SOURCE CREDIT: PsychCentral
9 Ways to Reduce Anxiety Right Here, Right Now
September 14, 2013 at 10:35 am
Written by Margarita Tartakovsky, M.S.
When you’re feeling anxious, you might feel stuck and unsure of how to feel better. You might even do things that unwittingly fuel your anxiety. You might hyperfocus on the future, and get carried away by a slew of what-ifs.
What if I start to feel worse? What if they hate my presentation? What if she sees me sweating? What if I bomb the exam? What if I don’t get the house?
You might judge and bash yourself for your anxiety. You might believe your negative, worst-case scenario thoughts are indisputable facts.
Thankfully, there are many tools and techniques you can use to manage anxiety effectively. Below, experts shared healthy ways to cope with anxiety right here, right now.
1. Take a deep breath.
“The first thing to do when you get anxious is to breathe,” said Tom Corboy, MFT, the founder and executive director of the OCD Center of Los Angeles, and co-author of the upcoming book The Mindfulness Workbook for OCD.
Deep diaphragmatic breathing is a powerful anxiety-reducing technique because it activates the body’s relaxation response. It helps the body go from the fight-or-flight response of the sympathetic nervous system to the relaxed response of the parasympathetic nervous system, said Marla W. Deibler, PsyD, a clinical psychologist and director of The Center for Emotional Health of Greater Philadelphia, LLC.
She suggested this practice: “Try slowly inhaling to a count of 4, filling your belly first and then your chest, gently holding your breath to a count of 4, and slowly exhaling to a count of 4 and repeat several times.”
2. Accept that you’re anxious.
Remember that “anxiety is just a feeling, like any other feeling,” said Deibler, also author of the Psych Central blog “Therapy That Works.” By reminding yourself that anxiety is simply an emotional reaction, you can start to accept it, Corboy said.
Acceptance is critical because trying to wrangle or eliminate anxiety often worsens it. It just perpetuates the idea that your anxiety is intolerable, he said.
But accepting your anxiety doesn’t mean liking it or resigning yourself to a miserable existence.
“It just means you would benefit by accepting reality as it is – and in that moment, reality includes anxiety. The bottom line is that the feeling of anxiety is less than ideal, but it is not intolerable.”
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3. Realize that your brain is playing tricks on you.
Psychiatrist Kelli Hyland, M.D., has seen first-hand how a person’s brain can make them believe they’re dying of a heart attack when they’re actually having a panic attack. She recalled an experience she had as a medical student.
“I had seen people having heart attacks and look this ill on the medical floors for medical reasons and it looked exactly the same. A wise, kind and experienced psychiatrist came over to [the patient] and gently, calmly reminded him that he is not dying, that it will pass and his brain is playing tricks on him. It calmed me too and we both just stayed with him until [the panic attack] was over.”
Today, Dr. Hyland, who has a private practice in Salt Lake City, Utah, tells her patients the same thing. “It helps remove the shame, guilt, pressure and responsibility for fixing yourself or judging yourself in the midst of needing nurturing more than ever.”
4. Question your thoughts.
“When people are anxious, their brains start coming up with all sorts of outlandish ideas, many of which are highly unrealistic and unlikely to occur,” Corboy said. And these thoughts only heighten an individual’s already anxious state.
For instance, say you’re about to give a wedding toast. Thoughts like “Oh my God, I can’t do this. It will kill me” may be running through your brain.
Remind yourself, however, that this isn’t a catastrophe, and in reality, no one has died giving a toast, Corboy said.
“Yes, you may be anxious, and you may even flub your toast. But the worst thing that will happen is that some people, many of whom will never see you again, will get a few chuckles, and that by tomorrow they will have completely forgotten about it.”
Deibler also suggested asking yourself these questions when challenging your thoughts:
- “Is this worry realistic?
- Is this really likely to happen?
- If the worst possible outcome happens, what would be so bad about that?
- Could I handle that?
- What might I do?
- If something bad happens, what might that mean about me?
- Is this really true or does it just seem that way?
- What might I do to prepare for whatever may happen?”
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5. Use a calming visualization.
Hyland suggested practicing the following meditation regularly, which will make it easier to access when you’re anxious in the moment.
“Picture yourself on a river bank or outside in a favorite park, field or beach. Watch leaves pass by on the river or clouds pass by in the sky. Assign [your] emotions, thoughts [and] sensations to the clouds and leaves, and just watch them float by.”
This is very different from what people typically do. Typically, we assign emotions, thoughts and physical sensations certain qualities and judgments, such as good or bad, right or wrong, Hyland said. And this often amplifies anxiety. Remember that “it is all just information.”
6. Be an observer — without judgment.
Hyland gives her new patients a 3×5 index card with the following written on it: “Practice observing (thoughts, feelings, emotions, sensations, judgment) with compassion, or without judgment.”
“I have had patients come back after months or years and say that they still have that card on their mirror or up on their car dash, and it helps them.”
7. Use positive self-talk.
Anxiety can produce a lot of negative chatter. Tell yourself “positive coping statements,” Deibler said. For instance, you might say, “this anxiety feels bad, but I can use strategies to manage it.”
8. Focus on right now.
“When people are anxious, they are usually obsessing about something that might occur in the future,” Corboy said. Instead, pause, breathe and pay attention to what’s happening right now, he said. Even if something serious is happening, focusing on the present moment will improve your ability to manage the situation, he added.
9. Focus on meaningful activities.
When you’re feeling anxious, it’s also helpful to focus your attention on a “meaningful, goal-directed activity,” Corboy said. He suggested asking yourself what you’d be doing if you weren’t anxious.
If you were going to see a movie, still go. If you were going to do the laundry, still do it.
“The worst thing you can do when anxious is to passively sit around obsessing about how you feel.” Doing what needs to get done teaches you key lessons, he said: getting out of your head feels better; you’re able to live your life even though you’re anxious; and you’ll get things done.
“The bottom line is, get busy with the business of life. Don’t sit around focusing on being anxious – nothing good will come of that.”
Margarita Tartakovsky, M.S. is an Associate Editor at Psych Central and blogs regularly about eating and self-image issues on her own blog, Weightless.
APA Reference Tartakovsky, M. (2013). 9 Ways to Reduce Anxiety Right Here, Right Now. Psych Central. Retrieved on September 14, 2013, from http://psychcentral.com/lib/9-ways-to-reduce-anxiety-right-here-right-now/00017762
Last reviewed: By John M. Grohol, Psy.D. on 12 Sep 2013 Published on PsychCentral.com. All rights reserved.
September 15, 2013
Posted by peterhbrown |
Acceptance and Commitment Therapy, anxiety, brain, Cognitive Behavior Therapy, Mindfulness, mood, Resources, therapy | Acceptance and Commitment Therapy, ACT, anxiety, breathing, calm, Mental health, Mindfulness, Obsessive–compulsive disorder, panic, panic attacks, Psych Central, strategies, tools, visualisation |
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SOURCE CREDIT: PsychCentral News : Research Finds Proven Strategies to Up Happiness, Life Satisfaction By RICK NAUERT PHD Senior News Editor : Reviewed by John M. Grohol, Psy.D. on September 11, 2013
READ THE COMPLETE ORIGINAL RESEARCH ARTICLE HERE FOR MORE DETAIL
Researchers have created four affective profiles that may help individuals improve the quality of their lives.
The profiles came from a research study of the self-reports of 1,400 US residents regarding positive and negative emotions.
Investigators believe the affective profiles can be used to discern differences in happiness, depression, life satisfaction and happiness-increasing strategies.
A central finding is that the promotion of positive emotions can positively influence a depressive-to-happy state — defined as increasing levels of happiness and decreasing levels of depression — as well as increase life satisfaction.
The study, published in the open access peer-reviewed scientific journal PeerJ, targets some of the important aspects of mental health that represent positive measures of well-being.
Brilliant Book! Click Image To Read Reviews and For More Detail
Happiness, for example, can be usefully understood as the opposite of depression, say the authors. Life satisfaction, another positive measure of well-being, refers instead to a comparison process in which individuals assess the quality of their lives on the basis of their own self-imposed standards.
Researchers posit that as people adopt strategies to increase their overall well-being, it is important to know which ones are capable of having a positive influence.
“We examined 8 ‘happiness-increasing’ strategies which were first identified by Tkach & Lyubomirsky in 2006″, said Danilo Garcia from the University of Gothenburg and the researcher leading the investigation.
“These were Social Affiliation (for example, “Support and encourage friends”), Partying and Clubbing (for example, “Drink alcohol”), Mental Control (for example, “Try not to think about being unhappy”), and Instrumental Goal Pursuit (for example, “Study”).
Additional strategies include: Passive Leisure (for example, “Surf the internet”), Active Leisure (for example, “Exercise”), Religion (for example, “Seek support from faith”) and Direct Attempts (for example, “Act happy and smile”).”
The researchers found that individuals with different affective profiles did indeed differ in the positive measures of well-being and all 8 strategies being studied.
For example, individuals classified as self-fulfilling — high positive emotions and low negative emotions — were the ones who showed lower levels of depression, tended to be happier, and were more satisfied with their lives.
Researchers found that specific happiness-increasing strategies were related to self-directed actions aimed at personal development or personally chosen goals. For example, autonomy, responsibility, self-acceptance, intern locus of control, and self-control.
Communal, or social affiliations, and spiritual values were positively related to a ‘self-fulfilling’ profile.
“This was the most surprising finding, because it supports suggestions about how self-awareness based on the self, our relation to others, and our place on earth might lead to greater happiness and mental harmony within the individual” said Garcia.
Source: Peerj
READ THE COMPLETE ORIGINAL RESEARCH ARTICLE HERE FOR MORE DETAIL
September 15, 2013
Posted by peterhbrown |
Acceptance and Commitment Therapy, Books, Cognitive Behavior Therapy, depression, happiness, Health Psychology, Identity, Mindfulness, mood, Positive Psychology, research, Resources | anxiety, contentment, depression, happiness, Mental health, mood, personality type, Psych Central, research, satisfaction, University of Gothenburg |
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Source Credit: ScienceDaily – Exposure/Ritual Prevention Therapy Boosts Antidepressant Treatment of OCD
READ THE COMPLETE ORIGINAL RESEARCH ARTICLE HERE
Sep. 12, 2013 — NIMH grantees have demonstrated that a form of behavioral therapy can augment antidepressant treatment of obsessive compulsive disorder (OCD) better than an antipsychotic. The researchers recommend that this specific form of cognitive behavior therapy (CBT) — exposure and ritual prevention — be offered to OCD patients who don’t respond adequately to treatment with an antidepressant alone, which is often the case. Current guidelines favor augmentation with antipsychotics.
(EDIT- FROM JOURNAL ARTICLE- description of CBT intervention:
EX/RP Augmentation
Patients randomized to EX/RP received 17 twice-weekly 90- minute sessions delivered over 8 weeks by
a study therapist. Treatment included 2 introductory sessions, 15 exposure sessions (during which
patients faced their obsessional fears for a prolonged period without ritualizing), daily homework
(at least 1 hour of self-directed exposures daily), and between- session telephone check-ins.16 At least 2 sessions occurred outside the clinic to promote generalization to daily life. The goal was for patients to stop their rituals as early in treatment as possible; patients were asked to try refraining from ritualizing after the first exposure session. Formal cognitive therapy procedures were not used, but dysfunctional cognitions were discussed within the context of exposure.)
Click Image To Read Reviews. My Favourite Resource For OCD. New Edition Includes Mindfulness Strategies
In the controlled trial with 100 antidepressant-refractory OCD patients, 80 percent of those who received CBT responded, compared to 23 percent of those who received the antipsychotic risperidone, and 15 percent of those who received placebo pills. Forty-three percent experienced symptoms reduced to a minimal level following CBT treatment, compared to 13 percent for risperidone and 5 percent for placebo.
The study, published September 11, 2013 in JAMA Psychiatry, was led by Helen Blair Simpson, M.D., of Columbia University, in New York City; and Edna Foa, Ph.D., of the University of Pennsylvania, Philadelphia.
In an accompanying editorial, grantees Kerry Ressler, M.D., and Barbara Rothbaum, Ph.D., of Emory University, Atlanta, note that antidepressants are effective in treating only a subset of OCD patients. They add that the targeted form of CBT works via different mechanisms — such as retraining the brain’s habit-forming circuitry to unlearn compulsive rituals.
Matthew Rudorfer, M.D., chief of the NIMH Somatic Treatments Program, which funded the study, said that in demonstrating how different patients respond best to different approaches, it helps to move the field toward the goal of more personalized treatment.
READ THE COMPLETE ORIGINAL RESEARCH ARTICLE HERE
Journal Reference: Helen Blair Simpson. Cognitive-Behavioral Therapy vs Risperidonefor Augmenting Serotonin Reuptake Inhibitors in Obsessive-Compulsive DisorderA Randomized Clinical TrialSerotonin Reuptake Inhibitor Augmentation.JAMA Psychiatry, 2013; DOI: 10.1001/jamapsychiatry.2013.1932
September 14, 2013
Posted by peterhbrown |
anxiety, brain, Cognition, Cognitive Behavior Therapy, Obsessive Compulsive Disorder, research | Barbara Rothbaum, CBT, Cognitive behavioral therapy, compulsion, Emory University, Health, Medicine, Mental health, New York City, obsessive compulsive disorder, OCD, research, response prevention, risperdone, ritual, science, ssri, University of Pennsylvania |
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SOURCE CREDIT: Author DONALD LATUMAHINA Lifeoptimizer.org
How to Achieve Goals Through Persistent Starting
Have you ever feel overwhelmed while trying to achieve a goal? I have, and I guess you have too. That’s why it’s important that you have a good strategy. Otherwise you might not achieve your goals, or will only achieve them through unnecessary stress and frustration.
One good strategy I found is persistent starting in The Now Habit by Neil Fiore. Here is what the book says about it:
“…essentially, all large tasks are completed in a series of starts… Keep on starting, and finishing will take care of itself.”
In essence, persistent starting means that you shouldn’t fill your mind with how big a project is. That will only make you feel overwhelmed. Instead, just focus on starting on it every day. By doing that, you will eventually finish the project and achieve your goal.
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Why Persistent Starting Is Powerful
There are three reasons why persistent starting is powerful:
1. It helps you reduce stress. Instead of filling your mind with how big a project is, you fill it with the simple task that you need to do today. That makes the burden much lighter.
2. It helps you overcome procrastination. One big reason why we procrastinate is that we feel overwhelmed by what we face. As a result, we hesitate to take action. This principle makes the task feel manageable.
3. It allows you to overcome seemingly insurmountable challenges. By just continually starting, you will eventually achieve a big goal. The whole journey might seem daunting, but by going through it one step at a time, you will eventually reach your destination.
A simple example in my life is when I tried to finish reading the Bible. It seemed like a huge task. If I focused on how hard it would be, it’s unlikely that I would ever finish it. But I focused instead on reading four chapters a day without thinking about how far I still had to go. With this attitude, I eventually finished reading it within a year.
How to Apply Persistent Starting
Here are four steps to apply persistent starting:
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1. Know your destination.
First of all, you need to know where you are going. If you don’t, you will only wander aimlessly. So set a clear goal. What is it that you are trying to achieve? How will success look?
2. Plan the route.
Now that you know your destination, you need to plan how to get there. A good way to do that is to set some milestones. These milestones serve two purposes:
They help you stay on track. You will know if you deviate from the right path.
They give you small victories along the way. Having a sense of accomplishment is important to stay motivated. By having milestones, you can get it along the way, not just at the end.
3. Keep doing the next simple task.
After planning the route, you should figure out the next simple task to do. What can you do today that will move you toward your destination? After you find it, then allocate time to do it.
4. Adjust your course as necessary.
You need to be careful not to go off course. So regularly check where you are (for example, by comparing your position with your next milestone) and adjust your course as necessary.
***
Persistent starting is a simple strategy, but it can help you achieve your goals with minimum stress and frustration. It works for me, and I hope it will work for you too.
September 13, 2013
Posted by peterhbrown |
anxiety, Books, brain, Cognition, Cognitive Behavior Therapy, depression, research, Resilience, stress | Bible, Cognition, efficiency, Goal, goal setting, how to achieve goals, human brain, insurmountable challenges, Mental health, neil fiore, performance anxiety, procrastinate, Procrastination, time management, unnecessary stress |
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Source Credit:
“For some people social anxiety is pretty pervasive,” said Justin Weeks, Ph.D, an assistant professor of psychology and director of the Center for Evaluation and Treatment of Anxiety at Ohio University. For others, the anxiety arises in specific social situations, he said.
The most common example is anxiety over public speaking. Making small talk, eating in front of others and using public restrooms also can trigger worry and unease for some.
Some people engage in what Weeks called “covert avoidance.” For example, they might go to parties but instead of mingling, they hang back in the kitchen, he said.
Social anxiety is defined as anxiety anticipating a social situation or anxiety during or after that situation, Weeks said. “At the heart of social anxiety is the fear of evaluation.” And it’s not just negative evaluation that people worry about; it’s positive evaluation, too.
Weeks’s research suggests that people perceive negative consequences from a social situation whether they do poorly or well. (Here’s one study.) For instance, people who do well at work might worry about the social repercussions of outshining their coworkers, he said.
In other words, people with social anxiety simply don’t want to stand out. “They want to be as inconspicuous as possible.”
Anxiety about social situations lies on a spectrum. “The consensus among the experts is that shyness and social anxiety disorder are all part of one continuum,” Weeks said. “It’s a question of severity.”
How much does social anxiety interfere with your life?
For instance, you might wish that you were more comfortable when interacting with people, Weeks said. But “you don’t feel like it’s holding you back,” in terms of your personal or professional goals.
“Social anxiety is more severe.” A person might avoid going to college because schools require passing a public speaking course and interacting with new people. They might want a romantic relationship but worry so much about rejection that they avoid potential partners.
Below, Weeks shared his suggestions for overcoming social anxiety.
1. Try a self-help manual.
Self-help manuals are designed to supplement therapy, but they’re also good tools for working on your own, Weeks said. He suggested the Managing Social Anxiety workbook. (PETER’S NOTE: For Teens I highly recommend The Shyness and Social Anxiety Workbook for Teens: CBT and ACT Skills to Help You Build Social Confidence )
2. Work with a therapist.
If social anxiety is stopping you from doing things you want or need to do, or you haven’t had much success with self-help, seek professional help. Find a therapist who specializes in anxiety disorders. You can start your search here.
The Workbook Recommended by Dr Justin Weeks. Click Image To Read Reviews and View Content
3. Practice deep breathing every day.
It’s helpful to engage in deep breathing before an anxiety-provoking social situation, Weeks said. But practice this technique every day. This way it becomes second nature, and you don’t hyperfocus on deep breathing and miss an entire conversation, he said. Here’s more on deep breathing.
4. Create an exposure hierarchy.
An exposure hierarchy is a list – akin to a ladder – where you write down situations that cause you anxiety, in order of severity. Then you perform the easiest behavior, and keep moving up the list.
To create your own hierarchy, list 10 anxiety-provoking situations, and rate them on a 100-point scale (zero being no anxiety; 100 being severe anxiety). Your list might start with asking a stranger for directions and end with joining Toastmasters.
This website features a link to various worksheets on coping with social anxiety, and includes “the fear and avoidance hierarchy.” (Look for “managing social anxiety: workbook.”)
5. Create objective goals.
People tend to disqualify the positive when they feel anxious, Weeks said. They might do well, even great, but because of their anxious feelings, they see their performance as abysmal. That’s why therapists encourage clients to create objective behavioral goals, he said.
These are behaviors that anyone in the room would be able to observe. It doesn’t matter how you feel or whether you’re blushing or sweating (which you can’t control anyway) in a social situation.
For instance, if you’re working in a group setting, the objective behavior would be to make three comments, Weeks said.
This also gives you a good barometer for judging your progress. Again, you’re not focusing on whether you felt nervous. Rather, you’re focusing on whether you performed the actual behavior.
My Recommended Workbook for Teens. Click Image To Read Reviews and View Content
Also, avoid focusing on others’ reactions. It doesn’t matter how your colleagues received your idea in the meeting. What matters is that you actually spoke up. It doesn’t matter whether a girl or guy said yes to your dinner invite. What matters is that you actually asked. It doesn’t matter how your child’s teacher reacted when you declined to volunteer for yet another school trip. What matters is that you were assertive and respected your own needs.
As Weeks said, “You did what you wanted to in a situation. We can’t control what another person is going to do.”
6. Keep a rational outlook.
Dispute both bleak thoughts that undermine your performance and fuel your anxiety, and equally unrealistic thoughts that are irrationally positive, Weeks said.
For instance, if you’re giving a speech, you might initially think, “I’m going to bomb.” But if you’ve given speeches before and done well, then this isn’t a rational or realistic perspective. You might say instead, “I’ve given speeches before. I’m prepared, and I’ll give it my best shot.”
If you’re asking someone out, it’s not rational to think, “They’re definitely going to say yes.” But it is rational to consider, “They might,” according to Weeks.
If social anxiety is sabotaging your goals and stopping you from living the life you want, seek help and try the above strategies. Social anxiety is highly treatable, Weeks said. You can get better, and grow in the process.
September 11, 2013
Posted by peterhbrown |
Acceptance and Commitment Therapy, Adolescence, anxiety, Cognitive Behavior Therapy, Education, Health Psychology, research, therapy | anxiety, Cognitive behavioral therapy, Health, Mental health, Ohio University, Psych Central, self help, social anxiety, social phobia, workbook |
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Credit: excerpted from psychologytoday.com
Self-change is tough, but it’s not impossible, nor does it have to be traumatic, according to change expert Stan Goldberg, Ph.D. Here, he lays out the 10 principles he deems necessary for successful change. [………]Many of us want to change but simply don’t know how to do it. After 25 years of researching how people change, I’ve discovered 10 major principles that encompass all self-change strategies. I’ve broken down those principles and, using one example—a man’s desire to be more punctual—I demonstrate strategies for implementing change in your own life.
All Behaviors Are Complex
Research by psychologist James O. Prochaska, Ph.D., an internationally renowned expert on planned change, has repeatedly found that change occurs in stages. To increase the overall probability of success, divide a behavior into parts and learn each part successively.
Strategy: Break down the behavior
Almost all behaviors can be broken down. Separate your desired behavior into smaller, self-contained units.
He wanted to be on time for work, so he wrote down what that would entail: waking up, showering, dressing, preparing breakfast, eating, driving, parking and buying coffee—all before 9 a.m.
Change Is Frightening
We resist change, but fear of the unknown can result in clinging to status quo behaviors—no matter how bad they are.
Strategy: Examine the consequences
Compare all possible consequences of both your status quo and desired behaviors. If there are more positive results associated with the new behavior, your fears of the unknown are unwarranted.
If he didn’t become more punctual, the next thing he’d be late for is the unemployment office. There was definitely a greater benefit to changing than to not changing.
Strategy: Prepare your observers
New behaviors can frighten the people observing them, so introduce them slowly.
Becoming timely overnight would make co-workers suspicious. He started arriving by 9 a.m. only on important days.
Strategy: Be realistic
Unrealistic goals increase fear. Fear increases the probability of failure.
Mornings found him sluggish, so he began preparing the night before and doubled his morning time.
Change Must Be Positive
As B.F. Skinner’s early research demonstrates, reinforcement-not punishment-is necessary for permanent change. Reinforcement can be intrinsic, extrinsic or extraneous. According to Carol Sansone, Ph.D., a psychology professor at the University of Utah, one type of reinforcement must be present for self-change, two would be better than one, and three would be best.
Strategy: Enjoy the act
Intrinsic reinforcement occurs when the act is reinforcing.
He loved dressing well. Seeing his clothes laid out at night was a joyful experience.
Strategy: Admire the outcome
An act doesn’t have to be enjoyable when the end result is extrinsically reinforcing. For instance, I hate cleaning my kitchen, but I do it because I like the sight of a clean kitchen.
After dressing, he looked in the mirror and enjoyed the payoff from his evening preparation: He looked impeccable.
Strategy: Reward yourself
Extraneous reinforcement isn’t directly connected to the act or its completion. A worker may despise his manufacturing job but will continue working for a good paycheck.
Whenever he met his target, he put $20 into his Hawaii vacation fund.
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Being Is Easier Than Becoming
In my karate class of 20 students, the instructor yelled, “No pain, no gain,” amid grueling instructions. After four weeks, only three students remained. Uncomfortable change becomes punishing, and rational people don’t continue activities that are more painful than they are rewarding.
Strategy: Take baby steps
In one San Francisco State University study, researchers found that participants were more successful when their goals were gradually approximated. Write down the behavior you want to change. Then to the right, write your goal. Draw four lines between the two and write a progressive step on each that takes you closer to your goal.
The first week, he would arrive by 9:20 a.m., then five minutes earlier each subsequent week until he achieved his goal.
Strategy: Simplify the process
Methods of changing are often unnecessarily complicated and frenetic. Through simplicity, clarity arises.
Instead of waiting in line at Starbucks, he would buy coffee in his office building.
Strategy: Prepare for problems
Perfect worlds don’t exist, and neither do perfect learning situations. Pamela Dunston, Ph.D., of Clemson University, found cueing to be an effective strategy.
His alarm clock failed to rouse him, so for the first month he’d use a telephone wake-up service.
Slower Is Better
Everything has its own natural speed; when altered, unpleasant things happen. Change is most effective when it occurs slowly, allowing behaviors to become automatic.
Strategy: Establish calm
Life is like a stirred-up lake: Allow it to calm and the mud will settle, clearing the water. The same is true for change.
To make mornings less harried, he no longer ran errands on his way to work.
Strategy: Appreciate the path
Author Ursula LeGuin once said, “It’s good to have an end to journey toward; but it is the journey that matters, in the end.” Don’t devise an arduous path; it should be as rewarding as the goal.
He enjoyed almost everything involved in being punctual. The coffee could be better, but it was a small price to pay.
Know More, Do Better
Surprise spells disaster for people seeking change. Knowing more about the process allows more control over it.
Strategy: Monitor your behaviors
Some therapists insist on awareness of both current and desired behaviors, but research suggests it’s sufficient to be aware of just the new one.
In a journal, he recorded the time taken for each step of work preparation.
Strategy: Request feedback
A study in the British Journal of Psychology found that reflecting on personal experiences with others is key to successful change. But because complimenting new behavior implies that the observer disliked the old one, it can make observers feel uncomfortable. If, for example, you were once demeaning to people, few would now say, “It’s nice talking with you since you stopped being a jerk.” Give the observer permission, suggests Paul Schutz, Ph.D., of the University of Georgia, and you will receive feedback.
Every Friday he asked a friend how well he was doing with his time problem.
Strategy: Understand the outcome
Success is satisfying, and if you know why you succeeded or failed, similar strategies can be applied when changing other behaviors.
Every morning, he analyzed why he did or did not arrive to work on time.
Change Requires Structure
Many people view structure as restrictive, something that inhibits spontaneity. While spontaneity is wonderful for some activities, it’s a surefire method for sabotaging change.
Strategy: Identify what works
Classify all activities and materials you’re using as either helpful, neutral or unhelpful in achieving your goal. Eliminate unhelpful ones, make neutrals into positives and keep or increase the positives.
After evaluating his morning routine, he replaced time-consuming breakfasts with quick protein drinks.
Strategy: Revisit your plan regularly
Review every day how and why you’re changing and the consequences of success and failure. Research by Daniel Willingham, Ph.D., a psychology professor at the University of Virginia, showed that repetition increases the probability of success.
Each night he reviewed his plan, smiled and said, “Hawaii, here I come.”
Strategy: Logically sequence events
According to behavior expert Richard Foxx, Ph.D., a psychology professor at Penn State University at Harrisburg, it’s important to sequence the aspects associated with learning a new behavior in order of level of difficulty or timing.
He completed all bathroom activities, then ate breakfast.
Practice Is Necessary
Practice is another key approach to change, suggests one study on changing conscious experience published recently in the British Journal of Psychology. I’ve found that the majority of failures occur because this principle is ignored. Practice makes new behaviors automatic and a natural part of who we are.
Strategy: Use helpers
Not all behaviors can be learned on your own. Sometimes it’s useful to enlist the help of a trusted friend.
When even the telephone answering service failed to wake him up, he asked his secretary to call.
Strategy: Practice in many settings
If you want to use a new behavior in different environments, practice it in those or similar settings. Dubbing this “generalization,” psychologists T.F. Stokes and D.M. Baer found it critical in maintaining new behaviors.
During the first week he would try to be punctual for work. The following week, he would try to be on time for his regularly scheduled tennis game.
New Behaviors Must Be Protected
Even when flawlessly performed, new behaviors are fragile and disappear if unprotected.
Strategy: Control your environment
Environmental issues such as noise and level of alertness may interfere with learning new behaviors. After identifying what helps and what hinders, increase the helpers and eliminate the rest.
Having a nightcap before bed made it difficult to wake up in the morning, so he avoided alcohol after 7 p.m.
Strategy: Use memory aides
Because a new behavior is neither familiar nor automatic, it’s easy to forget. Anything that helps memory is beneficial.
He kept a list in each room of his apartment describing the sequence of things to be done and the maximum allowable time to complete them.
Small Successes Are Big
Unfortunately, plans for big successes often result in big failures. Focus instead on a series of small successes. Each little success builds your reservoir of self-esteem; one big failure devastates it.
Strategy: Map your success
Approach each step as a separate mission and you’ll eventually arrive at the end goal.
For each morning activity he completed within his self-allotted time limit, he rewarded himself by putting money into his Hawaii-getaway fund.
The process of changing from what you are to what you would like to become can be either arduous and frustrating or easy and rewarding. The effort required for both paths is the same. Choose the first and you’ll probably recycle yourself endlessly. Apply my 10 principles, and change, once only a slight possibility, becomes an absolute certainty. The choice is yours.
Stan Goldberg, Ph.D., is a private speech therapist (www.speechstrategies.com), a change consultant and the author of four books on change.
//
August 31, 2010
Posted by peterhbrown |
brain, Cognition, Cognitive Behavior Therapy, Health Psychology, Positive Psychology | bad habits, change, growth, habit |
6 Comments
This article highlights how Acceptance and Commitment Therapy (ACT) is being integrated into weight loss programs for emotional eaters.
How many times have you, after a particularly hard day, reached for some chocolate or ice cream? It’s common for many people, but for those trying to lose weight, it can be detrimental to their long term success, and most weight-loss programs never even address it.
They focus on choosing healthier foods and exercising more, but they never answer a key question: how can people who have eaten to cope with emotions change their eating habits, when they haven’t learned other ways of coping with emotions?
Researchers at Temple’s Center for Obesity Research are trying to figure out the answer as part of a new, NIH-funded weight loss study. The new treatment incorporates skills that directly address the emotional eating, and essentially adds those skills to a state-of-the art behavioral weight loss treatment.
“The problem that we’re trying to address is that the success rates for long-term weight loss are not as good as we would like them to be,” said Edie Goldbacher, a postdoctoral fellow at CORE. “Emotional eating may be one reason why people don’t do as well in behavioral weight loss groups, because these groups don’t address emotional eating or any of its contributing factors.”
The study has already had one wave of participants come through, and many participants have seen some success in the short term, but have also learned the skills to help them achieve long term success.
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Janet Williams, part of that first cohort, said she lost about 17 pounds over 22 weeks, and still uses some of the techniques she learned in the study to help maintain her weight, which has not fluctuated.
“The program doesn’t just help you identify when you eat,” said Williams. “It helps you recognize triggers that make you eat, to help you break that cycle of reaching for food every time you feel bored, or frustrated, or sad.”
Williams said that the program teaches various techniques to help break that cycle, such as the “conveyor belt,” in which participants, when overcome with a specific emotion, can recognize it and take a step back, before reaching for chips or cookies, and put those feelings on their mental “conveyor belt” and watch them go away.
“I still use the skills I learned in the study,” she said. “I’ve learned to say, ‘I will not allow this emotional episode to control my eating habits.'”
Source:eurekalert
May 6, 2010
Posted by peterhbrown |
Acceptance and Commitment Therapy, Addiction, Books, Cognitive Behavior Therapy, depression, Eating Disorder, Health Psychology, Mindfulness, mood, stress | binge eating, bulimia, Chocolate, Eating, Emotion, emotional, Health, National Institutes Health, shopping, Support Groups, weight loss |
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A little while ago I posted a list of free interactive self-help web sites, all research based, which have been shown to effective in the treatment of anxiety & depression. A recent study adds to the body of evidence which supports web based intervention as a viable treatment option or adjunct.
Cognitive behaviour therapy (CBT) via the internet is just as effective in treating panic disorder (recurring panic attacks) as traditional group-based CBT. It is also efficacious in the treatment of mild and moderate depression. This according to a new doctoral thesis soon to be presented at Karolinska Institutet.
Read the original research thesis here (PDF)
“Internet-based CBT is also more cost-effective than group therapy,” says Jan Bergström, psychologist and doctoral student at the Center for Psychiatry Research. “The results therefore support the introduction of Internet treatment into regular psychiatry, which is also what the National Board of Health and Welfare recommends in its new guidelines for the treatment of depression and anxiety.”
It is estimated that depression affects some 15 per cent and panic disorder 4 per cent of all people during their lifetime. Depression can include a number of symptoms, such as low mood, lack of joy, guilt, lethargy, concentration difficulties, insomnia and a low zest for life. Panic disorder involves debilitating panic attacks that deter a person from entering places or situations previously associated with panic. Common symptoms include palpitations, shaking, nausea and a sense that something dangerous is about to happen (e.g. a heart attack or that one is going mad ).
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It is known from previous studies that CBT is an effective treatment for both panic disorder and depression. However, there is a lack of psychologists and psychotherapists that use CBT methods, and access to them varies greatly in Sweden as well as in many other countries. Internet-based CBT has therefore been developed, in which the patient undergoes an Internet-based self-help programme and has contact with a therapist by email.
The present doctoral thesis includes a randomised clinical trial of 104 patients with panic disorder and compares the effectiveness of Internet-based CBT and group CBT within a regular healthcare service. The study shows that both treatments worked very well and that there was no significant difference between them, either immediately after treatment or at a six-month follow-up. Analyses of the results for the treatment of depression show that Internet-based CBT is most effective if it is administered as early as possible. Patients with a higher severity of depression and/or a history of more frequent depressive episodes benefited less well from the Internet treatment.
Jan Bergström works as a clinical psychologist at the Anxiety Disorders Unit of the Psychiatry Northwest division of the Stockholm County Council. This research was also financed by the Stockholm County Council.
“Thanks to our research, Internet treatment is now implemented within regular healthcare in Stockholm, at the unit Internetpsykiatri.se of Psychiatry Southwest, which probably makes the Stockholm County Council the first in the world to offer such treatment in its regular psychiatric services,” says Jan Bergström.
Read the original research thesis here (PDF)
Credit: Adapted from materials provided by Karolinska Institutet.
April 18, 2010
Posted by peterhbrown |
anxiety, Books, Cognitive Behavior Therapy, depression, diagnosis, Education, Internet, research, stress, Technology, therapy | anxiety, CBT, Cognitive behavioral therapy, david burns, depression, Disorders, feeling good, Health, interactive, Internet, Major depressive disorder, Mental health, online, online help, Panic disorder, self help, Stockholm County Council, treatment, web, web site |
10 Comments
Compulsive collecting or Hoarding is a misunderstood and debilitating mental health issue. Many psychologists and counsellors never see someone with this condition as they very rarely present for help. This article from an Australian newspaper provides an excellent overview of the condition and issues underlying hoarding, and I have included links to two brilliant books co-authored by the researchers discussed in the article, who have developed a wholistic and novel approach to it’s treatment.
Credit: Kate Benson, Sydney Morning Herald April 8 2010
They may dress well or hold down a good job. But hoarders are unhappy people who suffer from a debilitating condition.
Every suburb has one. The elderly woman weaving through an overgrown backyard full of cardboard boxes, old tyres and discarded furniture. Cats perch on every surface; kittens roll about among the rusted drums and long grass.
Inside, behind closed curtains, the rooms are piled high with papers, cups, plates and bottles. Broken toys, old clothes and shopping bags spill across kitchen benches and floor, smothering the stove and filling the sink, neither of which has been used in years.
The stench of cat faeces, urine and food scraps fill the house.
To her neighbours, she is an oddity. Or a pest, bringing down house values and encouraging vermin.
But to therapists she is one of a growing band across Australia suffering from a debilitating condition known as compulsive hoarding, where people feel a need to collect and store items that seem useless to others.
Their homes become havens of insurmountable clutter and junk, often leaving them unable to sleep in their beds or use appliances. Many end up with electricity or gas supplies disconnected or their fridge and washing machines unusable because they fear their lifestyle will be revealed if they contact a tradesmen to make repairs.
This secrecy and shame make it difficult to know exactly how many people have the disorder.
Some experts think between 200,000 and 500,000 Australians compulsively hoard, but others put the figure closer to 800,000.
“It’s a sleeping giant,” Chris Mogan, a clinical psychologist and expert on hoarding, says. “There is no systematic estimate of how many hoarders there are in any Australian setting. I suspect there are many, many more out there than we are aware of.”
Louise Newman, the president of the Royal Australian and New Zealand College of Psychiatrists, agrees.
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“I’ve only seen one case in my career [because] these people usually only come to light when the council steps in and orders a clean-up. Hoarders desperately want to keep hoarding. They don’t want to be stopped.”
There is little research on the condition in Australia and not much in the way of funding or treatment programs, but experts are hopeful hoarding will be included in the next (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders, the bible used by mental health experts to diagnose psychiatric conditions.
Many sufferers fall between the cracks because hoarding is not a clinical diagnosis in its own right, but is seen more as an offshoot of obsessive compulsive disorder, muddled with depression, anxiety, panic disorder and low self-esteem.
“But it is different to OCD and once we get it in the DSM-V, therapists, psychiatrists, psychologists and social workers can then be trained in the management of it [and] we can attract funding for research,” Mogan says.
Jessica Grisham, a clinical psychologist who specialises in obsessive compulsive disorder, also believes compulsive hoarding should be included in the next edition as it requires specialised treatment.
She cites recent neural imaging studies in the US that showed that different parts of the brain were activated in hoarders than in obsessive compulsive disorder patients.
Mogan and Grisham agree that cognitive behaviour therapy, where sufferers are slowly taught to change their thought patterns, is more effective than medication alone.
But hoarders responded better to a specially adapted version of the therapy, developed by the American hoarding experts Gail Steketee and Randy Frost. It had been achieving success with about 60 per cent of hoarders – far more than standard cognitive behaviour therapy.
“But it has to be a long-term project. You don’t go in to someone’s place and do a sudden excavation against their will,” Grisham says.
“That’s a violation and it’s very traumatic for them. It might make great TV, but it’s not good clinically.”
Mogan agrees. A pay TV show, Hoarders, was damaging to the public’s understanding of the illness, because it focused on forcefully cleaning houses in three days.
“Within six to 12 months that house will be recluttered because it is a compulsion … they suffer a lot of grief after things are taken away.”
Mogan makes weekly home visits to hoarders, and focuses on getting them to reduce the associated dangers by ensuring their home has two exits for safety, and working appliances and smoke alarms.
“Just as we do with drugs and alcohol, we’re into harm minimisation. Once the house is safe, we gradually set more goals. If they are comfortable with that, they will continue to stay in touch and not reject us.”
Sometimes the problem extends beyond mounds of paperwork and clothes. Mogan and Grisham know patients who hoarded urine or fingernail clippings. Some stored their own faeces or collected one particular item, such as bicycles. One sufferer was hoarding so much junk, the only access to the house was a 30-centimetre gap at the top of the front door.
But for Allie Jalbert, of the RSPCA, the most distressing hoarders are those who keep scores of cats and dogs, all battling for attention and food on a crowded suburban block.
She has been calling for years to have hoarding classified as an illness in its own right to allow more people to receive treatment and put an end to the 100 per cent recidivism rate.
“Often, we find that hoarders might be treated for peripheral symptoms such as anxiety or depression, but their core problem, the hoarding, is not addressed. So once we have cleaned out the house, they reoffend, which is very, very frustrating for everyone involved,” Jalbert says.
Some people threatened suicide and had to be removed by police when faced with the prospect of giving up their animals or clutter.
“There’s a mixed bag of emotion when you deal with hoarders. Firstly, there is the concern for your personal safety but there is also a degree of empathy because often these people are quite emotional and attached to the animals. But it’s quite frustrating to see animals living in such horrific situations,” she says.
“I’ve seen bathtubs full of faeces and rubbish, sinks that no longer work, homes with no heating or cooling. Sometimes it’s quite an overwhelming experience.”
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Who develops the condition and why?
Some studies have shown that many hoarders have been brought up in households where chaos reigned. Some were neglected as children and witnessed pets being treated poorly.
Mogan accepts the aetiology is mostly unknown, but cites an Australian study that found sufferers reported failing to connect with their parents or growing up in households lacking emotional warmth.
“The lack of attachment causes them to become ambivalent about their identity and about other people. As a compensatory mechanism, they link with things, which they find more compelling, more predictable and dependable and less rejecting.”
But Grisham believes there is no real trigger, apart from children of hoarders being rewarded for saving things and getting punished for discarding. “Sometimes there is a traumatic head injury but those cases are very rare.”
The condition affects slightly more women than men but is found across all occupations, age groups and ethnicities. “And they are in relationships,” Mogan says. “Albeit strained ones.
“Some are going out to work, but they make sure no one comes to their house. They’re not agoraphobic. On the contrary, many hoarders go out a lot to escape. But their children’s lives can’t be normalised because they can never sit down for a meal or find space to do homework. It’s a real impost on the family experience.”
Mogan runs group therapy sessions in Melbourne and says that many patients do want to be cured.
“This condition is a disability and the source of quite a lot of human suffering and neglect. A lot of these people are quite relieved to get help.”
//
April 10, 2010
Posted by peterhbrown |
anxiety, Books, Cognitive Behavior Therapy, diagnosis, Identity, research, Resources, therapy | anxiety, Australia, buried in treaures, Compulsive hoarding, Disorders, Health, hoarding, Mental disorder, Mental health, Obsessive–compulsive disorder, OCD, therapy, United States |
9 Comments
(Information provided by The Wellcome Trust 1 April 2010)
Read the original research paper HERE (PDF)
Medication and behavioural interventions help children with attention deficit hyperactivity disorder (ADHD) better maintain attention and self-control by normalising activity in the same brain systems, according to research funded by the Wellcome Trust.
In a study published today in the journal ‘Biological Psychiatry’, researchers from the University of Nottingham show that medication has the most significant effect on brain function in children with ADHD, but this effect can be boosted by complementary use of rewards and incentives, which appear to mimic the effects of medication on brain systems.
ADHD is the most common mental health disorder in childhood, affecting around one in 20 children in the UK. Children with ADHD are excessively restless, impulsive and distractible, and experience difficulties at home and in school. Although no cure exists for the condition, symptoms can be reduced by a combination of medication and behaviour therapy.
Methylphenidate, a drug commonly used to treat ADHD, is believed to increase levels of dopamine in the brain. Dopamine is a chemical messenger associated with attention, learning and the brain’s reward and pleasure systems. This increase amplifies certain brain signals and can be measured using an electroencephalogram (EEG). Until now it has been unclear how rewards and incentives affect the brain, either with or without the additional use of medication.
To answer these questions, researchers at Nottingham’s Motivation, Inhibition and Development in ADHD Study (MIDAS) used EEG to measure brain activity while children played a simple game. They compared two particular markers of brain activity that relate to attention and impulsivity, and looked at how these were affected by medication and motivational incentives.
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The team worked with two groups of children aged nine to 15: one group of 28 children with ADHD and a control group of 28. The children played a computer game in which green aliens were randomly interspersed with less frequent black aliens, each appearing for a short interval. Their task was to ‘catch’ as many green aliens as possible, while avoiding catching black aliens. For each slow or missed response, they would lose one point; they would gain one point for each timely response.
In a test designed to study the effect of incentives, the reward for avoiding catching the black alien was increased to five points; a follow-up test replaced this reward with a five-point penalty for catching the wrong alien.
The researchers found that when given their usual dose of methylphenidate, children with ADHD performed significantly better at the tasks than when given no medication, with better attention and reduced impulsivity. Their brain activity appeared to normalise, becoming similar to that of the control group.
Similarly, motivational incentives also helped to normalise brain activity on the two EEG markers and improved attention and reduced impulsivity, though its effect was much smaller than that of medication.
“When the children were given rewards or penalties, their attention and self-control was much improved,” says Dr Maddie Groom, first author of the study. “We suspect that both medication and motivational incentives work by making a task more appealing, capturing the child’s attention and engaging his or her brain response control systems.”
Professor Chris Hollis, who led the study, believes the findings may help to reconcile the often-polarised debate between those who advocate either medication on the one hand, or psychological/behavioural therapy on the other.
“Although medication and behaviour therapy appear to be two very different approaches of treating ADHD, our study suggests that both types of intervention may have much in common in terms of their affect on the brain,” he says. “Both help normalise similar components of brain function and improve performance. What’s more, their effect
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is additive, meaning they can be more effective when used together.”
The researchers believe that the results lend support from neuroscience to current treatment guidelines
for ADHD as set out by the National Institute for Health and Clinical Excellence (NICE). These recommend that behavioural interventions, which have a smaller effect size, are appropriate for moderate ADHD, while medication, with its larger effect size, is added for severe ADHD.
Although the findings suggest that a combination of incentives and medication might work most effectively, and potentially enable children to take lower doses of medication, Professor Hollis believes more work is needed before the results can be applied to everyday clinical practice or classroom situations.
“The incentives and rewards in our study were immediate and consistent, but we know that children with ADHD respond disproportionately less well to delayed rewards,” he says. “This could mean that in the ‘real world’ of the classroom or home, the neural effects of behavioural approaches using reinforcement and rewards may be less effective.”
Read the original research paper HERE (PDF)
April 7, 2010
Posted by peterhbrown |
ADHD /ADD, Books, brain, Cognitive Behavior Therapy, diagnosis, research | ADD.ADHD, Attention-deficit hyperactivity disorder, behavior, behaviour, CBT, child, dexamphetamine, Electroencephalography, Mental health, research, ritalin, Scientific control, therapy, University of Nottingham, Wellcome Trust |
3 Comments
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Peter H Brown Clinical Psychologist 