yaelingh Uncategorized

It Takes Courage to Overcome a Phobia

Image: Courage the Cowardly Dog

Phobias are irrational or excessive fears. If a phobia interferes with someone’s everyday life, it may be anywhere from annoying to debilitating. Other phobias will only come up once every so often, so they are less intrusive.

If a phobia interferes with an everyday or essential activity–such as dental work, flying, or animals–a person might choose to get treatment in order to overcome it. Phobias can be treated by exposure treatment, an intervention in which the person is exposed to tolerable aspects of the phobia in a safe environment until their anxiety diminishes.

First, the treatment focuses on exposure to the least anxiety provoking aspects of the phobia, as determined by the patient in a “hierarchy of fear.” The accompanying anxiety is addressed until it diminishes to tolerable levels, however long that takes.

Then, and only then, does the exposure move to increasingly more anxiety provoking aspects of the phobia. This may take days, weeks, or even months, depending on the nature of the phobia and the person’s level of anxiety.

An example of a phobia hierarchy based on items generated by clients working in exposure treatment:

Hierarchy Example

Just thinking about exposure treatment may be anxiety provoking enough to count as exposure!

As a certain little pink dog has taught us, it takes courage to face your fears. Being courageous doesn’t mean not being afraid, it means taking action, even if it feels scary to begin.

yaelingh Uncategorized

What Attending Therapy Is About: (AKA We Are Not Just Sitting Here Chatting)

Everyone’s approach to attending therapy sessions is different: people’s needs, symptoms, and circumstances vary incredibly. People want and expect different things in session.

Clearly, there are specific, well-researched interventions that are likely to be effective with most people who experience a certain symptom or pattern of behavior. Some interventions can be practiced in a therapy session, and some interventions are good for a client to take home and practice on their own. I do have plenty of handouts to work on and books to recommend that you read!

But not every intervention is on a list of tips that I’m going to print out and give you outright, or on a sheet in a manual with steps 1, 2, and 3. In fact, nearly all of what we are doing while in session is an intervention, even if I do not formally announce it as such. That is to say, we are not just sitting here chatting, even if sometimes that’s what it appears to be.

When I’m asking about your week, or how you feel, if you’ve gotten over your flu, or how things are going with your family or job, for example, I’m actually assessing your anxiety, depression, hypomania, behavior patterns, physical well-being, environmental influences, sense of hopefulness, and any changes in how you are interacting…for starters.

But I’m not just gathering data. I’m also intentionally getting you to practice certain kinds of conversing, thinking, and interacting during session.

I’m getting you to practice speaking openly about things that may have felt “unspeakable,” uncomfortable, scary, or just awkward. I’m reframing or redirecting your thoughts as you speak them from “shoulds and musts” to “preferences and wants,” so that you can begin to change your internalized messages. I am giving you the chance to practice openly experiencing and expressing feelings in the presence of someone who will not censor or scold you for how “irrational” or “unacceptable” they are. I am often taking the role of defending you from your own inner critic! I am supporting you in developing an attachment that is not based in power and control or other unhealthy dynamics. I’m also simply being a trained witness to your life; checking in with you over time to see how you are changing and making sure you are okay.

Developing different patterns of thought and interaction takes time, and it’s a great deal more powerful if done with another person. That is why sessions are “booster shots” even for those who do a lot of internal work on their own. Humans are social creatures. Everyone, even introverts (like me!) must interact with others in order to process and develop emotionally.

And you know I can tell you’ve been making real progress when you stop yourself from saying “should” in session before I can give you the “shoulds” lecture yet again! ;D

So that is why–even if I didn’t give you a handout to take home or a list of suggested solutions to your situation–you made a LOT of progress in your session today.

Remember, “talk therapy” actually changes brain structure!

20180714_150311

yaelingh Uncategorized

Therapy Changes Your Brain Structure

Experiences change our brains. Not just in some vague way, but the structures and functions of our brains.

It’s true that our earliest experiences cast the longest shadows on our lives. But we can still heal and change our brains in positive directions throughout our lifetimes.

Yes, medications affect brain function directly, but “talk” therapy can also change your brain. For example, the more you practice thinking in a certain way, the more it becomes automatic.

If you were raised with conditioning (traumatic experiences, chaotic or abusive household) that led to depressive and anxious thoughts, you can practice new ways of thinking that will help to re-condition your brain. This is certainly not to say “just think cheerful thoughts and everything will be fine.” This is about targeting certain patterns of thoughts that you may not even realize you experience.

Thoughts are not the only part of your mental conditioning that can be re-trained, but they are often a good place to start.

Even severe conditions such as schizophrenia can show improvement in brain functioning through “talk” therapy, as research continues to show.