Building a Social Support Network

By Amy Brightman, LCSW

Establishing healthy social supports is an important component of overall wellness because it enables you to manage stress more effectively.  Social supports provide physical and emotional comfort and allow you to connect with a community, which offers a sense of being cared for and valued. Social supports can take many forms—emotional, practical, informational, and intellectual—and vary from person to person. There will be people in your life you can turn to when you need to talk to someone, when you need a ride to the airport, or when you need to understand something. 

Living in a large city like New York City, despite busy schedules and the constant crowds of people, can often feel very lonely.  Maybe you are new to the city, friends may have moved away, or perhaps you are in a new stage of life. This and many other factors can make it difficult to feel connected to others. 

One thing I always focus on in therapy is: “Who are your supports?” and “What are your supports?” If you understand the “whos”’ and “whats” of your support network, you are less vulnerable to depression, stress, and loneliness. So, how do you improve your social support network? Consider some of these suggestions:

  1. Take advantage of opportunity: Don’t hold back from putting yourself out there. If you’re invited to a networking event, give it a try. If you're free on Wednesday evenings,  try volunteering. You never know who you will meet or what you will enjoy.
  2. Schedule in advance: Make plans with your established supports regularly. Try putting a monthly dinner on the schedule with your friend. Not only is it is nice to look forward to plans, but it's better when you’re not only seeing each other when things are stressful.
  3. Out with the old, in with the new: Let go of unhealthy relationships and join something new like online dating websites, meetup.com, or book clubs. Understand your boundaries and what is healthy for you, and limit negative relationships that take a toll on your wellness. 
  4. Don’t give up: It takes time to meet new people, make new friends, and find new interests, so be patient when developing connections.  Having supports is an ongoing process, and establishing a trusting relationship doesn’t happen over night.

While putting yourself out there or finding the time in your busy schedule to make plans may be difficult, you are building and maintaining connections that will support you in the long term. 

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.

Man’s Search for Meaning

By Cherise White, LMSW

In his book, Man’s Search for Meaning, Viktor Frankl claims that future orientation is a way to self-preservation in extremely harsh conditions. This premise highlights the strength of the mind-body connection. Following the focus of the mind and its functioning, Frankl states, “emotion, which is suffering, ceases to be suffering as soon as we form a clear and precise picture of it.” This sounds like he is referencing what we know to be a component of mindfulness. This clarity can be found through awareness and acceptance of one’s emotions, thoughts, or sensations. Even though mindfulness as described by Bishop et al. (2004) is more about being present and in the moment than focusing on acceptance and awareness, these elements are still a part of the general perception of mindfulness as presented by Marsha Linehan in Dialectical Behavioral Therapy. 

Frankl also discussed the connection between the psychological and physiological parts of a human. He shed light on the relationship between immunity and the state of mind, courage, and hope. The physiological and psychological parts of a human were also discussed in Wager et al’s (2004) study on the anticipation and experience of pain. They highlight how pain is a psychological experience but that it has great effects on the physiological part of a human body. The same connection is discussed in Gross’s (1998) experiment on emotion regulation. Even when emotion regulation strategies such as suppression and reappraisal are used, there is still the potential for physiological effects as displayed in his findings. Therefore Frankl, from observation and experience, honed in on something research has now proven, that there is a strong link between the physiological state and the psychological state, cognition, and mind of a person.

In Man’s Search for Meaning, Frankl also calls for a change in attitude toward life. He states that one has to take responsibility in searching for an answer to one’s problems.  To an extent it seems Abramson et al.’s (1978) theme of learned helplessness could come into play. With the harsh conditions and circumstances the men faced in the concentration camps, many fell victim to learned helplessness and took on a perspective of a larger external locus of control. To combat ultimately being overtaken by helplessness, Frankl employed a number of emotion regulation strategies. He used both reappraisal and suppression (Gross, 1998). He also used cognitive strategies such as distraction (focusing on his wife and the everlasting feeling of love). At other times it appears he used mindfulness (find solitude for about five minutes) and visualization (“I dreamed longingly, and my thoughts wandered …in the direction of my home”) as coping mechanisms. 

Overall, Frankl underlined the idea of mind and body all throughout the novel as he presented the struggle for the prisoners to remain men and not objects, to implement mental toughness and remain hopeful, and for the men to employ cognitive strategies that could promote self-preservation in the midst of ambiguity of them ever being free. 

References

  • Abramson, L. T., Seligman, M. E. P., & Teasdale, J. D. (1978). Learned helplessness in humans: Critique and reformulation. Journal of Abnormal Psychology, 87, 49-74.
  • Bishop, S. R., Lau, M. , Shapiro, S. , Carlson, L. , Anderson, N. D., Carmody, J. , Segal, Z. V., Abbey, S. , Speca, M. , Velting, D. and Devins, G. (2004), Mindfulness: A Proposed Operational Definition. Clinical Psychology: Science and Practice, 11: 230-241. doi:10.1093/clipsy.bph077
  • Frankl, V. E. (2006). Man's search for meaning. Boston: Beacon Press.
  • Gross, J. J. (2002), Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology, 39: 281-291. doi:10.1017/S0048577201393198
  • Linehan, M., M., (2014). DBT Training Manual. New York, NY: The Guilford Press. 
  • Wager, T. D., Rilling, J. K., Smith, E. E., Sokolik, A., Casey, K. L., Davidson, R. J., Kossyn, S. M., Rose, R. M., & Cohen, J. D. (2014). Placebo-Induced Changes in fMRI in the Anticipation and Experience of Pain. SCIENCE, 20, 1162-1167

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.

Ambivalence in Eating Disorder Recovery

By Rosie Barton, LMSW

The decision to recover from an eating disorder is a challenging one, often fraught with feelings of uncertainty, ambivalence, grief, and fear. For many suffering with an eating disorder, the behaviors can feel like a security blanket and the disorder itself can become part of your identity. While most people seeking recovery are able to connect with reasons that their lives would be better without the disorder—more energy, healthier relationships, fewer distracting thoughts—the actual process of letting it go can be painful. 

Often times in the early stages of recovery, clients are tempted to run back to the familiar arms of their eating disorder. It provides them a sense of distraction and purpose in a world that can feel too overwhelming. I often describe the early stages of recovery through a metaphor. The person attempting to recover is stuck on a tiny raft in the middle of a stormy sea. They can see land and safety in the distance, but it will take a lot of courage to abandon the raft and begin swimming towards it. As they begin swimming, they get stung by jellyfish and the waves crash over their head, making them doubt their ability to make it to land. So they retreat back to the comfort of the raft, still longing for the safety and connection on the land within sight. 

When someone with a restrictive eating disorder begins to follow a meal plan regularly, feelings of guilt and anxiety can become deafening. Making healthy choices goes against everything that the eating disorder tells them to do. So they go back to restriction and the eating disorder behaviors that have been so comforting in the past. They are back on that little raft.

Recovery is very rarely a linear process. Usually someone will go swimming to shore, get scared or overwhelmed, and return to the raft. Eventually, through supportive therapists, friends, family, and their own courage, they will once again be willing and motivated to try and reach the shore. This is a natural part of recovery, and I always encourage clients to acknowledge their desire to return to the eating disorder. What is so compelling about it? How will you feel better if you relapse? Only through exploring this ambivalence can one begin to mourn the loss of the eating disorder and all that it has provided. 

So what do you do when you are swimming to shore and want to go back to the comfort of the eating disorder? To begin with, it’s important to share these feelings and fears with someone you trust. Suffering and fighting alone will only give power to the eating disorder. Part of recovery is the ability to have faith in your treatment team over faith in the eating disorder. It means following a meal plan, despite the urge to compensate for a binge or skip a meal. The more often you can make choices that align with your recovery, despite how scary the unfamiliar waters feel, the closer you will get to believing that the isolated raft isn’t going to save you after all. There might be safety there in an immediate sense, but lasting peace and connection can only be found through braving the journey to shore. And remember- you don’t have to go it alone. 

Rosie Barton 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.

The Three-Stage Model of Trauma Recovery

By Bethany Nickerson, LMSW

I work with many clients who have experienced trauma. Beginning the healing process can feel uncomfortable and overwhelming for clients because it is not a linear process. Not being able to know exactly how things will unfold can be distressing for both therapists and clients. It can be helpful to have a bit of a “road map” even if that road isn’t perfectly straight or flat. I love the three stage model Judith Herman outlined in her book Trauma and Recovery because it allows for a lot of customization and takes a very holistic approach.

  1. Stabilization: This phase is all about setting goals, establishing a treatment plan, and developing skills. The therapist will help the client to establish safety in their body and tap into their inner strengths. The client and therapist will assess for disassociation and work on recognizing the difference between being disassociated and being fully present. There are many different ways to help clients address their disassociation. The therapist provides psychoeducation about trauma and how it impacts the body and mind. This is typically very validating for the client because trauma responses can feel isolating and confusing.

  2. Reprocessing: During this phase treatment will focus on memories that are typically intensely distressing and disruptive to clients' lives. This can be done through: desensitization, grief work around unwanted or abusive experiences and how they impact functioning, mourning or working through grief about good experiences that one did not have, but that all children deserve, and/or re-parenting (which is encouraging the developed brain to care-take the developing brain). EMDR is a great tool to use during this phase.

  3. Reconnection: The final phase is centered on reconnecting with people, meaningful activities, and other aspects of life. Sometimes this will include peer led communities/groups, exploring identity components, learning to explore outside the client's comfort zone, and finding hobbies.

Herman, J. L. (1997). Trauma and Recovery. New York: BasicBooks.

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.

How to Cope with Travel Anxiety

By Kristen Quinones, LMSW

For those predisposed to anxiety or panic, travel can be a major trigger. It’s no secret that travel in New York City can be an added stress to one’s day. Whether it’s a crowded or stagnant train car, traffic above ground, or being stuck on a bridge or in a tunnel, it’s not that hard to start feeling a bit claustrophobic! Feeling stuck may make you feel out of control and ignite your “fight or flight response,” leading to a panic attack. Sometimes you need to do more than “just breathe” to survive these moments where fifteen minutes feel like an eternity.

1. Still breathe, please
Breathing exercises can help physically calm you down, so don’t discount using this as a skill. Breathing alone will not make your panic symptoms just disappear, so it is good to pair this with a cognitive strategy. Breathe slowly and deeply through your stomach. Practice this daily at bedtime to help your body adjust to this type of breathing. This will allow your body to more easily utilize the technique in moments of higher anxiety.

2. Engage your senses
This is the time to physically engage your body and distract yourself. Mindfully eat a peppermint candy, squeeze a stress ball, hold a cold beverage, or feel the texture of your bag/clothing with your hand. Focus on how these engage your senses. This form of physical self-soothing can help calm your nerves. Narrate the experience in your head to start overwriting your negative thoughts.

3. Practice thought stopping techniques: distract, distract, distract!
You cannot think two things at once! Play a game in your head to distract yourself from your anxiety driven thoughts. A book, podcast, music, or video can help you “thought stop.” Another great way to engage without any item is to count colors. Look around you. In New York there is no shortage of things to look at. Look around and count everything red around you and narrate this to yourself. “Here is one: a red hat. There is two: red sneakers. There is three: red letters on that sign.” Go through every color of the rainbow.

These are just a few techniques that can help pass the time until you are free to move around again. If you struggle with travel related anxiety or panic attacks, consider speaking about this with a therapist to learn more coping techniques like these.

Kristen Quinones 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.

Breaking the Stigma: Challenging 3 Common Myths About Mental Illness

By Dorette Greene, LMSW

On a recent drive home from work I observed a bumper sticker on a car that read: “I AM AN EDP.” For anyone that is unaware, “EDP” is an abbreviation utilized by many medical institutions, the Office of Mental Health (OMH) for the state of New York, and the New York City Police Department (NYPD), which stands for “emotionally disturbed person.” 

As a psychotherapist and mental health professional, working both in an outpatient context as well as in inpatient with acutely mentally ill individuals, I had so many questions upon reading this bumper sticker. I wondered if this person was actually an EDP, and if so, were they utilizing this sticker to shed awareness on mental health overall? I also questioned whether this sticker was meant as a joke, at the expense of people who struggle with mental health issues daily. Either way, having these questions and no context for an answer got me to thinking about the negative stereotypes and stigma that come with having mental health issues/illness.

Below I discuss 3 common myths and facts about mental illness with the intention of minimizing stigma and creating a dialogue of sensitivity and empathy towards people who are affected by mental illness.

Myth #1: Mental illness is uncommon.
Fact: Mental illness is quite common and prevalent.

According to a list of Mental Health Myths and Facts developed by NAMI (National Alliance on Mental Illness) 1 in 5 Americans will experience a mental illness in their lifetime. The issue is that many people don’t always recognize that what they are experiencing is related to mental illness. There are those that only conceptualize psychosis and psychotic symptoms such as hallucinations, delusions, and other perceptual disturbances as being related to mental illness. The truth, however, is that symptoms of other disorders such as anxiety and depression are also very prevalent and fall into the realm of mental illness.

Myth #2: Mental illness is caused by a personal weakness.
Fact: Having a mental health issue/illness is not a choice, nor is it based on any fault of the person experiencing it.

Mental illness can be caused by several different factors that are not inherent in the choice of the person experiencing that particular illness. Some mental health conditions can be hereditary (ex: bipolar disorder and schizophrenia), organic (ex: Alzheimer’s and dementia), related to physical trauma (ex: traumatic brain injury), a medical disorder (ex: seizure and strokes), substance-induced (drugs and alcohol), or potentially can be exacerbated by socioeconomic factors such as poverty and limited access to healthcare. People with mental health illness are often not “faking it” as some may assume. No one, if given the choice, would choose to have a mental illness, so sensitivity to the unique struggles of those experiencing mental illness is paramount in promoting adequate treatment, awareness, and access to appropriate services which will assist them in overcoming and stabilizing their condition.

Myth #3: Mental illness is not a real medical condition:
Fact: Many mental illnesses, like many physical ailments, require treatment

If someone breaks their leg, has uncontrolled diabetes, or heart disease they will likely seek the assistance of a medical profession to obtain medication and treatment to address the acuity or even chronic nature of their condition. This may include medication or physical therapy as treatment options. Mental health conditions are similar, in that they may require that someone complies with some sort of treatment regimen, be it intensive psychotherapy, group treatment, or even medication to assist them in maintaining stability, being able to function, and remaining healthy.

Ultimately, mental illness is a very real thing that should be considered with the same sensitivity to that of medical conditions and ailments. Though some symptoms may not be visible to the naked eye, and at times those experiencing symptoms may not be able to articulate or verbalize their experiences, it does not mean that they are not experiencing great amounts of torment, frustration, feelings of hopelessness, fear, and despair. Lack of empathy or even continued stereotyping and stigma around mental illness is insensitive and does no more than add insult to injury for the millions of Americans living with mental illness on a daily basis.

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.

How to Vacation Mindfully

By Vanessa Kensing, LMSW

With summer rapidly approaching, I hope you have some vacations or staycations planned! Time for relaxation, recuperation, and fun are an important part of mental health balance and stability! However, to allow yourself to relax, recoup, and enjoy, one must focus on the internal self (thoughts, expectations, and intentions). This is easier said that done! Below I explore what made me realize that I wasn’t vacationing in a way the worked for me, and the steps I’ve taken to be more mindful in this process. 

A few years ago I went to London with two close friends from college. We had studied abroad together ten years earlier and it was a sort of reunion trip. In the months leading up to the trip my excitement grew, but so did my anxiety. I wanted "to get the most out of the experience,"  “to not miss a thing," and “everyone to be happy."  This thinking led to me scheduling almost every seven days of our trip down to the minute. We definitely saw a lot and truly enjoyed our time together, but by the end I felt like I needed a vacation from my vacation! 

In the four years since our trip to London I’ve reflected upon that experience over and over again. It is hard to break thought and behavioral patterns, so changing the way I spend my downtime has taken time and effort. Below are some helpful ways to assess your thoughts and begin to change the way you think and engage in vacation time: 

Checking in on thoughts during the planning process.
If you are planning a trip or even some time home, begin to check in on your thoughts about the planning process. Are you planning a trip/time that reflects you and your needs? Are you planning what you like doing or what others think you should do or expect you to do? Are you over planning or under planning?  Are you thinking in extreme ways (This has to happen, I can't miss this, I should do everything)?

Checking in on your thoughts while you are there. 
Whether you are traveling or doing a staycation, while you are in it, check in on your intentions and expectations. Are you following through on setting a balanced routine and/or schedule for yourself? Are you present while you engage in activities and downtime? Have you set unrealistic expectations that need to be altered? 

Checking in on your thoughts after. 
There will be things that went as planned, went wrong, or went unexpectedly. As you reflect upon your trip or find yourself telling friends and family about your experiences, check in to see how you are framing it! Are you focusing on the negative? Are you learning from the experience? Are you finding space for gratitude and joy?

Lastly, a note about "checking in." As you ask yourself any of the many questions mentioned above, please attend to asking yourself these questions in a nonjudgmental and nurturing way. These questions are meant to help you be more present and enjoy your experience, not to criticize yourself! Using compassion for yourself as a framework allows for there to be change! 

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.

How to Take a Compliment

By Amy Brightman, LCSW

When I give my elevator pitch about who I am as a therapist and what my style is like, I often will comment on the importance of giving feedback in therapy. I make sure to stress how talking about things that aren’t working is just as important as talking about things that are working. This goes both ways - it is helpful to have a dialogue throughout the course of therapy about what the therapist is doing and what the client is doing that is going well. You want to balance focusing on barriers and struggles with reinforcing strengths and progress. Therefore, I will often find opportunities to give positive feedback and compliments when deserved. However, something that has stood out to me over the years is how many times feedback and compliments are met with a pause from clients. It’s hard to take a compliment, but why?

When someone positively comments on something about you, you might be quick to dismiss it. Taking a compliment requires two things: you believe the person is being genuine and you believe the feedback to be true for yourself. Much of this can come down to your self-esteem and your ability to give yourself credit when it’s due. Barriers that can block us from doing this are perfectionistic thinking, low confidence, and trust in others. Often times, clients will describe how compliments will make them think how they could have done something even better and, therefore, they don’t deserve the positive feedback. Others describe feeling embarrassed by the attention. The cycle of devaluing whatever the feedback is about continues and plays into feeling less confident about the compliment.

It’s important to give yourself credit when it’s due. If you know you work hard at something, allow yourself to feel good about it and allow others to recognize it. To change the way you respond to a compliment both internally and externally, hear what the person is telling you and minimize your automatic thought. Say the compliment by paraphrasing what they said in your own words to yourself. Then, own the effort you put into something by identifying the skills you used and validating yourself. Review the example below and try this for yourself:

1. Hear it.

Compliment: You did a great job with the presentation. It helped me understand how to better use the new system at work.

Internal Thought: It could have been better.

2. Say it.

Paraphrase: They are telling me they liked it because they improved their understanding and can be more efficient at work now.

3. Own it.

Skill & Validation: My explanations were organized and clear and my presentation was engaging. I spent time making sure my presentation was helpful for my co-workers. I put a lot of effort into this.

Finally, sum up these steps by responding with a genuine “thank you.” Even better, acknowledge that you heard them and share your appreciation for having your skills acknowledged. Follow the steps above and turn them into an external process. For example, say “Thank you. I’m happy to hear you found the presentation to be helpful. I spent a lot of time trying to make sure it was clear and concise.” Keep practicing these steps and soon you’ll be stopping the cycle of downplaying your positive attributes. Let yourself feel good about positive things!

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.

How to Practice the STOP Skill

By Shaudi Adel, LMSW

I would like to share one of my favorite DBT distress tolerance skills from Marsha Linehan’s DBT Skills Training Manual. It is based on the simple concept of taking a pause in the situation we are in, and yet it takes multiple steps and skilled intention to incorporate. 

  1. S is for STOP. 
    Stop in the moment and don’t react. Take a physical, emotional, and cognitive pause. You may even say the word “STOP!” in your mind or out loud. 
     
  2. Take a step back.
    Take a break from the situation mentally or physically. Take a deep breath in, and release. Detach from whatever is going on around you.
     
  3. Observe.
    Notice what is going on internally and externally in your surroundings. What are your current thoughts and feelings? What physical sensations are you experiencing? What situation are you in? What are you taking in with your senses?
     
  4. Proceed Mindfully.
    Proceed with mindfulness and awareness of your observed thoughts, feelings, and details of the situation you’re in. Remember your goals and your values. Consult your Wise Mind by asking yourself, “Will this action I want to take make things better or worse for me?”

I think this skill is a great one for when we find ourselves wanting to act impulsively on our emotions and thoughts. Again, it is based on a simple idea of taking a pause, although I think moving through each step can create a sequence of skills to help us return to Wise Mind when we need to the most. 

Reference:
Linehan, Marsha M. (2015). DBT Skills Training Manual. New York: Guilford Press.
 

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.

What to Do When Negative Self-Talk Hijacks Your Mind

By Salina Grilli, LMSW

A couple weeks ago I ran a half marathon. I planned on training, but other commitments took precedent. My ego barked, “If you can't beat you last years time, then it's not worth the effort." I did end up putting my ego aside, in part, for a friend who recently suffered a difficult loss and needed a healthy distraction; and, in part, because I always had fun at this race. 

It was cold and raining heavily when I arrived on race day. By the time I crossed the finish line, I was soaking wet and shivering. I spent the first half of the race wondering if I could even make it to the finish and the second half trying (and failing) to reframe my thoughts. Needles to say, I let my inner self-critic take over and finished much slower than I did the previous year. I could make excuses for my time, but the reality is that my attitude and negative self-talk was the culprit.  

After crossing the finish line, I not only felt disappointed with my time, but also frustrated with myself for how mean I had been to myself throughout the race.  Did I really need to spend a few hours of my life bullying MYSELF? No, not really. 

This is where the concept of self-compassion comes into play. Kristen Neff describes self-compassion as the following: “Instead of mercilessly judging and criticizing yourself for various inadequacies or shortcomings, self-compassion means you are kind and understanding when confronted with personal failings – after all, who ever said you were supposed to be perfect?”

This race reminded me of how difficult it can be to practice self-compassion in challenging moments, yet how crucial it can be to success. Had I spoken to myself with kindness and compassion during the race, I would have felt less discouraged and would likely have competed at a higher level. Even though I was unable to change my attitude during the race, I made a commitment to practice self-compassion afterwards.

Here are some self-compassion techniques I used to challenge my inner critic:

  1. Ask yourself, “What would I say to a close friend or a young child?” 
    • Practice reframing your thoughts by asking yourself, “If my friend had this thought, what would I say to them?” My guess it that you would be much more compassionate and less critical than you are being to yourself. 
       
  2. Practice mindfulness.
    • The “five senses countdown” is one mindfulness technique that shifts your attention away from distressing, unhelpful thoughts to the present moment. To practice, first take a few calming deep breaths and then proceed with these five steps: 
      1. Note five things you see around you.
      2. Note four things you can touch. 
      3. Note three things you can hear.
      4. Note two things you can smell. 
      5. Note one thing you can taste.
         
  3. Reach out for support.
    •  If you continue to struggle with judgmental, critical thoughts, try reaching out for support. Another perspective might help you look at your situation differently and with more compassion.
    • After the race I texted my Dad about my disappointment. His response was something along the lines of, “stop being so hard on yourself, I can’t do 13 miles of anything.” That quickly put me in my place. I began to remind myself that finishing in and of itself was an accomplishment. 

Remember self-compassion takes time and practice. As I sit here writing this article, I still feel a tad disappointed with my results, and that's okay. Every time I practice self-compassion these thoughts and emotions continue to dissipate allowing for new thoughts. 

Salina Grilli 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.

Tips for Attaining Healthy Romantic Relationships

By Heather Matzkowitz, LMSW

I was watching a TedTalk the other day titled, ‘Skills for Healthy Romantic Relationships,’ and found it to be incredibly insightful. Many of us know what a healthy relationship looks like, but that doesn’t necessarily mean that we know how to cultivate one. Joanne Davila and her colleagues identified three skills that form the basis of romantic competence: insight, mutuality, and emotion regulation. Romantic competence is the ability to function adaptively across all aspects of the relationships process. 

The first skill, insight, is about awareness and understanding of your partner and the situation. For example, if you notice yourself saying unkind words to your partner, you might notice that something at work stressed you out and that you need to remove yourself from the situation so that you do not continue to lash out. Insight also helps you understand your partner at a deeper level so that you can be more understanding of them. With insight, you’ll be able to learn from your mistakes in ways that allow you to behave differently in the future.

The second skill, mutuality, is being able to recognize that both individuals in the relationship have needs, and that both of their needs are important. With proper implementation of mutuality, you effectively communicate your needs to your partner in a way that increases the likelihood that they will be met. For example, let's say you need to go to a really stressful family event and you would like your partner to be there with you. In order to have your needs met, you could say something like, “This is going to be stressful for me and I would really like for you to be there with me because your presence helps me to feel less anxious. Is there any way you can clear your schedule so that you can come with me?” "I" statements, eye contact, and reflecting back to your partner what you think they are saying can be helpful when trying to have a constructive conversation.

The third skill, emotion regulation, deals with regulating your feelings in response to things that happen in your relationship. By utilizing this skill you are able to keep your emotions calm while simultaneously keeping things that happen in your relationship in perspective. I urge clients to engage in positive self-talk and problem solving (as opposed to jumping straight to complaining) when issues arise. Positive self-talk with emotion regulation can look like this: “I can handle this” or “I am going to figure this out.” Tolerating uncomfortable feelings and not acting out on them impulsively is also an important part of emotion regulation. 

Davila and her colleagues conducted a study amongst young adults (ages 18-25) and found that those who were more romantically competent felt more secure in relationships. They also reported making better and more conscious decisions. Additionally, they were more satisfied in their current relationship and reported fewer depressive and anxiety symptoms. Davila believes that the ability to use the aforementioned skills on a daily basis allows people to attain and maintain healthy relationships. 

Heather Matzkowitz 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.

Therapists Make Mistakes Too

By Erica Cramer, LMSW

One of the most important parts of being a therapist is self-care. Self-care is any activity that someone does deliberately to take care of their own mental, physical, or emotional wellbeing. It can range from getting your nails done, to going to the gym, to taking a vacation. These self-care activities are particularly important to mental health professionals who spend their days caring for others. If a therapist does not take proper care of their own wellbeing, they cannot effectively help their clients. 

To manage their mental health, many therapists actually see their own therapists! (Who would have thought?). Personally, I have seen a handful of therapists throughout my life for a variety of reasons. While some experiences were extremely positive, others were not so positive (to put it nicely). Since I have sat on both sides of the room, I thought it may be helpful to discuss mistakes that I have seen other therapists make and how they can effectively be addressed by clients in sessions.

  1. Disclosing too much personal information. All personal information that a therapist discloses should be solely for the client’s benefit. When a therapist discloses personal information to a client, it can be a great tool to establish rapport, strengthen the therapeutic alliance, or validate a client’s feelings. If you feel as though your therapist is disclosing information that is not relevant to you, be honest and let them know. Each client is different and unfortunately no therapist is psychic. If you are honest, chances are you can work out your differences.
     
  2. Not admitting they made a mistake. Therapists are people too, and will inevitably make mistakes. If your therapist says something that bothers you, I recommend confronting them and seeing what they say. If you confront your therapist, they should be able to handle it in a gracious manner, and if anything, it should make the therapeutic bond even stronger. If they are not able to handle your feedback, they may be working out their own issues. In my opinion, the most important thing to consider when a therapist makes a mistake is how they handle it.
     
  3. Making you feel guilty about cancelling therapy sessions. Therapy is important but it is also important to have a life outside of therapy. If you are constantly missing therapist sessions, your therapist should not make you feel guilty. Instead, you should have an open and honest discussion about the reasons why you are unable to attend your sessions and collaboratively develop solutions to resolve the problems. 
     
  4. Being inflexible with treatment options. Therapy is a commitment; however, each client’s level of commitment varies. Whether it is for financial or logistical reasons, every client may not be able to consistently attend in-person sessions on a weekly basis. Therefore, it is important that therapists are flexible with the frequency and manner in which sessions take place. Therapists should offer biweekly and virtual sessions when it is appropriate for a client. 
     
  5. Not respecting the value of a client. In my opinion, clients are the experts of themselves and are an extremely important part of the therapeutic process. Many clients already have the answers to their problems but need therapists to help them with the process of unlocking this information. If you feel as though your therapist does not understand the value that you bring to the table, I suggest discussing it with them and seeing what they have to say. Therapy is a collaborative partnership.

Erica Cramer 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.

Getting the Most Joy Out of Our Hectic Summers

By Jessica Glynn, LMSW

Most of us New Yorkers get very excited at the thought of summer and the three months of nice weather and sunshine it brings to us. We can get so excited that we jam pack our weekends with plans. Before we know it, all of our weeks are booked through until the end of August. While it feels great at first, some of that excitement fades when we recognize that it is all easier said than done.

The desire to get the most out of summer can quickly become days of stressful travel, squeezing ourselves into small spaces in shore houses and summer getaways, or packing ourselves into crowded rooftops and outdoor spaces in the city. This leaves us with limited alone time for relaxation, rest, and reflection (which many of us need to stay present and fulfilled). Here are few things to keep in mind to stay present and satisfied at the end of each of our weekends:

Plan alone time.
Decide to make a plan in the morning, the afternoon, or evening to set aside some time for yourself. Whether this is taking a walk, run, or a coffee break in a park, it is important to have an escape for yourself to relax and just breathe. Reflect upon the parts of the weekend that have past and enjoy thinking about what you would like to do with the rest of it to feel fulfilled. Since most of our days are filled with family, friends, and even many strangers around us, this is a time to quiet the mind and spend some time getting to know what you want.

Limit alcohol consumption.
Although summer’s motto may be “Rosè All Day,” this may not be the best way to fill your day. Drinking clouds our minds and it can feel like we aren’t as present as we could be. In addition to the chemical and physical anxiety consuming too much alcohol can bring the following day, it can also leave us feeling like we lost time. We might feel like the weekend got away from us and feel down on Monday. 

Take time to be active and engage with nature.
We often connect with others on a deeper level when we are bonding through physical activities like walking, hiking, kayaking, or stand up paddle boarding. This also gives us the opportunity to take in the beauty of nature. Planning these types of activities can make us feel more accomplished and happy with our decisions.

Jessica Glynn 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.

Changing Our Perspective on Change

By Amy Brightman, LCSW

Change. Take a look at this word and tune in to your reaction. What effect does one word have on you? Many clients come to therapy in light of a recent change or an anticipated change that is generating fear and anxiety. Change can come into our lives at all different angles (at a job, in a relationship, with your environment, etc), and it can be experienced in solitude or with others. And most importantly, it is inevitable. So if it is bound to happen, why do we keep getting scared when things change?

As with most things, I always recommend to clients that we explore their thoughts. What do you associate with change? Many relate change to negative words, such as unknown, uncertainty, risk, uncontrollable, loss, stress, and difficult, which generates a negative connotation that develops into a patterned reaction over time. Yes, all of these words can relate to what change is, but if you only see change this way, think about how it impacts your emotions and actions. You are ready to fight change, to not accept it, and will feel anxious throughout this fight. It might prevent you from seeing other solutions, asking for help, or finding confidence. 

Without options, support, and self-esteem, it will be difficult to cope with change. Even if change is welcomed, it is still challenging. I tell clients that change is an inevitable challenge that can be beneficial if you modify the way you view it. A simple way to get started is to remind yourself that change is an opportunity to..

  • Learn: New experiences create new opportunities to gain knowledge, develop awareness, and practice understanding.
     
  • Grow: What doesn’t kill you makes you stronger. Being challenged in life gives you the opportunity to expand on your skills and use the ones you already have, leading to increased confidence and self-esteem.
     
  • Relate: As you experience change, you learn how to interact and work with new people you maybe never would have in the past. Through this, you develop new perspectives and expand your world.
     
  • Develop: Change helps to recognize values and priorities, learning what is really important when faced with challenges.
     
  • Tolerate: Change can be uncomfortable and can create many different emotions. It is an opportunity to learn how emotions can come and go, just like change, and things will be ok in the end. 

Change is stressful for everyone, but if you can modify your relationship with change, it will help you be stronger through the challenges of change. Recognize that you have control over seeing change as opportunity, and that you have ability to adapt and adjust. You have probably already done so in many different ways at many different times in your life. So, don’t forget, change is an opportunity and this isn’t your first time.

Amy Brightman, LCSW is a therapist at Cobb Psychotherapy. If you would like support in managing change, visit cobbpsychotherapy.com to learn more about how therapy can help.

Take a Vacation! (It's Good for Your Health)

By Heather Matzkowitz, LMSW

Many of us place a great deal of importance on our jobs. We work long hours, try to never miss a day unless we are sick, and put a lot of time and energy into our careers. This is all important, don’t get me wrong, but it's just as important to take time away from work. There are a multitude of physical and mental health benefits to gain from taking a vacation.

The average employee in the United States takes only half of their assigned vacation time. People often have the misconception that in order to be successful they need to sacrifice their happiness. However, research has shown that by taking time off from work you’re going to be more productive, have higher performance, and improve your relationships with others. Vacations help to reduce stress by distancing us from the environments and daily activities that we associate with stress and anxiety. It's important to note that taking several smaller vacations per year has been shown to be more beneficial for increasing overall wellbeing as opposed to taking one long vacation. 

So what exactly are some of the benefits of taking a vacation?

Mental Health: Vacations make us feel good and happy, especially while planning them (aka the ‘pre-vacation high'). Rumination, which is the anxiety-creating tendency that enables us to focus on things in our lives that cause us distress, has been shown to decrease during vacations and remain low several weeks after being home. Returning to work after time off helps you to feel less stressed and more focused. 

Physical Improvements: Sleep quality is improved and mood continues to remain heightened during and after returning home from a vacation. Studies have also shown that taking vacations can decrease the chances of getting heart disease.

Career: Taking a vacation reduces burnout rates, which enables you to be to be a happier and more diligent worker. Travel has also been shown to boost creative thinking, which can improve work performance. 

Relationship Improvement: A vacation can help promote emotional bonding and bring you and your partner closer together. Spending time together in a different place can help you rediscover the foundations of what made you a couple in the first place. 

Going on a vacation that is far away can be expensive, so picking a vacation that is close by home is likely to be more affordable and just as beneficial for the soul. Go away for a weekend (or week) to a small cabin in the woods, or enjoy the warm weather by relaxing on a beach. While vacationing you should try to minimize doing work related tasks (yes, this includes sending emails) and going on social media, especially if you are away with your partner. Doing this will increase partner bonding and allow you to truly immerse yourself into relaxation. So what are you waiting for? Go take some time and plan your next vacation! 

Heather Matzkowitz, LMSW 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.

Podcast Review: Hurry Slowly

By Sarah Spitz, LMSW

A friend recently recommended the podcast called Hurry Slowly, which is all about "how you can be more productive, creative, and resilient through the simple act of slowing down."  The idea of "slowing down" is scary for many New Yorkers — we live in a world in which being busy gives us social capital, and we are constantly bombarded with messages that we aren't doing enough, we aren't successful enough, we don't have enough, that we aren't enough.  And faced with this, it can seem impossible to slow down. 

But what is lost if we live our lives in this way? Unfortunately, quite a lot.  We lose out on productivity, creativity, and we sacrifice our mental health.  I appreciate this podcast because it sheds light on exactly what we're up against, and the host Jocelyn K. Glei is committed to providing knowledge, resources, and insight into how we can live and work with more meaning.  

While there are many great episodes to choose from, I wanted to briefly highlight a minisode I listened to recently called, "The Tyranny of Choice." The episode is dedicated to exploring the anxiety many of us experience related to choice, and Glei interviews Renata Salecl, author of the book The Tyranny of Choice, which is all about decision-making.

We have been conditioned to believe that there is an ideal outcome for every choice we make, and as a result we invest immense time and energy into make the "right choice." This depletes our creativity and it takes away from our happiness. Not only does that resonate with me personally, but it comes up all the time in sessions with my clients. I frequently see anxiety, frustration, and paralysis when it comes to decisions. So how do we find freedom from this?  While this short episode can't answer this fully, it does give us a place to start. We must practice making the choice to embrace a little more chance in our lives.  Who knows, you may find more space for creativity, growth, and happiness! (And stay tuned for my next blog on practices to help cultivate this freedom). 

There are already 30 episodes of Hurry Slowly available, and if the minisode I described didn't resonate with you, there may be another episode that does.  Glei interviews people from all different industries (entrepreneurs to philosophers to marathon swimmers), who provide insight and perspectives that are helpful regardless of what you do professionally.  I definitely recommend this podcast for anyone who is curious about finding a better work/life balance, or is in need of a reminder that it's okay to slow down.  

Sarah Spitz 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.

Springing Into Summer With Self-Care

By Kristen Quinones, LMSW

The transition from spring to summer brings more than just warmer temperatures. For some it means graduation, moving, starting a new job, or having more social and family commitments. Although these things can be exciting, they also are an adjustment. Transitions can be difficult and warrant more self-care. It can be helpful to plan ahead to implement a different self-care plan as summer approaches. Three things to consider are practicing self compassion, prioritizing stress management techniques and your health, and effective boundary setting and communication skills.

Self-Compassion
Sometimes we can be a little hard on ourselves during transitions. We may tell ourselves we should be able to function the same way now than we did before the change. However, change brings more stress onto our minds and bodies. If we can speak more kindly to ourselves, practice patience, and recognize that we need more self-care now to compensate for the added stress, the transition can go more smoothly.

Prioritizing Stress Management and Health
Regardless of change, taking care of your physical and mental health are important. Often during times of high stress we can put our health appointments or relaxation techniques on the back burner, feeling that we are too busy to take care of those things. However, this is the most appropriate time to put your health first. A transition is when you should definitely make that therapy appointment, meditate, or go for that half hour walk! We function at our best when we have maintained our health.

Boundary Setting and Communication
The social calendar fills up in the blink of an eye in the summer. It is okay to decline some invitations if you know you are scheduling too much of your time. Take an honest look at a typical week of what you would like your time to look like and decide how many social commitments are a good balance for you. If you know you need one day or afternoon every week for yourself to decompress, add it to your calendar and make it a priority. When boundary setting with friends, communicate your needs and that you value the relationship, and try to make time to show them you care in other ways. If boundary setting is challenging for you, consider exploring it with your therapist.

Kristen Quinones 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.

Using Pain as a Tool for Healing

By Dan Perlman, LMSW

Many clients report a nearly debilitating emotional pain from their past or current relationships, which impacts their ability to think and can paralyze their decision making.  This brought to mind something I read in Principles: Life & Work a book by hedge fund manager Ray Dalio: “When you fall and you get banged up, reflect, there's a lesson there." While this may sound more like a social scientist than a calculating billionaire financier, it’s a powerful point I find applicable in session. When clients come in feeling their path forward is blocked anxiety or depression, I try to support them in breaking them free.  We work to harness the power of their pain and use it as fuel to move them forward. Just as Dialo says, we’ve got to “reflect” upon our pain to make “progress,” and that’s literally what we do. 

Thomas Edison said he didn’t fail, he just found 10,000 ways not to make a lightbulb. The 409 cleaner under our sinks was named for the 408 failures before the cleaning solution was perfected.  Pain isn’t always a bad thing —it is a message that something is wrong and we need to acknowledge it and find another way. Many people spend lifetimes avoiding the pain or backing out of therapy once confronted with the pain. Self-reflective clients take pain and turn it on it’s head to create learning opportunities. I believe the positivity we bring clients in session provides a holding vessel for their recovery. 

Putting it into formulaic terms,  Dalio says, “Pain + reflection=progress,” and that is helpful both on the trading desk and in the therapy room. 

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.

Koru Mindfulness - Mindfulness for Millennials

By Kaylen Hagadorn, LCSW

Often when we hear or think about the common practice of mindfulness, what we're thinking about is based on the Mindfulness-Based Stress Reduction (MBSR) model created in the 1990s. Traditional mindfulness courses encourage people to meet twice a week for 8 weeks, and ask their students to practice meditation for 30 minutes twice a day. While this is an effective model, it's not feasible for many busy young people between the ages of 18-29. 

Researchers at Duke University observed how busy college students were, so they attempted to find a way to introduce mindfulness in a quicker and easier way. Koru Mindfulness evolved from this and was developed by psychiatrists Holly Rogers, MD & Margaret Maytan, MD for the college students they worked with at the university's counseling center. The program consists of one 75 minute class per week, for 4 weeks with a daily meditation commitment of 10 minutes. The program is taught in small groups and is tailored to address skepticism of mindfulness, build motivation, and includes content that is relevant to young adults. Research showed that this method produced reductions in stress and sleep problems, as well as an increase in mindfulness and self-compassion. 

The program is becoming widely taught at colleges around the country, as well as community centers, wellness centers, and yoga studios. To learn more about Koru and whether it might be beneficial to you, check out The Center for Koru Mindfulness' website at: http://korumindfulness.org.  And if you're interested in teacher certification check out their upcoming trainings: http://korumindfulness.org/teacher-certification/workshop-listings/

Sources: 

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.

Emotional Deprivation & Schema Therapy, Part II

By Rosie Barton, LMSW

In my previous blog post I wrote about the concept of emotional deprivation and schema therapy. I discussed how someone might feel lonely, disconnected, or dissatisfied, though they have a hard time identifying an underlying reason for feeling this way. In this post, I’m going to be writing more about the three different types of emotional deprivation and how you can begin to shift this schema and engage in healthier coping mechanisms. You can read my previous blog post here to see if schema therapy and emotional deprivation might be something that resonates with you.

Emotional Deprivation is often so hard to detect because you might not even know that you were deprived! There are three different realms in which you might not have had your needs met in an adequate way during childhood, which could contribute to these feelings of emptiness. You could have been deprived of nurturance, empathy, protection, or maybe a combination of all three. 

  1. How much warmth and physical affection did you receive when you were growing up? How were you comforted or soothed when you were upset? If you can’t recall frequent physical connection with your caregivers, you might have experienced a deprivation of nurturance.
     
  2. Empathy on the other hand, is related to whether or not you felt understood by your caregivers. Did you feel that you could trust them with your feelings? Were you validated when you were upset? 
     
  3. And finally, a deprivation of protection occurs if you didn’t feel safe as a child. Did you have someone you could go to when you needed support? Did you have the sense that someone was looking out for you and that you could rely on them to be there consistently? 

A deficiency in any one of these three areas as a child can lead to the feeling that something is missing from your adult relationships. It takes consistent effort, but it is possible to overcome emotional deprivation. I will outline three steps that can help you to change this schema, though I recommend seeking the support of a therapist to process these memories and emotions. You don’t have to do this work alone.

The first step is to begin to understand your childhood deprivation and to access your emotions about what you experienced. You might realize that you feel angry or sad, and it’s important to feel the full breadth of your pain in order to begin healing. It can be helpful to use imagery during this stage. You can create images in your mind from specific memories in which your needs for connection weren’t met. During the imagery exercise, aim to fully experience the emotions that come up for you. Try to connect to that young place within you and to feel compassion for the child who needed something that he or she didn’t receive. 

The second step is related to the present and your adult self. It’s crucial to monitor your current feelings of deprivation within your relationships. Can you get in touch with your needs for nurturance, empathy, and guidance? Are you able to identify when you feel more connected to those things and when your feelings of emptiness are activated? Perhaps when your partner or friend is unavailable, you notice that you begin to feel empty or rejected. Again, it’s important not to block out any of the emotions that might arise. 

By becoming aware of the origins and the present nature of your emotional deprivation, you can start to clarify the patterns that you get stuck in repeatedly. It’s helpful to look into your past relationships during this stage. Are you constantly finding yourself in relationships where you partner is unable to meet your needs? Are you driving away those closest to you with constant demands? Or are you bored with people who treat you well? Emotional Deprivation can manifest itself in many ways, which is why it’s so useful to work with a therapist who can provide insight and perspective. Through your work together, you can identify what the unifying feature of your pattern is so that you can create a list of the pitfalls to avoid in future relationships. 

Emotional deprivation will not dissipate immediately, but through this process, you can slowly chip away at it. Each time it gets activated, you can counter it with your thoughts, feelings, and behavior. This will mean entering into some unfamiliar (and often times scary or uncomfortable) territory, but ultimately this work can help you experience your life as much richer, rewarding, and more fulfilling. 

Rosie Barton 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.