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.

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.

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.

Eating Right for Mental Health 

By Heather Matzkowitz, LMSW

I was listening to a podcast the other day titled 'Eating Right to Feel Good,’ which I found to be very insightful. A growing body of evidence suggests that people who suffer from depression may benefit from changes in their diet. If your body lacks essential nutrients, then it may not have what it needs to produce important brain chemicals (i.e. neurotransmitters). Serotonin is a well known neurotransmitter that regulates happiness, anxiety, and overall mood. Neurotransmitters are nourished from the nutrients that we consume. 

Research has shown that the modern western diet, which is high in saturated fats and refined processed foods, can increase depression likelihood by 50 percent. Alcohol, which is a depressant, should be consumed in smaller quantities as it can also contribute to depression. In the podcast, Dr. Leslie Korn talks about the importance of interpreting the messages we get from our cravings and then substituting healthier options. For instance, if you are experiencing a craving for chocolate, your body might be needing the mineral magnesium. Chocolate is rich in magnesium, which has a relaxing effect on our mood. We may crave chocolate without knowing that part of our body wisdom is saying, ‘give me more magnesium.’ The issue is that most chocolate is high in sugar, a pro-inflammatory food. Dr. Korn discusses how we now understand depression as an inflammatory disease, not a lack of serotonin. When reaching for chocolate try to go for some dark chocolate instead. 

To boost your mood, try adding more of these foods: 

  • Low-Glycemic foods (i.e. most fruits and vegetables, beans, minimally processed grains, low-fat dairy foods, lentils, nuts)
  • Magnesium (found in dark chocolate, avocados, bananas, nuts, legumes, tofu, seeds, whole grains, leafy greens, fish)
  • Omega-3 Fatty acids (walnuts, flaxseeds, chia seeds, sardines, salmon, mackerel)
  • Tryptophan (oats, chocolate, milk, yogurt, red meats, cottage cheese, fish, poultry, chickpeas, almonds, pumpkin seeds, spirulina, peanuts)

If you want to make changes in what you eat, try starting with small changes. For example, if you’re eating roasted peanuts, try switching to raw peanuts. If you’re eating milk chocolate, try to switch to dark chocolate. It’s important to check in with yourself and ask, “What foods make me feel good?” And “What foods sap my energy and make me feel depressed?” Make it a practice to be mindful of these answers when making food choices throughout the day. 

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.

Understanding Attachment Styles

By Dorette Greene, LMSW

In a previous post where I discussed Emotionally Focused Therapy, I indicated that I would later discuss attachment theory and attachment styles. My goal is to provide some information to help you understand attachment and how it affects your relationships with others, particularly romantic relationships.

Attachment theory was first conceptualized by psychologist, psychiatrist, and psychoanalyst John Bowlby to explain parent–infant relationships and connection.  However, in recent years, attachment theory has been applied to adult romantic relationships as well, serving to provide context to how these relationships develop and function.

The parent-infant relationship can be viewed as the earliest and likely most important intimate relationship. It is this initial connection that gives rise to either attachment security or insecurity (more on this later). It is within these particular interactions that individuals begin to form their most general ideas not only about those around them, but about who they are in this world. While the purpose of attachment is to form attachment bonds that help maintain closeness and proximity to loved ones, the most salient goal is the reduction of negative feelings and emotions as it relates to feeling connected to loved ones.

Although attachment bonds originate in infancy, they continue throughout the lifespan often influencing and changing an individual’s internal working model of “the self,” which is a person’s view of him or herself and others. An individual having a positive working model of the self is often associated with beliefs that they are worthy of love and belonging, and it also serves to reinforce the idea that others are reliable and responsive to their needs.

Attachment type relates to these beliefs and are usually contextualized into two dimensions— secure and insecure attachment. This can be broken down further into three distinct attachment styles which include secure, anxious and avoidant attachment.  Correlations can be made between an individual’s attachment style and their functioning and behavior in romantic relationships. For instance, insecure attachment such as anxiety and avoidance are correlated with maladaptive and unproductive relational behaviors (cheating, risky sexual behaviors, relational violence, etc.).

Secure attachment is born out of the general belief that those with secure attachment styles usually have a positive overall view of themselves and others. This allows them to maintain a positive view of themselves that isn’t hindered by negative interactions with others or negative patterns of interactions in their relationships. Secure attachment is often learned through the caretaker-child relationship and continues into peer/friend group interactions and then into adulthood and romantic relationships.

Insecure attachment on the other hand can present as anxious as well as avoidant attachment. Anxious attachment generally resembles worry, fears, and doubts regarding relationship security. Examples may be negative, and at times even irrational, thoughts regarding being rejected and abandoned, and even uncertainty regarding self-worth and worthiness of love and belonging. 

Avoidant attachment is characterized by the extent to which an individual recoils from closeness and intimate connection, dislikes depending on others, and downplays the importance of relationships altogether.  Avoidantly attached individuals often are unable to get their emotional needs met as they often minimize their need for emotional relatedness.

Attachment styles and the way they manifest in our behaviors and thoughts, particularly as it relates to relationships, can be as pervasive as the way core beliefs manifest in how we interact with the world. Even though we first learn our attachment style very early in life, attachment styles are not fixed, and as such, an individual’s attachment style is capable of change over time.

References:
Hepper, E. G., & Carnelley, K. B. (2012). Attachment and romantic relationships: The role of models of self and other. In M. Paludi (Ed.),The psychology of love (Vol. 1, pp. 133 154).Santa Barbara, CA: Praeger

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.

Challenging Our Distorted Thinking Patterns

As humans, it is common for us to develop certain thinking patterns. Many of these patterns reflect self-doubt, defeat, uncertainty, and negative self-perceptions. There are a number of questions we can practice asking ourselves in order to challenge our deeply rooted and distorted thinking patterns. Northern Ohio University Colleges of Medicine and Pharmacy present a helpful resource, based on Aaron Beck’s Cognitive Behavioral Therapy. Here are a few questions from their resource you can practice on a daily basis to expand your thinking, build perspective, and challenge your thoughts:

  1. Am I confusing a thought with a fact? 
  2. Would my thought stand up in court, or be dismissed as circumstantial? 
  3. What objective evidence do I have to back it up and to contradict it? 
  4. Am I jumping to conclusions? 
  5. How do I know what someone else is thinking? 
  6. Am I assuming my view of things is the only one possible? 
  7. Is the way I am thinking now, helping me achieve my goal? 
  8. Or is it standing in the way of what I want? 
  9. What are the advantages and disadvantages of thinking this way? 
  10. Am I asking questions that have no answers? 
    • How can I undo the past? 
    • Why aren’t I different?
    • What is the meaning of life? 
    • Why does this always happen to me? 
    • Why is life so unfair?
  11. Am I using ultimatum words in my thinking? 
    • Such as always/never
    • Everyone/none
    • Everything/nothing
  12. Am I concentrating on my weakness and forgetting my strengths? 
  13. How have I coped with similar difficulties in the past? 
  14. Am I blaming myself for something which is not really my fault? 
  15. Am I taking something personally which has little or nothing to do with me? 
  16. Am I expecting myself to be perfect? 
  17. Am I using a double standard? 
  18. How would I react to someone else in my situation? 
  19. Am I assuming I can do nothing to change my situation? 
  20. Am I predicting the future instead of experimenting with it? 

References: https://www.mcgill.ca/counselling/files/counselling/20_questions_to_challenge_negative_thoughts_0.pda

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.

A Podcast Review: “Where Should We Begin?”

By Alisha Bennett, LMSW

A client of mine recently reminded me of the name Esther Perel — a name that I started hearing last year and continue to hear among friends of mine, client’s, and colleagues. If you are in a relationship, regardless of whether it is extremely healthy, or has it’s many challenges, I highly recommend her podcast, "Where Should We Begin?"

To give a brief summary, Esther Perel has been a couple’s therapist for over 30 years, and is also an author and now podcast extraordinaire living in New York City. Her podcast has now completed two seasons and she is currently working on her third. Esther’s podcast consists of approximately 40-45 minutes of her work with real client's that is part recording of sessions and part her providing explanations about the couple or reason for a treatment decision. 

Here are some insights from her podcast to consider if you are looking for some new perspective in your own relationship: 

  • No matter how different the couple on each episode is from you and your partner/significant other, you can always learn something about how to better your relationship. 
  • We often see perfect relationships portrayed in movies, on television, and on social media. Listening to this podcast shows you that all couples are flawed and have to work on bettering their relationships and bettering themselves. 
  • Initially, I thought that it would feel intrusive and odd to start to listen to real couples in their counseling sessions. I thought, "this is going to be so far from real-life, in the same way that the Real Housewives is." However, “Where Should We Begin?” is the exact opposite. Although many of the couples' issues were far from my real life, I could relate to every couple in some way. 
  • Even when the couple appears to be very dissimilar to you and your spouse, the principles and advice Esther gives may resonate with you and there are likely many parallels that can be drawn to your own relationship. 
  • This podcast reminds me that we all have backgrounds that have led us to where we are now and who we are in our current lives. Every relationship faces problems and conflicts and always will. To be in a relationship with no conflict or issues is not reality. “Where Should We Begin?” normalizes this and helps you to better understand ways to deal with these issues together as a couple. 

If podcasts are part of your commute or daily routine, or if you’ve been thinking about starting to integrate them into your life, Esther Perel’s is highly recommended by many (Particularly if you are in a relationship or are seeking to make improvements in future relationships). 

If you are interested in learning more about Esther Perel or her podcast, visit: https://www.estherperel.com/podcast

Alisha Bennett 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 Does Self-Care Look Like For You?

By Salina Grilli, LMSW

Self-care has taken off in the wellness community with articles, bloggers, and even influencers asserting the myriad of benefits that come from simply slowing down and taking time to connect with oneself. 

But what does self-care actually mean? When I talk about the importance of self-care with my clients, I often find it difficult to describe what exactly self-care means. Isn’t it self-explanatory? If you were to look at the definition of self-care, it essentially boils down to making a conscious effort to take care of your basic needs. 

What I have found, however, is that self-care means something different for every person. For example, think about a Mom with three young children. Self-care for her might simply mean taking a shower every night and fueling her body with nutritious foods that give her energy.  For a 20-something work-a-holic, self-care might mean taking a quick 10-minute break during the day to de-stress.

Point being, what your bestie swears cured her anxiety, might not be helpful for you. Establishing a self-care routine and finding what works for you will take time and practice. Here are some ideas to begin integrating self-care into your life:

  • Take a long, warm shower before bed.
    • If you are feeling adventurous, try incorporating essential oil or a scented body-wash into your routine.  Focus on finding a scent that you find soothing and relaxing. Lavender, rose, jasmine, and chamomile can be especially calming.   
  • Light a candle when you get home from work.
  • Mindfully take a few minutes to take some deep breaths (Check out our therapist Amy Brightman's blog post on how deep, calming breaths can be used to reduce stress and anxiety).
  • Sneak out on your lunch break and go for a short (or even long) walk. 
    • Maybe venture down a new block and see if you can notice something you’ve never seen. The city is full of wonderful surprises. 
  • Get a monthly (or even weekly) massage.
  • Keep a gratitude journal
    • Write down three things that you are grateful for every night before going to bed. This can range from your parents being in good health or being thankful for your favorite barista.
 (Photo taken from  Chelsea   Baker ) 

(Photo taken from Chelsea Baker

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.

Let’s Get Back to Basics with Sleep

By Shaudi Adel, LMSW

Over the past few weeks I've noticed that the topic of sleep has come up in sessions pretty frequently. Usually, it’s brought up in regards to sleep quantity and quality problems. This makes sense, given that we are in the long stretch of time between President’s Day and Memorial Day when work doesn’t throw us an observed holiday, and when midterms strike for students and all-nighters seem like the only viable option to stay afloat.

Repeated sleepless nights have an impact on emotions, negative thought patterns, impulsive behaviors, and physical health and well-being. Sometimes, I think we overlook the significance of adequate and restful sleep because of how simplistic it may seem – in fact, when I do a brief assessment on sleep, many people say that they’ve completely forgotten how sleep deprivation can affect them physically and mentally! Let’s get back to basics and answer some questions to determine if we can make some changes to move sleep up on our priority list:

  1. How many hours of sleep on average do I need to feel rested or wake up feeling energized? Over the past week, how many nights did I meet this target?
     
  2.  Am I getting to bed around the same time every night, including on weekends? If not, how can I make changes to get to bed at a relatively regular time? Similarly, am I getting out of bed around the same time every morning, including on weekends? If not, how can I make some changes to ensure I am staying as consistent as possible?
     
  3. What is my nightly routine in preparation for sleep? Can it be enhanced with anything, such as a guided meditation, to relax the mind and body before bedtime?
     
  4. What is my screen time on my phone, laptop, and/or TV like before bed? Am I ending my screen time at least 30 minutes before bed?
     
  5.  Am I drinking caffeinated beverages (coffee, black tea, soda) after 5pm?
     
  6.  When I can’t fall asleep, what do I do? What are my thoughts like? Can I get up and engage in an activity, like read a book or write my to-do list for tomorrow?

If sleep has been on the back burner, hopefully these questions can help guide you to make some improvements to your routine around sleep. As Marsha Linehan describes it, “when it comes to sleep, ritual is everything.”  Today, find a way to honor your mind and body and engage in some serious self-care with sleep.

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.