Serving the City of Raleigh and Surrounding Areas

Month: December 2009

We’re Gonna Make a Resolution

So it’s that time of year again when everyone makes big plans for what they want to accomplish in the new year and then quickly ditch them for the easier, less stressful, more practical, or simply realistic way of life. That’s right, it’s time to make and then break those New Year’s Resolutions. So why make a resolution if we know we’re just going to break them? The number of answers to this abound – it gives us motivation, it sets a goal for the year, it helps us focus on ourselves for a change, etc. So then why do we break them within a few days of making them? The issue isn’t that we don’t try to stick to our pledge to never even look at a cigarette ad again or to finally lose those last 10 lbs. of baby weight. The issue is that because we feel so gung-ho to make changes in those first few days we often make the changes too big and too fast to stick. Think of it this way, if your goal is to add more fruits and vegetables to your diet that’s great and healthy. But, if your a person who doesn’t even know where they keep the fruits and veggies at the grocery store, this is going to be a huge challenge for you. You will most likely need to think about how to build up to your goal in steps rather than starting with your 5 fruits and veggies a day on January 1. So here are some tips for making and hopefully keeping your resolutions for more than a few days.

* Make sure that your resolution is actually attainable. If your goal is to reach your healthy weight but you’re over 100lbs overweight, you will most likely not reach this goal by year’s end (regardless of what the Biggest Loser did) and then feel frustrated. So keep in mind what is really realistic to accomplish in the time period that you have.

* In addition, if you’re making a large goal for yourself, you will most likely need to break it down into smaller steps and set mini deadlines for those goals. For instance if you want to eat better decide what steps would be involved in that for you. Maybe the first step is to lay off the fast food, so set a goal to not eat fast food for 2 weeks. Your next step might be to eat leaner meat, so use the next 2 weeks to add chicken and fish to your diet. Keep making and meeting these small goals until you reach “better eating.”

* While we’re talking about these small goals, it would be worth mentioning that the big goals probably need some defining. Our resolutions often tend to be broad sweeping statements like “I’m going to lose weight,” “I’m going to eat better,” “I’m going to do better with my money.” But we never really decide what each of these things look like – how much weight do you want to lose, what does “eat better” look like, what does do “better” with money mean? Without a clear picture of what your goal really is you’ll never be able to make the smaller steps or even really know if you’ve met your goal.

* So, you’ve chosen an attainable resolution, clearly defined it in a measurable way, and set smaller goals if your resolution is too big to handle in a few days. Now what happens when life happens and you don’t actually stick to those smaller steps? Well, nothing really. For a lot of people this is the end of the road and the attempts to make changes are over. They tell themselves, “I’ll never be able to . . . ” When really, all you need to do is just pick up where you left off. Did you fall off the cigarette wagon? That’s fine, take an objective look at what happened that led to smoking and make a plan for if that happens again. Then toss those new cigarettes in the trash with the old ones and re-resolve to quit.

* Now lets say that for some reason, you just cannot stick to your resolution. Maybe you need to look at whether you really want to do what you’ve chosen. Do you really believe that you should add more fiber to your diet? If not then maybe you chose the wrong thing to work on at this point. That’s fine, sometimes we choose stuff because we think it sounds good or because our doctor/spouse/friends/kids think we should. Maybe your real desire is to save enough money to finally take that trip to Paris, not to exercise 3 times a week. That’s great – DO IT!!!

It’s that time of year again – time to toast a new year and a new decade this time around, make grand plans for what we will do in the new year, and then quickly realize we don’t care that much about vacuuming every weekend. The new year is a great time to think about the things in our lives that we want to change, but maybe it could also be a time to give ourselves credit for all the things we already “do right.” Maybe instead of resolving to change yourself, you can resolve to reward yourself and give yourself some credit for the things you already do. Happy New Year and here’s to a content 2010.

ANXIETY!!!!

On a recent flight, I sat beside one of the most anxious people I have ever been around. By the time we landed, I thought I was going to have a panic attack. Not only was she miserable for most of the flight, but she was rude to her husband and definitely didn’t make my flight enjoyable. Now, I know some people are petrified of flying – some people are also scared of snakes, spiders, heights, or clowns. However, we also tend to do things to try to calm ourselves that only make the situation worse. Anxiety is an emotional response but it has very physical components. Often people feel short of breath, heart racing, palms sweating, shakiness, nausea, and light headedness. At the same time, what you often see people do when they start feeling anxious is to hold their breath, wring their hands, shake their legs, and squeeze their eyes closed as tightly as possible. The only thing these coping strategies will accomplish is to increase the anxiety you are experiencing. So in honor of the most anxious woman in the air – and in hopes of saving myself from another uncomfortable plane ride – here are some tips and tricks for decreasing anxiety. You never know, they might come in handy battling all the holiday shoppers.

1. BREATH!! For goodness sakes, take a breath already. It is amazing how often I see someone who is feeling anxious holding their breath or taking very shallow breaths. When you’re trying to decrease your anxiety, you want to take a breath so deep that your stomach expands. Two or three breaths like this and you should start to feel less anxious. Warning – don’t do it too much or you’ll make yourself hyperventilate. Think back to the advice your high school teacher gave before your presentation – take two cleansing breaths. That’s really all this is. Some people like to incorporate imagery and imagine they are blowing out their anxiety when they exhale. Some people think that’s cheesy – but laughter reduces anxiety too so cheese it up.

2. Sit still! All that jittering, jumping, and shaking plays right into the anxiety. Some people say that it releases energy, but if you really think about the action of shaking your leg, for instance, it takes a great deal of muscle tension to move your leg that fast. Muscle tension is a common symptom of anxiety, so doing something that will make you tense and will only increase your anxiety.

3. Live in the present. A lot of the reason people experience anxiety is because they get stuck in the what ifs of the future. I’m sure the woman on the plane was imagining the fireball she would become when the plane crashed. A good technique for being mindful of your current situation is to literally think only about the things your are currently experiencing – feel the furniture you’re sitting on, what do you smell, hear, in some cases taste. Combine this with the breathing and you’re on your way to relaxation.

4. Do not self medicate with alcohol or other drugs. One way to make anxiety worse the next time you have it is to avoid whatever it is that’s making you anxious now. So, if like my plane ride partner, you are afraid of flying the best way to guarantee a stronger anxiety response the next time you have to fly is to avoid this flight. Drinking and taking drugs is a way to avoid. It numbs your feelings and keeps you from being fully present. Your anxiety might be higher the first time you try this exposure but it will go down over time – and you won’t be broke from buying those little airplane bottles.

5. Lay off the caffeine. Caffeine is a stimulant. That means that it will mimic the things that are going to happen in your body when you’re anxious, especially if you don’t usually drink caffeine.

Now, if you are one of those people who has extreme anxiety that interferes with your ability to live your life, for example, keeping you from going to work, spending time with friends, or taking care of yourself on a daily basis, then you need to see a therapist. These tips will help you a little, but you’ll need much longer exposures to the things that make you anxious and will probably need to learn about how your anxiety came to exist to start with. You will also need more intensive forms of relaxation. You may also need medication in order to manage your anxiety, which should be monitored by a psychiatrist in conjunction with therapy. I hope these tips can help you the next time you have some event that makes you feel nervous. And please, if you’re going to be on the same flight as me – take a breath already!

Attacking the Science of Psychology

On October 2, 2009 a Newsweek article caught my attention that I just can’t stop thinking about. Granted, I am a few weeks behind in my reading so I really just read this about 2 weeks ago, but that’s beside the point. In this particular artical (Ignoring the Evidence) Sharon Begley makes the assertion that therapists do not understand nor use evidence based treatments in their practice. She also asserted that Clinical Psychology programs did not teach students how to be consumers of the literature. In addition, she implies that cognitive and behavioral techniques are the only interventions that can work in therapy. By the time I finished this article, I was incensed. Since that time, I have been ruminating about her article and decided to take some of my own advice and journal (or in this case blog) about it.

I think the main reason this article made me as angry as it did was that it only perpetuates the feelings that are already out there among people considering therapy. They’ve seen every episode of Law and Order where the therapist is sleeping with her clients and killing their spouses. They’ve seen all the news stories that talk about rebirthing “therapy.” All Ms. Begley, who, by the way, does not hold a degree in psychology, did with her article was create yet another stereotype. This is the therapist who despite the science, continues to use treatments that do not and will not work. Along with this stereotype, Begley also seems to be saying that psychology consists mainly of hocus pocus and maybe a little bit of luck.

To me, this was an extremely dangerous article that had the potential to dissuade someone on the fence about therapy from getting the help they need. Of course, as in every profession, there are some therapists who don’t know what they’re doing or who use interventions that harm rather than help their clients. Contrary to what Begley would have us believe, this is not the norm. Here are the facts about therapists and their training in research. Every doctoral level therapist has completed at least two courses in research design and statistics, most have three. They also have to complete a research project in which they either conduct their own original research or use the research of others to propose a new theory. If there therapist graduated from an accredited program, they also learned to consume the research of others and apply it to the work that they do. And what of Begley’s assertion that cognitive and behavioral therapy is the only therapy supported by research. That is blatantly not true. In reality, the bulk of the research shows that the strength of the relationship with your therapist is what really determines outcome, not which technique said therapist uses. Does this mean that if you have a good relationship with your therapist that any technique will work? Absolutely not, and I don’t know a therapist who would make this assertion. Every therapist knows that some techniques work better for some problems than others. For instance, if you are going to therapy in order to conquer your fear of flying and your therapist is analyzing your relationship with your father, you may want to find a new therapist. Sure, any therapist worth their salt will learn something about your family history in the first few sessions. But that therapist will also know that the best way to treat fears is to expose the person to the feared object or situation and help them reduce their anxiety.

It is always important for a profession to take a critical look at its shortcomings. This is especially true in psychology where others put their trust in you at their most vulnerable. However, false allegations only hurt those who truly need the help that therapy can offer when done well. If you are in therapy now and feel that your therapist is practicing below an acceptable level, then you should find a new therapist. You should also express your concerns to whoever oversees the licensing process in your state. It is their job to protect the public and ensure a standard of care. If you ever have questions about what your therapist is asking you to do, voice them. Regardless of how good your therapist is, you will only get out of the therapy what you put into it. Oh, and if your therapist starts talking about rebirthing – run.

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