What Is a Schema in Psychology? Definition and Examples

I like this intro to Schemas/Lifetraps:

Rory

*****

https://www.thoughtco.com/schema-definition-4691768
Human Head with Computer Folders

A schema is a cognitive structure that serves as a framework for one’s knowledge about people, places, objects, and events. Schemas help people organize their knowledge of the world and understand new information. While these mental shortcuts are useful in helping us make sense of the large amount of information we encounter on a daily basis, they can also narrow our thinking and result in stereotypes.

Key Takeaways: Schema

  • A schema is a mental representation that enables us to organize our knowledge into categories.
  • Our schemas help us simplify our interactions with the world. They are mental shortcuts that can both help us and hurt us.
  • We use our schemas to learn and think more quickly. However, some of our schemas may also be stereotypes that cause us to misinterpret or incorrectly recall information.
  • There are many types of schemas, including object, person, social, event, role, and self schemas.
  • Schemas are modified as we gain more information. This process can occur through assimilation or accommodation.

Schema: Definition and Origins

The term schema was first introduced in 1923 by developmental psychologist Jean Piaget. Piaget proposed a stage theory of cognitive development that utilized schemas as one of its key components. Piaget defined schemas as basic units of knowledge that related to all aspects of the world. He suggested that different schemas are mentally applied in appropriate situations to help people both comprehend and interpret information. To Piaget, cognitive development hinges on an individual acquiring more schemas and increasing the nuance and complexity of existing schemas.

The concept of schema was later described by psychologist Frederic Bartlett in 1932. Bartlett conducted experiments that tested how schemas factored into people’s memory of events. He said that people organize concepts into mental constructs he dubbed schemas. He suggested that schemas help people process and remember information. So when an individual is confronted with information that fits their existing schema, they will interpret it based on that cognitive framework. However, information that doesn’t fit into an existing schema will be forgotten.

Examples of Schemas

For example, when a child is young, they may develop a schema for a dog. They know a dog walks on four legs, is hairy, and has a tail. When the child goes to the zoo for the first time and sees a tiger, they may initially think the tiger is a dog as well. From the child’s perspective, the tiger fits their schema for a dog.

The child’s parents may explain that this is a tiger, a wild animal. It is not a dog because it doesn’t bark, it doesn’t live in people’s houses, and it hunts for its food. After learning the differences between a tiger and a dog, the child will modify their existing dog schema and create a new tiger schema.

As the child grows older and learns more about animals, they will develop more animal schemas. At the same time, their existing schemas for animals like dogs, birds, and cats will be modified to accommodate any new information they learn about animals. This is a process that continues into adulthood for all kinds of knowledge.

Types of Schemas

There are many kinds of schemas that assist us in understanding the world around us, the people we interact with, and even ourselves. Types of schemas include:

    • Object schemas, which help us understand and interpret inanimate objects, including what different objects are and how they work. For example, we have a schema for what a door is and how to use it. Our door schema may also include subcategories like sliding doors, screen doors, and revolving doors.
    • Person schemas, which are created to help us understand specific people. For instance, one’s schema for their significant other will include the way the individual looks, the way they act, what they like and don’t like, and their personality traits.
    • Social schemas, which help us understand how to behave in different social situations. For example, if an individual plans to see a movie, their movie schema provides them with a general understanding of the type of social situation to expect when they go to the movie theater.
    • Event schemas, also called scripts, which encompass the sequence of actions and behaviors one expects during a given event. For example, when an individual goes to see a movie, they anticipate going to the theater, buying their ticket, selecting a seat, silencing their mobile phone, watching the movie, and then exiting the theater.
  • Self-schemas, which help us understand ourselves. They focus on what we know about who we are now, who we were in the past, and who we could be in the future.
  • Role schemas, which encompass our expectations of how a person in a specific social role will behave. For example, we expect a waiter to be warm and welcoming. While not all waiters will act that way, our schema sets our expectations of each waiter we interact with.

Modification of Schema

As our example of the child changing their dog schema after encountering a tiger illustrates, schemas can be modified. Piaget suggested that we grow intellectually by adjusting our schemas when new information comes from the world around us. Schemas can be adjusted through:

  • Assimilation, the process of applying the schemas we already possess to understand something new.
  • Accommodation, the process of changing an existing schema or creating a new one because new information doesn’t fit the schemas one already has.

Impact on Learning and Memory

Schemas help us interact with the world efficiently. They help us categorize incoming information so we can learn and think more quickly. As a result, if we encounter new information that fits an existing schema, we can efficiently understand and interpret it with minimal cognitive effort.

However, schemas can also impact what we pay attention to and how we interpret new information. New information that fits an existing schema is more likely to attract an individual’s attention. In fact, people will occasionally change or distort new information so it will more comfortably fit into their existing schemas.

In addition, our schemas impact what we remember. Scholars William F. Brewer and James C. Treyens demonstrated this in a 1981 study. They individually brought 30 participants into a room and told them that the space was the office of the principal investigator. They waited in the office and after 35 seconds were taken to a different room. There, they were instructed to list everything they remembered about the room they had just been waiting in. Participants’ recall of the room was much better for objects that fit into their schema of an office, but they were less successful at remembering objects that didn’t fit their schema. For example, most participants remembered that the office had a desk and a chair, but only eight recalled the skull or bulletin board in the room. In addition, nine participants claimed that they saw books in the office when in reality there weren’t any there.

How Our Schemas Get Us Into Trouble

The study by Brewer and Trevens demonstrates that we notice and remember things that fit into our schemas but overlook and forget things that don’t. In addition, when we recall a memory that activates a certain schema, we may adjust that memory to better fit that schema.

So while schemas can help us efficiently learn and understand new information, at times they may also derail that process. For instance, schemas can lead to prejudice. Some of our schemas will be stereotypes, generalized ideas about whole groups of people. Whenever we encounter an individual from a certain group that we have a stereotype about, we will expect their behavior to fit into our schema. This can cause us to misinterpret the actions and intentions of others.

For example, we may believe anyone who is elderly is mentally compromised. If we meet an older individual who is sharp and perceptive and engage in an intellectually stimulating conversation with them, that would challenge our stereotype. However, instead of changing our schema, we might simply believe the individual was having a good day. Or we might recall the one time during our conversation that the individual seemed to have trouble remembering a fact and forget about the rest of the discussion when they were able to recall information perfectly. Our dependence on our schemas to simplify our interactions with the world may cause us to maintain incorrect and damaging stereotypes.

EMDR Therapy: What You Need to Know

here is a great article to start with.It explains some of the basics.

Rory

******

https://www.healthline.com/health/emdr-therapy

What to know before you try EMDR therapy

EMDR therapy is considered to be safe, with many fewer side effects than those of prescription medications. That said, there are some side effects that you may experience.

EMDR therapy causes a heightened awareness of thinking which does not end immediately when a session does. This can cause light-headedness. It can also cause vivid, realistic dreams.

It often takes several sessions to treat PTSD with EMDR therapy. This means that it doesn’t work overnight.

The beginning of therapy may be exceptionally triggering to people starting to deal with traumatic events, specifically because of the heightened focus. While the therapy will likely be effective in the long run, it may be emotionally stressful to move through the course of treatment.

Talk to your therapist about this when you start treatment so you’ll know how to cope if you experience these symptoms.

The bottom line

EMDR therapy has proven to be effective in treating trauma and PTSD. It may also be able to help treat other mental conditions like anxiety, depression, and panic disorders.

Some people may prefer this treatment to prescription medications, which can have unexpected side effects. Others may find that EMDR therapy strengthens the effectiveness of their medications.

If you think EMDR therapy is right for you, make an appointment with a licensed therapist.

10 Signs of Walking Depression

 

This is Part 1 in a series on depression in creatives.

Part 2: 10 Ways to Walk Away from Depression
Part 3: When Medication Isn’t Enough: Rethinking Depression with Eric Maisel

Note: I wrote this article to raise awareness of low-grade depression, which many people don’t recognize in themselves. I am an author and creativity coach, so I wrote it particularly for writers and artists, but these signs could apply to anyone ~ I believe we are all creative in one way or another.

There are many causes of depression; in my work I focus on people’s needs to create art and to make meaning, and on how to deal with the depression that arises when those needs go unmet for whatever reason.


Let’s play a little word association.

When I say someone is DEPRESSED, what comes to mind?

You might think of someone who:

  • Looks or acts sad most of the time
  • Cries often
  • Can’t feel any emotions (positive or negative)
  • Can’t get out of bed or leave the house
  • Can’t work
  • Can’t take care of themselves or others
  • Thinks or talks about suicide

That’s what severe depression can look like, and it’s a terrible and potentially deadly illness. Most people would notice those signs, realize something was wrong, and hopefully get some help.

But depression has many different faces and manifestations.

I was one of the walking depressed. Some of my clients are too.

We have many of the symptoms of clinical depression, but we are still functioning.

On the surface, people might not know anything is wrong. We keep working, keep going to school, keep looking after our families.

But we’re doing it all while profoundly unhappy. Depression is negatively impacting our lives and relationships and impairing our abilities.

Our depression may not be completely disabling, but it’s real.

10 Signs of Walking Depression

“I once read that succumbing to depression doesn’t mean you are weak, but that you have been trying to be strong for too long, which is maybe a form of denial. So much of life happens somewhere in between being okay and complete breakdown—that’s where many of us live, and doing so requires strength.” ~ novelist Matthew Quick

Walking depression can be hard to recognize because it doesn’t fit the more common picture of severe depression. But it can be just as dangerous to our well-being when left unacknowledged.

This list isn’t meant to be exhaustive or to diagnose anyone. But these are some of the signs I’ve observed in myself and those I’ve coached:

Nothing is fun. You root around for something to look forward to and come up empty.

You can’t find flow. Working on your creative projects feels like a grind, but you keep plodding away. There is research that shows that neuroticism (the tendency toward negative moods) is associated with lower rates of flow.

Your energy is low. Maybe you’re not getting enough rest because you’re too anxious to sleep, or you’re trying to cram too many tasks into a day, or you’re punishing yourself by staying up. Whatever the reason, you are effin’ tired.

You feel worse in the morning and better at night. I remember explaining this to a friend, who found it mystifying. In the morning I felt the crushing weight of all the things I had to do that day. In the evening I was temporarily free from expectations and could enjoy a moment’s respite.

You have simmering resentment toward others. Sure, you’re still doing what everybody asks of you, but you stew in anger the whole time. You are jealous of and bitter toward people who look happier than you feel.

Your self-talk gets caustic. You say nasty things in an effort to shock yourself into action. You use shame as a motivator.

You feel distanced from people around you. It’s hard to have genuine, intimate conversations because you have to keep up this front that you are alright.

You deprive yourself of creative work time (the artist as sadomasochist). This helps you exert some control and stirs up feelings of suffering that are perversely pleasurable. Also, taking on new projects that prevent you from writing or making art lets you prove to yourself that you’re still strong and capable.

Jen Lee has coined the term Dutiful Creatives to describe those who are inclined to take care of their responsibilities before anything else.

“If life were a meal, you’d consider your creativity as the dessert, and always strive to eat your vegetables first. Pacing and knowing how to say No are your strengths, but your creativity is more essential to your well-being than you realize.” from Jen Lee’s Quiz: What Kind of Creative Are You

You notice a significant mood change when you have caffeine or alcohol. A cup of coffee might make you feel a lot more revved-up and optimistic. A glass of wine might make you feel really mellow and even ~ gasp! ~ happy. (That’s how I finally realized that I was depressed.)

You feel like you’re wasting your life. Some people have a high sensitivity to the inherent meaning in what we do. Creativity coach Eric Maisel calls this our “existential intelligence.” If our daily activities don’t carry enough significance ~ if they don’t feel like a worthwhile use of our talents and passions ~ then soon we are asking ourselves, “What’s the point? Why should I keep going?”

(Eric Maisel has published a book called Rethinking Depression, which I talk to him about in this post, When Medication Isn’t Enough.)

Why is it hard to admit that you have walking depression?

You may recognize many of these signs in your life but still be slow to admit that you are depressed. Why is that?

Because it feels presumptuous to put yourself in that category when you’re still getting by. You feel like it would be insulting to those who are much worse off than you. You may feel like you have no real reason to be depressed.

Because your pride and your identity take a hit. You have to admit vulnerability and allow that you are not the all-conquering superhero you thought you were.

Because you realize that you and your life need to change, which feels like more work piled on your plate.

Because you are admitting your own responsibility for your unhappiness and that can trigger self-judgment.

Because you might uncover grief or anger at those around you for not seeing and taking better care of you.

What to do, what to do?

I’ve posted another entry about how creatives heal from walking depression, and here are the highlights:

  • Rest.
  • Make use of medication and other physical treatments.
  • Do therapy.
  • Practice gratitude.
  • Make connections.
  • Reduce your responsibilities.
  • Spend time creating.
  • Change your thoughts.
  • Develop a meaning practice.
  • Change your life.

These steps are simple to say, not easy to do, so make sure you get as much support as you can.

Important: If you are in dire straits, please contact your doctor or visit the International Suicide Prevention Wiki to find a hotline near you.

Investigating the ‘kayak method’ of negotiating at work

Thought I’d pass this along
. . .  An interesting way to frame negotiations, communication, and planning.

I just like the metaphor here.
Reminds me of summer . . . and the pond waterfall here is bubbling :-).
Best,
Rory

Columbia University professor Alexandra Carter finds kayaking to be a good metaphor for navigating your career.

When Columbia University law professor Alexandra Carter teaches people to negotiate, she shows them a picture of a kayak navigating a series of sea caves. It seems an unlikely metaphor, but the Merriam-Webster dictionary definition of negotiate is “to successfully travel along or over.”

She loves the metaphor because to get anywhere in a kayak, you need the right information and must steer, which comes by paddling with a steady rhythm. Outside forces can also carry you away. “Everything you see, hear and feel helps you to steer with accuracy toward your goal,” she writes in her recent book Ask for More.

Translate the kayak to your career, and she says the first lesson is that you don’t wait for a contract to come due with a client or the end of the year to negotiate salary with your boss. Instead, you are continuously piloting those relationships in every conversation you have. Also, you need the right information to steer you toward your goal, which comes by asking questions.

The core of her approach are 10 questions, the first five to ask of yourself and the next five of the other party. Those first five, which she calls “the mirror,” are:

  • What’s the problem I want to solve? Negotiations, after all, are about steering. Most people figure the fun part of negotiations is figuring out the answer, but the juicy part is defining your problem.
  • What do I need? People often prepare for negotiations by thinking about their worst case, bottom line for a deal. But she says research shows those who instead focus on identifying their goals get more from negotiations, especially if their aspirations are optimistic, specific and justifiable.
  • What do I feel? Feelings are facts. They are real and must be dealt with in any negotiation.
  • How have I handled this successfully in the past? Considering a past success boosts confidence and helps you to return to the successful mindset from that previous time, allowing you to access your inner wisdom and generate helpful ideas.
  • What’s the first step? There may be many issues on the table in the negotiation. Which one should you start with? Make sure you are likely to have success with it, so you can build momentum.

Now shift your eyes from the mirror to “the window” and ask these five questions to work with the other party:

  • Tell me … ? Cast a wide net by asking that person to share their view of the goal or problem that brought you together, any important details relating to it, their feelings and concerns, and anything else they feel like adding. “No question unlocks trust, creativity, understanding and mind-blowing solutions like ‘Tell me,’” she says. Sometimes the issue is not what you thought.
  • What do you need? This can be a game-changer, helping to dig underneath the other person’s demands and figure out what is driving them.
  • What are your concerns? This not only gives you information that you can use in the discussions but also makes the other person feel heard. If concerns are left unsaid, the negotiation will likely end unresolved.
  • How have you handled this successfully in the past? Again you travel back in time, but this time encouraging the other person to remember ways in which they have handled similar challenges successfully. “It triggers our memory bank of experiences to allow us to expand our pie of potential options for our current situation,” she says.
  • What’s the first step? You don’t have to accept what they say, but by asking you increase the chance some option they offer fits with your needs.

So get in your figurative kayak, armed with questions rather than paddles, and move ahead.

Quick hits

  • If you unexpectedly find 15 minutes in your day, what do you do with it? It’s unlikely your reaction was the same as renowned fashion designer Phillip Lim: “I just sit still and do nothing. … This is the ultimate luxury.”
  • With the future so uncertain, London Business School professor Herminia Ibarra recommends in Harvard Business Review conjuring up a diverse portfolio of options rather than sticking single-mindedly to one: “Today, more than ever, the path to your next career will be circuitous.”
  • The hardest thing of getting things done is doing one thing at a time, says career coach Dan Rockwell. The second hardest part of getting things done is choosing the right task.
  • Consultant John Linkner says you can sell better if you fill in the blanks on these three statements: After working with me, customers will have no more _____. After working with me, customers will have a good deal more _____. After working with me customers will have less _____.
  • To quickly open the Explorer window in Windows 10 hit Win+E on the keyboard.

How to Connect With Your Spouse After a Long Workday

https://www.verywellmind.com/is-work-affecting-how-well-you-connect-with-your-spouse-4138231

Once you’re finally home from work, you might flop down next to your spouse and ask, “How was your day?” They’ll likely reply, “Good.” They may go into detail or they may not. You may forget that you even asked the question while zoning out.

This person that you’re building a life with is pretty important. You know that. But after a long workday, possibly getting the kids bathed and in bed, plus cleaning up the house a bit, you have little energy left to connect with your spouse. The same goes for them, too. You love each other, but you’re exhausted.

Regardless of your energy levels, you’re in this life together and failing to make time to truly connect with each other can erode your relationship. So, here are six ways you can strengthen your bond that work even when you’re feeling wiped out.1

1

Ask Open-Ended Questions to Invoke Conversation

Ask open-ended questions to jump start your conversation

Getty Images / Gary John Norman

A close-ended question will result in a one-word response like “Okay” or “Fine”. We may use it as a warm-up for an in-depth conversation we’d like to start but instead, skip it. Get straight to the point and don’t waste your time and energy.

First, get your spouse’s attention, especially if they’ve already zoned out with electronics. Look them in the eyes, say hi, and then use the language of love. Go in for the kiss! Ah, now we’re talking! Contact has been made.2

Now, hook them into the conversation and ask a question like, “What was the best part of your day today?” to get them talking about something that excited instead of what stressed them out. Another question you could as is “What was your most important encounter today?” to learn who they connected with and what that was like.

Then, the most important part, listen with all your heart. Resist the urge to pick up your phone and mute the T.V. if you must. Leave the spotlight on them for as long as possible so that you can give each other your full attention.

Use the Language of Love

Use the language of love to connect with your spouse after a long work day

Pexels / Unsplash.com

Words are not the only way to connect with your spouse after a long day. If you don’t have the energy for a love-fest there are alternatives. You could have a long hug when you first see each other. When you feel like letting go, hug for a few more seconds and feel the connection between your hearts. Feels good, doesn’t it? Or give your spouse some really good kisses all night when they least expect it! You haven’t seen each other in over eight hours. Show them some love!

If this public display of affection bothers the kids physically make contact in discreet ways. You could hold hands while watching T.V. or walk hand in hand while taking the kids out for a walk. If your spouse is doing the dishes (yippee!), go up behind them and put your arms around them. This might feel funny, but that’s part of the game of love, right? Another idea is while on your tablets or laptops, touch their feet or legs with yours.

Reminisce About the Good Old Days

Take a trip down memory lane to connect with your spouse

Getty Images / Chris Ryan

If you don’t feel like hashing out your day talk about a specific funny or loving memory you shared. 3For example, you can ask, “Do you remember that time in Hawaii when we took our first helicopter ride and saw all those amazing waterfalls?” Then, enjoy the trip down memory lane.

Reminiscing takes you away from the stress of the daily grind. It sends you back to a happier time and thus gives you a burst of energy when you need it most, at the end of your day. You’ll feel grateful you were able to have that experience with your spouse. Your past has helped bring you both to where you are today.

Go to Bed Early – Together

Go to bed early with your spouse to connect after a long day

Getty Images / Lilly Bloom

Recoup from a tiring day by getting into bed early and at the same time. So, get ready for the next day together, like making coffee, putting out breakfast, or packing lunches together. Then, brush your teeth and get frisky or cuddle. Or, be silly—humor is a great way to bond! 3Then, jump under the covers and snuggle.

Snuggle time makes you feel secure and love. At the end of the day, a bit of affection tends to make us feel better, right? No words need, just getting warm and comfortable to prepare for a good night sleep.2

Smile at Each Other Often

Smile at each other, even if you don't feel happy, to connect with your spouse

Getty Images / SCC

Let’s say you come home in a bad mood. Although your spouse had nothing to do with that we tend to take out our frustrations on those we care about the most. With this perspective in mind, if you want to get over this bad mood and be able to connect with your spouse in a positive way, smile at them.

Psychologist and facial coding expert, Paul Ekman, discovered that if you smile with both your lips and eyes, even if it’s fake, it’ll put you in a better mood. Also, since we are wired to be social if your spouse sees you smiling, they can’t resist by smile back.4 Put this in your toolkit when you want to get your spouse out of their bad mood!

Start a Bucket List Together

Make a bucket list together to connect with yoru spouse

Getty Images / ZoneCreative

What do you want to do before you die? What does your spouse what to do before they die? After the kids are asleep start your bucket list. How many similar things do you want to accomplish?

This conversation connects you by dreaming about possibilities. These things don’t have to be done this weekend. They are goals you’d like to accomplish within your lifetime. This perspective takes the pressure off checking off the list and instead you dream together. Making plans this way can excite you both and give you another burst of energy at the end of a long day.

A Word From Verywell

At the end of the day, your marriage needs your attention. Not your undivided attention, and perhaps not every day. But making an effort, even a small one, will pay off in a closer connection and healthier marriage. Taking the time to nurture this relationship lets your partner know you care and that they (and your marriage) are a top priority—and helps keep your relationship strong.

How to ADHD!

Link:

Welcome to How to ADHD!

Welcome to How to ADHD!

 

What’s HowToADHD?

Have ADHD? Know someone with ADHD? Want to learn more? You’re in the right place! We post videos with tips, tricks and insights into the ADHD brain. This channel is my ADHD toolbox — a place to keep all the strategies I’ve learned about having and living with ADHD.  It’s also grown into an amazing community of brains (and hearts!) who support and help each other. Anyone looking to learn more about ADHD is welcome here!

 

Here at HowToADHD we aim to provide a safe, respectful, and welcoming community that help each other out. Whether you are a Brain, a Heart, or simply someone curious about ADHD, don’t worry! Everyone is welcome!

 

Don’t know where to start? Try here!

 

Some things about ADHD:

ADHD is a common neuro-developmental disorder that is incurable, but highly treatable. ADHD is also one of the most researched mental disorders, and has many available treatments, such as stimulant and non-stimulant medications, cognitive behavioral therapy, ADHD coaching and strategies such as mindfulness meditation and exercise.

It’s also important to remember that ADHD isn’t the same for everyone! There are 3 different presentations (primarily inattentive, primarily hyperactive-impulsive, and a combination of both). ADHD is also on a spectrum  — it ranges from mild to severe — and it is often accompanied by other conditions like anxiety or depression and learning disabilities like dyslexia. Therefore, what works for one ADHDer may not be right for others, but most ADHD brains benefit from a combination of treatment strategies. Medication is not a cure all answer!

Most importantly: Jessica is not a medical professional, nor does she claim to be one.

ADHD can only be diagnosed by a medical professional!

 

Have a question? Try checking out our FAQ!

7 Ways Psychotherapists Can Get in the Way of Psychotherapy

https://www.psychologytoday.com/us/blog/progress-notes/201910/7-ways-psychotherapists-can-get-in-the-way-psychotherapy

Verified by Psychology Today

Trained curiosity and assessment are not the soul of psychological change.

Posted Oct 13, 2019

StartupStockPhotos/Pixabay
Source: StartupStockPhotos/Pixabay

There is a vast gulf between diagnosable issues as seen through the lens of psychological expertise and the essence, identity, strengths, and hopes of a person before me. Psychotherapists mean well, but at times we all stray outside of the bounds of helpfulness. Here are seven ways psychotherapists get in the way of psychotherapy:

1. Interrogating

When people come into session in the midst of an emotional storm, the last thing they need is to be inundated with endless questions on the basis of an agenda that is likely intended more to fulfill organizational protocols than to promote a foundation of therapeutic empathy and rapport.

Questioning always runs the risk of interrogation. The details learned about people’s lives ever tempt helping professionals toward distraction. There is a distinct difference between a personality and a person, a diagnosis and a destiny. It is our responsibility to stir hope and catalyze strengths rather than to stew history and analyze at length.

2. Pathologizing

The concept of “mental disorder” is rigid and misleading. In short, diagnosis is description, and by and large, mental health diagnosis provides description of “software” issues rather than “hardware,” so to speak. It’s a language of understanding what type of struggle a person is experiencing. When therapists refer to people by these diagnostic labels, we may overgeneralize a person’s experience and distance ourselves from a critical resource: the powerful, complex, and fluid process of therapeutic understanding, the power center of effective therapy.

3. Shaming

We ever risk a false sense of expertise about people’s lives against the backdrop of anxiety about our own. If we’re not careful, we may find ourselves reinforcing the tyranny of the perceived should. Should is shame‘s accomplice, and therapists must take care not to aid and abet them.

4. Sympathizing

Researcher Brené Brown (2010) rightfully proclaimed, “Empathy fuels connection, while sympathy drives disconnection.” Saying you understand is unhelpful and probably not true. And let’s be honest: It’s usually a ploy to rush people out of their emotional state, which sends the message, “I really don’t care enough to walk with you through your suffering.”

Gerd Altmann/Pixabay
Source: Gerd Altmann/Pixabay

5. Lecturing

Psychologist and psychotherapy researcher Les Greenberg (2002) wrote, “Darwin, on jumping back from the strike of a glassed-in snake, having approached it with determination not to start back, noted that his will and reason were powerless against even the imagination of a danger that he had never even experienced. Reason is seldom sufficient to change automatic emergency-based emotional responses.”

With a surge in cognitive therapies, there has been a surge in their wrongful implementation, with many therapists engaging in power struggles to convince people of faulty beliefs in order for new, more positive truths to simply work some magic ripple effect into their lives.

As an emotion-focused therapist, I have been prone to, for instance, encourage couples to engage in safer, softer, and more emotionally responsive interactions, yet when I have stood on my own soapbox, encouraging them to do so out of pace with their own readiness, I have violated my own guidance. Miller (1986) observed that people will “persist in an action when they perceive that they have personally chosen to do so.”

6. Babbling

Silence can provoke anxiety, even for therapists, who think they should surely be redirecting, conjecturing, advising. I find myself observing people in therapy watch me watch them watching me watch them. And I have found a power in it. Like a Rorschach ink blot, presence has power in and of itself to nudge a person’s anxiety so it presents and speaks up for itself.

My former colleague, Blanche Douglas (2015), wrote: “There was a method in Freud‘s madness when he prescribed the analyst be as undefined as possible, not disclosing details about his life and sitting behind the patient out of sight, saying little. This forced the patient to make meaning out of an ambiguous situation, and the only way he could do this was by recourse to his own experiences.”

7. Methodologizing

If a psychotherapist is lifeless or their technique too technical, their efforts to help may be worthless. Therapy, in this case, is not a relationship but a poor excuse for scientific experimentation. The mechanisms of some psychotherapies undermine their therapeutic value. When we fixate on therapeutic modality, we run great risk of missing prime opportunities to interject the most valuable therapeutic tool we have to offer—ourselves.

Cristofer Jeschke/Unsplash
Source: Cristofer Jeschke/Unsplash

Conclusion

As a new therapist, I remember trying hard to demonstrate my own capacity for psychological insight—even though, I must confess for my wise professors’ sake, I was certainly not trained to be an egotistical show-off. Fortunately, somewhere along the way, I started to better understand and experience the disparity between knowing and being. All these years, I am still learning each day how to lean into the latter. There is something powerful in it, not just in the experience of the therapist but in the experience of the therapy.

The family therapy pioneer Lynn Hoffman, who sadly died in 2017, gave a language of values for sitting with clients—the non-expert position, relational responsibility, generous listening, one perspective is never enough.

If a therapist is not fully present as a warm, accepting, genuine, caring, and appropriately vulnerable person, the power center of therapy remains turned off. Whatever insight may come along the way, meaningful, sustainable change requires transformative experiencing. Analysis without encounter is nihilistic, all the apparatus of thought busily working in a vacuum. Only in the context of authentic relationship and therapeutic alliance can I grasp and catalyze the breadth and depth of formidable resources already existing within my clients.

This article originally appeared at Psychotherapy.net.

Chronic insomnia best treated with psychotherapy 1st – Health – CBC News

People with chronic insomnia should try cognitive behavioral therapy before medications, suggests a prominent group of U.S. doctors.

Source: Chronic insomnia best treated with psychotherapy 1st – Health – CBC News

Chronic insomnia is defined as at least three restless nights per week for at least three months.

Chronic insomnia is defined as at least three restless nights per week for at least three months. (Alyssa L. Miller, Flickr cc)

While the American College of Physicians (ACP) can’t say cognitive behavioural therapy (CBT) outperforms medications for chronic insomnia, the group does say psychotherapy is less risky than drugs.

“Sometimes we forget that sleep medications have the potential for serious side-effects in some patients, while cognitive behavioural therapy is very low [risk] to patients,” said Dr. Wayne J. Riley, ACP president.

“The evidence is clear that CBT and sleep hygiene can be long lasting, life long, durable and delivered at a lower cost,” said Riley, who is also affiliated with Vanderbilt University in Nashville.

About 6 to 10 per cent of people in the U.S. have insomnia. Through loss of productivity, the condition is estimated to have cost the country about $63 billion US in 2009, according to the ACP committee that wrote the new guideline, which is published in the Annals of Internal Medicine.

Chronic insomnia is defined as at least three restless nights per week for at least three months.

“We wanted to take a deep dive into the literature for what makes a big difference with insomnia,” Riley told Reuters Health.

The ACP commissioned two reviews of insomnia treatments. One focused on medications, and the second focused on psychological and behavioural treatments.

Medication and ‘sleep driving’

Overall, the first review found that some medications may improve sleep over a short period of time, but those come with the potential for changes in thinking and behaviour. Additionally, there is a risk for infrequent but serious harms.

The U.S. Food and Drug Administration says medications for insomnia should only be used for short periods. The agency warns those drugs may impair people during the daytime, lead to “sleep driving,” behavioural changes and worsening depression.

The review of psychological and behavioural treatments found that CBT for insomnia improved overall sleep with a low risk of harms, the researchers report.

Evidence collected separately for the two reviews found that “side-effects can be quite severe with the use of insomnia medications in contrast to CBT, where there are minimal side-effects,” said Riley.

CBT for insomnia is typically delivered in four to six one-hour weekly sessions. People are taught behavioural techniques such as sleep restriction and stimulus control, and they are also taught sleep hygiene.

When chronic insomnia isn’t helped by CBT alone, the ACP advises patients and doctors to consider a short course of medication. That discussion should touch on the potential benefits, harms and costs of medication, the ACP says.

Doctors should encourage patients with insomnia to engage in CBT, according two researchers whose editorial was published with the reviews and the guideline.

‘Prescription not the best solution in the long term’

But, they admit, CBT for insomnia might not be covered by insurance and is likely not available at doctors’ offices, write Dr. Roger Kathol, of the University of Minnesota in Minneapolis, and J. Todd Arnedt, of the University of Michigan Medical School in Ann Arbor.

“Unless access to and unencumbered payment for value-based behavioural interventions, such as CBT (for insomnia), in medical settings become a reality, patients with chronic insomnia will continue to receive suboptimal treatment and experience suboptimal outcomes,” they write.

Alternatives to in-person CBT for insomnia include group therapy session, telephone counseling, online lessons and self-help books, Riley said.

The ACP recommendations are similar to that of the American Academy of Sleep Medicine (AASM), said Dr. Alcibiades Rodriguez, who is medical director of NYU Langone Medical Center’s Comprehensive Epilepsy Center-Sleep Center in New York City.

The AASM’s 2008 practice guidelines for treating chronic insomnia endorse psychotherapy as a first-line treatment and suggests it be used when medications are prescribed.

“The recommendations made by the ACP will appeal to a broader group of physicians to make them aware of this,” said Rodriguez, who was not involved with the new recommendations. “Then the doctors know just giving patients who come to their office with sleep problems a prescription is not the best solution in the long term.”

Residential school survivor uses poetry, psychotherapy to heal – Saskatoon – CBC News

A poet and residential school survivor is releasing her latest collections of poems, and she says they have been instrumental in healing from the scars of residential schools.

Source: Residential school survivor uses poetry, psychotherapy to heal – Saskatoon – CBC News

Louise Bernice Halfe was was born in Two Hills, Alta., and completed programs at the University of Regina and University of Saskatchewan. She attended the Blue Quills Residential School, near St. Paul, Alta., for six years.

While the recently finished Truth and Reconciliation Commission was intended to help survivors heal, Bernice Halfe said the process opened old wounds. This collection of poetry, Burning in this Midnight Dream, helped heal those wounds.

Traditional ceremonies, psychology needed to help others

“It’s been extremely challenging and frightening as well,” she said of the process of walking backward, and retracing her past through the poetry. “What scared me was the feeling of being exposed and vlunerable.”

She said she needed to press ahead as a process of “accepting responsibility of my own actions and behaviours,” but the poetry is “also for the people who don’t have the vocabulary to articulate the shame and the pain and the anger that goes within their own stories.”

Bernice Halfe has training in drug and alcohol counseling, and in social work. She also emphasized the importance of psychotherapy and talking as tools for healing.

‘How do you recover as quickly as the people in the Canadian public want us to recover? I don’t know; I hope it’s possible. It’s very very hard.’– Louise Bernice Halfe

When asked how she wants to contribute to conversations on the legacy around residential schools, she described a photograph that showed her parents’ wedding and all of her relatives connected to her parents.

“There’s been a generational impact on whole communities. How do you recover as quickly as the people in the Canadian public want us to recover? I don’t know. I hope it’s possible. It’s very, very hard,” she said.

Bernice Halfe said she wants to see more aboriginal therapists and psychologists. “Not the kind that just prescribe pills,” she said.

Part of that responsibility is shared by the government, which she said has been insufficient in providing deep healing for aboriginal communities to recover from the legacy of residential schools.

“I would like to see more people trained in psychotherapy, along with their [traditional] ceremonial practices,” she said. “We needing funding for education in our communities. We also need mental health services closer to the communities.

“I’m talking about talk therapy. I’m talking about psychologists,” she emphasized.

Louise Bernice Halfe launches her latest collection of poems on Thursday at McNally Robinson in Saskatoon at 7 p.m. CST.

“Clara’s Big Ride”: Watch Online Full Episodes

Watch Online on CTV | Watch Full Episodes.

About “Clara’s Big Ride”

Part catalyst for change and part epic road movie, CLARA’S BIG RIDE is an inspiring new film that tackles the profound conversation about mental health and the stigma that surrounds it.

Latest Videos


  • Clara’s Big Ride

    S0:E | 2015-01-28

    Chronicles an unprecedented 11,000 km bicycle journey across Canada by Olympic medallist and Bell Let’s Talk spokesperson Clara Hughes.


  • Let’s Talk: A Marilyn Denis Special

    S0:E | 2015-01-15

    Joined by Dr. Marla Shapiro & Clara Hughes, Marilyn Denis uncovers the stories of 5 remarkable Canadians who struggle with mental illness.


  • Words Of Hope

    S0:E | 2015-01-15

    Nolan is a student at the University of Waterloo who wrote a column about his struggles with his own mental illness.


  • Coping With Anxiety

    S0:E | 2015-01-15

    Richie from Montreal discusses overcoming anxiety and gets to meet and interview Clara Hughes for his university’s radio show.

VIEW MORE ►

Psychotherapy Beats Medication for Social Anxiety Disorder | Psych Central News

Psychotherapy Beats Medication for Social Anxiety Disorder | Psych Central News.

By  Associate News Editor
Reviewed by John M. Grohol, Psy.D. on September 27, 2014

While antidepressants are the most commonly used treatment for social anxiety disorder, cognitive behavioral therapy (CBT) is more effective and — unlike medication — can have lasting effects long after treatment has stopped, according to a new study. CBT is one of the most common forms of talk therapy or psychotherapy.

According to researchers at John Hopkins University, social anxiety disorder, which is characterized by intense fear and avoidance of social situations, affects up to 13 percent of Americans and Europeans.

Most people never receive treatment. For those who do, medication is the more accessible treatment because there is a shortage of trained psychotherapists, according to the researchers.

“Social anxiety is more than just shyness,” said study leader Evan Mayo-Wilson, D.Phil., a research scientist in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health.

“People with this disorder can experience severe impairment, from shunning friendships to turning down promotions at work that would require increased social interaction.

“The good news from our study is that social anxiety is treatable. Now that we know what works best, we need to improve access to psychotherapy for those who are suffering.”

The study, a network meta-analysis that collected and analyzed data from 101 clinical trials comparing multiple types of medication and talk therapy, was a collaboration between the Johns Hopkins Bloomberg School of Public Health, Oxford University and University College in London, where Mayo-Wilson formerly worked.

For the new study, the researchers analyzed data from 13,164 participants in 101 clinical trials. All had severe and longstanding social anxiety. Approximately 9,000 received medication or a placebo, while more than 4,000 received a psychological intervention.

Few of the trials looked at combining medication with talk therapy, and there was no evidence that combined therapy was better than talk therapy alone, the researchers noted.

After comparing several different types of talk therapy, the researchers found that individual CBT was the most effective. CBT, which focuses on relationships between thoughts, feelings and behaviors, helps people challenge irrational fears and overcome their avoidance of social situations, according to Mayo-Wilson.

For people who don’t want talk therapy, or who lack access to CBT, the most commonly used antidepressants — selective serotonin reuptake inhibitors (SSRIs) — are effective, the researchers found. But they caution that medication can be associated with serious adverse events, that it doesn’t work at all for some people, and that improvements in symptoms do not last after patients stop taking the pills.

The researchers acknowledge that medication is important, but say it should be used as a second-line therapy for people who do not respond to or do not want psychological therapy.

According to Mayo-Wilson, the analysis has already led to new treatment guidelines in the U.K. and it could have a “significant impact on policymaking and the organization of care in the U.S.”

“Greater investment in psychological therapies would improve quality of life, increase workplace productivity, and reduce health care costs,” Mayo-Wilson said.

“The health care system does not treat mental health equitably, but meeting demand isn’t simply a matter of getting insurers to pay for psychological services. We need to improve infrastructure to treat mental health problems as the evidence shows they should be treated. We need more programs to train clinicians, more experienced supervisors who can work with new practitioners, more offices, and more support staff,” he said.

The study was published in The Lancet Psychiatry.

Source: Johns Hopkins University

After I Was Diagnosed With Bipolar Disorder, I Decided to Move Forward

After I Was Diagnosed With Bipolar Disorder, I Decided to Move Forward

Posted: Updated: 


When I was 17 years old, I was diagnosed with Bipolar Disorder, something that came as no surprise, as my life prior to my diagnosis was fraught with behavioral challenges. At 21 years old, after years of battling uncontrollable moods, fits of rage, a myriad of body image issues, addiction and frustration with finding adequate medication I found myself in my first psychotic episode. This was no way to live, I knew I was capable of so much more as an articulate young woman with big dreams. At 5 o’clock in the morning on July 7, 2011, after driving through the night with a head full of racing thoughts in a mind that possessed zero ability to cope, I found myself collapsed on the porch of my father’s home manic, enraged and inconsolable. I was surrendering, I could no longer fight the battle my life prior to that summer had felt so unrelenting and inhibiting. After a brief rest early that morning, the first few hours of sleep I had experienced in days, is when made my decision to thrive. For years prior to that hazy morning, I had been urged by loved ones to receive intensive clinical psychological treatment in a formal setting, but I believe part of me was always resisting in denial and arrogance. It was at the end of my rope where I found my desire to change the trajectory of my life. On July 11, 2011, I made the first imprints in the path toward my new way of being in the world. I spent 90 days in intensive psychological care and healing treatment where I acquired invaluable “tools” that allowed me to move forward in the world, the woman I was on my father’s porch that July morning became a shadow of my former self and an unwelcome stranger in my future.

Almost three years later not a day goes by where I don’t draw on the lessons learned through my decision to thrive. I am currently finishing my Bachelor’s degree in clinical psychology and work as a peer counselor to youth experiencing their first onset of mental illness in Los Angeles, California. Everything I do comes from a place of gratitude for my demons and experiences that catalyzed my decision to forge the path I am on today. For I would be nothing without them just as I would be nothing without the boundless compassion, patience and support of the loved ones in my life who have championed all of my efforts.

I used to think the notion that people could change was a farce … until I did it myself. I am changing everyday, creating a more authentic self with every opportunity to do so, and within the beautiful chaos of it all — I am thriving.

Arianna has invited her Facebook followers to share their wake-up calls — the moments they knew they had to make changes in their lives in order to truly thrive and not just succeed — as part of a series produced in conjunction with the release of her book Thrive: The Third Metric to Redefining Success and Creating a Life of Well-Being, Wisdom, Wonder and Giving. You can read all the posts in the series here.

Listening Skills – The 10 Principles of Listening | SkillsYouNeed

Listening Skills – The 10 Principles of Listening | SkillsYouNeed.

A good listener will listen not only to what is being said, but also to what is left unsaid or only partially said. Effective listening involves observing body language and noticing inconsistencies between verbal and non-verbal messages.

For example, if someone tells you that they are happy with their life but through gritted teeth or with tears filling their eyes, you should consider that the verbal and non-verbal messages are in conflict, they maybe don’t mean what they say.

1. Stop Talking

If we were supposed to talk more than we listen, we would have two tongues and one ear.” Mark Twain.

Don’t talk, listen.  When somebody else is talking listen to what they are saying, do not interrupt, talk over them or finish their sentences for them.  Stop, just listen.  When the other person has finished talking you may need to clarify to ensure you have received their message accurately.

2. Prepare Yourself to Listen

Relax.  Focus on the speaker.  Put other things out of mind.  The human mind is easily distracted by other thoughts – what’s for lunch, what time do I need to leave to catch my train, is it going to rain – try to put other thoughts out of mind and concentrate on the messages that are being communicated.

3. Put the Speaker at Ease

Help the speaker to feel free to speak.  Remember their needs and concerns.  Nod or use other gestures or words to encourage them to continue.  Maintain eye contact but don’t stare – show you are listening and understanding what is being said.

4. Remove Distractions

Focus on what is being said: don’t doodle, shuffle papers, look out the window, pick your fingernails or similar. Avoid unnecessary interruptions.  These behaviours disrupt the listening process and send messages to the speaker that you are bored or distracted.

5. Empathise

Try to understand the other person’s point of view.  Look at issues from their perspective.  Let go of preconceived ideas.  By having an open mind we can more fully empathise with the speaker.  If the speaker says something that you disagree with then wait and construct an argument to counter what is said but keep an open mind to the views and opinions of others.

See our page: What is Empathy?

6. Be Patient

A pause, even a long pause, does not necessarily mean that the speaker has finished.  Be patient and let the speaker continue in their own time, sometimes it takes time to formulate what to say and how to say it.  Never interrupt or finish a sentence for someone.

7. Avoid Personal Prejudice

Try to be impartial.  Don’t become irritated and don’t let the person’s habits or mannerisms distract you from what they are really saying.  Everybody has a different way of speaking – some people are for example more nervous or shy than others, some have regional accents or make excessive arm movements, some people like to pace whilst talking – others like to sit still.  Focus on what is being said and try to ignore styles of delivery.

8. Listen to the Tone

Volume and tone both add to what someone is saying.  A good speaker will use both volume and tone to their advantage to keep an audience attentive; everybody will use pitch, tone and volume of voice in certain situations – let these help you to understand the emphasis of what is being said.

See our page: Effective Speaking for more.

9. Listen for Ideas – Not Just Words

You need to get the whole picture, not just isolated bits and pieces.  Maybe one of the most difficult aspects of listening is the ability to link together pieces of information to reveal the ideas of others.   With proper concentration, letting go of distractions, and focus this becomes easier.

10. Wait and Watch for Non-Verbal Communication

Gestures, facial expressions, and eye-movements can all be important.  We don’t just listen with our ears but also with our eyes – watch and pick up the additional information being transmitted via non-verbal communication.

See our page: Non-verbal Communication.


Do not jump to conclusions about what you see and hear. You should always seek clarification to ensure that your understanding is correct.


See our pages: Clarification and Reflection for more information.

 

Find more at: http://www.skillsyouneed.com/ips/listening-skills.html#ixzz2if8JlXbH

Warrior Rising – A Soldier’s Journey to PTSD and Back

Warrior Rising-A Soldier’s Journey to PTSD and Back” – “Warrior Rising” by Chris Linford.

Why I wrote the book…
I considered writing this book for a few years but really got
going on it recently. I was incredibly inspired by the novel “Shake Hands with the Devil” by General (retired) and now Senator Romeo Dallaire some years ago as he was instrumental in achieving Post Traumatic Stress Disorder or PTSD being recognized and placed on the “map” for Canadians! For the first time, as a result of reading his book, my shame faded and I began to open my eyes to the
possibility I too could be healthy again!

I started to write of my military deployed operations many times but found it too difficult to think of the emotionally charged events. Many of the memories were disturbing and evoked a significant anxiety response in my head, chest and shoulders. The anxiety made it extremely difficult to think clearly and in depth about the specifics of certain events during my deployments, not to mention how they impacted my life both personally and professionally.

Recently, and after a year of intense therapy for PTSD at the Canadian Forces Health Services Centre (Pacific) in Esquimalt BC, I achieved the best health I have known for several years. I was able to concentrate again and think in detail of the stories in particular from Rwanda and Afghanistan without becoming agitated and overwhelmed; I had some new “tools” in my pack! I found the place in my head and soul where I could remember these events with clarity and honesty and was inspired to make my story available to everyone as so many Canadians are unaware of what can occur on military deployments and the illnesses and injuries we sometimes acquire. The stories need to be told, but the impact of those events is perhaps the most important part including the impact on military families.

I am 52 years old and awaiting medical release from the CF; my time for deployments is over. I have served 24 years in the Regular Force and 8 years with the Reserves. It has been a great career and I see my role changing from that of a medical commander to that of a “helper” or “peer” to those who have not yet figured out what steps need to be taken to claim life and personal health back.

I waited 10 years to get help after my Rwandan deployment as I thought I was okay and that I could manage the symptoms of anger, hyper arousal, depression and insomnia. I could not accept that I may be judged as a malingerer or as weak. I thought I could do it, but I was wrong. This is the reason I wrote this book, as many wait for years and try everything and anything we can to keep from asking for help to manage symptoms;  alcohol and drugs are often the answer for so many.

The stigma surrounding mental health within the military community is still very prevalent and must be eliminated to open the door for thousands of combat veterans to confidently present themselves to receive the help they deserve and not feel guilty or less of a soldier, sailor, airman or airwoman for doing so! Courage  can be demonstrated in many ways, and exercising it earlier rather than later is  by far the best approach to enable veterans to effectively manage the stress of  combat deployments and return to full and active military or civilian careers and lives.

The intent of this book is to get that premise understood. It needs to be in the public domain as it is the “community” that will diminish the stigma of “weakness” by insisting their military sons and daughters receive treatment early. So many veterans suffer and will continue in silence long after the combat missions are over and the media has gone on to new and more dynamic stories. For the Canadian public at large, the war is over in Afghanistan as the CF now concentrates upon a mentoring role of Afghan military and police forces. The war for hundreds, and perhaps thousands of CF veterans will continue in the form of an insidious, invisible war injury; an  Operational Stress Injury (OSI) which includes Post Traumatic Stress Disorder.

I was diagnosed with PTSD in 2004, almost 10 years after my deployment to Rwanda Africa just after the terrible genocide inflicted upon the Tutsi Tribe by the Hutu’s. I struggled emotionally for several years but eventually I had to ask for help as I became professionally and personally dysfunctional and unable to cope with even “normal” levels of daily stress! My wife Kathryn and my children would tell you that they knew something was wrong long before I thought people would notice. I played a game in my head using all my personal resources and energy to hide the fact that I was not well.

I achieved very good health once I was treated for my initial PTSD, which took about a year of therapy as well as medications. I was able to continue my military career and eventually go on to command medical units, as well as deploy again to Kandahar to be the Executive Officer (XO) of the NATO Role 3 Combat Surgical Hospital. This was an important event in my life and I would not
change any of it. I did get very sick again through this mission but looking back on it now, I would do it again as I was able to do what I was trained to do.

I hope my story will be helpful to all veterans, who need to know that they are not alone with this war injury, and there exists significant resources to help in their recovery; they just need to step forward and ask for it! It doesn’t always mean the end of a military career especially if it can be identified and treated early. This book is also for family members of those individuals as they often feel isolated and “at a loss” for what to do to help their loved one. Lastly, this book is for the Canadian public.

I have been asked many times if the CF is treating our veterans with PTSD better now. I have seen many changes since the first Gulf War in 1991, to Rwanda in 1994, to present day, and I can say with certainty that the CF is doing much better with treatment resources. After all, I am “walking talking proof” that what the CF Mental Health world offers worked for me! However, I do believe that more can be done, but it is important that only proven therapies are offered to CF Vets. Having said that, it is incumbent upon Mental Health professionals and senior leadership in the Canadian Forces Health Services to actively research and provide the finest treatment protocols. They must recognize that there is no “magic pill”, but in fact many worthy resources to treat this terrible injury. The right combination of therapies over time will enable Vets afflicted with PTSD to return to a good and healthy lifestyle.

Warrior Rising describes not only what made me ill with PTSD, but also what I did to battle it down. In the last chapter, I reflect upon my twice weekly therapy sessions and the practices I took on between those sessions. The road back to health can only be guided by the therapy; it is the veteran that must do the really hard work! These were difficult times for me and my family and I hope the honesty and frankness of this chapter will serve as encouragement for those on that path, as well as those not yet started. This is a very personal story and thus it is told as seen through my eyes and in the first person.

In the first chapter I present a short background of my life as a young person purely to demonstrate that I came from a fairly “normal” home with two parents and lived in a suburb of Montreal in the 60’s and 70’s. I also present my initial military experiences just to provide some context of my life leading up to my deployment to the first Gulf War in 1991. I minimized that deployment as it was less than 60 days and in the grand scheme of things was a “blip” on the radar. I provide a few significant moments of this first deployment as it really gave my wife Kathryn and I a quick lesson on how a military deployment can so incredibly impact family life!

I look back upon my career with pride now. It hasn’t always been that way as when I was really sick I had difficulty feeling pride thus, it was very difficult to even put on my uniform. Even though my deployment experiences made me very ill with PTSD and depression, I hold no resentment towards my military career history as it has led me to the place I am today with an incredibly improved understanding of myself, my injury, and my personal and professional relationships. It has also led me to a new focus in life to come to the aid of those veterans who have not yet found the way to get help. I hope this book can play a role to that end.

The button below is now linked to the Friesen Press Bookstore to purchase Warrior Rising in either hard/softcover format. It will be available in early July and will appear on their website when ready to order. For eBook readers, you can download it by doing a search for the title: Warrior Rising- A Soldier’s Journey to PTSD and Back. Thanks to all of you for your patience and your purchase.

 

Adult ADHD: 50 Tips of Management

Adult ADHD: 50 Tips of Management « Dr Hallowell.

 

Adult ADHD: 50 Tips of Management

by Edward M. Hallowell, M.D. and
John J. Ratey, M.D.

The treatment of adult ADHD begins with hope.

We break down the treatment of adult ADHD into five basic areas:
•    Diagnosis
•    Education
•    Structure, support, and coaching
•    Various forms of psychotherapy
•    Medication

Following are 50 Tips for the non-medication treatment of ADHD:

Insight and Education
1.    Be sure of the diagnosis. Make sure you’re working with a professional who really understands ADHD and has excluded related or similar conditions such as anxiety states, agitated depression, hyperthyroidism, manic-depressive illness, or obsessive-compulsive disorder.
2.    Educate yourself. Perhaps the single most powerful treatment for ADHD is understanding ADHD in the first place. Read books. Talk with professionals. Talk with other adults who have ADHD. You’ll be able to design your own treatment to fit your own version of ADHD.
3.    Coaching. It is useful for you to have a coach, for some person near you to keep after you, but always with humor. Your coach can help you get organized, stay on task, give you encouragement or remind you to get back to work. Friend, colleague, or therapist (it is possible, but risky for your coach to be your spouse), a coach is someone to stay on you to get things done, exhort you as coaches do, keep tabs on you, and in general be in your corner. A coach can be tremendously helpful in treating ADHD.
4.    Encouragement. ADHD adults need lots of encouragement. This is in part due to their having many self-doubts that have accumulated over the years. But it goes beyond that. More than the average person, the ADHD adult withers without encouragement and positively lights up like a Christmas tree when given it. They will often work for another person in a way they won’t work for themselves. This is not “bad”, it just is. It should be recognized and taken advantage of.
5.    Realize what H is NOT, i.e., conflict with mother, etc.
6.    Educate and involve others. Just as it is key for you to understand ADHD, it equally if not more important for those around you to understand it–family, job, school, friends. Once they get the concept they will be able to understand you much better and to help you as well.
7.    Give up guilt over high-stimulus-seeking behavior. Understand that you are drawn to high stimuli. Try to choose them wisely, rather than brooding over the “bad” ones.
8.    Listen to feedback from trusted others. Adults (and children, too) with ADHD are notoriously poor self-observers. They use a lot of what can appear to be denial.
9.    Consider joining or starting a support group. Much of the most useful information about ADHD has not yet found its way into books but remains stored in the minds of the people who have ADHD. In groups this information can come out. Plus, groups are really helpful in giving the kind of support that is so badly needed.
10.    Try to get rid of the negativity that may have infested your system if you have lived for years without knowing what you had was ADHD. A good psychotherapist may help in this regard.
11.    Don’t feel chained to conventional careers or conventional ways of coping. Give yourself permission to be yourself. Give up trying to be the person you always thought you should be–the model student or the organized executive, for example–and let yourself be who you are.
12.    Remember that what you have is a neuropsychiatric condition. It is genetically transmitted. It is caused by biology, by how your brain is wired. It is NOT a disease of the will, nor a moral failing. It is NOT caused by a weakness in character, nor by a failure to mature. It’s cure is not to be found in the power of the will, nor in punishment, nor in sacrifice, nor in pain. ALWAYS REMEMBER THIS. Try as they might, many people with ADHD have great trouble accepting the syndrome as being rooted in biology rather than weakness of character.
13.    Try to help others with ADHD. You’ll learn a lot about the condition in the process, as well as feel good to boot.

Performance Management
14.    External structure. Structure is the hallmark of the non-pharmacological treatment of the ADHD child. It can be equally useful with adults. Tedious to set up, once in place structure works like the walls of the bobsled slide, keeping the speedball sled from careening off the track.
15.    Make frequent use of:
◦    lists
◦    color-coding
◦    reminders
◦    notes to self
◦    rituals
◦    files
16.    Color coding. Mentioned above, color-coding deserves emphasis. Many people with ADHD are visually oriented. Take advantage of this by making things memorable with color: files, memoranda, texts, schedules, etc. Virtually anything in the black and white of type can be made more memorable, arresting, and therefore attention-getting with color.
17.    Use pizzazz. In keeping with #15, try to make your environment as peppy as you want it to be without letting it boil over.
18.    Set up your environment to reward rather than deflate. To understand what a deflating environment is, all most adult ADHD’ers need do is think back to school. Now that you have the freedom of adulthood, try to set things up so that you will not constantly be reminded of your limitations.
19.    Acknowledge and anticipate the inevitable collapse of X% of projects undertaken, relationships entered into, obligations incurred.
20.    Embrace challenges. ADHD people thrive with many challenges. As long as you know they won’t all pan out, as long as you don’t get too perfectionistic and fussy, you’ll get a lot done and stay out of trouble.
21.    Make deadlines.
22.    Break down large tasks into small ones. Attach deadlines to the small parts. Then, like magic, the large task will get done. This is one of the simplest and most powerful of all structuring devices. Often a large task will feel overwhelming to the person with ADHD. The mere thought of trying to perform the task makes one turn away. On the other hand, if the large task is broken down into small parts, each component may feel quite manageable.
23.    Prioritize. Avoid procrastination. When things get busy, the adult ADHD person loses perspective: paying an unpaid parking ticket can feel as pressing as putting out the fire that just got started in the wastebasket. Prioritize. Take a deep breath. Put first things first. Procrastination is one of the hallmarks of adult ADHD. You have to really discipline yourself to watch out for it and avoid it.
24.    Accept fear of things going well. Accept edginess when things are too easy, when there’s no conflict. Don’t gum things up just to make them more stimulating.
25.    Notice how and where you work best: in a noisy room, on the train, wrapped in three blankets, listening to music, whatever. Children and adults with ADHD can do their best under rather odd conditions. Let yourself work under whatever conditions are best for you.
26.    Know that it is O.K. to do two things at once: carry on a conversation and knit, or take a shower and do your best thinking, or jog and plan a business meeting. Often people with ADHD need to be doing several things at once in order to get anything done at all.
27.    Do what you’re good at. Again, if it seems easy, that is O.K. There is no rule that says you can only do what you’re bad at.
28.    Leave time between engagements to gather your thoughts. Transitions are difficult for ADHD’ers, and mini-breaks can help ease the transition.
29.    Keep a notepad in your car, by your bed, and in your pocketbook or jacket. You never know when a good idea will hit you, or you’ll want to remember something else.
30.    Read with a pen in hand, not only for marginal notes or underlining, but for the inevitable cascade of “other” thoughts that will occur to you.

Mood Management
31.    Have structured “blow-out” time. Set aside some time in every week for just letting go. Whatever you like to do–blasting yourself with loud music, taking a trip to the race track, having a feast–pick some kind of activity from time to time where you can let loose in a safe way.
32.    Recharge your batteries. Related to #30, most adults with ADHD need, on a daily basis, some time to waste without feeling guilty about it. One guilt-free way to conceptualize it is to call it time to recharge your batteries. Take a nap, watch T.V., meditate. Something calm, restful, at ease.
33.    Choose “good”, helpful addictions such as exercise. Many adults with ADHD have an addictive or compulsive personality such that they are always hooked on something. Try to make this something positive.
34.    Understand mood changes and ways to manage these. Know that your moods will change willy-nilly, independent of what’s going on in the external world. Don’t waste your time ferreting out the reason why or looking for someone to blame. Focus rather on learning to tolerate a bad mood, knowing that it will pass, and learning strategies to make it pass sooner. Changing sets, i.e., getting involved with some new activity (preferably interactive) such as a conversation with a friend or a tennis game or reading a book will often help.
35.    Related to #34, recognize the following cycle which is very common among adults with ADHD: Something “startles” your psychological system, a change or transition, a disappointment or even a success. The precipitant may be quite trivial. This “startle” is followed by a mini-panic with a sudden loss of perspective, the world being set topsy-turvy. You try to deal with this panic by falling into a mode of obsessing and ruminating over one or another aspect of the situation. This can last for hours, days, even months.
36.    Plan scenarios to deal with the inevitable blahs. Have a list of friends to call. Have a few videos that always engross you and get your mind off things. Have ready access to exercise. Have a punching bag or pillow handy if there’s extra angry energy. Rehearse a few pep talks you can give yourself, like, “You’ve been here before. These are the ADHD blues. They will soon pass. You are O.K.”
37.    Expect depression after success. People with ADHD commonly complain of feeling depressed, paradoxically, after a big success. This is because the high stimulus of the chase or the challenge or the preparation is over. The deed is done. Win or lose, the adult with ADHD misses the conflict, the high stimulus, and feels depressed.
38.    Learn symbols, slogans, sayings as shorthand ways of labelling and quickly putting into perspectives slip-ups, mistakes, or mood swings. When you turn left instead of right and take your family on a 20-minute detour, it is better to be able to say, “There goes my ADHD again,” than to have a 6-hour fight over your unconscious desire to sabotage the whole trip. These are not excuses. You still have to take responsibility for your actions. It is just good to know where your actions are coming from and where they’re not.
39.    Use “time-outs” as with children. When you are upset or overstimulated, take a time-out. Go away. Calm down.
40.    Learn how to advocate for yourself. Adults with ADHD are so used to being criticized, they are often unnecessarily defensive in putting their own case forward. Learn to get off the defensive.
41.    Avoid premature closure of a project, a conflict, a deal, or a conversation. Don’t “cut to the chase” too soon, even though you’re itching to.
42.    Try to let the successful moment last and be remembered, become sustaining over time. You’ll have to consciously and deliberately train yourself to do this because you’ll just as soon forget.
43.    Remember that ADHD usually includes a tendency to overfocus or hyperfocus at times. This hyperfocusing can be used constructively or destructively. Be aware of its destructive use: a tendency to obsess or ruminate over some imagined problem without being able to let it go.
44.    Exercise vigorously and regularly. You should schedule this into your life and stick with it. Exercise is positively one of the best treatments for ADHD. It helps work off excess energy and aggression in a positive way, it allows for noise-reduction within the mind, it stimulates the hormonal and neurochemical system in a most therapeutic way, and it soothes and calms the body. When you add all that to the well-known health benefits of exercise, you can see how important exercise is. Make it something fun so you can stick with it over the long haul, i.e., the rest of your life.
45.    Make a good choice in a significant other. Obviously this is good advice for anyone. But it is striking how the adult with ADHD can thrive or flounder depending on the choice of mate.
46.    Learn to joke with yourself and others about your various symptoms, from forgetfulness, to getting lost all the time, to being tactless or impulsive, whatever. If you can be relaxed about it all to have a sense of humor, others will forgive you much more.
47.    Schedule activities with friends. Adhere to these schedules faithfully. It is crucial for you to keep connected to other people.
48.    Find and join groups where you are liked, appreciated, understood, enjoyed. Conversely, don’t stay too long where you aren’t understood or appreciated.
49.    Pay compliments. Notice other people. In general, get social training, as from your coach.
50.    Set social deadlines.

 

PTSD: Moral Injury and War

What’s Really Happened to America’s Soldiers? » CounterPunch: Tells the Facts, Names the Names.

Moral Injury and American War

What’s Really Happened to America’s Soldiers?

by NAN LEVINSON

“PTSD is going to color everything you write,” came the warning from a stepmother of a Marine, a woman who keeps track of such things.  That was in 2005, when post-traumatic stress disorder, a.k.a. PTSD, wasn’t getting much attention, but soon it was pretty much all anyone wrote about.  Story upon story about the damage done to our guys in uniform — drinking, divorce, depression, destitution — a laundry list of miseries and victimhood.  When it comes to veterans, it seems like the only response we can imagine is to feel sorry for them.

Victim is one of the two roles we allow our soldiers and veterans (the other is, of course, hero), but most don’t have PTSD, and this isn’t one of those stories.

Civilian to the core, I’ve escaped any firsthand experience of war, but I’ve spent the past seven years talking with current GIs and recent veterans, and among the many things they’ve taught me is that nobody gets out of war unmarked.  That’s especially true when your war turns out to be a shadowy, relentless occupation of a distant land, which requires you to do things that you regret and that continue to haunt you.

Theoretically, whole countries go to war, not just their soldiers, but not this time.  Civilian sympathy for “the troops” may be just one more way for us to avoid a real reckoning with our last decade-plus of war, when the hostilities in Iraq and Afghanistan have shown up on the average American’s radar only if somebody screws up or noticeable numbers of Americans get killed.  The veterans at the heart of this story — victims, heroes, it doesn’t matter — struggle to reconcile what they did in those countries with the “service” we keep thanking them for.  We can see them as sick, with all the stigma, neediness, and expense that entails, or we can recognize them as human beings, confronting the morality of what they’ve done in our name and what they’ve seen and come to know — even as they try to move on.

Sacred Wounds, Moral Injuries

Former Army staff sergeant Andy Sapp spent a year at Forward Operating Base Speicher near Tikrit, Iraq, and has lived for the past six years with PTSD.  Seven if you count the year he refused to admit that he had it because he never left the base or fired his weapon, and who was he to suffer when others had it so much worse?  Nearly 50 when he deployed, he was much older than most of his National Guard unit.  He had put in 17 years in various branches of the military, had a stable family, strong religious ties, a good education, and a satisfying career as a high-school English teacher.  He expected all that to insulate him, so it took a while to realize that the whole time he was in Iraq, he was numb.  In the end, he would be diagnosed with PTSD and given an 80% disability rating, which, among other benefits, entitles him to sessions with a Veterans Administration psychologist, whom he credits with saving his life.

Andy recalls a 1985 BBC series called “Soldiers” in which a Marine commander says, “It’s not that we can’t take a man who’s 45 years old and turn him into a good soldier. It’s that we can’t make him love it.”  Like many soldiers, Andy had assumed that his role would be to protect his country when it was threatened. Instead, he now considers himself part of “something evil.” So at a point when his therapy stalled and his therapist suggested that his spiritual pain was exacerbating his psychological pain, it suddenly clicked. The spiritual part he now calls his sacred wound. Others call it “moral injury.”

It’s a concept in progress, defined as the result of taking part in or witnessing something of consequence that you find wrong, something which violates your deeply held beliefs about yourself and your role in the world. For a moment, at least, you become what you never wanted to be. While the symptoms and causes may overlap with PTSD, moral injury arises from what you did or failed to do, rather than from what was done to you.  It’s a sickness of the heart more than the head. Or, possibly, moral injury is what comes first and, if left unattended, can congeal into PTSD.

What we now call PTSD goes way back.  In Odysseus in America, psychiatrist (and MacArthur “genius” grantee) Jonathan Shay has traced similar symptoms to Homer’s account of Odysseus’s homecoming from the Trojan War.  The idea that a soldier may continue to be haunted by his wartime life has had a name since at least the Civil War.  It was called “soldier’s heart” then, a lovely name for a terrible affliction.

In World War I, it went by the names “shell shock” and “war neurosis” and was so widespread that Britain devoted 19 hospitals solely to treating soldiers who suffered from it.  During WWII, it was called “battle fatigue,” “combat neurosis,” or “gross stress reaction,” and the problem was severe enough in the U.S. Army that, at one point, psychiatric discharges outpaced new recruits. The Vietnam War gave us the term “post-Vietnam syndrome,” which in time evolved into PTSD, and eventually the insight that, whatever its name, it is probably neurologically based.

PTSD’s status as an anxiety disorder — and as the only mental health condition officially defined as caused by a single, external event — was established in 1980, when it was enshrined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of psychiatry. The diagnostic criteria have expanded since then and will probably be altered again in next year’s version of the DSM.  That troubles many therapists treating the ailment; some don’t think PTSD is a disease, others argue that the symptoms are just a natural response to being at war or that, in labeling it a disorder, political and cultural norms are being invoked to reinforce what is considered orderly.  As Katherine Boone, writing in the Wilson Quarterly, put it, “If you react normally to trauma, you have a disorder; if you act abnormally, you don’t.”

Most PTSD is short term, but perhaps one-third of cases become chronic, and those are the ones we keep hearing about, in part because it costs a lot to treat them.  For a variety of reasons, no one seems to have an exact number of recent combat veterans with PTSD.  The Veterans Administration estimates that between 11% and 20% of the 2.3 million troops who have cycled through Iraq and Afghanistan suffer from it, and the Congressional Budget Office calculates a cost of $8,300 per patient for the first year of treatment.  Do the math, and you could be talking about as much as $3.8 billion a year.  (What we’re not talking about nearly enough is the best way to prevent PTSD and other war-caused psychic distress, which is not to put soldiers in such untenable situations in the first place.)

Since the early days of diagnosis — when you were either sick with PTSD or you were fine — the medical response to it has gained in nuance and depth, which has brought beneficial funding for research and treatment.  In the public mind, though, PTSD still scoops up everything from risky behavior and aggression to substance abuse and suicide — kind of the way “Alzheimer’s” as a catch-all label stands in for forgetfulness over 50 — and that does a disservice to veterans who aren’t sick, but aren’t fine either.

“What you come into the war with will dictate how you come out of war,” Joshua Casteel testified about a soldier’s conscience at the Truth Commission on Conscience and War, which convened in New York in March 2010.  He had spent five months as an interrogator at Abu Ghraib shortly after the prisoner abuse scandal broke there.  He later left the Army as a conscientious objector after an impassioned conversation about faith and duty with a young Saudi jihadist, whom he was supposed to be questioning, led him to conclude that he could no longer do his job. Casting a soldier’s experience as unfathomable to anyone else was not only inaccurate, but also damaging, he said; he had never felt lonelier than when people were afraid to ask about his life during the war.

Our warriors today are all volunteers who signed up and are apparently supposed to put up with whatever comes their way.  As professionals, they’re supposed to be ready to fight, but as counterinsurgents they’re supposed to be tender-hearted and understanding — at least to kids, those village elders they’re fated to drink endless cross-cultural cups of tea with, and their buddies.  (Every veteran has a kid story, and mourning lost friends with tattoos, rituals, and drunken sorrow are among the few ways they’re allowed to grieve publicly.) They’re supposed to be anguished when they hear about the “bad apples” whogang-raped, then murdered and set fire to a 15-year-old girl near Mahmoudiya, Iraq, or the “kill team” that hunted Afghan civilians “for sport.”

Maybe it’s the confusion of these mixed signals that makes us treat our soldiers as if they’re tainted by some special, unwanted knowledge, something that should drive them over the edge with grief and guilt and remorse.  Maybe we think our soldiers are supposed to suffer.

The Right to Miss

A couple of decades ago, David Grossman, a professor of psychology and former Army Ranger, wrote an eye-opening, bone-chilling book called On Killing.  It begins with the premise that people have an inherent resistance to killing other people and goes on to examine how the military overcomes that inhibition.

On Killing examines the concerted effort of the military to increase firing rates among frontline riflemen.  Reportedly only about 15%-20% of them pulled the trigger during World War II.  Grossman suggests that many who did fire “exercised the soldier’s right to miss.”  Displeased, the U.S. Army set out to redesign its combat training to make firing your weapon a more reflexive action. The military (and most police forces) switched to realistic, human-shaped silhouettes, which pop up and fall down when hit, and later added video simulators for the most recent generation of soldiers raised on virtual reality.

This kind of Skinnerian conditioning — Grossman calls it “modern battleproofing” — upped the firing rate steadily to 55% in Korea, 90% in Vietnam, and somewhere near 100% in Iraq.  Soldiers are trained to shoot first and evaluate later, but as Grossman observes, “Killing comes with a price, and societies must learn that their soldiers will have to spend the rest of their lives living with what they have done.”

That price could be called moral injury.

The term may have come from Jonathan Shay, though he demurs.  Whatever its origin, it wasn’t until the end of 2009 that it began to resonate in therapeutic communities. That was when Brett Litz, the Associate Director of the National Center for PTSD in Boston, and several colleagues involved in a pilot study for the Marines published “Moral injury and moral repair in war veterans,” a paper aimed at other clinicians.  Their stated aim was not to create a new diagnostic category, nor to pathologize moral discomfort, but to encourage discussion and research into the lingering effects on soldiers of their moral transgressions in war.

The authors found that emotional distress was caused less by fear of personal harm than by the dissonance between what soldiers had done or seen and what they had previously held to be right.  This echoes Grossman, who concludes that the greatest cause of psychological injury to soldiers is the realization that there are people out there who really want to hurt you.

Moral injury seems to be widespread, but the concept is something of an orphan.  If it’s an injury, then it needs treatment, which puts it in the realm of medicine, but its overtones of sin and redemption also place it in the realm of the spiritual and so, religion.  Chaplains, however, are no better trained to deal with it than clinicians, since their essential job is to patch up soldiers, albeit spiritually, to fight another day.

Yet the idea that many soldiers suffer from a kind of heartsickness is gaining traction.  The military began to consider moral injury as a war wound and possible forerunner of PTSD when Litz presented his research at the Navy’s Combat Operational Stress Control conference in 2010.  The American Psychiatric Association is also thinking about adding guilt and shame to its diagnostic criteria for PTSD.  A small preliminary survey of chaplains, mental health clinicians, and researchers found unanimous support for including some version of moral injury in the description of the consequences of war, though they weren’t all enamored of the term.  As if to mark the start of a new era in considering the true costs of war, a new institution, the Soul Repair Center has just been launched at Brite Divinity School in Fort Worth, Texas, with a $650,000 grant from the Lilly Foundation to conduct research and education about moral injury in combat veterans.

Of course, to have a moral injury, you have to have a moral code, and to have a moral code, you have to believe, on some level, that the world is a place where justice will ultimately prevail.  Faith in a rightly ordered world must be hard for anyone who has been through war; it’s particularly elusive for soldiers mired in a war that makes little sense to them, one they’ve come, actively or passively, to resent and oppose.

When your job requires you to pull sleeping families from their beds at midnight thousands of miles from your home, or to shoot at oncoming cars without knowing who’s driving them, or to refuse medical care to decrepit old men, you begin to question what doing your job means.  When the reasons keep shifting for what you’re supposed to be doing in a country where most of the population wants you to go home even more than you want to, it’s hard to maintain any sense of innocence.  When someone going about his daily life is regularly mistaken for someone who means to kill you — as has repetitively been the case in our occupations of both Iraq and Afghanistan — everyone becomes the enemy.  And when you try — and fail — to do the right thing in a chaotic and threatening situation, which nothing could have trained you for, the enemy can move inside you and stay there for a very long time.

In trying to heal from a moral injury, people struggle to restore a sense of themselves as decent human beings, but the stumbling block for many veterans of recent U.S. wars is that their judgment about the immorality of their actions may well be correct.  Obviously, suffering which can be avoided should be, but it’s not clear what’s gained by robbing soldiers of a moral compass, save a salve to civilian conscience.  And despite all the gauzy glory we swath soldiers in when we wave them off to battle, nations need their veterans to remember how horrible war is, if only to remind us not to launch them as heedlessly as the U.S. has done over these last years.

When you’ve done irreparable harm, feeling bad about your acts — haunted, sorrowful, distraught, diminished, unhinged by them — is human.  Taking responsibility for them, however, is a step toward maturity.  Maybe that’s the way the Army makes a man of you, after all.

Two final observations from veterans who went to war, then committed themselves to waging peace, apparently a much harder task: Dave Cline began his lifetime of antiwar work as a G.I. in the Vietnam War.  A few years into the Iraq War, when he was president of Veterans For Peace, he told me, “Returning soldiers always try to make it not a waste.”  The second observation comes from Drew Cameron in a preface to a book of poems by a fellow veteran, published by hisCombat Paper Press: “To know war, to understand conflict, to respond to it is not an individual act, nor one of courage.  It is rather a very fair and necessary thing.”

Recognizing moral injury isn’t a panacea, but it opens up multiple possibilities.  It offers veterans a way to understand themselves, not as mad or bad, but as justifiably sad, and it allows the rest of us a way to avoid reducing their wartime experiences to a sickness or a smiley face.  Most important, moral repair is linked to moral restitution.  In an effort to waste neither their past nor their future, many veterans work to help heal their fellow veterans or the civilians in the countries they once occupied.  Others work for peace so the next generations of soldiers won’t have to know the heartache of moral injury.

Nan Levinson, a Boston-based journalist, reports on civil liberties, politics, and culture. Her next book, War Is Not a Game, is about the recent G.I. antiwar movement.  She is the author of Outspoken: Free Speech Stories, was the U.S. correspondent for Index on Censorship, and teaches journalism and fiction writing at Tufts University.

This article was originally published by TomDispatch.

A Wise Path to Work with Sleep Troubles | Mindfulness and Psychotherapy

very good quick article.

Rory

******

A Wise Path to Work with Sleep Troubles | Mindfulness and Psychotherapy.

By 

 

sleepcrpdI was recently giving a seminar to therapists on the application of mindfulness in psychotherapy. In that seminar the topic of insomnia came up and I couldn’t help it, I outed myself. I let people know that insomnia used to be a very real part of my life and that my practice in mindfulness was what saved me and continues to from time to time. One woman came up to me during the break and asked me how I applied mindfulness to heal my sleep troubles.

Here is what I said…

For most of us insomnia is a mental dis-ease that over time gets conditioned into our bodies as a habit. The trauma of it is stored in our memories and only serves to make our mind increasingly reactive to the symptoms or anticipations of not falling asleep. It becomes so easy for our anxious or restless mental buttons to get pushed. It’s as if you only need to drop the lightest worry of not being able to sleep, like a feather, and the brain begins swirling with anticipatory anxiety.

I was once told that practicing mindfulness was far more restorative than tossing and turning. Therefore, even if you just practiced being present all night long and you didn’t fall asleep that was still better for you. On top of that, time spent in mindfulness practice is training your mind in mindfulness which is good for so many other parts of life, not the least of which growing a stronger and healthier brain.

With that I could relieve my worries about needing to fall asleep and just make the night time in bed my time to practice. I would put on my ear phones and be guided with a body scan that didn’t have a bell at the end (find a 10-minute body scan here). Initially I noticed my mind getting pulled frequently, thoughts that this wouldn’t work would yank me away, but I stayed disciplined (as best I could) to gently bring myself back to the practice.

Eventually I was able to let go of the audio and either bring a general awareness to my body each time I closed my eyes noting the field of sensations that were moving around. At other times I would just follow my breath.

But first I needed the support of the audio to train me to eventually be able to just do it on my own.

It’s been years since insomnia has been an issue for me now, once in a long while it creeps up, but I am usually able to dispel it with my practice. Studies show mindfulness help with sleep in many people.

The key here is that there needs to be the understanding that you’re using this time to practice to train in mindfulness, not to fall asleep. If the explicit intention is to fall asleep then you set up a monitor in the back of the brain to continually check on that. You need to let that expectation go, it’s okay if you don’t fall asleep.

No matter what, using it as a time to train in mindfulness is a wise use of that time.

As always, please share your thoughts, stories and questions below. Your interaction creates a living wisdom for us all to benefit from.

Love and Mental Illness | GeekMom | Wired.com

Love and Mental Illness | GeekMom | Wired.com

Reaching the Skies by ThisWolfWalksAlone on deviantART. (CC-BY-3.0)

I haven’t publicly dwelled on my personal life of the past year, but to say it’s been eventful is an understatement. After 14 1/2 years of marriage, last spring my husband and I decided, together, amicably, to separate. Our divorce is now pending. Fast forward to the autumn, and I found love again. I found a Rory.

And here’s where I’ll out myself. In an attempt to meet interesting, geeky people, and other kids for my kids to play with, I joined the SCA. To those not in the know, SCA stands for The Society for Creative Anachronism. Sort of like medieval re-creation, but it feels closer to a living museum type activity. I had known one, count it, one person from the SCA before, when I lived in Colorado. (Hi Karl!) But even with that one data point, I knew I’d find some interesting people that I’d enjoy spending time with. I was right. So right, that now I have a slew of people who would go to the mat for me if anything big ever came up. (And I do seem to be testing that…)

I met Rory on my first day with the SCA. We got along really well, but he was dating someone else at the time, and so I thought nothing more of it. But they eventually broke up, and we quickly got closer. At that point, he filled me in on some important things about him. He is bipolar. He had once tried to commit suicide. And he told me a lot of other details about his background. At that point I wasn’t sure where this relationship was going, or where either one of us wanted it to go. But his openness about everything said a lot.

Very quickly after that we became inseparable. He shared his ups and downs, what it was like for him to have these moods, and enough other glimpses into his mind for me to see his actions in context.

I’ve had enough experience of my own with mental illness to be able to see his condition for what it is, and to not take things personally. I’ve struggled with anxiety all my life, sometimes debilitatingly so, and have had panic attacks upon occasion. I’ve also had at least two bouts with depression. But most of the time I function fairly normally.

But for the past couple of weeks, Rory had been extra low. In retrospect, this might have been a sign of things to come. But starting last weekend, his usually transitory thoughts of suicide settled in for a good long while. Finally, Tuesday afternoon we decided to take him to the hospital. He needed help, and I was exhausted from lack of sleep.

It was pretty obvious to the people who evaluated him that he needed to be admitted to the mental health facility. I was relieved, because he really needed a complete evaluation, official diagnosis, and a better medication regimen. So after many hours at the emergency room, we went to the mental health facility, and there he resides until they decide he can leave. For the first two days, I had no idea how he was, what he’d been spending his time doing, how they were helping him. Before I left him there, he said he was both excited and terrified. He’d been in there once before, after he tried to commit suicide. But this time was slightly different, because he hadn’t taken any action.

Thursday afternoon I finally heard from him. He wanted to make sure I was coming to visit that night, because he wanted his book, which he was finally allowed to have. Thursday night our visit was a good one, and we caught each other up on the preceding two days. He’s on all new meds, so we’ll see how well those do. I’m still not sure when he will be back with me, but it will likely be next week because of the med changes.

So now the mental illness of the man I love is front and center in my life. This is a new experience for me. If you’d like to follow along on our journey together, visit Rory’s blog, Terminally Intelligent. It started out being only a blog of his words, thoughts, experiences, and poetry, but I’ve written several posts on there now, and it may be evolving into how together as a team we navigate the difficult and continual ebb and flow of mental illness. I am hoping that our struggles and successes are helpful to some of you.

Got Stress? Here’s a Practice You Can BET On | Mindfulness and Psychotherapy

Got Stress? Here’s a Practice You Can BET On | Mindfulness and Psychotherapy.

 

stress tipsNo matter what time of year it is, stress will likely be a part of it. A little stress is good, it fuels motivation, but there’s a tipping point where it starts to have diminishing returns. When that higher level of stress hits, if it’s left unchecked it can lead to anxiety, depression, chronic pain, addictive behaviors, you name it. Today I want to give you something that you can BET on anywhere, anytime to help turn the volume down on the chaotic mind and bring you back into balance.

I’m a big fan of things that are short and sweet. Something I can remember that can help me in a pinch.

Here’s a short acronym that you can BET on throughout the day:

  • B – Body – At any point, bring attention to the body. How is it feeling? Is there any tension anywhere, in this moment of awareness, can you take a breath and allow it soften?
  • E- Emotions – What emotion is there in that moment? Is it anxiety, sadness, anger, confusion, joy, calm, or maybe just a neutral feeling? How does it feel as a sensation in the body? Research shows just labeling emotions turns activity down in the emotional center of the brain.
  • T – Thoughts – What’s on your mind? Is it busy or calm? If it’s a self-judgment or a judgment of another person, ask yourself, Is it absolutely true? How does this thought make me feel? What’s another way I can see this? Practice opening your mind.

Then just refocus on what matters in the moment.

That’s it, it’s that simple.

You can BET in the morning, before a test, during a business meeting, during stressful travel, while waiting at a stop light or on hold on the phone. You can BET before you open your email, in the midst of your kid’s temper tantrum, or just while taking a nice walk outside.

If you BET a few times a day, my guess is that you’ll break out of routine and back into the wonder of everyday life.

Try it out and let your experience be your teacher.

As always, please share your thoughts, stories and questions below. Your interaction is a living wisdom we can all benefit from.

Source: Mindfulness Meditations for the Anxious Traveler: Quick Exercises to Calm Your Mind

Top 10 Mindfulness Posts of 2012

 

Top 10 Mindfulness and Psychotherapy Posts of 2012

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mindfulnessWhether this is your first time you’re coming here or you’ve been around for the almost four years I’ve been writingThe Mindfulness and Psychotherapycolumn, I want to share a personal moment of gratitude and say “Thank You” for being a part of this community. This was a big year for this column,  it will become 4 years old and is also the year that The Now Effect andMindfulness Meditations for the Anxious Traveler hit bookshelves. Now it’s my turn to give you some gifts of my favorite Top 10 posts of the year. In these posts you’ll read about the power of mindfulness, the importance of self-compassion in healing, the upside to embracing dark emotions, how to be alone, why multitasking is ineffective, many short practices and much more.

May they bring you a sense of insight, ease, peace and freedom. Enjoy!

  1. Mindfulness is Not a Cure, It’s Better
  2. 7 Life Lessons for Dr. Seuss
  3. The Power of Self-Compassion
  4. Depression: Medicate, Meditate or Both?
  5. The Science Behind Why Everything You Do Matters
  6. The Upside to Embracing Dark Emotions
  7. Learn How to Be Alone through Mindfulness
  8. Neuroscience and Compassion Training Predict a Better World
  9. Media Multitasking Leads to Poorer Cognitive Performance: A Mindful Response
  10. A Simple Way to Trick Your Brain Toward Mindfulness