In my private practice, I do a lot of skill building with my clients and I find myself reminding them that the skills are simple concepts, but can be difficult to put into practice. These are skills that everyone, including myself, need to learn and actively use. The skill I most frequently teach my clients is how to be present in the moment. You can call it being grounded, being mindful, looking outward. Seems simple, right? Think about the last time you drove home from work or your child’s school. Can you specifically remember the ride or did you just find you were back at home? Were you busy, being in your head, thinking about what happened during the day or what you were going to make for dinner? This is NOT being present. Being present works by focusing outward on the world. The work is in the ability to center your mind and your focus on what is happening in the moment. Using all 5 of your senses to keep yourself focused on the here and now and out of your head thinking about the past and the future, things we are not able to control. Being grounded allows you to identify if you are becoming stressed, or anxious and to catch when life is out of balance. People will often say they feel overwhelmed or anxious and that these feelings “came out of nowhere”. One of he benefits of being present is the ability to catch these feelings, identify the self-talk which might fuel these feelings and make a change in your behavior.
Being present, centering, looking outward is a “simple” concept that requires active work on a daily basis. I usually encourage my clients to check in with themselves every hour. Ask yourself, “Where has my mind been? What do I taste, touch, smell, see, hear? Where should my focus be right now?” Like any new skill, the more you practice, the more quickly the skill becomes habit. A simple, but challenging grounding exercise based on the 100 breaths technique. You take 100 breaths, you count them and you try to not think about anything else but the breath.
Probably one of the biggest challenges of being a psychologist is learning to practice what I teach. Being present is skill that requires my constant attention. Even when life is going well, I actively remind myself to be in the moment and enjoy. Today, I had my Dailey Method socks as a reminder (thedaileymethod.com)
How to teach our kids to manage food:
When people find out I have a background in treating eating disorder clients, they often ask me, “How do I prevent my own child from getting an eating disorder?”
While there is no fool proof way to prevent eating disorder, as they have multiple biological, hereditary and cultural components, there are things I believe we, as parents can do, to help assist our children to learn to love their bodies, feel more confident and build resilience.
1.Nurture a positive view of yourself. Developing confidence in your ability to solve problems and trusting your instincts helps build resilience.
2. Model good eating habits for your children: don’t skip meals but insist your child clean their plate.
3. Avoid teasing about appearance. Likewise, praise your children for other qualities outside of their appearance.
4. Don’t get caught in the clean plate club trap. Teach your children to eat until they have a sense of being full.
5.Encorage balanced and flexible eating. No food is "bad".
6. Avoid dieting and diet talk. Girls and women who diet are 18x more likely to develop an eating disorder (ANAD Newsletter, Summer 2001). Focus on being healthy, mind, body AND spirit.
7. Encourage family meals, but also allow for the flexibility that maybe your child is not hungry at dinner time.
8. Teach your child do honor their body. Encourage them to respond appropriately. When they say they are full, don’t insist they “eat one more bite”. We are telling them that the signals their body is sending them are not accurate.
9. Teach your child to honor and express their feelings. Avoid telling your child, “That’s not how you feel” or “It’s not that bad”. Listen to what they say.
Often when I see clients who don’t manage food well, it is coupled with a significant distrust of their feelings, emotions and thoughts. They don’t trust their body will tell then accurately when they are full, hungry, sad or happy. They have learned not to honor their body and are open so disconnected from what is going on inside. When it comes to our children, teaching them how to accurately identify and trust their internal compass is a key component to building healthy, flexible, balanced adults.
Having been a licensed clinical psychologist for 15 years, you would think I would have “heard it all”. Unfortunately, this is not the case when it comes to some client's journeys to my office. A good portion of my clients have been in therapy in the past, with many positive experiences. I love to hear when someone has had a healing experience in therapy. But too often I have found my clients have had multiple, not so great experiences. Here are a few suggestions on how to avoid some of these mishaps when seeking therapy.
Maybe being new to therapy, you feel unsure about where to start looking for a therapist, what makes for a “good” therapist or whether the services you are getting are “therapeutic”.
Where to start?
First, are have to decide if you going to use insurance or pay out of pocket. If you choose to use insurance, it will be necessary to FIRST call your insurance company and ask for a list of providers, in your area, who specialize in the issue you are seeking treatment for. Also, it will be important to determine if you have behavioral health benefits. If so, what are they. Unfortunately, behavioral health (or mental health) benefits vary dramatically from company to company. Ask for both in network benefits (these are used with a specific list of providers who are contracted with your insurance company) and out of network benefits. This simply means your insurance will cover a percentage of therapy but not 100% for a therapist who is not in the network. Sometimes, these benefits are not that different. Also, remember just because your insurance company states you have 30 sessions per year, this does NOT mean they will approve you to use all 30 of those sessions. There are many pros and cons to using insurance. You have to determine for yourself whether this is in your best interest.
A great place to start is by asking friends and family. At least 1/3 of my referrals come from previous clients who have had a positive experience and let others know about it.
Search on the internet. We do just about everything over the internet these days, why not start your search here. A great place to start is either the American Psychological Association or your local states Psychological Association.
Make sure the psychologist you choose is licensed in your state. You can verify licensure by going to your states Department of Professional Regulation website. This site will also indicate if the therapist has ever had any disciplinary action.
Another place to search would be on a disorder specific site such as ANAD.org for eating disorders. Therapists listed on these sites typically have specialty training in the specific disorder and are likely treating clients with similar issues.
What am I looking for?
So you have a few names of psychologists…now what? How do you make the decision from here?
A good first step is to do an internet search. I recommend checking out their professional website, if they have one and possibly any publications or professional affiliations they have. Hopefully, from their website, you can begin to get a feel for who they are and what type of therapy they may provide.
Next, make a few phone calls. I always suggest to people to call the psychologist and ask a few questions over the phone before making the initial appointment. I believe the response from this first phone call can be very telling. First, does the psychologist actually call you back? I have heard too many times that a client has made multiple attempts to contact a provider and NEVER heard anything back from them. In my practice, I return every call, even if it is to let someone know my practice is full or that I do not serve a particular population or take insurance benefits.
Writing down a few key questions before speaking with a psychologist is recommended. Some questions may include:
-How long have you been practicing?
-What percentage of clients do you currently see that have my specific issue (depression, anxiety, anorexia, infertility).
-How many have of these cases have you treated in the past?
-What is the cost of treatment?
-Have you had any specialty training dealing with my issue?
After the phone call, spend a moment thinking about how it went. Did you feel rushed? Did the psychologist seem open to your questions? Does their practice allow you to speak to the psychologist BEFORE you make an appointment? Is this important to you?
Above all, you should listen to that guiding voice in your gut which seeks to steer you in in the right direction. You should feel “comfortable” being able to share your deep emotional issues with your therapist. When I say comfortable, I mean as comfortable as it can be to discuss often very difficult thoughts and feelings. Therapy can provoke feelings of anxiety: this is normal. You need to be able to trust your therapist 100% and believe they respect your thoughts, feelings and opinions. You need to be able to be honest and open in order for therapy to be successful. This is an investment in your future and your overall health. You should feel as though the psychologist is on the journey with you.
But I took the stairs!September 25, 2014
As a clinical psychologist in private practice, one of things I find myself discussing again and again with 95% of the people who sit on my couch is the benefit of exercise. Research suggests 25% of the population report no leisure-time physical activity! (Weir, 2011). Exercise can have a positive impact on long -term health, reducing anxiety, improving memory and stabilizing your mood. I am talking about setting aside a specific time, 30-60 minutes, about 3 times per week, to get your heart rate up. When I tell my clients this, most often, I hear an audible groan. “But I took the stairs today!” While this is a bonus, this is not exactly what I had in mind.
There are endless reasons to exercise. Some of the benefits of exercise include:
1. Improve sleep. One study of people who exercised regularly for about 10 weeks reported sleeping better than they had previously.
2. Reduce anxiety. It appears to change the chemistry of the brain by causing the release of GABA, a neurotransmitter that helps quiet brain activity and minimize anxiety.
3. Boost immunity: Regular exercise can reduce your risk of certain health conditions, including heart disease, diabetes and some cancers. It can also decrease your chances of developing some common illnesses, such as flus and colds. (According to one recent study, colds lasted 43% longer for people who exercised one time a week or less.)
4. Decrease PMS. Women often report feeling irritable and bloated before their periods, but exercise appears to minimize these conditions. One survey of close to 2,000 New Zealand women found that those who exercised, rested and wrote in a journal about their symptoms fared better than those who followed other advice.
5. Get you in the mood. For men, exercise can lower the risk of erectile dysfunction, and it helps both men and women feel good about themselves and their bodies.
6. Strengthen the brain. It has been found that working out can lessen the severity of memory problems in older adults, and even decrease the risk of diseases like Alzheimer's. It can also have a positive benefit on the brain function of younger people. Exercise has been found to improve certain executive functions in the brain, including planning, memory, reasoning, problem-solving and more.
7. Improve your heart health. Exercise has been shown to boost high-density lipoprotein (HDL), or "good," cholesterol and decrease unhealthy triglycerides, which can keep your blood flowing smoothly, decreasing your risk of cardiovascular diseases.
8. Improve your overall mood. Exercise can stimulate the brain to release chemicals, making us feel happier and more relaxed. It can also help you deal with current stress.
9. Fight Depression. Kotz and Haupt (2012) report burning as little as 350 calories three times a week, in a activity which raises your heart rate, can reduce the symptoms of depression. It is possible exercise stimulates the growth of neurons and connections between neurons, acting as a natural anti-depressant. Exercise appears to be a good compliment to the traditional treatment of mild to moderate depression.
10. Improve your body image and self-confidence. Setting small fitness goals and accomplishing them can improve how you feel about yourself. Get moving and you will see an improvement in your satisfaction with yourself.
11.Bolster you from aging and cognitive declines. Exercise can boost chemicals in the brain that are necessary for memory and learning, which may decline after age 45.
Mayo Clinic Staff. (2014). Exercise: 7 benefits of regular physical activity. Retrieved from http://www.mayoclinic.org/healthy-living/fitness/in-depth/exercise.
Kotz, Deborah & Haupt, Angela (2014, May 7). 7 Mind-Blowing Benefits of Exercise. Retrieved from health.us.news.com/health-news/diet-fitness/slideshows.
Weir, Kristen (2011, December). The exercise effect. Monitor on Psychology, 42 (11), 48. Retrieved from www.apa.org/monitor/2011/12/exercise.aspx