hostility changes following antidepressant treatment: Relationship to stress and negative thinking. J Psychiatr Res 1996;30:459-67.

10. Wood L, Egger M, Gluud LL, Schulz KF, Jüni P, Altman DG, et al. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: Meta-epidemiological study. BMJ 2008;336:601-5.

11. Steven Piantadosi. Clinical Trials: A Methodologic Perspective. 2nd ed. Hoboken: Wiley-Interscience; 2005.

12. Lynch D, Laws KR, McKenna PJ. Cognitive behavioural therapy for major psychiatric disorder: Does it really work? A meta-analytical review of well-controlled trials. Psychological Medicine 2010;40:9-24.