encomium-psychology

The Barnacles You Don't See

Wed, 11 Feb 2026 03:55:39 GMT

Unveiling What Hides In Your Blind Spots

Barnacles don’t look like a problem.

They’re small.
Quiet.
Easy to overlook.

They don’t crash into a ship or tear holes in the hull.
They don’t announce themselves.

They simply attach.

And slowly, the ship begins to drag.
It moves, but with more effort.
It burns more fuel just to stay on course.
It sits lower in the water than it should.

Nothing looks broken.
But everything feels heavier.

That’s how unresolved inner weight works.

Fear.
Anger.
Anxiety.

Confusion.
Doubt.

Unrelenting sadness.

These don’t always show up as obvious crises.
They don’t always feel dramatic or urgent.
Most of the time, they feel familiar.

Until one day you realize that life feels harder than it needs to be.

We often try to fix this by “doing better.”

Eating healthier.
Working harder.
Improving relationships.
Taking time off.
Searching for meaning.

All good things.

But effort alone doesn’t always restore momentum.

Because barnacles don’t attach to goals.

If they did, we’d spot them immediately.

They attach in our blind spots.
In the subconscious.
In patterns that run automatically, beneath awareness.

They don’t show up as clear thoughts.
They show up as reactions. Assumptions. Judgments.

As the discordant tone in your speech.
As mismanaged timing.
As the same situations repeating in slightly different forms.

They anchor themselves to the nervous system.
To the body’s memory.
To conclusions formed early in life, often before we had true agency.

Thoughts and feelings about safety, belonging, control, and loss.

That’s why surface reflections alone rarely removes them.
They were never living in the conscious mind to begin with.

Over time, the effects add up.

The rigidity and absence of flow in your gait.

Suboptimal health and vitality.

Unresolved disappointments and fear of abandonment corrode relationships.
Anxiety driven distractions drains our ability to truly rest and recover.
Doubt and fear quietly foul our work and ambitions, adding resistance and wasted energy.
And eventually, all of it erodes our sense of purpose and meaning.

We lose drive and direction.

We lose the lightness in our soul. We lose buoyancy.

And when progress slows, most people turn the blame inward.
They assume they’re outcasts, unmotivated, or broken.

They criticize the ship
instead of checking the hull.

Real change begins with attention.

I highlight the importance of awareness in my book Unself .

Not vague self-awareness, but intentional and precise noticing.

Paying close attention to patterns that repeat.
To moments of resistance.
To subtle shifts in the mind and body before reactions take over.

It’s less about force
and more about seeing clearly.
And over time, what no longer belongs can finally be shed.

Here’s the truth many of us miss:

We're not struggling because we're weak.
We struggle because we've been carrying unseen weight for a long time.

And here’s the quieter truth beneath that:

Some of that weight feels like identity. A part of who we are.
Letting go can feel unfamiliar. It certainly feels unsafe at first.

That’s why so many of us often cling to patterns we want to change

but never do.

You were built to move forward despite the presence of resistance.
To live with more ease than a lifetime of effort.

But first, you have to be willing to look beneath the surface
and notice what’s been quietly slowing you down.

Because the ocean was never the problem.

It was what was lurking underneath.

Your Enterprise Determines Your Future

Thu, 17 Apr 2025 06:31:14 GMT

How Learning, Career Fulfillment, and Financial Security Shape the Quality and Experience of Your Life

In my book Unself : Transform Your Life by Letting Go of Who You're Not, I discuss the importance of recognizing the intentional pursuit of one's Enterprise which consists of education, a career path, and financial habits that shape the quality of the experiences we have.

Many of us only come to appreciate the necessity of a holistic enterprise system after hardship enters our lives—whether through academic setbacks, professional stagnation, or financial strain. Often, it is through repeated encounters with these challenges, or by witnessing them in others, that we begin to understand something deeper: the profound interconnectedness between continuous learning, meaningful professional fulfillment, and financial stability.

Recognizing and embracing this triad reveals its essential role not only as a means of survival, but as a framework for building a deeply satisfying, resilient, and eudaemonic life.

Continuous Learning: The Pulse of Evolution

Intentional continuous learning is more than acquiring knowledge. It is the heartbeat of personal evolution. It reflects a growth mindset—the belief that intelligence and ability can expand through persistent effort and curiosity.

Lifelong learners see challenges not as threats, but as invitations to grow. Consider a student or professional who consistently hones their skills and remains agile in the face of change while recognizing precisely what it takes to exceed in their chosen field. This intellectual and emotional adaptability becomes a wellspring of innovation and creativity. By committing to the pursuit of learning, we equip ourselves with the tools and perspectives needed to thrive both individually and collectively.

Professional Fulfillment: Purpose in Action

Work occupies a significant portion of our lives. Its true value lies not just in the hours spent, but in the alignment between what we do, who we are and what we are trying to become. Professional fulfillment emerges when our daily efforts resonate with the inner compass driven by our motivations, strengths, and values.

According to Self-Determination Theory, fulfillment is rooted in autonomy, competence, and connection. Imagine the inspired educator whose passion turns each lesson into a vibrant exchange of ideas, leaving a lasting imprint on students. When work aligns with purpose, routine becomes ritual. Fulfillment infuses tasks with vitality, deepens engagement, and often leads to increased performance, recognition, and growth.

Financial Stability: The Foundation of Freedom

Financial stability is not solely about wealth accumulation. It is about freedom, the quality of our experiences, and psychological peace. When our financial foundations are secure, we can choose, not settle for a lifestyle, experience less stress and sustain more cognitive and emotional capacity for higher-order pursuits such as creativity, service, leisure, or exploration.

Like the deep roots of the ironwood tree, financial stability anchors us, allowing us to stretch and grow with confidence. It is not the end goal, but a powerful enabler of other HEART priorities and TRACE processes.

The Cost of Neglect: When Enterprise is Fragmented

Without a clear vision, inspiring role models, or structured guidance, these domains can feel overwhelming. Confusion often leads to missteps, regret, and missed opportunities. Misalignment in one area tends to create dysfunction in the others. A lack of learning can result in stagnation and unnecessary roadblocks. Work that lacks meaning can cause frustration, burnout and a lack of motivation. Financial uncertainty can lead to chronic anxiety, depression, envy and diminished joy.

When enterprise is fragmented, life becomes reactive rather than intentional. Instead of designing your days and experiencing the flow stemming from deep and meaningful engagement in your work, you drift through them.

The Journey Forward: Grit, Grace, and Growth

The journey toward enterprise excellence is not without obstacles. It requires clarity, courage, and consistency. Angela Duckworth describes grit as the combination of passion and perseverance over time. Grit fuels sustained effort, even when the path is unclear or progress is slow.

But grit alone is not enough. We need structure—visions turned into goals, goals translated into systems, and systems reinforced by consistent habits and continuous feedback that we are on the right path. We also need people. This cannot be overstated. A supportive community provides accountability, encouragement, and perspective. Just as importantly, we need gratitude, radical acceptance, compassion for ourselves and to manage expectations. Life rewards those who remain open to course corrections and surprises.

Beyond the Self: The Ripple Effect of Enterprise

Enterprise, cultivated with intention, does more than elevate individual lives. It enriches communities and influences generations. Lifelong learners create cultures of curiosity and progress. Fulfilled professionals model integrity, inspiring others to pursue meaningful work. Financially secure individuals invest in causes, create opportunities, and give generously.

This is the deeper promise of enterprise. It is not simply personal success. It is the architecture for collective flourishing.

And as explored in later chapters in my book, true sustainability also demands rest, recreation, and rejuvenation. Even the most vibrant enterprise must be anchored in recovery to endure.

Through deliberate attention to learning, vocation, and finance, you do more than build a stable life. You craft a life of depth, clarity, and contribution—one that leaves a legacy beyond your own reflection, and equips you with something you’d rather have and not need, than need and not have: options.

On Gratitude

drola@encomiumpsychology.com (Olabanji Adeniranye) — Fri, 24 Jan 2025 07:16:03 GMT

As you journey toward your vision of the life you create, embrace the art of managing attachment to outcomes. In an ever-changing world, anything can happen, and the only aspect within your control is the quality of your response and effort. This underscores the significance of gratitude, radical acceptance, and self-compassion. Across health, enterprise, authentic relationships, recreation, and transcendent purpose and meaning (HEART), one constant remains: change. We exist in a liminal space between becoming and unbecoming, entropy and negentropy—between beginnings and endings—a never-ending dance. Regardless of your pursuits and accomplishments, it is vital to acknowledge that nothing is promised. Gratitude, compassion for self and others, radical acceptance, and an understanding of life’s mercurial nature are essential practices to cultivate.

Gratitude holds a profound place in creating a life worth living. By cultivating gratitude, you not only find solace amidst life’s uncertainties but also gain a deeper appreciation for its intricacies. It is the practice of acknowledging simple joys, ephemeral moments, and interconnectedness—if you look closely enough. Gratitude allows you to savor the past, embrace the present, and anticipate the future, constructing a meaningful story even in the face of adversity. It is a transformative force that enriches both your life and the lives of those around you. Gratitude also reveals what often lingers unnoticed, quietly vital in the periphery of our awareness.

Millions of people around the world face unforeseen tribulations despite their hard work, ethical fidelity, dedicated practices, and ascetic commitment to one belief or another. We expect to show up to a job and not receive a pink slip. We expect our partners and friends to continue playing their roles with blind admiration. We expect that our bodies will continue to hold up in spite of the rigor of the world and many things we put ourselves through. Yet life reminds us otherwise. We shudder at hearing the stories of people who were lucky (If you can call it that) enough to discover that nature had planted some genetic time bomb that had for so long escaped detection until a routine checkup.

We expect the world and all its institutions to continue to function without interruption. Many of us can testify to the reality that things can turn helter skelter in the blink of an eye. A pandemic. A war. A breakup. A divorce. An illness. An accident. A betrayal. That one mistake from years ago. A miscalculation. A misstep. You misspoke. You forgot. You remembered. You were too early. Too late. On time. Too fast. Too slow. On pace. The straw that broke the camel’s back. The last drip that pressured the levees into collapse. Why did it happen over there and not here? Why did it happen to them and not us? Why did it happen to him or her and not you, until you realize that one person’s there is another person’s here . One person’s them is another person’s us.

Maybe you’re special. Maybe you are lucky. Maybe it’s just not your turn–yet. Nothing is owed to no one. Despite our surgical preparations, fate sometimes has other plans. Adopting this attitude fosters a climate for gratitude, even in the most miniscule of circumstances.

It becomes easier to have gratitude when we adopt the mindset that the universe does not inherently owe us anything–in essence, managing our conditioned personal and collective expectations of what the world is supposed to be like. With this attitude, we can appreciate life’s subtleties and the smallest of experiences. By reframing expectations, we appreciate life’s gifts: the breath filling our lungs, the cool breeze on our skin, the bed we sleep in, the companionship of those who care, and the clean water we drink. The privilege of knowing that the only nightmares you’ve had existed solely in your dreams and never outside your door. The roof over your head. The perceived failure that in hindsight led to opportunity. The privileges we take for granted, like safety and access to resources and opportunities, come into sharper focus. Gratitude tunes us into the blessings we often overlook, redirecting our focus from what is missing to what is present.

The journey through H.E.A.R.T priorities and T.R.A.C.E processes demands intentionality and self-reflection on gratitude. Through this system comes the reconfiguration of beliefs, emotions, relationships, behaviors, and values that terraform the worldviews shaping our lives. In this process, you begin to see that you, along with countless others and the forces of nature, are the catalysts behind the kinetic reshaping of your life. This awareness reveals countless reasons to be grateful—both within and beyond yourself.

Radical Self Compassion

drola@encomiumpsychology.com (Olabanji Adeniranye) — Wed, 02 Oct 2024 19:56:58 GMT

As many experience the process of transmutation and change through self education and self discovery, an unnerving grief may sink its talons into our psyche; its grip implacable; its grasp, irreconcilable–a grief that emerges as a result of using an enlightened viewpoint to judge past behaviors and choices that were made in the dark. Subsequently, the ritual of psychological self-flagellation occurs as we begin engaging in an infectious, self-contaminating routine of self-blame, shame, guilt and regret; internalizing a myopic and punitive narrative that distorts a complete picture of the totality of our experiences. What we seek; what we need, is clemency. Who better to receive and express compassion to other than yourself.

In spite of the amount of books you read or adages you subscribe to; in spite of the amount of compassion and validation you receive from others, nothing can come closer to the literal felt experience of being acquainted with your own slice of the human experience. Although many can empathize, sympathize and somewhat relate to the things you will inevitably go through, nothing will come closer to apprehending what it feels like for you to experience you–not even a perfectly crafted genetic clone of yourself. For this, we are in a way relegated to walking this idiosyncratic path of unique experiences alone.

Here is where self compassion must be implemented with nonnegotiable and unyielding stubbornness. As discussed in previous chapters, we will be faced with all manner of challenges that test the very limits of our sense of self, relationships, behaviors, beliefs, emotions and more. It is not a matter of if we will have these experiences, but when. Many of us have already suffered and witnessed directly or indirectly ineffable pain that escapes conceptualization and expression even to ourselves, let alone those around us. Inscribed onto the very fabric of human experience is the history of striving, survival, loss, disappointment, yearning, scratching and clawing for space, resources, peace, belonging, agency, safety, sanity and solitude. And while we wait our turn on the conveyor belt moving us toward the unavoidable hamster wheel of pain, futility and disappointment, we must take heart and have self compassion.

Self compassion that this one pain cannot be avoided. Self compassion for what it will do to you. Self compassion that you will be changed by the experience. Self compassion for your inner child and your current self and your inner elder. Self compassion that you could barely protect yourself let alone another. Self compassion that you were scared, ashamed, craven. Self compassion that you didn't know any better. Self compassion that maybe you thought you knew better–but how could you? If you knew this pain and suffering would be the outcome you would have certainly made a different choice; taken a different path. Self compassion that you were powerless in one situation or another. Self compassion because this will not be the last time you will feel the pain and suffering inherent in being born in this world, in your body, in your family, your country, in this place, this time, this zeitgeist. Epoch. Moment. Self compassion that no one gave you a blueprint, a map, a compass, the skills, the tools, the instruments you needed and even if by some fortune someone did, they were rudimentary and remedial at best. Self compassion that you did not know what questions to ask or what answers to give. Self compassion simply for the sake of it.

Trauma-Informed CBT For Adults: What Is It & How It Helps

Tue, 15 Jun 2021 00:46:01 GMT

Trauma-Informed Cognitive Behavioral Therapy (CBT) for adults is a type of mental health treatment. It's used to help people who have experienced trauma find ways to manage hurtful behaviors and emotions. The goal of this therapy is to help the person create a life worth living. This post will cover what Trauma-Informed CBT for adults is, when it is used, and how it helps people recover from PTSD and traumatic experiences. Living a full and satisfying life after trauma is possible.

What Is Trauma?

Trauma is a common response to a deeply distressing event or situation that overwhelms a person's ability to cope. The traumatic experience causes feelings of helplessness, fear, or lasting sadness. People often lose their sense of self and their ability to fully feel their emotions.

Traumatic life events include combat in war zones, natural disasters, being in an accident, and physical and/or sexual attacks. However, many people are traumatized as a result of relationships. Common causes of trauma in this area include:

Bullying
Sexual abuse
Domestic violence
Partner betrayal
Being raised by parents with addiction or mental illness
Parental divorce or one’s divorce
Death of a close friend or family member

People can experience Posttraumatic Stress Symptoms for weeks or months. Responses to trauma can be different from person to person. However, in most cases, these symptoms resolve on their own over time. When the symptoms persist and get worse, that person is at significant risk for developing PTSD.

What Is PTSD?

Posttraumatic Stress Disorder (PTSD) is a mental health condition that occurs after someone has experienced or witnessed a trauma that overwhelmed their ability to cope so badly that they can't recover from it.

Any person, regardless of age, sex, gender, nationality, race, or ethnicity can develop PTSD. In the U.S., members of the Latino, Black, and Asian communities, as well as women, are more likely to develop PTSD. Approximately 3.5% of U.S. adults are diagnosed with PTSD every year. About 1 in 11 adults in the U.S. will be diagnosed with PTSD in their lifetime.

PTSD causes physical, emotional, and psychological symptoms such as:

Forgetting parts of the trauma.
Being scared and on alert all the time.
Avoiding people, places, emotions, and/or thoughts related to the traumatic event
Feeling emotionally numb.
Developing Anxiety Disorders and Depression.
Having ongoing sleep issues (e.g., insomnia, frequent nightmares).
Physical health issues (e.g, high blood pressure, palpitations, muscle tension, frequent illnesses, pain disorders).

These symptoms happen because a traumatized person’s brain, nervous system, and body have been negatively changed by the experience. As a result, it becomes difficult for them to process different kinds of situations and information properly. This leads to everything around them feeling more painful, dangerous, and risky.

To qualify for a diagnosis of PTSD , these symptoms have to be present for at least a month and cause significant issues in daily functioning.

Why Is Trauma-Informed Care Important?

Trauma-informed mental health therapists know how to create a sense of stability and safety for traumatized people. This group is at higher risk for developing substance abuse disorders, mental health issues, and medical illnesses. Trauma-informed therapists also understand the deep impact trauma has on every area of life. They are trained to tailor their behavior, words, and treatment approach based on a person’s needs, personality, and triggers.

Trauma therapy can help people with PTSD as well as other trauma-related mental health issues. It builds on the inner strengths someone already has. Therapy helps someone develop a sense of safety as well as skills to handle the impact of trauma. As a result, the patient can work through the mental health issues keeping them stuck. The therapist must tailor the treatment to the type of trauma the patient has experienced, whether it's been ongoing, and who was involved.

Trauma-informed therapy for adults is different than that used with traumatized children and teens. Due to how our brains, bodies, and emotions develop at different stages, treatment for children and teens has to be appropriate to the child's needs and age. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT Treatment) is used with children and teens who are dealing with trauma or PTSD. It requires specific training that focuses on supporting the child while addressing issues related to their family as well as the circumstances they are living in.

What is Trauma-Informed Cognitive Behavioral Therapy?

This treatment approach is a form of Cognitive Behavioral Therapy (CBT) . Cognitive Behavioral Therapy helps people change their thoughts, beliefs, and behaviors in order to make their lives better. With trauma-informed CBT, a therapist helps the person change their thoughts and beliefs about the trauma. As a result, people learn to manage behaviors, thoughts, and emotions that are triggered by past or current overwhelming experiences.

People can recover from traumatic experiences through understanding what caused the trauma, accepting that it happened, and finding new meaning from the experience. As a result, when they have a painful emotion or memory, they can respond to it differently.

How Does Trauma-Informed CBT Work?

Trauma-informed approaches to therapy are based on the idea that trauma impacts our thoughts, feelings, memories, and sensations. This makes it difficult to think clearly or objectively about the trauma or life beforehand.

For this reason, creating a sense of safety for someone with PTSD symptoms is a critical first step in treatment. Unless therapy happens in a space that feels safe, there is a very small chance that the patient will open up enough to allow for healing.

CBT focuses on problem-solving skills. These new skills can help people change their emotional and physical reactions when confronted by triggers.

The goals of trauma-based CBT are to:

Promote a greater sense of control and trust.
Develop healthier and more effective ways to respond.
Calm panic responses in the body.

What Are Common Trauma-Informed Therapies?

After a traumatic event, it's very common for someone to experience their thoughts and bodily sensations separately. To calm their distress, they tend to rely on behaviors or substances that help them numb pain. Examples include drugs, sex, food, and/or being violent toward others. The goal of this therapy is to retrain the brain and body by connecting thoughts with feelings.

CBT for trauma usually involves helping a person develop new beliefs about the trauma, their role in it, and their ability to cope. They may also learn skills for dealing with overwhelming thoughts and feelings as well as how to handle emergencies. Therapists usually also teach people strategies for calming their bodies such as deep breathing.

It’s very common for therapists to use a combination of techniques when working with traumatized patients. Different techniques can help patients work through emotional blocks in helpful ways. This boosts the impact of the CBT treatment.

Other treatment methods that are commonly used with trauma-informed CBT include mindfulness, relaxation therapy, art therapy, and EMDR. Any additional treatment methods must fit the patient’s unique needs.

Is Trauma-Informed CBT Effective?

Research indicates that evidence-based trauma treatment is highly effective, whether it's used alone or with medication. Relapse rates are usually much lower once someone has finished cognitive-focused trauma therapy compared to just using medication.

Two main types of CBT are most effective in treating trauma:

Exposure Therapy:

Exposure-based therapy for trauma has the most research indicating it's successful in helping people recover from trauma. In this approach, the therapist and patient work on gradual exposure to the feared situation (e.g., driving on a busy highway) without any risk of the negative consequence happening (e.g., getting physically hurt in a car accident).

Repeating exposures as well as increasing their difficulty level eventually leads to breaking the association between the situation and overwhelming feelings (e.g., fear, anxiety).

Cognitive Processing Therapy:

This approach helps people identify the trauma narratives as well as hurtful stories and beliefs they developed. It provides strategies for looking at whether these stories and beliefs hold up now. Once a person develops a new perspective, therapy shifts toward teaching people how to challenge and change these beliefs. As a result, trauma survivors should feel safer and less anxious about the world.

Is Medication a Better Trauma Treatment?

Psychiatric medication is a common part of trauma therapy. These medications can help reduce the intensity of different symptoms. As a result, daily functioning and participating in therapy are easier.

When people only use medication to treat trauma-related symptoms, they experience relief as long as they continue using the medication. However, they are more likely to relapse once they stop taking medication. The main reason is that they don't learn to identify hurtful beliefs, understand where they came from, learn to challenge them, and develop new coping skills.

Next Steps for Trauma-Informed Cognitive Behavioral Therapy

Most people report feeling much better after finishing a trauma-informed CBT program. However, like any form of psychotherapy, not everyone will experience the same kind of results. That's why it’s important to work closely with a highly trained therapist who can figure out what's working. Then, they can make recommendations and/or changes based on a person's unique needs.

It's also essential that patients complete the entire treatment, learn to watch for warning signs that their overall functioning is getting worse, and check in with a therapist even after treatment is over to monitor progress.

When It’s Time to Start Trauma Therapy

Most people don’t know what to expect from therapy . They are also afraid to make themselves vulnerable by facing tough memories and emotions.

The good news is that you don't have to suffer or figure everything out on your own.

Wishing you the best of luck working through the feelings, thoughts, and memories that are keeping you stuck. You can live a fulfilling life despite the trauma you’ve experienced.

Ready to overcome trauma and feel the stability you want?

I am a psychologist and marriage and family therapist in San Diego, CA. I have significant experience working with adults, couples, and families dealing with trauma. Contact me so that we can help you overcome trauma and build the life you want.

Keyword: Trauma-Informed CBT

What to Expect From Therapy

Fri, 28 May 2021 17:35:25 GMT

Most people go to therapy when their thoughts and feelings about a current or past situation are more than they can hide or handle. By this point, these thoughts and feelings are impacting their work, relationships, and daily life. Most people don't know what to expect from therapy. Opening up to a stranger is hard, especially when you're suffering. However, therapy can help you change the beliefs, stories, and reactions that are keeping you stuck. If you're open, honest, and willing to change, therapy can help you achieve goals that will change your life.

In this post, I’ll explain:

The goal of therapy.
What happens during your first session.
What to expect from therapy in general.
How to get the most out of psychotherapy to achieve the peace and happiness you want.

Why go to therapy? What is the goal of therapy?

The decision to go to therapy is a tough one. You're choosing to open up to a stranger. By the time you meet with a therapist, you're probably dealing with strong emotions and suffering in some way. That makes opening up and connecting even harder. The goal of therapy is to give you a safe space where you can say, feel, and work through what's been keeping you from living the life you want.

There are many types of psychotherapy and specialties. Each therapist uses a variety of techniques based on their training and expertise. What they have in common is that mental health professionals are trained to provide a kind of attention and help you don't get in everyday life. A main goal of psychotherapy is to help you heal emotional wounds that have impacted every area of your daily life.

Therapy is a partnership in which you and your counselor work together to set and achieve specific treatment goals. You get practical skills to deal with emotions, thoughts, and relationships differently. As a result, you can make choices that support success and happiness instead of staying stuck.

What to expect from your first therapy session?

Whether you are starting online therapy or seeing a therapist in person, your first psychotherapy session is a chance for you and your therapist to learn about each other. Some therapists start with an extra-long first session while others stick to the traditional 50-minute session.

You'll be asked about your current situation and why you're seeking counseling now. Depending on the types of issues you're dealing with, your therapist will ask questions about different parts of your life. Some examples include family history, work, relationships, and health. They will also ask about your mental health history.

The first session is also a chance for you to ask the therapist questions, address concerns, and see if the therapist is a good fit. The quality of the therapist-client relationship is one of the biggest predictors of therapy success.

Don't settle for someone just because they're well known, you got an appointment quickly, or are in-network with your insurance company. You need to feel like they are experts in what you're dealing with and trustworthy. Otherwise, you'll constantly question the treatment plan and your progress.

What to expect from therapy and how to get the most benefit

Therapy is truly a process in which you will get what you invest in it.

You'll get the most out of therapy if you think of it as a long-term commitment to your mental and physical health. Exposing yourself to painful feelings and memories as well as changing is difficult. You might run through a range of feelings, from sadness to anger. Expect to be uncomfortable sometimes. Ironically, being open and honest about these tough thoughts and feelings is key to meaningful personal growth.

The reason you are at this point now is due to multiple factors. You're the result of past experiences. Additionally, you're impacted every day by the stories you tell yourself about your experiences. It takes vulnerability and bravery to rewrite the stories you have about yourself and build a life worth living.

How long does therapy take?

A healing therapy process is tailored to your needs. How long therapy takes depends on many factors. Some people need just a few sessions while others will be in therapy for months or years. Regardless of how long it takes, the goals for therapy focus on helping you live a healthier life. This way, you feel in control of your thoughts, feelings, choices, and responses.

Sometimes, people will work with a therapist for years. They either see their therapist regularly or check in from time to time. They want a confidential, safe advisor who knows how they work. As a result, they can get feedback and guidance from someone who knows them but isn't part of their day-to-day life.

Next steps to benefit from therapy

Whether you choose online therapy or to see a counselor face-to-face, psychotherapy can feel scary. Most people don't know what to expect from therapy. There are many types of therapy as well as a lot of potential therapists out there. To get the most out of therapy , you have to be vulnerable, deal with a range of emotions, and be open to change.

As a result, you want to feel comfortable and safe with whomever you chose. Make sure that you feel your therapist is qualified to help with your mental health issues. It's also essential that they provide the support and therapeutic relationship you need to make progress.

Understanding psychotherapy can help make the process less overwhelming. Ask your therapist questions if you don't understand something they said or the recommendation they're making. Tell them if you're uncomfortable opening up. They are trained to help with this.

A meaningful, more fulfilling life is possible. You don't have to suffer or figure everything out on your own.

Wishing you the best of luck reaching the goals that mean so much to you.

Ready to get the clarity, stability, and success you want?

I am a psychologist and marriage and family therapist in San Diego, CA. Contact me so that we can help you build the peace, success, health, connections, and life you want.

Keyword: What to Expect From Therapy

What Is Family Therapy? + 6 Techniques & Interventions

Mon, 24 Aug 2020 16:26:48 GMT

We all start this life with a family, whether that family is composed of blood relatives, adopted parents, a close-knit neighborhood, or a foster family. This family that we acquire when we are born influences every aspect of our lives, from our first moments to our last.

Our family affects who we are and who we become, for better and for worse. We learn our vocabulary, our habits, our customs and rituals, and how to view and observe the world around us.

We also learn how to love and how to interact with others from these first important relationships.

If we are born into a healthy family with healthy relationships, we are likely to learn how to maintain healthy relationships. If we are born into a dysfunctional family that struggles to connect, we may also struggle to connect with others.

While it is certainly unlucky to be born into the second kind of family, it’s not an unchangeable situation. Nearly all families deal with some sort of dysfunction at one time or another, yet most families retain or regain a sense of wholeness and happiness.

Family therapy offers families a way to do this—a way to develop or maintain a healthy, functional family.

What is Family Therapy / Family Counseling?

Family therapy or family counseling is a form of treatment that is designed to address specific issues affecting the health and functioning of a family. It can be used to help a family through a difficult period, a major transition, or mental or behavioral health problems in family members (“Family Therapy”, 2014).

As Dr. Michael Herkov explains, family therapy views individuals’ problems in the context of the larger unit: the family (2016). The assumption of this type of therapy is that problems cannot be successfully addressed or solved without understanding the dynamics of the group .

The way the family operates influences how the client’s problems formed and how they are encouraged or enabled by other members of their family.

Family therapy can employ techniques and exercises from cognitive therapy, behavior therapy, interpersonal therapy, or other types of individual therapy. Like with other types of treatment, the techniques employed will depend on the specific problems the client or clients present with.

Behavioral or emotional problems in children are common reasons to visit a family therapist. A child’s problems do not exist in a vacuum; they exist, and will likely need to be addressed, within the context of the family (Herkov, 2016).

It should be noted that in family therapy or counseling, the term “family” does not necessarily mean blood relatives. In this context, “family” is anyone who “plays a long-term supportive role in one’s life, which may not mean blood relations or family members in the same household” (King, 2017).

According to Licensed Clinical Social Worker Laney Cline King, these are the most common types of family therapy:

Bowenian: this form of family therapy is best suited for situations in which individuals cannot or do not want to involve other family members in the treatment. Bowenian therapy is built on two core concepts: triangulation (the natural tendency to vent or distress by talking to a third party) and differentiation (learning to become less emotionally reactive in family relationships);
Structural: Structural therapy focuses on adjusting and strengthening the family system to ensure that the parents are in control and that both children and adults set appropriate boundaries. In this form of therapy, the therapist “joins” the family in order to observe, learn, and enhance their ability to help the family strengthen their relationships;
Systemic: The Systemic model refers to the type of therapy that focuses on the unconscious communications and meanings behind family members’ behaviors. The therapist in this form of treatment is neutral and distant, allowing the family members to dive deeper into their issues and problems as a family;
Strategic: This form of therapy is more brief and direct than the others, in which the therapist assigns homework to the family. This homework is intended to change the way family members interact by assessing and adjusting the way the family communicates and makes decisions. The therapist takes the position of power in this type of therapy, which allows other family members who may not usually hold as much power to communicate more effectively (King, 2017).

What is a Family Counselor Trained For?

As the different types of therapy described above show, a family therapist may be called upon to take on many different roles. These many roles require a family therapist to undergo a great deal of training, formal education, and testing to ensure that the therapist is up to the task.

“In this therapy, the therapist takes responsibility for the outcome of the therapy. This has nothing to do with good or bad, guilt or innocence, right or wrong. It is the simple acknowledgement that you make a difference.” – Eileen Bobrow

While therapists may have different methods and preferred treatment techniques, they must all have at least a minimum level of experience with the treatment of:

Child and adolescent behavioral problems;
Grieving;
Depression and anxiety;
LGBTQ issues;
Domestic violence;
Infertility;
Marital conflicts;
Substance abuse (All Psychology Schools, 2017).

In order to treat these and other family issues, therapists must:

Observe how people interact within units;
Evaluate and resolve relationship problems;
Diagnose and treat psychological disorders within a family context;
Guide clients through transitional crises such as divorce or death;
Highlight problematic relational or behavioral patterns;
Help replace dysfunctional behaviors with healthy alternatives;
Take a holistic ( mind-body ) approach to wellness (All Psychology Schools, 2017).

In order to gain the skills necessary to perform these functions, a family therapist usually obtains a bachelor’s degree in counseling, psychology, sociology, or social work, followed by a master’s degree in counseling or marriage and family therapy.

Next, the therapist will most likely need to complete two years of supervised work after graduation, for a total of 2,000 to 4,000 hours of clinical experience. When these requirements are met, the therapist will also likely need to pass a state-sanctioned exam, as well as complete annual continuing education courses.

This education trains therapists for guidance with a wide range of problems, including:

Personal conflicts within couples or families;
Unexpected illness, death, or unemployment;
Developing or maintaining a healthy romantic relationship at any stage;
Behavioral problems in children ;
Divorce or separation;
Substance abuse or addiction;
Mental health problems like depression and anxiety .

This wide range of problems makes it clear that the answer to “What is a family therapist NOT trained to do?” may be shorter than the question of what they ARE trained to do!

To learn more about how marriage and family therapists are trained and how they practice their craft, the following websites are great resources:

The American Association for Marriage and Family Therapy website ;
The All Psychology Schools website ;
The Careers in Psychology website ;
The Marriage and Family Therapist Licensure website ;
The Learn website .

What is the Goal of Family Therapy?

“To put the world right in order, we must first put the nation in order; to put the nation in order, we must first put the family in order; to put the family in order, we must first cultivate our personal life; we must first set our hearts right.” – Confucius

In a nutshell, the goal of family therapy is to work together to heal any mental, emotional, or psychological problems tearing your family apart (Lee, 2010). To guide a family towards a healthy life, family therapists aim to aid people in improving communication , solving family problems, understanding and handling family situations, and creating a better functioning home environment (Family Therapy, 2017A).

The goals of family therapy depend on the presenting problems of the clients. For example, goals may differ based on the following scenarios:

A family member is suffering from schizophrenia or severe psychosis: The goal is to help other family members understand the disorder and adjust to the psychological changes that the patient may be undergoing;
Problems arising from cross-generational boundaries, such as when parents share a home with grandparents, or children are being raised by grandparents: The goal is to improve communication and help the family members set healthy boundaries;
Families deviating from social norms (unmarried parents, gay couples raising children, etc.): The goals here are not always to address any specific internal problems, but the family members may need help coping with external factors like societal attitudes;
Family members who come from mixed racial, cultural, or religious backgrounds: The goal is to help family members further their understanding of one another and develop healthy relationships;
One member is being scapegoated or having their treatment in individual therapy undermined: When one family member is struggling with feeling like the outcast or receives limited support from other family members, the goal is to facilitate increased empathy and understanding for the individual within their family and provide support for them to continue their treatment;
The patient’s problems seem inextricably tied to problems with other family members: In cases where the problem or problems are deeply rooted in problems with other family members, the goal is to address each of the contributing issues and solve or mitigate the effects of this pattern of problems;
A blended family (i.e., step-family): Blended families can suffer from problems unique to their situations. In blended families, the goal of family therapy is to enhance understanding and facilitate healthy interactions between family members (Family Therapy, 2017B).

Family Psychotherapy: Taking it One Step Further

We tend to think of therapy and psychotherapy as two different forms of treatment, but in fact, they are the same thing. This ambiguity is enhanced when we introduce the term “counseling” as well.

In truth, therapy is simply a shortened form of the word “psychotherapy” ( www.drpatrick.com ). However, counseling is sometimes called “talk therapy,” blurring the lines even further (Eder, “What is the Difference”).

Generally, counseling is applied in situations where an individual (or, in the case of family counseling, a family) engages the services of a counselor or other mental health professional to help with a specific problem or set of problems. Therapy, or psychotherapy, is a more in-depth and usually long-term form of treatment in which the client or clients discuss a wider range of issues and chronic patterns of problematic feelings, thoughts, and behaviors (Eder, “What is the Difference”).

A family who is struggling with a situation that brings added stress , such as the death of a family member, addiction, or dire financial straits, may benefit from counseling to help them through their struggles to emerge on the other side as a stronger and more cohesive unit.

If a family is struggling with more chronic mental or behavioral problems, such as a father dealing with schizophrenia, a mother fighting depression, or a child who has been abused, psychotherapy is likely the better choice.

This type of therapy is appropriate for families with problems such as these because a family therapist has a different perspective on treatment than an individual therapist. While the individual therapist works with one client on solving or curing a problem, the family therapist views problems in the context of the “system” of the family. To solve a problem in a system, you need to consider all parts of the system.

Fixing the alternator in a car will not fix the problem if it also has flat tires, a faulty transmission, and a plugged exhaust pipe.

Issues within a family are similar to the car with several problems. A parent struggling with alcoholism is not a problem in isolation; the parent’s struggle has likely affected their spouse and their children as well. A family therapist believes that problems must be addressed at the level of the whole family rather than on an individual level (Schwartz, 2009).

What are the Benefits of Family Therapy?

This more holistic approach to treating problems within a family has proven to be extremely effective in many cases. In family therapy, families can work on their problems with the guidance of a mental health professional in a safe and controlled environment.

The benefits of family therapy include:

A better understanding of healthy boundaries and family patterns and dynamics;
Enhanced communication;
Improved problem solving;
Deeper empathy;
Reduced conflict and better anger management skills (10 Acre Ranch, 2017).

More specifically, family therapy can improve family relationships through:

Bringing the family together after a crisis;
Creating honesty between family members;
Instilling trust in family members;
Developing a supportive family environment;
Reducing sources of tension and stress within the family;
Helping family members forgive each other;
Conflict resolution for family members;
Bringing back family members who have been isolated (American Addiction Centers, 2017).

Family therapy enhances the skills required for healthy family functioning, including communication, conflict resolution, and problem-solving. Improving these skills also increases the potential for success in overcoming and addressing family problems.

In family therapy, the focus is on providing all family members with the tools they need to facilitate healing (Teen Treatment Center, 2014).

6 Examples and Exercises

If family therapy sounds like a treatment that would benefit you and your loved ones, the best course of action is to find a licensed professional with whom you can build a good working relationship and address the problems your family is facing.

However, if you’re not quite ready for this step, or there are obstacles between you and getting treatment, there are many exercises and suggestions that you may find to be good alternatives.

The exercises and techniques below are meant to be used within the context of a therapeutic working relationship, but some also have applications for those who wish to explore the possibilities of family therapy before committing to long-term treatment with a therapist. If you are a therapist or other mental health professional, you may find these exercises to be useful additions to your therapy toolbox.

The Miracle Question

This exercise can be used in individual, couples, or family therapy, and is intended to help the client(s) explore the type of future they would like to build. We all struggle at times, but sometimes the struggle is greater because we simply do not know what our goals actually are.

The Miracle Question is an excellent way to help the client or clients probe their own dreams and desires. When used in the context of couples or family therapy, it can aid clients in understanding what their significant other or family member needs in order to be happy with their relationship .

This Miracle Question is posed as follows:

“Suppose tonight, while you slept, a miracle occurred. When you awake tomorrow, what would be some of the things you would notice that would tell you life had suddenly gotten better?” (Howes, 2010)

While the client may give an answer that is an impossibility in their waking life, their answer can still be useful. If they do give an impossible answer, the therapist can dive deeper into the clients’ preferred miracle with this question: “How would that make a difference?”

This question aids both the client and the therapist—the client in envisioning a positive future in which their problems are addressed or mitigated, and the therapist in learning how they can best help their client in their sessions.

You can learn more about this exercise at this link .

Colored Candy Go Around

If you’re looking for a fun and creative icebreaker or introduction to family therapy, this exercise can be a great way to start.

To engage in this exercise with your family, you need a package of Skittles, M&Ms, or a similar colorful candy. Distribute seven pieces to each family member, and instruct them to sort their candy by color (and refraining from eating it just yet!).

Next, ask a family member to pick a color and share how many they have. For however many candies of this color they have, instruct them to give the same number of responses to the following prompts based on the color:

Green – words to describe your family;
Purple – ways your family has fun;
Orange – things you would like to improve about your family;
Red – things you worry about;
Yellow – favorite memories with your family.

When the first family member has given their answers, tell them to choose the next family member to answer the same prompt based on the number of candies that person has.

Once the prompt has been answered, the candies can be eaten.

When all family members have responded to these prompts, initiate a discussion based on the answers provided by the family. The following questions can facilitate discussion:

What did you learn?
What was the most surprising thing you learned about someone else?
How will you work towards making changes/improvements?

Given the high sugar content in this exercise, you can see that this is a great game to play with young children! If this sounds like a useful exercise that you would like to try with your family, you can find further information and instructions on page 3 of this PDF from therapist Liana Lowenstein.

Emotions Ball

This is a simple exercise, requiring only a ball and a pen or marker to write with. It is frequently used with children and teenagers in many contexts, as it takes the pressure off of talking about emotions for those who may be uncomfortable sharing their feelings.

A beach ball is a perfect ball for this activity—big enough to write several emotions on and easy to throw back and forth in a circle. Write several emotions on the ball, such as “joyful,” “lonely,” “silly,” or “sad.”

Gather your family into a circle and begin to toss the ball back and forth between family members. When a family member catches the ball, have them describe a time when they felt the emotion facing them. Alternatively, you could have the catcher act out an emotion, an activity specially suited for children.

The intent of this exercise is to discuss emotions with your family and practice listening to one another and expressing your feelings.

You can read more about this exercise here .

The Family Gift

This exercise can help a therapist to get to know a family better. If you are using it without the guidance of a therapist, it can help you to further your understanding of your own family and provoke thoughtful discussion.

To give this exercise a try, gather a variety of art supplies and a gift bag. Explain to the family that they are going to create a gift from the materials provided. This gift will be a gift for the whole family, that everyone in the family wants. They must decide together on this gift and how it can be used within their family.

They have 30 minutes to decide on this gift and craft it. Once they have created the gift, they must place it in the gift bag. Within the context of family therapy, this exercise provides the therapist with a look at the inner workings of the family, how they make decisions and complete tasks as a unit.

If you are engaging in this exercise as a family without the presence of a therapist, it can help you to start a meaningful conversation.

Use these questions or prompts to facilitate the discussion:

Describe your gift.
Tell how you each felt as you were creating your gift.
Who made the decisions? For example, who decided what the gift should be?
Were two or more people in your family able to work well together?
Did anyone cause any difficulties or disagreements, and if so, how was this handled?
Is there anything about the way you did the activity that reminds you of how things work in your family at home?
How can the gift help your family? What else can help your family?

There is a wealth of information to be gained from observing these types of interactions or engaging in these kinds of discussion.

To read more about this exercise, see pages 3 and 4 of the PDF mentioned earlier.

Mirroring Activity

This fun exercise is a great way to help family members relate to each other and work together.

The activity can be explained to a family by the therapist with the following instructions:

“I want you to stand in front of me just right there (pointing to a spot about two feet in front of the practitioner). You are going to be my mirror. Everything I do you will try to copy, but the trick is to copy me at exactly the same time that I am doing it, so that you are my mirror. I will go slowly so you have a chance to think about where I will be moving and so that we can do it exactly at the same time. We can’t touch each other. I will lead first and then you will take a turn leading. Ready? Here we go!”

First, the therapist can model this exercise with one of the family members, then that person can take a turn leading another.

This is an especially useful exercise for children, but it can be used with family members of any age. It requires the family members to give each other their full attention, cooperate with one another, and communicate with both words and body language.

It also allows the family members to become more in tune with one another and can be applied with siblings, a parent, a child, or even couples in marriage counseling.

To see the instructions and read more about this exercise, see page 20 of this booklet , also from Liana Lowenstein.

Genogram

A genogram is a schematic or graphic representation of a client’s family tree. However, unlike the typical family tree, the genogram provides far more information on the relationships among members of the family.

It can be used to map out blood relations, medical conditions in the family, and, most often in the case of family therapy, emotional relationships.

Genograms contain two levels of information—that which is present on the traditional family tree and that which provides a much more comprehensive look at the family:

Basic Information: name, gender, date of birth, date of death (if any);
Additional Information: education, occupation, major life events, chronic illnesses, social behaviors, nature of family relationships, emotional relationships, social relationships, alcoholism, depression, diseases, alliances, and living situations (GenoPro, 2017).

By including this additional information, the therapist and client(s) can work together to identify patterns in the family history that may have influenced the client’s current emotions and behaviors. Sometimes the simple act of mapping out and observing this information can make clear things that were previously unnoticed.

The information on emotional relationships can include points of interest and any aspects of the relationship that may have impacted the client(s), such as whether the relationship is marked by abuse, whether a marriage is separated or intact, if a relationship is characterized by love or indifference, whether a relationship could be considered “normal” or dysfunctional, etc.

This exercise could be completed individually, but it is likely to be most effective when completed in conjunction with a qualified professional.

You can read more about the genogram here , and learn about how to use them in family therapy here .

Recommended Books

The Seven Principles for Making Marriage Work: A Practical Guide from the Country’s Foremost Relationship Expert by John M. Gottman

This is an excellent read for any non-professionals who wish to learn more about what family therapy can do for couples. Although this is intended for married couples, any individuals in a long-term relationship can benefit from this resource of practical wisdom.

Why Marriages Succeed or Fail: And How You Can Make Yours Last by John M. Gottman

Another entry from Dr. Gottman, this book provides an in-depth look at the inner workings of marriage and gives advice on how to ensure that your marriage is one of the successful ones.

Family Therapy: Concepts and Methods by Michael P. Nichols and Sean Davis

Those with only a casual interest in family therapy may not find much of interest in this book , but anyone who wishes to gain a deeper understanding of the theory and practice of family therapy will find this book invaluable. It gives the reader a solid foundation in the techniques, methods, and academic foundations of family therapy. If you are interested in becoming a family therapist, or simply learning more about the practice of therapy within the context of the family, this book is a perfect place to start.

Essential Skills in Family Therapy: From the First Termination by JoEllen Patterson, Lee Williams, Todd M. Edwards, Larry Chamow, Claudi Grauf-Grounds, and Douglas H. Sprenkle

This book is a fantastic resource for those with little or no experience in family therapy. The language is simple and accessible, and each chapter provides a guide for students and newly minted therapists who wish to prepare for their first sessions. Topics include intake and assessment, treatment planning, building and maintaining the therapeutic relationship , and problem-solving when treatment is not progressing.

The Family Therapy Treatment Planner by Frank M. Dattilio, Arthur E. Jongsma, Jr., and Sean D. Davis

This is another helpful resource for new therapists. The Family Therapy Treatment Planner will aid the therapist in planning treatment for clients, dealing with health insurance companies and health providers, and navigating the complex ocean of rules and regulations. In addition, this book includes many treatment plan options, a sample treatment plan, and guidelines on dealing with the most common presenting problems for family therapists.

A Take-Home Message

Family therapy is a way for you and your family to learn how to maintain healthy family relationships, communicate effectively with family members, and work cooperatively to solve family problems. This type of therapy is unique, in that problems are viewed through a broader lens and as part of the complex system of the family.

This perspective allows family therapists to help families get to the root of their problems and facilitates healing for all members of the family, whether the problem is related to substance abuse or addiction, abuse, mental health disorders, unexpected or dire circumstances, or just the ordinary everyday stress we all struggle with on occasion.

This piece described the benefits and goals of family therapy, introduced four of the most common types of therapy, contrasted family counseling with family psychotherapy, and provided examples of the exercises and techniques used in family therapy.

My hope is that you find this information useful whether you are interested in engaging with a family therapist, becoming a family therapist, or just learning more about family therapy.

If you have ever participated in family therapy or if you have practiced family therapy in your work as a mental health professional, we’d love to hear about your experiences in the comments. Did you find engaging in family therapy helpful?

Did you get to reap the benefits described here? If you have practiced family therapy, what are some of the most valuable things you have learned from your practice?

Thank you for reading!

Originally posted at Positive Psychology

References:

10 Acre Ranch. (2017, January 23). 10 Acre Ranch. Retrieved from https://www.10acreranch.org/blog/2017/01/23/5-benefits-family-therapy/
American Addiction Centers. (2017). The benefits of family therapy. Forterus. Retrieved from http://forterustreatment.com/therapy/family-therapy/
http://www.drpatrick.com/
Eder, A. What is the difference between counseling & psychotherapy? Ashley EderCounseling & Psychotherapy. Retrieved from http://www.ashleyeder.com/counseling-psychotherapy/
“Family Therapy”. (2014, January 14). Good Therapy. Retrieved from http://www.goodtherapy.org/learn-about-therapy/modes/family-therapy
Family therapy. (2017A). In Encyclopedia of Children’s Health. Retrieved from http://libguides.dixie.edu/c.php?g=57887&p=371718
Family therapy. (2017B). In Encyclopedia of Mental Disorders. Retrieved from http://www.minddisorders.com/Del-Fi/Family-therapy.html
GenoPro. (2017). Introduction to the genogram. GenoPro. Retrieved from https://www.genopro.com/genogram/
Herkov, M. (2016). About family therapy. Psych Central. Retrieved from https://psychcentral.com/lib/about-family-therapy/
Howes, R. (2010, January 17). The ten coolest therapy interventions: Introduction. Psychology Today. Retrieved from https://www.psychologytoday.com/blog/in-therapy/201001/the-ten-coolest-therapy-interventions-introduction
Schwartz, A. (2009, March 31). Family therapy: A different approach to psychotherapy. Mental Help. Retrieved from https://www.mentalhelp.net/blogs/family-therapy-a-different-approach-to-psychotherapy/
Teen Treatment Center. (2014, March 20). The benefits of family therapy. Teen Treatment Center. Retrieved from https://www.teentreatmentcenter.com/blog/the-benefits-of-family-therapy/

Keyword: What Is Family Therapy

Overcoming depression: How psychologists help with depressive disorders

Mon, 24 Aug 2020 16:02:40 GMT

Depression is extreme sadness or despair that lasts more than days and affects people in different ways. Fortunately, depression is highly treatable.

Everyone experiences sadness at times. But depression is something more. Depression is extreme sadness or despair that lasts more than days. It interferes with the activities of daily life and can even cause physical pain. Fortunately, depression is highly treatable.

Depression, also known as major depressive disorder or clinical depression, is one of the most common mental disorders in the United States. In 2014, an estimated 15.7 million adults in the U.S. — about 6.7 percent of all U.S. adults — had at least one major depressive episode , according to the National Institute of Mental Health (NIMH).

Understanding depression

Depression affects different people in different ways, but most of them experience some combination of the following symptoms:

Prolonged sadness or feelings of emptiness.
Feelings of helplessness or hopelessness.
Feelings of guilt or worthlessness.
Anger and irritability.
Restlessness.
Difficulty concentrating.
Fatigue.
Changes in sleep patterns.
Appetite changes.
Chronic pain, headaches or stomachaches.
Loss of interest in activities.
Withdrawal from friends and family.
Thoughts of death or suicide.

Depression is caused by a combination of genetic, biological, psychological, social and environmental factors. People who have a family history of depression, and people with serious chronic diseases such as heart disease or cancer, are at an increased risk of depression. Major life changes, trauma and stress can also bring about an episode of depression, although some episodes of depression begin without any obvious external cause.

Treatment for depression

Depression isn't a sign of weakness. It's not something you can just "snap out of." It's an illness that requires professional treatment. Yet with the right care, people can feel better.

Antidepressant medications can be helpful for reducing depression symptoms in some people, especially in people with severe depression. Psychotherapy is also an effective treatment, either alone or in combination with medications. The benefits of psychotherapy may have an enduring effect that protects against symptoms returning even after treatment is ended.

Seeing a psychologist about depression

Licensed psychologists are highly trained mental health professionals with experience in helping patients recover from depression. Several different approaches to psychotherapy have been shown to help individuals recover from depression, especially those with mild to moderate depression. Psychotherapy can help people with depression to:

Pinpoint life events that contribute to their depression and help them find ways to change, accept or adapt to those situations.
Set realistic goals for the future.
Identify distorted thought processes or unhelpful behaviors that contribute to feelings of hopelessness and helplessness.
Develop skills to cope with symptoms and problems, and identify or prevent future episodes of depression.

Two of the most common evidence-based therapies for depression are cognitive behavioral therapy and interpersonal therapy.

Cognitive Behavioral Therapy (CBT) is a type of therapy in which patients learn to identify and manage negative thought and behavior patterns that can contribute to their depression. CBT helps patients identify unhelpful or negative thinking, change inaccurate beliefs, change behaviors that might make depression worse, and interact with others in more positive ways.
Interpersonal Therapy (IPT) is a form of therapy in which patients learn to improve their relationships with others by better expressing their emotions and solving problems in healthier ways. IPT helps patients resolve or adapt to troubling life events, build social skills and organize their relationships to increase support for coping with depressive symptoms and life stressors.

There is no one "right" approach to therapy. Therapists work closely with their patients to create tailored treatment plans to address their unique needs and concerns. Psychotherapy can help patients learn ways to better cope with stress and manage their symptoms of depression. These strategies can lead to recovery and enable patients to function at their best.

Depression in children and adolescents

Depression is common in adolescents. In 2014, an estimated 2.8 million children age 12-17 in the U.S. (more than 11 percent) had at least one major depressive episode, according to NIMH.

Adolescents are often moody. But if your child is extremely irritable, has ongoing problems with motivation, or has persistent sadness that lasts two weeks or more, it's a good idea to have him or her evaluated for depression.

While antidepressant medications can be effective for children and adolescents, they can have side effects in young people, including an increased risk of suicidal thoughts. For that reason, many parents and healthcare providers prefer to try treating children with psychotherapy first. Both CBT and IPT are effective treatments for young people with depression. Studies also show that a combination of antidepressant medication and cognitive behavior therapy is highly effective in treating youth depression.

The good news is that most kids recover from depression. Still, research shows that people who have depression as children are at a higher risk of having a recurrence later in adolescence or adulthood. Both CBT and IPT can help kids recognize the signs of a depressive episode, so that they can monitor their symptoms and get help quickly if they experience a recurrence.

Keyword: Overcoming depression

The American Psychological Association gratefully acknowledges Laura Mufson, PhD, Lynn Bufka, PhD, and C. Vaile Wright, PhD for contributing to this fact sheet.

This article originally posted by and at the American Psychological Association

Five Ways to View Coverage of the Coronavirus

Mon, 24 Aug 2020 15:56:52 GMT

Tips

New reports about COVID-19 are becoming more widespread and are making some people anxious. Here are some tips to help you manage your anxiety, put news reports in perspective and maintain a positive outlook.

Keep things in perspective. Take a deep breath and remind yourself that most people who contract COVID-19 will only experience mild symptoms. Work is being done to help people who may be more vulnerable to the coronavirus, such as senior citizens and those with underlying health conditions. As coverage increases, it's important to take the necessary precautions to keep your family and loved ones healthy.
Get the facts. It is helpful to adopt a more analytical approach as you follow news reports about the coronavirus. You will also want to verify information that you receive from family, friends or social media. The U.S. Centers for Disease Control and Prevention has a webpage dedicated to information on the coronavirus outbreak . You may also find useful, reputable information from local or state public health agencies or even your family physician.
Communicate with your children. Discuss the news coverage of the coronavirus with honest and age-appropriate information. Parents can also help allay distress by focusing children on routines and schedules. Remember that children will observe your behaviors and emotions for cues on how to manage their own feelings during this time. You may want to limit how much media they consume to help keep their anxiety in check.
Keep connected. Maintaining social networks can foster a sense of normality and provide valuable outlets for sharing feelings and relieving stress. You can maintain these connections without increasing your risk of getting the virus by talking on the phone, texting or chatting with people on social media platforms. Feel free to share useful information you find on government websites with your friends and family. It will help them deal with their own anxiety.
Seek additional help. Individuals who feel an overwhelming nervousness, a lingering sadness, or other prolonged reactions that adversely affect their job performance or interpersonal relationships should consult with a trained and experienced mental health professional. Psychologists and other appropriate mental health providers can help people deal with extreme stress. These professionals work with individuals to help them find constructive ways to manage adversity.

Keyword: Coverage of the Coronavirus

This article originally posted by and at the American Psychological Association

Exposure therapy: What it is and what to expect

Fri, 21 Aug 2020 16:05:50 GMT

Exposure therapy is a type of behavioral therapy that can help treat various phobias and anxiety disorders.

With the guidance of a therapist, a person will face their fears and anxieties in a safe setting, either in their imagination or in a real life scenario.

This article looks at how exposure therapy works, some different types, and what to expect from treatment.

What is exposure therapy?

Exposure therapy may help a person manage symptoms of social anxiety disorder.

Exposure therapy is a type of psychological therapy that can help people overcome their fears or anxiety disorders. It can help reduce feelings of anxiety, distress, or fear that a person may have due to a disorder or previous trauma.

In exposure therapy, a person will have exposure to a situation or stimulus that triggers feelings of fear or panic for them. Over time, controlled exposure to these fears in a safe space can help reduce their feelings of anxiety and distress.

A therapist may use different types of exposure therapy depending on the type of fear or disorder that the person has. For example, the therapist may create a real life scenario for the person to go through, or they may use talking therapy to encourage the person to imagine situations or recall traumatic events.

What can it treat?

Exposure therapy can help treat a variety of fear-based and anxiety disorders, including:

phobias
panic disorder
social anxiety disorder
post-traumatic stress disorder (PTSD)
obsessive-compulsive disorder (OCD)
generalized anxiety disorder
trauma

Effectiveness

Exposure therapy can be an effective treatment for anxiety disorders. In fact, around 60–90% of people have either no symptoms or very mild symptoms of their original disorder upon completion of their course of exposure therapy.

A 2013 study looked at the effects of prolonged exposure therapy in 1,931 veterans with PTSD. The researchers found that prolonged exposure therapy was effective in reducing chronic PTSD and depression symptoms.

Another 2013 study found that narrative exposure therapy was effective in helping survivors of an earthquake in China. The researchers split 22 adult participants equally into two groups. The first group received narrative exposure therapy straight away, and the second group received treatment 2 weeks later.

Compared with the waiting group, the first group to receive the treatment had a significant reduction in:

PTSD symptoms
anxiety
depression
mental stress

What to expect

There are several different types of exposure therapy, and treatment will depend on each individual case.

The sections below will look at the types of exposure therapy available and what to expect from each.

In vivo

During in vivo exposure therapy, a person will confront a phobia or situation that causes fear or anxiety in real life.

If a person has a phobia of spiders, for example, they may gradually work toward handling a real spider.

Imaginal

During imaginal exposure therapy, a therapist will instruct a person to imagine in vivid detail the situation or trigger of their fear or anxiety. This can be an effective approach for people dealing with trauma, as it would not be suitable to recreate such events in vivo.

If a person has previous trauma or PTSD, they may recount their experience.

Imagining the source of fear or anxiety in a safe setting, alongside talking therapy, can help reduce feelings of distress.

Virtual reality

Some fears are not practical for a therapist to replicate in vivo. If a person has a fear of flying, for example, a therapist may stimulate the experience of flying using virtual reality technology.

This exposes the person to a realistic and similar experience to help reduce feelings of fear in association with flying, for example.

Interoceptive exposure

Interoceptive exposure therapy focuses on creating physical responses that people associate with panic or distress. For example, if a person has panic disorder, they may associate an increase in heart rate with the feeling of panic or danger.

For example, the therapist may instruct a person to run on the spot, in a safe setting, to create similar physical sensations without any sense of danger.

The therapist may also work with a client to establish a hierarchy of their fears or anxieties. This means placing scenarios in order of which the person finds the most challenging.

The therapist may then decide to expose the person to their smallest or biggest fear first. They may refer to these two approaches as graded exposure and flooding.

Graded exposure means that people face their least daunting fears first, before gradually building up to more challenging situations with time. This can help people build the confidence they need to overcome a bigger fear.

For example, if a person has a fear of snakes, they may first begin by looking at pictures of snakes. This may then progress to having a snake in the room behind glass, and eventually to holding the snake.

Flooding means that people begin with exposure to the most challenging fear first. This may then help them face lesser fears more easily.

People may require just one or two sessions to resolve an issue, or they may need a longer course of ongoing therapy sessions.

Prolonged exposure therapy

Prolonged exposure therapy provides repeated exposure and involves:

education about the symptoms and how prolonged exposure therapy can help
learning breathing techniques to help control feelings of distress
in vivo exposure to scenarios that may trigger fear and anxiety — for example, a soldier with previous trauma of roadside bombing may begin driving to overcome the fear
talking therapy, during which people recall traumatic experiences with a therapist to help them make sense of the events and reduce negative thoughts

Prolonged exposure therapy may be helpful for people with PTSD and other responses to trauma. The gradual pace of prolonged exposure therapy can help people overcome their fears and anxieties with time.

Treatment can vary depending on an individual’s circumstances. For example, some people may meet one-to-one with a therapist for around 90 minutes for a course of eight to 15 sessions.

Who offers this therapy?

Psychiatrists, psychologists, and therapists may provide exposure therapy. A psychiatrist is a medical doctor with additional training in psychiatry.

A psychologist will have training to a master’s or doctorate level. Choosing a board-certified health professional ensures that they have been through a suitable level of training and examination.

People can look for a health professional who has expertise and experience in carrying out exposure therapy.

To find a qualified therapist, a person can check to see if a particular health professional is a member of a recognized organization , such as the International OCD Foundation or the Association of Behavioral and Cognitive Therapists.

It is important for people to find a trained professional to carry out exposure therapy. Improperly administered exposure therapy may cause further trauma, fear, or anxiety.

Vs. systematic desensitization

Systematic desensitization is a similar type of behavior therapy to exposure therapy. It includes relaxation alongside exposure to a stimulus that causes distress or anxiety.

Systematic desensitization follows the same gradual process of graded exposure therapy, and it works in the following stages:

A therapist will train the person in how to relax their body through deep muscle relaxation.
The person will order their fears or anxieties from weakest to strongest, to create a hierarchy.
The person will then face their fears, starting with the weakest, either in their imagination or in a real life scenario.
While the person is undergoing exposure to their fears, they will practice the muscle relaxation technique they have learned.

The muscle relaxation prevents a response of anxiety, so people slowly build up resilience to the stimulus and respond in a less anxious way.

Relaxation techniques may not be suitable for all types of exposure therapy.

Summary

Exposure therapy can be an effective treatment option for a range of phobias and anxiety disorders, including PTSD, OCD, and panic disorder.

People will work alongside a therapist to face their fears or anxiety triggers. A therapist may stimulate their fears through imagination or create a scenario in real life for the person to face.

Systematic desensitization is a similar approach, but it uses muscle relaxation alongside exposure to reduce physical responses of anxiety.

People wanting to try exposure therapy should seek a psychologist or therapist with the appropriate experience and expertise.

This story originally posted at Medical News Today

Sources

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Keyword: Exposure therapy