Need to Relax? Try Some of These Activities

By Cherise White, LMSW

Do you check your calendar and realize your time is booked? Maybe your calendar consists of work, family and community commitments, school, social events, or time with friends. However, how much of your time is booked for relaxation and self-rejuvenation? Here are some simple ways to relax:

  • Adult coloring
    Mentally soothe yourself by connecting with your inner child and pulling out the coloring pencils, crayons, or markers and get lost for a while coloring pages from an adult coloring book. Book stores, retail shops, and even some grocery stores sell adult coloring books. This is a great way to relax your mind and mindlessly do something productive. The elaborate colors and repetitive movements will help you reach a calm inner state and focus your attention on something outside your busy life demands. 
     
  • Finger labyrinth
    Try googling a finger labyrinth in your free time. There are different versions out there, so you can opt for a printable option or you can just pull it up and enlarge it on your computer. Trace it with your finger, the end of a pen, or even a colored marker. You can trace to the middle, to the exit, opposite side, or inward and then back outward. It’s such a great activity for feeling calm, and it only takes a few minutes. 
     
  • Aromatherapy/ Diffuser/Candles
    The power of smell is often overlooked. If you find different smells to be captivating, why no try out a new candle or getting a diffuser you can put essential oils in. You can even get creative and mix oils to make scents that intrigue you, or find oils already mixed that address different needs such as improved sleep, anxiety relief, or mood enhancer. Other ways to use smell as a relaxation tool include candle warmers, scented lotion, bath bombs, homemade/stovetop potpourri, or simply peeling an orange.
     
  • Guided visualization
    There are a number of apps that provide meditations and promote mindfulness, however, within mindfulness and meditations is a category called guided visualization. There are various ways to do guided visualizations. There are scripts so you could to do it with others, apps with pre-loaded databases containing guided visualizations like the app Insight Timer, or you could always find a guided meditation on youtube. 
     
  • Virtual Fireplace or Beach
    Slow down and put on a virtual fireplace or beach on your electronic screen. Step away from the emails, papers, social media, and just be present. Allow your mind to bask in the tranquility of the peacefulness of a virtual fireplace or beach setting and just take a moment to breathe and regroup.
     
  • Drink tea
    Become a tea drinker and engage your various senses. Close your eyes and focus on the smell of hot tea, feel the warmth flow through your body as you hold the mug in your hands, savor the taste. Diversify the teas you try, whether you prefer herbal, nutty, fruity, or medicinal types of tea, there is something for everyone. 
     
  • Stretch
    Take a deep breath and stretch each area of your body. Try to stretch areas you may not normally remember to stretch such as your feet. We can often hold tension in different areas of our body so it is helpful and beneficial to get a good body stretch in when you can.
     
  • Smile
    s awkward as this may sound, sit and smile. Meaning, sometimes you have to fake it till you make it. By smiling even with no reason, you send a message to your brain and before you know it you aren’t faking it anymore. Or you can take time to consciously draw on memories and things that bring you joy and naturally make you smile. Reflecting on good times can be very comforting and a great way to take a break from the fast-paced lives we tend to live. 

No matter what you choose you can’t go wrong when you take a moment to relax. You give so many things your time and energy, but who gives it back to you? Taking a moment for yourself is always a great way to promote good mental health. Take a chance and see if any on the list above work for you.

Cherise White is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Talking to Your Child About Sexual Assault

By Alisha Bennett, LMSW

Sexual Assault. Over the last several months we have heard these two words in the news more than we can count. We’ve heard countless stories of women who have spoken up and whose voices are finally being heard.  

Hearing questions like, “why now?” or “why didn’t these women speak up sooner?” made me rethink about how many of us were raised and socialized to normalize this behavior or hide it because we are ashamed. When did I really learn this lesson for myself? It wasn’t until an elective in junior year of college that I really recall having a real conversation about this topic. I was 20 years old, an age when 1 in 4 girls and 1 in 6 boys have already experienced sexual abuse, mostly by people that they know (https://www.nyfoundling.org/capp/). Additionally, from 2011-2015, the Associated Press found about 17,000 sexual assaults were committed by U.S. students (though the number is likely higher due to underreporting) and about 5% percent of the victims were five and six year olds (http://neatoday.org/2017/12/04/sexual-assault-in-schools/) So as an parent/guardian, when and how do you have this conversation with your children?

When: The right time to talk to your children is right now. If 5% of assaulted children are in kindergarten and 1st grade, it is not too soon to talk about this with your young children. The younger the victim, the greater the vulnerability that they will experience repeated assault throughout their life. 

How: Young children need lessons when they’re young about their bodies. About what is private for them, about what is wrong and never okay, about what to do if something is wrong, and how to speak up. They should know that they can always come to you or to another trusted adult. Help them to identify who other trusted adults are, including one in their school that they can go to. It is important for them to know that they can and should speak up even if they feel scared, frightened, or embarrassed. They need to know that any sexual abuse or assault experience is not and will never be their fault and that they can get help. Conversations like these can, and in my opinion should, be had in elementary school, even at the earliest ages so that they can know what is right and wrong in regards to their bodies. 

Below are some resources for talking to your children about sexual assault: 

Alisha Bennett is a therapist at Cobb Psychotherapy.  If you are looking for support in talking to your child about sexual assault visit cobbpsychotherapy.com to learn how therapy might be able to help. 

 

Exploring the Mind–Body Connection

By Vanessa Kensing, LMSW

For centuries humans have explored the connection between our mind and our body. Early philosophers hypothesized about the difference between mental and physical properties, and what effect one had on the other.  Later psychologists would examine what effect consciousness (or lack thereof) had on our mental properties/mind, and what this meant for its relationship with the body. While the modern Western medical model conceptualizes the mind and body as connected, it also supports treating them separately.

Seeing this unnecessary divide, and how it has impacted myself and many of my clients, I was inspired to explore the mind-body connection in psychotherapy. Somatic psychotherapy is defined as a “holistic approach, incorporating a person’s mind, body, spirit, and emotions in the healing process” (goodtherapy.org). From this approach a therapist may provide education, understanding, processing, and healing using the mind-body connection. This connection can be viewed from both the perspective of the present and the past.

Mind-Body Connection in Present Time
Our body sends us physical symptoms and/or signals in present time. For example, when we encounter a real or imagined threat our mind and body can go into “fight, flight, or freeze.” Some of the bodily experiences may include: dry mouth, tight chest, increased heart rate, shallow breathing, sweating palms, pit in stomach, etc. Learning one’s physical symptoms allow an individual to understand how to self-sooth (instead of suppressing, repressing, unhealthily distracting, or numbing these feelings), and begin to examine the root of the issue(s) that cause this response. Similarly, our thoughts not only impact our bodily expression and experiences, but also how our DNA is expressed (Lipton).    

Mind-Body Connection from the Past
Somatic therapy posits that trauma can also be “stored” in the body and thus is in need of release. In these instances therapists work with the client to begin to connect to their bodily experiences that they may be dissociated from, or aid the client in working with bodily experiences that "contradict the helplessness, rage, or collapse that results from trauma" (Van Der Kolk,). This allows clients to begin to explore how posture, breathing, visualization, grounding, and bodily movement can begin to slowly release the trauma and fully embody healing.

Because this is a very cursory exploration of the topic, the following books are valuable in exploring the mind-body connection in further detail. 

  • The Divided Mind, John E. Sarno, M. D.
  • The Body Keeps the Score: Bessel Van Derk Kolk, M.D.
  • The Biology of Belief: Bruce H. Lipton, M.D.
  • A Symphony in the Brain: Jim Robbins

Other References:

Vanessa Kensing is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Understanding Emotionally Focused Therapy

By Dorette Green, LMSW

In honor of Valentine’s Day day tomorrow I decided to focus this particular post on relationships. As a therapist who not only works with individuals but also with couples, I find relationships fascinating! Relationships are imperative because engaging interpersonally is one of the most important parts of human development and the human experience.  Romantic love relationships are an important aspect of human advancement and growth from both a social aspect, as well as an evolutionary perspective. This has much to do with individual attachment styles and whether those attachments are secure or insecure (but I will save that discussion for a future post).

For this post I want to provide some information about one of my favorite modalities for working with couples. For some couples, relational issues can become so overwhelming that they make the relationship difficult to navigate. Couples in relational distress can at times repair their relationships, or begin the process of amicably ending their relationship through the assistance of couple’s therapy. While there are several different approaches to therapeutic work with couples, one of the most well studied, empirically validated, and by far my favorite approach is Emotionally Focused Therapy or EFT.

Emotionally Focused Therapy or EFT is a therapeutic modality developed by Susan M. Johnson and Les Greenburg in the 1980’s. EFT as a therapeutic intervention focuses on couples’ abilities to “deal with their emotions and, how they send emotional signals to their spouse, and how this emotion becomes the music of their interactional dance” (Johnson Interview, 2011). EFT can be utilized with individuals, couples, and families in relational distress. This distress usually has some relationship to attachment, as EFT is firmly rooted in attachment theory. As an attachment approach, EFT works on the assumption that individuals have a great need and desire “for safe connection and emotional contact,” the lack of which results in people becoming “stuck in very negative interactional patterns” (Johnson Interview, 2011). As such, EFT examines the adaptive and maladaptive emotional responses and patterns that are usually underpinned by basic attachment issues that keep individuals, couples, and families trapped in these negative patterns of interaction.

EFT has been described as “an intervention explicitly designed to improve a couple’s relationship satisfaction by making their attachment to one another more secure” (Benson, 2013). The ability to identify attachment style as well as a couple’s interactional patterns or “dance” is integral to the effective use of EFT. Couples often cannot recognize their own attachment issues, such as attachment “injuries” for instance. Attachment injuries are incidents related to attachment in which one partner did not provide support to, or betrayed the other partner during a time of need (Halchuk, Makinen, and Johnson, 2010). Attachment injuries can precipitate the negative cycles of interaction which inhibits the couple from beginning the process of repair in their relationship.

Repairing relational issues is an amazing benefit of engaging in EFT, but it is far from the goal. The goal of EFT is not necessarily working through relational problems with a focus on salvaging the relationship, but rather, as a way to work through relational issues based on poor and insecure attachment styles. First we work to understand these attachment styles and how they are represented in our interactions with our partner, and next we work to be able to articulate these patterns, the underlying feelings behind them, and how these feelings perpetuate a cycle of negative interaction. Often it’s these destructive and negative interactional patterns that are an indication that individuals are seeking to feel both safe and fulfilled in their relationships. What EFT does is “teach people communication skills so that they can problem solve and bargain better.” Given this understanding, what people ultimately learn is how to communicate their emotions and needs for safe connection (Johnson Interview, 2011). The ability to engage in relationships where communication becomes a tool utilized for better interaction, as opposed to one of the primary issues within the relationship, allows the couple to improve their attachment and overall relational satisfaction.

While it is clear that EFT works, it is also important to understand why and how it works. In part, EFT works because it is sustainable. Once couples are able to resolve their attachment issues, they are more cognizant of when they have reversions back those negative patterns and are better able to work through those issues. Couples learn to communicate more effectively and are better able to not only trust but forgive each other when there are negative interactions.

Ultimately, relationships can be difficult to navigate, but they are not impossible. It is important to understand that the people we engage in relationships with are bringing unique experiences, perspectives and beliefs into the dynamic.  Understanding those things, but also effectively communicating our own as well, is integral to the quality of the relationships in which we engage. In the end, we find that everyone is trying to meet the same basic needs for love, connection, safety, and understanding.

References / Sources:

  • Benson, L.A., Sevier, M., Christiensen, A. (2013).  The Impact of Behavioral Couple Therapy on Attachment in Distressed Couples. Journal of Marital and Family Therapy, 39(4), 407 420=
  • Halchuk, R., Makinen, J.A., Johnson, S.M. (2010). Resolving Attachment Injuries in Couples Using Emotionally Focused Therapy: A Three Year Follow-Up. Journal of Couples and Relationship Therapy, Vol. 9, 31-47
  • Yalom, V. (Interviewer) & Johnson, S. (Interviewee).  (2011). Sue Johnson on Emotionally Focused Therapy [Interview Transcript] Retrieved from Psychotherapy.net: http://www.psychotherapy.net/interview/sue-johnson-interview

Dorette Greene is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

What’s Mindfulness All About?

By Shaudi Adel, LMSW

These days, the term “mindfulness” gets thrown out a lot and it’s got some of us scratching our heads wondering what the term actually means. My hope is to define the term and take some of the mystery out of it in order to make it more user-friendly and practical for everyday life.

In my work as a therapist I use Dialectical Behavior Therapy, which treats mindfulness as the “core” of all skills training. It's usually the first topic I discuss with clients because I believe it sets the foundation for all the work we do in future sessions in reaching treatment goals. In DBT, mindfulness is defined as staying in the present moment with intention and awareness, while releasing any judgments or attachments that may arise. What this means on a practical level is bringing our awareness and focus to the present moment, removing any judgments, whether positive or negative, and allowing ourselves to fully experience the moment we have right now before it has passed.

Now you may be wondering, okay, how do I get started? So the great thing about mindfulness is that you can do almost any daily activity in a mindful way. Next time you take a walk, take a look around and describe what you see. Use your other senses too: observe or describe what you hear and notice what it feels like to have your feet hit the pavement as you walk. Next time you grab a coffee, take a few moments to savor the smell of your coffee. Next time you’re in a stressful work meeting, try elongating your breaths and notice how that feels in your body. Next time you’re with friends, cherish the moment and take note of the emotions you experience. These are just a few examples of how you can practice mindfulness on a regular basis, and as you may notice, your perception [and appreciation] of everyday experiences can change…for the better.

In our society, especially living in New York City, it’s almost a competition to see how many different things we can do at the same time and how quickly we can get things over with. What ultimately happens in this hustle and bustle is that we miss the present moment and orient our lives from a mindless perspective. By slowing things down in the current moment and incorporating some practices around mindfulness into our day, I believe we can find more peace and create a more meaningful and enriched life.

Reference:
DBT Skills Training Handouts and Worksheets, Second Edition, by Marsha M. Linehan. Copyright 2015 by Marsha M. Linehan.   

Shaudi Adel is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Three Ways to Feel More Alive and Thrive in Winter

By Allie Lewin, LMSW

February marks the midway point of winter. The holiday season has officially ended and as people fall back into the routine of their day-to-day lives, I think it’s safe to say that the negative effects of winter on our mental health may be at their peak. This time of year often feels dreary and bleak as we chug along awaiting the warmer months and the general shift in attitude that accompanies their arrival.  So what can we do to combat this sluggishness and feel more alive and invigorated? Here are three tricks to beat that winter funk and feel a greater sense of vitality:

  1. Get Outside:
    Going on vacation in winter is ideal for many reasons. If you opt for a warm weather trip it gives you a chance to escape the cold and soak up vitamin D, which we know plays a role in enhancing mood. But even spending a few days in a cold weather spot can drastically alter your mood, as long as you are actively engaging in nature. Studies have shown that being outside in nature makes people feel more alive (and interestingly, in these studies, even participants who just imagined being in a natural setting felt increased vitality!)  Unfortunately, our urge in the winter is to stay indoors and hibernate, but in doing so we decrease our connection to nature, which we now know can exacerbate our low energy and mental lethargy. 
     
  2. Invest in Experience:
    Maybe going on vacation and connecting to nature for an extended period isn’t feasible given financial or scheduling constraints. If that’s the case, I’d suggest investing in any sort of experience that shakes things up and gives you something to look forward to, whether that’s a concert, movie, nice meal out, or a visit to a new art exhibit. Over the last 15 years or so, psychology research has continued to show that experiences bring people more happiness than do possessions. A 2014 article in the Journal of Psychological Science examined this phenomenon and further finding that unlike purchases on possessions, the mental benefit of spending money on an experience begins before the purchase has been made and continues even after the experience has passed. This means that not only are you enjoying the experience in itself, but the anticipation of the event and the memory of the experience adds to your fulfillment and excitement. Take time out of your busy life to invest in new experiences and your body and mind will thank you before, during, and after for your effort to spice things up!
     
  3. Social Connection:
    Human beings are social creatures by nature, so when we start to spend too much time alone, we feel a heightened sense of discomfort and threat. When it’s cold out and we start feeling sluggish, we tend to isolate, which further increases our feelings of disconnection and decreases our sense of purpose, belonging, and happiness. This contributes to further feelings of loneliness, anxiety and depression, that may already exist in part due to the change in weather and ailments such as seasonal affective disorder. Don’t let the cold keep you from making plans and following through with social engagements.  During winter, you need the support of friends and family more than ever and these interactions are what’s most likely keeping you afloat. 

So next time you find yourself sitting on your couch, feeling sluggish, and drowning in mental fog, remind yourself to fight the urge to stay inside. Put in the effort to connect with nature, invest in experiences, and prioritize social connection. You’ll thank yourself as your vitality thrives and winter soon passes you by.

Allie Lewin is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Stress Management Skills in Under 10 Minutes: Breathing

By Amy Brightman, LCSW

Life puts several demands on us and when we wear a variety of hats throughout the day, it's understandable that stress is a common reason people seek therapy. Stress can be a helpful thing— it can help us feel motivated and energized, work on goals, and desire growth and development. However, stress that is chronic and high leads to physical, emotional, and behavioral problems. And as a result, these symptoms may lead to difficulties with how well we can wear our different hats. 

For many, the issue is not about recognizing stress, but about knowing what to do about it. Living busy lives and playing different roles makes it difficult for us to even find time to manage stress. Therefore, my next few blogs will feature different stress management skills that can all be done under ten minutes. I will give an explanation about each skill, explaining why it’s a stress management technique, and then give a specific exercise for how to practice it. Let’s start with a skill that takes under one minute and is the thing we all already do: breathing.

Breathing becomes shallow and fast when we're stressed, and sometimes we can even forget to breathe. As a result, we prevent our bodies from functioning at its best. Shallow breathing does not allow oxygen to get throughout our bodies, leading to other anxiety and stress symptoms such as heart palpitations, jitteriness, and muscle tension. Breathing deeply into your belly gets the oxygen to your muscles and brain and helps your parasympathetic nervous system, the “rest and digest” system, kick into gear. Deep breathing not only gives your body the oxygen that it needs, but it helps you feel in control, keeping you focused on feeling calm rather than whatever is stressing you out. Here is a step-by-step guide for deep breathing:

1. Begin by exhaling all your air out.

2. Inhale through your nose to a count of 4.

3. Hold your breath for a count of 7.

4. Exhale completing through your mouth to a count of 8.

5. Repeat steps #2-4 two more times for a total of three breaths.

The 4-7-8 breathing exercise is simple, fast, and effective. When deep breathing, remember to have your abdomen rise when you breathe in, and fall when you breathe out. Practice this exercise once a day as its impact on stress levels will gain power with repetition. Taking all three breaths takes only 57 seconds, so no excuses! You can use it at work, on the subway, or before bed. So, keep calm and breathe on.

Amy Brightman is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Common Cognitive Distortions and How to Fight Them

By Kaylen Hagadorn, LCSW

Most of us experience cognitive distortions, which are thoughts that convince us of something that’s not true. We think they are rational, but really they just continue to make us feel bad about ourselves. 

Some common cognitive distortions are:

  • All or Nothing Thinking: Things are either black or white. We are either perfect or a failure. There is no middle ground.
     
  • Overgeneralization: Coming to a conclusion based on one incident or piece of evidence. One upsetting event may be seen as part of a pattern of never-ending defeat.
     
  • Filtering: We magnify negative details of situations while filtering out all positive aspects. A person might dwell on a single unpleasant detail so intensely that their vision of reality becomes distorted.
     
  • Catastrophizing: Expecting disaster to strike no matter what.
     
  • Jumping to Conclusions: Assuming we know how people are feeling and why without them telling us so. 
     
  • Personalization: Believing everything others say or do is a direct, personal reaction to us. Assigning blame to ourselves for an external event we were not responsible for. 
     
  • Emotional Reasoning: We assume that what we feel must be the truth.
     
  • Should Statements: We have rules about how we and others should behave and feel guilty or frustrated when they are violated.
     
  • Control Fallacies: If we see ourselves as externally controlled, we are victims of fate. If we see ourselves as internally controlled, we are responsible for the pain and happiness of everyone around us. 
     
  • Blame: We hold others responsible for our pain, or we blame ourselves for every problem. There is no middle ground.

Ways to fight cognitive distortions:

  1. Identify Them: Make a list of these thoughts that cause us to feel bad about ourselves so we can examine them later.
     
  2. Examine the Evidence: Find evidence that contradicts these thoughts. If we are self-critical, find examples of times we were successful.
     
  3. Double Standard Method: Rather than harsh self-talk, talk to ourselves in the compassionate way we may talk to a friend in a similar situation.
     
  4. Think in Shades of Gray: Be open to considering experiences as partial successes rather than just successes or failures.
     
  5. Survey Method: Check with others to see if their perceptions of situations are the same as ours.
     
  6. Re-attribution: Identify external factors that may have contributed to problems we have been blaming ourselves for. Rather than focusing on blame, focus on coping.
     
  7. Cost-Benefit Analysis: List advantages and disadvantages of feelings/thoughts/behaviors. This can help us identify what we may be gaining from distorted thinking.

Kaylen Hagadorn is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Functional Action: Choosing Wellness Over Beauty

By Sarah Spitz, LMSW

Two summers ago I completed a training with Chelsea Roff, the founder of a non-profit called Eat Breathe Thrive, which supports individuals in overcoming food and body images challenges.  The Eat Breathe Thrive program uses interactive activities and mind-body practices to offer participants tools for long term recovery.  One of my favorite parts of the curriculum focuses on “functional action,” which means acting in a way that puts our body’s utility/wellness before beauty/attractiveness. This means appreciating our body for what it can do, rather than for what it looks like. 

So what does “functional action” really mean?

In regard to our bodies, the Eat Breathe Thrive program views “functionality” as our ability to embody the full potential of human life. When we make “functional” choices, we support our body’s ability to fully engage in life. For those of us with eating disorders, disordered eating, and body image struggles, many of our choices may not be “functional" and can lead to negative and harmful consequences. Below are some concrete examples to understand functional action. 

What does functional action look like in practice?

The statements below put “beauty” over "functionality." These types of thoughts and statements are not considering what is actually best for our bodies. These choices can lead to health consequences, as well as keep us from engaging fully in life.

Eating: “I eat x because it does not cause weight gain”
Exercise: “I go to the gym everyday because I want to have a flatter stomach”
Social Life: "I will ended up eating too many calories so I usually don't take my friends up on invites to got out to dinner."

Below are ways in which “functional action” can be applied to the above examples: 

Eating: “I eat x because it improves my digestion and gives me energy”  
Exercise: “I go to yoga three times a week because it helps me to de-stress after an intense work day."
Social Life: "I am going out for dinner tonight with friends who are really important to me, and am looking forward to enjoying their company over a delicious meal."

When trying to determine how to apply functional action to your life, think of what choice is nourishing to your body - physically, mentally, emotionally, and socially.

Sarah Spitz is therapist at Cobb Psychotherapy. If you would like support with disordered eating or body image struggles, contact Cobb Psychotherapy and see how therapy can help. 

Internet Algorithms and Our Unconscious

By Dan Perlman, LMSW

Having never before written a blog, nor constructed words for consumption beyond those to whom I’ve handed a physical copy, I hope not to embarrass myself in my contributions to the Cobb Psychotherapy blog. I plan to do my part and hope, with all humility, to contribute something worth reading and perhaps stimulate some of the ole grey matter (in the brain).

My grandfather used to make a speech such as mine above, and then say, “Okay, now I’ll get off the soap box.” According to Wikipedia, a soapbox is a raised platform which one stands on to make an impromptu speech, often about a political subject. The term originates from the days when speakers would elevate themselves by standing on a wooden crate originally used for the shipment of soap. To be reminded today of the need for an elevated soap box in order to be heard is a link to the past, which contrasts the degree to which information and ideas flow freely today. But perhaps not all information is healthy or helpful to us.

I recently read that former president Obama suggested that becoming “cocooned in information that reinforces our biases” is one of the dangers we face today, especially as the internet plays a larger role. It struck me that one of the fundamental ideas of psychodynamic thinking relates to the idea that much of who we are is “outside of our awareness.”  More specifically, who we are, what we feel, and why we behave as we do is actually thought, in psychodynamic circles, to reside outside of our own consciousness.  

This got me further thinking (which can be dangerous) that maybe we’re unconscious of the “cocooned reinforced biases” forming around our ideas because of our isolated exposure to the flood of information.  Maybe these biases are building up at such an accelerated pace and to such an extreme degree today because of the often reinforcing and isolating nature of the internet itself.  In a world where algorithms drive much of what we see on our screens, the impact on our unconscious is still decidedly unknown. How we slow this down, catch our breath, and begin to consciously understand our reactions to it all is a great challenge. 

It would seem, now more than ever, that we all might benefit from getting out, socializing, and meeting friends in the real world.  To see, talk, and hear one another without the filter of the web between us may be of supreme importance in 2018.  Perhaps, at the very least, the benefits of the individual strong therapeutic alliances we aspire to form with clients can open minds to bring people of different biases together and pull people away from the cocooned silos. 

References:

Dan Perlman is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Dear Therapists: It’s Our Responsibility to Provide Affirming, Competent Care to LGBTQ People

By Karalyn Violeta, LMSW

In October of 2017, my article, ‘Integration of desire, sexual orientation, and female embodiment of a transgender woman previously diagnosed with autism spectrum disorder: A case report,’ was published in the Journal of Gay & Lesbian Mental Health.  This case study was based upon my work with a long-term client over the course of more than two years, who also participated in the review and contributed content for the paper. It was initially presented at the Transgender Mental Health Symposium held by the Institute for Contemporary Psychotherapy in New York City in November, 2016, and then further developed for publication with my co-author, S.J. Langer. The paper was also presented at the annual Philadelphia Transgender Health Conference in September, 2017. 

As I stated in this paper, I think it is our responsibility as therapists to educate and familiarize ourselves with LGBTQ-affirming language, and to be aware of the culture, media, and health-related concerns of the communities and individuals we serve. We should be interested in our clients’ specific experiences as individuals, but not rely upon them to educate us on terminology, trans health care needs, etc. It’s very important for therapists (especially cisgender and/or straight therapists) to have knowledge about gender identity and sexual orientation, and how these issues may impact and intersect with other aspects of people’s lives, relationships, and identities. 

Both my Institute training and professional career as a psychotherapist have been focused on work with LGBTQ individuals and couples, with a particular focus on trans, non-binary, and queer-identified clients. As a member of the LGBTQ community in NYC, I know firsthand the importance of competent, affirming practice - whether it be in a doctor or therapist’s office, or anywhere services are provided. There is a particularly great need for psychotherapists to provide affirming care for trans and non-binary people; as a faculty member teaching in a social work graduate program, I incorporate basic education about trans issues and more advanced aspects of clinical practice with trans, non-binary, and lesbian, gay, bisexual, and queer clients into our classroom learning. 

It’s been my great pleasure to work with Cobb Psychotherapy, which has always fostered a caring, affirming environment for both my clients and for myself as a queer-identified therapist. I’m thrilled to be a member of the Cobb team and to bring my specialized skills and experience to the practice!

Link to a free copy of Karalyn’s recent article: http://www.tandfonline.com/eprint/E7duJbaPq9DyVjJNhzm5/full 

Karalyn Violeta is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

A Furry Friend a Day Keeps the Doctor Away

By Bethany Nickerson, LMSW

Growing up I never had pets. A neighborhood dog chased me home from school one day and it terrified me. For many years I was scared of dogs and went out of my way to avoid them. It wasn’t until I moved out on my own and in with someone who had a huge dog that I started to work on my fear. Then in 2013 a friend came to stay with me and brought with him a teeny tiny puppy named Hugo. From the moment I met that little guy we were bonded together. I would rush home from work to play with him and he would follow me all over the house. My friend found his own place and the time came for him and Hugo to move. I was devastated. The day before he was set to move out he came and told me that he would like to give me Hugo. Needless to say, the rest is history.

I think its safe to say that most people can list many reasons why their life is better because of their furry friends. I decided I wanted to do some research about how companion animals benefit our health. I was pleasantly surprised to find that there has been a fair amount of articles written on this topic. Learn more below: 

  1. Better outcomes in patients with heart disease. There was a very interesting study that followed up with patients one year after they were discharged from a coronary care unit. The patients who had companion animals were more likely to be alive than those who did not. “Because coronary heart disease is a stress-related disease research suggested that the protective effect of pet ownership is due to its effects on psychological risk factors” (Patronek and Glickman 1993). 
     
  2. Increased social support. It's well known that lack of social support is a big risk factor for subsequent physical and psychological issues. Companion animals not only provide support by reducing loneliness and providing unconditional love, they also “act as facilitators of social interactions between other human beings” (Beck and Katcher, 2003; Kruger and Serpell, 2006; McNicholas and Collis, 2006). There are few things that unite people like talking about their beloved pets!
     
  3. Higher (self report) life satisfaction and perceived health (Norris et al, 1999). 
     
  4. Elevated levels of Oxytocin (the “love hormone). Increased Oxytocin levels are associated with improved bonding with others, reduced aggression, more empathy and improved learning. 

I’ve always knows that Hugo makes my life better, but now I can prove it with science! If you are looking to improve you health and happiness try spending more time with your pets or volunteering at an animal shelter. 

References: 

  • O’Haire, Marguerite. (2010). Companion animals and human health: Benefits, challenges, and the road ahead. Journal of Veterinary Behavior: Clinical Applications and Research, 5(5), 226-234.
  • Takashima, G., & Day, M. (2014). Setting the One Health Agenda and the Human-Companion Animal Bond. International Journal Of Environmental Research And Public Health, 11(11), 11110-11120.

Bethany Nickerson is a therapist at Cobb Psychotherapy. If you would like support in prioritizing and taking care of your mental health, contact Cobb Psychotherapy and see how therapy can help.

Therapist Feature: Shaudi Adel, LMSW

We are excited to welcome Shaudi Adel, LMSW to the team! Learn more about Shaudi below.

What initially inspired you to pursue a career as a therapist?

When I was in middle school, I had a goal to reach out to all the 7th and 8th graders with hand-written notes to get to know my peers better, offering the opportunity to chat about any issues. To my surprise, so many students reached out to me – whether it was about boy troubles, issues at home, self-harm behaviors, or eating disorders. I felt that through this experience of providing empathy to others and being supportive, I had recognized my future career path – and I have never looked back since!

As a therapist, what are you most passionate about? 

At the top of my list, I would have to put helping clients achieve a healthy balance in life, take action (small or large), identify their true life purpose, understand and live out their core values, and achieve their goals.

What are your specialties and what drew you to them?

My specialties are addiction and eating disorders. Growing up, I saw how drug and alcohol addiction impacted multiple family members, which made me wonder why some people struggle with addiction and others do not. With my professional work in the field of addiction, I began to see the co-morbidities of other mental health conditions that impacted the quality of life for my clients, including depression, anxiety, PTSD, and eating disorders. I found the interplay of addiction and other mental health disorders intriguing and stumbled upon it as my specialty by the nature of the work I was doing with clients. Also, I have previously struggled with an eating disorder and so I find it truly rewarding to help clients with eating issues work towards recovery and a life free from dysfunctional eating.

What makes you unique as a therapist?

As a standard procedure when I first meet clients, I take inventory of client’s strengths and unique abilities that can be applied to the therapeutic process. I also believe that at an intuitive level, all clients have the answers and have somehow lost sight of that connection to their intuition. I work hard and at the pace set by clients to help them better reconnect with themselves and discover a life full of meaning and worth.

How would you describe your therapeutic approach?

I tend to be very focused on recent history to the here-and-now. I use a direct approach when needed, and I have been told I am a warm, welcoming therapist. I use humor and see the therapeutic relationship as a “real relationship between equals.”

Everyone needs self-care. How do you practice self-care?

I am a big fan of using the 5 senses to self-soothe, so burning a rose candle, sipping a hot tea, cooking one-mindfully after a busy day, and spending time with my half-Persian, half-Munchkin cat Lulu usually does the trick. I also lead a physically active lifestyle, including weight training, yoga, volleyball, and taking mindful walks around Central Park.

What is your favorite...

Quote: “You are imperfect, you are wired for struggle, but you are worthy of love and belonging.” –Brené Brown

Book: The Bible

Movie: Tie between Wall-E and Grease.

What is one thing that is important for anyone to know? 

All emotions, whether positive or negative, are temporary in nature. Sometimes, we get so caught up with an emotion we are experiencing, and cling to it with such intensity that our whole perspective is distorted through the lens of that fleeting emotion. In these moments, it is helpful to take a mindful stance of detachment and remind ourselves that no emotion lasts forever and we can learn to manage our emotions effectively and with acceptance.  

Shaudi Adel is a therapist at Cobb Psychotherapy. To schedule an appointment with her or learn more about how therapy can support you in reaching your goals, contact Cobb Psychotherapy.

Reassessing Friendships in the New Year

By Jessica Glynn, LMSW

Friendships can change drastically over time, making it important to assess these meaningful relationships and how they are affecting us. Especially, if you feel the friendship has been changing in a negative way. When friendships struggle from a disagreement, disappointment, or inconsideration, it can affect us deeply. Often, the reflections on our friendships come at a point of change in our lives. During a difficult time, can that friend be there for you equally to when all is going well? Alternatively, if you are experiencing new positive changes in your life, such as a progressive career change or a new romantic relationship, is that friend truly happy for you or does jealousy start to arise? Here are a couple concepts to consider when deciding if a friend in your life is deserving of your time and energy.

Reciprocity: Does your friend put similar effort into maintaining the relationship? If one person is always trying to make plans, and the other is not following through or canceling last minute, this can feel very hurtful. Typically, if a friend values your relationship, they will make time to keep the friendship going strong. All relationships require time and nurturing in order for them to be a positive support in our lives. If one person is consistently absent, then they cannot expect their friend to wait around for when they are ready to put forth sporadic effort. This also holds true for reciprocity in sharing vs. listening. Each person should be allowed the space to share and have the other listen with a supportive, understanding ear. If one person is always the sharer and one is always the listener, the listener may miss out on the support they need from that friendship and feel resentful.

Positive Support – Does your friend provide you with positive support and make you feel good about yourself? Often, when we've know someone for a long time, we start to feel comfortable joking around or poking fun at one another. When this light hearted, jovial banter becomes increasingly hurtful or negative, this may be someone who is trying to put you down rather than supporting you to feel proud and good about yourself. It is important to a healthy friendship that you can acknowledge these feelings with your friend and they respect you enough to alter this behavior. Whether friends are there to support you through a break up or there to celebrate with you over a great accomplishment, it is important that you feel your friends truly wants to see you happy

Trust - Are you able to tell your friend personal issues or feelings and know that they will be held in confidence? If you notice you and a particular friend’s conversation always seems to trend towards gossip, this may be a red flag to take into account. Not only could this be a sign of a jealous or competitive person, but could also leave you questioning what they are saying about you to others. Trust is an important component to a friendship that is a source of support in one’s life. If that trust is not there, you may as well be telling your personal secrets to any passe by willing to listen. A friend that you can confide in will be one that will hold your personal conversation as privileged, even when they are angry with you or you have a disagreement.

Jessica Glynn is a therapist at Cobb Psychotherapy. If you find yourself seeking support with navigating friendships visit cobbpsychotherapy.com to learn more about how therapy can help.

Understanding and Tolerating Guilt

By Rosie Barton, LMSW

We all experience guilt over the course of our lives. It’s one of our many emotions—just like sadness, joy, shame, or anger. And yet, I frequently work with clients who are experiencing a deep sense of guilt, often as a chronic, persistent feeling that they are never good enough or doing enough. During graduate school, one of my professors asked us in a class if we knew what the definition of guilt was, and I’ve never forgotten his response. He told us that “guilt is real or imagined wrongdoing.” 

I was struck by the concept of “imagined wrongdoing.” While I never want to invalidate a client’s feeling of guilt — after all, the feeling is one hundred percent real to him or her, I often try to explore whether they have actually done something so terrible as to merit those intense feelings of guilt and self-recrimination. 

Feeling guilty isn’t always a bad thing. Guilt serves a purpose after all — it’s a sign that we’re aware of what’s right and wrong, which is crucial as a member of society. Guilt also allows us to acknowledge when we have done something wrong, and to therefore make amends for it and change our behavior. However, guilt becomes less adaptive when we begin to feel guilty for who we are, rather than for something we have done. For example, a client with an eating disorder might feel guilty for eating a meal and then think “I am bad.” An important part of recovery is being able to tolerate that feeling of guilt and to still not skip the meal because of it.

For example, sometimes you might think:

  • “I can’t say no to my mom, I’ll feel too guilty.” 
  • “I’ll feel too guilty if I ask my coworker for help when she’s already so busy.” 
  • “If I take a break from studying to meet my friend, I’ll feel guilty.” 

And so what if you feel guilty? Can you set boundaries, ask for help, and practice self-care despite the feelings of guilt that might ensue? Chances are, feeling guilty is probably something you can live through. Being able to tolerate guilt (what I might call “imagined wrongdoing” in these instances) can actually be a sign that you are taking care of yourself and identifying your needs, which can feel very foreign and uncomfortable at first, especially if you are used to putting everyone else ahead of you. 

It’s ok to let yourself feel guilty, and more importantly, to not act on it through avoidance or perfectionism. I often find that clients avoid certain actions or conversations that might be beneficial to them because they fear feeling guilty. I like to remind them of exactly what I stated in the first paragraph: guilt is just one of many emotions that we will experience as humans. And, like all emotions, eventually guilt will shift and give way to other feelings. Sometimes that requires us to tolerate the discomfort of a feeling we might rather avoid. But the more we can allow ourselves to experience the full breadth of our emotions without avoiding them or pushing them beneath the surface, the more well-equipped we are to fully engage in our lives and with the people around us. 

Rosie Barton is a therapist at Cobb Psychotherapy. If you would like support in exploring and managing emotions, visit cobbpsychotherapy.com to learn more about how therapy can help.

 

Self-Care for the Commuting New Yorker

 By Kristen Quinones, LMSW

New York City is known as the city that never sleeps for a reason. There is always so much to do and lots of great things going on. As wonderful as that can be, living in this city also means walking amongst large crowds of people and using mass transit as you go about your daily routine. This can be stressful and very emotionally overstimulating. Here are some ways to practice self-care around commuting.

  1. Plan Ahead

    Mass transit can be unreliable at times. Plan ahead and give yourself more of a time cushion to get to where you need to go. Even fifteen minutes can make a difference. If you get to your destination early, do some extra self-care! Grab a coffee or tea, watch an episode of your favorite show online, go for a walk, call a friend, or do anything that gives you a few minutes of relaxation! This can help you emotionally settle into your day with more peace of mind.
     
  2. Be Open to Change

    Rush hour commutes can be exhausting. Be open to change; try to travel more at off-peak hours.  Maybe go into work a bit early or leave an hour later if you have that flexibility. Try out a different mode of transit, maybe a different train or bus service. Mix it up and see if you can find alternative routes that are less crowded.
     
  3. Walk, Walk, Walk

    There are so many benefits to walking. Not only does it benefit your physical health, but it can benefit your mood and lower stress. Get off the train a stop early, walk a scenic route, or take a short walk whenever you can to give you an extra boost of energy and stress relief.
     
  4. Use Awareness as Mindfulness

    In New York City you have to constantly be aware of your surroundings to keep yourself safe and alert. This can be draining. Use your awareness as mindfulness. Mindfulness focuses on experience, keeping yourself in the moment, and using your five senses to ground you to the present. Focus on the live music you hear in the subway, take in the smell of food cooking when the train doors open at an above ground station, or observe what people are doing around you. If you need a good distraction from a stressful commute, you can also ground yourself in some reading or meditation.

Kristen Quinones, LMSW is a therapist at Cobb Psychotherapy. If you would like support in incorporating self-care into your life, contact Cobb Psychotherapy and see how therapy can help.

Therapist Feature: Dan Perlman, LMSW

We are excited to welcome Dan Perlman, LMSW to the team! Learn more about Dan below.

What initially inspired you to pursue a career as a therapist?

I was inspired to pursue a career as a therapist following a tragic accident that befell a lifelong friend after seeing his amazing emotional resiliency and recovery.

As a therapist, what are you most passionate about? 

As a therapist I’m most passionate about helping patients turn the tide from defeatist thinking toward inspired thinking and being their full authentic selves.

What are your specialties and what drew you to them?

My specialties are adult and adolescent trauma and crises. I was drawn to them as a result of seeing and feeling people grapple with seemingly insurmountable medical & emotional issues as couples and individuals, and emerging stronger and more balanced. 

What makes you unique as a therapist?

What makes me unique as a therapist is my genuine love of being with patients where they are. My desire and commitment to understanding patients and sitting with them in their place of pain separates me from many others.  I also have a business background so I understand the resistance toward taking time out and making ourselves vulnerable. 

How would you describe your therapeutic approach?

My therapeutic approach is psychodynamic with the use of CBT when it dovetails.

Everyone needs self-care. How do you practice self-care?

I practice self care by playing ball and actively studying companies from my first life as a Stock analyst. I’ve also got a few kids so that’s tremendous fun too. 

What is your favorite...

Quote: Well my grandfather was a philosopher of sorts so I’ll give you a few. 

“The unexamined life is not worth living” 
“Don’t let a season of mourning turn into a lifetime” 
“They know the price of everything and the value of nothing” 

Movie: Again I’ve got to give you a few.  As a kid it was Ordinary People, then I fell in love with My Cousin Vinny, and these days it’s Forrest Gump.   

What is one thing that is important for anyone to know? 

I think everyone should do therapy at some point. Taking the time to stop everything else and consciously focus on how we feel takes courage and is empowering.  Learning objectively about our feelings is not just a gift to ourselves, but I believe also leads toward better choices, more money and more stable relationships.  

Dan Perlman is a therapist at Cobb Psychotherapy. To schedule an appointment with him or learn more about how therapy can support you in reaching your goals, contact Cobb Psychotherapy.

Make Your New Year's Resolutions SMART(ER)

By Dorette Greene, LMSW

Are you thinking about making a New Year's Resolution for 2018? Well, you’re not alone. Millions of people make resolutions each year and it’s estimated that many of those people fail. According to StatisticsBrain.Com the most popular resolution made in 2017 was to lose weight/have healthier eating habits at 21.4%. I’m going to go out on limb here, but I have a feeling this will be the most popular resolution again this year (and likely, by a majority of the folks who resolved this in 2017). BUT WHY?!

Resolutions aren’t necessarily hard to make, but for many they can be extremely difficult to keep. StatisticsBrain.com also reported the number of individuals who failed at their resolution completely was 42.4%. This just shows us that what we resolve to do in the New Year is not as important as how we resolve to do it. So how do we make a resolution and actually stick to it?  Think of your New Year's Resolution as a goal. Then do some goal setting. Sounds simple enough, right?

My favorite goal setting method is creating SMART goals. SMART being an acronym for specific, measurable, attainable/achievable/action oriented/assignable (pick whichever "A" is most pertinent to your goal), relevant, and time-related. If you want to be fancy you can also try SMART(ER) goals which include Evaluation and Review. Here’s an idea of how to get started thinking about SMART goals and how to change your 2018 resolution to a goal you will be able to actualize.

Make your goal....

Specific: The beauty in goal setting, especially when using SMART goals, is the ability to be specific. This means being concrete in identifying not only the target but also the metrics you will use in the process. Stay away from creating vague, broad, overarching goals. This part of the process is about the details.

Measurable: Creating measurable goals makes it easier to visualize your progress. Remember those metrics we just spoke about? That’s your yard stick. Use it to measure how far away from your goal you are and more importantly how much progress you have made since you started. Measuring your progress makes it easier to consider changes you can make to get better results, or reconsider things that may be hindering your progress.

Attainable/Achievable: Conceptualizing how attainable a goal is may be a matter of subjective opinion; however, it goes without saying that it’s never a good idea to create a goal you don’t believe you can actually achieve. Remember these are your goals, so you can set the bar as high as you want. Just make sure the bar is still within your reach.

Action-oriented: Set goals that require concerted action. This means you not only have a clear objective in mind but you also have a plan towards how you will mobilize those actions.

Assignable: If you are setting goals that involve others, make sure that the roles towards achieving those goals are assignable. Goal setting towards a collective goal requires that the other people involved are aware of the goal and understand their responsibilities in the process.

Relevant: Ensure that the actions you are taking are relevant to the goals you have set. There’s nothing worse than self-sabotaging, which is what happens when the actions you choose are not congruent with the goals you would like to accomplish.

Time-related: Create deadlines! Not just for the overall goal but for the actions around that goal. This ensures that you are consistently checking in with yourself and assessing your progress.

Evaluation: Consistent evaluation of your goal to asses for not only progress but patterns helps to maintain momentum in following through with a goal. Momentum is important as it's easier to maintain momentum than it is to stop and then start over again.

Review: This is where you reflect on whether you have completed the goal or not. Consistent assessment is integral to your success. I also like to tell my clients that the R can and should also stand for reward as you should reward yourself along the way. Particularly when you have little wins towards your greater goal.

Making a lasting change in your life is a daunting process and is difficult for most, but it can be done. New Years can be a great time to begin implementing changes in your life as well as setting new goals and more importantly accomplishing them. It doesn’t have to be hard, you just have to be a little SMARTER about it.

References:
https://www.statisticbrain.com/new-years-resolution-statistics/
https://www.projectsmart.co.uk/brief-history-of-smart-goals.php

Dorette Greene is a therapist at Cobb Psychotherapy.  If you are looking for support in making and reaching your goals,  visit cobbpsychotherapy.com to learn how therapy might be able to help. 

Emerging Leader Award From NASW

We are excited to announce that our founder and lead therapist, Elizabeth Cobb, has been awarded the Emerging Leader Award from the National Association of Social Workers New York City Chapter! 

Our founder: Elizabeth Cobb, LCSW at the 11th annual leadership awards dinner. 

Our founder: Elizabeth Cobb, LCSW at the 11th annual leadership awards dinner. 

 
THe NASW-NYC Leadership awards recognize "social workers who demonstrate exemplary leadership qualities and a unique commitment to the improvement of the social and human condition."

THe NASW-NYC Leadership awards recognize "social workers who demonstrate exemplary leadership qualities and a unique commitment to the improvement of the social and human condition."