We are all prone to making the mistake of thinking in either-or terms, but this trap becomes especially likely if we are dealing with depression and/or anxiety. Thinking in black and white terms is a cognitive distortion (see our blog from March 2020 for an introduction to cognitive distortions). This concept is also called all-or-nothing thinking, polarized thinking, or dichotomous thinking.

The hallmark feature of this pattern of thinking is dividing conclusions into two polar opposite categories-It’s good/acceptable or it’s bad/failure. And to add insult to injury, we tend to define what’s acceptable in very narrow terms which leaves a lot of room to deem everything else a failure.

What Happened to “The Gray Area?”

A great example of how dichotomous thinking functions comes from letter grades. I see quite a few students, and many assert that an A is acceptable and anything else is a failure. It’s been awhile since I was in school, but last time I checked, an F is a failure. Although maybe not ideal, Ds, Cs, and Bs mean you pass and produced work that didn’t constitute failure.

The real shame with this cognitive distortion is that it doesn’t allow for people to acknowledge what progress they have made. There is no room to say “I didn’t meet my ultimate goal, but I did accomplish X, Y, and Z.” We berate ourselves for not hitting that narrow range of acceptable and feel anxious/depressed as a result.

We Do Better Than We Realize

To combat this trap, we have to first realize that it’s happening. Ask yourself if you are prone to this way of thinking, and in what situations does it tend to happen. From there, when you recognize you’re falling into the trap, consider the following questions:

• What did I accomplish?
• What did go well?
• What can I give myself credit for?
• What’s the gray area I’m not seeing?

What was accomplished needs to become the focus-not where you fell short. If we can answer these questions honestly, they will illuminate that there are positive things going on which will decrease feelings of depression/anxiety.

If you are struggling with black and white thinking or cognitive distortions and want to work on them in counseling, I’d love to chat with you. Please give our office a call, and we can discuss further.

-Lindsey-

Mindfulness continues to gain popularity as an effective tactic to treat depression and anxiety. In this month’s blog, I outline some specific exercises you can do to engage in mindfulness. In short, mindfulness is consciously choosing to attend to the present moment and not allowing your mind to wander to the past or future. For a more in depth explanation for what mindfulness is, see our blog from June 2019.

Mindful Breathing

Attention to each breath. Feel every sensation as it enters, fills your lungs, expands your belly, and leaves your body.

• Counting patterns: 4 count inhale, pause for 1 count, 4 count exhale, or create your own
• Option for a peaceful word or scene
• Schedule designated time for mindful breathing or use in the moment when needed

Sensory Mindfulness

Paying close attention to information coming in through your senses.

• Visual: What does it look like? What’s the shape? What are the colors? What does the texture look like?
• Auditory: What is the overall sound? How loud is it? Does the sound change?
• Touch: What does it feel like? What is the texture? How hard or soft is it? Is there variation?
• Smell: What odors can you notice? How strong are they? Are they changing?
• Taste: What is the overall flavor? What’s the temperature? What’s the consistency? How is this bite unique?

Thought Diffusion

Observe your thoughts without judgment and without getting “hooked” on any of them. Don’t try to change them, rather just observe what enters your mind. Use a visualization exercise to excuse them:.

• Watch your thoughts float away on clouds
• See a stream and watch the thoughts float away on leaves
• See your thoughts written in the sand and watch the waves wash them away
• Picture yourself in your car and see your thoughts pass by on billboards
• Picture yourself standing in a room with 2 doors. Watch the thoughts come through one and exit through another
• Make up your own visualization

Emotion Exposure

Focus on the emotion you feel and study it while fully experiencing the feeling. Observe the emotion without acting on it or trying to change it.

• Identify the emotion. What is it?
• Are there other subtle emotions present? What are they?
• Is the feeling growing or diminishing? What’s the intensity?
• Is the emotion morphing into a different feeling? What is the new feeling?
• Notice any judgments about the emotion or yourself and excuse them.

You can do emotion exposure with any emotion, even with negative ones. Intensely studying the feeling tends to take its power away and enhances your feeling of control over the emotion.

If you’d like to learn more about mindfulness, I’d love to chat with you. Please give our office a call, and we can discuss further.

-Lindsey-

In honor of Valentine’s day, I wanted this blog to cover an important concept regarding romantic relationships: Adult Attachment. There is a growing body of research that examines how we as adults attach or bond to our significant others. There are 4 attachment styles that have been identified. Sometimes people fit cleanly into one category, and sometimes people are a mix. Securely attached people have healthy relationships while insecure attachment leads to conflictual relationships.

1.) Secure Attachment

• Comfortable with emotional closeness.
• Depends on partner to meet emotional needs and is able to meet the emotional needs of their partner.
• Has an independent life outside of the relationship and encourages their partner to have an independent life as well.
• Communicates directly and openly.
• Manages feelings effectively. Does not get overly emotional about relationship issues.

The following styles are considered Insecure Attachment which means the health and functioning of the relationship are at risk.

2.) Avoidant/Dismissive

• Emotionally distant and keeps partner at an arm’s length.
• Unable to meet emotional needs of partner especially when the partner is seeking closeness.
• Over-emphasis on independence. Does not invite partner into their world and prefers to be alone.
• Doesn’t communicate much about emotions. Tendency to hold emotions in and then explode.

3.) Anxious/Preoccupied

• Feels consistently worried about the state of the relationship. Has persistent concern about rejection and abandonment.
• Seeks reassurance from partner frequently which can push partner away.
• Independence is a source of anxiety. Wants to combine their life with partner’s and have no distinction between the two.
• Highly sensitive to partner’s behavior. Takes their partner’s actions personally.
• Emotion is not well regulated.
• Can appear controlling.

4.) Disorganized/Unresolved

• Potential history of trauma meaning neglect, physical, sexual, and/or emotional abuse as a child. As a result, may recreate past dysfunctional relationship patterns.
• Difficulty tolerating emotional closeness.
• Poor communication, argumentative, aggressive, highly confrontational.
• May demonstrate abusive behavior.
• Does not demonstrate much empathy or support for partner.

The way we attach to others as an adult stems from how we attached to caregivers in our early years. If responsive, supportive, loving caregivers were present, then children generally develop secure attachment which they carry with them into adulthood. However, if during childhood caregivers were inconsistent, emotionally distant, dysregulated, or even abusive, then it’s likely an insecure attachment style would develop and play out in adult relationships.

When it comes to insecure attachment, the good news is that people can shift their attachment style. They can learn new behaviors and new ways of interacting with partners that are more in line with secure attachment.

If you are struggling with a relationship and want to work through it in counseling, I’d love to chat with you. Please give our office a call, and we can discuss further.

-Lindsey-

Do an internet search for New Year’s Resolution memes and you’ll be met with a bevy of cynicism, lambasting people for failing to keep their personal commitments. The data doesn’t look much better. A Forbes survey found that only 25% of people show any ongoing commitment to their resolutions with 8% actually accomplishing their goals. Professional Counseling is the art and science of personal change. For many years, the field has studied what helps people accomplish change.  Consider these seven critical precursors to personal change before making your resolutions official:

1. A sense of necessity for change: Do you feel an urgency or believe that change will be instrumental to improving your life? Is it your idea to change or have you heard from others that you ought to change? Change is more likely to be accomplished when it comes from within.
2. A willingness or Readiness to experience anxiety: This is nothing easy about change. We are organisms who are more likely to repeat their past behavior that spontaneously demonstrate new behavior. Taking risks and getting outside of our comfort zone is a must.
3. Awareness of the problem: Not only is it important to understand your challenge as a problem, but also having awareness of the thoughts and emotions that surround it. As an example, many people have weight loss goals but only attempt to change their behavior regarding to diet and exercise, ignoring the role of their thoughts and emotions.
4. Confronting the Problem: Confrontation is not the same as awareness. Confrontation, as put by the researcher, is “the steady and deliberate attending to and observation of anything intimidating, painful, or confusing… in spite of the tendency to avoid.. or otherwise escape it”. Confrontation is much more willful and brave than simply knowing how and why a problem exists.
5. Effort or will towards change: Effort, time and energy are all invaluable agents in helping us grow. What we put our efforts towards tends to gain momentum and momentum is unlikely to be spontaneous
6. Hope for Change: Simply stated, this is a realistic expectation that change is possible. It is necessary to approach the challenge and anxieties of change believing you have a shot at being successful. Even somewhat unfavorable odds, say 1 in 5, encapsulate an amount of defeat that people can tolerate and feel as though risk is worthwhile.
7. Social support for change: We are social animals who accomplish few things alone. Consider the relationships that will help you maintain encouragement, accountability, and keep your progress in perspective

Read the full article by F. Hannah PhD below:

https://www.dhss.delaware.gov/dsamh/files/precursors1192.pdf

Hannah’s precursors for change make a compelling case. We can likely reference these against times in our lives when we were successful in meeting a goals verses unsuccessful times and see a corollary presence of the factors above. It seems that society does us no favors by making new years resolutions seem compulsory. If most of the precursory factors are absent a negative experience around goal setting seems probable and then likely discourage us from future goal setting. In short, an arbitrary date on the calendar is not a precursor to change. The right time for change is when you have the helpful elements in your life.

Sometimes, professional support is part of a person’s social support for change. If you are looking for professional collaboration we help people achieve their goals every day. Please reach out if you would like to learn more.  -Ben-

Often times, when people think of the benefits of seeing a therapist they assume that the purpose is to work through emotion or, in psycho-babble terms, experience emotional catharsis. We hear the adages about not bottling up our feelings to avoid them from overwhelming us and it can feel good to blow off some steam. However, the research is more and more indicating that expressing your feelings alone can be counterproductive.

Let’s take a deeper look into the logic of this maxim:

1. Let’s say we get some things off our chest by talking about what’s bothering us. At the same time, we are better prepared to cope if this happens again in the future. Often strong feelings are spurred on by life challenges. Simple pragmatism says that just talking about how you feel isn’t enough to resolve an ongoing challenge. By contrast, a plan of how to effectively address challenges tends to lower anxiety.
2. What if we vent off our feeling unchallenged? We could be missing something that we don’t understand about the situation or fail to see our own role in the emotional experience. Further, without being checked, catharsis may serve to reinforce our negative, erroneous beliefs about a situation making it harder to calm down or change one’s mind in the future.
3. When catharsis is performed through aggressive means it can have other adverse consequences. For example, when people dealing with anger are invited to express the anger through physically violent means (i.e. hitting a punching bag) it typically perpetuates further violent behavior in the future. The same could be said for verbal aggression used for “venting”.

I do not mean to insinuate that expressing your feelings is bad. However, I hope the examples above help to demonstrate the side effects and failures pure venting can incur. These emotional Catharsis myths help to illustrate some of the distinct benefits of talking to a therapist. For example, effective therapists offer evidence based skills, challenge and reframe what we think, and encourage adaptive means of coping. That being said, If you’re looking for therapy with lasting, high quality skills, reach out today.

When thinking about gratitude, many would define it as appreciating what you have. This is a valuable concept that I can readily appreciate. However it does tell the entire story. Let’s take a deeper look into the role of gratitude on one’s mental health and well being.

What if your lack of gratitude wasn’t just falling short of an ideal aspiration but actually harming you? Imagine for a moment that you are looking at a tiled wall, perhaps in a bathroom or kitchen. One tile happens to be missing, exposing the bare wall underneath. Where does your attention go? Suddenly, you tend to overlook the dozens of other tiles perfectly installed in favor of this irregularity. A tiled wall can easily be made complete but what if the missing tile is a part of you? We all can relate to wishing we were a little taller, a little more fit, a little less single, or different in some way. Furthermore, we tend to see our “missing tiles” everywhere. You enter a room and everyone seems to be taller than you or everyone seems to be coupled all because it demands our focus. Suddenly, we have magnified our perceived insufficiencies without even realizing it.

When we allow our focus to be drawn to what is missing not only do we not appreciate what we do have but we uncritically decide to make what we don’t have the most important part of us. Unlike a tiled wall, this missing part of us cannot always be resolved. To make something you cannot change or resolve the most essential part of your self-worth is a formula resulting in unhappiness without end in sight. Perhaps when we struggle to be gracious it is not a reflection of how thankful we are rather, we are yet to understand and accept our strengths and limitations in the world. A hyper-focus on what’s missing would certainly serve to fuel a sense of insecurity and inadequacy – feelings that routinely hinder people in modern life.

We all have amazing potential and inherent value as human beings and this is not simply wiped away due to our deficiencies. If you’re trying to make sense of your place in the world and would like some help, please don’t hesitate to give us a call.

-Ben-

In addressing depression and anxiety, it has been consistently shown that how we think and what we believe can highly influence our emotions and behavior (see our August 2019 blog on CBT). Many times people will find that what they think  is fraught with inaccuracies upon taking a closer look.

One such example of human thinking being unreliable is the Mandela effect, named after South African apartheid revolutionary Nelson Mandela. Circa 2010, It was widely believed that Mandela died in prison during the 1980’s. However, he was currently alive and would die at age 95 in 2013. This is a very unusual phenomena as the same false memory is shared across a majority of people, places, and cultures.

Here are some other examples of the Mandela effect:

• The monopoly man is commonly remembered wearing a monocle but he does not adorn any eyewear.
• Darth Vader never said “Luke, I am your father”. Rather, he simply states: “I am your father”.
• Your favorite childhood book The Berenstein Bears is actually The Berenstain Bears.
• Forest Gump actually said “Life was like a box chocolates…”

If I had to guess, at least one of those examples has you doubting your own reality which is a very odd sensation. We want things to match our current understanding so don’t feel bad if you don’t believe me or you’ve already run a fact check.

What the Mandela effect has to teach us is that we can quickly pick up information and accept it as an absolute truth without any critical thought or research. However, when shown contrary information we feel dissonance and unrest. We may be reluctant to let go of we think despite putting so little effort into arriving at this conclusion. We may have to look it up for ourself or have a different experience that results in us changing our minds.

What if what you think or believe isn’t a trivial movie quote but instead something keeping you up at night? What if this thought is routinely putting yourself down? Worse yet, what if you acquired this belief without critical consideration and it isn’t even true? These thoughts hold everyday people back all of the time. Further, the Mandela effect recommends that we should be more open to letting go and thinking better about ourselves.

We help people every day think more clearly and accurately, working towards their best life. Reach out today if you’d like to learn about the role thinking plays in your world.

-Ben-

(970) 329-1707
EvolveCounseingServices@gmail.com

Dialectical Behavior Therapy (DBT) is a counseling framework that is being utilized more and more by clinicians to treat a variety of mental health concerns. In my practice, I use DBT as a compliment to Cognitive-Behavior Therapy (see Aug 2019 for an overview of CBT). DBT contains 4 core skills that are designed to help people operate from a place of logic while simultaneously honoring the emotions they are experiencing. Below is a brief overview of the 4 core skills.

1.) Distress Tolerance

We all experience crises in our lives that produce intense emotions. When our emotions are escalated, we run the risk of engaging in destructive behavior. How many of us have done something dangerous when we were upset or said something we regret to a person we care about? Distress tolerance is all about recognizing our emotional escalation and engaging in distracting activities to stop the progression. The goal of distress tolerance is to endure the crisis, let the emotion die down, and not do anything that may make the situation worse.

2.) Mindfulness

Our brain likes to time travel to past memories or thoughts about the future. Unfortunately, many of these thoughts are negative, critical, and stressful which produce feelings of depression and anxiety. The vast majority of the time, the present moment we are experiencing right now is neutral, if not positive. Mindfulness is consciously choosing to be aware of the present moment-what’s happening right in front of you, and appreciating it rather than getting caught up in unpleasant thoughts of the past or future.

3.) Emotion Regulation

Emotions can be confusing and feel very intense. Emotion regulation focuses on developing a better understanding of your unique feelings, identifying what might trigger intense emotions, and implementing strategies for managing emotions that have the potential to be destructive.

3.) Interpersonal Effectiveness

As humans, we are social creatures which means we have to navigate relationships on a daily basis. Sometimes, we find ourselves dissatisfied with relationships or end up in unhealthy relationships, and we’re not sure how we got there. Interpersonal effectiveness is geared toward developing skills and behaviors that promote genuine connection with others and satisfaction with relationships. If we are operating in a healthy way with other people, then we don’t have to experience the painful emotions that come with being a part of dysfunctional relationships.

If you are interested in DBT and have questions or would like to learn the skills in therapy, I’d love to chat with you. Please be in touch, and we can discuss further.

-Lindsey-

(970) 329-1707
EvolveCounseingServices@gmail.com

Telehealth is getting a lot of attention right now as Coronavirus has affected how medical services are provided. This blog will focus on the concept of telehealth as it pertains to mental health therapy sessions. There are various terms used to describe the concept of telehealth. It is sometimes referred to as “telemedicine” or “teletherapy,” but regardless of what it’s called, the concept includes therapy sessions being conducted over video conferencing with the client in one location and the therapist in another.

Is it as effective as in-person therapy?

This is one of the most common questions in the minds of potential clients when deciding if telehealth is right for them. There is an emerging body of research on this topic, and the findings are consistently concluding that yes, telehealth is as effective as in-person therapy.

What are the benefits?

You can do therapy from the convenience of your home, office, or other environment that works for you. All you need is access to a computer with internet access or a smart phone.
There is no travel time. You don’t have to commute to your therapist’s office and can save the time.
Your therapist might get a better sense of you as a person. If you’re in your home, office, or other space you value, the environment may become a topic of conversation that provides insight for your therapist.
You get to be comfortable. By staying at home you get to settle into your favorite chair or even your bed. You can wear your pajamas. You can grab a cup of tea, coffee, or other tasty beverage.
You can work with a therapist in a different city (but same state-see below). This broadens your options for therapists, and as a result, increases the chances of you finding a good fit.

How do you actually do telehealth?

There is a variety of video conferencing options therapists can utilize to conduct telehealth. Our practice uses a platform called Doxyme for sessions. Doxyme is designed to be HIPPA secure and protect the privacy of clients. The process is very straightforward. I send a link to my clients by email or text, and all they need to do is click on the link using a computer or phone with internet access. I am notified my client is ready to start, and I click a button on my end to initiate the session. At that point we can see and hear each other on our respective screens. The experience is similar to Facetime or Skype.

Telehealth and State Laws

This is a tricky area to say the least, and it’s gotten even more convoluted as states have been suspending telehealth laws to help ease the impact of Coronavirus.

When it comes to telehealth, therapists are able to conduct sessions with clients in states where the therapist holds a license and the client is physically present at the time of sessions. I am licensed in Colorado, so I can see clients who reside anywhere in this state. If I was contacted by a potential client who lives in Florida wanting to do telehealth, I do not have a license in the state of Florida, so I would not be able to work with the client. However, if I live in Colorado, but held a license in Florida, then I would be able to work with the client. Some states make exceptions to the licensing issue. For example, if I start working with a client in Colorado, and the client moves to Illinois, Illinois grants permission for me to continue to see that person via telehealth even though I’m not licensed in that state.

The vast majority of states require therapists to hold a license in the state where the client is physically present without exception. If you have any questions if you would be able to work with a particular therapist who is in a different location than you, give the therapist a call or shoot them an email as the situational factors are different in every case. The therapist can then investigate applicable state laws and verify if they’d be able to work with you.

If you are interested in telehealth or have additional questions, I’d love to chat with you. Please give our office a call, and we can discuss further.

-Lindsey-

It’s a strange time we’re living in. For most of 2020, we’ve been dealing with Coronavirus and the adverse effects it’s been causing. Most people still feel a certain level of stress, overwhelm, uncertainty, or depression as a result of Coronavirus. Why? We’ve had time to accept what’s going on and make adjustments, but there are still these nagging negative emotions that continue to plague us. The answer is likely related to the on-going loss we continue to encounter.

1.) What is Loss?

The basic concept of loss is that something unpleasant happened, which was out of our control, and now we have to adapt to a new normal. We were all very aware of the initial losses and death associated with Coronavirus at the outset of the pandemic, but additional tragedies continue to occur that we may not think of as losses. Graduations didn’t happen, attending school in person stopped, birthday parties with friends are being cancelled, there won’t be large get togethers for fireworks displays on the 4^th of July, concerts are being cancelled, vacations are gone, employment has been deeply affected, and weddings are being rescheduled or cancelled entirely. Every time we encounter something that disrupts our “normal,” that’s a loss, and it takes a toll.

2.) Don’t Compare

When it comes to loss, it’s very natural to say “Well, no one in my family has died from Coronavirus, so what am I complaining about?” We tend to want to create a hierarchy of loss and tell ourselves that the more “minor things” don’t deserve an emotional reaction. Experts in grief and loss universally agree that it’s OK to think of any departure from normal, big or small, as a loss and call it a loss. Even if we label them minor, losses affect us, and there is no sense in trying to deny that fact. A healthy approach to loss includes naming it as such, accepting that it exists, and acknowledging that it is having a negative impact on you.

3.) Stages of Grief are Misleading

Grief is the emotion most commonly associated with loss. We tend to think of grief as occurring in stages based on the work of Elizabeth Kubler-Ross. She developed a theory of grief that includes five stages based on her research with people facing their own deaths. This research is highly important, but it inadvertently created this idea that people move through stages of grief in a linear fashion and that there is a “right way” to grieve. Let all of those misconceptions go. There is no right way to grieve. Feel how you feel and don’t judge yourself for grieving in a right or wrong manner. Even if an emotion is confusing or contradictory to what you thought you’d feel, let it be. Experts on grief encourage people to experience whatever emotion comes up and adopt an accepting attitude toward it. Fighting the emotion or judging yourself harshly for not grieving correctly is only going to pile on the negative emotion you’re already experiencing.

If you are struggling with loss related to Coronavirus and want to work through it in counseling, I’d love to chat with you. Please give our office a call, and we can discuss further.

-Lindsey-